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De la Torre EP, Serrano J, Martínez-Cuadrón D, Torres L, Sargas C, Ayala R, Bilbao-Sieyro C, Chillón MC, Larráyoz MJ, Soria E, Aparicio-Pérez C, Bergua JM, Bernal T, Gil C, Tormo M, Algarra L, Alonso-Domínguez JM, Rodriguez-Arbolí E, Martínez-Sanchez P, Oliva A, Colorado-Araujo AM, Rodríguez-Medina C, Vives S, Hermosín L, Martínez-López J, García-Sanz R, Pérez-Simón JA, Calasanz MJ, Gómez-Casares MT, Barragán E, Sánchez-García J J, Montesinos P. Validation of mutated CEBPA bZIP as a distinct prognosis entity in acute myeloid leukemia: a study by the Spanish PETHEMA registry. Haematologica 2024. [PMID: 38634126 DOI: 10.3324/haematol.2023.284601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Indexed: 04/19/2024] Open
Abstract
Not available.
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Affiliation(s)
- Esther Prados De la Torre
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), UGC Hematología Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), 14004 Córdoba
| | - Josefina Serrano
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), UGC Hematología Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), 14004 Córdoba
| | - David Martínez-Cuadrón
- Servicio de Hematología, Grupo Acreditado de Investigación en Hematología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia
| | - Laura Torres
- Servicio de Hematología, Grupo Acreditado de Investigación en Hematología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia
| | - Claudia Sargas
- Grupo Acreditado de Investigación en Hematología, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia
| | - Rosa Ayala
- Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center (CNIO), Department of Medicine, Complutense University, 28041 Madrid
| | - Cristina Bilbao-Sieyro
- Hospital Universitario de Gran Canaria Dr. Negrín, 35010, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria
| | - María Carmen Chillón
- Servicio de Hematología, Hospital Universitario de Salamanca (HUS/IBSAL), CIBERONC, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), 37007 Salamanca
| | - María José Larráyoz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, IdiSNA (Navarra Institute for Health Research), 31008 Pamplona
| | - Elena Soria
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS/CSIC), Universidad de Sevilla, 41013 Sevilla
| | - Clara Aparicio-Pérez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), UGC Hematología Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), 14004 Córdoba
| | - Juan M Bergua
- Hospital Universitario San Pedro de Alcántara, 10003 Cáceres
| | - Teresa Bernal
- Hospital Universitario Central de Asturias, Instituto Universitario (IUOPA), Instituto de Investigación del Principado de Asturias (ISPA), 33011 Oviedo
| | - Cristina Gil
- Hospital General Universitario de Alicante, 03010 Alicante
| | - Mar Tormo
- Hospital Clínico Universitario. Universidad de Valencia. Instituto de investigación INCLIVA, 46010 Valencia
| | | | | | - Eduardo Rodriguez-Arbolí
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS/CSIC), Universidad de Sevilla, 41013 Sevilla
| | - Pilar Martínez-Sanchez
- Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center (CNIO), Department of Medicine, Complutense University, 28041 Madrid
| | - Ana Oliva
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife
| | | | - Carlos Rodríguez-Medina
- Hospital Universitario de Gran Canaria Dr. Negrín, 35010, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria
| | - Susana Vives
- Hospital Universitario Germans Trias i Pujol - ICO Badalona
| | | | - Joaquín Martínez-López
- Hospital Universitario 12 de Octubre, Spanish National Cancer Research Center (CNIO), Department of Medicine, Complutense University, 28041 Madrid
| | - Ramón García-Sanz
- Servicio de Hematología, Hospital Universitario de Salamanca (HUS/IBSAL), CIBERONC, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), 37007 Salamanca
| | - José A Pérez-Simón
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina (IBIS/CSIC), Universidad de Sevilla, 41013 Sevilla
| | - María José Calasanz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, IdiSNA (Navarra Institute for Health Research), 31008 Pamplona
| | - María Teresa Gómez-Casares
- Hospital Universitario de Gran Canaria Dr. Negrín, 35010, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria
| | - Eva Barragán
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Servicio Análisis Clínicos, Grupo Acreditado de Investigación en Hematología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia
| | - Joaquín Sánchez-García J
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), UGC Hematología Hospital Universitario Reina Sofía, Universidad de Córdoba (UCO), 14004 Córdoba
| | - Pau Montesinos
- Servicio de Hematología, Grupo Acreditado de Investigación en Hematología, Hospital Universitario y Politécnico La Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia
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2
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Sobas M, Knopinska-Posluszny W, Piątkowska-Jakubas B, García-Álvarez F, Díez MEA, Caballero M, Martínez-Cuadrón D, Aguiar E, González-Campos J, Garrido A, Algarra L, Salamero O, de la Serna J, Sayas MJ, Perez-Encinas MM, Vives S, Vidriales B, Labrador J, Prado AI, Celebrin L, Mayer J, Brioso J, de Laiglesia A, Bergua JM, Amigo ML, Rodriguez-Medina C, Polo M, Pluta A, Cichocka E, Skarupski M, Sanz MA, Wierzbowska A, Montesinos P. Incidence, risk factors, and outcomes of second neoplasms in patients with acute promyelocytic leukemia: the PETHEMA-PALG experience. Ann Hematol 2024; 103:451-461. [PMID: 38110588 PMCID: PMC10799093 DOI: 10.1007/s00277-023-05582-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
The most important challenges in acute promyelocytic leukemia (APL) is preventing early death and reducing long-term events, such as second neoplasms (s-NPLs). We performed a retrospective analysis of 2670 unselected APL patients, treated with PETHEMA "chemotherapy based" and "chemotherapy free" protocols. Only de novo APL patients who achieved complete remission (CR) and completed the three consolidation cycles were enrolled into the analysis. Out of 2670 APL patients, there were 118 (4.4%) who developed s-NPLs with the median latency period (between first CR and diagnosis of s-NPL) of 48.0 months (range 2.8-231.1): 43.3 (range: 2.8-113.9) for s-MDS/AML and 61.7 (range: 7.1-231.1) for solid tumour. The 5-year CI of all s-NPLs was of 4.43% and 10 years of 7.92%. Among s-NPLs, there were 58 cases of s-MDS/AML, 3 cases of other hematological neoplasms, 57 solid tumours and 1 non-identified neoplasm. The most frequent solid tumour was colorectal, lung and breast cancer. Overall, the 2-year OS from diagnosis of s-NPLs was 40.6%, with a median OS of 11.1 months. Multivariate analysis identified age of 35 years (hazard ratio = 0.2584; p < 0.0001) as an independent prognostic factor for s-NPLs. There were no significant differences in CI of s-NPLs at 5 years between chemotherapy-based vs chemotherapy-free regimens (hazard ratio = 1.09; p = 0.932). Larger series with longer follow-up are required to confirm the potential impact of ATO+ATRA regimens to reduce the incidence of s-NPLs after front-line therapy for APL.
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Affiliation(s)
- Marta Sobas
- Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
| | | | | | | | | | - Mar Caballero
- Hospital Insular de Las Palmas, Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | | | | | | | | - Susana Vives
- Hospital U. Germans Trias i Pujol ICO, Badalona, Spain
| | - Belén Vidriales
- University Hospital of Salamanca (CAUSA/IBSAL) and Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | | | | | - Jiri Mayer
- University Hospital Brno, Masaryk University, Brno, Czechia
| | | | | | | | | | | | - Marta Polo
- Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Marek Skarupski
- Faculty of Pure and Applied Mathematics, Wrocław University of Science and Technology, Wroclaw, Poland
- Department of Mathematics and Computer Science, Eindhoven University of Technology, 5612, AZ, Eindhoven, The Netherlands
| | - Miguel A Sanz
- Hospital Universitario i Politècnico la Fe, Valencia, Spain
| | | | - Pau Montesinos
- Hospital Universitario i Politècnico la Fe, Valencia, Spain
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3
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Velasco‐Hernandez T, Trincado JL, Vinyoles M, Closa A, Martínez‐Moreno A, Gutiérrez‐Agüera F, Molina O, Rodríguez‐Cortez VC, Ximeno‐Parpal P, Fernández‐Fuentes N, Petazzi P, Beneyto‐Calabuig S, Velten L, Romecin P, Casquero R, Abollo‐Jiménez F, de la Guardia RD, Lorden P, Bataller A, Lapillonne H, Stam RW, Vives S, Torrebadell M, Fuster JL, Bueno C, Sarry J, Eyras E, Heyn H, Menéndez P. Integrative single-cell expression and functional studies unravels a sensitization to cytarabine-based chemotherapy through HIF pathway inhibition in AML leukemia stem cells. Hemasphere 2024; 8:e45. [PMID: 38435427 PMCID: PMC10895904 DOI: 10.1002/hem3.45] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/11/2023] [Accepted: 01/13/2024] [Indexed: 03/05/2024] Open
Abstract
Relapse remains a major challenge in the clinical management of acute myeloid leukemia (AML) and is driven by rare therapy-resistant leukemia stem cells (LSCs) that reside in specific bone marrow niches. Hypoxia signaling maintains cells in a quiescent and metabolically relaxed state, desensitizing them to chemotherapy. This suggests the hypothesis that hypoxia contributes to the chemoresistance of AML-LSCs and may represent a therapeutic target to sensitize AML-LSCs to chemotherapy. Here, we identify HIFhigh and HIFlow specific AML subgroups (inv(16)/t(8;21) and MLLr, respectively) and provide a comprehensive single-cell expression atlas of 119,000 AML cells and AML-LSCs in paired diagnostic-relapse samples from these molecular subgroups. The HIF/hypoxia pathway signature is attenuated in AML-LSCs compared with more differentiated AML cells but is more expressed than in healthy hematopoietic cells. Importantly, chemical inhibition of HIF cooperates with standard-of-care chemotherapy to impair AML growth and to substantially eliminate AML-LSCs in vitro and in vivo. These findings support the HIF pathway in the stem cell-driven drug resistance of AML and unravel avenues for combinatorial targeted and chemotherapy-based approaches to specifically eliminate AML-LSCs.
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Affiliation(s)
- Talia Velasco‐Hernandez
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | - Juan L. Trincado
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | - Meritxell Vinyoles
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | - Adria Closa
- The John Curtin School of Medical ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
- EMBL Australia Partner Laboratory Network at the Australian National UniversityCanberraAustralian Capital TerritoryAustralia
| | | | | | - Oscar Molina
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | - Virginia C. Rodríguez‐Cortez
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | | | | | - Paolo Petazzi
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | - Sergi Beneyto‐Calabuig
- Centre for Genomic Regulation (CRG)The Barcelona Institute of Science and TechnologyBarcelonaSpain
- Universitat Pompeu Fabra (UPF)BarcelonaSpain
| | - Lars Velten
- Centre for Genomic Regulation (CRG)The Barcelona Institute of Science and TechnologyBarcelonaSpain
- Universitat Pompeu Fabra (UPF)BarcelonaSpain
| | - Paola Romecin
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
| | | | | | - Rafael D. de la Guardia
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- GENYO, Center for Genomics and Oncological ResearchPfizer/Universidad de Granada/Junta de AndalucíaGranadaSpain
| | - Patricia Lorden
- CNAG‐CRG, Centre for Genomic Regulation (CRG)Barcelona Institute of Science and Technology (BIST)BarcelonaSpain
| | - Alex Bataller
- Department of HematologyHospital Clínic de BarcelonaBarcelonaSpain
| | - Hélène Lapillonne
- Centre de Recherce Saint‐AntoineArmand‐Trousseau Childrens HospitalParisFrance
| | - Ronald W. Stam
- Princess Maxima Center for Pediatric OncologyUtrechtThe Netherlands
| | - Susana Vives
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Hematology DepartmentICO‐Hospital Germans Trias i PujolBarcelonaSpain
| | - Montserrat Torrebadell
- Hematology LaboratoryHospital Sant Joan de DéuBarcelonaSpain
- Leukemia and Other Pediatric Hemopathies. Developmental Tumors Biology Group. Institut de Recerca Hospital Sant Joan de DéuBarcelonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) ISCIIIMadridSpain
| | - Jose L. Fuster
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
- Sección de Oncohematología PediátricaHospital Clínico Universitario Virgen de la Arrixaca and Instituto Murciano de Investigación Biosanitaria (IMIB)MurciaSpain
| | - Clara Bueno
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
- CIBER‐ONCBarcelonaSpain
| | - Jean‐Emmanuel Sarry
- Centre de Recherches en Cancérologie de ToulouseUniversité de ToulouseInserm U1037, CNRS U5077ToulouseFrance
- LabEx ToucanToulouseFrance
- Équipe Labellisée Ligue Nationale Contre le CancerToulouseFrance
| | - Eduardo Eyras
- The John Curtin School of Medical ResearchThe Australian National UniversityCanberraAustralian Capital TerritoryAustralia
- EMBL Australia Partner Laboratory Network at the Australian National UniversityCanberraAustralian Capital TerritoryAustralia
- Hospital del Mar Medical Research Institute (IMIM)BarcelonaSpain
- Institució Catalana de Recerca i Estudis Avançats (ICREA)BarcelonaSpain
| | - Holger Heyn
- CNAG‐CRG, Centre for Genomic Regulation (CRG)Barcelona Institute of Science and Technology (BIST)BarcelonaSpain
| | - Pablo Menéndez
- Josep Carreras Leukemia Research InstituteBarcelonaSpain
- Red Española de Terapias Avanzadas (TERAV)‐Instituto de Salud Carlos III (ISCIII) (RICORS, RD21/0017/0029)MadridSpain
- CIBER‐ONCBarcelonaSpain
- Institució Catalana de Recerca i Estudis Avançats (ICREA)BarcelonaSpain
- Department of Biomedicine, School of MedicineUniversity of BarcelonaBarcelonaSpain
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Oñate G, Pratcorona M, Garrido A, Artigas-Baleri A, Bataller A, Tormo M, Arnan M, Vives S, Coll R, Salamero O, Vall-Llovera F, Sampol A, Garcia A, Cervera M, Avila SG, Bargay J, Ortín X, Nomdedéu JF, Esteve J, Sierra J. Survival improvement of patients with FLT3 mutated acute myeloid leukemia: results from a prospective 9 years cohort. Blood Cancer J 2023; 13:69. [PMID: 37147301 PMCID: PMC10162955 DOI: 10.1038/s41408-023-00839-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 04/05/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023] Open
Abstract
Midostaurin added to intensive chemotherapy is the standard of care for acute myeloid leukemia (AML) with FLT3 mutations (FLT3mut). We analyzed the impact of midostaurin in 227 FLT3mut-AML patients included in the AML-12 prospective trial for fit patients ≤70 years (#NCT04687098). Patients were divided into an early (2012-2015) and late (2016-2020) cohorts. They were uniformly treated except for the addition of midostaurin in 71% of late group patients. No differences were observed in response rates or the number of allotransplants between groups. Outcome was improved in the late period: 2-year relapse incidence decreased from 42% vs 29% in early vs late group (p = 0.024) and 2-year overall survival (OS) improved from 47% vs 61% (p = 0.042), respectively. The effect of midostaurin was evident in NPM1mut patients (n = 151), with 2-yr OS of 72% (exposed) vs 50% (naive) patients (p = 0.011) and mitigated FLT3-ITD allelic ratio prognostic value: 2-yr OS with midostaurin was 85% and 58% in low and high ratio patients (p = 0.049) vs 67% and 39% in naive patients (p = 0.005). In the wild-type NPM1 subset (n = 75), we did not observe significant differences between both study periods. In conclusion, this study highlights the improved outcome of FLT3mut AML fit patients with the incorporation of midostaurin.
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Affiliation(s)
- Guadalupe Oñate
- Hospital de la Santa Creu i Sant Pau. Institut d'investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Marta Pratcorona
- Hospital de la Santa Creu i Sant Pau. Institut d'investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Ana Garrido
- Hospital de la Santa Creu i Sant Pau. Institut d'investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Alicia Artigas-Baleri
- Hospital de la Santa Creu i Sant Pau. Institut d'investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Alex Bataller
- Hospital Clinic. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Mar Tormo
- Hospital Clinico Universitario, Biomedical Research Institute INCLIVA, Valencia, Spain
| | - Montserrat Arnan
- Institut Catala d'Oncologia, Hospital Duran i Reynals, Institut d'Investigacio Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, University of Barcelona, Barcelona, Spain
| | - Susana Vives
- Institut Catala d'Oncologia, Hospital Germans Trias i Pujol. Josep Carreras Leukemia Research Institute, Badalona, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Rosa Coll
- Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | - Olga Salamero
- Hospital Universitari Vall d'Hebron and Institute of Oncology (VHIO), Universitat Autonoma of Barcelona, Barcelona, Spain
| | | | - Antònia Sampol
- Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | | | - Marta Cervera
- Institut Catala d'Oncologia, Hospital Joan XXIII, Tarragona, Spain
| | | | - Joan Bargay
- Hospital Son Llatzer, Palma de Mallorca, Spain
| | | | - Josep F Nomdedéu
- Hospital de la Santa Creu i Sant Pau. Institut d'investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Jordi Esteve
- Hospital Clinic. August Pi i Sunyer Biomedical Research Institute (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Jorge Sierra
- Hospital de la Santa Creu i Sant Pau. Institut d'investigació Biomèdica Sant Pau (IIB SANT PAU) Department of Medicine, Universitat Autonoma of Barcelona, Barcelona, Spain.
