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Dillon LW, Gui G, Page KM, Ravindra N, Wong ZC, Andrew G, Mukherjee D, Zeger SL, El Chaer F, Spellman S, Howard A, Chen K, Auletta J, Devine SM, Jimenez Jimenez AM, De Lima MJG, Litzow MR, Kebriaei P, Saber W, Weisdorf DJ, Hourigan CS. DNA Sequencing to Detect Residual Disease in Adults With Acute Myeloid Leukemia Prior to Hematopoietic Cell Transplant. JAMA 2023; 329:745-755. [PMID: 36881031 PMCID: PMC9993183 DOI: 10.1001/jama.2023.1363] [Citation(s) in RCA: 41] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/28/2023] [Indexed: 03/08/2023]
Abstract
Importance Preventing relapse for adults with acute myeloid leukemia (AML) in first remission is the most common indication for allogeneic hematopoietic cell transplant. The presence of AML measurable residual disease (MRD) has been associated with higher relapse rates, but testing is not standardized. Objective To determine whether DNA sequencing to identify residual variants in the blood of adults with AML in first remission before allogeneic hematopoietic cell transplant identifies patients at increased risk of relapse and poorer overall survival compared with those without these DNA variants. Design, Setting, and Participants In this retrospective observational study, DNA sequencing was performed on pretransplant blood from patients aged 18 years or older who had undergone their first allogeneic hematopoietic cell transplant during first remission for AML associated with variants in FLT3, NPM1, IDH1, IDH2, or KIT at 1 of 111 treatment sites from 2013 through 2019. Clinical data were collected, through May 2022, by the Center for International Blood and Marrow Transplant Research. Exposure Centralized DNA sequencing of banked pretransplant remission blood samples. Main Outcomes and Measures The primary outcomes were overall survival and relapse. Day of transplant was considered day 0. Hazard ratios were reported using Cox proportional hazards regression models. Results Of 1075 patients tested, 822 had FLT3 internal tandem duplication (FLT3-ITD) and/or NPM1 mutated AML (median age, 57.1 years, 54% female). Among 371 patients in the discovery cohort, the persistence of NPM1 and/or FLT3-ITD variants in the blood of 64 patients (17.3%) in remission before undergoing transplant was associated with worse outcomes after transplant (2013-2017). Similarly, of the 451 patients in the validation cohort who had undergone transplant in 2018-2019, 78 patients (17.3%) with residual NPM1 and/or FLT3-ITD variants had higher rates of relapse at 3 years (68% vs 21%; difference, 47% [95% CI, 26% to 69%]; HR, 4.32 [95% CI, 2.98 to 6.26]; P < .001) and decreased survival at 3 years (39% vs 63%; difference, -24% [2-sided 95% CI, -39% to -9%]; HR, 2.43 [95% CI, 1.71 to 3.45]; P < .001). Conclusions and Relevance Among patients with acute myeloid leukemia in first remission prior to allogeneic hematopoietic cell transplant, the persistence of FLT3 internal tandem duplication or NPM1 variants in the blood at an allele fraction of 0.01% or higher was associated with increased relapse and worse survival compared with those without these variants. Further study is needed to determine whether routine DNA-sequencing testing for residual variants can improve outcomes for patients with acute myeloid leukemia.
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MESH Headings
- Female
- Humans
- Male
- Middle Aged
- Hematopoietic Stem Cell Transplantation
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/therapy
- Neoplasm, Residual/blood
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Nuclear Proteins/genetics
- Preoperative Care
- Retrospective Studies
- Sequence Analysis, DNA
- Recurrence
- Survival Analysis
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Affiliation(s)
- Laura W. Dillon
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Gege Gui
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kristin M. Page
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
- Medical College of Wisconsin, Milwaukee
| | - Niveditha Ravindra
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Zoë C. Wong
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Georgia Andrew
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Devdeep Mukherjee
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Scott L. Zeger
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Stephen Spellman
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
- National Marrow Donor Program, Minneapolis, Minnesota
| | - Alan Howard
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
- National Marrow Donor Program, Minneapolis, Minnesota
| | - Karen Chen
- National Marrow Donor Program, Minneapolis, Minnesota
| | - Jeffery Auletta
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
- The Ohio State University College of Medicine, Columbus
| | - Steven M. Devine
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | | | | | | | | | - Wael Saber
- Medical College of Wisconsin, Milwaukee
- National Marrow Donor Program, Minneapolis, Minnesota
| | - Daniel J. Weisdorf
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
- University of Minnesota, Minneapolis
| | - Christopher S. Hourigan
- Laboratory of Myeloid Malignancies, Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
- Myeloid Malignancies Program, National Institutes of Health, Bethesda, Maryland
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2
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van de Velde ME, El Hassani SEM, Kaspers GJL, Broertjes J, Benninga MA, de Boer NKH, Budding AE, de Meij TGJ. Prediction of Bloodstream Infection in Pediatric Acute Leukemia by Microbiota and Volatile Organic Compounds Analysis. J Pediatr Hematol Oncol 2022; 44:e152-e159. [PMID: 34133377 DOI: 10.1097/mph.0000000000002210] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 03/28/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Bloodstream infections (BSIs) cause treatment-related mortality in pediatric acute leukemia. We explored the potential of intestinal microbiota and fecal volatile organic compounds (VOCs) analyses to predict BSI. METHODS In this case-control study, fecal samples of pediatric acute leukemia patients were collected. Microbiota composition and fecal VOC profiles of BSI cases and matched non-BSI controls were compared. RESULTS In total, 6 patients were included, of which 1 developed BSI and 1 neutropenic fever. Both showed reduced microbial diversity and stability of Bacteroidetes. In the BSI case, Pantoea was identified 15 days before BSI. Significant differences in fecal VOC profiles were measured between the case and controls. CONCLUSION Microbiota and fecal VOC could serve as biomarkers to predict BSI in pediatric leukemia.
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Affiliation(s)
| | - Sofia El Manouni El Hassani
- Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam
| | - Gert Jan L Kaspers
- Departments of Pediatric Oncology
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jorrit Broertjes
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam
| | - Marc A Benninga
- Department of Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam
| | - Nanne K H de Boer
- Department of Gastroenterology and Hepatology, Amsterdam UMC, Vrije Universiteit Amsterdam, AG&M Research Institute
| | | | - Tim G J de Meij
- Pediatric Gastroenterology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam
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3
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Bou-Tayeh B, Laletin V, Salem N, Just-Landi S, Fares J, Leblanc R, Balzano M, Kerdiles YM, Bidaut G, Hérault O, Olive D, Aurrand-Lions M, Walzer T, Nunès JA, Fauriat C. Chronic IL-15 Stimulation and Impaired mTOR Signaling and Metabolism in Natural Killer Cells During Acute Myeloid Leukemia. Front Immunol 2021; 12:730970. [PMID: 34975835 PMCID: PMC8718679 DOI: 10.3389/fimmu.2021.730970] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/24/2021] [Indexed: 11/28/2022] Open
Abstract
Natural Killer (NK) cells are potent anti-leukemic immune effectors. However, they display multiple defects in acute myeloid leukemia (AML) patients leading to reduced anti-tumor potential. Our limited understanding of the mechanisms underlying these defects hampers the development of strategies to restore NK cell potential. Here, we have used a mouse model of AML to gain insight into these mechanisms. We found that leukemia progression resulted in NK cell maturation defects and functional alterations. Next, we assessed NK cell cytokine signaling governing their behavior. We showed that NK cells from leukemic mice exhibit constitutive IL-15/mTOR signaling and type I IFN signaling. However, these cells failed to respond to IL-15 stimulation in vitro as illustrated by reduced activation of the mTOR pathway. Moreover, our data suggest that mTOR-mediated metabolic responses were reduced in NK cells from AML-bearing mice. Noteworthy, the reduction of mTOR-mediated activation of NK cells during AML development partially rescued NK cell metabolic and functional defects. Altogether, our data strongly suggest that NK cells from leukemic mice are metabolically and functionally exhausted as a result of a chronic cytokine activation, at least partially IL-15/mTOR signaling. NK cells from AML patients also displayed reduced IL-2/15Rβ expression and showed cues of reduced metabolic response to IL-15 stimulation in vitro, suggesting that a similar mechanism might occur in AML patients. Our study pinpoints the dysregulation of cytokine stimulation pathways as a new mechanism leading to NK cell defects in AML.
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Affiliation(s)
- Berna Bou-Tayeh
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Vladimir Laletin
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Nassim Salem
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Sylvaine Just-Landi
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
- IBiSA Immunomonitoring Platform, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Joanna Fares
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Raphael Leblanc
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Marielle Balzano
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Yann M. Kerdiles
- Aix-Marseille Université, Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Immunologie de Marseille-Luminy (CIML), Marseille, France
| | - Ghislain Bidaut
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
- Cibi Technological Platform, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Olivier Hérault
- Centre National de la Recherche Scientifique (CNRS) UMR 7292, LNOx Team, François Rabelais University, Tours, France
| | - Daniel Olive
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
- IBiSA Immunomonitoring Platform, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Michel Aurrand-Lions
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Thierry Walzer
- Centre International de Recherche en Infectiologie (CIRI), Inserm U1111, Ecole Normale Supérieure de Lyon, Université Lyon 1, CNRS UMR5308, Lyon, France
| | - Jacques A. Nunès
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
| | - Cyril Fauriat
- Aix-Marseille Université UM105, Centre National de la Recherche Scientifique (CNRS) UMR7258, Inserm UMR1068, Institut Paoli-Calmettes, Cancer Research Center of Marseille (CRCM), Marseille, France
- *Correspondence: Cyril Fauriat,
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Atkin ND, Raimer HM, Wang Z, Zang C, Wang YH. Assessing acute myeloid leukemia susceptibility in rearrangement-driven patients by DNA breakage at topoisomerase II and CCCTC-binding factor/cohesin binding sites. Genes Chromosomes Cancer 2021; 60:808-821. [PMID: 34405474 PMCID: PMC8511143 DOI: 10.1002/gcc.22993] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 12/29/2022] Open
Abstract
An initiating DNA double strand break (DSB) event precedes the formation of cancer-driven chromosomal abnormalities, such as gene rearrangements. Therefore, measuring DNA breaks at rearrangement-participating regions can provide a unique tool to identify and characterize susceptible individuals. Here, we developed a highly sensitive and low-input DNA break mapping method, the first of its kind for patient samples. We then measured genome-wide DNA breakage in normal cells of acute myeloid leukemia (AML) patients with KMT2A (previously MLL) rearrangements, compared to that of nonfusion AML individuals, as a means to evaluate individual susceptibility to gene rearrangements. DNA breakage at the KMT2A gene region was significantly greater in fusion-driven remission individuals, as compared to nonfusion individuals. Moreover, we identified select topoisomerase II (TOP2)-sensitive and CCCTC-binding factor (CTCF)/cohesin-binding sites with preferential DNA breakage in fusion-driven patients. Importantly, measuring DSBs at these sites, in addition to the KMT2A gene region, provided greater predictive power when assessing individual break susceptibility. We also demonstrated that low-dose etoposide exposure further elevated DNA breakage at these regions in fusion-driven AML patients, but not in nonfusion patients, indicating that these sites are preferentially sensitive to TOP2 activity in fusion-driven AML patients. These results support that mapping of DSBs in patients enables discovery of novel break-prone regions and monitoring of individuals susceptible to chromosomal abnormalities, and thus cancer. This will build the foundation for early detection of cancer-susceptible individuals, as well as those preferentially susceptible to therapy-related malignancies caused by treatment with TOP2 poisons.
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MESH Headings
- Binding Sites/genetics
- CCCTC-Binding Factor/blood
- CCCTC-Binding Factor/genetics
- Cell Cycle Proteins/blood
- Cell Cycle Proteins/genetics
- Chondroitin Sulfate Proteoglycans/blood
- Chondroitin Sulfate Proteoglycans/genetics
- Chromosomal Proteins, Non-Histone/blood
- Chromosomal Proteins, Non-Histone/genetics
- Chromosome Aberrations
- DNA Breaks, Double-Stranded/drug effects
- DNA Repair/genetics
- DNA Topoisomerases, Type II/blood
- DNA Topoisomerases, Type II/genetics
- DNA-Binding Proteins/blood
- DNA-Binding Proteins/genetics
- Etoposide/pharmacology
- Female
- Gene Rearrangement/genetics
- Genome, Human/genetics
- HeLa Cells
- Histone-Lysine N-Methyltransferase/blood
- Histone-Lysine N-Methyltransferase/genetics
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Myeloid-Lymphoid Leukemia Protein/blood
- Myeloid-Lymphoid Leukemia Protein/genetics
- Oncogene Proteins, Fusion/genetics
- Poly-ADP-Ribose Binding Proteins/blood
- Poly-ADP-Ribose Binding Proteins/genetics
- Cohesins
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Affiliation(s)
- Naomi D. Atkin
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
| | - Heather M. Raimer
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
| | - Zhenjia Wang
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
| | - Chongzhi Zang
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
| | - Yuh-Hwa Wang
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, Virginia, 22908-0733, USA
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5
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Peng M, Ren J, Jing Y, Jiang X, Xiao Q, Huang J, Tao Y, Lei L, Wang X, Yang Z, Yang Z, Zhan Q, Lin C, Jin G, Zhang X, Zhang L. Tumour-derived small extracellular vesicles suppress CD8+ T cell immune function by inhibiting SLC6A8-mediated creatine import in NPM1-mutated acute myeloid leukaemia. J Extracell Vesicles 2021; 10:e12168. [PMID: 34807526 PMCID: PMC8607980 DOI: 10.1002/jev2.12168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/04/2021] [Revised: 10/11/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022] Open
Abstract
Acute myeloid leukaemia (AML) carrying nucleophosmin (NPM1) mutations has been defined as a distinct entity of acute leukaemia. Despite remarkable improvements in diagnosis and treatment, the long-term outcomes for this entity remain unsatisfactory. Emerging evidence suggests that leukaemia, similar to other malignant diseases, employs various mechanisms to evade killing by immune cells. However, the mechanism of immune escape in NPM1-mutated AML remains unknown. In this study, both serum and leukemic cells from patients with NPM1-mutated AML impaired the immune function of CD8+ T cells in a co-culture system. Mechanistically, leukemic cells secreted miR-19a-3p into the tumour microenvironment (TME) via small extracellular vesicles (sEVs), which was controlled by the NPM1-mutated protein/CCCTC-binding factor (CTCF)/poly (A)-binding protein cytoplasmic 1 (PABPC1) signalling axis. sEV-related miR-19a-3p was internalized by CD8+ T cells and directly repressed the expression of solute-carrier family 6 member 8 (SLC6A8; a creatine-specific transporter) to inhibit creatine import. Decreased creatine levels can reduce ATP production and impair CD8+ T cell immune function, leading to immune escape by leukemic cells. In summary, leukemic cell-derived sEV-related miR-19a-3p confers immunosuppression to CD8+ T cells by targeting SLC6A8-mediated creatine import, indicating that sEV-related miR-19a-3p might be a promising therapeutic target for NPM1-mutated AML.
