1
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Matarraz S, Leoz P, Yeguas-Bermejo A, van der Velden V, Bras AE, Sánchez Gallego JI, Lecrevisse Q, Ayala-Bueno R, Teodosio C, Criado I, González-González M, Flores-Montero J, Avendaño A, Vidriales MB, Chillón MC, González T, García-Sanz R, Prieto Conde MI, Villamor N, Magnano L, Colado E, Fernández P, Sonneveld E, Philippé J, Reiterová M, Caballero Berrocal JC, Diaz-Gálvez FJ, Ramos F, Dávila Valls J, Manjón Sánchez R, Solano Tovar J, Calvo X, García Alonso L, Arenillas L, Alonso S, Fonseca A, Quirós Caso C, van Dongen JJM, Orfao A. Baseline immunophenotypic profile of bone marrow leukemia cells in acute myeloid leukemia with nucleophosmin-1 gene mutation: a EuroFlow study. Blood Cancer J 2023; 13:132. [PMID: 37666856 PMCID: PMC10477264 DOI: 10.1038/s41408-023-00909-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 09/06/2023] Open
Affiliation(s)
- Sergio Matarraz
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Pilar Leoz
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - Ana Yeguas-Bermejo
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - Vincent van der Velden
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne E Bras
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jose I Sánchez Gallego
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Quentin Lecrevisse
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Rosa Ayala-Bueno
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Cristina Teodosio
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ignacio Criado
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María González-González
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Juan Flores-Montero
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - Alejandro Avendaño
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - María B Vidriales
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - María C Chillón
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - Teresa González
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - Ramón García-Sanz
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - María I Prieto Conde
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Hematology Department, University Hospital of Salamanca, CIBERONC (CB16/12/00233), IBSAL, Accelerator program and Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca), Salamanca, Spain
| | - Neus Villamor
- Hematology Service, Hospital Clinic, Barcelona, Spain
| | - Laura Magnano
- Hematology Service, Hospital Clinic, Barcelona, Spain
| | - Enrique Colado
- Hematology Department and Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Paula Fernández
- FACS/Stem Cell Laboratory, Kantonsspital Aarau, Aarau, Switzerland
| | | | - Jan Philippé
- Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Michaela Reiterová
- CLIP-Department of Pediatric Hematology and Oncology, Second Medical Faculty, Charles University and University Hospital Motol, Prague, Czech Republic
| | | | | | - Fernando Ramos
- Department of Hematology, Complejo Asistencial Universitario de León, León, Spain
| | | | | | - Jackeline Solano Tovar
- Department of Hematology, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - Xavier Calvo
- Pathology Service, Hospital del Mar, Barcelona, Spain
| | | | | | - Sara Alonso
- Hematology Department and Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ariana Fonseca
- Hematology Department and Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Covadonga Quirós Caso
- Hematology Department and Laboratory Medicine Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Jacques J M van Dongen
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Alberto Orfao
- Translational and Clinical Research Program, Centro de Investigación del Cáncer (IBMCC; CSIC-University of Salamanca); Cytometry Service, NUCLEUS; Department of Medicine, University of Salamanca (USAL) and Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain.