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5
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Simoes C, Villar S, Ariceta B, Garcés JJ, Burgos L, Alignani D, Sarvide S, Martínez-Cuadrón D, Bergua JM, Vives S, Algarra L, Tormo M, Martinez P, Serrano J, Herrera P, Ramos F, Salamero O, Lavilla E, Gil C, Lopez-Lorenzo JL, Vidriales MB, Chillon C, Labrador J, Falantes JF, Sayas MJ, Ayala R, Martinez-Lopez J, Pierola AA, Calasanz MJ, Prosper F, San-Miguel JF, Sanz MÁ, Paiva B, Montesinos P. Transcriptional and genomic characterization of measurable residual disease in acute myeloid leukaemia. Br J Haematol 2023. [PMID: 37057357 DOI: 10.1111/bjh.18815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Affiliation(s)
- Catia Simoes
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Sara Villar
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Beñat Ariceta
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan-José Garcés
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Leire Burgos
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Diego Alignani
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Sarai Sarvide
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - David Martínez-Cuadrón
- CIBER-ONC number CB16/12/00284, Hospital Universitario y Politécnico La Fe, Valencia, Valencia, Spain
| | | | | | | | - Mar Tormo
- Hospital Clínico Universitario de Valencia, Valencia
| | - Pilar Martinez
- Hospital Universitario 12 de Octubre, I+12, CNIO, Complutense University, CIBERONC, Madrid, Spain
| | | | | | | | - Olga Salamero
- Hospital Universitario Vall d'Hebrón, Barcelona, Spain
| | | | - Cristina Gil
- Hospital General Universitario de Alicante, Alicante, Spain
| | | | - Maria-Belen Vidriales
- Hospital Universitario de Salamanca, IBSAL, CIBER-ONC number CB16/12/00233 y Centro de Investigación, Salamanca, Spain
| | - Carmen Chillon
- Hospital Universitario de Salamanca, IBSAL, CIBER-ONC number CB16/12/00233 y Centro de Investigación, Salamanca, Spain
| | - Jorge Labrador
- Hospital Universitario de Burgos, Universidad Isabel I, Burgos, Spain
| | | | | | - Rosa Ayala
- Hospital Universitario 12 de Octubre, I+12, CNIO, Complutense University, CIBERONC, Madrid, Spain
| | - Joaquin Martinez-Lopez
- Hospital Universitario 12 de Octubre, I+12, CNIO, Complutense University, CIBERONC, Madrid, Spain
| | - Ana Alfonso Pierola
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Maria-Jose Calasanz
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
- CIMA LAB Diagnostics, Universidad de Navarra, Pamplona, Spain
| | - Felipe Prosper
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Jesús F San-Miguel
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Miguel Á Sanz
- CIBER-ONC number CB16/12/00284, Hospital Universitario y Politécnico La Fe, Valencia, Valencia, Spain
| | - Bruno Paiva
- Centro de Investigación Médica Aplicada (CIMA), CCUN, IDISNA, CIBER-ONC number CB16/12/00369 and CB16/12/00489, Clínica Universidad de Navarra, Pamplona, Spain
| | - Pau Montesinos
- CIBER-ONC number CB16/12/00284, Hospital Universitario y Politécnico La Fe, Valencia, Valencia, Spain
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6
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Villar S, Ariceta B, Agirre X, Urribarri AD, Ayala R, Martínez-Cuadrón D, Bergua JM, Vives S, Algarra L, Tormo M, Martínez P, Serrano J, Simoes C, Herrera P, Calasanz MJ, Alfonso-Piérola A, Paiva B, Martínez-López J, San Miguel JF, Prósper F, Montesinos P. The transcriptomic landscape of elderly acute myeloid leukemia identifies B7H3 and BANP as a favorable signature in high-risk patients. Front Oncol 2022; 12:1054458. [PMID: 36505804 PMCID: PMC9729799 DOI: 10.3389/fonc.2022.1054458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 11/02/2022] [Indexed: 11/25/2022] Open
Abstract
Acute myeloid leukemia (AML) in the elderly remains a clinical challenge, with a five-year overall survival rate below 10%. The current ELN 2017 genetic risk classification considers cytogenetic and mutational characteristics to stratify fit AML patients into different prognostic groups. However, this classification is not validated for elderly patients treated with a non-intensive approach, and its performance may be suboptimal in this context. Indeed, the transcriptomic landscape of AML in the elderly has been less explored and it might help stratify this group of patients. In the current study, we analyzed the transcriptome of 224 AML patients > 65 years-old at diagnosis treated in the Spanish PETHEMA-FLUGAZA clinical trial in order to identify new prognostic biomarkers in this population. We identified a specific transcriptomic signature for high-risk patients with mutated TP53 or complex karyotype, revealing that low expression of B7H3 gene with high expression of BANP gene identifies a subset of high-risk AML patients surviving more than 12 months. This result was further validated in the BEAT AML cohort. This unique signature highlights the potential of transcriptomics to identify prognostic biomarkers in in elderly AML.
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Affiliation(s)
- Sara Villar
- Servicio de Hematología y Terapia Celular, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain,CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain
| | - Beñat Ariceta
- CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain,Centro de Investigación Médica Aplicada (CIMA) LAB Diagnostics, Universidad de Navarra, Pamplona, Spain,Program of Hematology-Oncology, CIMA, Universidad de Navarra, Pamplona, Spain
| | - Xabier Agirre
- CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain,Program of Hematology-Oncology, CIMA, Universidad de Navarra, Pamplona, Spain
| | | | - Rosa Ayala
- Hospital Universitario 12 de octubre, Madrid, Spain
| | | | | | - Susana Vives
- ICO Badalona- Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Mar Tormo
- Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | - Josefina Serrano
- Hospital Universitario Reina Sofía, Córdoba, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Catia Simoes
- Program of Hematology-Oncology, CIMA, Universidad de Navarra, Pamplona, Spain
| | | | - Maria José Calasanz
- CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain,Centro de Investigación Médica Aplicada (CIMA) LAB Diagnostics, Universidad de Navarra, Pamplona, Spain
| | - Ana Alfonso-Piérola
- Servicio de Hematología y Terapia Celular, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain,CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain
| | - Bruno Paiva
- Servicio de Hematología y Terapia Celular, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain,CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain,Centro de Investigación Médica Aplicada (CIMA) LAB Diagnostics, Universidad de Navarra, Pamplona, Spain
| | | | - Jesús F. San Miguel
- Servicio de Hematología y Terapia Celular, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain,CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain
| | - Felipe Prósper
- Servicio de Hematología y Terapia Celular, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona, Spain,CIBERONC Centro de Investigación Biomédica en Red de Cáncer, Pamplona, Spain,*Correspondence: Felipe Prósper, ; Pau Montesinos,
| | - Pau Montesinos
- Hospital Universitario y Politécnico la Fe, Valencia, Spain,*Correspondence: Felipe Prósper, ; Pau Montesinos,
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7
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Martínez-Cuadrón D, Serrano J, Mariz J, Gil C, Tormo M, Martínez-Sánchez P, Rodríguez-Arbolí E, García-Boyero R, Rodríguez-Medina C, Martínez-Chamorro C, Polo M, Bergua J, Aguiar E, Amigo ML, Herrera P, Alonso-Domínguez JM, Bernal T, Espadana A, Sayas MJ, Algarra L, Vidriales MB, Vasconcelos G, Vives S, Pérez-Encinas MM, López A, Noriega V, García-Fortes M, Chillón MC, Rodríguez-Gutiérrez JI, Calasanz MJ, Labrador J, López JA, Boluda B, Rodríguez-Veiga R, Martínez-López J, Barragán E, Sanz MA, Montesinos P. Characteristics and Outcomes of Adult Patients in the PETHEMA Registry with Relapsed or Refractory FLT3-ITD Mutation-Positive Acute Myeloid Leukemia. Cancers (Basel) 2022; 14:cancers14112817. [PMID: 35681796 PMCID: PMC9179309 DOI: 10.3390/cancers14112817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023] Open
Abstract
This retrospective study investigated outcomes of 404 patients with relapsed/refractory (R/R) FMS-like tyrosine kinase 3 (FLT3)-internal tandem duplication (ITD) acute myeloid leukemia (AML) enrolled in the PETHEMA registry, pre-approval of tyrosine kinase inhibitors. Most patients (63%) had received first-line intensive therapy with 3 + 7. Subsequently, patients received salvage with intensive therapy (n = 261), non-intensive therapy (n = 63) or supportive care only (n = 80). Active salvage therapy (i.e., intensive or non-intensive therapy) resulted in a complete remission (CR) or CR without hematological recovery (CRi) rate of 42%. More patients achieved a CR/CRi with intensive (48%) compared with non-intensive (19%) salvage therapy (p < 0.001). In the overall population, median overall survival (OS) was 5.5 months; 1- and 5-year OS rates were 25% and 7%. OS was significantly (p < 0.001) prolonged with intensive or non-intensive salvage therapy compared with supportive therapy, and in those achieving CR/CRi versus no responders. Of 280 evaluable patients, 61 (22%) had an allogeneic stem-cell transplant after they had achieved CR/CRi. In conclusion, in this large cohort study, salvage treatment approaches for patients with FLT3-ITD mutated R/R AML were heterogeneous. Median OS was poor with both non-intensive and intensive salvage therapy, with best long-term outcomes obtained in patients who achieved CR/CRi and subsequently underwent allogeneic stem-cell transplant.
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Affiliation(s)
- David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
- Correspondence: ; Tel.: +34-96-1244925
| | - Josefina Serrano
- Hospital Universitario Reina Sofía and Instituto Maimónides de Investigación Biomédica Córdoba (IMIBIC), 14004 Córdoba, Spain;
| | - José Mariz
- IPO (Istituto Portugues Oncologia), 4200-072 Porto, Portugal;
| | - Cristina Gil
- Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - Mar Tormo
- Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Pilar Martínez-Sánchez
- Hospital Universitario 12 de Octubre, Complutense University, i+12, CNIO, 28041 Madrid, Spain; (P.M.-S.); (J.M.-L.)
| | | | | | | | | | - Marta Polo
- Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Juan Bergua
- Hospital San Pedro Alcántara, 10003 Cáceres, Spain;
| | | | - María L. Amigo
- Hospital General Universitario Morales Meseguer, 30008 Murcia, Spain;
| | - Pilar Herrera
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | | | - Teresa Bernal
- Hospital Universitario Central de Asturias, 33011 Asturias, Spain;
| | - Ana Espadana
- Hospital de Coimbra, 3400-091 Coimbra, Portugal;
| | - María J. Sayas
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain;
| | - Lorenzo Algarra
- Hospital General Universitario de Albacete, 02006 Albacete, Spain;
| | - María B. Vidriales
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain; (M.B.V.); (M.C.C.)
| | | | - Susana Vives
- ICO-Hospital Germans Trias i Pujol, Badalona, José Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, 08916 Barcelona, Spain;
| | | | | | - Víctor Noriega
- Complejo Hospitalario Universitario A Coruña, 15006 La Coruna, Spain;
| | | | - María C. Chillón
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain; (M.B.V.); (M.C.C.)
| | | | | | | | - Juan A. López
- Complejo Hospitalario Ciudad de Jaén, 23007 Jaén, Spain;
| | - Blanca Boluda
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Rebeca Rodríguez-Veiga
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Joaquín Martínez-López
- Hospital Universitario 12 de Octubre, Complutense University, i+12, CNIO, 28041 Madrid, Spain; (P.M.-S.); (J.M.-L.)
| | - Eva Barragán
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Miguel A. Sanz
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
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Artigas-Baleri A, Oñate G, Brell A, Esteve J, Vives S, Tormo M, Arnan M, Garcia A, Coll R, Sampol A, Bargay J, Vall-llovera F, Salamero O, Nomdedéu J, Pratcorona M. P385: DETECTION OF KMT2A PARTIAL TANDEM DUPLICATIONS IN ACUTE MYELOID LEUKEMIA PATIENTS BY NGS. Hemasphere 2022. [DOI: 10.1097/01.hs9.0000844428.42339.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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9
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Labrador J, Martínez-Cuadrón D, de la Fuente A, Rodríguez-Veiga R, Serrano J, Tormo M, Rodriguez-Arboli E, Ramos F, Bernal T, López-Pavía M, Trigo F, Martínez-Sánchez MP, Rodríguez-Gutiérrez JI, Rodríguez-Medina C, Gil C, Belmonte DG, Vives S, Foncillas MÁ, Pérez-Encinas M, Novo A, Recio I, Rodríguez-Macías G, Bergua JM, Noriega V, Lavilla E, Roldán-Pérez A, Sanz MA, Montesinos P. Azacitidine vs. Decitabine in Unfit Newly Diagnosed Acute Myeloid Leukemia Patients: Results from the PETHEMA Registry. Cancers (Basel) 2022; 14:cancers14092342. [PMID: 35565471 PMCID: PMC9105404 DOI: 10.3390/cancers14092342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 12/04/2022] Open
Abstract
The hypomethylating agents, decitabine (DEC) and azacitidine (AZA), allowed more elderly acute myeloid leukemia (AML) patients to be treated. However, there are little direct comparative data on AZA and DEC. This multicenter retrospective study compared the outcomes of AZA and DEC in terms of response and overall survival (OS). Potential predictors associated with response and OS were also evaluated. A total of 626 AML patients were included (487 treated with AZA and 139 with DEC). Response rates were similar in both groups: CR was 18% with AZA vs. 23% with DEC (p = 0.20), CR/CRi was 20.5% vs. 25% (p = 0.27) and ORR was 32% vs. 39.5% (p = 0.12), respectively. Patients with leukocytes < 10 × 109/L, bone marrow blasts < 50% and ECOG ≥ 2 had higher ORR with DEC than with AZA. OS was similar in both groups: 10.4 months (95% CI: 9.2−11.7) vs. 8.8 months (95% CI: 6.7−11.0, p = 0.455), for AZA and DEC, respectively. Age (≥80 years), leukocytes (≥ 10 × 109/L), platelet count (<20 × 109/L) and eGFR (≥45 mL/min/1.73 m2) were associated with higher OS with AZA compared to DEC. In conclusion, we found no differences in response and OS rates in AML patients treated with AZA or DEC.
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Affiliation(s)
- Jorge Labrador
- Hematology Department, Research Unit, Complejo Asistencial Universitario de Burgos, 09006 Burgos, Spain
- Correspondence: (J.L.); (P.M.)
| | - David Martínez-Cuadrón
- Hematology Department, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (R.R.-V.); (M.A.S.)
| | - Adolfo de la Fuente
- Hematology Department, MD Anderson Cancer Center Madrid, 28033 Madrid, Spain;
| | - Rebeca Rodríguez-Veiga
- Hematology Department, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (R.R.-V.); (M.A.S.)
| | - Josefina Serrano
- Hematology Department, Hospital Universitario Reina Sofía, IMIBIC, 14004 Córdoba, Spain;
| | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario de Valencia, Instituto de Investigación Sanitaria—INCLIVA, 46010 Valencia, Spain;
| | - Eduardo Rodriguez-Arboli
- Hematology Department, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC), 41013 Sevilla, Spain;
| | - Fernando Ramos
- Hematology Department, Hospital Universitario de León, 24071 León, Spain;
| | - Teresa Bernal
- Hematology Department, Hospital Universitario Central Asturias, ISPA, IUOPA, 33011 Oviedo, Spain;
| | - María López-Pavía
- Hematology Department, Hospital General de Valencia, 46026 Valencia, Spain;
| | - Fernanda Trigo
- Hematology Department, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal;
| | | | | | - Carlos Rodríguez-Medina
- Hematology Department, Hospital Universitario de Gran Canaria Doctor Negrín, 35010 Las Palmas de Gran Canaria, Spain;
| | - Cristina Gil
- Hematology Department, Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | | | - Susana Vives
- Hematology Department, Hospital Germans Trias i Pujol-ICO, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, 08916 Badalona, Spain;
| | | | - Manuel Pérez-Encinas
- Hematology Department, Hospital Clínico Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | - Andrés Novo
- Hematology Department, Hospital Universitario Son Espases, 07120 Palma de Mallorca, Spain;
| | - Isabel Recio
- Hematology Department, Complejo Asistencial de Ávila, 05071 Avila, Spain;
| | | | - Juan Miguel Bergua
- Hematology Department, Hospital San Pedro de Alcántara, 10003 Caceres, Spain;
| | - Víctor Noriega
- Hematology Department, Hospital Universitario de A Coruña, 15006 La Coruna, Spain;
| | - Esperanza Lavilla
- Hematology Department, Hospital Universitario Lucus Augusti, 27003 Lugo, Spain;
| | - Alicia Roldán-Pérez
- Hematology Department, Hospital Universitario Infanta Sofía, 28702 San Sebastián de los Reyes, Spain;
| | - Miguel A. Sanz
- Hematology Department, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (R.R.-V.); (M.A.S.)
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (R.R.-V.); (M.A.S.)
- Correspondence: (J.L.); (P.M.)
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10
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Montesinos P, Recher C, Vives S, Zarzycka E, Wang J, Bertani G, Heuser M, Calado RT, Schuh AC, Yeh SP, Daigle SR, Hui J, Pandya SS, Gianolio DA, de Botton S, Döhner H. Ivosidenib and Azacitidine in IDH1-Mutated Acute Myeloid Leukemia. N Engl J Med 2022; 386:1519-1531. [PMID: 35443108 DOI: 10.1056/nejmoa2117344] [Citation(s) in RCA: 164] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The combination of ivosidenib - an inhibitor of mutant isocitrate dehydrogenase 1 (IDH1) - and azacitidine showed encouraging clinical activity in a phase 1b trial involving patients with newly diagnosed IDH1-mutated acute myeloid leukemia. METHODS In this phase 3 trial, we randomly assigned patients with newly diagnosed IDH1-mutated acute myeloid leukemia who were ineligible for intensive induction chemotherapy to receive oral ivosidenib (500 mg once daily) and subcutaneous or intravenous azacitidine (75 mg per square meter of body-surface area for 7 days in 28-day cycles) or to receive matched placebo and azacitidine. The primary end point was event-free survival, defined as the time from randomization until treatment failure (i.e., the patient did not have complete remission by week 24), relapse from remission, or death from any cause, whichever occurred first. RESULTS The intention-to-treat population included 146 patients: 72 in the ivosidenib-and-azacitidine group and 74 in the placebo-and-azacitidine group. At a median follow-up of 12.4 months, event-free survival was significantly longer in the ivosidenib-and-azacitidine group than in the placebo-and-azacitidine group (hazard ratio for treatment failure, relapse from remission, or death, 0.33; 95% confidence interval [CI], 0.16 to 0.69; P = 0.002). The estimated probability that a patient would remain event-free at 12 months was 37% in the ivosidenib-and-azacitidine group and 12% in the placebo-and-azacitidine group. The median overall survival was 24.0 months with ivosidenib and azacitidine and 7.9 months with placebo and azacitidine (hazard ratio for death, 0.44; 95% CI, 0.27 to 0.73; P = 0.001). Common adverse events of grade 3 or higher included febrile neutropenia (28% with ivosidenib and azacitidine and 34% with placebo and azacitidine) and neutropenia (27% and 16%, respectively); the incidence of bleeding events of any grade was 41% and 29%, respectively. The incidence of infection of any grade was 28% with ivosidenib and azacitidine and 49% with placebo and azacitidine. Differentiation syndrome of any grade occurred in 14% of the patients receiving ivosidenib and azacitidine and 8% of those receiving placebo and azacitidine. CONCLUSIONS Ivosidenib and azacitidine showed significant clinical benefit as compared with placebo and azacitidine in this difficult-to-treat population. Febrile neutropenia and infections were less frequent in the ivosidenib-and-azacitidine group than in the placebo-and-azacitidine group, whereas neutropenia and bleeding were more frequent in the ivosidenib-and-azacitidine group. (Funded by Agios Pharmaceuticals and Servier Pharmaceuticals; AGILE ClinicalTrials.gov number, NCT03173248.).
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Affiliation(s)
- Pau Montesinos
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Christian Recher
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Susana Vives
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Ewa Zarzycka
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Jianxiang Wang
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Giambattista Bertani
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Michael Heuser
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Rodrigo T Calado
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Andre C Schuh
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Su-Peng Yeh
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Scott R Daigle
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Jianan Hui
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Shuchi S Pandya
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Diego A Gianolio
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Stephane de Botton
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
| | - Hartmut Döhner
- From Hospital Universitari i Politècnic La Fe, Valencia (P.M.), and Hospital Universitario Germans Trias i Pujol-Institut Català d'Oncologia Badalona, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona (S.V.) - both in Spain; Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, Toulouse (C.R.), and Institut Gustave Roussy, Villejuif (S.B.) - both in France; Klinika Hematologii i Transplantologii, Uniwersyteckie Centrum Kliniczne, Gdansk, Poland (E.Z.); the Institute of Hematology and Hospital of Blood Disease, Peking Union Medical College, Tianjin, China (J.W.); Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan (G.B.); Hannover Medical School, Hannover (M.H.), and Ulm University Hospital, Ulm (H.D.) - both in Germany; Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, Brazil (R.T.C.); Princess Margaret Cancer Centre, Toronto (A.C.S.); China Medical University, Taichung, Taiwan (S.-P.Y.); and Servier Pharmaceuticals, Boston (S.R.D., J.H., S.S.P., D.A.G.)
