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Wang L, Chen Y, Wang Q, Xiang M, Zeng Z, Zhang Z, Zhang F, Chen S, Xue M. Identification and clinical implications of recurrent PAX5::MLLT3 fusion in lymphoid blastic phase chronic myeloid leukemia. Int J Lab Hematol 2024; 46:571-574. [PMID: 38389449 DOI: 10.1111/ijlh.14245] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/26/2024] [Indexed: 02/24/2024]
Affiliation(s)
- Lijun Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yu Chen
- Department of Hematology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, China
| | - Qingyuan Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng Xiang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhao Zeng
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zhibo Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fenghong Zhang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Suning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Mengxing Xue
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
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2
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Ito M, Fukushima N. Faggot cells observed in a patient with myelodysplastic syndrome with increased blasts. Int J Hematol 2024; 119:476-478. [PMID: 38554197 DOI: 10.1007/s12185-024-03767-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/01/2024]
Affiliation(s)
- Makoto Ito
- Department of Hematology and Oncology, Konan Kosei Hospital, 137 Omatsubara, Takaya-cho, Konan, Aichi, 483-8704, Japan.
- Department of Hematology, Tokoname City Hospital, Aichi, Japan.
| | - Nobuaki Fukushima
- Department of Hematology and Oncology, Konan Kosei Hospital, 137 Omatsubara, Takaya-cho, Konan, Aichi, 483-8704, Japan
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3
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Shin JE, Kim SH, Kong M, Kim HR, Yoon S, Kee KM, Kim JA, Kim DH, Park SY, Park JH, Kim H, No KT, Lee HW, Gee HY, Hong S, Guan KL, Roe JS, Lee H, Kim DW, Park HW. Targeting FLT3-TAZ signaling to suppress drug resistance in blast phase chronic myeloid leukemia. Mol Cancer 2023; 22:177. [PMID: 37932786 PMCID: PMC10626670 DOI: 10.1186/s12943-023-01837-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/01/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Although the development of BCR::ABL1 tyrosine kinase inhibitors (TKIs) rendered chronic myeloid leukemia (CML) a manageable condition, acquisition of drug resistance during blast phase (BP) progression remains a critical challenge. Here, we reposition FLT3, one of the most frequently mutated drivers of acute myeloid leukemia (AML), as a prognostic marker and therapeutic target of BP-CML. METHODS We generated FLT3 expressing BCR::ABL1 TKI-resistant CML cells and enrolled phase-specific CML patient cohort to obtain unpaired and paired serial specimens and verify the role of FLT3 signaling in BP-CML patients. We performed multi-omics approaches in animal and patient studies to demonstrate the clinical feasibility of FLT3 as a viable target of BP-CML by establishing the (1) molecular mechanisms of FLT3-driven drug resistance, (2) diagnostic methods of FLT3 protein expression and localization, (3) association between FLT3 signaling and CML prognosis, and (4) therapeutic strategies to tackle FLT3+ CML patients. RESULTS We reposition the significance of FLT3 in the acquisition of drug resistance in BP-CML, thereby, newly classify a FLT3+ BP-CML subgroup. Mechanistically, FLT3 expression in CML cells activated the FLT3-JAK-STAT3-TAZ-TEAD-CD36 signaling pathway, which conferred resistance to a wide range of BCR::ABL1 TKIs that was independent of recurrent BCR::ABL1 mutations. Notably, FLT3+ BP-CML patients had significantly less favorable prognosis than FLT3- patients. Remarkably, we demonstrate that repurposing FLT3 inhibitors combined with BCR::ABL1 targeted therapies or the single treatment with ponatinib alone can overcome drug resistance and promote BP-CML cell death in patient-derived FLT3+ BCR::ABL1 cells and mouse xenograft models. CONCLUSION Here, we reposition FLT3 as a critical determinant of CML progression via FLT3-JAK-STAT3-TAZ-TEAD-CD36 signaling pathway that promotes TKI resistance and predicts worse prognosis in BP-CML patients. Our findings open novel therapeutic opportunities that exploit the undescribed link between distinct types of malignancies.
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Affiliation(s)
- Ji Eun Shin
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Soo-Hyun Kim
- Leukemia Omics Research Institute, Eulji University, Uijeongbu-si, Gyeonggi-Do, Republic of Korea
| | - Mingyu Kong
- Center for Advanced Biomolecular Recognition, Korea Institute of Science and Technology, Seoul, 02792, Korea
| | - Hwa-Ryeon Kim
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sungmin Yoon
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Kyung-Mi Kee
- Leukemia Omics Research Institute, Eulji University, Uijeongbu-si, Gyeonggi-Do, Republic of Korea
| | - Jung Ah Kim
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Dong Hyeon Kim
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - So Yeon Park
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jae Hyung Park
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Hongtae Kim
- School of Life Sciences, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Kyoung Tai No
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
- Bioinformatics and Molecular Design Research Center (BMDRC), Incheon, 21983, Korea
| | - Han-Woong Lee
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Heon Yung Gee
- Department of Pharmacology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Seunghee Hong
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Kun-Liang Guan
- Department of Pharmacology and Moores Cancer Center, University of California San Diego, La Jolla, CA, 92093, USA
| | - Jae-Seok Roe
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea
| | - Hyunbeom Lee
- Center for Advanced Biomolecular Recognition, Korea Institute of Science and Technology, Seoul, 02792, Korea
| | - Dong-Wook Kim
- Leukemia Omics Research Institute, Eulji University, Uijeongbu-si, Gyeonggi-Do, Republic of Korea.
- Hematology Department, Eulji Medical Center, Eulji University, Uijeongbu-si, Gyeonggi-Do, Republic of Korea.
| | - Hyun Woo Park
- Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul, 03722, Republic of Korea.
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Farge T, Nakhle J, Lagarde D, Cognet G, Polley N, Castellano R, Nicolau ML, Bosc C, Sabatier M, Sahal A, Saland E, Jeanson Y, Guiraud N, Boet E, Bergoglio C, Gotanègre M, Mouchel PL, Stuani L, Larrue C, Sallese M, De Mas V, Moro C, Dray C, Collette Y, Raymond-Letron I, Ader I, Récher C, Sarry JE, Cabon F, Vergez F, Carrière A. CD36 Drives Metastasis and Relapse in Acute Myeloid Leukemia. Cancer Res 2023; 83:2824-2838. [PMID: 37327406 PMCID: PMC10472106 DOI: 10.1158/0008-5472.can-22-3682] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 03/31/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Abstract
Identifying mechanisms underlying relapse is a major clinical issue for effective cancer treatment. The emerging understanding of the importance of metastasis in hematologic malignancies suggests that it could also play a role in drug resistance and relapse in acute myeloid leukemia (AML). In a cohort of 1,273 AML patients, we uncovered that the multifunctional scavenger receptor CD36 was positively associated with extramedullary dissemination of leukemic blasts, increased risk of relapse after intensive chemotherapy, and reduced event-free and overall survival. CD36 was dispensable for lipid uptake but fostered blast migration through its binding with thrombospondin-1. CD36-expressing blasts, which were largely enriched after chemotherapy, exhibited a senescent-like phenotype while maintaining their migratory ability. In xenograft mouse models, CD36 inhibition reduced metastasis of blasts and prolonged survival of chemotherapy-treated mice. These results pave the way for the development of CD36 as an independent marker of poor prognosis in AML patients and a promising actionable target to improve the outcome of patients. SIGNIFICANCE CD36 promotes blast migration and extramedullary disease in acute myeloid leukemia and represents a critical target that can be exploited for clinical prognosis and patient treatment.
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Affiliation(s)
- Thomas Farge
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
- Institute of Metabolic and Cardiovascular Diseases, Team CERAMIC, INSERM, Paul Sabatier University, UMR1297, Toulouse, France
- Institut Fédératif de Biologie (IFB), CHU Toulouse, Toulouse, France
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Jean Nakhle
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Damien Lagarde
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
- McGill University, Rosalind and Morris Goodman Cancer Institute, Montréal, Québec, Canada
- McGill University, Department of Biochemistry, Montréal, Québec, Canada
| | - Guillaume Cognet
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Nathaniel Polley
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Rémy Castellano
- Centre de Recherche en Cancérologie de Marseille, Aix-Marseille Univ, Inserm, CNRS, Institut Paoli-Calmettes, 13009 Marseille, France
| | - Marie-Laure Nicolau
- University of Toulouse, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Claudie Bosc
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Marie Sabatier
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Ambrine Sahal
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Estelle Saland
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Yannick Jeanson
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Nathan Guiraud
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Emeline Boet
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Camille Bergoglio
- Institute of Metabolic and Cardiovascular Diseases, Team MetaDiab, INSERM, Paul Sabatier University, UMR1297, Toulouse, France
| | - Mathilde Gotanègre
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Pierre-Luc Mouchel
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
- University of Toulouse, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Lucille Stuani
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Clément Larrue
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Marie Sallese
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Véronique De Mas
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
- University of Toulouse, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Cedric Moro
- Institute of Metabolic and Cardiovascular Diseases, Team MetaDiab, INSERM, Paul Sabatier University, UMR1297, Toulouse, France
| | - Cédric Dray
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Yves Collette
- Centre de Recherche en Cancérologie de Marseille, Aix-Marseille Univ, Inserm, CNRS, Institut Paoli-Calmettes, 13009 Marseille, France
| | - Isabelle Raymond-Letron
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
- LabHPEC, Université de Toulouse, ENVT, Toulouse, France
| | - Isabelle Ader
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
| | - Christian Récher
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
- University of Toulouse, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Jean-Emmanuel Sarry
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - Florence Cabon
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
| | - François Vergez
- Centre de Recherches en Cancérologie de Toulouse, Université de Toulouse, Inserm, CNRS, Toulouse, France
- LabEx Toucan, Toulouse, France
- Equipe Labellisée Ligue Nationale Contre le Cancer 2023, Toulouse, France
- University of Toulouse, Toulouse, France
- Centre Hospitalier Universitaire de Toulouse, Institut Universitaire du Cancer de Toulouse Oncopole, Service d'Hématologie, Université Toulouse III Paul Sabatier, Toulouse, France
| | - Audrey Carrière
- RESTORE Research Center, Université Toulouse Paul Sabatier, INSERM 1301, CNRS 5070, EFS, ENVT, Toulouse, France
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Chan A, Kumar P, Gao Q, Baik J, Sigler A, Londono D, Liu Y, Arcila ME, Dogan A, Zhang Y, Roshal M, Xiao W. Abnormal B-lymphoblasts in myelodysplastic syndromes and myeloproliferative neoplasms other than chronic myeloid leukemia. Cytometry B Clin Cytom 2023; 104:243-252. [PMID: 34897961 PMCID: PMC10520891 DOI: 10.1002/cyto.b.22047] [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] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/16/2021] [Accepted: 12/01/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Lineage infidelity is characteristic of mixed phenotype acute leukemia and is also seen in blast phase of chronic myeloid leukemia (CML), myeloid/lymphoid neoplasia with eosinophilia and gene rearrangements, and subtypes of acute myeloid leukemia. Driver genetic events often occur in multipotent progenitor cells in myeloid neoplasms, suggesting that multilineage output may be more common than appreciated. This phenomenon is not well studied in myelodysplastic syndrome (MDS) and non-CML myeloproliferative neoplasms (MPN). METHODS We systematically evaluated phenotypic lineage infidelity by reviewing bone marrow pathology and flow cytometry (FC) studies of 1262 consecutive patients with a diagnosis of MDS and/or non-CML MPN. We assessed B- and T-cells in these patients by FC. When abnormal B-lymphoblast (ABLB) populations were detected, we additionally evaluated immature B-cells using a high sensitivity FC assay for B-lymphoblastic leukemia/lymphoma (B-ALL). RESULTS We identified 9 patients (7 MDS, 7/713, 1%; 2 non-CML MPN, 2/312, 0.6%; 0 in MDS/MPN) with low-level ABLB populations (0.012%-3.6% of WBCs in marrow) with abnormal immunophenotypes. Genetic studies on flow sorted cell populations confirmed that some ABLB populations were clonally related to myeloid blasts (4/6, 67%). On follow-up, ABLB populations in 8/9 patients remained stable or disappeared. Only 1 case progressed to B-ALL. CONCLUSIONS These findings demonstrate that phenotypically detectable abnormal immature B lineage output occurs in MDS and non-CML MPN, albeit rarely. While presence of ABLB does not necessarily reflect blast crisis, the underlying disease biology of our findings may ultimately be relevant to patient management and warrants further investigation.
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Affiliation(s)
- Alexander Chan
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Priyadarshini Kumar
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Qi Gao
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Jeeyeon Baik
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Allison Sigler
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Dory Londono
- Department of Pathology, Cytogenetics Laboratory, Memorial
Sloan Kettering Cancer Center
| | - Ying Liu
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
- Department of Pathology, Molecular Diagnostic Laboratory,
Memorial Sloan Kettering Cancer Center
| | - Maria E. Arcila
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
- Department of Pathology, Molecular Diagnostic Laboratory,
Memorial Sloan Kettering Cancer Center
| | - Ahmet Dogan
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Yanming Zhang
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
- Department of Pathology, Cytogenetics Laboratory, Memorial
Sloan Kettering Cancer Center
| | - Mikhail Roshal
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
| | - Wenbin Xiao
- Department of Pathology, Hematopathology Service, Memorial
Sloan Kettering Cancer Center
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Miyashita N, Onozawa M, Suto K, Fujisawa S, Okazaki N, Hidaka D, Ohigashi H, Yasumoto A, Sugita J, Hashimoto D, Matsuno Y, Teshima T. Aleukemic Extramedullary Blast Crisis as an Initial Presentation of Chronic Myeloid Leukemia with E1A3 BCR-ABL1 Fusion Transcript. Intern Med 2022; 61:1049-1054. [PMID: 34511573 PMCID: PMC9038454 DOI: 10.2169/internalmedicine.8319-21] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Right neck swelling and pain occurred in a 49-year-old man. A Blood count showed a slight increase in platelet count without leukemoid reaction. After a biopsy of the cervical mass and bone marrow aspiration, a diagnosis of extramedullary blast crisis (EBC) of chronic myeloid leukemia (CML) was made. Fluorescence in situ hybridization (FISH) analysis showed a BCR-ABL1 fusion signal, but results of real-time polymerase chain reaction (RT-PCR) for major and minor BCR-ABL1 transcripts were negative. We identified a rare e1a3 BCR-ABL1 fusion transcript. Administration of dasatinib resulted in disappearance of the extramedullary tumor. This is the first reported case of CML-EBC with e1a3 transcript. An aleukemic extramedullary tumor can be the initial presentation of CML.
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MESH Headings
- Blast Crisis/genetics
- Blast Crisis/pathology
- Dasatinib/therapeutic use
- Fusion Proteins, bcr-abl/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
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Affiliation(s)
- Naoki Miyashita
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Masahiro Onozawa
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Keito Suto
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Shinichi Fujisawa
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Japan
| | - Nanase Okazaki
- Department of Surgical Pathology, Hokkaido University Hospital, Japan
| | - Daisuke Hidaka
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Hiroyuki Ohigashi
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Atsushi Yasumoto
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Junichi Sugita
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Daigo Hashimoto
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Japan
| | - Takanori Teshima
- Department of Hematology, Faculty of Medicine, Hokkaido University, Japan
- Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Japan
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Rajakumar SA, Grandal I, Minden MD, Hitzler JK, Guidos CJ, Danska JS. Targeted blockade of immune mechanisms inhibit B precursor acute lymphoblastic leukemia cell invasion of the central nervous system. Cell Rep Med 2021; 2:100470. [PMID: 35028611 PMCID: PMC8714910 DOI: 10.1016/j.xcrm.2021.100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 10/05/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022]
Abstract
Acute lymphoblastic leukemia (ALL) dissemination to the central nervous system (CNS) is a challenging clinical problem whose underlying mechanisms are poorly understood. Here, we show that primary human ALL samples injected into the femora of immunodeficient mice migrate to the skull and vertebral bone marrow and provoke bone lesions that enable passage into the subarachnoid space. Treatment of leukemia xenografted mice with a biologic antagonist of receptor activator of nuclear factor κB ligand (RANKL) blocks this entry route. In addition to erosion of cranial and vertebral bone, samples from individuals with B-ALL also penetrate the blood-cerebrospinal fluid barrier of recipient mice. Co-administration of C-X-C chemokine receptor 4 (CXCR4) and RANKL antagonists attenuate both identified routes of entry. Our findings suggest that targeted RANKL and CXCR4 pathway inhibitors could attenuate routes of leukemia blast CNS invasion and provide benefit for B-ALL-affected individuals.