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Affiliation(s)
- Meixi Peng
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Jun Ren
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Yipei Jing
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Xueke Jiang
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Qiaoling Xiao
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Junpeng Huang
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Yonghong Tao
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Li Lei
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Xin Wang
- Department of HematologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Zailin Yang
- Department of Clinical Laboratory The Third Affiliated Hospital of Chongqing Medical UniversityChongqingChina
- Chongqing University Cancer HospitalChongqingChina
| | - Zesong Yang
- Department of HematologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Qian Zhan
- The Center for Clinical Molecular Medical detectionThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Can Lin
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
| | - Guoxiang Jin
- Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Xian Zhang
- Immunology ProgramMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Ling Zhang
- Key Laboratory of Laboratory Medical Diagnostics Designated by the Ministry of EducationSchool of Laboratory MedicineChongqing Medical UniversityChongqingChina
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6
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Lordo MR, Wu KG, Altynova E, Shilo N, Kronen P, Nalin AP, Weigel C, Zhang X, Yu J, Oakes CC, Caligiuri MA, Freud AG, Mundy-Bosse BL. Acute Myeloid Leukemia Alters Group 1 Innate Lymphoid Cell Differentiation from a Common Precursor. J Immunol 2021; 207:1672-1682. [PMID: 34417259 PMCID: PMC8429221 DOI: 10.4049/jimmunol.2100023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/20/2021] [Indexed: 11/19/2022]
Abstract
NK cells are known to be developmentally blocked and functionally inhibited in patients with acute myeloid leukemia (AML), resulting in poor clinical outcomes. In this study, we demonstrate that whereas NK cells are inhibited, closely related type 1 innate lymphoid cells (ILC1s) are enriched in the bone marrow of leukemic mice and in patients with AML. Because NK cells and ILC1s share a common precursor (ILCP), we asked if AML acts on the ILCP to alter developmental potential. A combination of ex vivo and in vivo studies revealed that AML skewing of the ILCP toward ILC1s and away from NK cells represented a major mechanism of ILC1 generation. This process was driven by AML-mediated activation of the aryl hydrocarbon receptor (AHR), a key transcription factor in ILCs, as inhibition of AHR led to decreased numbers of ILC1s and increased NK cells in the presence of AML. These results demonstrate a mechanism of ILC developmental skewing in AML and support further preclinical study of AHR inhibition in restoring normal NK cell development and function in the setting of AML.
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MESH Headings
- Animals
- Azo Compounds/pharmacology
- Basic Helix-Loop-Helix Transcription Factors/agonists
- Basic Helix-Loop-Helix Transcription Factors/antagonists & inhibitors
- Basic Helix-Loop-Helix Transcription Factors/metabolism
- Bone Marrow/immunology
- Carbazoles/pharmacology
- Cell Differentiation/drug effects
- Cell Differentiation/immunology
- Cells, Cultured
- Disease Models, Animal
- Female
- Humans
- Immunity, Innate
- Killer Cells, Natural/immunology
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/immunology
- Lymphocyte Count
- Male
- Mice
- Mice, Inbred C57BL
- Pyrazoles/pharmacology
- Receptors, Aryl Hydrocarbon/agonists
- Receptors, Aryl Hydrocarbon/antagonists & inhibitors
- Receptors, Aryl Hydrocarbon/metabolism
- Signal Transduction/drug effects
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Affiliation(s)
- Matthew R Lordo
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
- Medical Scientist Training Program, Biomedical Sciences Graduate Program, The Ohio State University, Columbus, OH
| | - Kevin G Wu
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | | | - Nikolas Shilo
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Parker Kronen
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Ansel P Nalin
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
- Medical Scientist Training Program, Biomedical Sciences Graduate Program, The Ohio State University, Columbus, OH
| | - Christoph Weigel
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
| | - Xiaoli Zhang
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
- Center for Biostatistics/Department of Biomedical Informatics, The Ohio State University, Columbus, OH
| | - Jianhua Yu
- City of Hope National Medical Center, Los Angeles, CA
| | - Christopher C Oakes
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH
- Division of Hematology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; and
| | | | - Aharon G Freud
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH;
- Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Bethany L Mundy-Bosse
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH;
- Division of Hematology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH; and
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7
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Beagan JJ, Drees EEE, Stathi P, Eijk PP, Meulenbroeks L, Kessler F, Middeldorp JM, Pegtel DM, Zijlstra JM, Sie D, Heideman DAM, Thunnissen E, Smit L, de Jong D, Mouliere F, Ylstra B, Roemer MGM, van Dijk E. PCR-Free Shallow Whole Genome Sequencing for Chromosomal Copy Number Detection from Plasma of Cancer Patients Is an Efficient Alternative to the Conventional PCR-Based Approach. J Mol Diagn 2021; 23:1553-1563. [PMID: 34454114 DOI: 10.1016/j.jmoldx.2021.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 07/27/2021] [Accepted: 08/09/2021] [Indexed: 11/19/2022] Open
Abstract
Somatic copy number alterations can be detected in cell-free DNA (cfDNA) by shallow whole genome sequencing (sWGS). PCR is typically included in library preparations, but a PCR-free method could serve as a high-throughput alternative. To evaluate a PCR-free method for research and diagnostics, archival peripheral blood or bone marrow plasma samples, collected in EDTA- or lithium-heparin-containing tubes, were collected from patients with non-small-cell lung cancer (n = 10 longitudinal samples; 4 patients), B-cell lymphoma (n = 31), and acute myeloid leukemia (n = 15), or from healthy donors (n = 14). sWGS was performed on PCR-free and PCR library preparations, and the mapping quality, percentage of unique reads, genome coverage, fragment lengths, and copy number profiles were compared. The percentage of unique reads was significantly higher for PCR-free method compared with PCR method, independent of the type of collection tube: EDTA PCR-free method, 96.4% (n = 35); EDTA PCR method, 85.1% (n = 32); heparin PCR-free method, 94.5% (n = 25); and heparin PCR method, 89.4% (n = 10). All other evaluated metrics were highly comparable for PCR-free and PCR library preparations. These results demonstrate the feasibility of somatic copy number alteration detection by PCR-free sWGS using cfDNA from plasma collected in EDTA- or lithium-heparin-containing tubes and pave the way for an automated cfDNA analysis workflow for samples from cancer patients.
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MESH Headings
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Blood Specimen Collection/methods
- Carcinoma, Non-Small-Cell Lung/blood
- Carcinoma, Non-Small-Cell Lung/diagnosis
- Carcinoma, Non-Small-Cell Lung/genetics
- Case-Control Studies
- Circulating Tumor DNA/blood
- Circulating Tumor DNA/genetics
- DNA Copy Number Variations
- Feasibility Studies
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Limit of Detection
- Liquid Biopsy
- Longitudinal Studies
- Lung Neoplasms/blood
- Lung Neoplasms/diagnosis
- Lung Neoplasms/genetics
- Lymphoma, B-Cell/blood
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/genetics
- Polymerase Chain Reaction/methods
- Whole Genome Sequencing/methods
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Affiliation(s)
- Jamie J Beagan
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Esther E E Drees
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Phylicia Stathi
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Paul P Eijk
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Laura Meulenbroeks
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Floortje Kessler
- Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Jaap M Middeldorp
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - D Michiel Pegtel
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Josée M Zijlstra
- Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Daoud Sie
- Department of Clinical Genetics, Core Facility Genomics, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Daniëlle A M Heideman
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Erik Thunnissen
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Linda Smit
- Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Daphne de Jong
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Florent Mouliere
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Bauke Ylstra
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands.
| | - Margaretha G M Roemer
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
| | - Erik van Dijk
- Department of Pathology, Cancer Center Amsterdam, Amsterdam University Medical Center, Location Vrije Universiteit Medical Center Amsterdam, Amsterdam, the Netherlands
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8
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Matei E, Aschie M, Mitroi AF, Ghinea MM, Gheorghe E, Petcu L, Dobrin N, Chisoi A, Mihaela M. Biomarkers involved in evaluation of platelets function in South-Eastern Romanian patients with hematological malignancies subtypes. Medicine (Baltimore) 2021; 100:e25944. [PMID: 34011073 PMCID: PMC8137019 DOI: 10.1097/md.0000000000025944] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/02/2021] [Accepted: 04/23/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT At present, various researches presented how subtypes of hematological malignancies are related to stages of the immune response, because the activated immune system represents a promising form in cancer treatment. This study explores the relationship between the adaptive immune system (T cells), and the coagulation system (platelets, platelet membrane glycoproteins, platelets derivate microparticles) which seems to play an important role in host immune defense of patients with acute myeloblastic leukemia (AML) or B cell lymphoma (BCL), 2 of the most common hematological malignancies subtypes.Blood samples (n = 114) obtained from patients with AML or BCL were analyzed for platelet membrane glycoproteins (CD42b, CD61), glycoprotein found on the surface of the T helper cells (CD4+), protein complex-specific antigen for T cells (CD3+), platelet-derived microparticles (CD61 PMP) biomarkers by flow cytometry, and hematological parameters were quantified by usual methods.In patients with AML, the means of the percentage of the expressions of the molecules on platelet surfaces (CD61 and CD42b, P < .01; paired T test) were lower as compared to both control subgroups. The expression of cytoplasmic granules content (CD61 PMP) had a significantly higher value in patients with AML reported to controlling subgroups (P < .01; paired T test), which is suggesting an intravascular activation of platelets.The platelet activation status was presented in patients with low stage BCL because CD61 and CD42b expressions were significantly higher than control subgroups, but the expression of CD 61 PMP had a significantly decreased value reported to control subgroups (all P < .01; paired T test). T helper/inducer lineage CD4+ and T lymphoid lineage CD3+ expressions presented significant differences between patients with AML or low stage BCL reported to control subgroups (all P < .01; paired T test).Platelet-lymphocyte interactions are involved in malignant disorders, and CD61, CD42b present on platelet membranes, as functionally active surface receptors mediate the adhesion of active platelets to lymphocytes, endothelial cells, and cancer cells.
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MESH Headings
- Aged
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/metabolism
- Blood Platelets/immunology
- Blood Platelets/metabolism
- CD3 Complex/blood
- Cell Adhesion/immunology
- Cell-Derived Microparticles
- Female
- Flow Cytometry
- Humans
- Integrin beta3/blood
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/immunology
- Lymphocyte Activation
- Lymphocyte Count
- Lymphoma, B-Cell/blood
- Lymphoma, B-Cell/immunology
- Male
- Middle Aged
- Platelet Activation/immunology
- Platelet Count
- Platelet Glycoprotein GPIb-IX Complex/analysis
- Romania
- T-Lymphocytes, Helper-Inducer/immunology
- T-Lymphocytes, Helper-Inducer/metabolism
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Affiliation(s)
- Elena Matei
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
| | - Mariana Aschie
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
- Clinical Service of Pathology
| | - Anca Florentina Mitroi
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
- Clinical Service of Pathology
| | - Mihaela Maria Ghinea
- Internal Medicine-Hematology Department, “Sf. Apostol Andrei” Emergency County Hospital
| | - Emma Gheorghe
- Medicine Faculty, “Ovidius” University of Constanta, Constanta, Romania
| | - Lucian Petcu
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
| | - Nicolae Dobrin
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
| | - Anca Chisoi
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
- Internal Medicine-Hematology Department, “Sf. Apostol Andrei” Emergency County Hospital
| | - Manea Mihaela
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology, “Ovidius” University of Constanta, CEDMOG
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9
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Markewitz RDH, Dargvainiene J. Mitotic and Apoptotic Figures on a Peripheral-Blood Smear. N Engl J Med 2021; 384:1942. [PMID: 34014049 DOI: 10.1056/nejmicm2033085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Robert D H Markewitz
- University Hospital Schleswig-Holstein Institute of Clinical Chemistry, Kiel, Germany
| | - Justina Dargvainiene
- University Hospital Schleswig-Holstein Institute of Clinical Chemistry, Kiel, Germany
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10
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Abstract
BACKGROUND The current study mainly aims to evaluate the role and clinical significance of miR-145 in the progression of AML. METHODS Serum and bone marrow nucleated cells (BMNc) were collected and the level of miR-145 was detected by RT-PCR. Pearson's correlation assay was carried out to analyze the correlation between serum miR-145 and clinical index. The receiver operating characteristic (ROC) curve was constructed to determine the diagnosis value of serum miR-145. RESULTS MiR-145 was significantly decreased in serum and BMNc of patients with AML compared with the control group. Pearson's correlation assay showed that serum miR-145 was positively correlated with miR-145 levels in BMNc. Further study showed that the level of serum miR-145 was much lower in AML patients with initial WBC count ≥ 50 x 109/L than that of WBC count < 50 x 109/L. Moreover, the level of serum miR-145 in prednisone poor responders was significantly lower than that in prednisone good responders. Compared with minimal residual disease (MRD) < 0.01% group, serum miR-145 was much lower in AML patients with MRD ≥ 0.01% group. Pearson's correlation analysis showed that serum miR-145 was positively correlated with MRD. In addition, miR-145 diagnosed AML with an AUC of 0.915 (95% confidence interval: 0.828 to 1.000; p < 0.001). CONCLUSIONS The level of miR-145 in serum and BMNc of AML patients was significantly lower than those of the control group. Serum miR-145 was related to poor prognosis and disease recurrence of AML.
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MESH Headings
- Adult
- Antineoplastic Agents, Hormonal/therapeutic use
- Area Under Curve
- Biomarkers, Pharmacological
- Biomarkers, Tumor/blood
- Bone Marrow/metabolism
- Bone Marrow Examination/methods
- Female
- Gene Expression Regulation, Leukemic
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/metabolism
- Male
- MicroRNAs/blood
- Prednisone/therapeutic use
- Prognosis
- Recurrence
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11
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Jiang H, Tang J, Qiu L, Zhang Z, Shi S, Xue L, Kui L, Huang T, Nan W, Zhou B, Zhao C, Yu M, Sun Q. Semaphorin 4D is a potential biomarker in pediatric leukemia and promotes leukemogenesis by activating PI3K/AKT and ERK signaling pathways. Oncol Rep 2021. [PMID: 33649851 DOI: 10.3892/or.2021.8021/html] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
Semaphorin 4D (Sema4D) is highly expressed in a variety of tumors and is associated with high invasion, poor prognosis and poor therapeutic response. However, the expression and role of Sema4D in leukemia remains unclear. The present study investigated the expression of Sema4D in pediatric leukemia and its effects in leukemia cells. The results demonstrated that Sema4D protein was highly expressed in peripheral blood mononuclear cells of patients with pediatric leukemia, and high levels of soluble Sema4D were also observed in the plasma of these patients. Sema4D knockdown induced cell cycle arrest in G0/G1 phase, inhibited proliferation and promoted apoptosis in BALL‑1 cells, while Sema4D overexpression exhibited the opposite effect. In Jurkat cells, Sema4D knockdown inhibited proliferation and promoted apoptosis, while Sema4D overexpression decreased the abundance of the cells in the G0/G1 phase of the cell cycle and promoted proliferation. Sema4D overexpression also increased the migratory capacity of Jurkat cells and the invasive capacity of BALL‑1 cells. The phosphorylation level of PI3K was decreased in both Sema4D knocked‑down Jurkat and BALL‑1 cells, and the phosphorylation level of ERK was decreased in Sema4D knocked‑down BALL‑1 cells. The phosphorylation levels of PI3K, ERK and AKT were elevated in patients with pediatric leukemia, and were correlated to the increased Sema4D expression. Sema4D overexpression was associated with a shorter overall survival in patients with acute myeloid leukemia. Overall, the results of the present study indicated that Sema4D serves an important role in leukemia development by activating PI3K/AKT and ERK signaling, and it may be used as a potential target for the diagnosis and treatment of leukemia.