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Labrador J, Saiz-Rodríguez M, de Miguel D, de Laiglesia A, Rodríguez-Medina C, Vidriales MB, Pérez-Encinas M, Sánchez-Sánchez MJ, Cuello R, Roldán-Pérez A, Vives S, Benzo-Callejo G, Colorado M, García-Fortes M, Sayas MJ, Olivier C, Recio I, Conde-Royo D, Bienert-García Á, Vahi M, Muñoz-García C, Seri-Merino C, Tormo M, Vall-llovera F, Foncillas MÁ, Martínez-Cuadrón D, Sanz MÁ, Montesinos P. Use of Venetoclax in Patients with Relapsed or Refractory Acute Myeloid Leukemia: The PETHEMA Registry Experience. Cancers (Basel) 2022; 14:cancers14071734. [PMID: 35406512 PMCID: PMC8997036 DOI: 10.3390/cancers14071734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/22/2022] [Revised: 03/12/2022] [Accepted: 03/24/2022] [Indexed: 12/20/2022] Open
Abstract
Simple Summary The use of venetoclax combined with hypomethylating agents or low-dose cytarabine in patients with newly diagnosed acute myeloid leukemia unfit for intensive chemotherapy was recently approved. However, the evidence in relapse or refractory patients is still scarce. The cohort of patients included in our study was heavily pretreated and had a poor performance status. It is still necessary to identify those patients at higher risk of early death who would not benefit from this type of treatment. For these ultra-high-risk patients, other treatment strategies should be followed. Abstract The effectiveness of venetoclax (VEN) in relapsed or refractory acute myeloid leukemia (RR-AML) has not been well established. This retrospective, multicenter, observational database studied the effectiveness of VEN in a cohort of 51 RR-AML patients and evaluated for predictors of response and overall survival (OS). The median age was 68 years, most were at high risk, 61% received ≥2 therapies for AML, 49% had received hypomethylating agents, and ECOG was ≥2 in 52%. Complete remission (CR) rate, including CR with incomplete hematological recovery (CRi), was 12.4%. Additionally, 10.4% experienced partial response (PR). The CR/CRi was higher in combination with azacitidine (AZA; 17.9%) than with decitabine (DEC; 6.7%) and low-dose cytarabine (LDAC; 0%). Mutated NPM1 was associated with increased CR/CRi. Median OS was 104 days (95% CI: 56–151). For the combination with AZA, DEC, and LDAC, median OS was 120 days, 104 days, and 69 days, respectively; p = 0.875. Treatment response and ECOG 0 influenced OS in a multivariate model. A total of 28% of patients required interruption of VEN because of toxicity. Our real-life series describes a marginal probability of CR/CRi and poor OS after VEN-based salvage. Patients included had very poor-risk features and were heavily pretreated. The small percentage of responders did not reach the median OS.
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Affiliation(s)
- Jorge Labrador
- Hematology Deparment, Hospital Universitario de Burgos, 09006 Burgos, Spain
- Research Unit, Fundación Burgos por la Investigación de la Salud (FBIS), Hospital Universitario de Burgos, 09006 Burgos, Spain;
- Correspondence: (J.L.); (P.M.)
| | - Miriam Saiz-Rodríguez
- Research Unit, Fundación Burgos por la Investigación de la Salud (FBIS), Hospital Universitario de Burgos, 09006 Burgos, Spain;
| | - Dunia de Miguel
- Hematology Deparment, Hospital Universitario de Guadalajara, 19002 Guadalajara, Spain;
| | | | - Carlos Rodríguez-Medina
- Hematology Deparment, Hospital de Gran Canaria Dr. Negrin, 35010 Las Palmas de Gran Canaria, Spain;
| | | | - Manuel Pérez-Encinas
- Hematology Deparment, Hospital Clínico Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain;
| | | | - Rebeca Cuello
- Hematology Deparment, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain;
| | - Alicia Roldán-Pérez
- Hematology Deparment, Hospital Universitario Infanta Sofía, 28703 Madrid, Spain;
| | - Susana Vives
- Hematology Deparment, Hospital Germans Trias i Pujol-ICO, 08907 Badalona, Spain;
| | | | - Mercedes Colorado
- Hematology Deparment, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain;
| | - María García-Fortes
- Hematology Deparment, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain;
| | - María José Sayas
- Hematology Deparment, Hospital Universitario Doctor Peset, 46017 Valencia, Spain;
| | - Carmen Olivier
- Hematology Deparment, Hospital General de Segovia, 40002 Segovia, Spain;
| | - Isabel Recio
- Hematology Deparment, Complejo Asistencial de Ávila, 05071 Ávila, Spain;
| | - Diego Conde-Royo
- Hematology Deparment, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, 28805 Madrid, Spain;
| | - Álvaro Bienert-García
- Hematology Deparment, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain;
| | - María Vahi
- Hematology Deparment, Hospital Universitario Virgen de Valme, 41014 Sevilla, Spain;
| | - Carmen Muñoz-García
- Hematology Deparment, Hospital Universitario Virgen Macarena, 41009 Sevilla, Spain;
| | - Cristina Seri-Merino
- Hematology Deparment, Hospital Central de la Defensa Gómez Ulla, 28047 Madrid, Spain;
| | - Mar Tormo
- Hematology Deparment, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;
| | - Ferran Vall-llovera
- Hematology Deparment, Hospital Universitari Mutua Terrasa, 08221 Barcelona, Spain;
| | | | - David Martínez-Cuadrón
- Hematology Deparment; Hospital Universitari I Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (M.Á.S.)
| | - Miguel Ángel Sanz
- Hematology Deparment; Hospital Universitari I Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (M.Á.S.)
| | - Pau Montesinos
- Hematology Deparment; Hospital Universitari I Politécnic La Fe, 46026 Valencia, Spain; (D.M.-C.); (M.Á.S.)
- Correspondence: (J.L.); (P.M.)
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12
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Sweet K, Bhatnagar B, Döhner H, Donnellan W, Frankfurt O, Heuser M, Kota V, Liu H, Raffoux E, Roboz GJ, Röllig C, Showel MM, Strickland SA, Vives S, Tang S, Unger TJ, Joshi A, Shen Y, Alvarez MJ, Califano A, Crochiere M, Landesman Y, Kauffman M, Shah J, Shacham S, Savona MR, Montesinos P. A 2:1 randomized, open-label, phase II study of selinexor vs. physician's choice in older patients with relapsed or refractory acute myeloid leukemia. Leuk Lymphoma 2021; 62:3192-3203. [PMID: 34323164 DOI: 10.1080/10428194.2021.1950706] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Selinexor, a selective inhibitor of nuclear export, has demonstrated promising activity in patients with acute myeloid leukemia (AML). This randomized, phase II study evaluated selinexor 60 mg twice weekly (n = 118) vs. physician's choice (PC) treatment (n = 57) in patients aged ≥60 years with relapsed/refractory (R/R) AML. The primary outcome was overall survival (OS). Median OS did not differ significantly for selinexor vs. PC (3.2 vs. 5.6 months; HR = 1.18 [95% CI: 0.79-1.75]; p = 0.422). Complete remission (CR) plus CR with incomplete hematologic recovery trending in favor of selinexor occurred in a minority of patients. Selinexor treated patients had an increased incidence of adverse events. The most common grade ≥3 adverse events were thrombocytopenia, febrile neutropenia, anemia, hyponatremia. Despite well-balanced baseline characteristics, there were numerically higher rates of TP53 mutations, prior myelodysplastic syndrome, and lower absolute neutrophil counts in the selinexor group; warranting further investigation of selinexor in more carefully stratified R/R AML patients.Registered trial: NCT02088541.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Susana Vives
- ICO Badalona-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | | | | | - Yao Shen
- DarwinHealth Inc, New York, NY, USA
| | - Mariano J Alvarez
- DarwinHealth Inc, New York, NY, USA.,Columbia University, New York, NY, USA
| | | | | | | | | | - Jatin Shah
- Karyopharm Therapeutics, Newton, MA, USA
| | | | | | - Pau Montesinos
- Departamento de Hematologia, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
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13
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Palanques-Pastor T, Megías-Vericat JE, Martínez P, López Lorenzo JL, Cornago Navascués J, Rodriguez Macias G, Cano I, Arnan Sangerman M, Vidriales Vicente MB, Algarra Algarra JL, Foncillas MÁ, Herrera P, Botella Prieto C, Vives S, Figuera Álvarez Á, Cuevas Palomares L, Sobas M, Contento Gonzalo A, Cuello García R, Amutio Diez ME, De Miguel Llorente D, Navas Elorza B, Bergua Burgues JM, Bernal Del Castillo T, Mateos Rodríguez MC, de Cabo López E, Franco Villegas AC, García Boyero R, Escolano Escobar C, Seri Merino C, Cervero C, Roldán Pérez A, Hermosín Ramos L, Cervera Calvo M, Olave MT, Villafuerte Gutiérrez P, de Laiglesiai A, Serrano J, Najera Irazu MJ, Piñana JL, Sanz MÁ, Martínez-López J, Montesinos P. Characteristics, clinical outcomes, and risk factors of SARS-COV-2 infection in adult acute myeloid leukemia patients: experience of the PETHEMA group. Leuk Lymphoma 2021; 62:2928-2938. [PMID: 34292118 DOI: 10.1080/10428194.2021.1948031] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection produces higher morbidity and mortality in hematological malignancies, but evidence in acute myeloid leukemia (AML) is scarce. A multicenter observational study was conducted to determine the clinical outcomes and assess the impact of therapeutic approaches in adult AML patients with SARS-CoV-2 infection in the first wave (March-May 2020). Overall, 108 patients were included: 51.9% with active leukemia and 70.4% under therapeutic schedules for AML. Signs and symptoms of SARS-CoV-2 were present in 96.3% of patients and 82.4% received specific treatment for SARS-CoV-2. The mortality rate was 43.5% and was correlated with age, gender, active leukemia, dyspnea, severe SARS-CoV-2, intensive care measures, neutrophil count, and D-dimer levels. A protective effect was found with azithromycin, lopinavir/ritonavir, and normal liver enzyme levels. During the SARS-CoV-2 first wave, our findings suggested an increased mortality in AML in a short period. SARS-CoV-2 management could be guided by risk factors in AML patients.
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Affiliation(s)
| | | | - Pilar Martínez
- Hematology and Hemotherapy Department, Hospital Universitario, Madrid, Spain
| | - José Luis López Lorenzo
- Hematology and Hemotherapy Department, Hospital Universitario Fundación Jiménez Díaz, Valencia, Spain
| | - Javier Cornago Navascués
- Hematology and Hemotherapy Department, Hospital Universitario Fundación Jiménez Díaz, Valencia, Spain
| | - Gabriela Rodriguez Macias
- Hematology and Hemotherapy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Isabel Cano
- Hematology and Hemotherapy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | | | | | - Pilar Herrera
- Hematology and Hemotherapy Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Carmen Botella Prieto
- Hematology and Hemotherapy Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Susana Vives
- Clinic Hematology Department, Instituto Catalán de Oncología, Badalona, Spain
| | - Ángela Figuera Álvarez
- Hematology and Hemotherapy Department, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Marta Sobas
- Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wrocław, Poland
| | | | - Rebeca Cuello García
- Hematology and Hemotherapy Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | | | - Begoña Navas Elorza
- Hematology and Hemotherapy Department, Hospital HLA Universitario Moncloa, Madrid, Spain
| | | | | | | | - Erik de Cabo López
- Hematology Department, Hospital Universitario del Bierzo, Ponferrada, Spain
| | | | - Raimundo García Boyero
- Hematology and Hemotherapy Department, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
| | | | - Cristina Seri Merino
- Hematology and Hemotherapy Department, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - Carlos Cervero
- Hematology Department, Hospital Virgen de la Luz, Cuenca, Spain
| | - Alicia Roldán Pérez
- Hematology and Hemotherapy Department, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Spain
| | - Lourdes Hermosín Ramos
- Hematology and Hemotherapy Department, Hospital Jerez de la Frontera, Jerez de la Frontera, Spain
| | | | - María Telesa Olave
- Hematology and Hemotherapy Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Almudena de Laiglesiai
- Hematology and Hemotherapy Department, Hospital Universitario Puerta del Hierro, Majadahonda, Spain
| | - Josefina Serrano
- Hematology Department, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - José Luis Piñana
- Hematology and Hemotherapy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Miguel Ángel Sanz
- Hematology and Hemotherapy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Pau Montesinos
- Hematology and Hemotherapy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Medrano M, Soleto A, Pastor C, Rodríguez C, Carrasco R, Lapayese F, de la Peña A, Pereira A, Rincón E, Cabrera S, Ramos F, de la Cal E, Mota F, Queral V, Lopez-Heredero R, Manzanares A, Alén-Cordero C, Letellier L, Vives S, Martin V, Guern FL, Piqueras J, Kocan M. Design overview of ex-vessel components for the Wide Angle Viewing System diagnostic for ITER Equatorial Port 12. Fusion Engineering and Design 2021. [DOI: 10.1016/j.fusengdes.2021.112651] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Genescà E, Morgades M, González-Gil C, Fuster-Tormo F, Haferlach C, Meggendorfer M, Montesinos P, Barba P, Gil C, Coll R, Moreno MJ, Martínez-Carballeira D, García-Cadenas I, Vives S, Ribera J, González-Campos J, Díaz-Beya M, Mercadal S, Artola MT, Cladera A, Tormo M, Bermúdez A, Vall-Llovera F, Martínez-Sánchez P, Amigo ML, Monsalvo S, Novo A, Cervera M, García-Guiñon A, Ciudad J, Cervera J, Hernández-Rivas JM, Granada I, Haferlach T, Orfao A, Solé F, Ribera JM. Adverse prognostic impact of complex karyotype (≥3 cytogenetic alterations) in adult T-cell acute lymphoblastic leukemia (T-ALL). Leuk Res 2021; 109:106612. [PMID: 34139642 DOI: 10.1016/j.leukres.2021.106612] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 02/24/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022]
Abstract
The potential prognostic value of conventional karyotyping in adult T-cell acute lymphoblastic leukemia (T-ALL) remains an open question. We hypothesized that a modified cytogenetic classification, based on the number and type of cytogenetic abnormalities, would allow the identification of high-risk adult T-ALL patients. Complex karyotype defined by the presence of ≥3 cytogenetic alterations identified T-ALL patients with poor prognosis in this study. Karyotypes with ≥3 abnormalities accounted for 16 % (22/139) of all evaluable karyotypes, corresponding to the largest poor prognosis cytogenetic subgroup of T-ALL identified so far. Patients carrying karyotypes with ≥3 cytogenetic alterations showed a significantly inferior response to therapy, and a poor outcome in terms of event-free survival (EFS), overall survival (OS) and cumulative incidence of relapse (CIR), independently of other baseline characteristics and the end-induction minimal residual disease (MRD) level. Additional molecular analyses of patients carrying ≥3 cytogenetic alterations showed a unique molecular profile that could contribute to understand the underlying molecular mechanisms of resistance and to evaluate novel targeted therapies (e.g. IL7R directed) with potential impact on outcome of adult T-ALL patients.
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Affiliation(s)
- Eulàlia Genescà
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain.
| | - Mireia Morgades
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain; Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Celia González-Gil
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Francisco Fuster-Tormo
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | | | | | - Pau Montesinos
- Hospital Universitari Politècnic La Fe & CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Pere Barba
- Clinical Hematology Service, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
| | - Cristina Gil
- Clinical Hematology Service, Hospital General de Alicante, Alicante, Spain
| | - Rosa Coll
- Clinical Hematology Service, Hospital Josep Trueta-ICO, Girona, Spain
| | - María-José Moreno
- Clinical Hematology Service, Hospital Virgen de la Victoria, Málaga, Spain
| | | | - Irene García-Cadenas
- Clinical Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Susana Vives
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain; Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Spain
| | - Jordi Ribera
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | | | - Marina Díaz-Beya
- Clinical Hematology Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Santiago Mercadal
- Clinical Hematology Service, Hospital Duran i Reynals-ICO, Hospitalet del LLobregat, Spain
| | - María-Teresa Artola
- Clinical Hematology Service, Hospital Universitario de Donostia, Donostia, Spain
| | - Antonia Cladera
- Clinical Hematology Service, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - Mar Tormo
- Clinical Hematology Service, Hospital Clínico de Valencia, Valencia, Spain
| | - Arancha Bermúdez
- Clinical Hematology Service, Hospital Marqués de Valdecilla, Santander, Spain
| | | | | | - María-Luz Amigo
- Clinical Hematology Service, Hospital Morales Meseguer, Murcia, Spain
| | - Silvia Monsalvo
- Clinical Hematology Service, Hospital Gregorio Marañón, Madrid, Spain
| | - Andrés Novo
- Clinical Hematology Service, Hospital Son Espases, Palma de Mallorca, Spain
| | - Marta Cervera
- Clinical Hematology Service, Hospital Joan XXIII, Tarragona, Spain
| | | | - Juana Ciudad
- Centro de Investigación del Cáncer (IBMCC-CSIC/USAL) (CIC), Hospital Clínico Universitario de Salamanca (HUS), Instituto Bio-Sanitario de Salamanca (IBSAL), CIBERONC, Salamanca, Spain
| | - José Cervera
- Hospital Universitari Politècnic La Fe & CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Jesús-María Hernández-Rivas
- Hospital Clínico Universitario de Salamanca (HUS), Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Centro de Investigación del Cáncer (CIC), Spain
| | - Isabel Granada
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain; Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Spain
| | | | - Alberto Orfao
- Centro de Investigación del Cáncer (IBMCC-CSIC/USAL) (CIC), Hospital Clínico Universitario de Salamanca (HUS), Instituto Bio-Sanitario de Salamanca (IBSAL), CIBERONC, Salamanca, Spain
| | - Francesc Solé
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - Josep-Maria Ribera
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain; Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Spain
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Solomon SR, Montesinos P, Nazha A, Strickland SA, Martinelli G, Santoro A, Walter RB, Cook RJ, Calbacho M, Vives S, Fazal S, Brzózka K, Shamsili S, Baldini S, Laurent D, Pellacani AUE, Ravandi F. Updated results from DIAMOND-01 (CLI24-001) trial: A phase I/II study of SEL24/MEN1703, a first-in-class dual PIM/FLT3 kinase inhibitor, in acute myeloid leukemia. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7023] [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: 11/20/2022] Open
Abstract
7023 Background: SEL24/MEN1703, a dual PIM/FLT3 kinase inhibitor, in the dose escalation (DE) DIAMOND-01 trial (CLI24-001, NCT03008187), showed an acceptable safety profile up to the recommended dose (RD) of 125 mg along with initial evidence of single agent activity and meaningful target engagement in heavily pre-treated patients (pts) with AML (Solomon et al, EHA 2020; Tomirotti et al, ASH 2020). Here we present updated data including pts enrolled in the Phase II, cohort expansion (CE) of the study. Methods: DIAMOND-01 trial enrolled pts unsuitable for chemotherapy having relapsed or refractory (R/R) (DE and CE) or previously untreated (DE) AML. Previous targeted therapies – except PIM inhibitors – were allowed. SEL24/MEN1703 was given orally, QD, 14 days ON / 7 days OFF until progression/unacceptable toxicity. The DE tested MEN1703 escalating doses from 25 to 150 mg, whereas in the CE the RP2D (125 mg) was administered. The key objectives of the CE were the confirmation of the safety profile determined in the DE along with further investigation of single agent activity. Adverse events (AEs) were graded according to NCI-CTCAE v.4.03; responses assessed as per ELN 2017 criteria. Results: As of January 21, 2021 (cut-off date), n = 48 pts were treated across DE (n = 25) and CE (n = 23). Median age was 69 (25-84) years. Overall, 20 (43%) and 15 (32%) pts had non de novo AML and primary refractory AML, respectively. Adverse karyotype was reported in 7 (15%) pts. Most frequently reported mutations were FLT3/ITD (23%, n = 11), DNMT3A (15% n = 7), NPM1 (15%, n = 7), IDH1 (13%, n = 6) and IDH2 (4%, n = 2), CEBPA (4%, n = 2), FLT3/TKD (2%, n = 1). Median number of cycles was 2 (1-8). At the RD (n = 30), most frequent serious treatment-emergent AEs (serious TEAEs) were pneumonia (23%), sepsis and febrile neutropenia (13%) and pulmonary mycosis (10%) whereas most frequent G≥3 TEAEs were febrile neutropenia and pneumonia (23%), leukocytosis (20%) and neutrophil count decrease, platelet count decrease, lymphocyte count decrease and sepsis (13%). Responses occurred in 2 pts in the CE, both with IDH1 mutant disease (naïve to IDH inhibitors) who achieved complete remission with incomplete hematologic recovery (CRi). Both responses occurred by Cycle 3, with a duration of 79 (ongoing at cut-off date) and 43 days, respectively. Across DE and CE, 4 CR/CRi occurred, three of which in pts with IDH mutations. A total of 3 out of 6 pts with IDH mutations treated at doses ≥75 mg achieved CR/CRi, including a CR in a patient with IDH2 mutant AML relapsed on Enasidenib. Conclusions: SEL24/MEN1703 confirmed a manageable safety profile at RD and showed preliminary single agent efficacy in R/R AML, particularly clustering in pts with IDH mutant disease either naïve or previously exposed to IDH inhibitors. These results warrant further investigation of SEL24/MEN1703 in AML, with potential focus in the IDH mutated subset. Clinical trial information: NCT03008187.