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Affiliation(s)
- Sujeetha A. Rajakumar
- Program in Genetics and Genome Biology, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Ildiko Grandal
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
| | - Mark D. Minden
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A8, Canada
- Princess Margaret Cancer Center, University Health Network, Toronto, ON M5G 2M9, Canada
| | - Johann K. Hitzler
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Department of Pediatrics, Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Cynthia J. Guidos
- Program in Developmental and Stem Cell Biology, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jayne S. Danska
- Program in Genetics and Genome Biology, The Hospital for Sick Children Research Institute, Toronto, ON M5G 0A4, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
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8
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Abdulmawjood B, Costa B, Roma-Rodrigues C, Baptista PV, Fernandes AR. Genetic Biomarkers in Chronic Myeloid Leukemia: What Have We Learned So Far? Int J Mol Sci 2021; 22:12516. [PMID: 34830398 PMCID: PMC8626020 DOI: 10.3390/ijms222212516] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 10/15/2021] [Revised: 11/11/2021] [Accepted: 11/18/2021] [Indexed: 12/20/2022] Open
Abstract
Chronic Myeloid Leukemia (CML) is a rare malignant proliferative disease of the hematopoietic system, whose molecular hallmark is the Philadelphia chromosome (Ph). The Ph chromosome originates an aberrant fusion gene with abnormal kinase activity, leading to the buildup of reactive oxygen species and genetic instability of relevance in disease progression. Several genetic abnormalities have been correlated with CML in the blast phase, including chromosomal aberrations and common altered genes. Some of these genes are involved in the regulation of cell apoptosis and proliferation, such as the epidermal growth factor receptor (EGFR), tumor protein p53 (TP53), or Schmidt-Ruppin A-2 proto-oncogene (SRC); cell adhesion, e.g., catenin beta 1 (CTNNB1); or genes associated to TGF-β, such as SKI like proto-oncogene (SKIL), transforming growth factor beta 1 (TGFB1) or transforming growth factor beta 2 (TGFB2); and TNF-α pathways, such as Tumor necrosis factor (TNFA) or Nuclear factor kappa B subunit 1 (NFKB1). The involvement of miRNAs in CML is also gaining momentum, where dysregulation of some critical miRNAs, such as miRNA-451 and miRNA-21, which have been associated to the molecular modulation of pathogenesis, progression of disease states, and response to therapeutics. In this review, the most relevant genomic alterations found in CML will be addressed.
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Affiliation(s)
- Bilal Abdulmawjood
- i4HB—Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal; (B.A.); (B.C.); (C.R.-R.)
- UCIBIO—Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Beatriz Costa
- i4HB—Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal; (B.A.); (B.C.); (C.R.-R.)
- UCIBIO—Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Catarina Roma-Rodrigues
- i4HB—Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal; (B.A.); (B.C.); (C.R.-R.)
- UCIBIO—Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Pedro V. Baptista
- i4HB—Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal; (B.A.); (B.C.); (C.R.-R.)
- UCIBIO—Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
| | - Alexandra R. Fernandes
- i4HB—Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal; (B.A.); (B.C.); (C.R.-R.)
- UCIBIO—Applied Molecular Biosciences Unit, Department of Life Sciences, NOVA School of Science and Technology, NOVA University Lisbon, 2819-516 Caparica, Portugal
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9
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Williams MS, Basma NJ, Amaral FMR, Wiseman DH, Somervaille TCP. Blast cells surviving acute myeloid leukemia induction therapy are in cycle with a signature of FOXM1 activity. BMC Cancer 2021; 21:1153. [PMID: 34711181 PMCID: PMC8554867 DOI: 10.1186/s12885-021-08839-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 10/05/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Disease relapse remains common following treatment of acute myeloid leukemia (AML) and is due to chemoresistance of leukemia cells with disease repopulating potential. To date, attempts to define the characteristics of in vivo resistant blasts have focused on comparisons between leukemic cells at presentation and relapse. However, further treatment responses are often seen following relapse, suggesting that most blasts remain chemosensitive. We sought to characterise in vivo chemoresistant blasts by studying the transcriptional and genetic features of blasts from before and shortly after induction chemotherapy using paired samples from six patients with primary refractory AML. METHODS Leukemic blasts were isolated by fluorescence-activated cell sorting. Fluorescence in situ hybridization (FISH), targeted genetic sequencing and detailed immunophenotypic analysis were used to confirm that sorted cells were leukemic. Sorted blasts were subjected to RNA sequencing. Lentiviral vectors expressing short hairpin RNAs were used to assess the effect of FOXM1 knockdown on colony forming capacity, proliferative capacity and apoptosis in cell lines, primary AML cells and CD34+ cells from healthy donors. RESULTS Molecular genetic analysis revealed early clonal selection occurring after induction chemotherapy. Immunophenotypic characterisation found leukemia-associated immunophenotypes in all cases that persisted following treatment. Despite the genetic heterogeneity of the leukemias studied, transcriptional analysis found concerted changes in gene expression in resistant blasts. Remarkably, the gene expression signature suggested that post-chemotherapy blasts were more proliferative than those at presentation. Resistant blasts also appeared less differentiated and expressed leukemia stem cell (LSC) maintenance genes. However, the proportion of immunophenotypically defined LSCs appeared to decrease following treatment, with implications for the targeting of these cells on the basis of cell surface antigen expression. The refractory gene signature was highly enriched with targets of the transcription factor FOXM1. shRNA knockdown experiments demonstrated that the viability of primary AML cells, but not normal CD34+ cells, depended on FOXM1 expression. CONCLUSIONS We found that chemorefractory blasts from leukemias with varied genetic backgrounds expressed a common transcriptional program. In contrast to the notion that LSC quiescence confers resistance to chemotherapy we find that refractory blasts are both actively proliferating and enriched with LSC maintenance genes. Using primary patient material from a relevant clinical context we also provide further support for the role of FOXM1 in chemotherapy resistance, proliferation and stem cell function in AML.
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MESH Headings
- Adolescent
- Adult
- Aged
- Apoptosis/genetics
- Blast Crisis/drug therapy
- Blast Crisis/genetics
- Blast Crisis/metabolism
- Blast Crisis/pathology
- Cell Differentiation
- Cell Proliferation/genetics
- Cell Survival
- Drug Resistance, Neoplasm/genetics
- Female
- Flow Cytometry
- Forkhead Box Protein M1/genetics
- Forkhead Box Protein M1/metabolism
- Gene Silencing
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Induction Chemotherapy
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/pathology
- Male
- Middle Aged
- Neoplastic Stem Cells/pathology
- RNA, Small Interfering/metabolism
- Recurrence
- Tumor Stem Cell Assay
- Young Adult
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Affiliation(s)
- Mark S Williams
- Leukaemia Biology Laboratory, Cancer Research UK Manchester Institute, Oglesby Cancer Research Building, The University of Manchester, 555 Wilmslow Road, Manchester, M20 4GJ, UK.
| | - Naseer J Basma
- Leukaemia Biology Laboratory, Cancer Research UK Manchester Institute, Oglesby Cancer Research Building, The University of Manchester, 555 Wilmslow Road, Manchester, M20 4GJ, UK
| | - Fabio M R Amaral
- Leukaemia Biology Laboratory, Cancer Research UK Manchester Institute, Oglesby Cancer Research Building, The University of Manchester, 555 Wilmslow Road, Manchester, M20 4GJ, UK
| | - Daniel H Wiseman
- Epigenetics of Haematopoiesis Group, Oglesby Cancer Research Building, The University of Manchester, Manchester, M20 4GJ, UK
| | - Tim C P Somervaille
- Leukaemia Biology Laboratory, Cancer Research UK Manchester Institute, Oglesby Cancer Research Building, The University of Manchester, 555 Wilmslow Road, Manchester, M20 4GJ, UK.
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10
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Koerber RM, Held SAE, Vonnahme M, Feldmann G, Wenzel J, Gütgemann I, Brossart P, Heine A. Blastic plasmacytoid dendritic-cell neoplasia: a challenging case report. J Cancer Res Clin Oncol 2021; 148:743-748. [PMID: 34529129 PMCID: PMC8881430 DOI: 10.1007/s00432-021-03777-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Received: 06/13/2021] [Accepted: 08/23/2021] [Indexed: 11/26/2022]
Abstract
Blastic plasmacytoid dendritic-cell neoplasm (BPDCN) is an extremely rare disease that originates from dendritic cells and is associated with a poor overall survival (OS). Diagnostic and therapeutic standards are less well-established in comparison to other leukemic conditions and standards of care are lacking. Morphologic and molecular similarities to acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) and chronic myelomonocytic leukemia (CMML) are hard to distinguish. We here report a BPDCN patient with a long, challenging diagnostic period. While bone marrow biopsies initially failed to prove the correct diagnosis, a cutaneous biopsy finally identified a CD45+/CD56+/CD4+/CD123+/CD33+/MPO− population suggestive of BPDCN which was confirmed by flow cytometry. Molecular analysis revealed an ASXL-1, TET2 and SRSF2-mutation, cytogenetic analysis showed a normal karyotype. Treatment with the recently approved CD123-cytotoxin Tagraxofusp showed initially a very good response. This case reflects diagnostic and therapeutic difficulties in BPDCN as very rare, easily misdiagnosed neoplasia and the need for precise diagnostic care.
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Affiliation(s)
- Ruth-Miriam Koerber
- Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Stefanie A E Held
- Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Maria Vonnahme
- Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Georg Feldmann
- Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Joerg Wenzel
- Department of Dermatology and Allergy, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Ines Gütgemann
- Department of Pathology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Peter Brossart
- Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Annkristin Heine
- Medical Clinic III for Oncology, Hematology, Immune-Oncology and Rheumatology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany.
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11
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Qi J, Zhang F, Liu Y, Yao J, Xu Y, He H. Extramedullary Blast Crisis of Chronic Myelogenous Leukemia With a Skin Lesion: A Case Report and Literature Review. Am J Dermatopathol 2021; 43:450-453. [PMID: 33481378 DOI: 10.1097/dad.0000000000001897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Extramedullary blast crisis of chronic myeloid leukemia (CML) is defined as extramedullary disease composed of blasts regardless of the proliferation of blasts in the bone marrow. The commonly affected sites are the lymph node, central nervous system, bone, skin, and soft tissue. However, skin infiltration of CML patients as the initial presentation while their bone marrow is still in the chronic phase is extremely rare. In this article, we present a case of a 51-year-old woman who was admitted to our hospital complaining about a skin nodule in her right calf and easy fatigability for 1 week. The peripheral blood and bone marrow analysis both supported the diagnosis of CML in the chronic phase, whereas the excisional biopsy specimen obtained from her right calf showed immature cells infiltration, and fluorescence in situ hybridization test was positive for p210 BCR/ABL1 gene rearrangement. Based on the presence of extramedullary myeloid sarcoma, the patient was diagnosed with extramedullary myeloid blast crisis of CML despite the chronic phase in the bone marrow.
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Affiliation(s)
- Jing Qi
- Departments of Hematology, and
| | - Fan Zhang
- Pathology, Yijishan Hospital, Wanna Medical College, Wuhu, Anhui, China
| | - Yinhua Liu
- Pathology, Yijishan Hospital, Wanna Medical College, Wuhu, Anhui, China
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12
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Shahin OA, Chifotides HT, Bose P, Masarova L, Verstovsek S. Accelerated Phase of Myeloproliferative Neoplasms. Acta Haematol 2021; 144:484-499. [PMID: 33882481 DOI: 10.1159/000512929] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 08/18/2020] [Accepted: 11/09/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Myeloproliferative neoplasms (MPNs) can transform into blast phase MPN (leukemic transformation; MPN-BP), typically via accelerated phase MPN (MPN-AP), in ∼20-25% of the cases. MPN-AP and MPN-BP are characterized by 10-19% and ≥20% blasts, respectively. MPN-AP/BP portend a dismal prognosis with no established conventional treatment. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the sole modality associated with long-term survival. SUMMARY MPN-AP/BP has a markedly different mutational profile from de novo acute myeloid leukemia (AML). In MPN-AP/BP, TP53 and IDH1/2 are more frequent, whereas FLT3 and DNMT3A are rare. Higher incidence of leukemic transformation has been associated with the most aggressive MPN subtype, myelofibrosis (MF); other risk factors for leukemic transformation include rising blast counts above 3-5%, advanced age, severe anemia, thrombocytopenia, leukocytosis, increasing bone marrow fibrosis, type 1 CALR-unmutated status, lack of driver mutations (negative for JAK2, CALR, or MPL genes), adverse cytogenetics, and acquisition of ≥2 high-molecular risk mutations (ASXL1, EZH2, IDH1/2, SRSF2, and U2AF1Q157). The aforementioned factors have been incorporated in several novel prognostic scoring systems for MF. Currently, elderly/unfit patients with MPN-AP/BP are treated with hypomethylating agents with/without ruxolitinib; these regimens appear to confer comparable benefit to intensive chemotherapy but with lower toxicity. Retrospective studies in patients who acquired actionable mutations during MPN-AP/BP showed positive outcomes with targeted AML treatments, such as IDH1/2 inhibitors, and require further evaluation in clinical trials. Key Messages: Therapy for MPN-AP patients represents an unmet medical need. MF patients, in particular, should be appropriately stratified regarding their prognosis and the risk for transformation. Higher-risk patients should be monitored regularly and treated prior to progression to MPN-BP. MPN-AP patients may be treated with hypomethylating agents alone or in combination with ruxolitinib; also, patients can be provided with the option to enroll in rationally designed clinical trials exploring combination regimens, including novel targeted drugs, with an ultimate goal to transition to transplant.
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Affiliation(s)
- Omar A Shahin
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Helen T Chifotides
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Prithviraj Bose
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lucia Masarova
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Srdan Verstovsek
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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13
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Huang YM, Wang YN, Zheng Y, Pan LL, Li Y, Li JG, Wang SY. The prognostic value of the peripheral blood cell counts changes during induction chemotherapy in Chinese patients with adult acute myeloid leukemia. Medicine (Baltimore) 2021; 100:e24614. [PMID: 33663070 PMCID: PMC7909157 DOI: 10.1097/md.0000000000024614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 01/07/2021] [Indexed: 01/05/2023] Open
Abstract
To investigate the prognostic value of the circulating peripheral blood cell counts changes in acute myeloid leukemia (AML) at different time points during induction chemotherapy.We retrospectively analyzed the clinical and laboratory data of 237 newly diagnosed AML patients admitted to Fujian Medical University Union Hospital from January 2011 to December 2014.1. When primitive cells were first removed from the circulating peripheral blood, it was called peripheral blood blast clearance (PBBC). These patients were divided into two groups, according to PBBC. Statistical analysis showed that the day 5 of induction chemotherapy was a better cut-off for PBBC. PBBC≤5 days is defined as early-blast-clearance, while PBBC >6 days is delayed-blast-clearance. There was significant difference between the two groups on complete remission (CR) rate (P = .002), recurrence-free survival (RFS) (P = .026) and overall survival (OS) (P = .001). 2. Multivariate analysis suggested PBBC is an independent prognostic factor for CR, RFS, and OS in AML. Receiver operating characteristic(ROC) curve analysis showed the CR rate of patients with white blood cell count less than 1.25 × 109/L was significantly higher than that of patients with white blood cell count more than 1.25 × 10 9/L (P < .001) at day 5 of induction chemotherapy, but the RFS and OS was no significantly different (P > .05).The dynamics of peripheral blood blast in AML after initiation of induction chemotherapy, especially the time length to achieve PBBC, has important prognostic value for CR rate, RFS, and OS in AML patients. It is a simple and feasible method to evaluate the efficacy of AML.