- Biomedical Research Networking Centre Consortium of Oncology (CIBERONC), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Pieters R, de Groot-Kruseman H, Fiocco M, Verwer F, Van Overveld M, Sonneveld E, van der Velden V, Beverloo HB, Bierings M, Dors N, de Haas V, Hoogerbrugge P, Van der Sluis I, Tissing W, Veening M, Boer J, Den Boer M. Improved Outcome for ALL by Prolonging Therapy for IKZF1 Deletion and Decreasing Therapy for Other Risk Groups. J Clin Oncol 2023; 41:4130-4142. [PMID: 37459571 DOI: 10.1200/jco.22.02705] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 12/01/2022] [Revised: 03/30/2023] [Accepted: 05/12/2023] [Indexed: 07/20/2023] Open
Abstract
PURPOSE The ALL10 protocol improved outcomes for children with ALL by stratifying and adapting therapy into three minimal residual disease-defined risk groups: standard risk, medium risk (MR), and high risk. IKZF1-deleted (IKZF1del) ALL in the largest MR group still showed poor outcome, in line with protocols worldwide, accounting for a high number of overall relapses. ALL10 showed high toxicity in Down syndrome (DS) and excellent outcome in ETV6::RUNX1 ALL. Poor prednisone responders (PPRs) were treated as high risk in ALL10. In ALL11, we prolonged therapy for IKZF1del from 2 to 3 years. We reduced therapy for DS by omitting anthracyclines completely, for ETV6::RUNX1 in intensification, and for PPR by treatment as MR. METHODS Eight hundred nineteen patients with ALL (age, 1-18 years) were enrolled on ALL11 and stratified as in ALL10. Results were compared with those in ALL10. RESULTS The five-year overall survival (OS), event-free survival (EFS), cumulative risk of relapse (CIR), and death in complete remission on ALL11 were 94.2% (SE, 0.9%), 89.0% (1.2), 8.2% (1.1), and 2.3% (0.6), respectively. Prolonged maintenance for IKZF1del MR improved 5-year CIR by 2.2-fold (10.8% v 23.4%; P = .035) and EFS (87.1% v 72.3%; P = .019). Landmark analysis at 2 years from diagnosis showed a 2.9-fold reduction of CIR (25.6%-8.8%; P = .008) and EFS improvement (74.4%-91.2%; P = .007). Reduced therapy did not abrogate 5-year outcome for ETV6::RUNX1 (EFS, 98.3%; OS, 99.4%), DS (EFS, 87.0%; OS, 87.0%), and PPR (EFS, 81.1%; OS, 94.9%). CONCLUSION Children with IKZF1del ALL seem to benefit from prolonged maintenance therapy. Chemotherapy was successfully reduced for patients with ETV6::RUNX1, DS, and PPR ALL. It has to be noted that these results were obtained in a nonrandomized study using a historical control group.
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Affiliation(s)
- Rob Pieters
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
| | - Hester de Groot-Kruseman
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
| | - Marta Fiocco
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
- Department of Biomedical Data Science, Section Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands
- Mathematical Institute, Leiden University, Leiden, the Netherlands
| | - Femke Verwer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
| | | | - Edwin Sonneveld
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
| | | | - H Berna Beverloo
- Department of Clinical Genetics, Erasmus MC, Rotterdam, the Netherlands
| | - Marc Bierings
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
| | - Natasja Dors
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Valérie de Haas
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Dutch Childhood Oncology Group (DCOG), Utrecht, the Netherlands
| | | | | | - Wim Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Margreet Veening
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Judith Boer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Monique Den Boer
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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3
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Schmitz A, Brøndum RF, Johnsen HE, Mellqvist UH, Waage A, Gimsing P, op Bruinink DH, van der Velden V, van der Holt B, Hansson M, Andersen NF, Frølund UC, Helleberg C, Schjesvold FH, Ahlberg L, Gulbrandsen N, Andreasson B, Lauri B, Haukas E, Bødker JS, Roug AS, Bøgsted M, Severinsen MT, Gregersen H, Abildgaard N, Sonneveld P, Dybkær K. Longitudinal minimal residual disease assessment in multiple myeloma patients in complete remission – results from the NMSG flow-MRD substudy within the EMN02/HO95 MM trial. BMC Cancer 2022; 22:147. [PMID: 35123422 PMCID: PMC8818194 DOI: 10.1186/s12885-022-09184-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 01/07/2022] [Indexed: 11/20/2022] Open
Abstract
Background Multiple myeloma remains an incurable disease with multiple relapses due to residual myeloma cells in the bone marrow of patients after therapy. Presence of small number of cancer cells in the body after cancer treatment, called minimal residual disease, has been shown to be prognostic for progression-free and overall survival. However, for multiple myeloma, it is unclear whether patients attaining minimal residual disease negativity may be candidates for treatment discontinuation. We investigated, if longitudinal flow cytometry-based monitoring of minimal residual disease (flow-MRD) may predict disease progression earlier and with higher sensitivity compared to biochemical assessments. Methods Patients from the Nordic countries with newly diagnosed multiple myeloma enrolled in the European-Myeloma-Network-02/Hovon-95 (EMN02/HO95) trial and undergoing bone marrow aspiration confirmation of complete response, were eligible for this Nordic Myeloma Study Group (NMSG) substudy. Longitdudinal flow-MRD assessment of bone marrow samples was performed to identify and enumerate residual malignant plasma cells until observed clinical progression. Results Minimal residual disease dynamics were compared to biochemically assessed changes in serum free light chain and M-component. Among 20 patients, reaching complete response or stringent complete response during the observation period, and with ≥3 sequential flow-MRD assessments analysed over time, increasing levels of minimal residual disease in the bone marrow were observed in six cases, preceding biochemically assessed disease and clinical progression by 5.5 months and 12.6 months (mean values), respectively. Mean malignant plasma cells doubling time for the six patients was 1.8 months (95% CI, 1.4–2.3 months). Minimal malignant plasma cells detection limit was 4 × 10–5. Conclusions Flow-MRD is a sensitive method for longitudinal monitoring of minimal residual disease dynamics in multiple myeloma patients in complete response. Increasing minimal residual disease levels precedes biochemically assessed changes and is an early indicator of subsequent clinical progression. Trial registration NCT01208766 Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09184-1.