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Affiliation(s)
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | | | - Giovanni Martinelli
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Armando Santoro
- Humanitas University, Humanitas Clinical and Research Center IRCCS, Milan, Italy
| | | | | | | | - Susana Vives
- ICO-Hospital Germans Trias i Pujol, Badalona, Spain
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17
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Ayala R, Rapado I, Onecha E, Martínez-Cuadrón D, Carreño-Tarragona G, Bergua JM, Vives S, Algarra JL, Tormo M, Martinez P, Serrano J, Herrera P, Ramos F, Salamero O, Lavilla E, Gil C, López Lorenzo JL, Vidriales MB, Labrador J, Falantes JF, Sayas MJ, Paiva B, Barragán E, Prosper F, Sanz MÁ, Martínez-López J, Montesinos P. The Mutational Landscape of Acute Myeloid Leukaemia Predicts Responses and Outcomes in Elderly Patients from the PETHEMA-FLUGAZA Phase 3 Clinical Trial. Cancers (Basel) 2021; 13:cancers13102458. [PMID: 34070172 PMCID: PMC8158477 DOI: 10.3390/cancers13102458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/06/2021] [Accepted: 05/12/2021] [Indexed: 12/30/2022] Open
Abstract
We sought to predict treatment responses and outcomes in older patients with newly diagnosed acute myeloid leukemia (AML) from our FLUGAZA phase III clinical trial (PETHEMA group) based on mutational status, comparing azacytidine (AZA) with fludarabine plus low-dose cytarabine (FLUGA). Mutational profiling using a custom 43-gene next-generation sequencing panel revealed differences in profiles between older and younger patients, and several prognostic markers that were useful in young patients were ineffective in older patients. We examined the associations between variables and overall responses at the end of the third cycle. Patients with mutated DNMT3A or EZH2 were shown to benefit from azacytidine in the treatment-adjusted subgroup analysis. An analysis of the associations with tumor burden using variant allele frequency (VAF) quantification showed that a higher overall response was associated with an increase in TET2 VAF (odds ratio (OR), 1.014; p = 0.030) and lower TP53 VAF (OR, 0.981; p = 0.003). In the treatment-adjusted multivariate survival analyses, only the NRAS (hazard ratio (HR), 1.9, p = 0.005) and TP53 (HR, 2.6, p = 9.8 × 10-7) variants were associated with shorter overall survival (OS), whereas only mutated BCOR (HR, 3.6, p = 0.0003) was associated with a shorter relapse-free survival (RFS). Subgroup analyses of OS according to biological and genomic characteristics showed that patients with low-intermediate cytogenetic risk (HR, 1.51, p = 0.045) and mutated NRAS (HR, 3.66, p = 0.047) benefited from azacytidine therapy. In the subgroup analyses, patients with mutated TP53 (HR, 4.71, p = 0.009) showed a better RFS in the azacytidine arm. In conclusion, differential mutational profiling might anticipate the outcomes of first-line treatment choices (AZA or FLUGA) in older patients with AML. The study is registered at ClinicalTrials.gov as NCT02319135.
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Affiliation(s)
- Rosa Ayala
- Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Imas12, 28041 Madrid, Spain; (I.R.); (E.O.); (G.C.-T.)
- Hematological Malignancies Clinical Research Unit, CNIO, 28029 Madrid, Spain
- Departament of Medicine, Complutense University, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Correspondence: (R.A.); (J.M.-L.)
| | - Inmaculada Rapado
- Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Imas12, 28041 Madrid, Spain; (I.R.); (E.O.); (G.C.-T.)
- Hematological Malignancies Clinical Research Unit, CNIO, 28029 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
| | - Esther Onecha
- Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Imas12, 28041 Madrid, Spain; (I.R.); (E.O.); (G.C.-T.)
- Hematological Malignancies Clinical Research Unit, CNIO, 28029 Madrid, Spain
| | - David Martínez-Cuadrón
- Hematology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
| | - Gonzalo Carreño-Tarragona
- Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Imas12, 28041 Madrid, Spain; (I.R.); (E.O.); (G.C.-T.)
- Hematological Malignancies Clinical Research Unit, CNIO, 28029 Madrid, Spain
| | - Juan Miguel Bergua
- Hematology Department, Hospital San Pedro Acantara, 10003 Cáceres, Spain;
| | - Susana Vives
- Department of Hematology, ICO Badalona-Hospital Germans Trias i Pujol. Josep Carreras Leukemia Research Institute. Universitat Autònoma de Barcelona, 08916 Badalona, Spain;
| | | | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain;
| | - Pilar Martinez
- Hematology Department, Hospital 12 de Octubre, 28041 Madrid, Spain;
| | - Josefina Serrano
- Hematology Department, Hospital Universitario Reina Sofía, 14004 Cordoba, Spain;
| | - Pilar Herrera
- Hematology Department, Hospital Ramon y Cajal, 28034 Madrid, Spain;
| | - Fernando Ramos
- Hematology Department, Hospital Universitario de León, 24008 León, Spain;
| | - Olga Salamero
- Hematology Department, Hospital Universitari Vall d’Hebron, 08035 Barcelona, Spain;
| | - Esperanza Lavilla
- Hematology Department, Hospital Universitario Xeral de Lugo, 27003 Lugo, Spain;
| | - Cristina Gil
- Hematology Department, Hospital General de Alicante, 03010 Alicante, Spain;
| | | | - María Belén Vidriales
- Hematology Department, Hospital Universitario de Salamanca, IBSAL, 37007 Salamanca, Spain;
| | - Jorge Labrador
- Hematology Department, Hospital Universitario de Burgos, 09001 Burgos, Spain;
| | - José Francisco Falantes
- Hematology Department, Hospital Universitario Vírgen del Rocío, Instituto de BioMedicina de Sevilla, 41013 Sevilla, Spain;
| | - María José Sayas
- Hematology Department, Hospital Doctor Peset, 46017 Valencia, Spain;
| | - Bruno Paiva
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Hematology Department, Clínica Universitaria de Navarra, 31008 Navarra, Spain
| | - Eva Barragán
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Hematology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
| | - Felipe Prosper
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Hematology Department, Clínica Universitaria de Navarra, 31008 Navarra, Spain
| | - Miguel Ángel Sanz
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Hematology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
| | - Joaquín Martínez-López
- Hematology Department, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Imas12, 28041 Madrid, Spain; (I.R.); (E.O.); (G.C.-T.)
- Hematological Malignancies Clinical Research Unit, CNIO, 28029 Madrid, Spain
- Departament of Medicine, Complutense University, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Correspondence: (R.A.); (J.M.-L.)
| | - Pau Montesinos
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, 28029 Madrid, Spain; (B.P.); (E.B.); (F.P.); (M.Á.S.); (P.M.)
- Hematology Department, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
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Martínez Sánchez MP, Megías-Vericat JE, Rodríguez-Veiga R, Vives S, Bergua JM, Torrent A, Suárez-Varela S, Boluda B, Martínez-López J, Cano-Ferri I, Acuña-Cruz E, Torres-Miñana L, Martín-Herreros B, Serrano A, Sempere A, Barragán E, Sargas C, Sanz M, Martínez-Cuadrón D, Montesinos P. A phase I trial of selinexor plus FLAG-Ida for the treatment of refractory/relapsed adult acute myeloid leukemia patients. Ann Hematol 2021; 100:1497-1508. [PMID: 33914097 DOI: 10.1007/s00277-021-04542-8] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
Prognosis for relapsed or refractory (R/R) acute myeloid leukemia (AML) despite salvage therapy is dismal. This phase I dose-escalation trial assessed the safety and preliminary clinical activity of selinexor, an oral exportin-1 (XPO1) inhibitor, in combination with FLAG-Ida in younger R/R AML patients. The aim was to find the recommended phase 2 dose (RP2D) and maximum tolerated dose (MTD). Fourteen patients were included, and selinexor dosage was 60 mg (3 patients), 80 mg (3 patients), and 100 mg (7 patients) weekly. No dose-limiting toxicities were reported. Grade ≥3 non-hematologic adverse events (AEs) occurred in 78.6% of patients. Two patients were non MTD evaluable due to early death, and overall, 3 out of 14 patients (21.4%) had fatal AEs. Five out of 12 (42%) response and MTD evaluable patients achieved a complete remission (CR; n=4) or CR with incomplete hematologic recovery (CRi, n=1), and 4 patients (33%) subsequently underwent allogeneic transplantation. The median overall survival (OS) and event-free survival (EFS) were 6.0 (range 0.9-19.3) and 1.1 months (range 0.7-19.3), respectively. Using selinexor 100 mg/weekly, CR/CRi rate of 66.7%, OS 13.6 months (range, 1.6-19.3), and EFS 10.6 months (range, 0.9-19.3). At last follow-up, 3 patients were alive. Selinexor 100 mg/weekly with FLAG-Ida combination in R/R AML showed acceptable tolerability and efficacy, establishing the RP2D of this regimen in future clinical trials. ClinicalTrials.gov Identifier: NCT03661515.
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Affiliation(s)
- María P Martínez Sánchez
- Servicio de Hematología y Hemoterapia, Hospital Universitario 12 de Octubre, UCM, CNIO, CIBERONC, Madrid, Spain
| | | | - Rebeca Rodríguez-Veiga
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Susana Vives
- Servicio de Hematología y Hemoterapia, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Juan Miguel Bergua
- Servicio de Hematología y Hemoterapia, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Anna Torrent
- Servicio de Hematología y Hemoterapia, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Sara Suárez-Varela
- Servicio de Hematología y Hemoterapia, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Blanca Boluda
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Joaquín Martínez-López
- Servicio de Hematología y Hemoterapia, Hospital Universitario 12 de Octubre, UCM, CNIO, CIBERONC, Madrid, Spain
| | - Isabel Cano-Ferri
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Evelyn Acuña-Cruz
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Laura Torres-Miñana
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Beatriz Martín-Herreros
- Grupo de investigación en Hematología, Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Alfons Serrano
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Amparo Sempere
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Eva Barragán
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Claudia Sargas
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Miguel Sanz
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - David Martínez-Cuadrón
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Pau Montesinos
- Servicio de Hematología y Hemoterapia, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
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19
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Vives S, Martínez-Cuadrón D, Bergua Burgues J, Algarra L, Tormo M, Martínez-Sánchez MP, Serrano J, Herrera P, Ramos F, Salamero O, Lavilla E, López-Lorenzo JL, Gil C, Vidriales B, Falantes JF, Serrano A, Labrador J, Sayas MJ, Foncillas MÁ, Amador Barciela ML, Olave MT, Colorado M, Gascón A, Fernández MÁ, Simiele A, Pérez-Encinas MM, Rodríguez-Veiga R, García O, Martínez-López J, Barragán E, Paiva B, Sanz MÁ, Montesinos P. A phase 3 trial of azacitidine versus a semi-intensive fludarabine and cytarabine schedule in older patients with untreated acute myeloid leukemia. Cancer 2021; 127:2003-2014. [PMID: 33626197 DOI: 10.1002/cncr.33403] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/22/2020] [Accepted: 11/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Options to treat elderly patients (≥65 years old) newly diagnosed with acute myeloid leukemia (AML) include intensive and attenuated chemotherapy, hypomethylating agents with or without venetoclax, and supportive care. This multicenter, randomized, open-label, phase 3 trial was designed to assess the efficacy and safety of a fludarabine, cytarabine, and filgrastim (FLUGA) regimen in comparison with azacitidine (AZA). METHODS Patients (n = 283) were randomized 1:1 to FLUGA (n = 141) or AZA (n = 142). Response was evaluated after cycles 1, 3, 6, and 9. Measurable residual disease (MRD) was assessed after cycle 9. When MRD was ≥0.01%, patients continued with the treatment until relapse or progressive disease. Patients with MRD < 0.01% suspended treatment to enter the follow-up phase. RESULTS The complete remission (CR) rate after 3 cycles was significantly better in the FLUGA arm (18% vs 9%; P = .04), but the CR/CR with incomplete recovery rate at 9 months was similar (33% vs 29%; P = .41). There were no significant differences between arms in early mortality at 30 or 60 days. Hematologic toxicities were more frequent with FLUGA, especially during induction. The 1-year overall survival (OS) rate and the median OS were superior with AZA versus FLUGA: 47% versus 27% and 9.8 months (95% confidence interval [CI], 5.6-14 months) versus 4.1 months (95% CI, 2.7-5.5 months; P = .005), respectively. The median event-free survival was 4.9 months (95% CI, 2.8-7 months) with AZA and 3 months (95% CI, 2.5-3.5 months) with FLUGA (P = .001). CONCLUSIONS FLUGA achieved more remissions after 3 cycles, but the 1-year OS rate was superior with AZA. However, long-term outcomes were disappointing in both arms (3-year OS rate, 10% vs 5%). This study supports the use of an AZA backbone for future combinations in elderly patients with AML.
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Affiliation(s)
- Susana Vives
- Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Spain.,José Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Spanish Biomedical Research Centre in Cancer, Carlos III Institute, Madrid, Spain
| | | | | | - Mar Tormo
- Hospital Clínic de Valencia (INCLIVA), Valencia, Spain
| | | | | | | | | | | | | | | | - Cristina Gil
- Hospital General Universitario de Alicante, Alicante, Spain
| | - Belén Vidriales
- Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Jose F Falantes
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Seville, Spain
| | | | | | | | | | | | | | | | - Adriana Gascón
- Hospital General Universitari de Castelló, Castelló, Spain
| | | | | | | | - Rebeca Rodríguez-Veiga
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Spanish Biomedical Research Centre in Cancer, Carlos III Institute, Madrid, Spain
| | - Olga García
- Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Badalona, Spain.,José Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Eva Barragán
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Spanish Biomedical Research Centre in Cancer, Carlos III Institute, Madrid, Spain
| | - Bruno Paiva
- Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Miguel Á Sanz
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Spanish Biomedical Research Centre in Cancer, Carlos III Institute, Madrid, Spain
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Spanish Biomedical Research Centre in Cancer, Carlos III Institute, Madrid, Spain
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20
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Acha P, Hoyos M, Pratcorona M, Fuster-Tormo F, Palomo L, Ortega E, Zamora L, Vives S, Granada I, Montoro J, Garcia A, Arnan M, Cervera M, Canet M, Gallardo D, Arenillas L, Esteve J, Baragay J, Salamero O, Motlló C, Ortín X, Sierra J, Solé F. Genetic characterization of acute myeloid leukemia patients with mutations in IDH1/2 genes. Leuk Res 2021; 101:106492. [PMID: 33494038 DOI: 10.1016/j.leukres.2020.106492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/01/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Pamela Acha
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Montserrat Hoyos
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Marta Pratcorona
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Francisco Fuster-Tormo
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Laura Palomo
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Esther Ortega
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lurdes Zamora
- Hematology Service, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Susana Vives
- Hematology Service, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Isabel Granada
- Hematology Service, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Julia Montoro
- Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Antoni Garcia
- Hematology Service, Hospital Universitari Arnau Vilanova, Lleida, Spain
| | - Montserrat Arnan
- Hematology Service, Institut Català d'Oncologia-Hospital Duran i Reynals, Barcelona, Spain
| | - Marta Cervera
- Hematology Service, Hospital Universitari Joan XXIII de Tarragona, Tarragona, Spain
| | - Marta Canet
- Hematology Service, Hospital Universitari Mútua Terrassa, Terrassa, Spain
| | - David Gallardo
- Institut Català d'Oncologia-Hospital Dr. Josep trueta, Girona, Spain
| | | | - Jordi Esteve
- Hematology Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Joan Baragay
- Hematology Service, Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain
| | - Olga Salamero
- Hospital Universitari, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | | | - Xavier Ortín
- Hematology Service, Hospital de Tortosa Verge de la Cinta, Tortosa, Spain
| | - Jordi Sierra
- Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Francesc Solé
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.