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Affiliation(s)
- Yuan-Mao Huang
- Union Clinical Medical College, Fujian Medical University
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
- Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou 363000, Fujian, P.R. China
| | - Yan-Ni Wang
- Union Clinical Medical College, Fujian Medical University
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Yi Zheng
- Union Clinical Medical College, Fujian Medical University
| | - Li-Li Pan
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Yang Li
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Jing-Gang Li
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
| | - Shao-Yuan Wang
- Union Clinical Medical College, Fujian Medical University
- Department of Hematology, Fujian Institute of Hematology, Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fuzhou
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14
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Liu APY, Kelsey MM, Sabbaghian N, Park SH, Deal CL, Esbenshade AJ, Ploner O, Peet A, Traunecker H, Ahmed YHE, Zacharin M, Tiulpakov A, Lapshina AM, Walter AW, Dutta P, Rai A, Korbonits M, de Kock L, Nichols KE, Foulkes WD, Priest JR. Clinical Outcomes and Complications of Pituitary Blastoma. J Clin Endocrinol Metab 2021; 106:351-363. [PMID: 33236116 PMCID: PMC7823240 DOI: 10.1210/clinem/dgaa857] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Indexed: 12/22/2022]
Abstract
CONTEXT Pituitary blastoma is a rare, dysontogenetic hypophyseal tumor of infancy first described in 2008, strongly suggestive of DICER1 syndrome. OBJECTIVE This work aims to describe genetic alterations, clinical courses, outcomes, and complications in all known pituitary blastoma cases. DESIGN AND SETTING A multi-institutional case series is presented from tertiary pediatric oncology centers. PATIENTS Patients included children with pituitary blastoma. INTERVENTIONS Genetic testing, surgery, oncologic therapy, endocrine support are reported. OUTCOME MEASURES Outcome measures included survival, long-term morbidities, and germline and tumor DICER1 genotypes. RESULTS Seventeen pituitary blastoma cases were studied (10 girls and 7 boys); median age at diagnosis was 11 months (range, 2-24 months). Cushing syndrome was the most frequent presentation (n = 10). Cushingoid stigmata were absent in 7 children (2 with increased adrenocorticotropin [ACTH]; 5 with normal/unmeasured ACTH). Ophthalmoplegia and increased intracranial pressure were also observed. Surgical procedures included gross/near-total resection (n = 7), subtotal resection (n = 9), and biopsy (n = 1). Six children received adjuvant therapy. At a median follow-up of 6.7 years, 9 patients were alive; 8 patients died of the following causes: early medical/surgical complications (n = 3), sepsis (n = 1), catheter-related complication (n = 1), aneurysmal bleeding (n = 1), second brain tumor (n = 1), and progression (n = 1). Surgery was the only intervention for 5 of 9 survivors. Extent of resection, but neither Ki67 labeling index nor adjuvant therapy, was significantly associated with survival. Chronic complications included neuroendocrine (n = 8), visual (n = 4), and neurodevelopmental (n = 3) deficits. Sixteen pituitary blastomas were attributed to DICER1 abnormalities. CONCLUSIONS Pituitary blastoma is a locally destructive tumor associated with high mortality. Surgical resection alone provides long-term disease control for some patients. Quality survival is possible with long-term neuroendocrine management.
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Affiliation(s)
- Anthony P Y Liu
- Division of Neuro-Oncology, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
- Correspondence and Reprint Requests: Anthony P.Y. Liu, MBBS, MMedSc; MS 260, St. Jude Children’s Research Hospital, 262 Danny Thomas Pl, Memphis, TN 38105, USA. E-mail:
| | - Megan M Kelsey
- Department of Pediatrics, Section of Pediatric Endocrinology, Children’s Hospital Colorado and University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Nelly Sabbaghian
- Department of Medical Genetics, The Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada
| | - Sung-Hye Park
- Department of Pathology, Seoul National University, College of Medicine, Seoul, Republic of Korea
| | - Cheri L Deal
- Endocrinology and Diabetes Service, CHU-Sainte Justine and Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
| | - Adam J Esbenshade
- Department of Pediatrics, Monroe Carell Jr. Children’s Hospital, Nashville, Tennessee, USA
| | | | - Andrew Peet
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK
| | | | | | - Margaret Zacharin
- Department of Endocrinology and Diabetes, Royal Children’s Hospital, Parkville, Melbourne, Victoria, Australia
| | - Anatoly Tiulpakov
- Department and Laboratory of Inherited Endocrine Disorders, Endocrinology Research Centre, Moscow, Russia
| | - Anastasia M Lapshina
- Department of Fundamental Pathomorphology, Endocrinology Research Centre, Moscow, Russia
| | | | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashutosh Rai
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Márta Korbonits
- Department of Endocrinology, Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Leanne de Kock
- Harry Perkins Institute of Medical Research, QEII Medical Centre and UWA Centre for Medical Research, the University of Western Australia, Perth, Australia
| | - Kim E Nichols
- Division of Cancer Predisposition, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, Tennessee, USA
| | - William D Foulkes
- Department of Medical Genetics, The Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada
- Department of Medical Genetics and Cancer Research Program, Research Institute McGill University Health Centre, Montreal, Quebec, Canada
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15
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Latif AL, Newcombe A, Li S, Gilroy K, Robertson NA, Lei X, Stewart HJS, Cole J, Terradas MT, Rishi L, McGarry L, McKeeve C, Reid C, Clark W, Campos J, Kirschner K, Davis A, Lopez J, Sakamaki JI, Morton JP, Ryan KM, Tait SWG, Abraham SA, Holyoake T, Higgins B, Huang X, Blyth K, Copland M, Chevassut TJT, Keeshan K, Adams PD. BRD4-mediated repression of p53 is a target for combination therapy in AML. Nat Commun 2021; 12:241. [PMID: 33431824 PMCID: PMC7801601 DOI: 10.1038/s41467-020-20378-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [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] [Received: 10/18/2019] [Accepted: 11/25/2020] [Indexed: 12/20/2022] Open
Abstract
Acute myeloid leukemia (AML) is a typically lethal molecularly heterogeneous disease, with few broad-spectrum therapeutic targets. Unusually, most AML retain wild-type TP53, encoding the pro-apoptotic tumor suppressor p53. MDM2 inhibitors (MDM2i), which activate wild-type p53, and BET inhibitors (BETi), targeting the BET-family co-activator BRD4, both show encouraging pre-clinical activity, but limited clinical activity as single agents. Here, we report enhanced toxicity of combined MDM2i and BETi towards AML cell lines, primary human blasts and mouse models, resulting from BETi's ability to evict an unexpected repressive form of BRD4 from p53 target genes, and hence potentiate MDM2i-induced p53 activation. These results indicate that wild-type TP53 and a transcriptional repressor function of BRD4 together represent a potential broad-spectrum synthetic therapeutic vulnerability for AML.
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Affiliation(s)
| | - Ashley Newcombe
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Sha Li
- Sanford Burnham Prebys Medical Discovery Institute, San Diego, CA, USA
| | - Kathryn Gilroy
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Neil A Robertson
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Xue Lei
- Sanford Burnham Prebys Medical Discovery Institute, San Diego, CA, USA
| | - Helen J S Stewart
- Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - John Cole
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Loveena Rishi
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Lynn McGarry
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Claire McKeeve
- West of Scotland Genomics Services (Laboratories), Queen Elizabeth University Hospital, Glasgow, UK
| | - Claire Reid
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Joana Campos
- Paul O'Gorman Leukemia Research Centre, Institute of Cancer Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Andrew Davis
- Sanford Burnham Prebys Medical Discovery Institute, San Diego, CA, USA
| | - Jonathan Lopez
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | - Jennifer P Morton
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Kevin M Ryan
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Stephen W G Tait
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - Sheela A Abraham
- Paul O'Gorman Leukemia Research Centre, Institute of Cancer Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- Department Of Biomedical And Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Tessa Holyoake
- Paul O'Gorman Leukemia Research Centre, Institute of Cancer Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Brian Higgins
- Pharma Research and Early Development, Roche Innovation Center-New York, New York, USA
| | - Xu Huang
- Paul O'Gorman Leukemia Research Centre, Institute of Cancer Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Karen Blyth
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Cancer Research UK Beatson Institute, Glasgow, UK
| | - Mhairi Copland
- Paul O'Gorman Leukemia Research Centre, Institute of Cancer Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | - Karen Keeshan
- Paul O'Gorman Leukemia Research Centre, Institute of Cancer Sciences, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Peter D Adams
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.
- Sanford Burnham Prebys Medical Discovery Institute, San Diego, CA, USA.
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16
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Spinler K, Bajaj J, Ito T, Zimdahl B, Hamilton M, Ahmadi A, Koechlein CS, Lytle N, Kwon HY, Anower-E-Khuda F, Sun H, Blevins A, Weeks J, Kritzik M, Karlseder J, Ginsberg MH, Park PW, Esko JD, Reya T. A stem cell reporter based platform to identify and target drug resistant stem cells in myeloid leukemia. Nat Commun 2020; 11:5998. [PMID: 33243988 PMCID: PMC7691523 DOI: 10.1038/s41467-020-19782-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Received: 03/13/2020] [Accepted: 10/29/2020] [Indexed: 12/14/2022] Open
Abstract
Intratumoral heterogeneity is a common feature of many myeloid leukemias and a significant reason for treatment failure and relapse. Thus, identifying the cells responsible for residual disease and leukemia re-growth is critical to better understanding how they are regulated. Here, we show that a knock-in reporter mouse for the stem cell gene Musashi 2 (Msi2) allows identification of leukemia stem cells in aggressive myeloid malignancies, and provides a strategy for defining their core dependencies. Specifically, we carry out a high throughput screen using Msi2-reporter blast crisis chronic myeloid leukemia (bcCML) and identify several adhesion molecules that are preferentially expressed in therapy resistant bcCML cells and play a key role in bcCML. In particular, we focus on syndecan-1, whose deletion triggers defects in bcCML growth and propagation and markedly improves survival of transplanted mice. Further, live imaging reveals that the spatiotemporal dynamics of leukemia cells are critically dependent on syndecan signaling, as loss of this signal impairs their localization, migration and dissemination to distant sites. Finally, at a molecular level, syndecan loss directly impairs integrin β7 function, suggesting that syndecan exerts its influence, at least in part, by coordinating integrin activity in bcCML. These data present a platform for delineating the biological underpinnings of leukemia stem cell function, and highlight the Sdc1-Itgβ7 signaling axis as a key regulatory control point for bcCML growth and dissemination.
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MESH Headings
- Animals
- Antineoplastic Agents/therapeutic use
- Blast Crisis/genetics
- Blast Crisis/pathology
- Blast Crisis/therapy
- Chemoradiotherapy/methods
- Disease Models, Animal
- Drug Resistance, Neoplasm/drug effects
- Gene Knock-In Techniques
- Gene Knockout Techniques
- Genes, Reporter/genetics
- Green Fluorescent Proteins/chemistry
- Green Fluorescent Proteins/genetics
- High-Throughput Screening Assays
- Humans
- Imatinib Mesylate/pharmacology
- Imatinib Mesylate/therapeutic use
- Integrin beta Chains/metabolism
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Mice, Transgenic
- Neoplastic Stem Cells/drug effects
- Neoplastic Stem Cells/pathology
- Neoplastic Stem Cells/radiation effects
- RNA-Binding Proteins/genetics
- RNA-Seq
- Signal Transduction/drug effects
- Syndecan-1/antagonists & inhibitors
- Syndecan-1/genetics
- Syndecan-1/metabolism
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Affiliation(s)
- Kyle Spinler
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Jeevisha Bajaj
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Takahiro Ito
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Bryan Zimdahl
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
- Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA
| | - Michael Hamilton
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Armin Ahmadi
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Claire S Koechlein
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Nikki Lytle
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Hyog Young Kwon
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Ferdous Anower-E-Khuda
- Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Hao Sun
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Allen Blevins
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Joi Weeks
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | - Marcie Kritzik
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA
| | | | - Mark H Ginsberg
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Pyong Woo Park
- Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jeffrey D Esko
- Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Tannishtha Reya
- Department of Pharmacology, University of California San Diego School of Medicine, La Jolla, CA, USA.
- Sanford Consortium for Regenerative Medicine, La Jolla, CA, USA.
- Department of Medicine, University of California San Diego, La Jolla, CA, USA.
- Moores Cancer Center, University of California San Diego School of Medicine, La Jolla, CA, USA.
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17
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Meyran D, Petit A, Guilhot J, Suttorp M, Sedlacek P, De Bont E, Li CK, Kalwak K, Lausen B, Culic S, de Moerloose B, Biondi A, Millot F. Lymphoblastic predominance of blastic phase in children with chronic myeloid leukaemia treated with imatinib: A report from the I-CML-Ped Study. Eur J Cancer 2020; 137:224-234. [PMID: 32799036 DOI: 10.1016/j.ejca.2020.06.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 02/09/2020] [Revised: 06/10/2020] [Accepted: 06/19/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Chronic myeloid leukaemia (CML) is a rare disease in children. The frequency and outcome of children evolving to accelerated phase (AP) or blastic phase (BP) under treatment with imatinib is unknown. The aim of the current study is to assess the incidence of progression from CML in chronic phase with imatinib frontline in a paediatric setting and describe the management and outcome of these patients. PATIENTS AND METHODS In the I-CML-Ped Study database (www.clinicaltrials.gov, #NCT01281735), 19 of 339 paediatric patients in chronic phase treated with imatinib in the frontline evolved to CML-AP or CML-BP. RESULTS With a median follow-up of 38 months (range: 2-190 months), the cumulative incidence of progression at 1 and 3 years was 3% (confidence interval [CI] 95%: 1-5%) and 7% (CI 95%: 4-11%), respectively. We observed a large predominance of lymphoid-BP (70%) over myeloid-BP (30%) with imatinib in frontline therapy. Sixteen patients underwent haematopoietic stem cell transplantation, and eight were treated with a tyrosine kinase inhibitor after transplant. Only the transplanted patients are alive. The 5-year overall survival rate of children with CML-AP/BP is 44%, with no statistical difference between the lymphoid-BP and myeloid-BP outcome. CONCLUSION Children evolving to AP or BP under treatment with imatinib have a very poor prognosis with an overall survival under 50%, much worse than children with advanced phase at diagnosis.