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4
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Flores-Montero J, Kalina T, Corral-Mateos A, Sanoja-Flores L, Pérez-Andrés M, Martin-Ayuso M, Sedek L, Rejlova K, Mayado A, Fernández P, van der Velden V, Bottcher S, van Dongen JJM, Orfao A. Fluorochrome choices for multi-color flow cytometry. J Immunol Methods 2019; 475:112618. [PMID: 31181212 DOI: 10.1016/j.jim.2019.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/29/2019] [Accepted: 06/04/2019] [Indexed: 12/21/2022]
Abstract
Fluorochrome selection is a key step in designing multi-color antibody panels. The list of available fluorochromes is continuously growing, fitting current needs in clinical flow cytometry to simultaneously use more markers to better define multiple leukocyte subpopulations in a single tube. Several criteria guide fluorochrome selection: i) the fluorescence profiles (excitation and emission), ii) relative brightness, iii) fluorescence overlap, iv) fluorochrome stability, and v) reproducible conjugation to antibodies. Here we used 75 samples (45 bone marrow and 30 blood) to illustrate EuroFlow strategies for evaluation of compatible fluorochromes, and how the results obtained guide fluorochrome selection as a critical step in the antibody-panel building process. Our results allowed identification of optimal fluorescence profiles (e.g. higher fluorescence intensity and/or resolution with limited fluorescence overlap into neighbor channels) for brilliant violet (BV)421 and BV510 in the violet laser and allophycocyanin (APC) hilite 7 (H7) or APC C750 in the red laser vs. other candidate fluorochromes generally applied for the same detectors and here evaluated. Moreover, evaluation of the same characteristics for another group of fluorochromes (e.g. BV605, BV650, PE CF594, AF700 or APC AF700) guided selection of the most appropriate fluorochrome conjugates to be combined in a multi-color antibody panel. Albeit this is a demanding approach, it could be successfully applied for selection of fluorochrome combinations for the EuroFlow antibody panels for diagnosis, classification and monitoring of hematological malignancies and primary immunodeficiencies. Consequently, sets of 8-, 10- and 12-color fluorochrome combinations are proposed as frame of reference for initial antibody panel design.
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Affiliation(s)
- Juan Flores-Montero
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Tomas Kalina
- CLIP Cytometry, Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alba Corral-Mateos
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Luzalba Sanoja-Flores
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Martin Pérez-Andrés
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Lukasz Sedek
- Department of Pediatric Hematology and Oncology, Medical University of Silesia in Katowice, Zabrze, Poland
| | - Katerina Rejlova
- CLIP Cytometry, Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Andrea Mayado
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain
| | - Paula Fernández
- FACS/Stem cell Laboratory, Institute of Laboratory Medicine, Kantonsspital Aarau AG, Aarau, Switzerland
| | - Vincent van der Velden
- Department of Immunology, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Sebastian Bottcher
- Rostock University Medical Center, Division of Internal Medicine, Medical Clinic III, Hematology, Oncology and Palliative Medicine, Special Hematology Laboratory, Rostock, Germany
| | - Jaques J M van Dongen
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, the Netherlands.
| | - Alberto Orfao
- Cancer Research Center (IBMCC-CSIC/USAL-IBSAL), Cytometry Service (NUCLEUS) and Department of Medicine, University of Salamanca, Salamanca, Spain; Centro de Investigación Biomédica en Red de Cáncer (CIBER-ONC) CB16/12/00400, Instituto de Salud Carlos III, Madrid, Spain..