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21
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Rodríguez-Arbolí E, Martínez-Cuadrón D, Rodríguez-Veiga R, Carrillo-Cruz E, Gil-Cortés C, Serrano-López J, Bernal Del Castillo T, Martínez-Sánchez MDP, Rodríguez-Medina C, Vidriales B, Bergua JM, Benavente C, García-Boyero R, Herrera-Puente P, Algarra L, Sayas-Lloris MJ, Fernández R, Labrador J, Lavilla-Rubira E, Barrios-García M, Tormo M, Serrano-Maestro A, Sossa-Melo CL, García-Belmonte D, Vives S, Rodríguez-Gutiérrez JI, Albo-López C, Garrastazul-Sánchez MP, Colorado-Araujo M, Mariz J, Sanz MÁ, Pérez-Simón JA, Montesinos P. Long-Term Outcomes After Autologous Versus Allogeneic Stem Cell Transplantation in Molecularly-Stratified Patients With Intermediate Cytogenetic Risk Acute Myeloid Leukemia: A PETHEMA Study. Transplant Cell Ther 2021; 27:311.e1-311.e10. [PMID: 33836871 DOI: 10.1016/j.jtct.2020.12.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/20/2020] [Accepted: 12/24/2020] [Indexed: 12/12/2022]
Abstract
Acute myeloid leukemia (AML) with intermediate risk cytogenetics (IRcyto) comprises a variety of biological entities with distinct mutational landscapes that translate into differential risks of relapse and prognosis. Optimal postremission therapy choice in this heterogeneous patient population is currently unsettled. In the current study, we compared outcomes in IRcyto AML recipients of autologous (autoSCT) (n = 312) or allogeneic stem cell transplantation (alloSCT) (n = 279) in first complete remission (CR1). Molecular risk was defined based on CEBPA, NPM1, and FLT3-ITD mutational status, per European LeukemiaNet 2017 criteria. Five-year overall survival (OS) in patients with favorable molecular risk (FRmol) was 62% (95% confidence interval [CI], 50-72) after autoSCT and 66% (95% CI, 41-83) after matched sibling donor (MSD) alloSCT (P = .68). For patients of intermediate molecular risk (IRmol), MSD alloSCT was associated with lower cumulative incidence of relapse (P < .001), as well as with increased nonrelapse mortality (P = .01), as compared to autoSCT. The 5-year OS was 47% (95% CI, 34-58) after autoSCT and 70% (95% CI, 59-79) after MSD alloSCT (P = .02) in this patient subgroup. In a propensity-score matched IRmol subcohort (n = 106), MSD alloSCT was associated with superior leukemia-free survival (hazard ratio [HR] 0.33, P = .004) and increased OS in patients alive 1 year after transplantation (HR 0.20, P = .004). These results indicate that, within IRcyto AML in CR1, autoSCT may be a valid option for FRmol patients, whereas MSD alloSCT should be the preferred postremission strategy in IRmol patients.
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Affiliation(s)
- Eduardo Rodríguez-Arbolí
- Department of Hematology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), University of Seville, Seville, Spain
| | | | | | - Estrella Carrillo-Cruz
- Department of Hematology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), University of Seville, Seville, Spain
| | - Cristina Gil-Cortés
- Department of Hematology, Hospital General Universitario de Alicante, Alicante, Spain
| | - Josefina Serrano-López
- Department of Hematology, Reina Sofía University Hospital/Maimónides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba, Córdoba, Spain
| | | | | | - Carlos Rodríguez-Medina
- Department of Hematology, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Spain
| | - Belén Vidriales
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC- CB16/12/00233 and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Juan Miguel Bergua
- Department of Hematology, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Celina Benavente
- Department of Hematology, Hospital Clínico San Carlos, Madrid, Spain
| | - Raimundo García-Boyero
- Department of Hematology, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
| | | | - Lorenzo Algarra
- Department of Hematology, Hospital General de Albacete, Albacete, Spain
| | | | - Rosa Fernández
- Department of Hematology, Hospital Universitario Insular de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Jorge Labrador
- Department of Hematology and Research Unit, Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Mar Tormo
- Deparment of Hematology, Hospital Clínico Universitario de Valencia, Instituto de Investigación INCLIVA, Valencia, Spain
| | | | | | | | - Susana Vives
- Department of Hematology - ICO Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Badalona , Spain
| | | | - Carmen Albo-López
- Department of Hematology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | | | - José Mariz
- Department of Hematology, Instituto Português de Oncologia do Porto FG, Porto, Portugal
| | - Miguel Ángel Sanz
- Department of Hematology, Hospital Universitario La Fe, Valencia, Spain
| | - José Antonio Pérez-Simón
- Department of Hematology, Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), University of Seville, Seville, Spain.
| | - Pau Montesinos
- Department of Hematology, Hospital Universitario La Fe, Valencia, Spain
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22
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Sitges M, Vives S, Ribera JM. Blastic plasmacytoid dendritic cell neoplasm. A study of three cases. Med Clin (Barc) 2020; 154:524-525. [PMID: 31350059 DOI: 10.1016/j.medcli.2019.04.029] [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] [Received: 03/12/2019] [Revised: 04/11/2019] [Accepted: 04/25/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Marta Sitges
- Servicio de Hematología Clínica, ICO-Badalona, Hospital Germans Trias i Pujol, Badalona, España; Instituto de Investigación contra la Leucemia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, España.
| | - Susana Vives
- Servicio de Hematología Clínica, ICO-Badalona, Hospital Germans Trias i Pujol, Badalona, España; Instituto de Investigación contra la Leucemia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, España
| | - Josep-Maria Ribera
- Servicio de Hematología Clínica, ICO-Badalona, Hospital Germans Trias i Pujol, Badalona, España; Instituto de Investigación contra la Leucemia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, España
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23
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Sitges M, Boluda B, Garrido A, Morgades M, Granada I, Barragan E, Arnan M, Serrano J, Tormo M, Miguel Bergua J, Colorado M, Salamero O, Esteve J, Benavente C, Pérez-Encinas M, Coll R, Martí-Tutusaus JM, Brunet S, Sierra J, Ángel Sanz M, Montesinos P, Ribera JM, Vives S. Acute myeloid leukemia with inv(3)(q21.3q26.2)/t(3;3)(q21.3;q26.2): Study of 61 patients treated with intensive protocols. Eur J Haematol 2020; 105:138-147. [PMID: 32243655 DOI: 10.1111/ejh.13417] [Citation(s) in RCA: 8] [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: 02/23/2020] [Accepted: 03/17/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Inv(3)(q21.3q26.2)/t(3;3)(q21.3;q26.2) is a rare poor prognosis cytogenetic abnormality present in acute myeloid leukemia (AML) and other myeloid neoplasms. OBJECTIVE The aim of this study was to evaluate the outcome of a cohort of 61 patients with newly diagnosed AML with inv(3)/t(3;3) treated with homogeneous intensive chemotherapy protocols conducted by the Spanish PETHEMA and CETLAM cooperative groups between 1999 and 2017. METHODS In this retrospective study the main clinical and biologic parameters were collected. The complete response (CR) rate, the cumulative incidence of relapse (CIR) and the overall survival (OS) were calculated. An analysis of prognostic factors for survival was performed. RESULTS Sixty-one patients received induction and only 18 (29%) achieved CR (median age, 46 years). Allogeneic hematopoietic stem cell transplantation (alloHSCT) was performed in 36 patients (59%), 15 with active disease. One- and 4-year CIR were 52% and 56%. One- and 4-year OS probabilities were 41% and 13%. By multivariate analysis monosomal karyotype (MK) was associated with poorer OS (HR 2.0, P = .017). CONCLUSION Inv(3)/t(3;3) AML is a poor prognosis entity with low response to standard chemotherapy and to alloHSCT because of frequent and early relapse. MK was associated with a poorer prognosis. Improved therapeutic strategies are clearly needed.
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Affiliation(s)
- Marta Sitges
- Hematology Departments of ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain.,ICO-Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Blanca Boluda
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Ana Garrido
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mireia Morgades
- Hematology Departments of ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Isabel Granada
- Hematology Departments of ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Eva Barragan
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Montserrat Arnan
- ICO-Hospital Duran i Reynals, IDIBELL, L'Hospitalet de Llobregat, Llobregat, Spain
| | | | - Mar Tormo
- Hospital Clínico Universitario, Valencia, Spain
| | | | | | - Olga Salamero
- Hospital Universitari Vall d'Hebron/VHIO, Barcelona, Spain
| | | | | | | | - Rosa Coll
- ICO-Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | | | - Salut Brunet
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Jorge Sierra
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Josep-Maria Ribera
- Hematology Departments of ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Susana Vives
- Hematology Departments of ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
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24
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Bataller A, Oñate G, Diaz-Beyá M, Guijarro F, Garrido A, Vives S, Tormo M, Arnan M, Salamero O, Sampol A, Coll R, Vall-Llovera F, Oliver-Caldés A, López-Guerra M, Pratcorona M, Zamora L, Villamon E, Roué G, Blanco A, Nomdedeu JF, Colomer D, Brunet S, Sierra J, Esteve J. Acute myeloid leukemia with NPM1 mutation and favorable European LeukemiaNet category: outcome after preemptive intervention based on measurable residual disease. Br J Haematol 2020; 191:52-61. [PMID: 32510599 DOI: 10.1111/bjh.16857] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/18/2020] [Indexed: 01/22/2023]
Abstract
In the European LeukemiaNet favourable risk category, allogeneic haematopoietic stem cell transplantation (alloSCT) is not indicated in first complete remission for patients with acute myeloid leukaemia (AML) with NPM1 mutations (ELNfav NPM1 AML), although a proportion of these patients will relapse. Given the prognostic importance of measurable residual disease (MRD), CETLAM-12 considered a pre-emptive intervention in patients with molecular failure (MF). We analyzed 110 ELNfav NPM1 AML patients achieving complete remission (CR) after induction chemotherapy. Two-year cumulative incidence of relapse (CIR), overall survival (OS) and leukaemia-free survival (LFS) were 17%, 81·5% and 82%, respectively. Forty-six patients required additional therapy for MF (n = 33) or haematological relapse (HemR; n = 13), resulting in a molecular LFS (molLFS) and a cumulative incidence of MF at two years of 61% and 38% respectively. Two-year OS for these 46 patients was 66%, with a different outcome between patients with MF (86%) and HemR (42%) (P = 0·002). Quantitative NPM1 detection at different timepoints was predictive of molLFS; an MRD ratio (NPM1mut/ABL1 × 100) cut-off of 0·05 after first consolidation identified two cohorts with a two-year molLFS of 77% and 40% for patients below and above 0·05, respectively. In conclusion, MRD-based pre-emptive intervention resulted in a favourable outcome for ELNfav NPM1 AML patients.
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Affiliation(s)
- Alex Bataller
- Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Guadalupe Oñate
- Hematology Department, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - Marina Diaz-Beyá
- Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Francesca Guijarro
- Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Ana Garrido
- Hematology Department, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - Susana Vives
- Hematology Department, ICO - Hospital Germans Trias i Pujol, Badalona, Spain
| | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Montserrat Arnan
- Hematology Department, ICO - Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Olga Salamero
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Antònia Sampol
- Hematology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Rosa Coll
- Hematology Department, ICO - Hospital Universitari Dr. Josep Trueta, Girona, Spain
| | - Ferran Vall-Llovera
- Hematology Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Aina Oliver-Caldés
- Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Mònica López-Guerra
- Hematopathology Section, Hospital Clínic, IDIBAPS, CIBERONC, UB, Barcelona, Spain
| | - Marta Pratcorona
- Hematology Department, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - Lurdes Zamora
- Hematology Department, ICO - Hospital Germans Trias i Pujol, Badalona, Spain
| | - Eva Villamon
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Gaël Roué
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Adoración Blanco
- Hematology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep F Nomdedeu
- Hematology Department, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - Dolors Colomer
- Hematopathology Section, Hospital Clínic, IDIBAPS, CIBERONC, UB, Barcelona, Spain
| | - Salut Brunet
- Hematology Department, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - Jorge Sierra
- Hematology Department, Hospital de la Santa Creu i Sant Pau, UAB, Barcelona, Spain
| | - Jordi Esteve
- Hematology Department, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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25
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Baroni ML, Sanchez Martinez D, Gutierrez Aguera F, Roca Ho H, Castella M, Zanetti SR, Velasco Hernandez T, Diaz de la Guardia R, Castaño J, Anguita E, Vives S, Nomdedeu J, Lapillone H, Bras AE, van der Velden VHJ, Junca J, Marin P, Bataller A, Esteve J, Vick B, Jeremias I, Lopez A, Sorigue M, Bueno C, Menendez P. 41BB-based and CD28-based CD123-redirected T-cells ablate human normal hematopoiesis in vivo. J Immunother Cancer 2020; 8:e000845. [PMID: 32527933 PMCID: PMC7292050 DOI: 10.1136/jitc-2020-000845] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Acute myeloid leukemia (AML) is a hematopoietic malignancy which is biologically, phenotypically and genetically very heterogeneous. Outcome of patients with AML remains dismal, highlighting the need for improved, less toxic therapies. Chimeric antigen receptor T-cell (CART) immunotherapies for patients with refractory or relapse (R/R) AML are challenging because of the absence of a universal pan-AML target antigen and the shared expression of target antigens with normal hematopoietic stem/progenitor cells (HSPCs), which may lead to life-threating on-target/off-tumor cytotoxicity. CD33-redirected and CD123-redirected CARTs for AML are in advanced preclinical and clinical development, and they exhibit robust antileukemic activity. However, preclinical and clinical controversy exists on whether such CARTs are myeloablative. METHODS We set out to comparatively characterize in vitro and in vivo the efficacy and safety of 41BB-based and CD28-based CARCD123. We analyzed 97 diagnostic and relapse AML primary samples to investigate whether CD123 is a suitable immunotherapeutic target, and we used several xenograft models and in vitro assays to assess the myeloablative potential of our second-generation CD123 CARTs. RESULTS Here, we show that CD123 represents a bona fide target for AML and show that both 41BB-based and CD28-based CD123 CARTs are very efficient in eliminating both AML cell lines and primary cells in vitro and in vivo. However, both 41BB-based and CD28-based CD123 CARTs ablate normal human hematopoiesis and prevent the establishment of de novo hematopoietic reconstitution by targeting both immature and myeloid HSPCs. CONCLUSIONS This study calls for caution when clinically implementing CD123 CARTs, encouraging its preferential use as a bridge to allo-HSCT in patients with R/R AML.
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Affiliation(s)
- Matteo Libero Baroni
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | - Diego Sanchez Martinez
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | | | - Heleia Roca Ho
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | - Maria Castella
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | - Samanta Romina Zanetti
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | - Talia Velasco Hernandez
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | | | - Julio Castaño
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
| | - Eduardo Anguita
- Hematology and Hemotherapy Department, Hospital Clinico Universitario San Carlos Instituto Cardiovascular, Madrid, Comunidad de Madrid, Spain
| | - Susana Vives
- Hematology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain
| | - Josep Nomdedeu
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya, Spain
| | - Helene Lapillone
- Centre de Recherce Saint-Antoine, Armand-Trousseau Childrens Hospital, Paris, Île-de-France, France
| | - Anne E Bras
- Immunology Department, Erasmus Medical Center, Rotterdam, Zuid-Holland, Netherlands
| | | | - Jordi Junca
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
- Hematology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain
| | - Pedro Marin
- Hematology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Alex Bataller
- Hematology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Jordi Esteve
- Hematology Department, Hospital Clinic de Barcelona, Barcelona, Catalunya, Spain
| | - Binje Vick
- Helmholtz Center, Munich German Research Center for Environmental Health, Neuherberg, Bayern, Germany
| | - Irmela Jeremias
- Helmholtz Center, Munich German Research Center for Environmental Health, Neuherberg, Bayern, Germany
- Pediatrics Department, Munich University Hospital Dr von Hauner Children's Hospital, Munchen, Bayern, Germany
| | - Angel Lopez
- Human Immunology Department, Centre for Cancer Biology, Adelaide, South Australia, Australia
| | - Marc Sorigue
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
- Hematology Department, Hospital Universitari Germans Trias i Pujol, Badalona, Catalunya, Spain
| | - Clara Bueno
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
- Centro de investigación en Red-Oncología, CIBERONC, Comunidad de Madrid, Madrid, Spain
| | - Pablo Menendez
- Biomedicine, Research Institute Against Leukemia Josep Carreras, Barcelona, Catalunya, Spain
- Centro de investigación en Red-Oncología, CIBERONC, Comunidad de Madrid, Madrid, Spain
- Instituciò Catalana de Recerca i Estudis Avançats, ICREA, Barcelona, Catalunya, Spain
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26
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Sánchez R, Ribera J, Morgades M, Ayala R, Onecha E, Ruiz-Heredia Y, Juárez-Rufián A, de Nicolás R, Sánchez-Pina J, Vives S, Zamora L, Mercadal S, Coll R, Cervera M, García O, Ribera JM, Martínez-López J. A novel targeted RNA-Seq panel identifies a subset of adult patients with acute lymphoblastic leukemia with BCR-ABL1-like characteristics. Blood Cancer J 2020; 10:43. [PMID: 32332702 PMCID: PMC7182567 DOI: 10.1038/s41408-020-0308-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/23/2020] [Accepted: 04/01/2020] [Indexed: 12/16/2022] Open
Abstract
BCR-ABL1-like B-cell precursor acute lymphoblastic leukemia (BCP-ALL) remains poorly characterized in adults. We sought to establish the frequency and outcome of adolescent and adult BCR-ABL1-like ALL using a novel RNA-Seq signature in a series of patients with BCP-ALL. To this end, we developed and tested an RNA-Seq custom panel of 42 genes related to a BCR-ABL1-like signature in a cohort of 100 patients with BCP-ALL and treated with risk-adapted ALL trials. Mutations related to BCR-ABL1-like ALL were studied in a panel of 33 genes by next-generation sequencing (NGS). Also, CRLF2 overexpression and IKZF1/CDKN2A/B deletions were analyzed. Twenty out of 79 patients (12–84 years) were classified as BCR-ABL1-like (25%) based on heatmap clustering, with significant overexpression of ENAM, IGJ, and CRLF2 (P ≤ 0.001). The BCR-ABL1-like subgroup accounted for 29% of 15–60-year-old patients, with the following molecular characteristics: CRLF2 overexpression (75% of cases), IKZF1 deletions (64%), CDKN2A/B deletions (57%), and JAK2 mutations (57%). Among patients with postinduction negative minimal residual disease, those with the BCR-ABL1-like ALL signature had a higher rate of relapse and lower complete response duration than non-BCR-ABL1-like patients (P = 0.007). Thus, we have identified a new molecular signature of BCR-ABL1-like ALL that correlates with adverse prognosis in adult patients with ALL.
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Affiliation(s)
- Ricardo Sánchez
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain. .,Instituto de Investigación Hospital 12 Octubre (i+12), Madrid, Spain. .,Haematological Malignancies Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.
| | - Jordi Ribera
- Hematology Department, ICO - Hospital Germans Trias i Pujol. Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Mireia Morgades
- Hematology Department, ICO - Hospital Germans Trias i Pujol. Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Rosa Ayala
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.,Instituto de Investigación Hospital 12 Octubre (i+12), Madrid, Spain.,Haematological Malignancies Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain.,Universidad Complutense de Madrid, Madrid, Spain
| | - Esther Onecha
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.,Instituto de Investigación Hospital 12 Octubre (i+12), Madrid, Spain
| | | | | | - Rodrigo de Nicolás
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - José Sánchez-Pina
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Susana Vives
- Hematology Department, ICO - Hospital Germans Trias i Pujol. Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lurdes Zamora
- Hematology Department, ICO - Hospital Germans Trias i Pujol. Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Santiago Mercadal
- Hematology Department, ICO - Hospital Duran i Reynals (Bellvitge), Barcelona, Spain
| | - Rosa Coll
- Hematology Department, ICO - Hospital Dr. Josep Trueta, Girona, Spain
| | - Marta Cervera
- Hematology Department, ICO - Hospital Universitari Joan XXIII, Tarragona, Spain
| | - Olga García
- Hematology Department, ICO - Hospital Germans Trias i Pujol. Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep-Maria Ribera
- Hematology Department, ICO - Hospital Germans Trias i Pujol. Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Joaquín Martínez-López
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain. .,Instituto de Investigación Hospital 12 Octubre (i+12), Madrid, Spain. .,Haematological Malignancies Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain. .,Centro de Investigación Biomédica en Red Cáncer (CIBERONC), Madrid, Spain. .,Universidad Complutense de Madrid, Madrid, Spain.
