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Linke P, Munding N, Kimmle E, Kaufmann S, Hayashi K, Nakahata M, Takashima Y, Sano M, Bastmeyer M, Holstein T, Dietrich S, Müller-Tidow C, Harada A, Ho AD, Tanaka M. Reversible Host-Guest Crosslinks in Supramolecular Hydrogels for On-Demand Mechanical Stimulation of Human Mesenchymal Stem Cells. Adv Healthc Mater 2024; 13:e2302607. [PMID: 38118064 DOI: 10.1002/adhm.202302607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/12/2023] [Indexed: 12/22/2023]
Abstract
Stem cells are regulated not only by biochemical signals but also by biophysical properties of extracellular matrix (ECM). The ECM is constantly monitored and remodeled because the fate of stem cells can be misdirected when the mechanical interaction between cells and ECM is imbalanced. A well-defined ECM model for bone marrow-derived human mesenchymal stem cells (hMSCs) based on supramolecular hydrogels containing reversible host-guest crosslinks is fabricated. The stiffness (Young's modulus E) of the hydrogels can be switched reversibly by altering the concentration of non-cytotoxic, free guest molecules dissolved in the culture medium. Fine-adjustment of substrate stiffness enables the authors to determine the critical stiffness level E* at which hMSCs turn the mechano-sensory machinery on or off. Next, the substrate stiffness across E* is switched and the dynamic adaptation characteristics such as morphology, traction force, and YAP/TAZ signaling of hMSCs are monitored. These data demonstrate the instantaneous switching of traction force, which is followed by YAP/TAZ signaling and morphological adaptation. Periodical switching of the substrate stiffness across E* proves that frequent applications of mechanical stimuli drastically suppress hMSC proliferation. Mechanical stimulation across E* level using dynamic hydrogels is a promising strategy for the on-demand control of hMSC transcription and proliferation.
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Affiliation(s)
- Philipp Linke
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Natalie Munding
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Esther Kimmle
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Stefan Kaufmann
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Kentaro Hayashi
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
| | - Masaki Nakahata
- Department of Macromolecular Science, Graduate School of Science, Osaka University, Osaka, 560-0043, Japan
| | - Yoshinori Takashima
- Department of Macromolecular Science, Graduate School of Science, Osaka University, Osaka, 560-0043, Japan
| | - Masaki Sano
- Institute of Natural Sciences, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Martin Bastmeyer
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
- Cell and Neurobiology, Zoological Institute, Karlsruhe Institute of Technology, 76131, Karlsruhe, Germany
- Institute for Biological and Chemical Systems - Biological Information Processing (IBCS-BIP), Karlsruhe Institute of Technology, 76334, Eggenstein-Leopoldshafen, Germany
| | - Thomas Holstein
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
- Molecular Genetics and Evolution, Centre for Organismal Studies, Heidelberg University, 69221, Heidelberg, Germany
| | - Sascha Dietrich
- Department of Internal Medicine V, Hematology, Oncology, Rheumatology, University Hospital Heidelberg, 69120, Heidelberg, Germany
- Department of Haematology, Oncology, and Clinical Immunology, Universitätsklinikum Düsseldorf, 40225, Düsseldorf, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, Hematology, Oncology, Rheumatology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Akira Harada
- The Institute of Scientific and Industrial Research, Osaka University, 8-1 Mihogaoka, Ibaraki, Osaka, 567-0047, Japan
| | - Anthony D Ho
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
- Department of Internal Medicine V, Hematology, Oncology, Rheumatology, University Hospital Heidelberg, 69120, Heidelberg, Germany
- Molecular Medicine Partnership Unit Heidelberg, EMBL and Heidelberg University, 69120, Heidelberg, Germany
| | - Motomu Tanaka
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
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Schubert ML, Schmitt A, Hückelhoven-Krauss A, Neuber B, Kunz A, Waldhoff P, Vonficht D, Yousefian S, Jopp-Saile L, Wang L, Korell F, Keib A, Michels B, Haas D, Sauer T, Derigs P, Kulozik A, Kunz J, Pavel P, Laier S, Wuchter P, Schmier J, Bug G, Lang F, Gökbuget N, Casper J, Görner M, Finke J, Neubauer A, Ringhoffer M, Wolleschak D, Brüggemann M, Haas S, Ho AD, Müller-Tidow C, Dreger P, Schmitt M. Treatment of adult ALL patients with third-generation CD19-directed CAR T cells: results of a pivotal trial. J Hematol Oncol 2023; 16:79. [PMID: 37481608 PMCID: PMC10363324 DOI: 10.1186/s13045-023-01470-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/20/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Third-generation chimeric antigen receptor (CAR)-engineered T cells (CARTs) might improve clinical outcome of patients with B cell malignancies. This is the first report on a third-generation CART dose-escalating, phase-1/2 investigator-initiated trial treating adult patients with refractory and/or relapsed (r/r) acute lymphoblastic leukemia (ALL). METHODS Thirteen patients were treated with escalating doses of CD19-directed CARTs between 1 × 106 and 50 × 106 CARTs/m2. Leukapheresis, manufacturing and administration of CARTs were performed in-house. RESULTS For all patients, CART manufacturing was feasible. None of the patients developed any grade of Immune effector cell-associated neurotoxicity syndrome (ICANS) or a higher-grade (≥ grade III) catokine release syndrome (CRS). CART expansion and long-term CART persistence were evident in the peripheral blood (PB) of evaluable patients. At end of study on day 90 after CARTs, ten patients were evaluable for response: Eight patients (80%) achieved a complete remission (CR), including five patients (50%) with minimal residual disease (MRD)-negative CR. Response and outcome were associated with the administered CART dose. At 1-year follow-up, median overall survival was not reached and progression-free survival (PFS) was 38%. Median PFS was reached on day 120. Lack of CD39-expression on memory-like T cells was more frequent in CART products of responders when compared to CART products of non-responders. After CART administration, higher CD8 + and γδ-T cell frequencies, a physiological pattern of immune cells and lower monocyte counts in the PB were associated with response. CONCLUSION In conclusion, third-generation CARTs were associated with promising clinical efficacy and remarkably low procedure-specific toxicity, thereby opening new therapeutic perspectives for patients with r/r ALL. Trial registration This trial was registered at www. CLINICALTRIALS gov as NCT03676504.
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Affiliation(s)
- Maria-Luisa Schubert
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Anita Schmitt
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Angela Hückelhoven-Krauss
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Brigitte Neuber
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Alexander Kunz
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Philip Waldhoff
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Dominik Vonficht
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
- Division of Stem Cells and Cancer, Deutsches Krebsforschungszentrum (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Schayan Yousefian
- Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Department of Hematology, Oncology and Tumor Immunology, Charité University Medicine, Berlin, Germany
| | - Lea Jopp-Saile
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
- Division of Stem Cells and Cancer, Deutsches Krebsforschungszentrum (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Germany
- Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Lei Wang
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Felix Korell
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Anna Keib
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Birgit Michels
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Dominik Haas
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Tim Sauer
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Patrick Derigs
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Andreas Kulozik
- Department of Pediatric Hematology, Oncology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Kunz
- Department of Pediatric Hematology, Oncology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - Petra Pavel
- Institute for Clinical Transfusion Medicine and Cell Therapy (IKTZ), German Red Cross Blood Service Baden-Württemberg-Hessen, Heidelberg, Germany
| | - Sascha Laier
- Institute for Clinical Transfusion Medicine and Cell Therapy (IKTZ), German Red Cross Blood Service Baden-Württemberg-Hessen, Heidelberg, Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, of the Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | | | - Gesine Bug
- Department of Internal Medicine II, University Hospital Frankfurt, Frankfurt, Germany
| | - Fabian Lang
- Department of Internal Medicine II, University Hospital Frankfurt, Frankfurt, Germany
| | - Nicola Gökbuget
- Department of Internal Medicine II, University Hospital Frankfurt, Frankfurt, Germany
| | - Jochen Casper
- Department of Hematology and Oncology, University Hospital Oldenburg, Oldenburg, Germany
| | - Martin Görner
- Department of Hematology and Oncology, Hospital Bielefeld, Bielefeld, Germany
| | - Jürgen Finke
- Department of Internal Medicine I, University Hospital Freiburg, Freiburg, Germany
| | - Andreas Neubauer
- Department of Hematology, Oncology and Immunology, University Hospital Giessen und Marburg, Marburg, Germany
| | | | - Denise Wolleschak
- Department of Hematology and Oncology, Center of Internal Medicine, Otto-von-Guericke University Medical Center, Magdeburg, Germany
| | - Monika Brüggemann
- Department of Internal Medicine II, University Hospital Kiel, Kiel, Germany
| | - Simon Haas
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
- Division of Stem Cells and Cancer, Deutsches Krebsforschungszentrum (DKFZ) and DKFZ-ZMBH Alliance, Heidelberg, Germany
- Berlin Institute of Health (BIH) at Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute for Medical Systems Biology, Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany
- Department of Hematology, Oncology and Tumor Immunology, Charité University Medicine, Berlin, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Peter Dreger
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
- German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Center for Tumor Diseases (NCT), Heidelberg, Germany.
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Tanaka M, Thoma J, Poisa-Beiro L, Wuchter P, Eckstein V, Dietrich S, Pabst C, Müller-Tidow C, Ohta T, Ho AD. Physical biomarkers for human hematopoietic stem and progenitor cells. Cells Dev 2023; 174:203845. [PMID: 37116713 DOI: 10.1016/j.cdev.2023.203845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 04/30/2023]
Abstract
Adhesion of hematopoietic stem and progenitor cells (HSPCs) to the bone marrow niche plays critical roles in the maintenance of the most primitive HSPCs. The interactions of HSPC-niche interactions are clinically relevant in acute myeloid leukemia (AML), because (i) leukemia-initiating cells adhered to the marrow niche are protected from the cytotoxic effect by chemotherapy and (ii) mobilization of HSPCs from healthy donors' bone marrow is crucial for the effective stem cell transplantation. However, although many clinical agents have been developed for the HSPC mobilization, the effects caused by the extrinsic molecular cues were traditionally evaluated based on phenomenological observations. This review highlights the recent interdisciplinary challenges of hematologists, biophysicists and cell biologists towards the design of defined in vitro niche models and the development of physical biomarkers for quantitative indexing of differential effects of clinical agents on human HSPCs.
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Affiliation(s)
- Motomu Tanaka
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, INF253, Heidelberg University, 69120 Heidelberg, Germany; Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, 606-8501 Kyoto, Japan.
| | - Judith Thoma
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, INF253, Heidelberg University, 69120 Heidelberg, Germany
| | - Laura Poisa-Beiro
- Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany
| | - Patrick Wuchter
- Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany
| | - Volker Eckstein
- Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany
| | - Sascha Dietrich
- Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany
| | - Caroline Pabst
- Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany
| | - Takao Ohta
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, 606-8501 Kyoto, Japan
| | - Anthony D Ho
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, 606-8501 Kyoto, Japan; Department of Medicine V, Heidelberg University, INF410, 69120 Heidelberg, Germany; Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory (EMBL), Heidelberg University, 69120 Heidelberg, Germany.
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4
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Kayser S, Martínez-Cuadrón D, Rodriguez-Veiga R, Hänel M, Tormo M, Schäfer-Eckart K, Botella C, Stölzel F, Del Castillo TB, Keller U, Rodriguez-Medina C, Held G, Amigo ML, Schliemann C, Colorado M, Kaufmann M, Garcia MB, Krause SW, Görner M, Jost E, Steffen B, Zukunft S, Platzbecker U, Ho AD, Baldus CD, Serve H, Müller-Tidow C, Thiede C, Bornhäuser M, Montesinos P, Röllig C, Schlenk RF. Impact of trisomy 19 on outcome according to genetic makeup in patients with acute myeloid leukemia. Haematologica 2023. [PMID: 36815361 PMCID: PMC10388269 DOI: 10.3324/haematol.2022.282127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Indexed: 02/24/2023] Open
Abstract
We retrospectively studied 97 AML patients with trisomy 19 (tris-19; median age at diagnosis 57 years; range, 17-83 years) treated between 2001 and 2019 within two multicenter study groups. Tris-19 occurred solely in 10 (10.5%), with additional abnormalities in non-complex karyotypes in 8 (8%) and within complex karyotypes in 79 (82%) patients. Altogether, karyotypes characterized by trisomies only were present in 27 (28%) patients. Data on response and outcome of intensively treated patients were available in 92 patients and median follow-up was 6.4 years (95%-CI, 2.9-9.0 years). Complete remission (CR) after induction therapy was achieved in 52% (n=48) and early death rate was 10% (n=9). Notably, patients with tris-19 as sole abnormality had a CR rate of 89%. An allogeneic hematopoietic stem cell transplantation (allo-HCT) was performed in 34 (35%) patients (CR, n=19; active disease, n=15). Five-year relapse-free and overall survival (OS) rates were 26% (95%-CI, 16-43%) and 20% (95%-CI, 13-31%), respectively. OS rates were significantly higher in patients with tris-19 as sole abnormality or within karyotypes characterized by trisomies only (P=0.05). An Andersen-Gill model including allo-HCT as a time dependent covariable on OS revealed tris-19 as sole abnormality or within karyotypes characterized by trisomies only as favorable factors (HR, 0.47; P=0.021); higher age at diagnosis had an adverse impact (10 years difference; HR, 1.29; P=0.002), whereas allo-HCT had no beneficial impact (OR, 1.45; P=0.21). In our cohort, patients with tris-19 as sole abnormality or within karyotypes characterized by trisomies only had a high CR rate and better clinical outcome.