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Affiliation(s)
- Deborah Meyran
- Department of Pediatric Hematology, Robert Debré Hospital, APHP, Université de Paris, Paris, France.
| | - Arnaud Petit
- Department of Pediatric Hematology, Armand Trousseau Hospital, APHP, Sorbonne Université, Paris, France
| | | | - Meinolf Suttorp
- Medical Faculty, Pediatric Hemato-Oncology, Technical University, Dresden, Germany
| | - Petr Sedlacek
- Department of Pediatric Hemato-Oncology, University Hospital Motol, Prague, Czech Republic
| | - Eveline De Bont
- Departments of Paediatric Oncology/Haematology, Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Chi Kong Li
- Department of Pediatrics, Prince of Wales Hospital, Hong Kong, China
| | - Krzysztof Kalwak
- Department of Pediatric Hematology Oncology and Transplantation, Wroclaw Medical University, Poland
| | - Birgitte Lausen
- Department of Pediatrics, Rigshospitalet, University Hospital, Copenhagen, Denmark
| | - Srdjana Culic
- Department of Pediatric Hematology Oncology Immunology and Medical Genetics, Clinical Hospital Split, Croatia
| | | | - Andrea Biondi
- Department of Pediatrics, University of Milano-Bicocca, San Gerardo Hospital, Fondazione MBBM, Monza, Italy
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18
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Klobuch S, Hammon K, Vatter-Leising S, Neidlinger E, Zwerger M, Wandel A, Neuber LM, Heilmeier B, Fichtner R, Mirbeth C, Herr W, Thomas S. HLA-DPB1 Reactive T Cell Receptors for Adoptive Immunotherapy in Allogeneic Stem Cell Transplantation. Cells 2020; 9:cells9051264. [PMID: 32443793 PMCID: PMC7290340 DOI: 10.3390/cells9051264] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/07/2020] [Accepted: 05/19/2020] [Indexed: 12/30/2022] Open
Abstract
HLA-DPB1 antigens are mismatched in about 80% of allogeneic hematopoietic stem cell transplantations from HLA 10/10 matched unrelated donors and were shown to be associated with a decreased risk of leukemia relapse. We recently developed a reliable in vitro method to generate HLA-DPB1 mismatch-reactive CD4 T-cell clones from allogeneic donors. Here, we isolated HLA-DPB1 specific T cell receptors (TCR DP) and used them either as wild-type or genetically optimized receptors to analyze in detail the reactivity of transduced CD4 and CD8 T cells toward primary AML blasts. While both CD4 and CD8 T cells showed strong AML reactivity in vitro, only CD4 T cells were able to effectively eliminate leukemia blasts in AML engrafted NOD/SCID/IL2Rγc−/− (NSG) mice. Further analysis showed that optimized TCR DP and under some conditions wild-type TCR DP also mediated reactivity to non-hematopoietic cells like fibroblasts or tumor cell lines after HLA-DP upregulation. In conclusion, T cells engineered with selected allo-HLA-DPB1 specific TCRs might be powerful off-the-shelf reagents in allogeneic T-cell therapy of leukemia. However, because of frequent (common) cross-reactivity to non-hematopoietic cells with optimized TCR DP T cells, safety mechanisms are mandatory.
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Affiliation(s)
- Sebastian Klobuch
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
- Correspondence: (S.K.); (S.T.); Tel.: +49-941-944-5142 (S.T.)
| | - Kathrin Hammon
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
- Regensburg Center for Interventional Immunology, University of Regensburg, 93042 Regensburg, Germany
| | - Sarah Vatter-Leising
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Elisabeth Neidlinger
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Michael Zwerger
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Annika Wandel
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Laura Maria Neuber
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Bernhard Heilmeier
- Department of Oncology and Hematology, Hospital Barmherzige Brueder, 93049 Regensburg, Germany;
| | - Regina Fichtner
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Carina Mirbeth
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Wolfgang Herr
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
| | - Simone Thomas
- Department of Internal Medicine III, University Hospital Regensburg, 93042 Regensburg, Germany; (K.H.); (S.V.-L.); (E.N.); (M.Z.); (A.W.); (L.M.N.); (R.F.); (C.M.); (W.H.)
- Regensburg Center for Interventional Immunology, University of Regensburg, 93042 Regensburg, Germany
- Correspondence: (S.K.); (S.T.); Tel.: +49-941-944-5142 (S.T.)
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19
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Shvachko LP, Zavelevich MP, Gluzman DF, Telegeev GD. Aberrant expression of placental-like alkaline phosphatase in chronic myeloid leukemia cells in vitro and its modulation by vitamin E. Exp Oncol 2020; 42:31-34. [PMID: 32231189 DOI: 10.32471/exp-oncology.2312-8852.vol-42-no-1.14285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
UNLABELLED Placental-like alkaline phosphatase (PLAP) is expressed by many tumors and can be detected in sera of patients with various cancers. Its aberrant expression has been considered to be potentially useful as tumor marker. However, the biological background of the role of this aberrant alkaline phosphatase (AP) in cancer is still unclear. The expression of various forms of AP in cells of chronic myeloid leukemia (CML) has not yet been studied. AIM To analyze the expression patterns of various AP forms in cells originated from CML patients in blast crisis and to modify their expression by vitamin E. MATERIALS AND METHODS RNA extracted from leukemic cells was converted to cDNA and real-time reverse transcription polymerase chain reaction was performed using SYBR Green protocol with primers to tissue non-specific alkaline phosphatase (TNAP), intestinal alkaline phosphatase and CCAAT-enhancer-binding proteins alpha (C/EBPα). To analyze the modulation of expression of APs and C/EBPα, CML cells were incubated with 100 µM vitamin E. RESULTS We have observed the aberrant expression of mRNA intestinal alkaline phosphatase in CML cells that upon sequencing demonstrated the significant alignment with PLAP sequence while no gene homology with tissue placental alkaline phosphatase (PAP) was revealed. Vitamin E decreases mRNA PLAP expression and increases mRNA TNAP expression. Moreover, along with down-regulation of aberrant PLAP and up-regulation of TNAP, vitamin E increases C/EBPα mRNA expression. CONCLUSION The loss of TNAP in CML may contribute to pathogenesis of this disease. PLAP may be considered as a putative target in differentiation therapies in myeloid neoplasms. Our findings suggest the potential role of vitamin E as the inducer of differentiation potential of leukemic cells in CML.
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MESH Headings
- Alkaline Phosphatase/genetics
- Biomarkers, Tumor/genetics
- Blast Crisis/enzymology
- Blast Crisis/genetics
- Blast Crisis/pathology
- Cell Line, Tumor
- Down-Regulation
- Gene Expression Regulation, Neoplastic/drug effects
- Humans
- Isoenzymes/genetics
- K562 Cells
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/enzymology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Up-Regulation
- Vitamin E/pharmacology
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Affiliation(s)
- L P Shvachko
- Institute of Molecular Biology and Genetics, NAS of Ukraine, Kyiv 03680, Ukraine
| | - M P Zavelevich
- R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine, Kyiv 03022, Ukraine
| | - D F Gluzman
- R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, NAS of Ukraine, Kyiv 03022, Ukraine
| | - G D Telegeev
- Institute of Molecular Biology and Genetics, NAS of Ukraine, Kyiv 03680, Ukraine
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20
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Hayatigolkhatmi K, Padroni G, Su W, Fang L, Gómez-Castañeda E, Hsieh YC, Jackson L, Pellicano F, Burley GA, Jørgensen HG. An investigation of targeted inhibition of transcription factor activity with pyrrole imidazole polyamide (PA) in chronic myeloid leukemia (CML) blast crisis cells. Bioorg Med Chem Lett 2019; 29:2622-2625. [PMID: 31378570 DOI: 10.1016/j.bmcl.2019.07.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/14/2019] [Revised: 06/28/2019] [Accepted: 07/26/2019] [Indexed: 10/26/2022]
Abstract
Tyrosine kinase inhibitor (TKI) therapy is the standard treatment for chronic phase (CP)-chronic myeloid leukemia (CML), yet patients in blast crisis (BC) phase of CML are unlikely to respond to TKI therapy. The transcription factor E2F1 is a down-stream target of the tyrosine kinase BCR-ABL1 and is up-regulated in TKI-resistant leukemia stem cells (LSC). Pyrrole imidazole polyamides (PA) are minor groove binders which can be programmed to target DNA sequences in a gene-selective manner. This manuscript describes such an approach with a PA designed to down-regulate E2F1 controlled gene expression by targeting a DNA sequence within 100 base pairs (bp) upstream of the E2F1 consensus sequence. Human BC-CML KCL22 cells were assessed after treatment with PA, TKI or their combination. Our PA inhibited BC-CML cell expansion based on cell density analysis compared to an untreated control after a 48-hour time-course of PA treatment. However, no evidence of cell cycle arrest was observed among BC-CML cells treated with PA, with respect to their no drug control counterparts. Thus, this work demonstrates that PAs are effective in inhibiting E2F1 TF activity which results in a temporal reduction in BC-CML cell number. We envisage that PAs could be used in the future to map genes under E2F1 control in CML LSCs.
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MESH Headings
- Antineoplastic Agents/chemical synthesis
- Antineoplastic Agents/chemistry
- Antineoplastic Agents/pharmacology
- Blast Crisis/drug therapy
- Blast Crisis/metabolism
- Blast Crisis/pathology
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Dose-Response Relationship, Drug
- Drug Screening Assays, Antitumor
- E2F1 Transcription Factor/antagonists & inhibitors
- E2F1 Transcription Factor/genetics
- E2F1 Transcription Factor/metabolism
- Humans
- Imidazoles/chemistry
- Imidazoles/pharmacology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Molecular Structure
- Nylons/chemistry
- Nylons/pharmacology
- Protein Kinase Inhibitors/chemical synthesis
- Protein Kinase Inhibitors/chemistry
- Protein Kinase Inhibitors/pharmacology
- Pyrroles/chemistry
- Pyrroles/pharmacology
- Structure-Activity Relationship
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Affiliation(s)
- K Hayatigolkhatmi
- Paul O'Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - G Padroni
- Department of Pure and Applied Chemistry, University of Strathclyde, Thomas Graham Building, Glasgow, UK
| | - W Su
- Guangdong Key Laboratory of Nanomedicine, Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, PR China
| | - L Fang
- Guangdong Key Laboratory of Nanomedicine, Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, PR China
| | - E Gómez-Castañeda
- Paul O'Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - Y C Hsieh
- Paul O'Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - L Jackson
- Paul O'Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK
| | - F Pellicano
- Drug Discovery Program, Cancer Research UK Beatson Institute, Garscube Estate, Glasgow, UK
| | - G A Burley
- Department of Pure and Applied Chemistry, University of Strathclyde, Thomas Graham Building, Glasgow, UK
| | - H G Jørgensen
- Paul O'Gorman Leukaemia Research Centre, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
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21
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Kuan JW, Su AT, Leong CF, Osato M, Sashida G. Systematic Review of Normal Subjects Harbouring BCR-ABL1 Fusion Gene. Acta Haematol 2019; 143:96-111. [PMID: 31401626 DOI: 10.1159/000501146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 02/12/2019] [Accepted: 05/24/2019] [Indexed: 11/19/2022]
Abstract
The treatment of chronic myeloid leukaemia (CML) requires quantitative polymerase chain reaction (qPCR) to monitor BCR-ABL1 in International Scale (IS). Some normal subjects were found to harbour BCR-ABL1. We performed a systematic review on normal subjects harbouring BCR-ABL1. A literature search was done on July 16, 2017 using EBSCOhost Research Databases interface and Western Pacific Region Index Medicus. Two authors selected the studies, extracted the data, and evaluated the quality of studies using the modified Appraisal Tool for Cross-Sectional Studies independently. The outcomes were prevalence, level of BCR-ABL1IS, proportion, and time of progression to CML. The initial search returned 4,770 studies. Eleven studies, all having used convenient sampling, were included, with total of 1,360 subjects. Ten studies used qualitative PCR and one used qPCR (not IS). The mean prevalence of M-BCR was 5.9, 15.5, and 15.9% in cord blood/newborns/infants (CB/NB/I) (n = 170), children (n = 90), and adults (n = 454), respectively, while m-BCR was 15, 26.9, and 23.1% in CB/NB/I (n = 786), children (n = 67), and adults (n = 208), respectively. No study reported the proportion and time of progression to CML. Nine studies were graded as moderate quality, one study as poor quality, and one study as unacceptable. The result of the studies could neither be inferred to the general normal population nor compared. Follow-up data were scarce.
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Affiliation(s)
- Jew Win Kuan
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia,
- International Research Centre for Medical Sciences, Kumamoto University, Kumamoto, Japan,
| | - Anselm Ting Su
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Chooi Fun Leong
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Motomi Osato
- International Research Centre for Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Goro Sashida
- International Research Centre for Medical Sciences, Kumamoto University, Kumamoto, Japan
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22
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Lo TH, Abadir E, Gasiorowski RE, Kabani K, Ramesh M, Orellana D, Fromm PD, Kupresanin F, Newman E, Cunningham I, Hart DNJ, Silveira PA, Clark GJ. Examination of CD302 as a potential therapeutic target for acute myeloid leukemia. PLoS One 2019; 14:e0216368. [PMID: 31075107 PMCID: PMC6510432 DOI: 10.1371/journal.pone.0216368] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 04/18/2019] [Indexed: 01/03/2023] Open
Abstract
Acute myeloid leukemia (AML) is the most common form of adult acute leukemia with ~20,000 new cases yearly. The disease develops in people of all ages, but is more prominent in the elderly, who due to limited treatment options, have poor overall survival rates. Monoclonal antibodies (mAb) targeting specific cell surface molecules have proven to be safe and effective in different haematological malignancies. However, AML target molecules are currently limited so discovery of new targets would be highly beneficial to patients. We examined the C-type lectin receptor CD302 as a potential therapeutic target for AML due to its selective expression in myeloid immune populations. In a cohort of 33 AML patients with varied morphological and karyotypic classifications, 88% were found to express CD302 on the surface of blasts and 80% on the surface of CD34+ CD38- population enriched with leukemic stem cells. A mAb targeting human CD302 was effective in mediating antibody dependent cell cytotoxicity and was internalised, making it amenable to toxin conjugation. Targeting CD302 with antibody limited in vivo engraftment of the leukemic cell line HL-60 in NOD/SCID mice. While CD302 was expressed in a hepatic cell line, HepG2, this molecule was not detected on the surface of HepG2, nor could HepG2 be killed using a CD302 antibody-drug conjugate. Expression was however found on the surface of haematopoietic stem cells suggesting that targeting CD302 would be most effective prior to haematopoietic transplantation. These studies provide the foundation for examining CD302 as a potential therapeutic target for AML.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Animals
- Antigens, Neoplasm/metabolism
- Antineoplastic Agents, Immunological/pharmacology
- Blast Crisis/drug therapy
- Blast Crisis/metabolism
- Blast Crisis/pathology
- Drug Delivery Systems
- Female
- HL-60 Cells
- Hematopoietic Stem Cell Transplantation
- Hep G2 Cells
- Humans
- Lectins, C-Type/metabolism
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Male
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Middle Aged
- Neoplastic Stem Cells/metabolism
- Neoplastic Stem Cells/pathology
- Receptors, Cell Surface/metabolism
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Tsun-Ho Lo
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
| | - Edward Abadir
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Robin E. Gasiorowski
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Department of Haematology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Karieshma Kabani
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Murari Ramesh
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Daniel Orellana
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Phillip D. Fromm
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Fiona Kupresanin
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
| | - Elizabeth Newman
- Department of Haematology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Ilona Cunningham
- Department of Haematology, Concord Repatriation General Hospital, Sydney, NSW, Australia
| | - Derek N. J. Hart
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- Department of Haematology, Concord Repatriation General Hospital, Sydney, NSW, Australia
- Institute of Haematology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Pablo A. Silveira
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Georgina J. Clark
- Dendritic Cell Research, ANZAC Research Institute, Sydney, NSW, Australia
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
- * E-mail:
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23
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Iurlo A, Cattaneo D, Gianelli U. Blast Transformation in Myeloproliferative Neoplasms: Risk Factors, Biological Findings, and Targeted Therapeutic Options. Int J Mol Sci 2019; 20:ijms20081839. [PMID: 31013941 PMCID: PMC6514804 DOI: 10.3390/ijms20081839] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [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: 03/08/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 01/24/2023] Open
Abstract
Myeloproliferative neoplasms represent a heterogenous group of disorders of the hematopoietic stem cell, with an intrinsic risk of evolution into acute myeloid leukemia. The frequency of leukemic evolution varies according to myeloproliferative neoplasms subtype. It is highest in primary myelofibrosis, where it is estimated to be approximately 10–20% at 10 years, following by polycythemia vera, with a risk of 2.3% at 10 years and 7.9% at 20 years. In essential thrombocythemia, however, transformation to acute myeloid leukemia is considered relatively uncommon. Different factors are associated with leukemic evolution in myeloproliferative neoplasms, but generally include advanced age, leukocytosis, exposure to myelosuppressive therapy, cytogenetic abnormalities, as well as increased number of mutations in genes associated with myeloid neoplasms. The prognosis of these patients is dismal, with a medium overall survival ranging from 2.6–7.0 months. Currently, there is no standard of care for managing the blast phase of these diseases, and no treatment to date has consistently led to prolonged survival and/or hematological remission apart from an allogeneic stem cell transplant. Nevertheless, new targeted agents are currently under development. In this review, we present the current evidence regarding risk factors, molecular characterization, and treatment options for this critical subset of myeloproliferative neoplasms patients.