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27
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Ribera JM, Morgades M, Montesinos P, Tormo M, Martínez-Carballeira D, González-Campos J, Gil C, Barba P, García-Boyero R, Coll R, Pedreño M, Ribera J, Mercadal S, Vives S, Novo A, Genescà E, Hernández-Rivas JM, Bergua J, Amigo ML, Vall-Llovera F, Martínez-Sánchez P, Calbacho M, García-Cadenas I, Garcia-Guiñon A, Sánchez-Sánchez MJ, Cervera M, Feliu E, Orfao A. A pediatric regimen for adolescents and young adults with Philadelphia chromosome-negative acute lymphoblastic leukemia: Results of the ALLRE08 PETHEMA trial. Cancer Med 2020; 9:2317-2329. [PMID: 32022463 PMCID: PMC7131850 DOI: 10.1002/cam4.2814] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 09/17/2019] [Revised: 12/12/2019] [Accepted: 12/16/2019] [Indexed: 11/19/2022] Open
Abstract
Background Pediatric‐based or ‐inspired trials have improved the prognosis of adolescents and young adults (AYA) with Philadelphia chromosome‐negative (Ph‐neg) acute lymphoblastic leukemia (ALL). Methods This study reports the results of treatment of the ALLRE08 trial, a full pediatric trial for AYA aged 15‐30 years with standard‐risk (SR) ALL. Results From 2008 to 2018, 89 patients (38 adolescents [15‐18 years] and 51 young adults [YA, 19‐30 years], median age: 20 [15‐29] years) were enrolled in the ALLRE08 trial. The complete response (CR) was 95%. Twenty‐two patients were transferred to a high‐risk (HR) protocol because of poor marrow response on day 14 (n = 20) or high‐level of end‐induction minimal residual response (MRD ≥ 0.25%, n = 2). Cumulative incidence of relapse (CIR) at 5 years was 35% (95%CI: 23%‐47%), with significant differences between adolescents and YA: 13% (4%‐28%) vs 52% (34%‐67%), P = .012. No treatment‐related mortality was observed in 66/66 patients following the ALLRE08 trial vs 3/23 patients moved to a HR trial. The estimated 5‐year overall survival (OS) was 74% (95%CI: 63%‐85%), with significantly higher rates for adolescents vs YA: 87% (95%CI: 74%‐100%) vs 63% (46%‐80%), P = .021. Although CIR or OS were lower in patients who were transferred to a HR trial, the differences were not statistically significant (CIR: 34% [21%‐47%] vs 37% [14%‐61%]; OS: 78% [66%‐90%] vs 61% [31%;91%]). Conclusion A full pediatric trial is feasible and effective for AYA with Ph‐neg, SR‐ALL, with better results for adolescents than for YA. Outcome of patients with poor early response rescued with a HR trial was not significantly inferior.
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Affiliation(s)
- Josep-Maria Ribera
- Departments of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Morgades
- Departments of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pau Montesinos
- Departments of Clinical Hematology, Hospital Universitari i Politècnic La Fe, CIBERONC, Instituto Carlos III, Valencia, Spain, Madrid, Spain
| | - Mar Tormo
- Departments of Clinical Hematology, Hospital Clínico Valencia, Valencia, Spain
| | | | - José González-Campos
- Departments of Clinical Hematology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Cristina Gil
- Departments of Clinical Hematology, Hospital General Universitario de Alicante, Alicante, Spain
| | - Pere Barba
- Departments of Clinical Hematology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Raimundo García-Boyero
- Departments of Clinical Hematology, Hospital General Universitario de Castellón, Castelló, Spain
| | - Rosa Coll
- Departments of Clinical Hematology, ICO-Hospital Josep Trueta, Girona, Spain
| | - María Pedreño
- Departments of Clinical Hematology, Hospital Dr. Peset, Valencia, Spain
| | - Jordi Ribera
- Departments of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Santiago Mercadal
- Departments of Clinical Hematology, ICO-Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Susana Vives
- Departments of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andrés Novo
- Departments of Clinical Hematology, Hospital Son Espases, Palma de Mallorca, Spain
| | - Eulàlia Genescà
- Departments of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesús-María Hernández-Rivas
- Departments of Clinical Hematology, Hospital Clínico Universitario, Cancer Research Center (IBMCC-CSIC/USAL), Cytometry Service CIBERONC, Salamanca, Spain
| | - Juan Bergua
- Departments of Clinical Hematology, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - María-Luz Amigo
- Departments of Clinical Hematology, Hospital Morales Meseguer, Murcia, Spain
| | - Ferran Vall-Llovera
- Departments of Clinical Hematology, Hospital Mútua de Terrassa, Terrassa, Spain
| | | | - María Calbacho
- Departments of Clinical Hematology, Hospital Ramón y Cajal, Madrid, Spain
| | | | | | | | - Marta Cervera
- Departments of Clinical Hematology, ICO-Hospital Joan XXIII, Tarragona, Spain
| | - Evarist Feliu
- Departments of Clinical Hematology, ICO-Hospital Germans Trias i Pujol. Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alberto Orfao
- Departments of Clinical Hematology, Hospital Clínico Universitario, Cancer Research Center (IBMCC-CSIC/USAL), Cytometry Service CIBERONC, Salamanca, Spain
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Diaz de la Guardia R, González-Silva L, López-Millán B, Rodríguez-Sevilla JJ, Baroni ML, Bueno C, Anguita E, Vives S, Palomo L, Lapillonne H, Varela I, Menendez P. Bone Marrow Clonogenic Myeloid Progenitors from NPM1-Mutated AML Patients Do Not Harbor the NPM1 Mutation: Implication for the Cell-Of-Origin of NPM1+ AML. Genes (Basel) 2020; 11:genes11010073. [PMID: 31936647 PMCID: PMC7017102 DOI: 10.3390/genes11010073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/05/2020] [Accepted: 01/07/2020] [Indexed: 11/24/2022] Open
Abstract
The cell-of-origin of NPM1- and FLT3-mutated acute myeloid leukemia (AML) is still a matter of debate. Here, we combined in vitro clonogenic assays with targeted sequencing to gain further insights into the cell-of-origin of NPM1 and FLT3-ITD-mutated AML in diagnostic bone marrow (BM) from nine NPM1+/FLT3-ITD (+/−) AMLs. We reasoned that individually plucked colony forming units (CFUs) are clonal and reflect the progeny of a single stem/progenitor cell. NPM1 and FLT3-ITD mutations seen in the diagnostic blasts were found in only 2/95 and 1/57 individually plucked CFUs, suggesting that BM clonogenic myeloid progenitors in NPM1-mutated and NPM1/FLT3-ITD-mutated AML patients do not harbor such molecular lesions. This supports previous studies on NPM1 mutations as secondary mutations in AML, likely acquired in an expanded pool of committed myeloid progenitors, perhaps CD34−, in line with the CD34−/low phenotype of NPM1-mutated AMLs. This study has important implications on the cell-of-origin of NPM1+ AML, and reinforces that therapeutic targeting of either NPM1 or FLT3-ITD mutations might only have a transient clinical benefit in debulking the leukemia, but is unlikely to be curative since will not target the AML-initiating/preleukemic cells. The absence of NPM1 and FLT3-ITD mutations in normal clonogenic myeloid progenitors is in line with their absence in clonal hematopoiesis of indeterminate potential.
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Affiliation(s)
- Rafael Diaz de la Guardia
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (R.D.d.l.G.); (B.L.-M.); (J.J.R.-S.); (M.L.B.); (C.B.)
| | - Laura González-Silva
- Instituto de Biomedicina y Biotecnología de Cantabria, Universidad de Cantabria-CSIC, 39011 Santander, Spain; (L.G.-S.); (I.V.)
| | - Belén López-Millán
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (R.D.d.l.G.); (B.L.-M.); (J.J.R.-S.); (M.L.B.); (C.B.)
| | - Juan José Rodríguez-Sevilla
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (R.D.d.l.G.); (B.L.-M.); (J.J.R.-S.); (M.L.B.); (C.B.)
| | - Matteo L. Baroni
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (R.D.d.l.G.); (B.L.-M.); (J.J.R.-S.); (M.L.B.); (C.B.)
| | - Clara Bueno
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (R.D.d.l.G.); (B.L.-M.); (J.J.R.-S.); (M.L.B.); (C.B.)
| | - Eduardo Anguita
- Hematology and hemotherapy Department, Hospital Clínico San Carlos, IMDL, IdISSC, Departamento de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Susana Vives
- Hematology Department, ICO-Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.V.); (L.P.)
- Josep Carreras Leukemia Research Institute, Universitat Autònoma Barcelona, 08193 Barcelona, Spain
| | - Laura Palomo
- Hematology Department, ICO-Hospital Germans Trias i Pujol, 08916 Badalona, Spain; (S.V.); (L.P.)
- Josep Carreras Leukemia Research Institute, Universitat Autònoma Barcelona, 08193 Barcelona, Spain
| | - Helene Lapillonne
- Sorbonne Université, INSERM, Centre de recherche Saint-Antoine CRSA, AP-HP, Hôspital Armand Trousseau, Haematology Laboratory, F-75012 Paris, France;
| | - Ignacio Varela
- Instituto de Biomedicina y Biotecnología de Cantabria, Universidad de Cantabria-CSIC, 39011 Santander, Spain; (L.G.-S.); (I.V.)
| | - Pablo Menendez
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (R.D.d.l.G.); (B.L.-M.); (J.J.R.-S.); (M.L.B.); (C.B.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC), ISCIII, 08036 Barcelona, Spain
- Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona 08010, Spain
- Correspondence:
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Genescà E, Morgades M, Montesinos P, Barba P, Gil C, Guàrdia R, Moreno MJ, Martínez-Carballeira D, García-Cadenas I, Vives S, Ribera J, González-Campos J, González-Gil C, Zamora L, Ramírez JL, Díaz-Beya M, Mercadal S, Artola MT, Cladera A, Tormo M, Bermúdez A, Vall-Llovera F, Martínez P, Amigo ML, Monsalvo S, Novo A, Cervera M, García-Guiñon A, Juncà J, Ciudad J, Orfao A, Ribera JM. Unique clinico-biological, genetic and prognostic features of adult early T-cell precursor acute lymphoblastic leukemia. Haematologica 2019; 105:e294-e297. [PMID: 31537688 DOI: 10.3324/haematol.2019.225078] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Eulàlia Genescà
- Josep Carreras Leukaemia Research Institute, Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - Mireia Morgades
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe & CIBERONC, Instituto Carlos III, Madrid
| | - Pere Barba
- Clinical Hematology Service, Hospital Universitari de la Vall d'Hebron, Barcelona
| | - Cristina Gil
- Clinical Hematology Service, Hospital General de Alicante, Alicante
| | - Ramon Guàrdia
- Clinical Hematology Service, Hospital Josep Trueta-ICO, Girona
| | | | | | | | - Susana Vives
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - Jordi Ribera
- Josep Carreras Leukaemia Research Institute, Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | | | - Celia González-Gil
- Josep Carreras Leukaemia Research Institute, Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - Lurdes Zamora
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - José-Luís Ramírez
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - Marina Díaz-Beya
- Clinical Hematology Service, Hospital Clínic de Barcelona, Barcelona
| | - Santiago Mercadal
- Clinical Hematology Service, Hospital Duran i Reynals-ICO, Hospitalet del Llobregat
| | | | - Antònia Cladera
- Clinical Hematology Service, Hospital Son Llàtzer, Palma de Mallorca
| | - Mar Tormo
- Clinical Hematology Service, Hospital Clínico de Valencia, Valencia
| | - Arancha Bermúdez
- Clinical Hematology Service, Hospital Marqués de Valdecilla, Santander
| | | | - Pilar Martínez
- Clinical Hematology Service, Hospital 12 de Octubre, Madrid
| | - María-Luz Amigo
- Clinical Hematology Service, Hospital Morales Meseguer, Murcia
| | - Silvia Monsalvo
- Clinical Hematology Service, Hospital Gregorio Marañón, Madrid
| | - Andrés Novo
- Clinical Hematology Service, Hospital Son Espases, Palma de Mallorca
| | - Marta Cervera
- Clinical Hematology Service, Hospital Joan XXIII, Tarragona
| | | | - Jordi Juncà
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
| | - Juana Ciudad
- Centro de Investigación del Cáncer (IBMCC-CSIC/USAL), Hospital Clínico Universitario de Salamanca, Instituto Bio-Sanitario de Salamanca, CIBERONC Salamanca, Spain
| | - Alberto Orfao
- Centro de Investigación del Cáncer (IBMCC-CSIC/USAL), Hospital Clínico Universitario de Salamanca, Instituto Bio-Sanitario de Salamanca, CIBERONC Salamanca, Spain
| | - Josep-Maria Ribera
- Josep Carreras Leukaemia Research Institute, Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona.,Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona
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30
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Ribera J, Zamora L, Morgades M, Vives S, Granada I, Montesinos P, Gómez‐Seguí I, Mercadal S, Guàrdia R, Nomdedeu J, Pratcorona M, Tormo M, Martínez‐Lopez J, Hernández‐Rivas J, Ciudad J, Orfao A, González‐Campos J, Barba P, Escoda L, Esteve J, Genescà E, Solé F, Feliu E, Ribera J. Molecular profiling refines minimal residual disease‐based prognostic assessment in adults with Philadelphia chromosome‐negative B‐cell precursor acute lymphoblastic leukemia. Genes Chromosomes Cancer 2019; 58:815-819. [DOI: 10.1002/gcc.22788] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/07/2019] [Accepted: 06/13/2019] [Indexed: 12/12/2022] Open
Affiliation(s)
- Jordi Ribera
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Lurdes Zamora
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Mireia Morgades
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Susana Vives
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Isabel Granada
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | | | | | | | - Ramon Guàrdia
- Institut Català d'OncologiaHospital Josep Trueta Girona Spain
| | - Josep Nomdedeu
- Institut de Recerca contra la Leucemia Josep CarrerasHospital Sant Pau Barcelona Spain
| | - Marta Pratcorona
- Institut de Recerca contra la Leucemia Josep CarrerasHospital Sant Pau Barcelona Spain
| | - Mar Tormo
- Hematology Department, Hospital Clínico Valencia Spain
| | | | - Jesús‐María Hernández‐Rivas
- Hospital Universitario de SalamancaUniversidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC Salamanca Spain
| | - Juana Ciudad
- Hospital Universitario de SalamancaUniversidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC Salamanca Spain
| | - Alberto Orfao
- Hospital Universitario de SalamancaUniversidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC Salamanca Spain
| | | | - Pere Barba
- Hematology Department, Hospital Vall d'Hebron Barcelona Spain
| | - Lourdes Escoda
- Institut Català d'OncologiaHospital Joan XXIII Tarragona Spain
| | - Jordi Esteve
- Institut de Recerca contra la Leucemia Josep CarrerasHospital Clínic Barcelona Spain
| | - Eulàlia Genescà
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Francesc Solé
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Evarist Feliu
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
| | - Josep‐Maria Ribera
- Institut de Recerca Contra la Leucemia Josep Carreras, Hospital Germans Trias i PujolUniversitat Autònoma de Barcelona, Institut Català d'Oncologia, Hospital Germans Trias i Pujol Barcelona Spain
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31
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Salamero O, Martínez-Cuadrón D, Sobas M, Benavente C, Vives S, De la Serna J, Pérez-Encinas M, Escoda L, Gil C, Brunet S, Ramos F, Esteve J, Amigo M, Krsnik I, Manso F, Arias J, González-Campos J, Serrano J, Oleksiuk J, Barrios M, García-Boyero R, Novo A, Sanz MA, Montesinos P. Real life outcomes of patients aged ≥75 years old with acute promyelocytic leukemia: experience of the PETHEMA registry. Leuk Lymphoma 2019; 60:2720-2732. [PMID: 31068052 DOI: 10.1080/10428194.2019.1607327] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Acute promyelocytic leukemia is infrequent among patients aged ≥75 years old, a population that is rarely eligible for clinical protocols. This study aims to analyze the treatment strategies and clinical outcomes of very old APL patients reported to the international PETHEMA registry. Between 1997 and 2017, among 2501 APL cases registered 120 were ≥75 years old. Treatment approaches were: AIDA regimen, 79 patients; ATRA alone, 23; 16, supportive care (SC) and 2, other strategies. Patients treated with AIDA were younger, had better ECOG and lower leukocytes. Complete remission (CR) was achieved in 65% of AIDA-group vs. 45% in the ATRA-group, being infections followed by bleeding the most frequent causes of induction death. Patients in CR after AIDA showed 3-year DFS of 73%. Our real-life series of very old APL patients provides a reference basis for future treatment strategies aiming to improve clinical outcomes in this challenging population.
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Affiliation(s)
- Olga Salamero
- UAB-Medicine Department, Hospital Universitario Vall d'Hebron, VHIO, Barcelona, Spain
| | - David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Marta Sobas
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | | | - Susana Vives
- ICO-Hospital Universitari Germans Trias i Pujol, Jose Carreras Research Institute, Badalona, Spain
| | | | | | | | | | - Salut Brunet
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | | | | - Félix Manso
- Hospital General de Albacete, Albacete, Spain
| | - Jesús Arias
- Hospital Universitario Lucus Augusti, Lugo, Spain
| | | | | | | | - Manuel Barrios
- Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | | | - Andrés Novo
- Hospital Universitari Son Espases, Palma, Spain
| | - Miguel A Sanz
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
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32
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Ribera J, García O, Moreno M, Barba P, García‐Cadenas I, Mercadal S, Montesinos P, Barrios M, González‐Campos J, Martínez‐Carballeira D, Gil C, Ribera J, Vives S, Novo A, Cervera M, Serrano J, Lavilla E, Abella E, Tormo M, Amigo M, Artola M, Genescà E, Bravo P, García‐Belmonte D, García‐Guiñón A, Hernández‐Rivas J, Feliu E. Incidence and outcome after first molecular versus overt recurrence in patients with Philadelphia chromosome–positive acute lymphoblastic leukemia included in the ALL Ph08 trial from the Spanish PETHEMA Group. Cancer 2019; 125:2810-2817. [DOI: 10.1002/cncr.32156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 01/13/2023]
Affiliation(s)
- Josep‐Maria Ribera
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Olga García
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - María‐José Moreno
- Department of Hematology Hospital of the Virgen de la Victoria Malaga Spain
| | - Pere Barba
- Department of Hematology Vall d’Hebron University Hospital, Autonomous University of Barcelona Barcelona Spain
| | | | - Santiago Mercadal
- Department of Hematology ICO‐Hospital Duran i Reynals, L’Hospitalet de Llobregat Catalonia Spain
| | - Pau Montesinos
- Department of Hematology Le Fe University and Polytechnic Hospital Valencia Spain
| | - Manuel Barrios
- Department of Hematology Carlos Haya Hospital Malaga Spain
| | | | | | - Cristina Gil
- Department of Hematology General University Hospital of Alicante Alicante Spain
| | - Jordi Ribera
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Susana Vives
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Andrés Novo
- Department of Hematology Son Espases Hospital Palma de Mallorca Spain
| | - Marta Cervera
- Department of Hematology ICO‐Hospital Joan XXIII Tarragona Spain
| | | | | | - Eugenia Abella
- Department of Hematology del Mar Hospital Barcelona Spain
| | - Mar Tormo
- Department of Hematology Clinical Hospital Valencia Spain
| | - María‐Luz Amigo
- Department of Hematology Morales Meseguer University General Hospital Murcia Spain
| | | | - Eulalia Genescà
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
| | - Pilar Bravo
- Department of Hematology Fuenlabrada University Hospital Madrid Spain
| | | | | | | | - Evarist Feliu
- Department of Clinical Hematology ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Autonomous University of Barcelona Badalona Spain
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33
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Ribera J, Granada I, Morgades M, Vives S, Genescà E, González C, Nomdedeu J, Escoda L, Montesinos P, Mercadal S, Coll R, González-Campos J, Abella E, Barba P, Bermúdez A, Gil C, Tormo M, Pedreño M, Martínez-Carballeira D, Hernández-Rivas JM, Orfao A, Martínez-López J, Esteve J, Bravo P, Garcia-Guiñon A, Debén G, Moraleda JM, Queizán JA, Ortín X, Moreno MJ, Feliu E, Solé F, Ribera JM. The poor prognosis of low hypodiploidy in adults with B-cell precursor acute lymphoblastic leukaemia is restricted to older adults and elderly patients. Br J Haematol 2019; 186:263-268. [PMID: 30916384 DOI: 10.1111/bjh.15887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 02/06/2019] [Indexed: 11/28/2022]
Abstract
The prognostic significance of low-hypodiploidy has not been extensively evaluated in minimal residual disease (MRD)-oriented protocols for adult acute lymphoblastic leukaemia (ALL). We analysed the outcome of hypodiploid adult ALL patients treated within Programa Español de Tratamientos en Hematología (PETHEMA) protocols. The 5-year cumulative incidence of relapse (CIR) of low-hypodiploid B-cell precursor (BCP)-ALL was significantly higher than that of high-hypodiploids (52% vs. 12%, P = 0.013). Low-hypodiploid BCP-ALL patients aged ≤35 years showed superior survival (71% vs. 21%, P = 0.026) and lower 5-year CIR (17% vs. 66%, P = 0.090) than low-hypodiploids aged >35 years. Older adults and elderly low-hypodiploid BCP-ALL patients show dismal prognosis although achieving an end-induction good MRD response.