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Affiliation(s)
- Sabine Kayser
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany; NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany; Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig.
| | - David Martínez-Cuadrón
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain; CIBERONC, Instituto Carlos III, Madrid
| | | | | | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario, INCLIVA Research Institute, University of Valencia, Valencia
| | | | | | - Friedrich Stölzel
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden
| | | | - Ulrich Keller
- Department of Hematology, Oncology and Cancer Immunology, Charité-University Medical Center, Campus Benjamin Franklin, Berlin
| | - Carlos Rodriguez-Medina
- Hematology Department, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria
| | | | | | | | | | | | | | - Stefan W Krause
- Department of Internal Medicine 5 - Hematology/Oncology, University Hospital of Erlangen, Erlangen
| | - Martin Görner
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Bielefeld Mitte
| | - Edgar Jost
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, University Hospital RWTH Aachen, Aachen
| | - Björn Steffen
- Department of Internal Medicine II, University Hospital of Frankfurt Main
| | - Sven Zukunft
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden
| | - Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig
| | - Anthony D Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg
| | - Claudia D Baldus
- Department of Internal Medicine II, University Hospital of Kiel, Kiel Germany
| | - Hubert Serve
- Department of Internal Medicine II, University Hospital of Frankfurt Main
| | | | - Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden
| | - Martin Bornhäuser
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain; CIBERONC, Instituto Carlos III, Madrid
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden
| | - Richard F Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany; Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg
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5
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McLaughlin P, Grillo-López AJ, Link BK, Levy R, Czuczman MS, Williams ME, Heyman MR, Bence-Bruckler I, White CA, Cabanillas F, Jain V, Ho AD, Lister J, Wey K, Shen D, Dallaire BK. Rituximab Chimeric Anti-CD20 Monoclonal Antibody Therapy for Relapsed Indolent Lymphoma: Half of Patients Respond to a Four-Dose Treatment Program. J Clin Oncol 2023; 41:154-162. [PMID: 36603541 DOI: 10.1200/jco.22.02403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE The CD20 antigen is expressed on more than 90% of B-cell lymphomas. It is appealing for targeted therapy, because it does not shed or modulate. A chimeric monoclonal antibody more effectively mediates host effector functions and is itself less immunogenic than are murine antibodies. PATIENTS AND METHODS This was a multiinstitutional trial of the chimeric anti-CD20 antibody, IDEC-C2B8. Patients with relapsed low grade or follicular lymphoma received an outpatient treatment course of IDEC-C2B8 375 mg/m2 intravenously weekly for four doses. RESULTS From 31 centers, 166 patients were entered. Of this intent-to-treat group, 48% responded. With a median follow-up duration of 11.8 months, the projected median time to progression for responders is 13.0 months. Serum antibody levels were sustained longer after the fourth infusion than after the first, and were higher in responders and in patients with lower tumor burden. The majority of adverse events occurred during the first infusion and were grade 1 or 2; fever and chills were the most common events. Only 12% of patients had grade 3 and 3% grade 4 toxicities. A human antichimeric antibody was detected in only one patient. CONCLUSION The response rate of 48% with IDEC-C2B8 is comparable to results with single-agent cytotoxic chemotherapy. Toxicity was mild. Attention needs to be paid to the rate of antibody infusion, with titration according to toxicity. Further investigation of this agent is warranted, including its use in conjunction with standard chemotherapy.
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Affiliation(s)
- P McLaughlin
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - A J Grillo-López
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - B K Link
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - R Levy
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - M S Czuczman
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - M E Williams
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - M R Heyman
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - I Bence-Bruckler
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - C A White
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - F Cabanillas
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - V Jain
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - A D Ho
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - J Lister
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - K Wey
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - D Shen
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
| | - B K Dallaire
- Department of Hematology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
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6
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Meissner J, Schmitt M, Andrulis M, Schweizer L, Dietrich S, Alber B, Harting I, Kurz FT, Martens UM, Ho AD, Müller-Tidow C, Dreger P. Cure of intravascular NK/T-cell lymphoma of the central nervous system by allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2022; 57:1451-1454. [PMID: 35680996 PMCID: PMC9439947 DOI: 10.1038/s41409-022-01734-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Julia Meissner
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany.
| | - Michael Schmitt
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Mindaugas Andrulis
- Department of General Pathology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany.,Institute of Pathology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - Leonille Schweizer
- Department of Neuropathology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany.,Institute of Neuropathology, Charité, Berlin, Germany
| | - Sascha Dietrich
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Bettina Alber
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Inga Harting
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany
| | - Felix T Kurz
- Department of Neuroradiology, University of Heidelberg, Heidelberg, Germany.,Department of Radiology, German Cancer Research Center, Heidelberg, Germany
| | - Uwe M Martens
- Department of Hematology/Oncology, Clinics Heilbronn GmbH, Heilbronn, Germany
| | - Anthony D Ho
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | | | - Peter Dreger
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
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Kayser S, Martínez-Cuadrón D, Hanoun M, Stölzel F, Gil C, Reinhardt HC, Aguiar E, Schäfer-Eckart K, Burgues JMB, Steffen B, Bernal T, Krause SW, Riaza R, Schliemann C, Cervera J, Kaufmann M, Torres-Miñana L, Hänel M, Acuña-Cruz E, Jost E, Algarra JL, Crysandt M, Fransecky L, Cornago-Navascues J, Kraus S, Martinez-Lopez J, Einsele H, Niemann D, Neubauer A, Seggewiss-Bernhardt R, Scholl S, Klein SA, Schmid C, Schaich M, Schmidt-Hieber M, Zukunft S, Ho AD, Platzbecker U, Baldus CD, Müller-Tidow C, Thiede C, Bornhäuser M, Serve H, Levis MJ, Montesinos P, Röllig C, Schlenk RF. Characteristics and outcome of patients with acute myeloid leukemia and trisomy 4. Haematologica 2022; 108:34-41. [PMID: 35678031 PMCID: PMC9827151 DOI: 10.3324/haematol.2022.281137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Indexed: 02/04/2023] Open
Abstract
We retrospectively studied 125 patients with acute myeloid leukemia and trisomy 4 (median age at diagnosis, 58 years; range, 16-77 years) treated between 2000 and 2019 within a multicenter study. Trisomy 4 was the sole abnormality in 28 (22%) patients and additional abnormalities were present in 97 (78%) patients. Twenty-two (22%) and 15 (15%) of 101 tested patients harbored NPM1 and FLT3-ITD mutations. Two (3%) of 72 tested patients had double CEBPA mutations. Data on response to intensive anthracycline-based induction therapy were available for 119 patients. Complete remission was achieved in 67% (n=80) and the early death rate was 5% (n=6). Notably, patients with trisomy 4 as sole abnormality had a complete remission rate of 89%. Allogeneic hematopoietic cell transplantation was performed in 40 (34%) patients, of whom 19 were transplanted in first complete remission. The median follow-up of the intensively treated cohort was 5.76 years (95% confidence interval [95% CI]: 2.99-7.61 years). The 5-year overall survival and relapse-free survival rates were 30% (95% CI: 22-41%) and 27% (95% CI: 18-41%), respectively. An Andersen-Gill regression model on overall survival revealed that favorable-risk according to the European LeukemiaNet classification (hazard ratio [HR]=0.34; P=0.006) and trisomy 4 as sole abnormality (HR=0.41; P=0.01) were favorable factors, whereas age with a difference of 10 years (HR=1.15; P=0.11), female gender (HR=0.74; P=0.20) and allogeneic hematopoietic cell transplantation (HR=0.64; P=0.14) did not have an significant impact. In our cohort, patients with trisomy 4 as their sole abnormality had a high complete remission rate and favorable clinical outcome. Allogeneic hematopoietic cell transplantation did not seem to improve overall survival.
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Affiliation(s)
- Sabine Kayser
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany,NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany,S. Kayser
| | - David Martínez-Cuadrón
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Maher Hanoun
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
| | - Friedrich Stölzel
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Dresden, Germany
| | | | - H. Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
| | - Eliana Aguiar
- Clinical Haematology Department, Centro Hospitalar São João, Oporto, Portugal
| | - Kerstin Schäfer-Eckart
- Department of Internal Medicine 5, Paracelsus Medical Private University Nürnberg, Nürnberg, Germany
| | | | - Björn Steffen
- Department of Internal Medicine II, University Hospital of Frankfurt Main, Frankfurt Main, Germany
| | | | - Stefan W. Krause
- Department of Internal Medicine 5 – Hematology/Oncology, University Hospital of Erlangen, Erlangen, Germany
| | - Rosalía Riaza
- Hematology Department, Hospital Universitario Severo Ochoa, Madrid, Spain
| | | | - Jose Cervera
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | | | - Laura Torres-Miñana
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | | | - Evelyn Acuña-Cruz
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Edgar Jost
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | | | - Martina Crysandt
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Lars Fransecky
- Department of Internal Medicine II, University Hospital of Kiel, Kiel, Germany
| | | | | | | | | | - Dirk Niemann
- Gemeinschaftsklinikum Mittelrhein gGmbH, Koblenz, Germany
| | - Andreas Neubauer
- Philipps University Marburg, and University Hospital Giessen and Marburg, Marburg, Germany
| | | | - Sebastian Scholl
- Klinik für Innere Medizin II, Universitätsklinikum Jena, Jena, Germany
| | - Stefan A. Klein
- Department of Hematology and Oncology, University Hospital Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoph Schmid
- Department of Hematology and Oncology, Augsburg University Hospital, Augsburg, Germany
| | - Markus Schaich
- Department of Hematology, Oncology and Palliative Care, Rems-Murr-Hospital Winnenden, Winnenden, Germany
| | | | - Sven Zukunft
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Dresden, Germany
| | - Anthony D. Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany
| | - Claudia D. Baldus
- Department of Internal Medicine II, University Hospital of Kiel, Kiel, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Dresden, Germany
| | - Martin Bornhäuser
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Dresden, Germany
| | - Hubert Serve
- Department of Internal Medicine II, University Hospital of Frankfurt Main, Frankfurt Main, Germany
| | - Mark J. Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Dresden, Germany
| | - Richard F. Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany,Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany,Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
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Beiro-Poisa L, Landry JJ, Ho AD. Immuno-senescence and elevated central carbon metabolism in hematopoietic stem cell compartment upon aging. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e24030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e24030 Background: Aging is associated with decline of hematopoiesis, compromised innate immunity, and propensity for malignancies. Aging of the hematopoietic stem and progenitor cell (HSPC) compartment is caused by accumulation of senescent cells and elimination of the latter rejuvenates innate immunity in animal models. Methods: HSC (CD34+) were isolated from the bone marrow of healthy human subjects (age range 20 – 74 years; n = 18) and separated by FACS in 3 distinct subsets with high, intermediate, and low glucose uptake (GU) capacity (GUhigh, GUinter, GUlow). Single-cell RNA-sequencing (scRNAseq) studies, followed by gene ontology (GO) analysis of biological processes, analysis of cell cycle, and gene set enrichment analysis (GSEA) were performed. Results: While the percentages of GUinter and GUlow subpopulations remain relatively constant with age, the proportion of GUhigh subset increases continuously with age (from 0.2% in adults < 30 years to 6,7% in > 60 years). GO analysis revealed that the GUhigh subset showed a significantly higher expression of genes involved in myeloid development, cell cycle arrest, inflammation and stress response, apoptosis, and significantly lower expressions of genes involved in lymphoid development. GSEA confirmed that the gene sets for cell cycle arrest, senescence associated secretory phenotype (SASP), anti-apoptosis/survival and P53 pathways are significantly up-regulated in the GUhigh subset. The latter shows therefore all deregulations that are inherent hallmarks of senescence. Most of the molecular deregulations are similar to those found in murine models of aging, but there are significant differences. In addition, cell cycle analysis revealed that the proportion of cells in the G1 phase was significantly reduced in the GUhigh subset. Comparing the frequencies of old to young GUhigh, GUlow cells along the cell cycle progression ranks showed a significant depletion of cells in late G1 phase among GUhigh cells but not in the other subsets. The frequencies of non-cycling cells in the GUlowsubset have remained high (> 70%) irrespective of age, thus providing evidence for the quiescence status of the GUlow subset, as well as for persistence of HSPC with “young phenotype”. Conclusions: Our series of proteome and single cell transcriptome analyses have shown that the GUhigh subpopulation is highly enriched in senescent HSPCs. This property may be exploited to enrich, visualize, and trace senescence in human bone marrow. Cell cycle analysis has revealed a significantly shortened G1 phase that is linked to dedifferentiated state in the senescent HSPC. Our results indicate a dependency of senescent HSPCs on elevated glucose metabolism as well as on anti-apoptotic factors for survival. These may represent ideal targets for elimination of senescent HSPC to restore innate immunity as demonstrated in murine models.
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Poisa-Beiro L, Landry JJM, Raffel S, Tanaka M, Zaugg J, Gavin AC, Ho AD. Glucose Metabolism and Aging of Hematopoietic Stem and Progenitor Cells. Int J Mol Sci 2022; 23:ijms23063028. [PMID: 35328449 PMCID: PMC8955027 DOI: 10.3390/ijms23063028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 12/13/2022] Open
Abstract
Comprehensive proteomics studies of human hematopoietic stem and progenitor cells (HSPC) have revealed that aging of the HSPC compartment is characterized by elevated glycolysis. This is in addition to deregulations found in murine transcriptomics studies, such as an increased differentiation bias towards the myeloid lineage, alterations in DNA repair, and a decrease in lymphoid development. The increase in glycolytic enzyme activity is caused by the expansion of a more glycolytic HSPC subset. We therefore developed a method to isolate HSPC into three distinct categories according to their glucose uptake (GU) levels, namely the GUhigh, GUinter and GUlow subsets. Single-cell transcriptomics studies showed that the GUhigh subset is highly enriched for HSPC with a differentiation bias towards myeloid lineages. Gene set enrichment analysis (GSEA) demonstrated that the gene sets for cell cycle arrest, senescence-associated secretory phenotype, and the anti-apoptosis and P53 pathways are significantly upregulated in the GUhigh population. With this series of studies, we have produced a comprehensive proteomics and single-cell transcriptomics atlas of molecular changes in human HSPC upon aging. Although many of the molecular deregulations are similar to those found in mice, there are significant differences. The most unique finding is the association of elevated central carbon metabolism with senescence. Due to the lack of specific markers, the isolation and collection of senescent cells have yet to be developed, especially for human HSPC. The GUhigh subset from the human HSPC compartment possesses all the transcriptome characteristics of senescence. This property may be exploited to accurately enrich, visualize, and trace senescence development in human bone marrow.