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5
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Cazzaniga G, De Lorenzo P, Alten J, Röttgers S, Hancock J, Saha V, Castor A, Madsen HO, Gandemer V, Cavé H, Leoni V, Köhler R, Ferrari GM, Bleckmann K, Pieters R, van der Velden V, Stary J, Zuna J, Escherich G, Stadt UZ, Aricò M, Conter V, Schrappe M, Valsecchi MG, Biondi A. Predictive value of minimal residual disease in Philadelphia-chromosome-positive acute lymphoblastic leukemia treated with imatinib in the European intergroup study of post-induction treatment of Philadelphia-chromosome-positive acute lymphoblastic leukemia, based on immunoglobulin/T-cell receptor and BCR/ABL1 methodologies. Haematologica 2017; 103:107-115. [PMID: 29079599 PMCID: PMC5777198 DOI: 10.3324/haematol.2017.176917] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [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: 07/19/2017] [Accepted: 10/25/2017] [Indexed: 11/19/2022] Open
Abstract
The prognostic value of minimal residual disease (MRD) in Philadelphia-chromosome-positive (Ph+) childhood acute lymphoblastic leukemia (ALL) treated with tyrosine kinase inhibitors is not fully established. We detected MRD by real-time quantitative polymerase chain reaction (RQ-PCR) of rearranged immunoglobulin/T-cell receptor genes (IG/TR) and/or BCR/ABL1 fusion transcript to investigate its predictive value in patients receiving Berlin-Frankfurt-Münster (BFM) high-risk (HR) therapy and post-induction intermittent imatinib (the European intergroup study of post-induction treatment of Philadelphia-chromosome-positive acute lymphoblastic leukemia (EsPhALL) study). MRD was monitored after induction (time point (TP)1), consolidation Phase IB (TP2), HR Blocks, reinductions, and at the end of therapy. MRD negativity progressively increased over time, both by IG/TR and BCR/ABL1. Of 90 patients with IG/TR MRD at TP1, nine were negative and none relapsed, while 11 with MRD<5×10−4 and 70 with MRD≥5×10−4 had a comparable 5-year cumulative incidence of relapse of 36.4 (15.4) and 35.2 (5.9), respectively. Patients who achieved MRD negativity at TP2 had a low relapse risk (5-yr cumulative incidence of relapse (CIR)=14.3[9.8]), whereas those who attained MRD negativity at a later date showed higher CIR, comparable to patients with positive MRD at any level. BCR/ABL1 MRD negative patients at TP1 had a relapse risk similar to those who were IG/TR MRD negative (1/8 relapses). The overall concordance between the two methods is 69%, with significantly higher positivity by BCR/ABL1. In conclusion, MRD monitoring by both methods may be functional not only for measuring response but also for guiding biological studies aimed at investigating causes for discrepancies, although from our data IG/TR MRD monitoring appears to be more reliable. Early MRD negativity is highly predictive of favorable outcome. The earlier MRD negativity is achieved, the better the prognosis.
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Affiliation(s)
- Giovanni Cazzaniga
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Centro Ricerca Tettamanti, Pediatric Department, University of Milano-Bicocca, Monza, Italy
| | - Paola De Lorenzo
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Centro Ricerca Tettamanti, Pediatric Department, University of Milano-Bicocca, Monza, Italy.,European intergroup study of post-induction treatment of Philadelphia-chromosome-positive acute lymphoblastic leukemia (EsPhALL) Trial Data Center, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Julia Alten
- Berlin-Frankfurt-Münster Group Germany (BFM-G), Germany and Switzerland
| | - Silja Röttgers
- Berlin-Frankfurt-Münster Group Germany (BFM-G), Germany and Switzerland
| | | | - Vaskar Saha
- Children's Cancer and Leukaemia Group (CCLG), UK
| | - Anders Castor
- Nordic Society of Paediatric Haematology and Oncology (NOPHO), Sweden, Denmark, Norway, Finland and Iceland
| | - Hans O Madsen
- Nordic Society of Paediatric Haematology and Oncology (NOPHO), Sweden, Denmark, Norway, Finland and Iceland
| | - Virginie Gandemer
- French Acute Lymphoblastic Leukemia Study Groups (French Acute Lymphoblastic Leukemia Study Group, FRALLE and European Organisation for Research and Treatment of Cancer, EORTC), Italy
| | - Hélène Cavé
- French Acute Lymphoblastic Leukemia Study Groups (French Acute Lymphoblastic Leukemia Study Group, FRALLE and European Organisation for Research and Treatment of Cancer, EORTC), Italy
| | - Veronica Leoni