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MESH Headings
- Adolescent
- Antigens, CD/biosynthesis
- Antigens, CD/blood
- Biomarkers, Tumor/biosynthesis
- Biomarkers, Tumor/blood
- Case-Control Studies
- Cell Line, Tumor
- Cell Proliferation/physiology
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Jurkat Cells
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/pathology
- Leukocytes, Mononuclear/metabolism
- MAP Kinase Signaling System
- Male
- Phosphatidylinositol 3-Kinases/metabolism
- Phosphorylation
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/metabolism
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Proto-Oncogene Proteins c-akt/metabolism
- Semaphorins/biosynthesis
- Semaphorins/blood
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Affiliation(s)
- Hongchao Jiang
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Jiaolian Tang
- Institute of Pediatrics, Children's Hospital Affiliated to Kunming Medical University, Kunming, Yunnan 650228, P.R. China
| | - Lijuan Qiu
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Zhen Zhang
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Shulan Shi
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Li Xue
- Institute of Medicine, Dali University, Dali, Yunnan 671000, P.R. China
| | - Liyue Kui
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Tilong Huang
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Weiwei Nan
- Institute of Medicine, Dali University, Dali, Yunnan 671000, P.R. China
| | - Bailing Zhou
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Canchun Zhao
- Institute of Pediatrics, The Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Ming Yu
- Yunnan Key Laboratory of Stem Cell and Regenerative Medicine, Biomedical Engineering Research Center, Kunming Medical University, Kunming, Yunnan 650500, P.R. China
| | - Qiangming Sun
- Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming, Yunnan 650118, P.R. China
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12
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Dou J, Li L, Guo M, Mei F, Zheng D, Xu H, Xue R, Bao X, Zhao F, Zhang Y. Iron Oxide Nanoparticles Combined with Cytosine Arabinoside Show Anti-Leukemia Stem Cell Effects on Acute Myeloid Leukemia by Regulating Reactive Oxygen Species. Int J Nanomedicine 2021; 16:1231-1244. [PMID: 33633448 PMCID: PMC7900778 DOI: 10.2147/ijn.s278885] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/15/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND AND AIM Acute myeloid leukemia (AML), initiated and maintained by leukemia stem cells (LSCs), is often relapsed or refractory to therapy. The present study aimed at assessing the effects of nanozyme-like Fe3O4 nanoparticles (IONPs) combined with cytosine arabinoside (Ara-C) on LSCs in vitro and in vivo. METHODS The CD34+CD38-LSCs, isolated from human AML cell line KG1a by a magnetic activated cell sorting method, were treated with Ara-C, IONPs, and Ara-C+ IONPs respectively in vitro. The cellular proliferation, apoptosis, reactive oxygen species (ROS), and the related molecular expression levels in LSCs were analyzed using flow cytometry, RT-qPCR, and Western blot. The nonobese diabetic/severe combined immune deficiency mice were transplanted with LSCs or non-LSCs via tail vein, and then the mice were treated with Ara-C, IONPs and IONPs plus Ara-C, respectively. The therapeutic effects on the AML bearing mice were further evaluated. RESULTS LSCs indicated stronger cellular proliferation, more clone formation, and more robust resistance to Ara-C than non-LSCs. Compared with LSCs treated with Ara-C alone, LSCs treated with IONPs plus Ara-C showed a significant increase in apoptosis and ROS levels that might be regulated by nanozyme-like IONPs via improving the expression of pro-oxidation molecule gp91-phox but decreasing the expression of antioxidation molecule superoxide dismutase 1. The in vivo results suggested that, compared with the AML bearing mice treated with Ara-C alone, the mice treated with IONPs plus Ara-C markedly reduced the abnormal leukocyte numbers in peripheral blood and bone marrow and significantly extended the survival of AML bearing mice. CONCLUSION IONPs combined with Ara-C showed the effectiveness on reducing AML burden in the mice engrafted with LSCs and extending mouse survival by increasing LSC's ROS level to induce LSC apoptosis. Our findings suggest that targeting LSCs could control the AML relapse by using IONPs plus Ara-C.
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Affiliation(s)
- Jun Dou
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Luoyang Li
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Mei Guo
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Feng Mei
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Danfeng Zheng
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Hui Xu
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Rui Xue
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Xueyang Bao
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Fengshu Zhao
- Department of Pathogenic Biology and Immunology, Medical College, Southeast University, Nanjing, 210009, People’s Republic of China
| | - Yu Zhang
- State Key Laboratory of Bioelectronics, Jiangsu Key Laboratory for Biomaterials and Devices, School of Biological Science and Medical Engineering, Southeast University, Nanjing, 210009, People’s Republic of China
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13
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Godwin CD, Zhou Y, Othus M, Asmuth MM, Shaw CM, Gardner KM, Wood BL, Walter RB, Estey EH. Acute myeloid leukemia measurable residual disease detection by flow cytometry in peripheral blood vs bone marrow. Blood 2021; 137:569-572. [PMID: 33507294 PMCID: PMC7845008 DOI: 10.1182/blood.2020006219] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 04/08/2020] [Accepted: 09/22/2020] [Indexed: 12/14/2022] Open
Affiliation(s)
- Colin D Godwin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, Division of Hematology, and
| | - Yi Zhou
- Department of Laboratory Medicine, Division of Hematopathology, University of Washington, Seattle, WA
| | - Megan Othus
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA; and
| | | | - Carole M Shaw
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Brent L Wood
- Department of Laboratory Medicine, Division of Hematopathology, University of Washington, Seattle, WA
| | - Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, Division of Hematology, and
- Department of Pathology, and
- Department of Epidemiology, University of Washington, Seattle, WA
| | - Elihu H Estey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA
- Department of Medicine, Division of Hematology, and
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14
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Shi M, Yang R, Lin J, Wei QI, Chen L, Gong W, Li Y, Guo X. LncRNA-SNHG16 promotes proliferation and migration of acute myeloid leukemia cells via PTEN/PI3K/AKT axis through suppressing CELF2 protein. J Biosci 2021; 46:4. [PMID: 33576342] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The silence of lncRNA small nucleolar RNA host gene 16 (SNHG16) suppressed acute lymphoblastic leukemia (ALL) cell proliferation and migration, whereas its role in acute myeloid leukemia (AML) still lacks clarity. This study showed that SNHG16 was upregulated in AML patients and cells. And SNHG16 overexpression remarkably enhanced the proliferation and migration capacities of HL60 and AML-193 cells, while SNHG16 knockdown acted the opposite way. Subsequently, we revealed that SNHG16 directly bound to CELF2 (CUGBP Elav-like family member 2) protein, and caused CELF2 mRNA unstably and proteins reducing. CELF2 was decreased both in AML patients and cells. CELF2 overexpression or interference weakened the effect of overexpressing or silencing SNHG16 on proliferation and migration. Moreover, the transfection of pcDNA-CELF2 elevated PTEN (phosphatase and tensin homolog) activity and hindered the phosphoinositide 3-kinase (PI3K)/AKT signaling. And SNHG16 reduced PTEN activity and promoted the PI3K/AKT pathway activation by restraining CELF2. Furthermore, GDC-0941 (a specific inhibitor of the PI3K/AKT pathway) impeded the effect of SNHG16 increase, and bpV(pic) (a specific PTEN inhibitor) declined the effect of SNHG16 decrease on cell proliferation and migration. Taken together, the present study indicated that SNHG16 promoted proliferation and migration of AML cells via PTEN/PI3K/AKT axis through suppressing CELF2 protein.
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MESH Headings
- CELF Proteins/blood
- CELF Proteins/genetics
- Cell Line, Tumor
- Cell Movement/genetics
- Cell Proliferation/genetics
- Female
- Gene Expression Regulation, Leukemic/genetics
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Nerve Tissue Proteins/blood
- Nerve Tissue Proteins/genetics
- Oncogene Protein v-akt/blood
- Oncogene Protein v-akt/genetics
- PTEN Phosphohydrolase/blood
- PTEN Phosphohydrolase/genetics
- Phosphatidylinositol 3-Kinases/blood
- Phosphatidylinositol 3-Kinases/genetics
- RNA, Long Noncoding/blood
- RNA, Long Noncoding/genetics
- Signal Transduction/genetics
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Affiliation(s)
- Min Shi
- School of Medicine, Xi'an Peihua University, 888 Changning Street, Xi'an 710125, China
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15
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Angenendt L, Hilgefort I, Mikesch JH, Schlüter B, Berdel WE, Lenz G, Stelljes M, Schliemann C. Magnesium levels and outcome after allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia. Ann Hematol 2020; 100:1871-1878. [PMID: 33341918 PMCID: PMC8195955 DOI: 10.1007/s00277-020-04382-y] [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: 09/11/2020] [Accepted: 12/16/2020] [Indexed: 12/21/2022]
Abstract
Low intake of magnesium has been associated with the occurrence of lymphomas and decreased magnesium levels suppress the cytotoxic function of T cells and natural killer cells in patients with “X-linked immunodeficiency with magnesium defect, Epstein-Barr virus infection, and neoplasia” (XMEN) syndrome. These cell types are also important mediators of immune-mediated effects after allogeneic hematopoietic stem cell transplantation. Here, we show that high posttransplant magnesium levels independently associate with a lower incidence of relapse, a higher risk of acute graft-versus-host disease, and a higher non-relapse mortality in 368 patients with acute myeloid leukemia from our center. Magnesium serum levels might impact on donor-cell-mediated immune responses in acute myeloid leukemia.
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Affiliation(s)
- Linus Angenendt
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany.
| | - Isabel Hilgefort
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Jan-Henrik Mikesch
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Bernhard Schlüter
- Centre for Laboratory Medicine, University Hospital Münster, Münster, Germany
| | - Wolfgang E Berdel
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Georg Lenz
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Matthias Stelljes
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
| | - Christoph Schliemann
- Department of Medicine A, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Germany
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16
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Bebeshko VG, Bruslova KM, Lyashenko LO, Tsvietkova NM, Gonchar LO, Galkina SG, Zaitseva AL, Reznikova LS, Iatsemyrskii SM, Tsvet LO. PROGNOSIS OF ACUTE LEUKEMIA DEPENDING ON THE IRON METABOLISM PARAMETERS IN CHILDREN AFTER CHORNOBYL NUCLEAR POWER PLANT ACCIDENT. Probl Radiac Med Radiobiol 2020; 25:390-401. [PMID: 33361849 DOI: 10.33145/2304-8336-2020-25-390-401] [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] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To determine the influence of iron metabolism on the prognosis of acute lymphoblastic (ALL) and (AML)myeloblastic leukemia at the different phases of chemotherapy in children after Chоrnobyl accident. MATERIALS AND METHODS 333 children (295 - ALL, 38 - AML) were examined at the stages of chemotherapy. Thecomparison group included 93 children without leukemia. Acute leukemia variants, patients survival, relapses, thenature of disease (live child or died), iron methabolism (morphometric parameters of erythrocytes, SI, SF, STf, TS),manifestations of dyserythropoiesis, bone marrow sideroblast and patients radiation dose were taken into account. RESULTS In 295 patients with ALL the following variants of leukemia were established: pro-B-ALL in 23, «common»type of ALL in 224, pre-B-ALL in 29, T-ALL in 19. Thirty eight patients were diagnosed with AML (11 - M1, 19 - M2,8 - M4). Doses of radiation in patients with AL were (2.78 ± 0.10) mSv and they did not correlate with clinical andhematological parameters, disease variant. Relapse rates and shorter survival were in patients with T-ALL, pro-B-ALLand AML with SF levels > 500 ng/ml (p < 0.05). The amount of children with normochromic-normocytic anemias andmanifestations of dysplasia of erythroid lineage elements was greater in the AML than in ALL. SF content in patientswas elevated during chemotherapy and was lower than the initial one only in the remission period. Transferrin wasreliably overloaded with iron: TS (70.2 ± 2.3) % compared with the control group (32.7 ± 2.1) %. Correlationbetween TS and survival of patients was detected (rs = -0.45). Direct correlation between the number of iron granules in erythrocariocytes and SF level (rs = 0.43) was established, indicating the phenomena of ineffective erythropoiesis. CONCLUSIONS The negative influence of iron excess in the patients body on the hemopoiesis function, manifestations of ineffective erythropoiesis and the course of acute leukemia in children have been established. Changes inferrokinetic processes in children can be the basis of leukemоgenesis development.
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MESH Headings
- Adolescent
- Anemia, Sideroblastic/blood
- Anemia, Sideroblastic/drug therapy
- Anemia, Sideroblastic/etiology
- Anemia, Sideroblastic/mortality
- Antineoplastic Agents/therapeutic use
- Bone Marrow/pathology
- Bone Marrow/radiation effects
- Chernobyl Nuclear Accident
- Child
- Child, Preschool
- Erythroid Cells/pathology
- Erythroid Cells/radiation effects
- Erythropoiesis/radiation effects
- Female
- Humans
- Iron/blood
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myeloid, Acute/mortality
- Male
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/blood
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/etiology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality
- Prognosis
- Radiation Exposure/adverse effects
- Radiation, Ionizing
- Recurrence
- Remission Induction
- Survival Analysis
- Transferrin/metabolism
- Ukraine/epidemiology
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Affiliation(s)
- V G Bebeshko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - K M Bruslova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - L O Lyashenko
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - N M Tsvietkova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - L O Gonchar
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - S G Galkina
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - A L Zaitseva
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - L S Reznikova
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - S M Iatsemyrskii
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
| | - L O Tsvet
- State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka str., Kyiv, 04050, Ukraine
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17
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Yehia S, Abdel-Salam IM, Elgamal BM, El-Agamy B, Hamdy GM, Aldesouki HM. Cytotoxic and Apoptotic Effects of Luffa Cylindrica Leaves Extract against Acute Lymphoblastic Leukemic Stem Cells. Asian Pac J Cancer Prev 2020; 21:3661-3668. [PMID: 33369466 PMCID: PMC8046306 DOI: 10.31557/apjcp.2020.21.12.3661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 10/06/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Acute lymphoblastic leukemia (ALL) is an aggressive malignancy defined by accumulation of lymphoblasts in the bone marrow. Leukemic stem cells (LSCs) are the major cause of the recurrence and metastasis of ALL. This study aimed to develop an effective anti-cancer agent targeting these LSCs. Luffa Cylindrica (L.C.) leaves extract was selected to evaluate its effect on ALL via eradicating the LSCs as it contains many active anti-cancer flavonoids. METHODS Thirty-two bone marrow samples of ALL patients were used in this study. LSCs population was identified in the selected samples. Cell viability was measured by MTT assay and flow cytometry. Cell cycle, apoptosis, proliferation marker; ki-67 and colony forming assay were further analyzed. RESULTS This study revealed the expression of CD34+/CD38+ cells in addition to CD34+/CD38- population and the extract was effective against the two LSCs populations. MTT assay showed that treated leukemic cells exhibited significant reduction in the viable cells in a dose dependent manner with IC50 of 3 µg/µl which was then confirmed by flow cytometry. Cell cycle analysis results showed significant reduction in the percentage of cells treated with L.C. extract in both the S and G0/G1 phases, with concomitant increase in the G2/M phase. Also, L.C. extract could effectively induce apoptosis, inhibit proliferation and suppress colonogenecity of leukemic cells. CONCLUSION This study validated the medicinal potential of L.C. leaves extract as a promising anti-leukemic agent targeting both LSCs and blasts in ALL patients, which may be explained by the synergy found between its potent flavonoids especially apigenin, luteolin and kaempferol.
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Affiliation(s)
- Shimaa Yehia
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
| | | | - Basma M. Elgamal
- Clinical Pathology Department, National Cancer Institute, Cairo University, Cairo, Egypt.
| | - Basma El-Agamy
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
| | - Germine M. Hamdy
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
| | - Hala M. Aldesouki
- Biochemistry Department, Faculty of Science, Ain Shams University, Cairo, Egypt.