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Affiliation(s)
- Laura Poisa-Beiro
- Department of Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; (L.P.-B.); (S.R.)
- Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory (EMBL) & Heidelberg University, 69120 Heidelberg, Germany; (J.Z.); (A.-C.G.)
| | - Jonathan J. M. Landry
- Genomics Core Facility, European Molecular Biology Laboratory (EMBL), Meyerhofstr. 1, 69117 Heidelberg, Germany;
| | - Simon Raffel
- Department of Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; (L.P.-B.); (S.R.)
| | - Motomu Tanaka
- Physical Chemistry of Biosystems, Inst, Heidelberg University, Im Neuenheimer Feld 253, 69120 Heidelberg, Germany;
| | - Judith Zaugg
- Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory (EMBL) & Heidelberg University, 69120 Heidelberg, Germany; (J.Z.); (A.-C.G.)
- European Molecular Biology Laboratory, Meyerhofstr. 1, 69117 Heidelberg, Germany
| | - Anne-Claude Gavin
- Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory (EMBL) & Heidelberg University, 69120 Heidelberg, Germany; (J.Z.); (A.-C.G.)
- Department for Cell Physiology and Metabolism, Centre Medical Universitaire, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland
| | - Anthony D. Ho
- Department of Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany; (L.P.-B.); (S.R.)
- Molecular Medicine Partnership Unit Heidelberg, European Molecular Biology Laboratory (EMBL) & Heidelberg University, 69120 Heidelberg, Germany; (J.Z.); (A.-C.G.)
- Correspondence:
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10
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Kayser S, Sartor C, Luskin MR, Webster J, Giglio F, Panitz N, Brunner AM, Fante M, Lutz C, Wolff D, Ho AD, Levis MJ, Schlenk RF, Papayannidis C. Outcome of relapsed or refractory acute B-lymphoblastic leukemia patients and BCR-ABL positive blast cell crisis of B-lymphoid lineage with extramedullary disease receiving inotuzumab ozogamicin. Haematologica 2022; 107:2064-2071. [PMID: 35142153 PMCID: PMC9425305 DOI: 10.3324/haematol.2021.280433] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Indexed: 11/09/2022] Open
Abstract
Acute lymphoblastic leukemia (ALL) can relapse in the extramedullary compartment, with or without medullary involvement. Response to treatment may be unique. We evaluated response to inotuzumab ozogamicin (INO) in 31 relapsed/refractory (r/r) BALL patients with extramedullary disease (EMD). Median age was 31 (range, 19-81) years. All patients were heavily pretreated, including allogeneic hematopoietic stem cell transplantation (allo-HCT; n=18). Overall response rate after two INO cycles was 84% (complete remission (CR), 55%; partial remission (PR), 29%; resistant disease (PD), 13%; early death, 3%). Median follow-up was 29 months and median overall survival (OS) 12.8 months. One-year and 2-year OS rates were 53% (95%-CI, 37-76%) and 18% (95%-CI, 8-43%), respectively. Age had no impact on OS when assessed as a continuous variable or dichotomized at 60 years. Twelve patients proceeded to allo-HCT (CR, n=6; PR, n=3; PD, n=3). Prior to allo-HCT, eight patients received ≤2 and four patients 3-4 INO cycles. Sinusoidal obstruction syndrome was reported in three patients, including one after transplant. Allo-HCT evaluated as a time-dependent variable had no impact on OS. INO seems to be effective as debulking strategy in r/r-ALL with EMD. However, INO followed by allo-HCT seems not to be effective in maintaining long term disease control.
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Affiliation(s)
- Sabine Kayser
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany; NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg.
| | - Chiara Sartor
- Istituto di Ematologia "Seràgnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università degli Studi, Bologna
| | - Marlise R Luskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Jonathan Webster
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Fabio Giglio
- Haematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milan
| | - Nydia Panitz
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig
| | | | - Matthias Fante
- Department of Hematology and Oncology, Internal Medicine III, University Hospital Regensburg, Regensburg
| | - Christoph Lutz
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany; Praxis for Hematology and Oncology Koblenz, Koblenz
| | - Daniel Wolff
- Department of Hematology and Oncology, Internal Medicine III, University Hospital Regensburg, Regensburg
| | - Anthony D Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg
| | - Mark J Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
| | - Richard F Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg
| | - Cristina Papayannidis
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli" Bologna
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11
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Mai EK, Schmitt T, Radujkovic A, König L, Goldschmidt H, Ho AD, Luft T, Müller-Tidow C, Dreger P, Hegenbart U, Schönland SO. Submyeloablative total body irradiation-based conditioning and allogeneic stem cell transplantation in high-risk myeloma with early progression after up-front autologous transplantation. Br J Haematol 2021; 196:244-248. [PMID: 34431093 DOI: 10.1111/bjh.17779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Elias K Mai
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Schmitt
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Aleksandar Radujkovic
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Laila König
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Luft
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Dreger
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Ute Hegenbart
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan O Schönland
- Department of Internal Medicine V, University Hospital Heidelberg, Heidelberg, Germany
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12
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Kayser S, Kramer M, Martínez-Cuadrón D, Grenet J, Metzeler KH, Sustkova Z, Luskin MR, Brunner AM, Elliott MA, Gil C, Marini SC, Ráčil Z, Cetkovsky P, Novak J, Perl AE, Platzbecker U, Stölzel F, Ho AD, Thiede C, Stone RM, Röllig C, Montesinos P, Schlenk RF, Levis MJ. Characteristics and outcome of patients with core-binding factor acute myeloid leukemia and FLT3-ITD: results from an international collaborative study. Haematologica 2021; 107:836-843. [PMID: 34348451 PMCID: PMC8968900 DOI: 10.3324/haematol.2021.278645] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Indexed: 02/02/2023] Open
Abstract
The aim of this study was to evaluate the prognostic impact of FLT3-ITD in core-binding factor acute myeloid leukemia (CBFAML) in an international, multicenter survey of 97 patients of whom 52% had t(8;21)(q22;q22) and 48% had inv(16)(p13q22)/t(16;16)(p13;q22). The median age of the patients was 53 years (range, 19-81). Complete remission after anthracycline-based induction (n=86) and non-intensive therapy (n=11) was achieved in 97% and 36% of the patients, respectively. The median follow-up was 4.43 years (95% confidence interval [95% CI]: 3.35-7.39 years). The median survival after intensive and non-intensive treatment was not reached and 0.96 years, respectively. Among intensively treated patients, inv(16) with trisomy 22 (n=11) was associated with a favorable 4-year relapse-free survival rate of 80% (95% CI: 59-100%) as compared to 38% (95% CI: 27-54%; P=0.02) in all other patients with CBFAML/ FLT3-ITD (n=75). Overall, 24 patients underwent allogeneic hematopoietic cell transplantation (HCT), 12 in first complete remission and 12 after relapse. Allogeneic HCT in first complete remission was not beneficial (P=0.60); however, allogeneic HCT seemed to improve median survival in relapsed patients compared to that of patients treated with chemotherapy (not reached vs. 0.6 years, respectively; P=0.002). Excluding patients with inv(16) with trisomy 22, our data indicate that compathe outcome of CBF-AML patients with FLT3-ITD may be inferior to that of patients without FLT3-ITD (based on previously published data), suggesting that prognostically CBF-AML patients with FLT3-ITD should not be classified as favorable-risk. FLT3-inhibitors may improve the outcome of these patients.
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Affiliation(s)
- Sabine Kayser
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany,NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany,Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany,SABINE KAYSER
| | - Michael Kramer
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - David Martínez-Cuadrón
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Justin Grenet
- Division of Hematology & Oncology, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Klaus H. Metzeler
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany,Laboratory for Leukemia Diagnostics, Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Zuzana Sustkova
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Marlise R. Luskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Michelle A. Elliott
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Sandra Casal Marini
- Department of Clinical Haematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Zdeněk Ráčil
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic,Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Petr Cetkovsky
- Department of Internal Medicine and Haematology, 3 Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Jan Novak
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Alexander E. Perl
- Division of Hematology & Oncology, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany
| | - Friedrich Stölzel
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Anthony D. Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Richard M. Stone
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic, La Fe, València, Spain,CIBERONC, Instituto Carlos III, Madrid, Spain
| | - Richard F. Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany,Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany,Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany,RFS and MJL contributed equally as co-senior authors
| | - Mark J. Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA,RFS and MJL contributed equally as co-senior authors
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Graf F, Horn P, Ho AD, Boutros M, Maercker C. The extracellular matrix proteins type I collagen, type III collagen, fibronectin, and laminin 421 stimulate migration of cancer cells. FASEB J 2021; 35:e21692. [PMID: 34118087 DOI: 10.1096/fj.202002558rr] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 01/01/2023]
Abstract
For metastasis formation, individual cells from a primary tumor must migrate toward other tissues. The aim of this study was to determine if mesenchymal stromal cells (MSCs) from human bone marrow are able to emit signals that induce this migratory activity in cancer cells. We separated the supernatant of MSCs derived from human bone marrow by size-exclusion and ion-exchange chromatography and have subsequently studied the migratory behavior of the prostate cancer cell line PC3 and the breast cancer cell line MDA-MB-231 toward the respective fractions in a transwell migration assay. We identified the extracellular matrix (ECM) proteins type I collagen, type III collagen, fibronectin, and laminin 421 as potential drivers of cancer cell migration. These results could be reproduced using the corresponding isolated or recombinant ECM proteins. Knockdown of the gene encoding beta 1 integrin, an important cell surface receptor for fibronectin, has led to inhibition of cancer cell migration. This supports the hypothesis that beta 1 integrin signaling represents an initial event that leads to metastasis, and that signaling is triggered by binding of integrin heterodimers to ECM molecules. Further characterization of signaling factors and their respective receptors will have implications for anticancer drug development.
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Affiliation(s)
- Fabian Graf
- Division Signaling and Functional Genomics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Biotechnology, Mannheim University of Applied Sciences, Mannheim, Germany
| | - Patrick Horn
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Michael Boutros
- Division Signaling and Functional Genomics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department for Cell and Molecular Biology, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - Christian Maercker
- Division Signaling and Functional Genomics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Biotechnology, Mannheim University of Applied Sciences, Mannheim, Germany
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14
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Ho AD, Verkerke H, Allen JW, Saeedi BJ, Boyer D, Owens J, Shin S, Horwath M, Patel K, Paul A, Wu SC, Chonat S, Zerra P, Lough C, Roback JD, Neish A, Josephson CD, Arthur CM, Stowell SR. An automated approach to determine antibody endpoint titers for COVID-19 by an enzyme-linked immunosorbent assay. Immunohematology 2021; 37:33-43. [PMID: 33962490 DOI: 10.21307/immunohematology-2021-007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While a variety of therapeutic options continue to emerge for COVID-19 treatment, convalescent plasma (CP) has been used as a possible treatment option early in the pandemic. One of the most significant challenges with CP therapy, however, both when defining its efficacy and implementing its approach clinically, is accurately and efficiently characterizing an otherwise heterogenous therapeutic treatment. Given current limitations, our goal is to leverage a SARS antibody testing platform with a newly developed automated endpoint titer analysis program to rapidly define SARS-CoV-2 antibody levels in CP donors and hospitalized patients. A newly developed antibody detection platform was used to perform a serial dilution enzyme-linked immunosorbent assay (ELISA) for immunoglobulin (Ig)G, IgM, and IgA SARS-CoV-2 antibodies. Data were then analyzed using commercially available software, GraphPad Prism, or a newly developed program developed in Python called TiterScape, to analyze endpoint titers. Endpoint titer calculations and analysis times were then compared between the two analysis approaches. Serial dilution analysis of SARS-CoV-2 antibody levels revealed a high level of heterogeneity between individuals. Commercial platform analysis required significant time for manual data input and extrapolated endpoint titer values when the last serial dilution was above the endpoint cutoff, occasionally producing erroneously high results. By contrast, TiterScape processed 1008 samples for endpoint titer results in roughly 14 minutes compared with the 8 hours required for the commercial software program analysis. Equally important, results generated by TiterScape and Prism were highly similar, with differences averaging 1.26 ± 0.2 percent (mean ± SD). The pandemic has created unprecedented challenges when seeking to accurately test large numbers of individuals for SARS-CoV-2 antibody levels with a rapid turnaround time. ELISA platforms capable of serial dilution analysis coupled with a highly flexible software interface may provide a useful tool when seeking to define endpoint titers in a high-throughput manner. Immunohematology 2021;37:33-43. While a variety of therapeutic options continue to emerge for COVID-19 treatment, convalescent plasma (CP) has been used as a possible treatment option early in the pandemic. One of the most significant challenges with CP therapy, however, both when defining its efficacy and implementing its approach clinically, is accurately and efficiently characterizing an otherwise heterogenous therapeutic treatment. Given current limitations, our goal is to leverage a SARS antibody testing platform with a newly developed automated endpoint titer analysis program to rapidly define SARS-CoV-2 antibody levels in CP donors and hospitalized patients. A newly developed antibody detection platform was used to perform a serial dilution enzyme-linked immunosorbent assay (ELISA) for immunoglobulin (Ig)G, IgM, and IgA SARS-CoV-2 antibodies. Data were then analyzed using commercially available software, GraphPad Prism, or a newly developed program developed in Python called TiterScape, to analyze endpoint titers. Endpoint titer calculations and analysis times were then compared between the two analysis approaches. Serial dilution analysis of SARS-CoV-2 antibody levels revealed a high level of heterogeneity between individuals. Commercial platform analysis required significant time for manual data input and extrapolated endpoint titer values when the last serial dilution was above the endpoint cutoff, occasionally producing erroneously high results. By contrast, TiterScape processed 1008 samples for endpoint titer results in roughly 14 minutes compared with the 8 hours required for the commercial software program analysis. Equally important, results generated by TiterScape and Prism were highly similar, with differences averaging 1.26 ± 0.2 percent (mean ± SD). The pandemic has created unprecedented challenges when seeking to accurately test large numbers of individuals for SARS-CoV-2 antibody levels with a rapid turnaround time. ELISA platforms capable of serial dilution analysis coupled with a highly flexible software interface may provide a useful tool when seeking to define endpoint titers in a high-throughput manner. Immunohematology 2021;37:33–43.