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Pediatric Department, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
| | - Rolf Köhler
- Berlin-Frankfurt-Münster Group Germany (BFM-G), Germany and Switzerland
| | - Giulia M Ferrari
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Pediatric Department, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
| | - Kirsten Bleckmann
- Berlin-Frankfurt-Münster Group Germany (BFM-G), Germany and Switzerland
| | - Rob Pieters
- Dutch Childhood Oncology Group (DCOG), the Netherlands
| | | | - Jan Stary
- Czech Pediatric Hematology Working Group (CPH), Czech Republic
| | - Jan Zuna
- Czech Pediatric Hematology Working Group (CPH), Czech Republic
| | | | - Udo Zur Stadt
- Cooperative study group for treatment of ALL (COALL), Germany
| | - Maurizio Aricò
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Azienda Sanitaria Provinciale, Ragusa, Italy
| | - Valentino Conter
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Pediatric Department, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
| | - Martin Schrappe
- Berlin-Frankfurt-Münster Group Germany (BFM-G), Germany and Switzerland
| | - Maria Grazia Valsecchi
- European intergroup study of post-induction treatment of Philadelphia-chromosome-positive acute lymphoblastic leukemia (EsPhALL) Trial Data Center, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Andrea Biondi
- Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Centro Ricerca Tettamanti, Pediatric Department, University of Milano-Bicocca, Monza, Italy.,Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP), Pediatric Department, University of Milano-Bicocca, Fondazione MBBM, Monza, Italy
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6
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Oliva S, Hofste op Bruinink D, ŘÍhová L, Spada S, van der Holt B, Troia R, Gambella M, Pantani L, Grammatico S, Gilestro M, Offidani M, Ribolla R, Galli M, Hajek R, Palumbo A, Cavo M, Omedè P, van der Velden V, Boccadoro M, Sonneveld P. Minimal residual disease (MRD) monitoring by multiparameter flow cytometry (MFC) in newly diagnosed transplant eligible multiple myeloma (MM) patients: Results from the EMN02/HO95 phase 3 trial. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.8011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8011 Background: MRD detection is a sensitive tool to measure response in MM. We assessed MRD by MFC in newly diagnosed MM patients (pts) enrolled in the EMN02/HO95 phase 3 trial. Methods: Pts were ≤65 years old and received Bortezomib-Cyclophosphamide-Dexamethasone (VCD) induction, intensification with Bortezomib-Melphalan-Prednisone (VMP) vs High-Dose-Melphalan (HDM) followed by stem cell transplant, consolidation with Bortezomib-Lenalidomide-Dexamethasone (VRD) vs no consolidation, and Lenalidomide maintenance. MRD analysis was performed in pts achieving at least a very good partial response (VGPR) before starting maintenance (after HDM, VMP or VRD) and during maintenance every 6-12 months; samples were centralized to 3 European labs. MFC was performed on bone marrow according to Euroflow-based methods (8 colors, 2 tubes) with a sensitivity of 10-5. Quality checks were performed to compare sensitivity and to show correlation between protocols (Hofste op Bruinink D ASH 2016 abstract 2072). Results: 316 pts were evaluable before maintenance: median age was 57 years, 18% (57/316) pts had ISS III and 22% (70/316) had high risk cytogenetic (HR-C) defined as having at least one among del17, t(4;14) or t(14;16); 63% (199/316) had received HDM and 37% (117/316) VMP; thereafter 51% (160/316) had received VRD. 76% (239/316) were MRD negative (MRD-) of whom 64% (153/239) received HDM vs 36% (86/239) VMP, with a median follow-up time of 30 months from MRD enrolment. 3-year PFS was 50% in MRD positive (MRD+) vs 77% in MRD- pts (HR: 2.87, p < 0.001). Subgroup analyses were performed to evaluate the risk factors for MRD+ according to baseline characteristics and therapies: HR-C was the most important risk factor (HR 9.87, interaction-p = 0.001). Finally, 48% of MRD+ pts at pre-maintenance who had a second MRD evaluation after at least 1 year of lenalidomide became MRD-. Conclusions: MRD by MFC is a strong prognostic factor in MM pts receiving intensification with novel agents or transplant; lenalidomide maintenance further improved depth of response; HR-C is the most important prognostic factor in MRD+ pts. Clinical trial information: NCT01208766.