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18
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Abaza Y, Kantarjian H, Alwash Y, Borthakur G, Champlin R, Kadia T, Garcia-Manero G, Daver N, Ravandi F, Verstovsek S, Burger J, Estrov Z, Ohanian M, Lim M, Pemmaraju N, Jabbour E, Cortes J. Phase I/II study of dasatinib in combination with decitabine in patients with accelerated or blast phase chronic myeloid leukemia. Am J Hematol 2020; 95:1288-1295. [PMID: 32681739 DOI: 10.1002/ajh.25939] [Citation(s) in RCA: 24] [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: 06/01/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 12/14/2022]
Abstract
Treatment of advanced-phase chronic myeloid leukemia (CML) remains unsatisfactory. Single-agent tyrosine kinase inhibitors have modest and short-lived activity in this setting. We conducted a phase I/II study to determine safety and efficacy of the combination of dasatinib and decitabine in patients with advanced CML. Two different dose schedules were investigated with a starting decitabine dose of either 10 mg/m2 or 20 mg/m2 daily for 10 days plus dasatinib 100 mg daily. The target dose level was decitabine 10 mg/m2 or 20 mg/m2 daily for 10 days plus dasatinib 140 mg daily. Thirty patients were enrolled, including seven with accelerated-phase CML, 19 with blast-phase CML, and four with Philadelphia-chromosome positive acute myeloid leukemia. No dose-limiting toxicity was observed at the starting dose level with either schedule. Grade ≥3 treatment emergent hematological adverse events were reported in 28 patients. Thirteen patients (48%) achieved a major hematologic response and six (22%) achieved a minor hematologic response, with 44% of these patients achieving a major cytogenetic response and 33% achieving a major molecular response. Median overall survival (OS) was 13.8 months, with significantly higher OS among patients who achieved a hematologic response compared to non-responders (not reached vs 4.65 months; P < .001). Decitabine plus dasatinib is a safe and active regimen in advanced CML. Further studies using this combination are warranted.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Blast Crisis/blood
- Blast Crisis/drug therapy
- Blast Crisis/mortality
- Dasatinib/administration & dosage
- Dasatinib/adverse effects
- Decitabine/administration & dosage
- Decitabine/adverse effects
- Disease-Free Survival
- Female
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/mortality
- Male
- Middle Aged
- Survival Rate
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Affiliation(s)
- Yasmin Abaza
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yasmin Alwash
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gautam Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard Champlin
- Department of Stem Cell Transplant, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tapan Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Srdan Verstovsek
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jan Burger
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zeev Estrov
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Maro Ohanian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Miranda Lim
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jorge Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Georgia Cancer Center, Augusta University, Augusta, Georgia
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19
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Borthakur G, Zeng Z, Cortes JE, Chen HC, Huang X, Konopleva M, Ravandi F, Kadia T, Patel KP, Daver N, Kelly MA, McQueen T, Wang RY, Kantarjian H, Andreeff M. Phase 1 study of combinatorial sorafenib, G-CSF, and plerixafor treatment in relapsed/refractory, FLT3-ITD-mutated acute myelogenous leukemia patients. Am J Hematol 2020; 95:1296-1303. [PMID: 32697348 DOI: 10.1002/ajh.25943] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 05/12/2020] [Revised: 07/14/2020] [Accepted: 07/20/2020] [Indexed: 01/18/2023]
Abstract
Stroma-leukemia interactions mediated by CXCR4, CD44, VLA4, and their respective ligands contribute to therapy resistance in FLT3-ITD-mutated acute myelogenous leukemia (AML). We conducted a phase 1 study with the combination of sorafenib (a FLT3-ITD inhibitor), plerixafor (a SDF-1/CXCR4 inhibitor), and G-CSF (that cleaves SDF-1, CD44, and VLA4). Twenty-eight patients with relapsed/refractory FLT3-ITD-mutated AML were enrolled from December 2010 to December 2013 at three dose levels of sorafenib (400, 600, and 800 mg twice daily) and G-CSF and plerixafor were administered every other day for seven doses starting on day one. Sorafenib 800 mg twice daily was selected for the expansion phase. While no dose-limiting toxicities (DLT) were encountered in the four-week DLT window, hand-foot syndrome and rash were seen beyond the DLT window, which required dose reductions in most patients. The response rate was 36% (complete response (CR) = 4, complete remission with incomplete platelet recovery (CRp) = 4, complete remission with incomplete hematologic recovery (CRi) = 1, and partial response (PR) = 1) for the intention to treat population. Treatment resulted in 58.4 and 47 mean fold mobilization of blasts and CD34 /38- stem/progenitor cells, respectively, to the circulation. Expression of the adhesion molecules CXCR4, CD44, and VLA4 on circulating leukemia cells correlated negatively with the mobilization of CD34+/38-, CD34+/38-/123+ "progenitor" cells (all P ≤ .002). Mass cytometry analysis of sequential samples from two patients demonstrated resistance emerging early on from sub-clones with persistent Akt and/or ERK signaling. In conclusion, the strategy of combined inhibition of FLT3 kinase and stromal adhesive interactions has promising activity in relapsed/refractory, FLT3-ITD-mutated AML, which warrants further evaluation in the front-line setting.
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Affiliation(s)
- Gautam Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Section of Molecular Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zhihong Zeng
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Section of Molecular Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jorge E Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hsiang-Chun Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xuelin Huang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Section of Molecular Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tapan Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Keyur P Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mary A Kelly
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Teresa McQueen
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Section of Molecular Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ru-Yiu Wang
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Section of Molecular Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael Andreeff
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Section of Molecular Hematology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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20
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Abstract
Patient-derived xenografts (PDXs) are the most valuable tool for preclinical drug testing because they retain the genetic diversity and phenotypic heterogeneity of the original tumor. Acute myeloid leukemia (AML) remains difficult to engraft in immunodeficient mice. This is particularly true for long-term frozen patient specimens. This protocol is designed to establish PDXs of human AML with improved engraftment rates. The optimized approach increases the viability of patient cells before implantation, efficiently monitors in vivo engraftment, and maximizes bone marrow collection. For complete details on the use and execution of this protocol, please refer to Salik et al. (2020) and Lynch et al. (2019). This protocol describes the establishment of AML patient-derived xenograft mouse models Increased viability of injected cells is critical for high engraftment rate in mice Effective collection of bone marrow is a key step in the process of PDX establishment
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Affiliation(s)
- Nunki Hassan
- Cancer and Stem Cell Biology Group, Children’s Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Corresponding author
| | - Jonason Yang
- Cancer and Stem Cell Biology Group, Children’s Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jenny Y. Wang
- Cancer and Stem Cell Biology Group, Children’s Cancer Institute, Lowy Cancer Research Centre, University of New South Wales, Sydney, NSW 2052, Australia
- Corresponding author
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21
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Cornelissen LL, Kreuger AL, Caram-Deelder C, Middelburg RA, Kerkhoffs JLH, von dem Borne PA, Beckers EAM, de Vooght KMK, Kuball J, Zwaginga JJ, van der Bom JG. Thrombocytopenia and the effect of platelet transfusions on the occurrence of intracranial hemorrhage in patients with acute leukemia - a nested case-control study. Ann Hematol 2020; 100:261-271. [PMID: 33067700 PMCID: PMC7782440 DOI: 10.1007/s00277-020-04298-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/03/2020] [Indexed: 02/04/2023]
Abstract
We designed a study to describe the incidence of intracranial hemorrhage according to severity and duration of thrombocytopenia and to quantify the associations of platelet transfusions with intracranial hemorrhage in patients with acute leukemia. In this case-control study nested in a cohort of 859 leukemia patients, cases (n = 17) were patients diagnosed with intracranial hemorrhage who were matched with control patients (n = 55). We documented platelet counts and transfusions for seven days before the intracranial hemorrhage in cases and in a “matched” week for control patients. Three measures of platelet count exposure were assessed in four potentially important time periods before hemorrhage. Among these leukemia patients, we observed the cumulative incidence of intracranial hemorrhage of 3.5%. Low platelet counts were, especially in the three to seven days preceding intracranial hemorrhage, associated with the incidence of intracranial hemorrhage, although with wide confidence intervals. Platelet transfusions during the week preceding the hemorrhage were associated with higher incidences of intracranial hemorrhage; rate ratios (95% confidence interval) for one or two platelet transfusions and for more than two transfusions compared with none were 4.04 (0.73 to 22.27) and 8.91 (1.53 to 51.73) respectively. Thus, among acute leukemia patients, the risk of intracranial hemorrhage was higher among patients with low platelet counts and after receiving more platelet transfusions. Especially, the latter is likely due to clinical factors leading to increased transfusion needs.
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Affiliation(s)
- Loes L Cornelissen
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands
- Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Aukje L Kreuger
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Camila Caram-Deelder
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rutger A Middelburg
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean Louis H Kerkhoffs
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands
- Department of Hematology, Haga Teaching Hospital, Den Haag, The Netherlands
| | | | - Erik A M Beckers
- Department of Hematology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Karen M K de Vooght
- Central Diagnostic Laboratory, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jürgen Kuball
- Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - J J Zwaginga
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands
- Department of Immunology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johanna G van der Bom
- Jon J van Rood Center for Clinical Transfusion Medicine, Sanquin/LUMC, Leiden, The Netherlands.
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
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22
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Merlant M, Lepelletier C, Battistella M, Vignon-Pennamen MD, Duriez P, Moguelet P, Brunet-Possenti F, Bagot M, Chasset F, Bouaziz JD. Acute myeloid leukemia and myelodysplastic syndrome-associated Sweet syndrome: A comparative multicenter retrospective study of 39 patients. J Am Acad Dermatol 2020; 84:838-840. [PMID: 33065169 DOI: 10.1016/j.jaad.2020.09.089] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/14/2020] [Accepted: 09/19/2020] [Indexed: 11/20/2022]
Affiliation(s)
- Marie Merlant
- Faculté de Médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Dermatologie, Hôpital Saint-Louis, Paris, France.
| | - Clémence Lepelletier
- Faculté de Médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Dermatologie, Hôpital Saint-Louis, Paris, France
| | - Maxime Battistella
- Faculté de Médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Pathologie, Hôpital Saint-Louis, Paris, France
| | - Marie-Dominique Vignon-Pennamen
- Faculté de Médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Pathologie, Hôpital Saint-Louis, Paris, France
| | - Paul Duriez
- Faculté de Médecine Sorbonne Université, Assistance Publique de Hôpitaux de Paris, Service de Pathologie, Hôpital Saint-Antoine, Paris, France
| | - Philippe Moguelet
- Faculté de Médecine Sorbonne Université, Assistance Publique de Hôpitaux de Paris, Pathologie, Hôpital Tenon, Paris, France
| | - Florence Brunet-Possenti
- Faculté de médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Dermatologie, Hôpital Bichat, Paris, France
| | - Martine Bagot
- Faculté de Médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Dermatologie, Hôpital Saint-Louis, Paris, France
| | - François Chasset
- Faculté de Médecine Sorbonne Université, Assistance Publique de Hôpitaux de Paris, Service de Dermatologie et Allergologie, Hôpital Tenon, Paris, France
| | - Jean David Bouaziz
- Faculté de Médecine Paris Diderot, Assistance Publique de Hôpitaux de Paris, Service de Dermatologie, Hôpital Saint-Louis, Paris, France
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23
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Valkova V, Vydra J, Markova M, Cerovska E, Vrana M, Marinov I, Cechova H, Cetkovsky P, Vitek A, Salek C. WT1 Gene Expression in Peripheral Blood Before and After Allogeneic Stem Cell Transplantation is a Clinically Relevant Prognostic Marker in AML - A Single-center 14-year Experience. Clin Lymphoma Myeloma Leuk 2020; 21:e145-e151. [PMID: 33160932 DOI: 10.1016/j.clml.2020.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/17/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND This work summarizes our experience with WT1 monitoring before and after allogeneic hematopoietic stem cell transplantation (allo-HSCT). PATIENTS AND METHODS The expression of WT1 gene was measured by real-time polymerase chain reaction in peripheral blood according to the European Leukemia Net recommendations. Between May 2005 and August 2019, we analyzed 147 consecutive patients with acute myeloid leukemia with high WT1 expression at diagnosis, transplanted in first (CR1) or second (CR2) complete remission. RESULTS At the time of allo-HSCT, 107 patients had WT1-normal expression (WT1 ≤ 50 copies), and 40 patients had WT1-high expression. The median follow-up was 21 months. The estimated 5-year overall survival and event-free survival was significantly better in the WT1-normal cohort (65% and 57% vs. 37% and 25%; P = .0003 and P < .0001, respectively) and 5-year cumulative incidence of relapse was significantly lower in the WT1-normal group (19% vs. 53%; P < .0001). Five-year non-relapse mortality was not significantly different (20% and 23%). Multivariate analysis revealed WT1-high expression and acute graft-versus-host disease grade 3/4 as significantly negative prognostic factors for OS. Overall, 49 patients developed WT1 molecular relapse in the post-transplant period; in 14 cases, the therapeutic intervention was done. In all but 1 relapsed patient where WT1 minimal residual disease (MRD) was monitored (38 patients), we detected WT1-high levels (sensitivity of 97%). CONCLUSION The results of the analysis confirmed our previous experience that WT1 status before allo-HSCT is a strong prognostic factor for both OS and relapse risk. In addition, we confirmed the usefulness of this marker for MRD monitoring after allo-HSCT. The main advantage is the possibility of frequent MRD monitoring in peripheral blood and early bone marrow examination based on WT1-high expression.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/metabolism
- Disease-Free Survival
- Feasibility Studies
- Female
- Follow-Up Studies
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic
- Graft vs Host Disease/diagnosis
- Graft vs Host Disease/epidemiology
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Incidence
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/therapy
- Male
- Middle Aged
- Neoplasm Recurrence, Local/epidemiology
- Neoplasm Recurrence, Local/genetics
- Neoplasm, Residual
- Prognosis
- Risk Assessment/methods
- Risk Factors
- Severity of Illness Index
- WT1 Proteins/blood
- WT1 Proteins/metabolism
- Young Adult
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Affiliation(s)
- Veronika Valkova
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Jan Vydra
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marketa Markova
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ela Cerovska
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Milena Vrana
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Iuri Marinov
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Cechova
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Petr Cetkovsky
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Antonin Vitek
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Cyril Salek
- Department of Bone Marrow Transplant, Institute of Hematology and Blood Transfusion, Prague, Czech Republic; Institute of Clinical and Experimental Hematology, First Faculty of Medicine, Charles University, Prague, Czech Republic
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Bauer M, Vaxevanis C, Heimer N, Al-Ali HK, Jaekel N, Bachmann M, Wickenhauser C, Seliger B. Expression, Regulation and Function of microRNA as Important Players in the Transition of MDS to Secondary AML and Their Cross Talk to RNA-Binding Proteins. Int J Mol Sci 2020; 21:ijms21197140. [PMID: 32992663 PMCID: PMC7582632 DOI: 10.3390/ijms21197140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 08/24/2020] [Revised: 09/14/2020] [Accepted: 09/22/2020] [Indexed: 12/12/2022] Open
Abstract
Myelodysplastic syndromes (MDS), heterogeneous diseases of hematopoietic stem cells, exhibit a significant risk of progression to secondary acute myeloid leukemia (sAML) that are typically accompanied by MDS-related changes and therefore significantly differ to de novo acute myeloid leukemia (AML). Within these disorders, the spectrum of cytogenetic alterations and oncogenic mutations, the extent of a predisposing defective osteohematopoietic niche, and the irregularity of the tumor microenvironment is highly diverse. However, the exact underlying pathophysiological mechanisms resulting in hematopoietic failure in patients with MDS and sAML remain elusive. There is recent evidence that the post-transcriptional control of gene expression mediated by microRNAs (miRNAs), long noncoding RNAs, and/or RNA-binding proteins (RBPs) are key components in the pathogenic events of both diseases. In addition, an interplay between RBPs and miRNAs has been postulated in MDS and sAML. Although a plethora of miRNAs is aberrantly expressed in MDS and sAML, their expression pattern significantly depends on the cell type and on the molecular make-up of the sample, including chromosomal alterations and single nucleotide polymorphisms, which also reflects their role in disease progression and prediction. Decreased expression levels of miRNAs or RBPs preventing the maturation or inhibiting translation of genes involved in pathogenesis of both diseases were found. Therefore, this review will summarize the current knowledge regarding the heterogeneity of expression, function, and clinical relevance of miRNAs, its link to molecular abnormalities in MDS and sAML with specific focus on the interplay with RBPs, and the current treatment options. This information might improve the use of miRNAs and/or RBPs as prognostic markers and therapeutic targets for both malignancies.