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Affiliation(s)
- A D Ho
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA , and Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - H Verkerke
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA , and Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - J W Allen
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA , and Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - B J Saeedi
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - D Boyer
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - J Owens
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - S Shin
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - M Horwath
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - K Patel
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - A Paul
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - S-C Wu
- Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , Boston, MA
| | - S Chonat
- Department of Pediatrics, Emory University School of Medicine , Atlanta, GA
| | - P Zerra
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - C Lough
- Lifesouth Blood Donation Services , Gainesville, FL
| | - J D Roback
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - A Neish
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - C D Josephson
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - C M Arthur
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , Atlanta, GA
| | - S R Stowell
- Center for Transfusion Medicine and Cellular Therapies, and Department of Pathology and Laboratory Medicine, Emory University School of Medicine , 201 Dowman Drive, Atlanta, GA 30322 , and Joint Program in Transfusion Medicine, Department of Pathology, Brigham and Women's Hospital, Harvard Medical School , 630E New Research Building, 77 Avenue Louis Pasteur, Boston, MA 02115
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15
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Kayser S, Hills RK, Langova R, Kramer M, Guijarro F, Sustkova Z, Estey EH, Shaw CM, Ráčil Z, Mayer J, Zak P, Baer MR, Brunner AM, Szotkowski T, Cetkovsky P, Grimwade D, Walter RB, Burnett AK, Ho AD, Ehninger G, Müller-Tidow C, Platzbecker U, Thiede C, Röllig C, Schulz A, Warsow G, Brors B, Esteve J, Russell NH, Schlenk RF, Levis MJ. Characteristics and outcome of patients with acute myeloid leukaemia and t(8;16)(p11;p13): results from an International Collaborative Study. Br J Haematol 2021; 192:832-842. [PMID: 33529373 DOI: 10.1111/bjh.17336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 12/03/2020] [Indexed: 02/06/2023]
Abstract
In acute myeloid leukaemia (AML) t(8;16)(p11;p13)/MYST3-CREBBP is a very rare abnormality. Previous small series suggested poor outcome. We report on 59 patients with t(8;16) within an international, collaborative study. Median age was 52 (range: 16-75) years. AML was de novo in 58%, therapy-related (t-AML) in 37% and secondary after myelodysplastic syndrome (s-AML) in 5%. Cytogenetics revealed a complex karyotype in 43%. Besides MYST3-CREBBP, whole-genome sequencing on a subset of 10 patients revealed recurrent mutations in ASXL1, BRD3, FLT3, MLH1, POLG, TP53, SAMD4B (n = 3, each), EYS, KRTAP9-1 SPTBN5 (n = 4, each), RUNX1 and TET2 (n = 2, each). Complete remission after intensive chemotherapy was achieved in 84%. Median follow-up was 5·48 years; five-year survival rate was 17%. Patients with s-/t-AML (P = 0·01) and those with complex karyotype (P = 0·04) had an inferior prognosis. Allogeneic haematopoietic cell transplantation (allo-HCT) was performed in 21 (36%) patients, including 15 in first complete remission (CR1). Allo-HCT in CR1 significantly improved survival (P = 0·04); multivariable analysis revealed that allo-HCT in CR1 was effective in de novo AML but not in patients with s-AML/t-AML and less in patients exhibiting a complex karyotype. In summary, outcomes of patients with t(8;16) are dismal with chemotherapy, and may be substantially improved with allo-HCT performed in CR1.
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Affiliation(s)
- Sabine Kayser
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany.,NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Ralitsa Langova
- Division Applied Bioinformatics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Bioscience, University of Heidelberg, Heidelberg, Germany
| | - Michael Kramer
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | | | - Zuzana Sustkova
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Elihu H Estey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
| | - Carole M Shaw
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
| | - Zdeněk Ráčil
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic.,Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Jiri Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Pavel Zak
- 4th Department of Internal Medicine-Hematology, Faculty of Medicine, Charles University and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Maria R Baer
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA.,Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Tomas Szotkowski
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - Petr Cetkovsky
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - David Grimwade
- Department of Medical & Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA.,Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Alan K Burnett
- Department of Haematology, School of Medicine, Cardiff University, Cardiff, UK
| | - Anthony D Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Gerhard Ehninger
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany
| | - Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Angela Schulz
- Genomics and Proteomics Core Facility High Throughput Sequencing, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Gregor Warsow
- Omics IT and Data Management, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Benedikt Brors
- Division Applied Bioinformatics, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany.,German Cancer Consortium (DKTK), Core Center Heidelberg, Heidelberg, Germany
| | | | - Nigel H Russell
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Richard F Schlenk
- NCT Trial Center, National Center of Tumor Diseases, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Department of Medical Oncology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - Mark J Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
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16
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Saeed BR, Manta L, Raffel S, Pyl PT, Buss EC, Wang W, Eckstein V, Jauch A, Trumpp A, Huber W, Ho AD, Lutz C. Analysis of nonleukemic cellular subcompartments reconstructs clonal evolution of acute myeloid leukemia and identifies therapy-resistant preleukemic clones. Int J Cancer 2021; 148:2825-2838. [PMID: 33411954 DOI: 10.1002/ijc.33461] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/16/2020] [Accepted: 08/27/2020] [Indexed: 12/19/2022]
Abstract
To acquire a better understanding of clonal evolution of acute myeloid leukemia (AML) and to identify the clone(s) responsible for disease recurrence, we have comparatively studied leukemia-specific mutations by whole-exome-sequencing (WES) of both the leukemia and the nonleukemia compartments derived from the bone marrow of AML patients. The T-lymphocytes, B-lymphocytes and the functionally normal hematopoietic stem cells (HSC), that is, CD34+ /CD38- /ALDH+ cells for AML with rare-ALDH+ blasts (<1.9% ALDH+ cells) were defined as the nonleukemia compartments. WES identified 62 point-mutations in the leukemia compartment derived from 12 AML-patients at the time of diagnosis and 73 mutations in 3 matched relapse cases. Most patients (8/12) showed 4 to 6 point-mutations per sample at diagnosis. Other than the mutations in the recurrently mutated genes such as DNMT3A, NRAS and KIT, we were able to identify novel point-mutations that have not yet been described in AML. Some leukemia-specific mutations and cytogenetic abnormalities including DNMT3A(R882H), EZH2(I146T) and inversion(16) were also detectable in the respective T-lymphocytes, B-lymphocytes and HSC in 5/12 patients, suggesting that preleukemia HSC might represent the source of leukemogenesis for these cases. The leukemic evolution was reconstructed for five cases with detectable preleukemia clones, which were tracked in follow-up and relapse samples. Four of the five patients with detectable preleukemic mutations developed relapse. The presence of leukemia-specific mutations in these nonleukemia compartments, especially after chemotherapy or after allogeneic stem cell transplantation, is highly relevant, as these could be responsible for relapse. This discovery may facilitate the identification of novel targets for long-term cure.
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Affiliation(s)
- Borhan R Saeed
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Linda Manta
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Simon Raffel
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Paul Theodor Pyl
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany.,Division of Surgery, Oncology and Pathology, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
| | - Eike C Buss
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Wenwen Wang
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Volker Eckstein
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Anna Jauch
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Andreas Trumpp
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Wolfgang Huber
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Christoph Lutz
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Praxis for Hematology and Oncology Koblenz, Koblenz, Germany
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17
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Poisa-Beiro L, Thoma J, Landry J, Sauer S, Yamamoto A, Eckstein V, Romanov N, Raffel S, Hoffmann GF, Bork P, Benes V, Gavin AC, Tanaka M, Ho AD. Glycogen accumulation, central carbon metabolism, and aging of hematopoietic stem and progenitor cells. Sci Rep 2020; 10:11597. [PMID: 32665666 PMCID: PMC7360735 DOI: 10.1038/s41598-020-68396-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/24/2020] [Indexed: 11/09/2022] Open
Abstract
Inspired by recent proteomic data demonstrating the upregulation of carbon and glycogen metabolism in aging human hematopoietic stem and progenitor cells (HPCs, CD34+ cells), this report addresses whether this is caused by elevated glycolysis of the HPCs on a per cell basis, or by a subpopulation that has become more glycolytic. The average glycogen content in individual CD34+ cells from older subjects (> 50 years) was 3.5 times higher and more heterogeneous compared to younger subjects (< 35 years). Representative glycolytic enzyme activities in HPCs confirmed a significant increase in glycolysis in older subjects. The HPCs from older subjects can be fractionated into three distinct subsets with high, intermediate, and low glucose uptake (GU) capacity, while the subset with a high GU capacity could scarcely be detected in younger subjects. Thus, we conclude that upregulated glycolysis in aging HPCs is caused by the expansion of a more glycolytic HPC subset. Since single-cell RNA analysis has also demonstrated that this subpopulation is linked to myeloid differentiation and increased proliferation, isolation and mechanistic characterization of this subpopulation can be utilized to elucidate specific targets for therapeutic interventions to restore the lineage balance of aging HPCs.
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Affiliation(s)
- Laura Poisa-Beiro
- Department of Medicine V, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.,Molecular Medicine Partnership Unit Heidelberg, EMBL and Heidelberg University, 69120, Heidelberg, Germany
| | - Judith Thoma
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, Im Neuenheimer Feld 253, 69120, Heidelberg, Germany.,Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
| | - Jonathan Landry
- Genomics Core Facility, European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117, Heidelberg, Germany
| | - Sven Sauer
- Division of Child Neurology and Metabolic Diseases, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
| | - Akihisa Yamamoto
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan
| | - Volker Eckstein
- Department of Medicine V, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Natalie Romanov
- Structural and Computational Biology Unit, European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117, Heidelberg, Germany.,Max Planck Institute of Biophysics, Max-von-Laue Straße 3, 60438, Frankfurt am Main, Germany
| | - Simon Raffel
- Department of Medicine V, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Georg F Hoffmann
- Division of Child Neurology and Metabolic Diseases, Centre for Child and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120, Heidelberg, Germany
| | - Peer Bork
- Molecular Medicine Partnership Unit Heidelberg, EMBL and Heidelberg University, 69120, Heidelberg, Germany.,Structural and Computational Biology Unit, European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117, Heidelberg, Germany
| | - Vladimir Benes
- Genomics Core Facility, European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117, Heidelberg, Germany
| | - Anne-Claude Gavin
- Molecular Medicine Partnership Unit Heidelberg, EMBL and Heidelberg University, 69120, Heidelberg, Germany.,Structural and Computational Biology Unit, European Molecular Biology Laboratory (EMBL), Meyerhofstrasse 1, 69117, Heidelberg, Germany.,Department for Cell Physiology and Metabolism, Centre Medical Universitaire, University of Geneva, Rue Michel-Servet 1, 1211, Geneva 4, Switzerland
| | - Motomu Tanaka
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, Im Neuenheimer Feld 253, 69120, Heidelberg, Germany. .,Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan.
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. .,Molecular Medicine Partnership Unit Heidelberg, EMBL and Heidelberg University, 69120, Heidelberg, Germany. .,Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, Kyoto, 606-8501, Japan.
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18
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Schubert ML, Dietrich S, Stilgenbauer S, Schmitt A, Pavel P, Kunz A, Bondong A, Wegner M, Stadtherr P, Jung S, Ho AD, Müller-Tidow C, Schmitt M, Dreger P. Feasibility and Safety of CD19 Chimeric Antigen Receptor T Cell Treatment for B Cell Lymphoma Relapse after Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2020; 26:1575-1580. [PMID: 32422254 DOI: 10.1016/j.bbmt.2020.04.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/20/2020] [Accepted: 04/23/2020] [Indexed: 12/21/2022]
Abstract
Although CD19-directed chimeric antigen receptor (CAR) T cells have been successfully used after a preceding allogeneic stem cell transplant (alloHCT) in patients with acute lymphoblastic leukemia, little is known about the feasibility and outcome of CAR T cell treatment in patients who have been previously allotransplanted for lymphoma. In a single-center retrospective analysis, course and outcome of all allografted patients treated with CD19 CAR constructs for B cell lymphoma between October 2018 and November 2019 were studied. CAR therapy consisted either of a third-generation CAR (HD-CAR-1) or of commercially manufactured axicabtagene ciloleucel (axi-cel; Gilead, Santa Monica, U.S.). Altogether, 10 CAR T cell dosings using recipient leukapheresis products were performed in 8 patients: 4 patients (2 mantle cell lymphoma, 2 chronic lymphocytic leukemia) received 6 dosings with HD-CAR-1 and 4 patients (all with diffuse large B cell lymphoma) received 4 dosings with axi-cel. Overall, 6 of 8 patients (75%) responded. CAR treatment was well tolerated with grade ≥ 3 cytokine release syndrome and neurotoxicity each being observed after 1 of 10 dosings. A single patient had moderate chronic graft-versus-host disease. Of note, 3 of 4 patients who received axi-cel had ongoing grade ≥ 3 cytopenia 3 months postdosing, whereas prolonged cytopenia was not observed in 9 alloHCT-naive patients who received axi-cel during the same time period. In conclusion, CAR T cell treatment from recipient-derived leukapheresis products after a prior alloHCT appears to be feasible, effective, and safe in patients with B cell lymphoma. Protracted cytopenia after axi-cel treatment is a matter of concern and requires further exploration.