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Affiliation(s)
- Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, and University of Milan, 20122 Milan, Italy.
| | - Daniele Cattaneo
- Hematology Division, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, and University of Milan, 20122 Milan, Italy.
| | - Umberto Gianelli
- Division of Pathology, Department of Pathophysiology and Transplantation, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, and University of Milan, 20122 Milan, Italy.
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24
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Müller-Thomas C, Tüchler H, Rudelius M, Schneider H, Pfefferkorn S, Götze KS. Serum Vitamin D Levels in Patients with Myelodysplastic Syndromes: A Retrospective Single-Center Analysis. Acta Haematol 2019; 141:225-231. [PMID: 30965326 DOI: 10.1159/000496014] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/30/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS There is growing evidence supporting the role of innate immune deregulation and inflammation in the pathogenesis of myelodysplastic syndromes (MDS). Vitamin D (VD) is known to be involved in various immune and epigenetic processes. This analysis aimed to evaluate serum VD levels in patients with MDS and to analyze associations between serum VD levels and disease characteristics. METHODS Serum levels of 25-hydroxyvitamin D3 (25(OH)-D3), the major form of VD in human serum, were measured by chemiluminescence immunoassay in 62 unselected patients with MDS. Associations between serum 25(OH)-D3 levels and disease characteristics were analyzed using Kendall's tau and two-sided p values. RESULTS The median serum 25(OH)-D3 level was markedly reduced (17.5 ng/mL). Patients with lower-risk disease features had lower serum 25(OH)-D3 levels than patients with higher-risk disease features with regard to medullary blast counts (16 vs. 31 ng/mL, p < 0.001), the revised international prognostic scoring system (13 vs. 30.5 ng/mL, p = 0.001), and blood counts. CONCLUSIONS We show that patients with lower-risk disease characteristics exhibit lower serum VD levels than patients with higher-risk disease characteristics. Whether these findings might reflect innate immune deregulation has to be investigated in further studies.
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Affiliation(s)
- Catharina Müller-Thomas
- Department of Medicine III, Hematology and Oncology, Technische Universität München, Munich, Germany,
| | - Heinz Tüchler
- Ludwig Boltzmann Institute for Leukemia Research, Vienna, Austria
| | - Martina Rudelius
- Institute of Pathology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Heike Schneider
- Institute of Clinical Chemistry und Pathobiochemistry, Technische Universität München, Munich, Germany
| | - Sabrina Pfefferkorn
- Department of Medicine III, Hematology and Oncology, Technische Universität München, Munich, Germany
| | - Katharina S Götze
- Department of Medicine III, Hematology and Oncology, Technische Universität München, Munich, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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25
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Klumb CE, Barbosa TDC, Nestal de Moraes G, Schramm MT, Emerenciano M, Maia RC. IKZF1 deletion and co-occurrence with other aberrations in a child with chronic myeloid leukemia progressing to acute lymphoblastic leukemia. Pediatr Blood Cancer 2019; 66:e27570. [PMID: 30511400 DOI: 10.1002/pbc.27570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/24/2018] [Accepted: 11/05/2018] [Indexed: 12/20/2022]
Abstract
Chronic myeloid leukemia (CML) is a rare disease in children. Different from that in adults, childhood CML involves transformative events occurring over a short time period. CML transformation to lymphoid blast phase (BP) is associated with copy number abnormalities, characteristic of BCR-ABL1 positive acute lymphoblastic leukemia, but not of CML in the chronic phase. Here, we present an unusual case of CML progressing to BP in a 1.6-year-old child, harboring IKZF1, PAX5, CDKN2A, and ETV6 deletions at diagnosis. It remains to be addressed whether distinct mechanisms might account for CML pathogenesis in early childhood.
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Affiliation(s)
- Claudete Esteves Klumb
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Pesquisa em Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | | | - Gabriela Nestal de Moraes
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Pesquisa em Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | | | - Mariana Emerenciano
- Grupo de Estudo em Câncer Molecular, Divisão de Pesquisa Clínica, INCA, Rio de Janeiro, Brazil
| | - Raquel Ciuvalschi Maia
- Laboratório de Hemato-Oncologia Celular e Molecular, Programa de Pesquisa em Hemato-Oncologia Molecular, Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
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26
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Scherber RM, Mesa RA. Managing myelofibrosis (MF) that "blasts" through: advancements in the treatment of relapsed/refractory and blast-phase MF. Hematology Am Soc Hematol Educ Program 2018; 2018:118-126. [PMID: 30504300 PMCID: PMC6245993 DOI: 10.1182/asheducation-2018.1.118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Myelofibrosis (MF) is the most aggressive form of Philadelphia chromosome-negative myeloproliferative neoplasm, and it is complicated by severe symptom burden, thrombotic events, infections, cytopenias, and transformation to acute myeloid leukemia (AML). Ruxolitinib, the first-line therapy for symptomatic or intermediate- and high-prognostic risk MF, has improved overall survival for this population. However, approximately one-half of MF patients will discontinue ruxolitinib by the first few years of therapy due to a spectrum of resistance, intolerance, relapse, or progression to blast phase disease. Danazol, erythropoietin-stimulating agents, and spleen-directed therapies can be useful in the ruxolitinib-resistant setting. In the ruxolitinib-refractory or -intolerant setting, commercial and novel therapies, either alone or in combination with ruxolitinib, have shown clinical utility. For blast-phase MF, the recent advancements in available AML therapies have increased the options with targeted and more tolerable therapies. In this article, we will discuss our paradigm for the management of relapsed/refractory and blast-phase MF in the context of therapeutic advancements in both AML and MF.
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Affiliation(s)
- Robyn M. Scherber
- Department of Hematology and Oncology, Mays Cancer Center, University of Texas MD Anderson, University of Texas, San Antonio, TX; and
| | - Ruben A. Mesa
- Mays Cancer Center, University of Texas MD Anderson, University of Texas, San Antonio, TX
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27
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Abstract
The use of multiagent combination chemotherapy regimens results in cure rates of >90% for children and ∼40% for adults with acute lymphoblastic leukemia (ALL) but is associated with extensive toxicity and disappointingly low efficacy in relapsed patients. ALL blast cells express several surface antigens, including CD20, CD22, and CD19, which represent valuable targets for immunotherapy. Monoclonal antibodies, antibody-drug conjugates, and bispecific T-cell-engaging antibodies targeting these antigens offer novel mechanisms of action. Within the last several years, the anti-CD20 antibody rituximab has been added to chemotherapy for newly diagnosed patients <60 years with CD20+ pre-B ALL and significantly improved the 2-year event-free survival from 52% to 65%. In adults with relapsed or refractory CD22+ ALL, the antibody-drug conjugate inotuzumab ozogamicin resulted in a complete response rate of 81% and median overall survival of 7.7 months with reduced toxicity compared with standard chemotherapy. Similarly, the bispecific T-cell-engaging antibody blinatumomab yielded a complete response rate of 44% and a median overall survival of 7.7 months in an extensively treated ALL population. Moreover, ∼80% of ALL patients in complete remission with evidence of minimal residual disease (MRD) achieved a complete MRD response following treatment with blinatumomab. These results highlight the tremendous promise of antibody-based treatment approaches for ALL. Ongoing and future research is critical to further define the role of the various immunotherapies in the frontline treatment of ALL. Additional challenges include the optimal sequencing of the available antibodies in the relapsed setting as well as their integration with stem cell transplant and chimeric antigen receptor T-cell therapy.
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Affiliation(s)
- Shira Dinner
- Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; and
| | - Michaela Liedtke
- Division of Hematology, Department of Medicine, Stanford University School of Medicine, Stanford, CA
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28
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Affiliation(s)
- Ahmet Emre Eskazan
- a Division of Hematology, Department of Internal Medicine, Cerrahpasa Faculty of Medicine , Istanbul University , Istanbul , Turkey
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29
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Inoue M, Hagihara M, Uchida T, Hua J, Nakajima T, Tajima S, Ota Y. A Rare Monocytic Crisis of Chronic Myelogenous Leukemia Presenting with Unusual Extramedullary Manifestations and an Atypical (14;22)(q24;q11.2) Translocation in the Bone Marrow. Intern Med 2017; 56:3341-3346. [PMID: 29021476 PMCID: PMC5790724 DOI: 10.2169/internalmedicine.8617-16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A 48-year-old man was admitted due to marked leukocytosis. Bone marrow examinations resulted in a diagnosis of Philadelphia (Ph) chromosome-positive chronic myeloid leukemia. One month later, massive muscle and bone invasion by leukemic cells was detected. After induction chemotherapy, he complained of a headache and visual loss, which was caused by a leukemic infiltration in the central nervous system. After temporary remission in response to chemotherapy, the disease relapsed in the form of an intracranial tumor. The unusual t(14;22)(q24;q11.2) translocation of the Ph-chromosome and the significant increase in monocytes observed might have contributed to the unique and aggressive clinical course.
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MESH Headings
- Blast Crisis/pathology
- Bone Marrow Neoplasms/secondary
- Central Nervous System Neoplasms/secondary
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Middle Aged
- Monocytes/pathology
- Philadelphia Chromosome
- Translocation, Genetic
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Affiliation(s)
| | | | | | - Jian Hua
- Depatment of Hematology, Eiju General Hospital, Japan
| | | | - Shogo Tajima
- Department of Pathology, Eiju General Hospital, Japan
| | - Yasunori Ota
- Department of Pathology, Teikyo University School of Medicine, Japan
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30
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Brock K, Billingham L, Copland M, Siddique S, Sirovica M, Yap C. Implementing the EffTox dose-finding design in the Matchpoint trial. BMC Med Res Methodol 2017; 17:112. [PMID: 28728594 PMCID: PMC5520236 DOI: 10.1186/s12874-017-0381-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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] [Received: 02/03/2017] [Accepted: 06/30/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The Matchpoint trial aims to identify the optimal dose of ponatinib to give with conventional chemotherapy consisting of fludarabine, cytarabine and idarubicin to chronic myeloid leukaemia patients in blastic transformation phase. The dose should be both tolerable and efficacious. This paper describes our experience implementing EffTox in the Matchpoint trial. METHODS EffTox is a Bayesian adaptive dose-finding trial design that jointly scrutinises binary efficacy and toxicity outcomes. We describe a nomenclature for succinctly describing outcomes in phase I/II dose-finding trials. We use dose-transition pathways, where doses are calculated for each feasible set of outcomes in future cohorts. We introduce the phenomenon of dose ambivalence, where EffTox can recommend different doses after observing the same outcomes. We also describe our experiences with outcome ambiguity, where the categorical evaluation of some primary outcomes is temporarily delayed. RESULTS We arrived at an EffTox parameterisation that is simulated to perform well over a range of scenarios. In scenarios where dose ambivalence manifested, we were guided by the dose-transition pathways. This technique facilitates planning, and also helped us overcome short-term outcome ambiguity. CONCLUSIONS EffTox is an efficient and powerful design, but not without its challenges. Joint phase I/II clinical trial designs will likely become increasingly important in coming years as we further investigate non-cytotoxic treatments and streamline the drug approval process. We hope this account of the problems we faced and the solutions we used will help others implement this dose-finding clinical trial design. TRIAL REGISTRATION Matchpoint was added to the European Clinical Trials Database ( https://www.clinicaltrialsregister.eu/ctr-search/trial/2012-005629-65/GB ) on 2013-12-30.
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Affiliation(s)
- Kristian Brock
- Cancer Research UK Clinical Trials Unit, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
| | - Lucinda Billingham
- Cancer Research UK Clinical Trials Unit, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Mhairi Copland
- Paul O'Gorman Leukaemia Research Centre, University of Glasgow, Glasgow, UK
| | - Shamyla Siddique
- Cancer Research UK Clinical Trials Unit, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Mirjana Sirovica
- Cancer Research UK Clinical Trials Unit, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Christina Yap
- Cancer Research UK Clinical Trials Unit, Institute of Cancer & Genomic Sciences, University of Birmingham, Birmingham, B15 2TT, UK
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31
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Etchin J, Berezovskaya A, Conway AS, Galinsky IA, Stone RM, Baloglu E, Senapedis W, Landesman Y, Kauffman M, Shacham S, Wang JCY, Look AT. KPT-8602, a second-generation inhibitor of XPO1-mediated nuclear export, is well tolerated and highly active against AML blasts and leukemia-initiating cells. Leukemia 2017; 31:143-150. [PMID: 27211268 PMCID: PMC5220128 DOI: 10.1038/leu.2016.145] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 03/24/2016] [Accepted: 04/25/2016] [Indexed: 12/30/2022]
Abstract
Acute myeloid leukemia (AML) is a clonal hematologic malignant disease of developing myeloid cells that have acquired aberrant survival, uncontrolled proliferation and a block in normal hematopoietic cell differentiation. Standard chemotherapy often induces remissions in AML patients, but the disease frequently relapses due to incomplete targeting of leukemia-initiating cells (LICs), emphasizing the need for novel effective treatments. Exportin 1 (XPO1)-mediated nuclear export, which is inhibited by the drug selinexor, is an attractive new therapeutic target in AML. Selinexor has shown impressive activity in Phase I/II clinical trials for AML. Here we report the anti-leukemic efficacy and tolerability of KPT-8602, a second-generation XPO1 inhibitor. KPT-8602 demonstrates substantially reduced brain penetration compared to selinexor, with resultant attenuation of the central nervous system mediated side effects of anorexia and weight loss. Due to its improved tolerability profile, KPT-8602 can be given daily compared to the two or three times weekly regimen of selinexor, and exhibits greater anti-leukemic efficacy against both leukemic blasts and LICs in AML patient-derived xenograft models. Importantly, normal hematopoietic stem and progenitor cell (HSPC) frequency is not significantly reduced by KPT-8602, providing a therapeutic window for elimination of relapse-driving LICs while sparing normal HSPCs. These findings strongly endorse clinical testing of KPT-8602 in patients with relapsed and refractory AML.