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Affiliation(s)
- Jordi Ribera
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Isabel Granada
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Mireia Morgades
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Susana Vives
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Eulàlia Genescà
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Celia González
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep Nomdedeu
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Sant Pau, Barcelona, Spain
| | - Lourdes Escoda
- Institut Català d'Oncologia, Hospital Joan XXIII, Tarragona, Spain
| | | | - Santiago Mercadal
- Institut Català d'Oncologia, Hospital Duran i Reynals, Hospitalet de Llobregat, Llobregat, Spain
| | - Rosa Coll
- Institut Català d'Oncologia, Hospital Josep Trueta, Girona, Spain
| | | | | | - Pere Barba
- Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | | | | | | | - Jesús-María Hernández-Rivas
- Hospital Universitario de Salamanca, Universidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC, Salamanca, Spain
| | - Alberto Orfao
- Hospital Universitario de Salamanca, Universidad de Salamanca, IBMCC (CSIC/USAL), IBSAL and CIBERONC, Salamanca, Spain
| | | | - Jordi Esteve
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Clínic, Barcelona, Spain
| | - Pilar Bravo
- Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain
| | | | | | - José M Moraleda
- Hospital Clínico Universitario Virgen de la Arrixaca, IMIB, Universidad de Murcia, Murcia, Spain
| | | | | | | | - Evarist Feliu
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Francesc Solé
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep M Ribera
- Institut de Recerca contra la Leucemia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain
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Barba P, Morgades M, Montesinos P, Gil C, Fox M, Ciudad J, Moreno M, González‐Campos J, Genescà E, Martínez‐Carballeira D, Martino R, Vives S, Guardia R, Mercadal S, Artola M, Cladera A, Tormo M, Esteve J, Bergua J, Vall‐Llovera F, Ribera J, Martínez‐Sanchez P, Amigo M, Bermúdez A, Calbacho M, Hernández‐Rivas J, Feliu E, Orfao A, Ribera J. Increased survival due to lower toxicity for high‐risk T‐cell acute lymphoblastic leukemia patients in two consecutive pediatric‐inspired PETHEMA trials. Eur J Haematol 2018; 102:79-86. [DOI: 10.1111/ejh.13178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/29/2022]
Affiliation(s)
- Pere Barba
- Hospital Universitari Vall Hebron Universitat Autònoma de Barcelona Barcelona Spain
| | - Mireia Morgades
- ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute Universitat Autònoma de Barcelona Badalona Spain
| | | | | | - María‐Laura Fox
- Hospital Universitari Vall Hebron Universitat Autònoma de Barcelona Barcelona Spain
| | - Juana Ciudad
- Centro de Investigación del Cáncer (CIC, IBMCC USAL‐CSIC), Servicio General de Citometría, Instituto de Investigación Biomédica de Salamanca (IBSAL) Universidad de Salamanca Salamanca Spain
| | | | | | - Eulàlia Genescà
- Josep Carreras Leukaemia Research Institute (IJC) Badalona Spain
| | | | | | - Susana Vives
- ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute Universitat Autònoma de Barcelona Badalona Spain
| | | | - Santiago Mercadal
- ICO L'Hospitalet‐ Hospital Duran i Reynals L'Hospitalet de Llobregat Spain
| | | | | | - Mar Tormo
- Hospital Clínico Universitario de Valencia Valencia Spain
| | - Jordi Esteve
- Hospital Clínic Universitari de Barcelona Barcelona Spain
| | - Juan Bergua
- Hospital San Pedro de Alcántara Cáceres Spain
| | | | - Jordi Ribera
- Josep Carreras Leukaemia Research Institute (IJC) Badalona Spain
| | | | | | | | | | | | - Evaristo Feliu
- ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute Universitat Autònoma de Barcelona Badalona Spain
| | - Alberto Orfao
- Centro de Investigación del Cáncer (CIC, IBMCC USAL‐CSIC), Servicio General de Citometría, Instituto de Investigación Biomédica de Salamanca (IBSAL) Universidad de Salamanca Salamanca Spain
| | - Josep‐María Ribera
- ICO Badalona‐Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute Universitat Autònoma de Barcelona Badalona Spain
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35
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Martínez-Cuadrón D, Gil C, Serrano J, Rodríguez G, Pérez-Oteyza J, García-Boyero R, Jiménez-Bravo S, Vives S, Vidriales MB, Lavilla E, Pérez-Simón JA, Tormo M, Colorado M, Bergua J, López JA, Herrera P, Hernández-Campo P, Gorrochategui J, Primo D, Rojas JL, Villoria J, Moscardó F, Troconiz I, Linares Gómez M, Martínez-López J, Ballesteros J, Sanz M, Montesinos P. A precision medicine test predicts clinical response after idarubicin and cytarabine induction therapy in AML patients. Leuk Res 2018; 76:1-10. [PMID: 30468991 DOI: 10.1016/j.leukres.2018.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 10/29/2018] [Accepted: 11/12/2018] [Indexed: 01/20/2023]
Abstract
Complete remission (CR) after induction therapy is the first treatment goal in acute myeloid leukemia (AML) patients and has prognostic impact. Our purpose is to determine the correlation between the observed CR/CRi rate after idarubicin (IDA) and cytarabine (CYT) 3 + 7 induction and the leukemic chemosensitivity measured by an ex vivo test of drug activity. Bone marrow samples from adult patients with newly diagnosed AML were included in this study. Whole bone marrow samples were incubated for 48 h in well plates containing IDA, CYT, or their combination. Pharmacological response parameters were estimated using population pharmacodynamic models. Patients attaining a CR/CRi with up to two induction cycles of 3 + 7 were classified as responders and the remaining as resistant. A total of 123 patients fulfilled the inclusion criteria and were evaluable for correlation analyses. The strongest clinical predictors were the area under the curve of the concentration response curves of CYT and IDA. The overall accuracy achieved using MaxSpSe criteria to define positivity was 81%, predicting better responder (93%) than non-responder patients (60%). The ex vivo test provides better yet similar information than cytogenetics, but can be provided before treatment representing a valuable in-time addition. After validation in an external cohort, this novel ex vivo test could be useful to select AML patients for 3 + 7 regimen vs. alternative schedules.
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Affiliation(s)
- David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, Valencia, Spain; CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Cristina Gil
- Hospital General Universitario de Alicante, Alicante, Spain
| | | | | | | | | | | | - Susana Vives
- ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | | | | | | | - Mar Tormo
- Hospital Clínico Universitario, Valencia, Spain
| | | | - Juan Bergua
- Hospital San Pedro de Alcántara, Cáceres, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | - Miguel Sanz
- Hospital Universitari i Politècnic La Fe, Valencia, Spain; CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, Valencia, Spain; CIBERONC, Instituto Carlos III, Madrid, Spain.
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36
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de la Guardia RD, Lopez-Millan B, Roca-Ho H, Bueno C, Gutiérrez-Agüera F, Fuster JL, Anguita E, Zanetti SR, Vives S, Nomdedeu J, Sackstein R, Lavoie J, Gónzalez-Rey E, Delgado M, Rosu-Myles M, Menendez P. Bone marrow mesenchymal stem/stromal cells from risk-stratified acute myeloid leukemia patients are anti-inflammatory in in vivo preclinical models of hematopoietic reconstitution and severe colitis. Haematologica 2018; 104:e54-e58. [PMID: 30237260 DOI: 10.3324/haematol.2018.196568] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Rafael Diaz de la Guardia
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain
| | - Belen Lopez-Millan
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain
| | - Heleia Roca-Ho
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain
| | - Clara Bueno
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain
| | - Francisco Gutiérrez-Agüera
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain
| | - Jose Luis Fuster
- Sección de Oncohematología Pediátrica, Hospital Virgen de Arrixaca, Murcia, Spain
| | - Eduardo Anguita
- Servicio de Hematología, Hospital Clínico San Carlos, IdISSC, Medicina UCM, Madrid, Spain
| | - Samanta Romina Zanetti
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain
| | - Susana Vives
- Hematology Department, ICO-Hospital Germans Trias i Pujol and Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Josep Nomdedeu
- Servicio de Hematología, Hospital de la Santa Creu i Sant Pau and Josep Carreras Leukemia Research Institute, Barcelona, Spain
| | - Robert Sackstein
- Department of Medicine and Program of Excellence in Glycosciences, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jessie Lavoie
- Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON, Canada
| | - Elena Gónzalez-Rey
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain
| | - Mario Delgado
- Instituto de Parasitología y Biomedicina López-Neyra, CSIC, Granada, Spain
| | - Michael Rosu-Myles
- Biologics and Genetic Therapies Directorate, Health Products and Food Branch, Health Canada, Ottawa, ON, Canada
| | - Pablo Menendez
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, University of Barcelona, Spain .,Instituciò Catalana de Reserca i EstudisAvançats (ICREA), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Cancer (CIBER-ONC), Barcelona, Spain
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37
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Genescà E, Lazarenkov A, Morgades M, Berbis G, Ruíz-Xivillé N, Gómez-Marzo P, Ribera J, Juncà J, González-Pérez A, Mercadal S, Guardia R, Artola MT, Moreno MJ, Martínez-López J, Zamora L, Barba P, Gil C, Tormo M, Cladera A, Novo A, Pratcorona M, Nomdedeu J, González-Campos J, Almeida M, Cervera J, Montesinos P, Batlle M, Vives S, Esteve J, Feliu E, Solé F, Orfao A, Ribera JM. Frequency and clinical impact of CDKN2A/ARF/CDKN2B gene deletions as assessed by in-depth genetic analyses in adult T cell acute lymphoblastic leukemia. J Hematol Oncol 2018; 11:96. [PMID: 30041662 PMCID: PMC6057006 DOI: 10.1186/s13045-018-0639-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 05/07/2018] [Accepted: 07/09/2018] [Indexed: 01/14/2023] Open
Abstract
Recurrent deletions of the CDKN2A/ARF/CDKN2B genes encoded at chromosome 9p21 have been described in both pediatric and adult acute lymphoblastic leukemia (ALL), but their prognostic value remains controversial, with limited data on adult T-ALL. Here, we investigated the presence of homozygous and heterozygous deletions of the CDKN2A/ARF and CDKN2B genes in 64 adult T-ALL patients enrolled in two consecutive trials from the Spanish PETHEMA group. Alterations in CDKN2A/ARF/CDKN2B were detected in 35/64 patients (55%). Most of them consisted of 9p21 losses involving homozygous deletions of the CDKNA/ARF gene (26/64), as confirmed by single nucleotide polymorphism (SNP) arrays and interphase fluorescence in situ hybridization (iFISH). Deletions involving the CDKN2A/ARF/CDKN2B locus correlated with a higher frequency of cortical T cell phenotype and a better clearance of minimal residual disease (MRD) after induction therapy. Moreover, the combination of an altered copy-number-value (CNV) involving the CDKN2A/ARF/CDKN2B gene locus and undetectable MRD (≤ 0.01%) values allowed the identification of a subset of T-ALL with better overall survival in the absence of hematopoietic stem cell transplantation.
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Affiliation(s)
- E Genescà
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain. .,ALL Research Group, Josep Carreras Leukaemia Research Institute (IJC), Camí de les Escoles s/n. Edifici IJC, 08916, Badalona, Spain.
| | - A Lazarenkov
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - M Morgades
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - G Berbis
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - N Ruíz-Xivillé
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - P Gómez-Marzo
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - J Ribera
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - J Juncà
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - A González-Pérez
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Research Program on Biomedical Informatics, Universitat Pompeu Fabra, Barcelona, Spain
| | - S Mercadal
- Clinical Hematology Service, Hospital Duran i Reynals-ICO, Hospitalet del LLobregat, Barcelona, Spain
| | - R Guardia
- Clinical Hematology Service, Hospital Josep Trueta-ICO, Girona, Spain
| | - M T Artola
- Clinical Hematology Service, Hospital Universitario de Donostia, Donostia, Spain
| | - M J Moreno
- Clinical Hematology Service, Hospital Vírgen de la Victoria, Málaga, Spain
| | - J Martínez-López
- Hematology Department, Hospital 12 de Octubre, CNIO, Universidad Complutense, Madrid, Spain
| | - L Zamora
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - P Barba
- Clinical Hematology Service, Hospital Universitari de la Vall d'Hebron, Barcelona, Spain
| | - C Gil
- Clinical Hematology Service, Hospital General de Alicante, Alicante, Spain
| | - M Tormo
- Clinical Hematology Service, Hospital Clínico de Valencia, Valencia, Spain
| | - A Cladera
- Clinical Hematology Service, Hospital Son Llàtzer, Palma, Spain
| | - A Novo
- Clinical Hematology Service, Hospital Son Espases, Palma, Spain
| | - M Pratcorona
- Clinical Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J Nomdedeu
- Clinical Hematology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J González-Campos
- Clinical Hematology Service, Hospital Vírgen del Rocío, Sevilla, Spain
| | - M Almeida
- Banco Nacional de ADN Carlos III, Universidad de Salamanca, Salamanca, Spain
| | - J Cervera
- Biobanco de la Fe, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - P Montesinos
- Clinical Hematology Service, Hospital La Fe, Valencia, Spain
| | - M Batlle
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - S Vives
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J Esteve
- Clinical Hematology Service, Hospital Clínic de Barcelona, Barcelona, Spain
| | - E Feliu
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - F Solé
- Josep Carreras Leukaemia Research Institute (IJC), Campus ICO-Germans Trias i Pujol, Universitat Autònoma de Barcelona (UAB), Badalona, Spain
| | - A Orfao
- Centro de Investigación del Cáncer (IBMCC-CSIC/USAL) (CIC), Hospital Clínico Universitario de Salamanca (HUS), Instituto Bio-Sanitario de Salamanca (IBSAL), CIBERONC, Salamanca, Spain
| | - J M Ribera
- Clinical Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Martínez-Cuadrón D, Boluda B, Martínez P, Bergua J, Rodríguez-Veiga R, Esteve J, Vives S, Serrano J, Vidriales B, Salamero O, Cordón L, Sempere A, Jiménez-Ubieto A, Prieto-Delgado J, Díaz-Beyá M, Garrido A, Benavente C, Pérez-Simón JA, Moscardó F, Sanz MA, Montesinos P. Correction to: A phase I–II study of plerixafor in combination with fludarabine, idarubicin, cytarabine, and G-CSF (PLERIFLAG regimen) for the treatment of patients with the first early-relapsed or refractory acute myeloid leukemia. Ann Hematol 2018; 97:923. [DOI: 10.1007/s00277-018-3277-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Martínez-Cuadrón D, Boluda B, Martínez P, Bergua J, Rodríguez-Veiga R, Esteve J, Vives S, Serrano J, Vidriales B, Salamero O, Cordón L, Sempere A, Jiménez-Ubieto A, Prieto-Delgado J, Díaz-Beyá M, Garrido A, Benavente C, Pérez-Simón JA, Moscardó F, Sanz MA, Montesinos P. A phase I-II study of plerixafor in combination with fludarabine, idarubicin, cytarabine, and G-CSF (PLERIFLAG regimen) for the treatment of patients with the first early-relapsed or refractory acute myeloid leukemia. Ann Hematol 2018; 97:763-772. [PMID: 29392425 DOI: 10.1007/s00277-018-3229-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 10/04/2017] [Accepted: 12/28/2017] [Indexed: 12/01/2022]
Abstract
Clinical outcomes of patients with acute myeloid leukemia (AML) showing the first primary refractory or early-relapsed disease remain very poor. The Programa Español de Tratamientos en Hematología (PETHEMA) group designed a phase I-II trial using FLAG-Ida (fludarabine, idarubicin, cytarabine, and G-CSF) plus high-dose intravenous plerixafor, a molecule inducing mobilization of blasts through the SDF-1α-CXCR4 axis blockade and potentially leading to chemosensitization of the leukemic cells. We aimed to establish a recommended phase 2 dose (RP2D) of plerixafor plus FLAG-Ida, as well as the efficacy and safety of this combination for early-relapsed (first complete remission (CR/CRi) < 12 months) or primary refractory AML. Between 2012 and 2015, 57 patients were enrolled, and 41 received the RP2D (median age 52 years [range, 18-64]). Among these patients, 20 (49%) achieved CR/CRi, and 3 (7%) died during induction. CR/CRi rate was 50% (13/26) among primary refractory and 47% (7/15) among early relapse. Overall, 25 patients (61%) were allografted. Median overall and disease-free survivals were 9.9 and 13 months, respectively. In summary, the combination of plerixafor plus FLAG-Ida resulted in a relatively high CR/CRi rate in adult patients with primary refractory or early relapsed AML, with an acceptable toxicity profile and induction mortality rate, bridging the majority of patients to allogeneic stem cell transplantation. ClinicalTrials.gov Identifier: NCT01435343.
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Affiliation(s)
- David Martínez-Cuadrón
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Blanca Boluda
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain
| | | | - Juan Bergua
- Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Rebeca Rodríguez-Veiga
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain
| | | | - Susana Vives
- Hospital ICO-Universitari Germans Trias i Pujol, José Carreras Leukemia Research Institute, Badalona, Spain
| | | | | | - Olga Salamero
- Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Lourdes Cordón
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Amparo Sempere
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain
| | | | | | | | - Ana Garrido
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | - Federico Moscardó
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain
| | - Miguel A Sanz
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain.,CIBERONC, Instituto Carlos III, Madrid, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic, La Fe, Avinguda Fernando Abril Martorell, 106, 46026, València, Spain. .,CIBERONC, Instituto Carlos III, Madrid, Spain.