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Affiliation(s)
- Marcus Bauer
- Institute of Pathology, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (M.B.); (C.W.)
| | - Christoforos Vaxevanis
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle 06112, Germany; (C.V.); (N.H.)
| | - Nadine Heimer
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle 06112, Germany; (C.V.); (N.H.)
| | - Haifa Kathrin Al-Ali
- Department of Hematology/Oncology, University Hospital Halle, 06112 Halle, Germany; (H.K.A.-A.); (N.J.)
| | - Nadja Jaekel
- Department of Hematology/Oncology, University Hospital Halle, 06112 Halle, Germany; (H.K.A.-A.); (N.J.)
| | - Michael Bachmann
- Helmholtz-Zentrum Dresden Rossendorf, Institute of Radiopharmaceutical Cancer Research, 01328 Dresden, Germany;
| | - Claudia Wickenhauser
- Institute of Pathology, Martin Luther University Halle-Wittenberg, 06112 Halle, Germany; (M.B.); (C.W.)
| | - Barbara Seliger
- Institute of Medical Immunology, Martin Luther University Halle-Wittenberg, Halle 06112, Germany; (C.V.); (N.H.)
- Fraunhofer Institute for Cell Therapy and Immunology, 04103 Leipzig, Germany
- Correspondence: ; Tel.: +49-345-557-4054
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25
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Yoo KH, Cho J, Han B, Kim SH, Shin DY, Hong J, Kim H, Kim HJ, Zang DY, Yoon SS, Jin JY, Lee JH, Hong DS, Park SK. Outcomes of decitabine treatment for newly diagnosed acute myeloid leukemia in older adults. PLoS One 2020; 15:e0235503. [PMID: 32760083 PMCID: PMC7410295 DOI: 10.1371/journal.pone.0235503] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 06/17/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE We evaluated the outcomes of decitabine as first-line treatment in older patients with acute myeloid leukemia (AML) and investigated the predictors, including a baseline mini nutritional assessment short form (MNA-SF) score, of response and survival. PATIENTS AND METHODS Between 2010 and 2018, 96 AML patients aged 65 and above who received decitabine treatment at 6 centers in Korea were retrospectively evaluated. Response rates, hematologic improvements (HI), progression-free survival (PFS), and overall survival (OS) were analyzed. RESULTS The median age at diagnosis was 73.9 years, and the median number of decitabine treatments administered to the patients was 4 (range, 1-29). Of 85 patients, 15 patients (17.6%) achieved complete remission (CR) or CR with incomplete blood count recovery. Twelve patients (14.1%) showed partial remission (PR), and 18 (21.2%) demonstrated HI without an objective response. The median PFS and OS were 7.0 (95% confidence interval [CI], 4.9-9.0) and 10.6 (95% CI, 7.7-13.5%) months, respectively. In multivariate analyses, MNA-SF score ≥ 8 and the absence of peripheral blood (PB) blasts were significant predictors for improved PFS and OS. CONCLUSIONS For older patients with newly diagnosed AML, a high MNA-SF score and the absence of PB blasts were independently associated with improved survival.
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MESH Headings
- Age Factors
- Aged
- Aged, 80 and over
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/adverse effects
- Blood Cell Count
- Bone Marrow/pathology
- Decitabine/administration & dosage
- Decitabine/adverse effects
- Drug Administration Schedule
- Female
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/pathology
- Male
- Nutrition Assessment
- Progression-Free Survival
- Remission Induction/methods
- Republic of Korea/epidemiology
- Retrospective Studies
- Weight Loss
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Affiliation(s)
- Kwai Han Yoo
- Division of Hematology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Jinhyun Cho
- Division of Hematology-Oncology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - Boram Han
- Division of Hematology/Oncology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Se Hyung Kim
- Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Dong-Yeop Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Junshik Hong
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hawk Kim
- Division of Hematology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Hyo Jung Kim
- Division of Hematology/Oncology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Dae young Zang
- Division of Hematology/Oncology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jong-Youl Jin
- Division of Hemato-Oncology, Department of Internal Medicine, Bucheon St. Mary's Hospital, Bucheon, Korea
| | - Jae Hoon Lee
- Division of Hematology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Dae-Sik Hong
- Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Seong Kyu Park
- Division of Hemato-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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Sorror ML, Agarwal S, Othus M, Lynch Y, Nyland JE, Percival M, Becker PS, Appelbaum FR, Estey EH. Regimen-intensity per count-recovery and hospitalization index: A new tool to assign regimen intensity for AML. Cancer Med 2020; 9:6515-6523. [PMID: 32706528 PMCID: PMC7520345 DOI: 10.1002/cam4.3311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/03/2020] [Revised: 06/01/2020] [Accepted: 06/28/2020] [Indexed: 11/07/2022] Open
Abstract
Background Low‐intensity regimens have been increasingly used to treat older patients with acute myeloid leukemia (AML). Recent studies, however, suggest older patients can tolerate and potentially benefit from intensive chemotherapeutic regimens. The ability to compare the utility of varying regimen intensities in AML is hindered by the lack of a standardized definition of “regimen intensity.” Methods We conducted a survey asking AML physicians which of 38 regimens they would consider intensive vs less‐intensive. Electronic medical records of 592 patients receiving many of these regimens were used to design a model characterizing regimens as intensive vs less‐intensive as identified by ≥75% physician consensus. Variables included frequency and length of hospitalizations, intensive care unit admissions, severe gastrointestinal toxicities, time to nadir, and recovery of neutrophil/platelet count. Results Physicians agreed at a rate of 75%‐100% on the assignment of degree of intensity to the majority (n = 28) of these regimens, while the level of agreement was <75% for the remaining 10 regimens (26%). Logistic regression analyses identified number and length of hospitalizations to be significantly associated with intensive regimens and count recovery with less‐intensive regimens. We created the “regimen‐intensity per count‐recovery and hospitalization” (RICH) index with an AUC of 0.87. Independent model validation yielded an AUC of 0.75. Conclusions We were able to generate a novel model that defines regimen intensity for many therapies used to treat AML. Results facilitate a future randomized study comparing intensive vs less‐intensive regimens.
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Affiliation(s)
- Mohamed L. Sorror
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of MedicineUniversity of Washington School of MedicineSeattleWAUSA
| | - Shirali Agarwal
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
| | - Megan Othus
- Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of BiostatisticsUniversity of Washington School of MedicineSeattleWAUSA
| | - Ylinne Lynch
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of MedicineUniversity of Washington School of MedicineSeattleWAUSA
| | - Jennifer E. Nyland
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Present address:
Department of Neural & Behavioral SciencesPennsylvania State UniversityState CollegePAUSA
| | - Mary‐Elizabeth Percival
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of MedicineUniversity of Washington School of MedicineSeattleWAUSA
| | - Pamela S. Becker
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of MedicineUniversity of Washington School of MedicineSeattleWAUSA
| | - Frederick R. Appelbaum
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of MedicineUniversity of Washington School of MedicineSeattleWAUSA
| | - Elihu H. Estey
- Divisions of Clinical ResearchFred Hutchinson Cancer Research CenterSeattleWAUSA
- Department of MedicineUniversity of Washington School of MedicineSeattleWAUSA
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27
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Abstract
BACKGROUND AND OBJECTIVE Gemtuzumab ozogamicin is an antibody-drug conjugate composed of the anti-CD33 monoclonal antibody hP67.6 covalently linked to N-acetyl-gamma-calicheamicin dimethylhydrazide, a potent cytotoxic antibiotic. The aim of this study was to characterize the population pharmacokinetics of gemtuzumab ozogamicin, represented by total hP67.6 antibody and unconjugated calicheamicin, in adult patients with acute myeloid leukemia to support drug dosing strategies and explore intrinsic and extrinsic factors that may influence exposure. Pharmacokinetic data from seven previous phase I and II studies in adult patients with relapsed, refractory, or de novo acute myeloid leukemia were integrated and analyzed using nonlinear mixed-effects modeling. METHODS The pharmacokinetics of total hP67.6 antibody was described in 407 patients (5643 concentrations) who received gemtuzumab ozogamicin doses ranging from 0.25 to 9 mg/m2 using a two-compartment model with linear and time-dependent clearance components. The pharmacokinetics of unconjugated calicheamicin was characterized in 338 patients (4281 concentrations) using a two-compartment model with an input rate of formation dependent on the amount of hP67.6 eliminated. No statistically significant baseline covariates (sex, albumin, bone marrow, and peripheral blast percentage) demonstrated a clinically meaningful impact. RESULTS AND CONCLUSION Total hP67.6 antibody disposition did not appear altered in patients with mild or moderate renal disease or hepatic impairment. Gemtuzumab ozogamicin was approved for the treatment of acute myeloid leukemia by the US Food and Drug Administration in September 2017. The model-based simulations described here provided a pharmacokinetic rationale for the approved dosing regimen of 3 mg/m2 on days 1, 4, and 7, and served as the basis for all exposure-response modeling included in the recent Biologics License Application submission. Clinical trials identifiers: 0903A1-101-US; 0903A1-103-JA; 0903B1-201-US/CA (NCT00003131); 0903B1-202-EU; 0903B1-203-US/EU (NCT00003673); 0903B1-205-US/EU/AU (NCT00037596); and 0903B1-206-US/EU/AU (NCT00037583).
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Monoclonal
- Antineoplastic Agents, Immunological/administration & dosage
- Antineoplastic Agents, Immunological/pharmacokinetics
- Antineoplastic Agents, Immunological/therapeutic use
- Calicheamicins/blood
- Calicheamicins/pharmacokinetics
- Drug Design
- Female
- Gemtuzumab/administration & dosage
- Gemtuzumab/pharmacokinetics
- Gemtuzumab/therapeutic use
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/ethnology
- Male
- Middle Aged
- Sialic Acid Binding Ig-like Lectin 3/antagonists & inhibitors
- Sialic Acid Binding Ig-like Lectin 3/blood
- Sialic Acid Binding Ig-like Lectin 3/pharmacokinetics
- United States
- United States Food and Drug Administration
- Young Adult
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Affiliation(s)
- Jennifer Hibma
- Pfizer Inc., 10555 Science Center Drive, 2405, San Diego, CA, 92121, USA.
| | - Beverly Knight
- Pfizer Inc., 10555 Science Center Drive, 2405, San Diego, CA, 92121, USA
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28
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Xiao Y, Deng T, Ming X, Xu J. TRIM31 promotes acute myeloid leukemia progression and sensitivity to daunorubicin through the Wnt/β-catenin signaling. Biosci Rep 2020; 40:BSR20194334. [PMID: 32232394 PMCID: PMC7160243 DOI: 10.1042/bsr20194334] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/27/2020] [Accepted: 03/09/2020] [Indexed: 12/27/2022] Open
Abstract
Tripartite motif (TRIM) 31 is a member of TRIM family and exerts oncogenic role in the progression and drug resistance of several cancers. However, little is known about the relevance of TRIM31 in acute myeloid leukemia (AML). Herein, we investigated the role of TRIM31 in AML. We examined the expression levels of TRIM31 in the blood samples from 34 patients with AML and 34 healthy volunteers using qRT-PCR. The mRNA levels of TRIM31 in human bone marrow stromal cells (HS-5) and five AML cell lines were also detected. Loss/gain-of-function assays were performed to assess the role of TRIM31 in AML cells proliferation, apoptosis and sensitivity to daunorubicin. The expression levels of pro-caspase 3, cleaved caspase 3, Wnt3a, β-catenin, cyclin D1 and c-Myc were measured using Western blot. TRIM31 expression levels were significantly up-regulated in AML patients and cell lines. Knockdown of TRIM31 suppressed cell proliferation and promoted apoptosis in AML-5 and U937 cells. The IC50 of daunorubicin was significantly decreased in TRIM31 siRNA (si-TRIM31) transfected cells. Oppositely, induced cell proliferation and decreased cell apoptosis were observed in pcDNA-3.1-TRIM31 transfected cells. Furthermore, knockdown of TRIM31 suppressed the activation of Wnt/β-catenin pathway in AML cells. Activation of Wnt/β-catenin pathway by LiCl abolished the effects of si-TRIM31 on cell proliferation, apoptosis and sensitivity to daunorubicin in AML cells. In conclusion, the results indicated that TRIM31 promoted leukemogenesis and chemoresistance to daunorubicin in AML. The oncogenic role of TRIM31 in AML was mediated by the Wnt/β-catenin pathway. Thus, TRIM31 might serve as a therapeutic target for the AML treatment.
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MESH Headings
- Antibiotics, Antineoplastic/pharmacology
- Antibiotics, Antineoplastic/therapeutic use
- Apoptosis/drug effects
- Case-Control Studies
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Daunorubicin/pharmacology
- Daunorubicin/therapeutic use
- Disease Progression
- Drug Resistance, Neoplasm
- Healthy Volunteers
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Lithium Chloride/pharmacology
- RNA, Small Interfering/metabolism
- Tripartite Motif Proteins/blood
- Tripartite Motif Proteins/genetics
- Tripartite Motif Proteins/metabolism
- Ubiquitin-Protein Ligases/blood
- Ubiquitin-Protein Ligases/genetics
- Ubiquitin-Protein Ligases/metabolism
- Wnt Signaling Pathway/drug effects
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Affiliation(s)
- Yi Xiao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Taoran Deng
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xi Ming
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jinhuang Xu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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29
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Hourigan CS, Dillon LW, Gui G, Logan BR, Fei M, Ghannam J, Li Y, Licon A, Alyea EP, Bashey A, Deeg HJ, Devine SM, Fernandez HF, Giralt S, Hamadani M, Howard A, Maziarz RT, Porter DL, Scott BL, Warlick ED, Pasquini MC, Horwitz ME. Impact of Conditioning Intensity of Allogeneic Transplantation for Acute Myeloid Leukemia With Genomic Evidence of Residual Disease. J Clin Oncol 2020; 38:1273-1283. [PMID: 31860405 PMCID: PMC7164487 DOI: 10.1200/jco.19.03011] [Citation(s) in RCA: 251] [Impact Index Per Article: 62.8] [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] [Accepted: 11/26/2019] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Patients with acute myeloid leukemia (AML) in remission remain at risk for relapse even after allogeneic hematopoietic cell transplantation (alloHCT). AML measurable residual disease (MRD) status before alloHCT has been shown to be prognostic. Whether modulation of the intensity of the alloHCT conditioning regimen in patients with AML who test positive for MRD can prevent relapse and improve survival is unknown. METHODS Ultra-deep, error-corrected sequencing for 13 commonly mutated genes in AML was performed on preconditioning blood from patients treated in a phase III clinical trial that randomly assigned adult patients with myeloid malignancy in morphologic complete remission to myeloablative conditioning (MAC) or reduced-intensity conditioning (RIC). RESULTS No mutations were detected in 32% of MAC and 37% of RIC recipients; these groups had similar survival (3-year overall survival [OS], 56% v 63%; P = .96). In patients with a detectable mutation (next-generation sequencing [NGS] positive), relapse (3-year cumulative incidence, 19% v 67%; P < .001) and survival (3-year OS, 61% v 43%; P = .02) was significantly different between the MAC and RIC arms, respectively. In multivariable analysis for NGS-positive patients, adjusting for disease risk and donor group, RIC was significantly associated with increased relapse (hazard ratio [HR], 6.38; 95% CI, 3.37 to 12.10; P < .001), decreased relapse-free survival (HR, 2.94; 95% CI, 1.84 to 4.69; P < .001), and decreased OS (HR, 1.97; 95% CI, 1.17 to 3.30; P = .01) compared with MAC. Models of AML MRD also showed benefit for MAC over RIC for those who tested positive. CONCLUSION This study provides evidence that MAC rather than RIC in patients with AML with genomic evidence of MRD before alloHCT can result in improved survival.