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Affiliation(s)
- J Etchin
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Division of Hematology/Oncology, Children's Hospital, Boston, MA, USA
| | - A Berezovskaya
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - A S Conway
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - I A Galinsky
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - R M Stone
- Department of Medical Oncology, Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - E Baloglu
- Karyopharm Therapeutics, Newton, MA, USA
| | | | | | - M Kauffman
- Karyopharm Therapeutics, Newton, MA, USA
| | - S Shacham
- Karyopharm Therapeutics, Newton, MA, USA
| | - J C Y Wang
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - A T Look
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Division of Hematology/Oncology, Children's Hospital, Boston, MA, USA
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32
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Dasgupta Y, Koptyra M, Hoser G, Kantekure K, Roy D, Gornicka B, Nieborowska-Skorska M, Bolton-Gillespie E, Cerny-Reiterer S, Müschen M, Valent P, Wasik MA, Richardson C, Hantschel O, van der Kuip H, Stoklosa T, Skorski T. Normal ABL1 is a tumor suppressor and therapeutic target in human and mouse leukemias expressing oncogenic ABL1 kinases. Blood 2016; 127:2131-43. [PMID: 26864341 PMCID: PMC4850868 DOI: 10.1182/blood-2015-11-681171] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Accepted: 02/07/2016] [Indexed: 11/20/2022] Open
Abstract
Leukemias expressing constitutively activated mutants of ABL1 tyrosine kinase (BCR-ABL1, TEL-ABL1, NUP214-ABL1) usually contain at least 1 normal ABL1 allele. Because oncogenic and normal ABL1 kinases may exert opposite effects on cell behavior, we examined the role of normal ABL1 in leukemias induced by oncogenic ABL1 kinases. BCR-ABL1-Abl1(-/-) cells generated highly aggressive chronic myeloid leukemia (CML)-blast phase-like disease in mice compared with less malignant CML-chronic phase-like disease from BCR-ABL1-Abl1(+/+) cells. Additionally, loss of ABL1 stimulated proliferation and expansion of BCR-ABL1 murine leukemia stem cells, arrested myeloid differentiation, inhibited genotoxic stress-induced apoptosis, and facilitated accumulation of chromosomal aberrations. Conversely, allosteric stimulation of ABL1 kinase activity enhanced the antileukemia effect of ABL1 tyrosine kinase inhibitors (imatinib and ponatinib) in human and murine leukemias expressing BCR-ABL1, TEL-ABL1, and NUP214-ABL1. Therefore, we postulate that normal ABL1 kinase behaves like a tumor suppressor and therapeutic target in leukemias expressing oncogenic forms of the kinase.
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MESH Headings
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Blast Crisis/drug therapy
- Blast Crisis/enzymology
- Blast Crisis/genetics
- Blast Crisis/pathology
- Cell Division/drug effects
- Cell Line, Tumor
- Cytostatic Agents/pharmacology
- Gene Expression Regulation, Leukemic/drug effects
- Genes, Tumor Suppressor
- Genes, abl
- Genomic Instability
- Humans
- Imatinib Mesylate/pharmacology
- Imatinib Mesylate/therapeutic use
- Imidazoles/pharmacology
- Imidazoles/therapeutic use
- Leukemia, Experimental/drug therapy
- Leukemia, Experimental/enzymology
- Leukemia, Experimental/genetics
- Leukemia, Experimental/pathology
- Leukemia, Myeloid, Chronic-Phase/drug therapy
- Leukemia, Myeloid, Chronic-Phase/enzymology
- Leukemia, Myeloid, Chronic-Phase/genetics
- Leukemia, Myeloid, Chronic-Phase/pathology
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Neoplasm Proteins/antagonists & inhibitors
- Neoplasm Proteins/genetics
- Neoplasm Proteins/physiology
- Neoplastic Stem Cells/drug effects
- Neoplastic Stem Cells/enzymology
- Oncogene Proteins v-abl/antagonists & inhibitors
- Oncogene Proteins v-abl/genetics
- Oncogene Proteins v-abl/physiology
- Oncogene Proteins, Fusion/antagonists & inhibitors
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/physiology
- Oxidative Stress
- Protein Kinase Inhibitors/pharmacology
- Protein Kinase Inhibitors/therapeutic use
- Proto-Oncogene Proteins c-abl/genetics
- Proto-Oncogene Proteins c-abl/physiology
- Pyridazines/pharmacology
- Pyridazines/therapeutic use
- Tumor Suppressor Proteins/antagonists & inhibitors
- Tumor Suppressor Proteins/genetics
- Tumor Suppressor Proteins/physiology
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Affiliation(s)
- Yashodhara Dasgupta
- Department of Microbiology & Immunology, Temple University School of Medicine, Philadelphia, PA
| | - Mateusz Koptyra
- Department of Microbiology & Immunology, Temple University School of Medicine, Philadelphia, PA
| | - Grazyna Hoser
- Department of Clinical Cytology, Medical Center for Postgraduate Education, Warsaw, Poland
| | - Kanchan Kantekure
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Darshan Roy
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Barbara Gornicka
- Department of Pathology, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Sabine Cerny-Reiterer
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna and Ludwig-Boltzmann Cluster Oncology, Vienna, Austria
| | - Markus Müschen
- Department of Laboratory Medicine, University of California San Francisco, San Francisco, CA
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna and Ludwig-Boltzmann Cluster Oncology, Vienna, Austria
| | - Mariusz A Wasik
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA
| | - Christine Richardson
- Department of Biological Sciences and Center of Bioinformatics, University of North Carolina at Charlotte, Charlotte, NC
| | - Oliver Hantschel
- Swiss Institute for Experimental Cancer Research, School of Life Sciences, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Heiko van der Kuip
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology and University of Tuebingen, Stuttgart, Germany; and
| | - Tomasz Stoklosa
- Department of Immunology, Medical University of Warsaw, Warsaw, Poland
| | - Tomasz Skorski
- Department of Microbiology & Immunology, Temple University School of Medicine, Philadelphia, PA
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Bhagwat AS, Roe JS, Mok BYL, Hohmann AF, Shi J, Vakoc CR. BET Bromodomain Inhibition Releases the Mediator Complex from Select cis-Regulatory Elements. Cell Rep 2016; 15:519-530. [PMID: 27068464 DOI: 10.1016/j.celrep.2016.03.054] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 01/22/2016] [Accepted: 03/14/2016] [Indexed: 12/17/2022] Open
Abstract
The bromodomain and extraterminal (BET) protein BRD4 can physically interact with the Mediator complex, but the relevance of this association to the therapeutic effects of BET inhibitors in cancer is unclear. Here, we show that BET inhibition causes a rapid release of Mediator from a subset of cis-regulatory elements in the genome of acute myeloid leukemia (AML) cells. These sites of Mediator eviction were highly correlated with transcriptional suppression of neighboring genes, which are enriched for targets of the transcription factor MYB and for functions related to leukemogenesis. A shRNA screen of Mediator in AML cells identified the MED12, MED13, MED23, and MED24 subunits as performing a similar regulatory function to BRD4 in this context, including a shared role in sustaining a block in myeloid maturation. These findings suggest that the interaction between BRD4 and Mediator has functional importance for gene-specific transcriptional activation and for AML maintenance.
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Affiliation(s)
- Anand S Bhagwat
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA; Department of Molecular Genetics and Microbiology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jae-Seok Roe
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Beverly Y L Mok
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Anja F Hohmann
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA
| | - Junwei Shi
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY 11724, USA; Molecular and Cellular Biology Program, Stony Brook University, Stony Brook, NY 11794, USA
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34
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DiNardo CD, Garcia-Manero G, Pierce S, Nazha A, Bueso-Ramos C, Jabbour E, Ravandi F, Cortes J, Kantarjian H. Interactions and relevance of blast percentage and treatment strategy among younger and older patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Am J Hematol 2016; 91:227-32. [PMID: 26799610 PMCID: PMC5486407 DOI: 10.1002/ajh.24252] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 11/19/2015] [Indexed: 12/31/2022]
Abstract
Acute myeloid leukemia (AML) is defined as ≥20% myeloblasts, representing a change from original guidelines where ≤30% blasts were considered as myelodysplastic syndromes (MDS), and 20-29% blasts classified as refractory anemia with excess blasts in transformation (RAEB-T). Whether the diagnostic bone marrow blast percentage has current value with regards to patient prognostication or identification of optimal treatment strategies is unclear. We retrospectively studied 1652 treatment-naïve adults with MDS or AML and ≥10% blasts from January 2000 to April 2014. Patients with 20-29% blasts were more similar to MDS patients in terms of advanced age, increased frequency of poor-risk cytogenetics, lower WBC count, and less frequent NPM1 and FLT3-ITD mutations. Median overall survival of MDS and RAEB-T were similar, 16.0 and 16.0 months, compared to 13.5 months for AML with ≥30% blasts (P = 0.045). Multivariate analysis showed inferior survival with increased age (HR 1.81 age 60-69, HR 2.68 age ≥70, P < 0.0005); poor-risk cytogenetics (HR 2.25, P < 0.0005); therapy-related disease (HR 1.44, P < 0.0005); and markers of proliferative disease including WBC ≥25 × 10(9) /L (HR 1.35, P = 0.0003), elevated LDH count (HR 1.24, P = 0.0015), and peripheral blasts (HR 1.25, P = 0.004). Among younger patients (≤60 years), intensive AML-type therapy resulted in similar outcomes regardless of blast percentage, suggesting this to be optimal therapy in this context. Among older patients (≥70 years), patients with 20-29% blasts had similar outcomes to patients with <20% blasts, and better than those with ≥30% blasts. In addition, among older patients, epigenetic therapy provided at least equivalent outcome to intensive chemotherapy.
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Affiliation(s)
- Courtney D. DiNardo
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Sherry Pierce
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Aziz Nazha
- Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio
| | - Carlos Bueso-Ramos
- Department of Hematopathology, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elias Jabbour
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Farhad Ravandi
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Jorge Cortes
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Hagop Kantarjian
- Department of Leukemia, University of Texas M.D. Anderson Cancer Center, Houston, Texas
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35
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Kurosawa S, Doki N, Hino Y, Sakaguchi M, Fukushima K, Shingai N, Hattori K, Watanabe K, Hagino T, Igarashi A, Najima Y, Kobayashi T, Kakihana K, Sakamaki H, Ohashi K. Occurrence of Donor Cell-derived Lymphoid Blast Crisis 24 Years Following Related Bone Marrow Transplantation for Chronic Myeloid Leukemia. Intern Med 2016; 55:395-7. [PMID: 26875966 DOI: 10.2169/internalmedicine.55.5400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a unique case of donor cell leukemia (DCL), as donor cell-derived lymphoid blast crisis of chronic myeloid leukemia (CML) was observed 24 years after related bone marrow transplantation for CML in the chronic phase. Short tandem repeat testing of the leukemic blast sample revealed full donor chimerism, strongly indicative of DCL. The original donor is healthy with a normal complete blood cell count for the past 24 years. This rare case may provide a precious opportunity to consider not only the underlying mechanism of DCL, but also the pathogenesis of CML.
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Affiliation(s)
- Shuhei Kurosawa
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Japan
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36
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Gambacorti‐Passerini C, Kantarjian HM, Kim D, Khoury HJ, Turkina AG, Brümmendorf TH, Matczak E, Bardy‐Bouxin N, Shapiro M, Turnbull K, Leip E, Cortes JE. Long-term efficacy and safety of bosutinib in patients with advanced leukemia following resistance/intolerance to imatinib and other tyrosine kinase inhibitors. Am J Hematol 2015; 90:755-68. [PMID: 26040495 PMCID: PMC5132035 DOI: 10.1002/ajh.24034] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/04/2015] [Indexed: 01/24/2023]
Abstract
Long-term efficacy and safety of bosutinib (≥4 years follow-up from last enrolled patient) were evaluated in an ongoing phase 1/2 study in the advanced leukemia cohort with prior treatment failure (accelerated-phase [AP, n = 79] chronic myeloid leukemia [CML], blast-phase [BP, n = 64] CML, acute lymphoblastic leukemia [ALL, n = 24]). Fourteen AP, 2 BP, and 1 ALL patient remained on bosutinib at 4 years (vs. 38, 8, 1 at 1 year); median (range) treatment durations: 10.2 (0.1-88.6), 2.8 (0.03-55.9), 0.97 (0.3-89.2) months. Among AP and BP patients, 57% and 28% newly attained or maintained baseline overall hematologic response (OHR); 40% and 37% attained/maintained major cytogenetic response (MCyR) by 4 years (most by 12 months). In responders at 1 versus 4 years, Kaplan-Meier (KM) probabilities of maintaining OHR were 78% versus 49% (AP) and 28% versus 19% (BP); KM probabilities of maintaining MCyR were 65% versus 49% (AP) and 21% versus 21% (BP). Most common AEs (AP, BP) were gastrointestinal (96%; 83%), primarily diarrhea (85%; 64%), which was typically low grade (maximum grade 1/2: 81%; 59%) and transient; no patient discontinued due to diarrhea. Serious AEs occurred in 44 (56%) AP and 37 (58%) BP patients, most commonly pneumonia (n = 9) for AP and pyrexia (n = 6) for BP; 11 and 13 died within 30 days of last dose (2 considered bosutinib-related [AP] per investigator). Responses were durable in ∼50% AP responders at 4 years (∼25% BP patients responded at year 1, suggesting possible bridge-to-transplant role in BP patients); toxicity was manageable.
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Affiliation(s)
| | - Hagop M. Kantarjian
- Department of LeukemiaDivision of Cancer MedicineUniversity of Texas MD Anderson Cancer CenterHoustonTexas
| | - Dong‐Wook Kim
- Department of HematologySeoul St. Mary's HospitalSeoulSouth Korea
| | - Hanna J. Khoury
- Division of HematologyWinship Cancer Institute of Emory UniversityAtlantaGeorgia
| | | | - Tim H. Brümmendorf
- Clinic for OncologyHematologyand Stem Cell TransplantationUniversitätsklinikum Aachen, RWTH AachenGermany
- OncologyHematologyand Stem Cell TransplantationUniversitätsklinikum Hamburg‐EppendorfHamburgGermany
| | | | | | | | | | | | - Jorge E. Cortes
- Department of LeukemiaDivision of Cancer MedicineUniversity of Texas MD Anderson Cancer CenterHoustonTexas
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37
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Mikosik A, Henc I, Ruckemann-Dziurdzińska K, Frąckowiak JE, Płoszyńska A, Balcerska A, Bryl E, Witkowski JM. Increased μ-Calpain Activity in Blasts of Common B-Precursor Childhood Acute Lymphoblastic Leukemia Correlates with Their Lower Susceptibility to Apoptosis. PLoS One 2015; 10:e0136615. [PMID: 26317226 PMCID: PMC4552652 DOI: 10.1371/journal.pone.0136615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 07/23/2015] [Indexed: 12/11/2022] Open
Abstract
Childhood acute lymphoblastic leukemia (ALL) blasts are characterized by inhibited apoptosis promoting fast disease progress. It is known that in chronic lymphocytic and acute myeloid leukemias the reduced apoptosis is strongly related with the activity of calpain-calpastatin system (CCS) composed of cytoplasmic proteases—calpains—performing the modulatory proteolysis of key proteins involved in cell proliferation and apoptosis, and of their endogenous inhibitor—calpastatin. Here, the CCS protein abundance and activity was for the first time studied in childhood ALL blasts and in control bone marrow CD19+ B cells by semi-quantitative flow cytometry and western blotting of calpastatin fragments resulting from endogenous calpain activity. Significantly higher μ-calpain (CAPN1) gene transcription, protein amounts and activity (but not those of m-calpain), with calpastatin amount and transcription of its gene (CAST) greatly varying were observed in CD19+ ALL blasts compared to control cells. Significant inverse relation between the amount/activity of calpain and spontaneous apoptosis was noted. Patients older than 10 years (considered at higher risk) displayed increased amounts and activities of blast calpain. Finally, treatment of blasts with the tripeptide calpain inhibitors II and IV significantly and in dose-dependent fashion increased the percentage of blasts entering apoptosis. Together, these findings make the CCS a potential new predictive tool and therapeutic target in childhood ALL.