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Affiliation(s)
- Stefania Oliva
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | | | - Lucie ŘÍhová
- Babak Myeloma Group, Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Stefano Spada
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | - Bronno van der Holt
- Department of Hematology, Erasmus Medical Center Cancer Institute, HOVON Data Center, Rotterdam, Netherlands
| | - Rossella Troia
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | - Manuela Gambella
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | | | | | - Milena Gilestro
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | | | | | | | - Roman Hajek
- Department of Haematooncology, Faculty of Medicine, University of Ostrava and University Hospital Ostrava, Ostrava, Czech Republic
| | - Antonio Palumbo
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | | | - Paola Omedè
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | | | - Mario Boccadoro
- Myeloma Unit, Division of Hematology, University of Torino, Torino, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus Medical Center, Rotterdam, Netherlands
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7
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Nováková M, Žaliová M, Suková M, Wlodarski M, Janda A, Froňková E, Campr V, Lejhancová K, Zapletal O, Pospíšilová D, Černá Z, Kuhn T, Švec P, Pelková V, Zemanová Z, Kerndrup G, van den Heuvel-Eibrink M, van der Velden V, Niemeyer C, Kalina T, Trka J, Starý J, Hrušák O, Mejstříková E. Loss of B cells and their precursors is the most constant feature of GATA-2 deficiency in childhood myelodysplastic syndrome. Haematologica 2016; 101:707-16. [PMID: 27013649 DOI: 10.3324/haematol.2015.137711] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Accepted: 03/18/2016] [Indexed: 11/09/2022] Open
Abstract
GATA-2 deficiency was recently described as common cause of overlapping syndromes of immunodeficiency, lymphedema, familiar myelodysplastic syndrome or acute myeloid leukemia. The aim of our study was to analyze bone marrow and peripheral blood samples of children with myelodysplastic syndrome or aplastic anemia to define prevalence of the GATA2 mutation and to assess whether mutations in GATA-2 transcription factor exhibit specific immunophenotypic features. The prevalence of a GATA2 mutation in a consecutively diagnosed cohort of children was 14% in advanced forms of myelodysplastic syndrome (refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, and myelodysplasia-related acute myeloid leukemia), 17% in refractory cytopenia of childhood, and 0% in aplastic anemia. In GATA-2-deficient cases, we found the most profound B-cell lymphopenia, including its progenitors in blood and bone marrow, which correlated with significantly diminished intronRSS-Kde recombination excision circles in comparison to other myelodysplastic syndrome/aplastic anemia cases. The other typical features of GATA-2 deficiency (monocytopenia and natural killer cell lymphopenia) were less discriminative. In conclusion, we suggest screening for GATA2 mutations in pediatric myelodysplastic syndrome, preferentially in patients with impaired B-cell homeostasis in bone marrow and peripheral blood (low number of progenitors, intronRSS-Kde recombination excision circles and naïve cells).
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Affiliation(s)
- Michaela Nováková
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Markéta Žaliová
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Martina Suková
- Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marcin Wlodarski
- Center for Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
| | - Aleš Janda
- Center for Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
| | - Eva Froňková
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Vít Campr
- Department of Pathology and Molecular Medicine, University Hospital Motol, Prague, Czech Republic
| | - Kateřina Lejhancová
- Department of Pediatrics, Charles University, University Hospital Hradec Králové, Czech Republic
| | - Ondřej Zapletal
- Department of Pediatric Hematology, Children's University Hospital, Brno, Czech Republic
| | - Dagmar Pospíšilová
- Department of Pediatrics, Palacky University and University Hospital Olomouc, Czech Republic
| | - Zdeňka Černá
- Department of Pediatrics, University Hospital Pilsen, Czech Republic
| | - Tomáš Kuhn
- Department of Pediatrics Ostrava, University Hospital Ostrava, Czech Republic
| | - Peter Švec
- Department of Pediatric Hematology and Oncology, University Hospital Bratislava, Slovakia
| | - Vendula Pelková
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Zuzana Zemanová
- Centre of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, 1 Faculty of Medicine and General University Hospital and Charles University, Prague, Czech Republic
| | - Gitte Kerndrup
- Department of Pathology, Aarhus University Hospital, Denmark
| | | | | | - Charlotte Niemeyer
- Center for Pediatrics and Adolescent Medicine, University Medical Center, Freiburg, Germany
| | - Tomáš Kalina
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jan Trka
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Jan Starý
- Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Ondřej Hrušák
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Ester Mejstříková
- CLIP-Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic Department of Pediatric Hematology and Oncology, 2 Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
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