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Affiliation(s)
- Maria-Luisa Schubert
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.
| | - Sascha Dietrich
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Stephan Stilgenbauer
- Department of Internal Medicine III, Ulm University Medical Center, Ulm, Germany.; Department of Internal Medicine I, Saarland University Medical Center, Homburg, Germany
| | - Anita Schmitt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Petra Pavel
- Stem Cell Laboratory, Institute for Clinical Transfusion Medicine and Cell Therapy (IKTZ), German Red Cross Blood Service Baden-Württemberg-Hessen, Heidelberg, Germany
| | - Alexander Kunz
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Andrea Bondong
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Mandy Wegner
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Peter Stadtherr
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Susanne Jung
- Diakonissenkrankenhaus und Paulinenhilfe gGmbH, Diakonie-Klinikum, Stuttgart, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Centre for Tumor Diseases (NCT), Heidelberg, Germany
| | - Peter Dreger
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ)/National Centre for Tumor Diseases (NCT), Heidelberg, Germany
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19
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Viol L, Hata S, Pastor-Peidro A, Neuner A, Murke F, Wuchter P, Ho AD, Giebel B, Pereira G. Nek2 kinase displaces distal appendages from the mother centriole prior to mitosis. J Cell Biol 2020; 219:e201907136. [PMID: 32211891 PMCID: PMC7055001 DOI: 10.1083/jcb.201907136] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [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: 07/18/2019] [Revised: 11/25/2019] [Accepted: 01/09/2020] [Indexed: 12/12/2022] Open
Abstract
Distal appendages (DAs) of the mother centriole are essential for the initial steps of ciliogenesis in G1/G0 phase of the cell cycle. DAs are released from centrosomes in mitosis by an undefined mechanism. Here, we show that specific DAs lose their centrosomal localization at the G2/M transition in a manner that relies upon Nek2 kinase activity to ensure low DA levels at mitotic centrosomes. Overexpression of active Nek2A, but not kinase-dead Nek2A, prematurely displaced DAs from the interphase centrosomes of immortalized retina pigment epithelial (RPE1) cells. This dramatic impact was also observed in mammary epithelial cells with constitutively high levels of Nek2. Conversely, Nek2 knockout led to incomplete dissociation of DAs and cilia in mitosis. As a consequence, we observed the presence of a cilia remnant that promoted the asymmetric inheritance of ciliary signaling components and supported cilium reassembly after cell division. Together, our data establish Nek2 as an important kinase that regulates DAs before mitosis.
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Affiliation(s)
- Linda Viol
- Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
- German Cancer Research Centre, German Cancer Research Centre-Centre for Cell and Molecular Biology Alliance, Heidelberg, Germany
| | - Shoji Hata
- Centre for Cell and Molecular Biology, German Cancer Research Centre-Centre for Cell and Molecular Biology Alliance, University of Heidelberg, Heidelberg, Germany
| | - Ana Pastor-Peidro
- Centre for Cell and Molecular Biology, German Cancer Research Centre-Centre for Cell and Molecular Biology Alliance, University of Heidelberg, Heidelberg, Germany
| | - Annett Neuner
- Centre for Cell and Molecular Biology, German Cancer Research Centre-Centre for Cell and Molecular Biology Alliance, University of Heidelberg, Heidelberg, Germany
| | - Florian Murke
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Patrick Wuchter
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Anthony D. Ho
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Bernd Giebel
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gislene Pereira
- Centre for Organismal Studies, University of Heidelberg, Heidelberg, Germany
- German Cancer Research Centre, German Cancer Research Centre-Centre for Cell and Molecular Biology Alliance, Heidelberg, Germany
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20
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Kayser S, Hills RK, Luskin MR, Brunner AM, Terré C, Westermann J, Menghrajani K, Shaw C, Baer MR, Elliott MA, Perl AE, Ráčil Z, Mayer J, Zak P, Szotkowski T, de Botton S, Grimwade D, Mayer K, Walter RB, Krämer A, Burnett AK, Ho AD, Platzbecker U, Thiede C, Ehninger G, Stone RM, Röllig C, Tallman MS, Estey EH, Müller-Tidow C, Russell NH, Schlenk RF, Levis MJ. Allogeneic hematopoietic cell transplantation improves outcome of adults with t(6;9) acute myeloid leukemia: results from an international collaborative study. Haematologica 2020; 105:161-169. [PMID: 31004014 PMCID: PMC6939530 DOI: 10.3324/haematol.2018.208678] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 01/21/2019] [Accepted: 04/15/2019] [Indexed: 12/13/2022] Open
Abstract
Acute myeloid leukemia (AML) with t(6;9)(p22;q34) is a distinct entity accounting for 1-2% of AML cases. A substantial proportion of these patients have a concomitant FLT3-ITD. While outcomes are dismal with intensive chemotherapy, limited evidence suggests allogeneic hematopoietic cell transplantation (allo-HCT) may improve survival if performed early during first complete remission. We report on a cohort of 178 patients with t(6;9)(p22;q34) within an international, multicenter collaboration. Median age was 46 years (range: 16-76), AML was de novo in 88%, FLT3-ITD was present in 62%, and additional cytogenetic abnormalities in 21%. Complete remission was achieved in 81% (n=144), including 14 patients who received high-dose cytarabine after initial induction failure. With a median follow up of 5.43 years, estimated overall survival at five years was 38% (95%CI: 31-47%). Allo-HCT was performed in 117 (66%) patients, including 89 in first complete remission. Allo-HCT in first complete remission was associated with higher 5-year relapse-free and overall survival as compared to consolidation chemotherapy: 45% (95%CI: 35-59%) and 53% (95%CI: 42-66%) versus 7% (95%CI: 3-19%) and 23% (95%CI: 13-38%), respectively. For patients undergoing allo-HCT, there was no difference in overall survival rates at five years according to whether it was performed in first [53% (95%CI: 42-66%)], or second [58% (95%CI: 31-100%); n=10] complete remission or with active disease/relapse [54% (95%CI: 34-84%); n=18] (P=0.67). Neither FLT3-ITD nor additional chromosomal abnormalities impacted survival. In conclusion, outcomes of t(6;9)(p22;q34) AML are poor with chemotherapy, and can be substantially improved with allo-HCT.
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Affiliation(s)
- Sabine Kayser
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
- German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | | | - Marlise R Luskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Christine Terré
- Laboratory of Hematology, André Mignot Hospital, Le Chesnay, France
| | - Jörg Westermann
- Department of Hematology, Oncology and Tumor Immunology, Charité-University Medical Center, Campus Virchow Clinic, Berlin, Germany
| | - Kamal Menghrajani
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Carole Shaw
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
| | - Maria R Baer
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Michelle A Elliott
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Alexander E Perl
- Division of Hematology and Oncology, Abramson Cancer Center, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Zdeněk Ráčil
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Jiri Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - Pavel Zak
- 4 Department of Internal Medicine-Hematology, Faculty of Medicine, Charles University and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Tomas Szotkowski
- Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | | | - David Grimwade
- Department of Medical & Molecular Genetics, King's College London, Faculty of Life Sciences and Medicine, London, UK
| | - Karin Mayer
- Medical Clinic III for Oncology, Hematology and Rheumatology, University Hospital Bonn, Bonn, Germany
| | - Roland B Walter
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Alwin Krämer
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
- German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | | | - Anthony D Ho
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany
| | - Christian Thiede
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Gerhard Ehninger
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Richard M Stone
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christoph Röllig
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Martin S Tallman
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - Elihu H Estey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - Nigel H Russell
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Richard F Schlenk
- NCT Trial Center, National Center for Tumor Diseases, Heidelberg, Germany
| | - Mark J Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD, USA
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21
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Bentele T, Amadei F, Kimmle E, Veschgini M, Linke P, Sontag-González M, Tennigkeit J, Ho AD, Özbek S, Tanaka M. New Class of Crosslinker-Free Nanofiber Biomaterials from Hydra Nematocyst Proteins. Sci Rep 2019; 9:19116. [PMID: 31836799 PMCID: PMC6910907 DOI: 10.1038/s41598-019-55655-0] [Citation(s) in RCA: 4] [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: 04/30/2019] [Accepted: 10/30/2019] [Indexed: 11/10/2022] Open
Abstract
Nematocysts, the stinging organelles of cnidarians, have remarkable mechanical properties. Hydra nematocyst capsules undergo volume changes of 50% during their explosive exocytosis and withstand osmotic pressures of beyond 100 bar. Recently, two novel protein components building up the nematocyst capsule wall in Hydra were identified. The cnidarian proline-rich protein 1 (CPP-1) characterized by a "rigid" polyproline motif and the elastic Cnidoin possessing a silk-like domain were shown to be part of the capsule structure via short cysteine-rich domains that spontaneously crosslink the proteins via disulfide bonds. In this study, recombinant Cnidoin and CPP-1 are expressed in E. coli and the elastic modulus of spontaneously crosslinked bulk proteins is compared with that of isolated nematocysts. For the fabrication of uniform protein nanofibers by electrospinning, the preparative conditions are systematically optimized. Both fibers remain stable even after rigorous washing and immersion into bulk water owing to the simultaneous crosslinking of cysteine-rich domains. This makes our nanofibers clearly different from other protein nanofibers that are not stable without chemical crosslinkers. Following the quantitative assessment of mechanical properties, the potential of Cnidoin and CPP-1 nanofibers is examined towards the maintenance of human mesenchymal stem cells.
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Affiliation(s)
- Theresa Bentele
- Centre for Organismal Studies, Department of Molecular Evolution and Genomics, Heidelberg University, 69120, Heidelberg, Germany
| | - Federico Amadei
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Esther Kimmle
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Mariam Veschgini
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Philipp Linke
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Mariana Sontag-González
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
- School of Earth and Environmental Sciences, Science Medicine and Health, University of Wollongong, NSW 2522, Wollongong, Australia
| | - Jutta Tennigkeit
- Centre for Organismal Studies, Department of Molecular Evolution and Genomics, Heidelberg University, 69120, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, University of Heidelberg, 69120, Heidelberg, Germany
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, 606-8501, Kyoto, Japan
| | - Suat Özbek
- Centre for Organismal Studies, Department of Molecular Evolution and Genomics, Heidelberg University, 69120, Heidelberg, Germany.
| | - Motomu Tanaka
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany.
- Center for Integrative Medicine and Physics, Institute for Advanced Study, Kyoto University, 606-8501, Kyoto, Japan.
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22
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Kriegsmann K, Klee JS, Hensel M, Buss EC, Kriegsmann M, Cremer M, Ho AD, Egerer G, Wuchter P, Witzens-Harig M. Patients With Malignant Lymphoma and HIV Infection Experiencing Remission After First-Line Treatment Have an Excellent Prognosis. Clin Lymphoma Myeloma Leuk 2019; 19:e581-e587. [PMID: 31377211 DOI: 10.1016/j.clml.2019.05.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Malignant lymphoma is still the leading cause of death among AIDS-related diseases. PATIENTS AND METHODS We performed a retrospective analysis of 50 HIV-positive lymphoma patients. The median interval between HIV and malignant lymphoma diagnosis was 4 years. Eight patients (16%) had Hodgkin lymphoma and 42 (84%) non-Hodgkin lymphoma. Among non-Hodgkin lymphoma patients, diffuse large B-cell lymphoma (n = 18, 42%), Burkitt lymphoma (n = 11, 26%), and plasmoblastic lymphoma (n = 5, 12%) were the most frequent entities. RESULTS Lymphoma was treated according to standard protocols. Forty-four patients (88%) received combination antiretroviral therapy, 2 (4%) were not treated, and in 4 (8%) the HIV treatment status was not clarified. Response to first-line therapy was complete response (CR) in 24 (56%), partial response (PR) in 15 (35%), and stable disease in 1 (2%). Three patients (7%) developed progressive disease, and 9 (18%) experienced relapse after CR or PR. At a median observation period of 31 (range, 0.4-192) months, the 1-, 2-, and 5-year overall survival was 87%, 79%, and 76%, respectively. At univariate analysis, remission status after first-line treatment was predictive of outcome, as the 2-year overall survival was 95%, 66%, and 0 for patients with CR, with PR, and with progressive disease (P < .001). Results of the multivariate analysis revealed lactate dehydrogenase concentration at lymphoma diagnosis (P = .046) and relapse (P = .050) to be independent factors for overall survival. CONCLUSION First-line treatment of lymphoma in HIV positive patients is crucial. Patients who experienced and maintained a first CR had a favorable prognosis.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany.
| | - Julia S Klee
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | | | - Eike C Buss
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Mark Kriegsmann
- Institute of Pathology, Heidelberg University, Heidelberg, Germany
| | - Martin Cremer
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Gerlinde Egerer
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany
| | - Mathias Witzens-Harig
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
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23
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Schubert ML, Schmitt A, Sellner L, Neuber B, Kunz J, Wuchter P, Kunz A, Gern U, Michels B, Hofmann S, Hückelhoven-Krauss A, Kulozik A, Ho AD, Müller-Tidow C, Dreger P, Schmitt M. Treatment of patients with relapsed or refractory CD19+ lymphoid disease with T lymphocytes transduced by RV-SFG.CD19.CD28.4-1BBzeta retroviral vector: a unicentre phase I/II clinical trial protocol. BMJ Open 2019; 9:e026644. [PMID: 31110096 PMCID: PMC6530404 DOI: 10.1136/bmjopen-2018-026644] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [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] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Chimeric antigen receptor (CAR) T cells spark hope for patients with CD19+ B cell neoplasia, including relapsed or refractory (r/r) acute lymphoblastic leukaemia (ALL) or r/r non-Hodgkin's lymphoma (NHL). Published studies have mostly used second-generation CARs with 4-1BB or CD28 as costimulatory domains. Preclinical results of third-generation CARs incorporating both elements have shown superiority concerning longevity and proliferation. The University Hospital of Heidelberg is the first institution to run an investigator-initiated trial (IIT) CAR T cell trial (Heidelberg Chimeric Antigen Receptor T cell Trial number 1 [HD-CAR-1]) in Germany with third-generation CD19-directed CAR T cells. METHODS AND ANALYSIS Adult patients with r/r ALL (stratum I), r/r NHL including chronic lymphocytic leukaemia, diffuse large B-cell lymphoma, follicular lymphoma or mantle cell lymphoma (stratum II) as well as paediatric patients with r/r ALL (stratum III) will be treated with autologous T-lymphocytes transduced by third-generation RV-SFG.CD19.CD28.4-1BB zeta retroviral vector (CD19.CAR T cells). The main purpose of this study is to evaluate safety and feasibility of escalating CD19.CAR T cell doses (1-20×106 transduced cells/m2) after lymphodepletion with fludarabine (flu) and cyclophosphamide (cyc). Patients will be monitored for cytokine release syndrome (CRS), neurotoxicity, i.e. CAR-T-cell-related encephalopathy syndrome (CRES) and/or other toxicities (primary objectives). Secondary objectives include evaluation of in vivo function and survival of CD19.CAR T cells and assessment of CD19.CAR T cell antitumour efficacy.HD-CAR-1 as a prospective, monocentric trial aims to make CAR T cell therapy accessible to patients in Europe. Currently, HD-CAR-1 is the first and only CAR T cell IIT in Germany. A third-generation Good Manufacturing Practice (GMP) grade retroviral vector, a broad spectrum of NHL, treatment of paediatric and adult ALL patients and inclusion of patients even after allogeneic stem cell transplantation (alloSCT) make this trial unique. ETHICS AND DISSEMINATION Ethical approval and approvals from the local and federal competent authorities were granted. Trial results will be reported via peer-reviewed journals and presented at conferences and scientific meetings. TRIAL REGISTRATION NUMBER Eudra CT 2016-004808-60; NCT03676504; Pre-results.