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MESH Headings
- Adult
- Aged
- Circulating Tumor DNA/blood
- Circulating Tumor DNA/genetics
- Clinical Trials, Phase III as Topic
- Female
- Hematopoietic Stem Cell Transplantation/methods
- High-Throughput Nucleotide Sequencing
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Male
- Middle Aged
- Mutation
- Neoplasm, Residual
- Prognosis
- Randomized Controlled Trials as Topic
- Transplantation Conditioning/methods
- Transplantation, Homologous
- Young Adult
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Affiliation(s)
| | - Laura W. Dillon
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Gege Gui
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Jack Ghannam
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Yuesheng Li
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Asad Bashey
- Blood and Marrow Transplant Program at Northside Hospital, Atlanta, GA
| | | | - Steven M. Devine
- National Marrow Donor Program and Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | | | - Sergio Giralt
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Alan Howard
- National Marrow Donor Program and Center for International Blood and Marrow Transplant Research, Minneapolis, MN
| | - Richard T. Maziarz
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR
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30
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Demir MK. A diagnostic dilemma in the emergency room: intracranial hemorrhages in acute myeloblastic leukemia with hyperleukocytosis. Acta Neurol Belg 2020; 120:487-489. [PMID: 29687365 DOI: 10.1007/s13760-018-0925-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/16/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Mustafa Kemal Demir
- Department of Radiology, Bahçeşehir University School of Medicine, Göztepe Medical Park Training and Education Hospital, 11. kisim, Yasemin Apt, D blok. Daire 35 Ataköy, 34158, Istanbul, Turkey.
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Merdin A, Dal MS, Çakar MK, Yildiz J, Ulu BU, Batgi H, Tetik A, Seçilmiş S, Darçin T, Şahin D, Bakirtaş M, Başçi S, Yiğenoğlu TN, Baysal NA, İskender D, Altuntaş F. Analysis of pre-chemotherapy WBC, PLT, monocyte, hemoglobin, and MPV levels in acute myeloid leukemia patients with WT1, FLT3, or NPM gene mutations. Medicine (Baltimore) 2020; 99:e19627. [PMID: 32243389 PMCID: PMC7440304 DOI: 10.1097/md.0000000000019627] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Effects of mutations on AML (acute myeloid leukemia) patients have been an area of clinical interest. The aim of this study was to analyze pre-chemotherapy WBC (white blood cell), platelet, monocyte, hemoglobin, and mean platelet volume (MPV) levels in acute myeloid leukemia patients with Wilms tumor 1 (WT1), FMS-like tyrosine kinase 3 (FLT3), or nucleophosmin (NPM) gene mutations, attempting to detect and compare possible differences in these values.The study included 71 patients with acute myeloid leukemia known to have WT1, FLT3, or NPM gene mutations. The patients were divided into 3 groups: FLT3-mutated AML patients without any accompanying known mutations other than WT1 at the time of diagnosis (Group 1), NPM-mutated AML patients without any accompanying known mutations other than WT1 at the time of diagnosis (Group 2), WT1-mutated AML patients with no other accompanying known mutations at the time of diagnosis (Group 3). We carried out intergroup comparisons of WBC, platelet (PLT), monocyte, hemoglobin, and MPV levels before chemotherapy.There was a statistically significant difference between the groups in terms of WBC parameters (P = .001). There were no statistically significant differences between the groups with respect to hemoglobin, platelet, and monocyte levels.Higher white blood cell counts could be observed in patients with FLT3-mutated AML.
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Affiliation(s)
- Alparslan Merdin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Mehmet Sinan Dal
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Merih Kizil Çakar
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Jale Yildiz
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Bahar Uncu Ulu
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Hikmetullah Batgi
- Internal Medicine Clinic, University of Health Sciences Ankara Education and Research Hospital, Ankara, Turkey
| | - Ayşegül Tetik
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Sema Seçilmiş
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Tahir Darçin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Derya Şahin
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Mehmet Bakirtaş
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Semih Başçi
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Tuğçe Nur Yiğenoğlu
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Nuran Ahu Baysal
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Dicle İskender
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
| | - Fevzi Altuntaş
- Hematology Clinic and Bone Marrow Transplantation Unit, University of Health Sciences Ankara Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital
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Fang Z, Wang X, Wu J, Xiao R, Liu J. High serum extracellular vesicle miR-10b expression predicts poor prognosis in patients with acute myeloid leukemia. Cancer Biomark 2020; 27:1-9. [PMID: 31594209 DOI: 10.3233/cbm-190211] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Increasing evidence have demonstrated that serum extracellular vesicle microRNAs (EV-miRNAs) are promising noninvasive biomarkers for various cancer types. OBJECTIVE In this study, we aimed to investigate and evaluate the potential clinical significance of serum EV-miR-10b for acute myeloid leukemia (AML). METHODS Blood samples were collected from a cohort of 95 de novo AML patients and 80 healthy individuals. Of all AML patients, 51 patients were considered as cytogenetic normal AML (CN-AML). Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) was performed to measure the expression levels of serum EV-miR-10b. RESULTS The extracellular vesicles we extracted from the serum samples were positive for EV/exosome markers including TSG101, CD63, Flotillin-1 and CD9. The expression levels of serum EV-miR-10b were significantly higher in AML/CN-AML patients than healthy controls. In addition, serum EV-miR-10b expression was strongly correlated with aggressive clinical characteristics. Moreover, receiver operating characteristic analysis showed serum EV-miR-10b yielded an area under the curve of 0.875, with 77.89% specificity and 82.50% sensitivity in identifying AML patients from normal controls. Furthermore, AML patients with higher serum EV-miR-10b expression had significantly shorter survival and serum EV-miR-10b was demonstrated to be an independent prognostic marker for overall survival in AML. CONCLUSIONS Taken together, serum EV-miR-10b might serve as a promising biomarker for predicting the prognosis of AML.
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Qin J, Huang S, Qian J, Xu C, Li S, Yu S, Yan H, Wu M, Chen J, Ren H, Peng M. The prognostic relevance and expression of progranulin in adult patients with acute myeloid leukemia. Medicine (Baltimore) 2020; 99:e18574. [PMID: 31895802 PMCID: PMC6946396 DOI: 10.1097/md.0000000000018574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 12/26/2022] Open
Abstract
Progranulin (PGRN) is a secreted protein that can regulate cell cycle progression, cell motility, and tumorigenesis. The PGRN expression in hematological malignancies is limited to multiple myeloma, but its expression and survival prognostic role in acute myeloid leukemia (AML) is still controversial.To evaluate the PGRN expression and estimate its survival prognostic role in AML patients.In this study, all patients were divided into three groups, which included 38 newly diagnosed adult AML patients, 33 complete remissions (CR-AML) patients, and 60 healthy control (HC) patients. The endpoints were relapse-free survival (RFS) and overall survival (OS). We investigated plasma PGRN levels by using enzyme-linked immunosorbent assay.Plasma PGRN levels in AML patients were higher than that in CR-AML and HC groups. After two chemo cycles, 16 patients had complete remission (CR). The level of plasma PGRN in non-CR patients compared to CR patients was obviously different (median 44.19 vs 21.10 ng/mL) (P = .025). In non-M3 (French-American-British classification) patients, 70% (21/30) patients relapsed in 1 year and 80% (24/80) patients died in the observed time. Using the value (median 19.95) as a "cut-off" value, we have divided non-M3 patients into low- and high-PGRN expression groups. High-PGRN expression patients had a poorer RFS with a median of 5.4 months (95% CI 3.7-7.1) and low-PGRN expression patients had a good RFS with a median of 8.9 months (95% CI 6.3-11.5; P = .027). In the survival analyses, high-PGRN expression of AML patients had shorter OS than low-PGRN expression of AML patients (6.2 vs 20.5 months, P = .008).PGRN is overexpressed in AML, which is a convenient and independent prognostic marker that is measured easily in AML patients.
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Affiliation(s)
- Jiajia Qin
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Shigao Huang
- Cancer Center, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR
| | - Jiao Qian
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Chunyan Xu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Shixiao Li
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Sufei Yu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Haixi Yan
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Mingjiao Wu
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
| | - Jiaxi Chen
- Department of Clinical Laboratory, Enze Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group)
| | - Hanxing Ren
- Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Minfei Peng
- Department of Clinical Laboratory, Taizhou Hospital of Zhejiang Province, Taizhou Enze Medical Center (Group), Linhai, Zhejiang Province
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Abstract
Risk classification and tailoring of treatment are essential for improving outcome for patients with acute myeloid leukemia or high-risk myelodysplastic syndrome. Both patient and leukemia-specific characteristics assessed using morphology, cytogenetics, molecular biology, and multicolor flow cytometry are relevant at diagnosis and during induction, consolidation, and maintenance phases of the treatment. In particular, minimal residual disease (MRD) during therapy has potential as a prognostic factor of outcome, determination of response to therapy, and direction of targeted therapy. MRD can be determined by cell surface markers using multicolor flow cytometry, whereas leukemia-specific translocations and mutations are measured using polymerase chain reaction-based techniques and recently using next-generation sequencing. All these methods of MRD detection have their (dis)advantages, and all need to be standardized, prospectively validated, and improved to be used for uniform clinical decision making and a potential surrogate end point for clinical trials testing novel treatment strategies. Important issues to be solved are time point of MRD measurement and threshold for MRD positivity. MRD is used for stem cell transplantation (SCT) selection in the large subgroup of patients with an intermediate risk profile. Patients who are MRD positive will benefit from allo-SCT. However, MRD-negative patients have a better chance of survival after SCT. Therefore, it is debated whether MRD-positive patients should be extensively treated to become MRD negative before SCT. Either way, accurate monitoring of potential residual or upcoming disease is mandatory. Tailoring therapy according to MRD monitoring may be the most successful way to provide appropriate specifically targeted, personalized treatment.
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Affiliation(s)
- Jacqueline Cloos
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, VUMC, Amsterdam, The Netherlands; and
| | - Gert J Ossenkoppele
- Department of Hematology, Cancer Center Amsterdam, Amsterdam UMC, VUMC, Amsterdam, The Netherlands; and
| | - Richard Dillon
- Department of Medical and Molecular Genetics, King's College, London, United Kingdom
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Abstract
Nowadays a donor can be found for virtually all patients in need of an allogeneic stem cell transplantation, and the decision whether to use a matched or mismatched unrelated donor, an unrelated donor for umbilical cord blood transplantation (UCBT), or a haploidentical donor depends not only on the availability of the donor but also on patient-, disease-, and center-related factors. This paper summarizes the recent criteria in the selection of cord blood unit, including the cell dose requirement and the HLA typing for the optimal donor choice. The main strategies to optimize the results of UCBT, the conditioning regimens, and the use of antithymocyte globulin and the other platforms of graft-versus-host disease prophylaxis are discussed. The paper describes the results of UCBT in children and adults with malignant and nonmalignant diseases and the comparative analysis with other donor type and stem cell sources. Emerging strategies, focusing on the different platforms of ex vivo expansion and the new applications using cord blood stem cell, are also examined.
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MESH Headings
- Adolescent
- Adult
- Anemia, Aplastic/blood
- Anemia, Aplastic/diagnosis
- Anemia, Aplastic/genetics
- Anemia, Aplastic/therapy
- Cord Blood Stem Cell Transplantation
- Donor Selection
- Female
- Histocompatibility Testing
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/therapy
- Male
- Transplantation Conditioning
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Affiliation(s)
- Annalisa Ruggeri
- Department of Pediatric Hematology and Oncology, Bambino Gesù Children's Hospital, Rome, Italy; Eurocord, Hôpital Saint Louis, Paris, France; and Cellular Therapy and Immunobiology Working Party of the European Society for Blood and Marrow Transplantation
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Sillar JR, Germon ZP, De Iuliis GN, Dun MD. The Role of Reactive Oxygen Species in Acute Myeloid Leukaemia. Int J Mol Sci 2019; 20:ijms20236003. [PMID: 31795243 PMCID: PMC6929020 DOI: 10.3390/ijms20236003] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [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: 10/16/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 12/26/2022] Open
Abstract
Acute myeloid leukaemia (AML) is an aggressive haematological malignancy with a poor overall survival. Reactive oxygen species (ROS) have been shown to be elevated in a wide range of cancers including AML. Whilst previously thought to be mere by-products of cellular metabolism, it is now clear that ROS modulate the function of signalling proteins through oxidation of critical cysteine residues. In this way, ROS have been shown to regulate normal haematopoiesis as well as promote leukaemogenesis in AML. In addition, ROS promote genomic instability by damaging DNA, which promotes chemotherapy resistance. The source of ROS in AML appears to be derived from members of the “NOX family” of NADPH oxidases. Most studies link NOX-derived ROS to activating mutations in the Fms-like tyrosine kinase 3 (FLT3) and Ras-related C3 botulinum toxin substrate (Ras). Targeting ROS through either ROS induction or ROS inhibition provides a novel therapeutic target in AML. In this review, we summarise the role of ROS in normal haematopoiesis and in AML. We also explore the current treatments that modulate ROS levels in AML and discuss emerging drug targets based on pre-clinical work.
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Affiliation(s)
- Jonathan R. Sillar
- Haematology Department, Calvary Mater Hospital, Newcastle, NSW 2298, Australia
- Cancer Signalling Research Group, School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Callaghan, NSW 2308, Australia;
- Priority Research Centre for Cancer Research, Innovation & Translation, Faculty of Health & Medicine, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Correspondence: (J.R.S.); (M.D.D.); Tel.: +612-4921-5693 (M.D.D.)
| | - Zacary P. Germon
- Cancer Signalling Research Group, School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Callaghan, NSW 2308, Australia;
- Priority Research Centre for Cancer Research, Innovation & Translation, Faculty of Health & Medicine, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
| | - Geoffry N. De Iuliis
- Priority Research Centre for Reproductive Sciences, Faculty of Science, University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Matthew D. Dun
- Cancer Signalling Research Group, School of Biomedical Sciences & Pharmacy, Faculty of Health & Medicine, University of Newcastle, Callaghan, NSW 2308, Australia;
- Priority Research Centre for Cancer Research, Innovation & Translation, Faculty of Health & Medicine, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia
- Correspondence: (J.R.S.); (M.D.D.); Tel.: +612-4921-5693 (M.D.D.)