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Affiliation(s)
- Anna Mikosik
- Department of Pathophysiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Izabella Henc
- Department of Pathology and Experimental Rheumatology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Anna Płoszyńska
- Clinic of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Anna Balcerska
- Clinic of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Ewa Bryl
- Department of Pathology and Experimental Rheumatology, Medical University of Gdańsk, Gdańsk, Poland
| | - Jacek M. Witkowski
- Department of Pathophysiology, Medical University of Gdańsk, Gdańsk, Poland
- * E-mail:
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38
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Haaß W, Kleiner H, Weiß C, Haferlach C, Schlegelberger B, Müller MC, Hehlmann R, Hofmann WK, Fabarius A, Seifarth W. Clonal Evolution and Blast Crisis Correlate with Enhanced Proteolytic Activity of Separase in BCR-ABL b3a2 Fusion Type CML under Imatinib Therapy. PLoS One 2015; 10:e0129648. [PMID: 26087013 PMCID: PMC4472749 DOI: 10.1371/journal.pone.0129648] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 05/07/2015] [Indexed: 11/18/2022] Open
Abstract
Unbalanced (major route) additional cytogenetic aberrations (ACA) at diagnosis of chronic myeloid leukemia (CML) indicate an increased risk of progression and shorter survival. Moreover, newly arising ACA under imatinib treatment and clonal evolution are considered features of acceleration and define failure of therapy according to the European LeukemiaNet (ELN) recommendations. On the basis of 1151 Philadelphia chromosome positive chronic phase patients of the randomized CML-study IV, we examined the incidence of newly arising ACA under imatinib treatment with regard to the p210BCR-ABL breakpoint variants b2a2 and b3a2. We found a preferential acquisition of unbalanced ACA in patients with b3a2 vs. b2a2 fusion type (ratio: 6.3 vs. 1.6, p = 0.0246) concurring with a faster progress to blast crisis for b3a2 patients (p = 0.0124). ESPL1/Separase, a cysteine endopeptidase, is a key player in chromosomal segregation during mitosis. Separase overexpression and/or hyperactivity has been reported from a wide range of cancers and cause defective mitotic spindles, chromosome missegregation and aneuploidy. We investigated the influence of p210BCR-ABL breakpoint variants and imatinib treatment on expression and proteolytic activity of Separase as measured with a specific fluorogenic assay on CML cell lines (b2a2: KCL-22, BV-173; b3a2: K562, LAMA-84). Despite a drop in Separase protein levels an up to 5.4-fold increase of Separase activity under imatinib treatment was observed exclusively in b3a2 but not in b2a2 cell lines. Mimicking the influence of imatinib on BV-173 and LAMA-84 cells by ESPL1 silencing stimulated Separase proteolytic activity in both b3a2 and b2a2 cell lines. Our data suggest the existence of a fusion type-related feedback mechanism that posttranslationally stimulates Separase proteolytic activity after therapy-induced decreases in Separase protein levels. This could render b3a2 CML cells more prone to aneuploidy and clonal evolution than b2a2 progenitors and may therefore explain the cytogenetic results of CML patients.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/therapeutic use
- Blast Crisis/enzymology
- Blast Crisis/genetics
- Blast Crisis/pathology
- Cell Line, Tumor
- Chromosome Aberrations
- Chromosome Breakage
- Clonal Evolution
- Fusion Proteins, bcr-abl/genetics
- Humans
- Imatinib Mesylate/therapeutic use
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/enzymology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Middle Aged
- Proteolysis
- Separase/metabolism
- Young Adult
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Affiliation(s)
- Wiltrud Haaß
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Helga Kleiner
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Christel Weiß
- Abteilung Medizinische Statistik und Biomathematik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | | | | | - Martin C. Müller
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Rüdiger Hehlmann
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Wolf-Karsten Hofmann
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Alice Fabarius
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Wolfgang Seifarth
- III. Medizinische Universitätsklinik (Hämatologie und Onkologie), Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
- * E-mail:
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39
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Badar T, Kantarjian HM, Ravandi F, Jabbour E, Borthakur G, Cortes JE, Pemmaraju N, Pierce SR, Newberry KJ, Daver N, Verstovsek S. Therapeutic benefit of decitabine, a hypomethylating agent, in patients with high-risk primary myelofibrosis and myeloproliferative neoplasm in accelerated or blastic/acute myeloid leukemia phase. Leuk Res 2015; 39:950-6. [PMID: 26183878 DOI: 10.1016/j.leukres.2015.06.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [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: 03/10/2015] [Revised: 05/27/2015] [Accepted: 06/06/2015] [Indexed: 12/11/2022]
Abstract
Myeloproliferative neoplasm (MPN) transformed to acute myeloid leukemia (MPN-AML), MPN in accelerated phase (MPN-AP), and high-risk primary myelofibrosis (PMF) are associated with a poor response to therapy and very short survival. Several reports have suggested clinical activity of hypomethylating agents in these patients. We conducted a retrospective study of 21 patients with MPN-AML, 13 with MPN-AP and 11 with DIPSS-plus high-risk PMF treated with decitabine at our institution over the last 7 years and evaluated their clinical outcomes. Six patients (29%) with MPN-AML responded to decitabine (3 CR, 2 CRi, and 1 PR); median response duration was 7 months. The median overall survival (OS) was significantly higher in those who responded (10.5 vs 4 months). Among patients with MPN-AP, 8 patients (62%) benefited; the median response duration was 6.5 months. The median OS was 11.8 months in responders vs 4.7 months in non-responders. Among patients with DIPSS-plus high-risk PMF, 9 (82%) benefited; the median response duration was 9 months. The median OS was 32 months in responders vs 16.3 months in non-responders. Decitabine is a viable therapeutic option for patients with MPN-AML, MP-AP and high-risk PMF. Prospective clinical studies combining decitabine with other clinically active agents are needed to improve overall outcome.
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Affiliation(s)
- Talha Badar
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hagop M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gautam Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jorge E Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sherry R Pierce
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kate J Newberry
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Srdan Verstovsek
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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40
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Münch C, Dragoi D, Frey AV, Thurig K, Lübbert M, Wäsch R, Bogatyreva L, Hauschke D, Lassmann S, Werner M, May AM. Therapeutic polo-like kinase 1 inhibition results in mitotic arrest and subsequent cell death of blasts in the bone marrow of AML patients and has similar effects in non-neoplastic cell lines. Leuk Res 2015; 39:462-70. [PMID: 25697066 DOI: 10.1016/j.leukres.2015.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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: 06/11/2014] [Revised: 01/15/2015] [Accepted: 01/17/2015] [Indexed: 12/14/2022]
Abstract
Polo-like kinase 1 (PLK1) is an important regulator of the cell cycle and is overexpressed in various solid and hematological malignancies. Small molecule inhibitors targeting PLK1, such as BI2536 or BI6727 (Volasertib) are a promising therapeutic approach in such malignancies. Here, we show a loss of specifically localized PLK1 in AML blasts in vivo, accompanied by mitotic arrest with transition into apoptosis, in bone marrow biopsies of AML patients after treatment with BI2536. We verify these results in live cell imaging experiments with the AML cell line HL-60, and demonstrate that non-neoplastic, immortalized lymphoblastoid cells are also sensitive to PLK1 inhibition. It is demonstrated that normal granulopoietic precursors have similar PLK1 expression levels as leukemic blasts. These results are in line with the adverse effects of PLK1 inhibition and underline the great potential of PLK1 inhibitors in the treatment of AML.
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MESH Headings
- Aged
- Aged, 80 and over
- Antimitotic Agents/pharmacology
- Apoptosis/drug effects
- Blast Crisis/drug therapy
- Blast Crisis/enzymology
- Blast Crisis/pathology
- Blotting, Western
- Bone Marrow/drug effects
- Bone Marrow/enzymology
- Bone Marrow/pathology
- Cell Cycle Proteins/antagonists & inhibitors
- Cell Cycle Proteins/metabolism
- Cell Proliferation/drug effects
- Female
- Humans
- Immunoenzyme Techniques
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/enzymology
- Leukemia, Myeloid, Acute/pathology
- Male
- Mitosis/drug effects
- Protein Serine-Threonine Kinases/antagonists & inhibitors
- Protein Serine-Threonine Kinases/metabolism
- Proto-Oncogene Proteins/antagonists & inhibitors
- Proto-Oncogene Proteins/metabolism
- Pteridines/pharmacology
- RNA, Messenger/genetics
- Real-Time Polymerase Chain Reaction
- Reverse Transcriptase Polymerase Chain Reaction
- Tumor Cells, Cultured
- Polo-Like Kinase 1
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Affiliation(s)
- Claudia Münch
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Diana Dragoi
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Anna-Verena Frey
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Katja Thurig
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany
| | - Michael Lübbert
- Department of Hematology and Oncology, University Medical Center, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Ralph Wäsch
- Department of Hematology and Oncology, University Medical Center, Hugstetter Str. 55, 79106 Freiburg, Germany
| | - Lioudmila Bogatyreva
- Institute of Medical Biometry and Medical Informatics, University Medical Center, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
| | - Dieter Hauschke
- Institute of Medical Biometry and Medical Informatics, University Medical Center, Stefan-Meier-Str. 26, 79104 Freiburg, Germany
| | - Silke Lassmann
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany; BIOSS Centre for Biological Signalling Studies, University of Freiburg, Germany
| | - Martin Werner
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Annette M May
- Institute of Clinical Pathology, Department of Pathology, University Medical Center, Breisacher Str. 115a, 79106 Freiburg, Germany.
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Griffiths EA, Golding MC, Srivastava P, Povinelli BJ, James SR, Ford LA, Wetzler M, Wang ES, Nemeth MJ. Pharmacological targeting of β-catenin in normal karyotype acute myeloid leukemia blasts. Haematologica 2015; 100:e49-52. [PMID: 25381132 PMCID: PMC4803144 DOI: 10.3324/haematol.2014.113118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [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] [Indexed: 12/22/2022] Open
Affiliation(s)
- Elizabeth A Griffiths
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA Department of Pharmacology and Experimental Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Michelle C Golding
- Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Pragya Srivastava
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Benjamin J Povinelli
- Department of Molecular and Cellular Biology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Smitha R James
- Department of Pharmacology and Experimental Therapeutics, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Laurie A Ford
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Meir Wetzler
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Eunice S Wang
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Michael J Nemeth
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA Department of Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA
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42
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Fitting J, Blume T, ten Haaf A, Blau W, Gattenlöhner S, Tur MK, Barth S. Phage display-based generation of novel internalizing antibody fragments for immunotoxin-based treatment of acute myeloid leukemia. MAbs 2015; 7:390-402. [PMID: 25760770 PMCID: PMC4622674 DOI: 10.1080/19420862.2015.1007818] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 11/28/2014] [Revised: 12/04/2014] [Accepted: 12/04/2014] [Indexed: 12/21/2022] Open
Abstract
The current standard treatment for acute myeloid leukemia (AML) is chemotherapy based on cytarabine and daunorubicine (7 + 3), but it discriminates poorly between malignant and benign cells. Dose-limiting off‑target effects and intrinsic drug resistance result in the inefficient eradication of leukemic blast cells and their survival beyond remission. This minimal residual disease is the major cause of relapse and is responsible for a 5-year survival rate of only 24%. More specific and efficient approaches are therefore required to eradicate malignant cells while leaving healthy cells unaffected. In this study, we generated scFv antibodies that bind specifically to the surface of AML blast cells and AML bone marrow biopsy specimens. We isolated the antibodies by phage display, using subtractive whole-cell panning with AML M2‑derived Kasumi‑1 cells. By selecting for internalizing scFv antibody fragments, we focused on potentially novel agents for intracellular drug delivery and tumor modulation. Two independent methods showed that 4 binders were internalized by Kasumi-1 cells. Furthermore, we observed the AML‑selective inhibition of cell proliferation and the induction of apoptosis by a recombinant immunotoxin comprising one scFv fused to a truncated form of Pseudomonas exotoxin A (ETA'). This method may therefore be useful for the selection of novel disease-specific internalizing antibody fragments, providing a novel immunotherapeutic strategy for the treatment of AML patients.
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MESH Headings
- ADP Ribose Transferases/genetics
- ADP Ribose Transferases/immunology
- ADP Ribose Transferases/pharmacology
- Antibodies, Neoplasm/genetics
- Antibodies, Neoplasm/immunology
- Antibodies, Neoplasm/pharmacology
- Antibody Specificity/genetics
- Bacterial Toxins/genetics
- Bacterial Toxins/immunology
- Bacterial Toxins/pharmacology
- Blast Crisis/drug therapy
- Blast Crisis/immunology
- Blast Crisis/pathology
- Cell Line, Tumor
- Exotoxins/genetics
- Exotoxins/immunology
- Exotoxins/pharmacology
- Humans
- Immunotoxins/genetics
- Immunotoxins/immunology
- Immunotoxins/pharmacology
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Single-Chain Antibodies/genetics
- Single-Chain Antibodies/immunology
- Single-Chain Antibodies/pharmacology
- Virulence Factors/genetics
- Virulence Factors/immunology
- Virulence Factors/pharmacology
- Pseudomonas aeruginosa Exotoxin A
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Affiliation(s)
- Jenny Fitting
- Department of Experimental Medicine and Immunotherapy; Institute of Applied Medical Engineering; Helmholtz-Institute for Biomedical Engineering; University Hospital RWTH Aachen; Aachen, Germany
| | - Tobias Blume
- Department of Experimental Medicine and Immunotherapy; Institute of Applied Medical Engineering; Helmholtz-Institute for Biomedical Engineering; University Hospital RWTH Aachen; Aachen, Germany
| | - Andre ten Haaf
- Institute of Pathology; University Hospital; Justus-Liebig-University Giessen; Giessen, Germany
| | - Wolfgang Blau
- Medical Clinic IV (Hematology); University Hospital; Justus-Liebig-University; Giessen, Germany
| | - Stefan Gattenlöhner
- Institute of Pathology; University Hospital; Justus-Liebig-University Giessen; Giessen, Germany
| | - Mehmet Kemal Tur
- Institute of Pathology; University Hospital; Justus-Liebig-University Giessen; Giessen, Germany
| | - Stefan Barth
- Department of Experimental Medicine and Immunotherapy; Institute of Applied Medical Engineering; Helmholtz-Institute for Biomedical Engineering; University Hospital RWTH Aachen; Aachen, Germany
- Department of Pharmaceutical Product Development; Fraunhofer Institute for Molecular Biology and Applied Ecology; Aachen, Germany
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Misra A, Verma D, Chandramohan J, Bakhshi S, Kumar R, Gajendra S, Chopra A. Nuclear cupping in the blasts-more to the cup than myeloid. Hematol Oncol 2014; 34:171-3. [PMID: 25370525 DOI: 10.1002/hon.2180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 10/04/2014] [Accepted: 10/09/2014] [Indexed: 11/07/2022]
MESH Headings
- Blast Crisis/genetics
- Blast Crisis/metabolism
- Blast Crisis/pathology
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Leukemia, Biphenotypic, Acute/genetics
- Leukemia, Biphenotypic, Acute/metabolism
- Leukemia, Biphenotypic, Acute/pathology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/pathology
- Male
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Affiliation(s)
- Aroonima Misra
- Laboratory Oncology Unit, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Deepak Verma
- Laboratory Oncology Unit, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Jagan Chandramohan
- Laboratory Oncology Unit, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Sameer Bakhshi
- Department of Medical Oncology, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rajive Kumar
- Laboratory Oncology Unit, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Smeeta Gajendra
- Laboratory Oncology Unit, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Anita Chopra
- Laboratory Oncology Unit, Dr. B.R.A Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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44
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Panuzzo C, Crivellaro S, Carrà G, Guerrasio A, Saglio G, Morotti A. BCR-ABL promotes PTEN downregulation in chronic myeloid leukemia. PLoS One 2014; 9:e110682. [PMID: 25343485 PMCID: PMC4208795 DOI: 10.1371/journal.pone.0110682] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 09/24/2014] [Indexed: 11/18/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the t(9;22) translocation coding for the chimeric protein p210 BCR-ABL. The tumor suppressor PTEN plays a critical role in the pathogenesis of CML chronic phase, through non genomic loss of function mechanisms, such as protein down-regulation and impaired nuclear/cytoplasmic shuttling. Here we demonstrate that BCR-ABL promotes PTEN downregulation through a MEK dependent pathway. Furthermore, we describe a novel not recurrent N212D-PTEN point mutation found in the EM2 blast crisis cell line.