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Affiliation(s)
- Maria-Luisa Schubert
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Anita Schmitt
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Leopold Sellner
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), National Centre for Tumour Diseases (NCT), Heidelberg, Germany
| | - Brigitte Neuber
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Joachim Kunz
- Department of Pediatric Hematology, Oncology and Immunology, Children’s Hospital, Heidelberg University Hospital, Heidelberg, Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Alexander Kunz
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Ulrike Gern
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Birgit Michels
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Susanne Hofmann
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Andreas Kulozik
- Department of Pediatric Hematology, Oncology and Immunology, Children’s Hospital, Heidelberg University Hospital, Heidelberg, Germany
| | - Anthony D. Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), National Centre for Tumour Diseases (NCT), Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), National Centre for Tumour Diseases (NCT), Heidelberg, Germany
| | - Peter Dreger
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), National Centre for Tumour Diseases (NCT), Heidelberg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
- German Cancer Consortium (DKTK), National Centre for Tumour Diseases (NCT), Heidelberg, Germany
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24
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Hoffmann A, Dietrich S, Hain S, Rieger M, Hegenbart U, Sellner L, Ho AD, Müller-Tidow C, Dreger P. Allogeneic transplantation in high-risk chronic lymphocytic leukemia: a single-center, intent-to-treat analysis. Haematologica 2019; 104:e304-e306. [PMID: 30630979 DOI: 10.3324/haematol.2018.209486] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Almuth Hoffmann
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Sascha Dietrich
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Susanne Hain
- Department Medicine III, St. Marienkrankenhaus, Siegen
| | | | - Ute Hegenbart
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Leopold Sellner
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Anthony D Ho
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
| | - Peter Dreger
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg
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25
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Wang L, Ni M, Hückelhoven-Krauss A, Sellner L, Hoffmann JM, Neuber B, Luft T, Hegenbart U, Schönland S, Kleist C, Sill M, Chen BA, Wuchter P, Eckstein V, Krüger W, Hilgendorf I, Yerushalmi R, Nagler A, Müller-Tidow C, Ho AD, Dreger P, Schmitt M, Schmitt A. Modulation of B Cells and Homing Marker on NK Cells Through Extracorporeal Photopheresis in Patients With Steroid-Refractory/Resistant Graft-Vs.-Host Disease Without Hampering Anti-viral/Anti-leukemic Effects. Front Immunol 2018; 9:2207. [PMID: 30349527 PMCID: PMC6186805 DOI: 10.3389/fimmu.2018.02207] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/05/2018] [Indexed: 11/13/2022] Open
Abstract
Graft-vs.-host disease (GvHD), a severe complication of allogeneic hematopoietic stem cell transplantation, significantly affects the post-transplant morbidity and mortality. Systemic steroids remain the gold standard for the initial management of GvHD. However, up to 60% of patients will not sufficiently respond to steroids. Extracorporeal photopheresis (ECP), a cell-based immunotherapy, has shown good clinical results in such steroid-refractory/resistant GvHD patients. Given its immunomodulatory, but not global immunosuppressive and steroid-sparing capacity, ECP constitutes an attractive option. In the case of GvHD, the balance of immune cells is destroyed: effector cells are not any longer efficiently controlled by regulatory cells. ECP therapy may restore this balance. However, the precise mechanism and the impact of ECP on anti-viral/anti-leukemic function remain unclear. In this study, 839 ECP treatments were performed on patients with acute GvHD (aGvHD) and chronic GvHD (cGvHD). A comprehensive analysis of effector and regulatory cells in patients under ECP therapy included multi-parametric flow cytometry and tetramer staining, LuminexTM-based cytokine, interferon-γ enzyme-linked immunospot, and chromium-51 release assays. Gene profiling of myeloid-derived suppressor cells (MDSCs) was performed by microarray analysis. Immunologically, modulations of effector and regulatory cells as well as proinflammatory cytokines were observed under ECP treatment: (1) GvHD-relevant cell subsets like CD62L+ NK cells and newly defined CD19hiCD20hi B cells were modulated, but (2) quantity and quality of anti-viral/anti-leukemic effector cells were preserved. (3) The development of MDSCs was promoted and switched from an inactivated subset (CD33-CD11b+) to an activated subset (CD33+CD11b+). (4) The frequency of Foxp3+CD4+ regulatory T cells (Tregs) and CD24+CD38hi regulatory B cells was considerably increased in aGvHD patients, and Foxp3+CD8+ Tregs in cGvHD patients. (5) Proinflammatory cytokines like IL-1β, IL-6, IL-8, and TNF-α were significantly reduced. In summary, ECP constitutes an effective immunomodulatory therapy for patients with steroid-refractory/resistant GvHD without impairment of anti-viral/leukemia effects.
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Affiliation(s)
- Lei Wang
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Ming Ni
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany.,Department of Hematology, the Affiliated Hospital of Guizhou Medical University, Guizhou, China
| | | | - Leopold Sellner
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Jean-Marc Hoffmann
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Brigitte Neuber
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Thomas Luft
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Ute Hegenbart
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Stefan Schönland
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Christian Kleist
- Department of Nuclear Medicine, University Clinic Heidelberg, Heidelberg, Germany
| | - Martin Sill
- Division Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - Bao-An Chen
- Department of Hematology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Patrick Wuchter
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany.,German Red Cross Blood Service, Medical Faculty Mannheim, Institute of Transfusion Medicine and Immunology Mannheim, Mannheim, Germany
| | - Volker Eckstein
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - William Krüger
- Department of Internal Medicine C, Haematology, Oncology, Stem Cell Transplantation, Palliative Care, University Clinic Greifswald, Greifswald, Germany
| | - Inken Hilgendorf
- Department of Internal Medicine II, University Clinic Jena, Jena, Germany
| | - Ronit Yerushalmi
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Arnon Nagler
- Hematology Division, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Peter Dreger
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
| | - Anita Schmitt
- Department of Internal Medicine V, University Clinic Heidelberg, Heidelberg, Germany
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26
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Raffel S, Falcone M, Kneisel N, Hansson J, Wang W, Lutz C, Bullinger L, Poschet G, Nonnenmacher Y, Barnert A, Bahr C, Zeisberger P, Przybylla A, Sohn M, Tönjes M, Erez A, Adler L, Jensen P, Scholl C, Fröhling S, Cocciardi S, Wuchter P, Thiede C, Flörcken A, Westermann J, Ehninger G, Lichter P, Hiller K, Hell R, Herrmann C, Ho AD, Krijgsveld J, Radlwimmer B, Trumpp A. Author Correction: BCAT1 restricts αKG levels in AML stem cells leading to IDH mut-like DNA hypermethylation. Nature 2018; 560:E28. [PMID: 30069041 DOI: 10.1038/s41586-018-0403-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In Extended Data Fig. 1a of this Letter, the flow cytometry plot depicting the surface phenotype of AML sample DD08 was a duplicate of the plot for AML sample DD06. Supplementary Data 4 has been added to the Supplementary Information of the original Letter to clarify the proteome data acquisition and presentation. The original Letter has been corrected online.
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Affiliation(s)
- Simon Raffel
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany.,Department of Internal Medicine V, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Mattia Falcone
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany
| | - Niclas Kneisel
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Jenny Hansson
- Genome Biology Unit, European Molecular Biology Laboratory (EMBL), 69117, Heidelberg, Germany
| | - Wei Wang
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Christoph Lutz
- Department of Internal Medicine V, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Lars Bullinger
- Department of Internal Medicine III, University Hospital Ulm, 89081, Ulm, Germany
| | - Gernot Poschet
- Centre for Organismal Studies (COS), University of Heidelberg, 69120, Heidelberg, Germany
| | - Yannic Nonnenmacher
- Department of Bioinfomatics and Biochemistry and Braunschweig Integrated Center of Systems Biology (BRICS), Technical University Braunschweig, 38106, Braunschweig, Germany.,Luxemburg Centre for Systems Biomedicine, University of Luxemburg, L-4367, Belvaux, Luxembourg
| | - Andrea Barnert
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany
| | - Carsten Bahr
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany
| | - Petra Zeisberger
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany
| | - Adriana Przybylla
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany
| | - Markus Sohn
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany
| | - Martje Tönjes
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Ayelet Erez
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Lital Adler
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Patrizia Jensen
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - Claudia Scholl
- Division of Applied Functional Genomics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120, Heidelberg, Germany
| | - Stefan Fröhling
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Section for Personalized Oncology, Heidelberg University Hospital, 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120, Heidelberg, Germany
| | - Sibylle Cocciardi
- Department of Internal Medicine III, University Hospital Ulm, 89081, Ulm, Germany
| | - Patrick Wuchter
- Department of Internal Medicine V, Heidelberg University Hospital, 69120, Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology Mannheim, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167, Mannheim, Germany
| | - Christian Thiede
- Medical Department 1, University Hospital Carl Gustav Carus, 01307, Dresden, Germany
| | - Anne Flörcken
- Department of Hematology, Oncology and Tumor Immunology; Charité-University Medicine Berlin, Campus Virchow Klinikum, 13353, Berlin, Germany
| | - Jörg Westermann
- Department of Hematology, Oncology and Tumor Immunology; Charité-University Medicine Berlin, Campus Virchow Klinikum, 13353, Berlin, Germany
| | - Gerhard Ehninger
- Medical Department 1, University Hospital Carl Gustav Carus, 01307, Dresden, Germany
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120, Heidelberg, Germany
| | - Karsten Hiller
- Department of Bioinfomatics and Biochemistry and Braunschweig Integrated Center of Systems Biology (BRICS), Technical University Braunschweig, 38106, Braunschweig, Germany.,Luxemburg Centre for Systems Biomedicine, University of Luxemburg, L-4367, Belvaux, Luxembourg
| | - Rüdiger Hell
- Centre for Organismal Studies (COS), University of Heidelberg, 69120, Heidelberg, Germany
| | - Carl Herrmann
- Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pharmacy and Molecular Biotechnology, and Bioquant Center, University of Heidelberg, 69120, Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, Heidelberg University Hospital, 69120, Heidelberg, Germany
| | - Jeroen Krijgsveld
- Genome Biology Unit, European Molecular Biology Laboratory (EMBL), 69117, Heidelberg, Germany
| | - Bernhard Radlwimmer
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany. .,German Cancer Consortium (DKTK), DKFZ, 69120, Heidelberg, Germany.
| | - Andreas Trumpp
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120, Heidelberg, Germany. .,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120, Heidelberg, Germany. .,German Cancer Consortium (DKTK), DKFZ, 69120, Heidelberg, Germany.