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Milne P, Wilhelm-Benartzi C, Grunwald MR, Bigley V, Dillon R, Freeman SD, Gallagher K, Publicover A, Pagan S, Marr H, Jones GL, Dickinson AM, Grech A, Burnett AK, Russell NH, Levis M, Knapper S, Collin M. Serum Flt3 ligand is a biomarker of progenitor cell mass and prognosis in acute myeloid leukemia. Blood Adv 2019; 3:3052-3061. [PMID: 31648336 PMCID: PMC6849950 DOI: 10.1182/bloodadvances.2019000197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 03/20/2019] [Accepted: 07/30/2019] [Indexed: 11/20/2022] Open
Abstract
Fms-like tyrosine kinase 3 (Flt3) is expressed on progenitor cells and acute myeloid leukemia (AML) blasts. Fms-like tyrosine kinase 3 ligand (Flt3L) is detectable during homeostasis and increases in hypoplasia due to genetic defects or treatment with cytoreductive agents. Conversely, Flt3+ AML is associated with depletion of Flt3L to undetectable levels. After induction chemotherapy, Flt3L is restored in patients entering complete remission (CR) but remains depressed in those with refractory disease. Weekly sampling reveals marked differences in the kinetics of Flt3L response during the first 6 weeks of treatment, proportionate to the clearance of blasts and cellularity of the bone marrow. In the UK NCRI AML17 trial, Flt3L was measured at day 26 in a subgroup of 140 patients with Flt3 mutation randomized to the tyrosine kinase inhibitor lestaurtinib or placebo. In these patients, attainment of CR was associated with higher Flt3L at day 26 (Mann-Whitney UP < .0001). Day 26 Flt3L was also associated with survival; Flt3L ≤291 pg/mL was associated with inferior event-free survival (EFS), and Flt3L >1185 pg/mL was associated with higher overall survival (OS; P = .0119). The separation of EFS and OS curves increased when minimal residual disease (MRD) status was combined with Flt3L measurement, and Flt3L retained a near-significant association with survival after adjusting for MRD in a proportional hazards model. Serial measurement of Flt3L in patients who had received a hematopoietic stem cell transplant for AML illustrates the potential value of monitoring Flt3L to identify relapse. Measurement of Flt3L is a noninvasive test with the potential to inform clinical decisions in patients with AML.
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Affiliation(s)
- Paul Milne
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Charlotte Wilhelm-Benartzi
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Michael R Grunwald
- Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute, Atrium Health, Charlotte, NC
| | - Venetia Bigley
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Richard Dillon
- Department of Medical and Molecular Genetics, King's College, Strand, London, United Kingdom
| | - Sylvie D Freeman
- Clinical Immunology Service, Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham Edgbaston, Birmingham, United Kingdom
| | - Kathleen Gallagher
- Immune Monitoring Laboratory, Massachusetts General Hospital Center for Cancer Research, Boston, MA
| | - Amy Publicover
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sarah Pagan
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Helen Marr
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Gail L Jones
- Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Anne M Dickinson
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | - Angela Grech
- Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Alan K Burnett
- Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Nigel H Russell
- Department of Haematology, Nottingham University Hospital, Nottingham, United Kingdom; and
| | - Mark Levis
- Division of Hematological Malignancies, Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, MD
| | - Steven Knapper
- Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Matthew Collin
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre at Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
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Yang Y, Tang Z, An T, Zhao L. The impact of iron chelation therapy on patients with lower/intermediate IPSS MDS and the prognostic role of elevated serum ferritin in patients with MDS and AML: A meta-analysis. Medicine (Baltimore) 2019; 98:e17406. [PMID: 31577751 PMCID: PMC6783160 DOI: 10.1097/md.0000000000017406] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Serum ferritin (SF) has been identified as a potential prognostic factor for patients undergoing stem cell transplantation, but the prognostic value of SF in acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) patients and the impact of iron chelation therapy (ICT) on MDS patients are controversial. The present meta-analysis aimed to better elucidate these relationships.Three electronic databases were searched systematically to identify reports on the prognostic role of SF in MDS and AML patients, and those investigating the impact of ICT on prognosis of MDS patients. The hazard ratios (HRs) and its 95% confidence interval (95%CI) were extracted from the identified studies using Cox proportional hazard regression model for overall survival (OS) and progression of MDS to AML.Twenty reports including 1066 AML patients and 4054 MDS patients were included in present study. The overall pooled HRs for OS of AML and MDS patients with elevated SF prior to transplantation was 1.73 (1.40-2.14), subgroup analyses stratified by the cut-off value of SF ≥1400/1000 ng/mL showed that the pooled HRs were 1.45 (0.98-2.15) and 1.65 (1.30-2.10), respectively. The pooled HRs for ICT in MDS patients was 0.30 (0.23-0.40). For ICT, the pooled HRs for the progression of MDS to AML was 0.84 (0.61-1.61).SF has a negative impact on the OS of AML and MDS patients when it is higher than 1000 ng/mL. ICT can improve the OS of MDS patients with iron overload but it is not associated with the progression of MDS to AML.
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Affiliation(s)
- Yuan Yang
- The First Clinical Medical School of Lanzhou University
- Center Laboratory of The First Hospital of Lanzhou University
| | - Zengwei Tang
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou
| | - Tianli An
- The First Clinical Medical School of Lanzhou University
- Center Laboratory of The First Hospital of Lanzhou University
| | - Li Zhao
- The First Clinical Medical School of Lanzhou University
- Center Laboratory of The First Hospital of Lanzhou University
- Department of Hematology, The First Hospital of Lanzhou University, Lanzhou, China
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Jiang L, Zhang X, Chen Y, Huo X, Deng S, Yang X, Luo Y, Luo Y, Lu X, Zhang M, Huang H. Alteration of Serum 25(OH) Vitamin D, Vitamin D Binding Protein, and C-reactive Protein Levels in Acute Leukemia Patients. Clin Lab 2019; 64:1553-1559. [PMID: 30274014 DOI: 10.7754/clin.lab.2018.180412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Acute leukemia is a common hematologic malignancy with poorly differentiated leukocytes. Alteration of circulating vitamin D (VD) and its carrier vitamin D binding protein (VDBP) have been reported in certain types of cancers and may play a role in the course of the disease. Understanding of the status of serum VD and VDBP, as well as the acute phase protein C-reactive protein (CRP) levels in pre- and post-treatment of acute leukemia patients, may be helpful in the management of acute leukemia. METHODS Enzyme linked immunosorbent assay (ELISA), chemiluminescence immunoassay, and immunofluorescent assay were used to analyze the 25(OH) vitamin D (25(OH)D), VDBP, and CRP in the serum of a cohort of leukemia patients. RESULTS Serum 25(OH)D levels in patients (pre- and post-treatment) were significantly lower than in control subjects. There was no significant difference in 25(OH)D levels between pre- and post-treatment. Serum VDBP level was raised in both pre- and post-treatment of acute leukemia patients, with that of pre-treatment being higher. The average serum VDBP was reduced in post-treatment; however, no significant difference was found. Elevated serum CRP levels in both pre- and post-treatment patient groups have been observed but were reduced significantly after treatment. Results also revealed that serum VDBP levels in acute myeloid leukemia patients were significantly higher than in acute lymphoid leukemia patients, while 25(OH)D levels in acute myeloid leukemia were significantly lower than in acute lymphoid leukemia. No significant difference between the serum CRP levels of acute myeloid leukemia and acute lymphoid leukemia was observed. CONCLUSIONS Serum 25(OH)D, VDBP, and CRP may be used together and could be potential indicators of the disease course of acute leukemia and assist in its management which merits further investigation.
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Adnan-Awad S, Meligui YME, Salem SE, Salaheldin O, Ayoub MA, Kamel MM. Prognostic Impact of WT-1 and Survivin Gene Expression in Acute Myeloid Leukemia Patients. Clin Lab 2019; 65. [PMID: 30969080 DOI: 10.7754/clin.lab.2018.180329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Wilms Tumor 1 (WT1) and Survivin genes are important leukemia-associated antigens (LAAs) in AML with potential prognostic impact. METHODS We investigated WT1 and Survivin expression levels by RT-PCR in 61 AML patients in correlation with clinical characteristics and outcomes. RESULTS WT1 was overexpressed in 45 patients (73.8%), associated with higher BM blasts (p = 0.017), lower incidence of favorable-prognosis cytogenetics (p = 0.035), and higher incidence of Flt3-ITD mutations (p = 0.026). Survivin was overexpressed in 17 patients (27.9%) with higher mean WBC count (p = 0.049). Patients with overexpression of either gene showed inferior complete remission (CR) rates and survival rates, patients with overexpression of both genes showed higher mean WBCs (p = 0.035) and higher BM blasts (p = 0.029) while the double negative group showed higher incidence of favorable cytogenetic events (p = 0.021), better CR rates and survival rates. CONCLUSIONS Our findings support the introduced prognostic impact of WT1 and Survivin genes in AML patients and its potential use in MRD monitoring and immunotherapy.
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Meehan S, Kolyagin GA, Parks D, Youngyunpipatkul J, Herzenberg LA, Walther G, Ghosn EEB, Orlova DY. Automated subset identification and characterization pipeline for multidimensional flow and mass cytometry data clustering and visualization. Commun Biol 2019; 2:229. [PMID: 31240267 PMCID: PMC6586874 DOI: 10.1038/s42003-019-0467-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 11/23/2018] [Accepted: 05/21/2019] [Indexed: 11/21/2022] Open
Abstract
When examining datasets of any dimensionality, researchers frequently aim to identify individual subsets (clusters) of objects within the dataset. The ubiquity of multidimensional data has motivated the replacement of user-guided clustering with fully automated clustering. The fully automated methods are designed to make clustering more accurate, standardized and faster. However, the adoption of these methods is still limited by the lack of intuitive visualization and cluster matching methods that would allow users to readily interpret fully automatically generated clusters. To address these issues, we developed a fully automated subset identification and characterization (SIC) pipeline providing robust cluster matching and data visualization tools for high-dimensional flow/mass cytometry (and other) data. This pipeline automatically (and intuitively) generates two-dimensional representations of high-dimensional datasets that are safe from the curse of dimensionality. This new approach allows more robust and reproducible data analysis,+ facilitating the development of new gold standard practices across laboratories and institutions.
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Affiliation(s)
- Stephen Meehan
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305 USA
| | | | - David Parks
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305 USA
| | | | - Leonore A. Herzenberg
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305 USA
| | - Guenther Walther
- Department of Statistics, Stanford University, Stanford, CA 94305 USA
| | - Eliver E. B. Ghosn
- Departments of Medicine and Pediatrics, Lowance Center for Human Immunology, Emory Vaccine Center, Children’s Healthcare of Atlanta, Emory University, Atlanta, GA 30322 USA
| | - Darya Y. Orlova
- Department of Genetics, Stanford University School of Medicine, Stanford, CA 94305 USA
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Guo Z, Chen Z, Xu Y, Zhang Y, Hu L, Yu F, Chai J, Liu L, Ren X. The Association of Circulating T Follicular Helper Cells and Regulatory Cells with Acute Myeloid Leukemia Patients. Acta Haematol 2019; 143:19-25. [PMID: 31212277 DOI: 10.1159/000500588] [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] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 04/25/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE This study aims to investigate the association of circulating T follicular helper (cTfh) cells and T follicular regulatory (cTfr) cells with acute myeloid leukemia (AML) patients. METHODS A total of 22 newly diagnosed, untreated AML patients as well as 26 healthy controls were enrolled. Percentages of cTfh and cTfr cells were detected using flow cytometry. RESULTS Compared to healthy controls, a significantly higher percentage of cTfr cells was observed in AML patients (4.10 ± 11.18 vs. 0.63 ± 0.38%) (p < 0.05). In addition, a significantly lower cTfh/cTfr ratio was found in the AML patients' group when compared to the control group (9.04 ± 9.19 vs. 11.66 ± 5.68) (p < 0.05). A lower level of plasma IL-2 and TGF-β1 was found in AML patients. Based on the complete remission (CR) response after one cycle of inductive chemotherapy, patients were divided into two groups at sample collection: AML with and without CR. Significantly lower percentages of cTfr cells and a higher cTfh/cTfr ratio were found in the group of AML patients with CR than in the AML patients without CR. CONCLUSION There was a significantly higher percentage of cTfr cells in AML patients. cTfr cells may have a potential association with the pathogenesis of AML patients.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/therapeutic use
- Case-Control Studies
- Female
- Humans
- Interleukin-2/blood
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Leukocyte Count
- Male
- Middle Aged
- Remission Induction
- T-Lymphocytes, Helper-Inducer/cytology
- T-Lymphocytes, Helper-Inducer/immunology
- T-Lymphocytes, Regulatory/cytology
- T-Lymphocytes, Regulatory/immunology
- Transforming Growth Factor beta1/blood
- Young Adult
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Affiliation(s)
- Zhenxing Guo
- Department of Hematology/Oncology, First Hospital of Tsinghua University, Beijing, China,
| | - Zhenping Chen
- Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Yaru Xu
- Department of Hematology/Oncology, First Hospital of Tsinghua University, Beijing, China
| | - Yu Zhang
- Department of Hematopoietic Stem Cell Transplantation, the 307 Hospital of Chinese PLA, Beijing, China
| | - Liangding Hu
- Department of Hematopoietic Stem Cell Transplantation, the 307 Hospital of Chinese PLA, Beijing, China
| | - Fan Yu
- Department of Hematology/Oncology, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Junyue Chai
- Department of Hematology, Beijing No. 6 Hospital, Beijing, China
| | - Li Liu
- Department of Hematology/Oncology, First Hospital of Tsinghua University, Beijing, China
| | - Xiuhong Ren
- Department of Hematology/Oncology, First Hospital of Tsinghua University, Beijing, China
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43
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Brodská B, Otevřelová P, Šálek C, Fuchs O, Gašová Z, Kuželová K. High PD-L1 Expression Predicts for Worse Outcome of Leukemia Patients with Concomitant NPM1 and FLT3 Mutations. Int J Mol Sci 2019; 20:ijms20112823. [PMID: 31185600 PMCID: PMC6600137 DOI: 10.3390/ijms20112823] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 04/30/2019] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 12/23/2022] Open
Abstract
Compared to solid tumors, the role of PD-L1 in hematological malignancies is less explored, and the knowledge in this area is mostly limited to lymphomas. However, several studies indicated that PD-L1 is also overexpressed in myeloid malignancies. Successful treatment of the acute myeloid leukemia (AML) is likely associated with elimination of the residual disease by the immune system, and possible involvement of PD-L1 in this process remains to be elucidated. We analyzed PD-L1 expression on AML primary cells by flow cytometry and, in parallel, transcript levels were determined for the transcription variants v1 and v2. The ratio of v1/v2 cDNA correlated with the surface protein amount, and high v1/v2 levels were associated with worse overall survival (p = 0.0045). The prognostic impact of PD-L1 was limited to AML with mutated nucleophosmin and concomitant internal tandem duplications in the FLT3 gene (p less than 0.0001 for this particular AML subgroup).