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40
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Ribera JM, Morgades M, Montesinos P, Martino R, Barba P, Soria B, Bermúdez A, Moreno MJ, González-Campos J, Vives S, Gil C, Abella E, Guàrdia R, Martínez-Carballeira D, Martínez-Sánchez P, Amigo ML, Mercadal S, Serrano A, López-Martínez A, Vall-Llovera F, Sánchez-Sánchez MJ, Peñarrubia MJ, Calbacho M, Méndez JA, Bergua J, Cladera A, Tormo M, García-Belmonte D, Feliu E, Ciudad J, Orfao A. Efficacy and safety of native versus pegylated Escherichia coli asparaginase for treatment of adults with high-risk, Philadelphia chromosome-negative acute lymphoblastic leukemia. Leuk Lymphoma 2017; 59:1634-1643. [PMID: 29165013 DOI: 10.1080/10428194.2017.1397661] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Native or pegylated (PEG) asparaginase (ASP) are commonly used in treatment of acute lymphoblastic leukemia (ALL), but have been scarcely compared in the same trial in adult patients. Native vs. PEG-ASP administered according to availability in each center were prospectively evaluated in adults with high-risk ALL. Ninety-one patients received native ASP and 35 PEG-ASP in induction. No significant differences were observed in complete remission, minimal residual disease levels after induction and after consolidation, disease-free survival, and overall survival. No significant differences in grades 3-4 toxicity were observed in the induction period, although a trend for higher hepatic toxicity was observed in patients receiving PEG-ASP. In this trial the type of ASP did not influence patient response and outcome.
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Affiliation(s)
- Josep-Maria Ribera
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Mireia Morgades
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Pau Montesinos
- b Hospital Universitari i Politècnic La Fe , Valencia , Spain
| | | | - Pere Barba
- d Hospital Vall d'Hebron Universitat Autònoma de Barcelona , Barcelona , Spain
| | - Beatriz Soria
- e Hospital Universitario de Canarias , Santa Cruz de Tenerife , Spain
| | - Arancha Bermúdez
- f Hospital Universitario Marqués de Valdecilla , Santander , Spain
| | - María-José Moreno
- g Hospital Clínico Universitario Virgen de la Victoria , Málaga , Spain
| | | | - Susana Vives
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Cristina Gil
- i Hospital General de Alicante , Alicante , Spain
| | | | | | | | | | | | - Santiago Mercadal
- o ICO L'Hospitalet-Hospital Duran i Reynals, L'Hospitalet de Llobregat , L'Hospitalet de Llobregat, Spain
| | | | | | | | | | | | | | | | - Juan Bergua
- w Hospital San Pedro de Alcántara , Cáceres , Spain
| | | | - Mar Tormo
- y Hospital Clínico Universitario de Valencia , Valencia , Spain
| | | | - Evarist Feliu
- a ICO Badalona-Hospital Germans Trias i Pujol , Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Juana Ciudad
- aa Centro de Investigación del Cáncer (CIC, IBMCC USAL-CSIC), Servicio General de Citometría, and Instituto de Investigación Biomédica de Salamanca (IBSAL) , Universidad de Salamanca , Salamanca , Spain
| | - Alberto Orfao
- aa Centro de Investigación del Cáncer (CIC, IBMCC USAL-CSIC), Servicio General de Citometría, and Instituto de Investigación Biomédica de Salamanca (IBSAL) , Universidad de Salamanca , Salamanca , Spain
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41
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Ribera J, Zamora L, Morgades M, Mallo M, Solanes N, Batlle M, Vives S, Granada I, Juncà J, Malinverni R, Genescà E, Guàrdia R, Mercadal S, Escoda L, Martinez-Lopez J, Tormo M, Esteve J, Pratcorona M, Martinez-Losada C, Solé F, Feliu E, Ribera JM. Copy number profiling of adult relapsed B-cell precursor acute lymphoblastic leukemia reveals potential leukemia progression mechanisms. Genes Chromosomes Cancer 2017; 56:810-820. [PMID: 28758283 DOI: 10.1002/gcc.22486] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 07/22/2017] [Accepted: 07/22/2017] [Indexed: 12/11/2022] Open
Abstract
The outcome of relapsed adult acute lymphoblastic leukemia (ALL) remains dismal despite new therapeutic approaches. Previous studies analyzing relapse samples have shown a high degree of heterogeneity regarding gene alterations without an evident relapse signature. Bone marrow or peripheral blood samples from 31 adult B-cell precursor ALL patients at first relapse, and 21 paired diagnostic samples were analyzed by multiplex ligation probe-dependent amplification (MLPA). Nineteen paired diagnostic and relapse samples of these 21 patients were also analyzed by SNP arrays. A trend to acquire homozygous CDKN2A/B deletions and a significant increase in the number of copy number alterations (CNA) was observed from diagnosis to first relapse. Evolution from an ancestral clone was the main pattern of clonal evolution. Relapse samples were extremely heterogeneous regarding CNA frequencies. However, CDKN2A/B, PAX5, ETV6, ATM, IKZF1, VPREB1, and TP53 deletions and duplications of 1q, 8q, 17q, 21, X/Y PAR1, and Xp were frequently detected at relapse. Duplications of genes involved in cell proliferation, drug resistance and stem cell homeostasis regulation, as well as deletions of KDM6A and STAG2 genes emerged as specific alterations at relapse. Genomics of relapsed adult B-cell precursor ALL is highly heterogeneous, although some recurrent lesions involved in essential pathways deregulation were frequently observed. Selective and simultaneous targeting of these deregulated pathways may improve the results of current salvage therapies.
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Affiliation(s)
- Jordi Ribera
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lurdes Zamora
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Mireia Morgades
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Mar Mallo
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Neus Solanes
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Montserrat Batlle
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Susana Vives
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Isabel Granada
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Jordi Juncà
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Roberto Malinverni
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Eulàlia Genescà
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Ramon Guàrdia
- Catalan Institute of Oncology-Josep Trueta, Girona, Spain
| | - Santiago Mercadal
- Catalan Institute of Oncology-Duran i Reynals, L'Hospitalet de Llobregat, Spain
| | - Lourdes Escoda
- Catalan Institute of Oncology-Joan XXIII, Tarragona, Spain
| | | | | | - Jordi Esteve
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Clinic Hospital, Barcelona, Spain
| | - Marta Pratcorona
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Sant Pau Hospital, Barcelona, Spain
| | | | - Francesc Solé
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
| | - Evarist Feliu
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
| | - Josep-Maria Ribera
- Josep Carreras Leukemia Research Institute (IJC), Universitat Autònoma de Barcelona, Badalona, Spain
- Catalan Institute of Oncology-Germans Trias i Pujol, Badalona, Spain
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42
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Affiliation(s)
- Josep-Maria Ribera
- Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universidad Autónoma de Barcelona, Badalona, Barcelona, España.
| | - Susana Vives
- Servicio de Hematología Clínica, Institut Català d'Oncologia-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras, Universidad Autónoma de Barcelona, Badalona, Barcelona, España
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Diaz de la Guardia R, Lopez-Millan B, Lavoie JR, Bueno C, Castaño J, Gómez-Casares M, Vives S, Palomo L, Juan M, Delgado J, Blanco ML, Nomdedeu J, Chaparro A, Fuster JL, Anguita E, Rosu-Myles M, Menéndez P. Detailed Characterization of Mesenchymal Stem/Stromal Cells from a Large Cohort of AML Patients Demonstrates a Definitive Link to Treatment Outcomes. Stem Cell Reports 2017; 8:1573-1586. [PMID: 28528702 PMCID: PMC5470078 DOI: 10.1016/j.stemcr.2017.04.019] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 04/15/2017] [Accepted: 04/18/2017] [Indexed: 01/01/2023] Open
Abstract
Bone marrow mesenchymal stem/stromal cells (BM-MSCs) are key components of the hematopoietic niche thought to have a direct role in leukemia pathogenesis. BM-MSCs from patients with acute myeloid leukemia (AML) have been poorly characterized due to disease heterogeneity. We report a functional, genetic, and immunological characterization of BM-MSC cultures from 46 AML patients, stratified by molecular/cytogenetics into low-risk (LR), intermediate-risk (IR), and high-risk (HR) subgroups. Stable MSC cultures were successfully established and characterized from 40 of 46 AML patients irrespective of the risk subgroup. AML-derived BM-MSCs never harbored tumor-specific cytogenetic/molecular alterations present in blasts, but displayed higher clonogenic potential than healthy donor (HD)-derived BM-MSCs. Although HD- and AML-derived BM-MSCs equally provided chemoprotection to AML cells in vitro, AML-derived BM-MSCs were more immunosuppressive/anti-inflammatory, enhanced suppression of lymphocyte proliferation, and diminished secretion of pro-inflammatory cytokines. Multivariate analysis revealed that the level of interleukin-10 produced by AML-derived BM-MSCs as an independent prognostic factor negatively affected overall survival. Collectively our data show that AML-derived BM-MSCs are not tumor related, but display functional differences contributing to therapy resistance and disease evolution.
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Affiliation(s)
- Rafael Diaz de la Guardia
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, Universitat de Barcelona, Casanova 143, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red-Oncología (CIBERONC), ISCIII, Madrid 28031, Spain.
| | - Belen Lopez-Millan
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, Universitat de Barcelona, Casanova 143, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red-Oncología (CIBERONC), ISCIII, Madrid 28031, Spain
| | - Jessie R Lavoie
- Regulatory Research Division, Centre for Biologics Evaluation, Biologics and Genetic Therapies Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada
| | - Clara Bueno
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, Universitat de Barcelona, Casanova 143, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red-Oncología (CIBERONC), ISCIII, Madrid 28031, Spain
| | - Julio Castaño
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, Universitat de Barcelona, Casanova 143, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red-Oncología (CIBERONC), ISCIII, Madrid 28031, Spain
| | - Maite Gómez-Casares
- Servicio de Hematología, Hospital Universitario de Gran Canaria Dr. Negrin, Las Palmas de Gran Canaria 35010, Spain
| | - Susana Vives
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona 08916, Spain; Josep Carreras Leukemia Research Institute, Universitat Autònoma Barcelona, Barcelona 08193, Spain
| | - Laura Palomo
- Hematology Department, ICO-Hospital Germans Trias i Pujol, Badalona 08916, Spain; Josep Carreras Leukemia Research Institute, Universitat Autònoma Barcelona, Barcelona 08193, Spain
| | - Manel Juan
- Servicio de Inmunología, Hospital Clínico de Barcelona, Barcelona 08036, Spain
| | - Julio Delgado
- Centro de Investigación Biomédica en Red-Oncología (CIBERONC), ISCIII, Madrid 28031, Spain; Servicio de Hematología, Hospital Clínico de Barcelona, Barcelona 08036, Spain
| | - Maria L Blanco
- Servicio de Hematología, Hospital de la Santa Creu I Sant Pau, Barcelona 08041, Spain
| | - Josep Nomdedeu
- Servicio de Hematología, Hospital de la Santa Creu I Sant Pau, Barcelona 08041, Spain
| | - Alberto Chaparro
- Hematology Department, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Jose Luis Fuster
- Sección de Oncohematología Pediátrica, Hospital Clínico Virgen de Arrixaca, Murcia 30120, Spain
| | - Eduardo Anguita
- Hematology Department, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Michael Rosu-Myles
- Regulatory Research Division, Centre for Biologics Evaluation, Biologics and Genetic Therapies Directorate, Health Canada, Ottawa, ON K1A 0L2, Canada.
| | - Pablo Menéndez
- Josep Carreras Leukemia Research Institute, Department of Biomedicine, School of Medicine, Universitat de Barcelona, Casanova 143, Barcelona 08036, Spain; Centro de Investigación Biomédica en Red-Oncología (CIBERONC), ISCIII, Madrid 28031, Spain; Instituciò Catalana de Recerca i Estudis Avançats (ICREA), Barcelona 08010, Spain.
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Sorigue M, Sancho JM, Morgades M, Moreno M, Grífols JR, Alonso E, Juncà J, Ferrà C, Batlle M, Vives S, Motlló C, García-Caro M, Navarro JT, Millà F, Feliu E, Ribera JM. Relapse risk after autologous stem cell transplantation in patients with lymphoma based on CD34+ cell dose. Leuk Lymphoma 2016; 58:916-922. [PMID: 27561733 DOI: 10.1080/10428194.2016.1222378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
It is unclear whether higher CD34 + cell doses infused for ASCT have any influence on survival or relapse in patients with lymphoma. We analyzed the correlation of infused CD34 + cell dose with relapse, survival, and hematopoietic recovery in 146 consecutive patients undergoing ASCT for lymphoma. Higher doses (>5 × 106/kg) were significantly correlated with earlier hematopoietic recovery, fewer infectious episodes, lower transfusion needs. No differences were observed in lymphoma outcomes (4-year relapse incidence of 38% [95%CI: 29%-48%] in the lower dose group versus 51% [95%CI: 30%-69%] in the higher dose group, 10-year OS probabilities of 58% [95%CI: 48%-68%] versus 75% [95%CI: 59%-91%], 10-year DFS probabilities of 47% [95%CI: 37%-57%] versus 42% [95%CI: 23%-61%], p = NS for all outcomes). In this series, a higher infused CD34 + cell dose did not correlate with survival or relapse but correlated with earlier hematopoietic recovery and lower resource consumption.
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Affiliation(s)
- Marc Sorigue
- a Department of Hematology , Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona , Badalona , Spain
| | - Juan-Manuel Sancho
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Mireia Morgades
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Miriam Moreno
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Juan-Ramon Grífols
- c Banc de Sang i Teixits, Hospital Germans Trias i Pujol , Badalona , Spain
| | - Eva Alonso
- c Banc de Sang i Teixits, Hospital Germans Trias i Pujol , Badalona , Spain
| | - Jordi Juncà
- d Department of Laboratory Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Christelle Ferrà
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Montserrat Batlle
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Susana Vives
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Cristina Motlló
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Montserrat García-Caro
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Jose-Tomás Navarro
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Fuensanta Millà
- d Department of Laboratory Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Evarist Feliu
- d Department of Laboratory Hematology, ICO-Hospital Germans Trias i Pujol, Institut de Recerca Josep Carreras , Universitat Autònoma de Barcelona , Badalona , Spain
| | - Josep-María Ribera
- b Department of Clinical Hematology, ICO-Hospital Germans Trias i Pujol, Josep Carreras Research Institute , Universitat Autònoma de Barcelona , Badalona , Spain
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45
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Ballesteros J, Montesinos P, Martinez Cuadron D, Martinez J, Serrano J, Perez de Oteyza J, Fernandez P, Rodriguez-Macias G, Vidriales MB, Herrera P, Tormo M, Bergua JM, Garcia-Boyero R, Vives S, Fernandez MA, Villoria J, Moscardo F, Troconiz IF, Sanz MA. An ex vivo native environment precision medicine AML test and the correlation with responses to 1st line treatment. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e18510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Pau Montesinos
- Hospital Universitari i Politecnic La Fe de Valencia, Valencia, Spain
| | | | | | | | | | | | | | | | | | - Mar Tormo
- Hospital Clínico Universitario, Valencia, Valencia, Spain
| | - Juan M Bergua
- Hospital Universitario San Pedro de Alcántara, Cáceres, Cáceres, Spain
| | | | - Susana Vives
- Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | | | | | - Inaki F Troconiz
- Department of Pharmacy, School of Pharmacy, University of Navarra, Pamplona, Spain
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46
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Ribera JM, Vives S, Motlló C, Jiménez-Lorenzo MJ. Blinatumomab for treating acute lymphoblastic leukemia. Expert Opin Orphan Drugs 2015. [DOI: 10.1517/21678707.2015.1024223] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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47
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Vives S, Oriol A, Piernas S, Brunet S, Clapés V, Guardia R, Subirà M, Sierra J, Ribera JM. Feasibility and efficacy of outpatient therapy with intermediate dose cytarabine, fludarabine and idarubicin for patients with acute myeloid leukaemia aged 70 or older. Eur J Haematol 2015; 95:576-82. [DOI: 10.1111/ejh.12538] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Susana Vives
- Haematology Department; ICO-Hospital Germans Trias i Pujol; Badalona Spain
- Haematology Department; Jose Carreras Leukaemia Research Institute; Universitat Autonòma of Barcelona; Barcelona Spain
| | - Albert Oriol
- Haematology Department; ICO-Hospital Germans Trias i Pujol; Badalona Spain
- Haematology Department; Jose Carreras Leukaemia Research Institute; Universitat Autonòma of Barcelona; Barcelona Spain
| | - Sònia Piernas
- Haematology Department; Hospital Taulí; Sabadell Spain
| | - Salut Brunet
- Haematology Department; Jose Carreras Leukaemia Research Institute; Universitat Autonòma of Barcelona; Barcelona Spain
- Haematology Department; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - Victòria Clapés
- Haematology Department; ICO-Hospital Duran y Reynals; Barcelona Spain
| | - Ramon Guardia
- Haematology Department; ICO-Hospital Josep Trueta; Girona Spain
| | | | - Jordi Sierra
- Haematology Department; Jose Carreras Leukaemia Research Institute; Universitat Autonòma of Barcelona; Barcelona Spain
- Haematology Department; Hospital de la Santa Creu i Sant Pau; Barcelona Spain
| | - Josep-Maria Ribera
- Haematology Department; ICO-Hospital Germans Trias i Pujol; Badalona Spain
- Haematology Department; Jose Carreras Leukaemia Research Institute; Universitat Autonòma of Barcelona; Barcelona Spain
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48
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Sorigué M, Juncà J, Sancho JM, Morgades M, Esteban D, Navarro JT, Vives S, Feliu E, Ribera JM. Flow cytometry for detection of central nervous system disease in acute myeloid leukemia. Leuk Lymphoma 2015; 56:2190-2. [PMID: 25641427 DOI: 10.3109/10428194.2014.996752] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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]
Affiliation(s)
- Marc Sorigué
- Department of Hematology, Hospital Germans Trias i Pujol, Universitat Autonoma de Barcelona , Badalona , Spain
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49
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Fernández-Sojo J, Vives S, Oliveras Vilà T, Ribera JM. Derrame pericárdico exudativo y oligoartritis en un paciente recién diagnosticado de síndrome mielodisplásico. Med Clin (Barc) 2014; 143:43-4. [DOI: 10.1016/j.medcli.2013.09.009] [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] [Received: 09/12/2013] [Accepted: 09/12/2013] [Indexed: 11/28/2022]
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50
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Batlle M, Morgades M, Vives S, Ferrà C, Oriol A, Sancho JM, Xicoy B, Moreno M, Magallón L, Ribera JM. Usefulness and safety of oral cryotherapy in the prevention of oral mucositis after conditioning regimens with high-dose melphalan for autologous stem cell transplantation for lymphoma and myeloma. Eur J Haematol 2014; 93:487-91. [DOI: 10.1111/ejh.12386] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Montserrat Batlle
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Mireia Morgades
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Susana Vives
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Christelle Ferrà
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Albert Oriol
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Juan-Manuel Sancho
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Blanca Xicoy
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Miriam Moreno
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Laura Magallón
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
| | - Josep-Maria Ribera
- Clinical Haematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; José Carreras Research Institute; Badalona Spain
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