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27
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Kriegsmann K, Wack M, Kriegsmann M, Cremer M, Bruckner T, Ho AD, Wuchter P, Witzens-Harig M. Selective contrast-enhanced computed tomography is appropriate in diffuse large B-cell lymphoma therapy response assessment. Eur J Haematol 2018; 101:613-619. [PMID: 30047174 DOI: 10.1111/ejh.13150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Although not the gold standard, contrast-enhanced CT of neck, thorax, and abdomen/pelvis is routinely performed in diagnosis and response assessment of DLBCL. PD during first-line treatment is a relatively rare event. The question arises if the imaging of initially involved regions only might be sufficient for response evaluation. METHOD We retrospectively analyzed the data of 167 DLBCL patients who had an extensive contrast-enhanced CT scan at first diagnosis. The majority of patients (n = 128, 77%) was treated with R-CHOP. Therapy response was assessed as interim and end of treatment staging by contrast-enhanced CT. RESULTS The overall response rate at the end of treatment was 94%. None of the patients showed involvement of new sites at interim staging. As a major finding, none of the patients showed an involvement of sites, which were not initially involved. Four patients developed PD during first-line chemotherapy/after mid-treatment staging and 31 relapsed. A conclusive comparison between initial and PD/relapse DLBCL involvement was possible in 27 patients: 8 patients did and 19 patients did not show additional/new sites of involvement compared to first diagnosis. CONCLUSION Our retrospective analysis provides a rationale for selective imaging of initially involved DLBCL sites for therapy response assessment.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Maurizio Wack
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Mark Kriegsmann
- Institute of Pathology, Heidelberg University, Heidelberg, Germany
| | - Martin Cremer
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Thomas Bruckner
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Patrick Wuchter
- Medical Faculty Mannheim, Institute of Transfusion Medicine and Immunology, German Red Cross Blood Service Baden-Württemberg - Hessen, Heidelberg University, Mannheim, Germany
| | - Mathias Witzens-Harig
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
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28
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Seckinger A, Hillengass J, Emde M, Beck S, Kimmich C, Dittrich T, Hundemer M, Jauch A, Hegenbart U, Raab MS, Ho AD, Schönland S, Hose D. CD38 as Immunotherapeutic Target in Light Chain Amyloidosis and Multiple Myeloma-Association With Molecular Entities, Risk, Survival, and Mechanisms of Upfront Resistance. Front Immunol 2018; 9:1676. [PMID: 30079070 PMCID: PMC6062598 DOI: 10.3389/fimmu.2018.01676] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/09/2018] [Indexed: 12/18/2022] Open
Abstract
Monoclonal antibodies against the cell surface antigen CD38, e.g., isatuximab, daratumumab, or Mor202, have entered the therapeutic armamentarium in multiple myeloma due to single agent overall response rates of 29 vs. 36 vs. 31%, effectivity in combination regimen, e.g., with lenalidomide or bortezomib plus dexamethasone, and tolerable side effects. Despite clinical use, many questions remain. In this manuscript, we address three of these: first, upfront CD38 target-expression in AL-amyloidosis, monoclonal gammopathy of unknown significance (MGUS), asymptomatic, symptomatic, and relapsed multiple myeloma. Second, relation of CD38-expression to survival, disease stages, molecular entities, and high-risk definitions. Third, alternative splicing or lack of CD38-expression as potential mechanisms of upfront resistance. We assessed CD138-purified plasma cell samples from 196 AL-amyloidosis, 62 MGUS, 259 asymptomatic, 764 symptomatic, and 90 relapsed myeloma patients, including longitudinal pairs of asymptomatic/symptomatic (n = 34) and symptomatic/relapsed myeloma (n = 57) regarding interphase fluorescence in situ hybridization (n = 1,380), CD38-expression by gene expression profiling (n = 1,371), RNA-sequencing (n = 593), and flow cytometry (n = 800). Samples of normal bone marrow plasma cells (n = 10), memory B-cells (n = 9), polyclonal plasmablastic cells (n = 9), and human myeloma cell lines (n = 54) were used as comparators. CD38 was expressed in all malignant plasma cell samples, but significantly lower compared to normal plasma cells with small but significant downregulation in longitudinal sample pairs. Higher CD38 expression was associated with the presence of t(4;14) and high-risk according to the UAMS70-gene score, lower expression was associated with del17p13 and hyperdiploidy in symptomatic myeloma as well as t(11;14) in asymptomatic myeloma. Higher CD38-expression was associated with slower progression to symptomatic and relapsed myeloma and better overall survival in the latter two entities. CD38 expression, t(4;14), del17p13, and gain of 1q21 are independently prognostic in multivariate analysis. By contrast, high CD38-expression is associated with adverse survival in AL-amyloidosis. Regarding mechanisms of upfront anti-CD38-treatment resistance, lack of CD38-expression and alternative splicing of receptor binding-sites could be excluded. Here, of the two protein coding CD38-transcripts CD38-001 (eight-exon, full length) and CD38-005 (truncated), CD38-001 conveyed >97% of reads spanning the respective CD38 splice junction.
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Affiliation(s)
- Anja Seckinger
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Jens Hillengass
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Martina Emde
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Susanne Beck
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Christoph Kimmich
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Tobias Dittrich
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Michael Hundemer
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Anna Jauch
- Institut für Humangenetik, Universität Heidelberg, Heidelberg, Germany
| | - Ute Hegenbart
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Marc-Steffen Raab
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Stefan Schönland
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Dirk Hose
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
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29
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Ohta T, Monzel C, Becker AS, Ho AD, Tanaka M. Simple Physical Model Unravels Influences of Chemokine on Shape Deformation and Migration of Human Hematopoietic Stem Cells. Sci Rep 2018; 8:10630. [PMID: 30006633 PMCID: PMC6045678 DOI: 10.1038/s41598-018-28750-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/29/2018] [Indexed: 01/15/2023] Open
Abstract
We studied the dynamic behavior of human hematopoietic stem cells (HSC) on the in vitro model of bone marrow surfaces in the absence and presence of chemokine (SDF1α). The deformation and migration of cells were investigated by varying the chemokine concentration and surface density of ligand molecules. Since HSC used in this study were primary cells extracted from the human umbilical cord blood, it is not possible to introduce molecular reporter systems before or during the live cell imaging. To account for the experimental observations, we propose a simple and general theoretical model for cell crawling. In contrast to other theoretical models reported previously, our model focuses on the nonlinear coupling between shape deformation and translational motion and is free from any molecular-level process. Therefore, it is ideally suited for the comparison with our experimental results. We have demonstrated that the results in the absence of SDF1α were well recapitulated by the linear model, while the nonlinear model is necessary to reproduce the elongated migration observed in the presence of SDF1α. The combination of the simple theoretical model and the label-free, live cell observations of human primary cells opens a large potential to numerically identify the differential effects of extrinsic factors such as chemokines, growth factors, and clinical drugs on dynamic phenotypes of primary cells.
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Affiliation(s)
- Takao Ohta
- Department of Physics, The University of Tokyo, Tokyo, 113-0033, Japan. .,Toyota Physical and Chemical Research Institute, Nagakute, Aichi, 480-1192, Japan. .,Center for Integrative Medicine and Physics, Institute for Advanced Studies, Kyoto University, 606-8501, Kyoto, Japan.
| | - Cornelia Monzel
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, D69210, Heidelberg, Germany.,Experimental Medical Physics, Heinrich-Heine University Düsseldorf, 40225, Düsseldorf, Germany
| | - Alexandra S Becker
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, D69210, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University, D69120, Heidelberg, Germany
| | - Motomu Tanaka
- Center for Integrative Medicine and Physics, Institute for Advanced Studies, Kyoto University, 606-8501, Kyoto, Japan. .,Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, D69210, Heidelberg, Germany.
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30
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Sauer S, Hüsing J, Hajda J, Neumann F, Radujkovic A, Ho AD, Dreger P, Luft T. A prospective study on serum Cytokeratin (CK)-18 and CK18 fragments as biomarkers of acute hepato-intestinal GVHD. Leukemia 2018; 32:2685-2692. [PMID: 29950693 DOI: 10.1038/s41375-018-0183-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/22/2018] [Accepted: 05/30/2018] [Indexed: 01/02/2023]
Abstract
Apoptotic intestinal crypt cells are pathognomonic of acute intestinal graft versus host disease (GVHD). Serum levels of the apoptotic degradation product cytokeratin-18 fragments (CK18F) were associated with acute hepato-intestinal GVHD. Here we present a prospective clinical observational trial (NCT00935324) investigating serum levels of total CK18 (tCK18) and apoptotic CK18F to predict imminent acute hepato-intestinal GVHD and response to treatment. Total (t)CK18 and CK18F kinetics were measured before transplantation and in weekly intervals thereafter. In total 109 patients were enrolled. Acute hepato-intestinal GVHD grade I-IV was suspected in 36 patients (33%) at a median of 56 days post-transplant, 12 of these patients developed steroid-refractory GVHD. Both tCK18 and apoptotic CK18F increased at GVHD onset, and distinguished patients with suspected acute hepato-intestinal GVHD who were negative in intestinal histology. In patients with clinical acute hepato-intestinal GVHD, tCK18 significantly raised already 7-14 days before symptom onset. In receiver operator characteristics, areas under the curve at GVHD onset were 0.927 (p < 0.001) for tCK18 and 0.875 (p < 0.001) for apoptotic CK18F for patients with proven hepato-intestinal acute GVHD. This prospective study validates CK18F and highlights tCK18 as specific biomarkers suitable for improving prediction and diagnosis of suspected imminent and clinically manifest acute hepato-intestinal GVHD.
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Affiliation(s)
- Sandra Sauer
- Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany
| | - Johannes Hüsing
- Division of Biostatistics, Coordination Centre for Clinical Trials, University of Heidelberg, Heidelberg, Germany
| | - Jacek Hajda
- Division of Biostatistics, Coordination Centre for Clinical Trials, University of Heidelberg, Heidelberg, Germany
| | | | - Aleksandar Radujkovic
- Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany
| | - Peter Dreger
- Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Luft
- Department of Hematology and Oncology, University of Heidelberg, Heidelberg, Germany.
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31
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Gdynia G, Robak T, Kopitz J, Heller A, Grekova S, Duglova K, Laukemper G, Heinzel-Gutenbrunner M, Gutenbrunner C, Roth W, Ho AD, Schirmacher P, Schmitt M, Dreger P, Sellner L. Distinct Activities of Glycolytic Enzymes Identify Chronic Lymphocytic Leukemia Patients with a more Aggressive Course and Resistance to Chemo-Immunotherapy. EBioMedicine 2018; 32:125-133. [PMID: 29884457 PMCID: PMC6021262 DOI: 10.1016/j.ebiom.2018.05.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 12/12/2022] Open
Abstract
A higher capacity to grow under hypoxic conditions can lead to a more aggressive behavior of tumor cells. Determining tumor activity under hypoxia may identify chronic lymphocytic leukemia (CLL) with aggressive clinical course and predict response to chemo-immunotherapy (CIT). A metabolic score was generated by determining pyruvate kinase and lactate dehydrogenase, key enzymes of glycolysis, ex vivo in primary CLL samples under normoxic and hypoxic conditions. This score was further correlated with clinical endpoints and response to CIT in 96 CLL patients. 45 patients were classified as metabolic high risk (HR), 51 as low risk (LR). Treatment-free survival (TFS) was significantly shorter in HR patients (median 394 vs 723 days, p = .021). 15 HR patients and 14 LR patients received CIT after sample acquisition. HR patients had a significantly shorter progression-free survival after treatment compared to LR patients (median 216 days vs not reached, p = .008). Multivariate analysis evaluating age, IGHV, TP53 deletion or mutation and 11q22–23 deletion besides the capacity of tumor cells to grow under severe hypoxic conditions identified the metabolic profile as the strongest independent risk factor for shorter TFS (hazard ratio 2.37, p = .011). The metabolic risk can provide prognostic and predictive information complementary to genetic biomarkers and identify patients who might benefit from alternative treatment approaches. The activity of distinct glycolytic enzymes can identify CLL patients with resistance to chemo-immunotherapy The activity of distinct glycolytic enzymes can identify CLL patients who may benefit from specific pathway inhibitors We provide a tool for the evaluation of specific glycolytic enzymes in primary CLL cells for clinical diagnostics
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Affiliation(s)
- Georg Gdynia
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Tadeusz Robak
- Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland
| | - Jürgen Kopitz
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Anette Heller
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Svetlana Grekova
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Katarina Duglova
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Gloria Laukemper
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - Wilfried Roth
- Institute of Pathology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany
| | - Anthony D Ho
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Schmitt
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Peter Dreger
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Leopold Sellner
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany; National Center for Tumor Diseases (NCT), German Cancer Consortium (DKTK), Heidelberg, Germany.
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32
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Kriegsmann K, Löffler H, Eckstein V, Schulz R, Kräker S, Braun U, Luft T, Hegenbart U, Schönland S, Dreger P, Krämer A, Ho AD, Müller-Tidow C, Hundemer M. CD7 is expressed on a subset of normal CD34-positive myeloid precursors. Eur J Haematol 2018; 101:318-325. [PMID: 29797671 DOI: 10.1111/ejh.13100] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To improve monitoring of myeloid neoplasms by flow cytometry-based minimal residual disease (MRD) analysis, we analyzed the significance of leukemia-associated immunophenotype (LAIP) markers in 44 patients. METHODS In a pilot study cohort, peripheral blood or bone marrow samples from 13 patients with myeloid neoplasms and one case of B lymphoblastic leukemia in complete hematologic remission after allogeneic bone marrow or stem cell transplantation were subjected to selection for leukemia-specific phenotypes by fluorescence-activated cell sorting using individual marker combinations, followed by PCR-based chimerism analysis. RESULTS The feasibility of this method could be demonstrated, with selection being successful in 12 cases, including two cases where mixed chimerism was found exclusively in sorted cells. Interestingly, four specimens displayed full donor chimerism in cells expressing the presumably aberrant combination CD34+ /CD7+ . Further analyses, including assessment of an independent cohort of 25 patients not affected by neoplastic bone marrow infiltration, revealed that normal myeloid precursors usually include a population coexpressing CD34, CD13, CD33, and CD7. CONCLUSION We conclude that the combination CD34+ /CD7+ might not be suitable as an LAIP for MRD diagnostics and that a subset of normal myeloid precursors in the bone marrow expresses CD7.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Harald Löffler
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Volker Eckstein
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Renate Schulz
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Sandra Kräker
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Ute Braun
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Thomas Luft
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Ute Hegenbart
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Stefan Schönland
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Peter Dreger
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Alwin Krämer
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Michael Hundemer
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
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33
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Monzel C, Becker AS, Saffrich R, Wuchter P, Eckstein V, Ho AD, Tanaka M. Author Correction: Dynamic cellular phenotyping defines specific mobilization mechanisms of human hematopoietic stem and progenitor cells induced by SDF1α versus synthetic agents. Sci Rep 2018; 8:6996. [PMID: 29713008 PMCID: PMC5928094 DOI: 10.1038/s41598-018-25253-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Cornelia Monzel
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany.,Laboratoire Physico-Chimie, Institut Curie, CNRS UMR168, 75005, Paris, France
| | - Alexandra S Becker
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Rainer Saffrich
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, 68167, Mannheim, Germany
| | - Patrick Wuchter
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, 68167, Mannheim, Germany
| | - Volker Eckstein
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany.
| | - Motomu Tanaka
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany. .,Institute for IntegratedCell-Material Sciences, Kyoto University, 606-8501, Kyoto, Japan.