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Affiliation(s)
- Cristina Panuzzo
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Sabrina Crivellaro
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Giovanna Carrà
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Angelo Guerrasio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Giuseppe Saglio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Alessandro Morotti
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
- * E-mail:
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45
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Schimmer AD, Raza A, Carter TH, Claxton D, Erba H, DeAngelo DJ, Tallman MS, Goard C, Borthakur G. A multicenter phase I/II study of obatoclax mesylate administered as a 3- or 24-hour infusion in older patients with previously untreated acute myeloid leukemia. PLoS One 2014; 9:e108694. [PMID: 25285531 PMCID: PMC4186779 DOI: 10.1371/journal.pone.0108694] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 08/19/2014] [Indexed: 01/19/2023] Open
Abstract
PURPOSE An open-label phase I/II study of single-agent obatoclax determined a maximum tolerated dose (MTD) and schedule, safety, and efficacy in older patients (≥ 70 yr) with untreated acute myeloid leukemia (AML). EXPERIMENTAL DESIGN Phase I evaluated the safety of obatoclax infused for 3 hours on 3 consecutive days (3 h × 3 d) in 2-week cycles. Initial obatoclax dose was 30 mg/day (3 h × 3 d; n = 3). Obatoclax was increased to 45 mg/day (3 h × 3 d) if ≤ 1 patient had a dose-limiting toxicity (DLT) and decreased to 20 mg/day (3 h × 3 d) if DLT occurred in ≥ 2 patients. In the phase II study, 12 patients were randomized to receive obatoclax at the dose identified during phase I (3 h × 3 d) or 60 mg/day administered by continuous infusion over 24 hours for 3 days (24 h × 3 d) to determine the morphologic complete response rate. RESULTS In phase I, two of three patients receiving obatoclax 30 mg/day (3 h × 3 d) experienced grade 3 neurologic DLTs (confusion, ataxia, and somnolence). Obatoclax was decreased to 20 mg/day (3 h × 3 d). In phase II, no clinically relevant safety differences were observed between the 20 mg/day (3 h × 3 d; n = 7) and 60 mg/day (24 h × 3 d; n = 5) arms. Neurologic and psychiatric adverse events were most common and were generally transient and reversible. Complete response was not achieved in any patient. CONCLUSIONS Obatoclax 20 mg/day was the MTD (3 h × 3 d) in older patients with AML. In the schedules tested, single-agent obatoclax was not associated with an objective response. Evaluation in additional subgroups or in combination with other chemotherapy modalities may be considered for future study. TRIAL REGISTRATION ClinicalTrials.gov NCT00684918.
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Affiliation(s)
| | - Azra Raza
- Columbia University Medical Center, New York, New York, United States of America
| | - Thomas H. Carter
- The University of Iowa, Iowa City, Iowa, United States of America
| | - David Claxton
- Penn State, Hershey, Pennsylvania, United States of America
| | - Harry Erba
- University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Daniel J. DeAngelo
- Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Martin S. Tallman
- Leukemia Service, Memorial Sloan-Kettering Cancer Center, Weill Cornell Medical College, New York, New York, United States of America
| | - Carolyn Goard
- Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Gautam Borthakur
- The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America
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Li Y, Deng Z, Zho J, Ding B, Shi Y, Li Y. Homoharringtonine combined with cytarabine to treat chronic myelogenous leukemia in myeloid blast crisis and its impact on bone marrow CD34+CD7+ cells. Acta Haematol 2014; 132:172-6. [PMID: 24603361 DOI: 10.1159/000356742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 10/08/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND The therapeutic response of chronic myelogenous leukemia in myeloid blast crisis (CML-MBC) is very poor. AIM To explore the therapeutic effect of homoharringtonine (HHT) combined with cytarabine (HA regimen) on CML-MBC and its influence on bone marrow CD34+CD7+ cells. RESULTS Thirty-four patients with CML-MBC were treated with the HA regimen and bone marrow CD34+CD7+ cells were assayed prior to and after treatment. Among 33 evaluable patients, the overall hematological response (complete/ partial hematological response and hematological improvement) was 60.1%. Seven patients (21.2%) had a cytogenetic response 12 months after treatment. In the untreated CMLMBC patients, the proportion of bone marrow CD34+CD7+ cells was much higher than in the control group (19.4 ± 7.9 vs. 4.4 ± 1.5%, p < 0.05) and decreased to 14.1 ± 7.1% (p < 0.05) after treatment. Before treatment, the proportion of CD34+CD7+ cells was lower in the patients who had a hematological response to the HA regimen than in the patients who did not respond. CONCLUSION The HA regimen is an effective treatment for CML-MBC and CD34+CD7+ cells may be one of the valuable clinical parameters to assess treatment effectiveness.
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47
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Gluzman DF, Skliarenko LM, Koval' SV, Ivanivskaia TS. [About possible additions to actual scheme of normal blood formation on the basis of study of leukemic blast cells]. Klin Lab Diagn 2014:40-43. [PMID: 25080799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The issue of introduction of number of additions into actual scheme of blood formation is discussed. The long standing experience of laboratory diagnostic of oncologic hematological diseases in adults and children and the analysis of published data about normal blood formation are involved into consideration. The existence is surmised of common oligo-linear precursors for B-lymphocytes and monocytes, natural killer cells and monocytes and common cell-precursor of T-lymphocytes and dendrite cells as well. At the same time, the issue concerning the existence of human common cell-precursor of lymphization capable of differentiating into Band T-lymphocytes and natural killer cells is disputable.
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48
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Uchida T, Kitaura J, Nakahara F, Togami K, Inoue D, Maehara A, Nishimura K, Kawabata KC, Doki N, Kakihana K, Yoshioka K, Izawa K, Oki T, Sada A, Harada Y, Ohashi K, Katayama Y, Matsui T, Harada H, Kitamura T. Hes1 upregulation contributes to the development of FIP1L1-PDGRA-positive leukemia in blast crisis. Exp Hematol 2014; 42:369-379.e3. [PMID: 24486648 DOI: 10.1016/j.exphem.2014.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 01/01/2014] [Revised: 01/17/2014] [Accepted: 01/19/2014] [Indexed: 01/21/2023]
Abstract
We have previously shown that elevated expression of Hairy enhancer of split 1 (Hes1) contributes to blast crisis transition in Bcr-Abl-positive chronic myelogenous leukemia. Here we investigate whether Hes1 is involved in the development of other myeloid neoplasms. Notably, Hes1 expression was elevated in only a few cases of 65 samples with different types of myeloid neoplasms. Interestingly, elevated expression of Hes1 was found in two of five samples of Fip1-like1 platelet-derived growth factor receptor-α (FIP1L1-PDGFA)-positive myeloid neoplasms associated with eosinophilia. Whereas FIP1L1-PDGFRα alone induced acute T-cell leukemia or myeloproliferative neoplasms in mouse bone marrow transplantation models, mice transplanted with bone marrow cells expressing both Hes1 and FIP1L1-PDGFRα developed acute leukemia characterized by an expansion of myeloid blasts and leukemic cells without eosinophilic granules. FIP1L1-PDGFRα conferred cytokine-independent growth to Hes1-transduced common myeloid progenitors, interleukin-3-dependent cells. Imatinib inhibited the growth of common myeloid progenitors expressing Hes1 with FIP1L1-PDGFRα, but not with imatinib-resistant FIP1L1-PDGFRα mutants harboring T674I or D842V. In contrast, ponatinib efficiently eradicated leukemic cells expressing Hes1 and the imatinib-resistant FLP1L1-PDGFRΑ mutant in vitro and in vivo. Thus, we have established mouse models of FIP1L1-PDGFRA-positive leukemia in myeloid blast crisis, which will help elucidate the pathogenesis of the disease and develop a new treatment for it.
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MESH Headings
- Amino Acid Substitution
- Animals
- Antineoplastic Agents/pharmacology
- Basic Helix-Loop-Helix Transcription Factors/biosynthesis
- Basic Helix-Loop-Helix Transcription Factors/genetics
- Benzamides/pharmacology
- Blast Crisis/genetics
- Blast Crisis/metabolism
- Blast Crisis/pathology
- Female
- Gene Expression Regulation, Leukemic
- Homeodomain Proteins/biosynthesis
- Homeodomain Proteins/genetics
- Humans
- Imatinib Mesylate
- Interleukin-3/biosynthesis
- Interleukin-3/genetics
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/pathology
- Male
- Mice
- Mice, Inbred BALB C
- Mutation, Missense
- Neoplasms, Experimental/drug therapy
- Neoplasms, Experimental/genetics
- Neoplasms, Experimental/metabolism
- Neoplasms, Experimental/pathology
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Piperazines/pharmacology
- Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Pyrimidines/pharmacology
- Receptor, Platelet-Derived Growth Factor alpha/genetics
- Receptor, Platelet-Derived Growth Factor alpha/metabolism
- Transcription Factor HES-1
- mRNA Cleavage and Polyadenylation Factors/genetics
- mRNA Cleavage and Polyadenylation Factors/metabolism
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Affiliation(s)
- Tomoyuki Uchida
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Jiro Kitaura
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Fumio Nakahara
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Katsuhiro Togami
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Daichi Inoue
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Akie Maehara
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Koutarou Nishimura
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Kimihito C Kawabata
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Noriko Doki
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kazuhiko Kakihana
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kosuke Yoshioka
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Kumi Izawa
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Toshihiko Oki
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Division of Stem Cell Signaling, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Akiko Sada
- Heamatology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuka Harada
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan; Division of Radiation Information Registry, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Kazuteru Ohashi
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yoshio Katayama
- Heamatology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Toshimitsu Matsui
- Heamatology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hironori Harada
- Department of Hematology, Juntendo University School of Medicine, Tokyo, Japan; Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Toshio Kitamura
- Division of Cellular Therapy, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan; Division of Stem Cell Signaling, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.
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Roy A, Lahiry L, Banerjee D, Ghosh M, Banerjee S. Increased cytoplasmic localization of p27(kip1) and its modulation of RhoA activity during progression of chronic myeloid leukemia. PLoS One 2013; 8:e76527. [PMID: 24098519 PMCID: PMC3788125 DOI: 10.1371/journal.pone.0076527] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 09/01/2013] [Indexed: 01/19/2023] Open
Abstract
The role of p27kip1 in Chronic Myeloid Leukemia (CML) has been well studied in relation to its function as a cell cycle inhibitor. However, its cytoplasmic function especially in CML remains to be seen. We studied the localization of p27kip1 and its function during the progression of CML from chronic to blast phase. Our investigations revealed an increased localization of p27kip1 in the cytoplasm of CD34+ cells in the blast phase compared to chronic phase. Cytoplasmic p27kip1 was found to modulate RhoA activity in CD34+ stem and progenitor cells. Further, RhoA activity was shown to be dependent on cytoplasmic p27kip1 which in turn was dependent on p210Bcr-Abl kinase activity. Interestingly, RhoA activity was observed to affect cell survival in the presence of imatinib through the SAPK/JNK pathway. Accordingly, inhibition of SAPK/JNK pathway using SP600125 increased apoptosis of K562 cells in presence of imatinib. Our results, for the first time, thus reveal a crucial link between cytoplasmic p27kip1, RhoA activity and SAPK/JNK signalling. To this effect we observed a correlation between increased cytoplasmic p27kip1, increased RhoA protein levels, decreased RhoA-GTP levels and increased SAPK/JNK phosphorylation in blast phase CD34+ cells compared to chronic phase CD34+ cells.
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MESH Headings
- Anthracenes/pharmacology
- Antigens, CD34/genetics
- Antigens, CD34/metabolism
- Apoptosis
- Blast Crisis/genetics
- Blast Crisis/metabolism
- Blast Crisis/pathology
- Cyclin-Dependent Kinase Inhibitor p27/genetics
- Cyclin-Dependent Kinase Inhibitor p27/metabolism
- Cytoplasm/metabolism
- Cytoplasm/pathology
- Disease Progression
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/metabolism
- Gene Expression Regulation, Leukemic
- Guanosine Triphosphate/metabolism
- Humans
- K562 Cells
- Leukemia, Myeloid, Chronic-Phase/genetics
- Leukemia, Myeloid, Chronic-Phase/metabolism
- Leukemia, Myeloid, Chronic-Phase/pathology
- Lymphocytes/metabolism
- Lymphocytes/pathology
- MAP Kinase Kinase 4/antagonists & inhibitors
- MAP Kinase Kinase 4/genetics
- MAP Kinase Kinase 4/metabolism
- Phosphorylation/drug effects
- Primary Cell Culture
- Protein Kinase Inhibitors/pharmacology
- Signal Transduction
- rhoA GTP-Binding Protein/genetics
- rhoA GTP-Binding Protein/metabolism
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Affiliation(s)
- Anita Roy
- Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, West Bengal, India
| | - Lakshmishri Lahiry
- Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, West Bengal, India
| | - Debasis Banerjee
- Department of Haematology, Ramkrishna Mission Seva Pratisthan, Kolkata, West Bengal, India
| | - Malay Ghosh
- Department of Haematology, N R S Medical College and Hospital, Kolkata, West Bengal, India
| | - Subrata Banerjee
- Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, West Bengal, India
- * E-mail:
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Abstract
Chronic myelomonocytic leukemia (CMML) is a clonal disease of the hematopoietic stem cell that provokes a stable increase in peripheral blood monocyte count. The World Health Organisation classification appropriately underlines that the disease combines dysplastic and proliferative features. The percentage of blast cells in the blood and bone marrow distinguishes CMML-1 from CMML-2. The disease is usually diagnosed after the age of 50, with a strong male predominance. Inconstant and non-specific cytogenetic aberrations have a negative prognostic impact. Recurrent gene mutations affect mainly the TET2, SRSF2, and ASXL1 genes. Median survival is 3 years, with patients dying from progression to AML (20-30%) or from cytopenias. ASXL1 is the only gene whose mutation predicts outcome and can be included within a prognostic score. Allogeneic stem cell transplantation is possibly curative but rarely feasible. Hydroxyurea, which is the conventional cytoreductive agent, is used in myeloproliferative forms, and demethylating agents could be efficient in the most aggressive forms of the disease.
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Affiliation(s)
| | - Pierre Fenaux
- Hôpital Avicenne, Service d'hématologie clinique, Paris 13 university, 125 rue de Stalingrad, 93009 Bobigny, France.
| | - Eric Solary
- Inserm UMR 1009, Institut Gustave Roussy, 14 rue Edouard Vaillant, 94805 Villejuif cedex, France.
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