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Affiliation(s)
- Barbora Brodská
- Institute of Hematology and Blood Transfusion, Prague 128 20, Czech Republic.
| | - Petra Otevřelová
- Institute of Hematology and Blood Transfusion, Prague 128 20, Czech Republic.
| | - Cyril Šálek
- Institute of Hematology and Blood Transfusion, Prague 128 20, Czech Republic.
| | - Ota Fuchs
- Institute of Hematology and Blood Transfusion, Prague 128 20, Czech Republic.
| | - Zdenka Gašová
- Institute of Hematology and Blood Transfusion, Prague 128 20, Czech Republic.
| | - Kateřina Kuželová
- Institute of Hematology and Blood Transfusion, Prague 128 20, Czech Republic.
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44
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Basheer F, Giotopoulos G, Meduri E, Yun H, Mazan M, Sasca D, Gallipoli P, Marando L, Gozdecka M, Asby R, Sheppard O, Dudek M, Bullinger L, Döhner H, Dillon R, Freeman S, Ottmann O, Burnett A, Russell N, Papaemmanuil E, Hills R, Campbell P, Vassiliou GS, Huntly BJP. Contrasting requirements during disease evolution identify EZH2 as a therapeutic target in AML. J Exp Med 2019; 216:966-981. [PMID: 30890554 PMCID: PMC6446874 DOI: 10.1084/jem.20181276] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [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: 07/06/2018] [Revised: 01/02/2019] [Accepted: 02/13/2019] [Indexed: 12/16/2022] Open
Abstract
Epigenetic regulators, such as EZH2, are frequently mutated in cancer, and loss-of-function EZH2 mutations are common in myeloid malignancies. We have examined the importance of cellular context for Ezh2 loss during the evolution of acute myeloid leukemia (AML), where we observed stage-specific and diametrically opposite functions for Ezh2 at the early and late stages of disease. During disease maintenance, WT Ezh2 exerts an oncogenic function that may be therapeutically targeted. In contrast, Ezh2 acts as a tumor suppressor during AML induction. Transcriptional analysis explains this apparent paradox, demonstrating that loss of Ezh2 derepresses different expression programs during disease induction and maintenance. During disease induction, Ezh2 loss derepresses a subset of bivalent promoters that resolve toward gene activation, inducing a feto-oncogenic program that includes genes such as Plag1, whose overexpression phenocopies Ezh2 loss to accelerate AML induction in mouse models. Our data highlight the importance of cellular context and disease phase for the function of Ezh2 and its potential therapeutic implications.
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MESH Headings
- Animals
- Bone Marrow Cells/metabolism
- Bone Marrow Transplantation
- Cell Line, Tumor
- Cohort Studies
- Disease Models, Animal
- Disease Progression
- Enhancer of Zeste Homolog 2 Protein/genetics
- Gene Frequency
- Histones/metabolism
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/pathology
- Loss of Function Mutation
- Mice
- Mice, Inbred C57BL
- Prognosis
- Survival Rate
- Transduction, Genetic
- Transplantation, Homologous
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Affiliation(s)
- Faisal Basheer
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - George Giotopoulos
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Eshwar Meduri
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Haiyang Yun
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Milena Mazan
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Wellcome Trust Sanger Institute, Hinxton, UK
| | - Daniel Sasca
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Paolo Gallipoli
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Ludovica Marando
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Malgorzata Gozdecka
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Wellcome Trust Sanger Institute, Hinxton, UK
| | - Ryan Asby
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | - Olivia Sheppard
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
| | | | | | - Hartmut Döhner
- Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Richard Dillon
- Department of Medical and Molecular Genetics, Kings College School of Medicine, UK
| | - Sylvie Freeman
- Department of Clinical Immunology, University of Birmingham Medical School, Edgbaston, Birmingham, UK
| | - Oliver Ottmann
- Department of Haematology, University of Cardiff, Cardiff, UK
| | | | - Nigel Russell
- Department of Haematology, University of Nottingham, Nottingham, UK
| | - Elli Papaemmanuil
- Departments of Epidemiology and Biostatistics and Cancer Biology, the Center for Molecular Oncology and the Center for Hematologic Malignancies, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Robert Hills
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - George S Vassiliou
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Wellcome Trust Sanger Institute, Hinxton, UK
| | - Brian J P Huntly
- Wellcome Trust-Medical Research Council Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Cambridge, UK
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Pandita A, Ramadas P, Poudel A, Saad N, Anand A, Basnet A, Wang D, Middleton F, Gilligan DM. Differential expression of miRNAs in acute myeloid leukemia quantified by Nextgen sequencing of whole blood samples. PLoS One 2019; 14:e0213078. [PMID: 30893351 PMCID: PMC6426230 DOI: 10.1371/journal.pone.0213078] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/20/2018] [Accepted: 02/08/2019] [Indexed: 12/13/2022] Open
Abstract
New approaches are needed for understanding and treating acute myeloid leukemia (AML). MicroRNAs (miRs) are important regulators of gene expression in all cells and disruption of their normal expression can lead to changes in phenotype of a cell, in particular the emergence of a leukemic clone. We collected peripheral blood samples from 10 adult patients with newly diagnosed AML, prior to induction chemotherapy, and 9 controls. Two and a half ml of whole blood was collected in Paxgene RNA tubes. MiRNA was purified using RNeasy mini column (Qiagen). We sequenced approximately 1000 miRs from each of 10 AML patients and 9 controls. In subset analysis, patients with NPM1 and FLT3 mutations showed the greatest number of miRNAs (63) with expression levels that differed from control with adjusted p-value of 0.05 or less. Some of these miRs have been described previously in association with leukemia, but many are new. Our approach of global sequencing of miRs as opposed to microarray analysis removes the bias regarding which miRs to assay and has demonstrated discovery of new associations of miRs with AML. Another strength of our approach is that sequencing miRs is specific for the 5p or 3p strand of the gene, greatly narrowing the proposed target genes to study further. Our study provides new information about the molecular changes that lead to evolution of the leukemic clone and offers new possibilities for monitoring relapse and developing new treatment strategies.
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Affiliation(s)
- Aakriti Pandita
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
| | - Poornima Ramadas
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
| | - Aarati Poudel
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
| | - Nibal Saad
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
| | - Ankit Anand
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
| | - Alina Basnet
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, Upstate Medical University, Syracuse, New York, United States of America
| | - Frank Middleton
- Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, New York, United States of America
| | - Diana M. Gilligan
- Department of Medicine, Division of Hematology/Oncology, Upstate Medical University, Syracuse, New York, United States of America
- * E-mail:
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46
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Valadbeigi S, Javadian S, Ebrahimi-Rad M, Khatami S, Saghiri R. Assessment of trace elements in serum of acute lymphoblastic and myeloid leukemia patients. Exp Oncol 2019; 41:69-71. [PMID: 30932404] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM Trace elements play a key role in human metabolism. The aim of the present study was to measure essential trace elements in the serum of patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). MATERIALS AND METHODS 32 patients with ALL and 16 patients with AML were studied. The control group consisted of 36 subjects. Serum levels of the trace elements selenium, copper and zinc were measured by spectrophotometry. RESULTS The mean of copper concentrations in the groups of patients with AML and ALL was significantly higher than in the control group (p < 0.0001), whereas serum levels of selenium and zinc were significantly lower in AML patients (p < 0.0001). Also in ALL patients the levels of selenium and zinc were significantly decreased compared with the control group (p < 0.0001; p = 0.0003). CONCLUSION Our results indicate that the levels of zinc and selenium are significantly decreased and copper levels are significantly increased in the serum of patients with acute leukemia (AML, ALL).
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Affiliation(s)
- S Valadbeigi
- Department of Biochemistry, Pasteur Institute of Iran, Tehran 1316943551, Iran
| | - S Javadian
- Chemical Analysis Laboratory, Pasteur Institute of Iran, Tehran 1316943551, Iran
| | - M Ebrahimi-Rad
- Department of Biochemistry, Pasteur Institute of Iran, Tehran 1316943551, Iran
| | - S Khatami
- Department of Biochemistry, Pasteur Institute of Iran, Tehran 1316943551, Iran
| | - R Saghiri
- Department of Biochemistry, Pasteur Institute of Iran, Tehran 1316943551, Iran
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47
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Appelbaum FR. Hematopoietic cell transplantation as treatment of patients with acute myeloid leukemia with measurable residual disease after consolidation therapy. Best Pract Res Clin Haematol 2018; 31:405-409. [PMID: 30466757 PMCID: PMC6347460 DOI: 10.1016/j.beha.2018.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The persistence of measurable residual disease (MRD) following induction chemotherapy is the single most powerful prognostic factor available to clinicians treating patients with acute myeloid leukemia (AML). How to use this information to guide subsequent therapy is complex, and influenced by the category of AML being treated, the assays used to measure MRD, MRD levels and kinetics, and the spectrum of therapies available to the patient. In this literature-based review, each of these issues will be discussed, with a particular emphasis on the role of hematopoietic cell transplantation in the treatment of MRD-positive patients.
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Affiliation(s)
- Frederick R Appelbaum
- Fred Hutchinson Cancer Research Center and University of Washington, 100 Fairview Avenue N, D5-310, Seattle, WA 98109, USA.
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48
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Khalid A, Siddiqui AJ, Huang JH, Shamsi T, Musharraf SG. Alteration of Serum Free Fatty Acids are Indicators for Progression of Pre-leukaemia Diseases to Leukaemia. Sci Rep 2018; 8:14883. [PMID: 30291286 PMCID: PMC6173776 DOI: 10.1038/s41598-018-33224-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/05/2018] [Indexed: 02/08/2023] Open
Abstract
Acute Leukaemia (AL) is a neoplasm of WBCs (white blood cells). Being an important class of metabolites, alteration in free fatty acids (FFAs) levels play a key role in cancer development and progression. As they involve in cell signaling, maintain membrane integrity, regulate homeostasis and effect cell and tissue functions. Considering this fact, a comprehensive analysis of FFAs was conducted to monitor their alteration in AL, pre-leukaemic diseases and healthy control. Fifteen FFAs were analyzed in 179 serum samples of myelodysplastic syndrome (MDS), aplastic anemia (APA), acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML) and healthy control using gas chromatography-multiple reaction monitoring-mass spectrometry (GC-MRM-MS). A multivariate statistical method of random forest (RF) was employed for chemometric analysis. Serum level of two FFAs including C18:0 and C14:0 were found discriminative among all five groups, and between ALL and AML, respectively. Moreover, C14:0 was identified as differentiated FFAs for systematic progression of pre-leukaemic conditions towards AML. C16:0 came as discriminated FFAs between APA and MDS/AML. Over all it was identified that FFAs profile not only become altered in leukaemia but also in pre-leukaemic diseases.
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Affiliation(s)
- Ayesha Khalid
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Amna Jabbar Siddiqui
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan
| | - Jian-Hua Huang
- TCM and Ethnomedicine Innovation and Development Laboratory, Changsha, Hunan, China
| | - Tahir Shamsi
- National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan
| | - Syed Ghulam Musharraf
- H.E.J. Research Institute of Chemistry, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, 75270, Pakistan.
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Abstract
BACKGROUND MicroRNA-195 acts as a tumor suppressor in a variety of cancers. However, its clinical significance in pediatric acute myeloid leukemia (AML) remains largely undefined. OBJECTIVE To investigate the diagnostic and prognostic relevance of miR-195 in this malignancy. METHODS Expression levels of miR-195 in peripheral blood and bone marrow samples of patients with pediatric AML and normal controls were detected by real-time quantitative PCR. Then, receiver-operating characteristic (ROC) curve analysis, Kaplan-Meier method, and Cox regression analysis were performed to evaluate the diagnostic and prognostic relevance of serum miR-195 in pediatric AML. RESULTS Compared to normal controls, the expression levels of miR-195 in both bone marrow and patients' sera were significantly decreased (both P< 0.001). In addition, serum miR-195 had an optimal diagnostic cut-off point (2.09) for pediatric AML with sensitivity of 68.87% and specificity of 96.23%. The area under the ROC curve (AUC) based on serum miR-195 was 0.910. Moreover, patients with low serum miR-195 level more often had French-American-British classification subtype M7 (P= 0.02), unfavorable karyotypes (P= 0.01), and shorter relapse-free and overall survivals (both P= 0.001) than those with high serum miR-195 level. Furthermore, the multivariate analysis identified serum miR-195 level as an independent prognostic factor for both relapse-free and overall survivals. CONCLUSION The findings of this study suggest that the aberrant expression of miR-195 may play crucial roles in the development and progression of pediatric AML patients. Serum miR-195 may serve as a promising marker for monitoring the occurrence of this disease and predicting the clinical outcome of patients.
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50
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Xiao H, Li L, Pang Y, Wu Y, Jiang Z, Liu Z, Wu J, Xiao Y, Huang F, Liu Q, Zhang H, Luo Y, Huang H. Sequential treatment combining cladribine-based re-induction, myeloablative allogeneic HSCT, and prophylactic donor lymphocyte infusion: a promising treatment for refractory acute myeloid leukemia. Ann Hematol 2018; 97:2479-2490. [PMID: 30078144 DOI: 10.1007/s00277-018-3453-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/19/2017] [Accepted: 07/19/2018] [Indexed: 11/26/2022]
Abstract
We describe the first multicenter prospective study to assess the efficacy, safety, and immune reconstitution of a novel sequential transplant approach in 24 patients with primary induction failure/relapsed acute myeloid leukemia (AML). The sequential regimen consisted of cladribine 5 mg/m2/day and cytarabine 2 g/m2/day for 5 days and mitoxantrone 7 mg/m2/day for 3 days, followed by myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) using intravenous busulfan (3.2 mg/kg/day) for 4 days and cyclophosphamide (60 mg/kg/day) for 2 days. Patients in CR without acute graft-versus-host disease at day + 90 received prophylactic donor lymphocyte infusion (pDLI). At the time of transplantation, a marrow blast infiltration > 20% or any level of circulating blasts was found in 62.5% of patients. The cumulative incidence of relapse at 2 years was 29.8%. Overall survival (OS) was 74.5% at 1 year and 56.5% at 2 years. Leukemia-free survival (LFS) at 1 and 2 years was 62.5 and 50.5%, respectively. Multivariate analysis demonstrated that haploidentical related donor, pDLI, and experiencing chronic graft-versus-host disease (cGVHD) were protective from relapse. Total T cells and T cell subsets in peripheral blood recovered at 3 months post-HSCT. The expressions of immune checkpoints (cytotoxic T lymphocyte antigen 4 and programmed death 1) were extremely low in T cells over the first 1 year post-transplantation.
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Affiliation(s)
- Haowen Xiao
- Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, No. 111 Liuhua Rd., Guangzhou, 510010, Guangdong Province, People's Republic of China.
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.
| | - Li Li
- Center of Cell-Biological Therapy and Research, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong Province, People's Republic of China
| | - Yan Pang
- Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, No. 111 Liuhua Rd., Guangzhou, 510010, Guangdong Province, People's Republic of China
| | - Yuanbin Wu
- Department of Hematology, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, People's Republic of China
| | - Zujun Jiang
- Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, No. 111 Liuhua Rd., Guangzhou, 510010, Guangdong Province, People's Republic of China
| | - Zenghui Liu
- Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, No. 111 Liuhua Rd., Guangzhou, 510010, Guangdong Province, People's Republic of China
| | - Jiulong Wu
- Center of Cell-Biological Therapy and Research, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, Guangdong Province, People's Republic of China
| | - Yang Xiao
- Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, No. 111 Liuhua Rd., Guangzhou, 510010, Guangdong Province, People's Republic of China
| | - Fen Huang
- Department of Hematology, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Qifa Liu
- Department of Hematology, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong Province, People's Republic of China
| | - Hang Zhang
- Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - Yi Luo
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
| | - He Huang
- Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China
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