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34
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Kriegsmann K, Dittrich T, Neuber B, Awwad MHS, Hegenbart U, Goldschmidt H, Hillengass J, Hose D, Seckinger A, Müller-Tidow C, Ho AD, Schönland S, Hundemer M. Quantification of number of CD38 sites on bone marrow plasma cells in patients with light chain amyloidosis and smoldering multiple myeloma. Cytometry B Clin Cytom 2018; 94:611-620. [PMID: 29577600 DOI: 10.1002/cyto.b.21636] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 02/06/2018] [Accepted: 03/21/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Recent approaches in multiple myeloma (MM) treatment have targeted CD38. As antigen expression levels on plasma cells (PCs) were demonstrated to affect response to monoclonal antibody (mAb) treatment, a precise characterization of PC phenotype is warranted. METHODS Anti-CD38 mAb (isatuximab) was tested for antibody-dependent cellular cytotoxicity (ADCC) in MM cell lines. Quantification of the number of sites (NOS) of CD38 on bone marrow PCs and other immune cells obtained from light chain (AL) amyloidosis (n = 46) and smoldering multiple myeloma (SMM) patients (n = 19) was performed with two different quantitative flow cytometry (QFCM) applications. RESULTS ADCC activity of isatuximab was observed in cell lines with >100 × 103 CD38-NOS only. The average PC CD38-NOS was 153 ± 53 × 103 in AL amyloidosis and 138.7 ± 53 × 103 in SMM patients. Eight (17%) AL amyloidosis and 4 (21%) SMM patients showed a PC CD38-NOS level <100 × 103 . In four AL amyloidosis and two SMM patients <10% of PCs had a CD38-NOS ≥100 × 103 . The CD38-NOS identified on bone marrow lymphocytes, monocytes, and granulocytes was two log units below the CD38-NOS on PCs (P < 0.001). No significant differences in CD38-NOS expression levels on any of the analyzed PC subpopulations in AL amyloidosis and SMM patients were identified. CONCLUSION Levels of CD38 expression affect the isatuximab-mediated ADCC in vitro. As PCs of patients with AL amyloidosis and SMM do not homogenously express high CD38 our data provide a rationale for assessment of CD38-NOS in patients with PC disorders prior to anti-CD38 treatment. © 2018 International Clinical Cytometry Society.
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Affiliation(s)
- Katharina Kriegsmann
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Tobias Dittrich
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Brigitte Neuber
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Mohamed H S Awwad
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Ute Hegenbart
- Amyloidosis Center, Heidelberg University, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany.,National Center for Tumor Diseases, University Hospital, Heidelberg, Germany
| | - Jens Hillengass
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Dirk Hose
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany.,National Center for Tumor Diseases, University Hospital, Heidelberg, Germany
| | - Anja Seckinger
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany.,National Center for Tumor Diseases, University Hospital, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
| | | | - Michael Hundemer
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Heidelberg, Germany
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35
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Mani J, Wang L, Hückelhoven AG, Schmitt A, Gedvilaite A, Jin N, Kleist C, Ho AD, Schmitt M. Definition and characterization of novel HLA-*A02-restricted CD8+ T cell epitopes derived from JCV polyomavirus with clinical relevance. Oncotarget 2018; 8:2485-2500. [PMID: 27705933 PMCID: PMC5356818 DOI: 10.18632/oncotarget.12387] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/19/2016] [Indexed: 11/25/2022] Open
Abstract
Human JC and BK polyomaviruses (JCV/BKV) can establish a latent infection without any clinical symptoms in healthy individuals. In immunocompromised hosts infection or reactivation of JCV and BKV can cause lethal progressive multifocal leukoencephalopathy (PML) and hemorrhagic cystitis, respectively. Vaccination with JCV/BKV derived antigen epitope peptides or adoptive transfer of virus-specific T cells would constitute an elegant approach to clear virus-infected cells. Furthermore, donor leukocyte infusion (DLI) is another therapeutic approach which could be helpful for patients with JCV/BKV infections.So far, only few immunodominant T cell epitopes of JCV and BKV have been described and therefore is a fervent need for the definition of novel epitopes. In this study, we identified novel T cell epitopes by screening libraries of overlapping peptides derived from the major capsid protein VP1 of JCV. Virus like particles (VLPs) were used to confirm naturally processing. Two human leucocyte antigen (HLA)-A*02-restricted epitopes were characterized by fine mapping with overlapping peptides and nonamer peptide sequences were identified. Cytokine release profile of the epitope-specific T cells was analyzed by enzyme-linked immunospot (ELISPOT) assays and by flow cytometry. We demonstrated that T cell responses were of polyfunctional nature with the potential of epitope-specific killing and cross-reactivity between JCV and BKV. These novel epitopes might constitute a new potential tool to design effective diagnostic and therapeutic approaches against both polyomaviruses.
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Affiliation(s)
- Jiju Mani
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Lei Wang
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Angela G Hückelhoven
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Anita Schmitt
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Alma Gedvilaite
- Department of Eukaryote Genetic Engineering, Institute of Biotechnology, Vilnius University, Vilnius, Lithuania
| | - Nan Jin
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Department of Hematology, ZhongDa Hospital, Southeast University, Nanjing, P. R. China
| | - Christian Kleist
- Department of Transplantation Immunology, Heidelberg University Hospital, Heidelberg, Germany.,Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
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36
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Stiehl T, Ho AD, Marciniak-Czochra A. Mathematical modeling of the impact of cytokine response of acute myeloid leukemia cells on patient prognosis. Sci Rep 2018; 8:2809. [PMID: 29434256 PMCID: PMC5809606 DOI: 10.1038/s41598-018-21115-4] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/30/2018] [Indexed: 12/14/2022] Open
Abstract
Acute myeloid leukemia (AML) is a heterogeneous disease. One reason for the heterogeneity may originate from inter-individual differences in the responses of leukemic cells to endogenous cytokines. On the basis of mathematical modeling, computer simulations and patient data, we have provided evidence that cytokine-independent leukemic cell proliferation may be linked to early relapses and poor overall survival. Depending whether the model of cytokine-dependent or cytokine-independent leukemic cell proliferation fits to the clinical data, patients can be assigned to two groups that differ significantly with respect to overall survival. The modeling approach further enables us to identify parameter constellations that can explain unexpected responses of some patients to external cytokines such as blast crisis or remission without chemotherapy.
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Affiliation(s)
- Thomas Stiehl
- Institute of Applied Mathematics, Interdisciplinary Center of Scientific Computing and BIOQUANT Center, Heidelberg University, Im Neuenheimer Feld 205, 69120, Heidelberg, Germany.
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany
| | - Anna Marciniak-Czochra
- Institute of Applied Mathematics, Interdisciplinary Center of Scientific Computing and BIOQUANT Center, Heidelberg University, Im Neuenheimer Feld 205, 69120, Heidelberg, Germany
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37
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Monzel C, Becker AS, Saffrich R, Wuchter P, Eckstein V, Ho AD, Tanaka M. Dynamic cellular phynotyping defines specific mobilization mechanisms of human hematopoietic stem and progenitor cells induced by SDF1α versus synthetic agents. Sci Rep 2018; 8:1841. [PMID: 29382856 PMCID: PMC5789976 DOI: 10.1038/s41598-018-19557-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/03/2018] [Indexed: 02/06/2023] Open
Abstract
Efficient mobilization of hematopoietic stem and progenitor cells (HSPC) is one of the most crucial issues for harvesting an adequate amount of peripheral HSPC for successful clinical transplantation. Applying well-defined surrogate models for the bone marrow niche, live cell imaging techniques, and novel tools in statistical physics, we have quantified the functionality of two mobilization agents that have been applied in the clinic, NOX-A12 and AMD3100 (plerixafor), as compared to a naturally occurring chemokine in the bone marrow, SDF1α. We found that NOX-A12, an L-enantiomeric RNA oligonucleotide to SDF1, significantly reduced the adhesion of HSPC to the niche surface mediated via the CXCR4-SDF1α axis, and stretched the migration trajectories of the HSPC. We found that the stretching of trajectories by NOX-A12 was more prominent than that by SDF1α. In contrast, plerixafor exhibited no detectable interference with adhesion and migration. We also found that the deformation of HSPC induced by SDF1α or plerixafor was also drastically suppressed in the presence of NOX-A12. This novel technology of quantitative assessment of "dynamic phenotypes" by physical tools has therefore enabled us to define different mechanisms of function for various extrinsic factors compared to naturally occurring chemokines.
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Affiliation(s)
- Cornelia Monzel
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany.,Laboratoire Physico-Chimie, Institut Curie, CNRS UMR168, 75005, Paris, France
| | - Alexandra S Becker
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany
| | - Rainer Saffrich
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, 68167, Mannheim, Germany
| | - Patrick Wuchter
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, 68167, Mannheim, Germany
| | - Volker Eckstein
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, Heidelberg University, 69120, Heidelberg, Germany.
| | - Motomu Tanaka
- Physical Chemistry of Biosystems, Institute of Physical Chemistry, Heidelberg University, 69120, Heidelberg, Germany. .,Institute for Integrated Cell-Material Sciences, Kyoto University, 606-8501, Kyoto, Japan.
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38
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Blume R, Rempel E, Manta L, Saeed BR, Wang W, Raffel S, Ermakova O, Eckstein V, Benes V, Trumpp A, Ho AD, Lutz C. The molecular signature of AML with increased ALDH activity suggests a stem cell origin. Leuk Lymphoma 2018; 59:2201-2210. [DOI: 10.1080/10428194.2017.1422862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Rachel Blume
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Eugen Rempel
- Centre for Organismal Studies, Heidelberg University, Heidelberg, Germany
| | - Linda Manta
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Borhan R. Saeed
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Wenwen Wang
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Simon Raffel
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
- Division of Stem Cells and Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
| | - Olga Ermakova
- Centre for Organismal Studies, Heidelberg University, Heidelberg, Germany
| | - Volker Eckstein
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Vladimir Benes
- European Molecular Biology Laboratory, Heidelberg, Germany
| | - Andreas Trumpp
- Division of Stem Cells and Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), Heidelberg, Germany
| | - Anthony D. Ho
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Christoph Lutz
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
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39
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Hoffmann JM, Schubert ML, Wang L, Hückelhoven A, Sellner L, Stock S, Schmitt A, Kleist C, Gern U, Loskog A, Wuchter P, Hofmann S, Ho AD, Müller-Tidow C, Dreger P, Schmitt M. Differences in Expansion Potential of Naive Chimeric Antigen Receptor T Cells from Healthy Donors and Untreated Chronic Lymphocytic Leukemia Patients. Front Immunol 2018; 8:1956. [PMID: 29375575 PMCID: PMC5767585 DOI: 10.3389/fimmu.2017.01956] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 12/19/2017] [Indexed: 12/20/2022] Open
Abstract
Introduction Therapy with chimeric antigen receptor T (CART) cells for hematological malignancies has shown promising results. Effectiveness of CART cells may depend on the ratio of naive (TN) vs. effector (TE) T cells, TN cells being responsible for an enduring antitumor activity through maturation. Therefore, we investigated factors influencing the TN/TE ratio of CART cells. Materials and methods CART cells were generated upon transduction of peripheral blood mononuclear cells with a CD19.CAR-CD28-CD137zeta third generation retroviral vector under two different stimulating culture conditions: anti-CD3/anti-CD28 antibodies adding either interleukin (IL)-7/IL-15 or IL-2. CART cells were maintained in culture for 20 days. We evaluated 24 healthy donors (HDs) and 11 patients with chronic lymphocytic leukemia (CLL) for the composition of cell subsets and produced CART cells. Phenotype and functionality were tested using flow cytometry and chromium release assays. Results IL-7/IL-15 preferentially induced differentiation into TN, stem cell memory (TSCM: naive CD27+ CD95+), CD4+ and CXCR3+ CART cells, while IL-2 increased effector memory (TEM), CD56+ and CD4+ T regulatory (TReg) CART cells. The net amplification of different CART subpopulations derived from HDs and untreated CLL patients was compared. Particularly the expansion of CD4+ CARTN cells differed significantly between the two groups. For HDs, this subtype expanded >60-fold, whereas CD4+ CARTN cells of untreated CLL patients expanded less than 10-fold. Expression of exhaustion marker programmed cell death 1 on CARTN cells on day 10 of culture was significantly higher in patient samples compared to HD samples. As the percentage of malignant B cells was expectedly higher within patient samples, an excessive amount of B cells during culture could account for the reduced expansion potential of CARTN cells in untreated CLL patients. Final TN/TE ratio stayed <0.3 despite stimulation condition for patients, whereas this ratio was >2 in samples from HDs stimulated with IL-7/IL-15, thus demonstrating efficient CARTN expansion. Conclusion Untreated CLL patients might constitute a challenge for long-lasting CART effects in vivo since only a low number of TN among the CART product could be generated. Depletion of malignant B cells before starting CART production might be considered to increase the TN/TE ratio within the CART product.
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Affiliation(s)
- Jean-Marc Hoffmann
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Maria-Luisa Schubert
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Lei Wang
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Angela Hückelhoven
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Leopold Sellner
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Sophia Stock
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Anita Schmitt
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Kleist
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany
| | - Ulrike Gern
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Angelica Loskog
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Patrick Wuchter
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Medical Faculty Mannheim, Institute of Transfusion Medicine and Immunology, Heidelberg University, German Red Cross Blood Service Baden-Württemberg - Hessen, Mannheim, Germany
| | - Susanne Hofmann
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Anthony D Ho
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Carsten Müller-Tidow
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Peter Dreger
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Michael Schmitt
- Cellular Immunotherapy, GMP Core Facility, Department of Internal Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,National Center for Tumor Diseases (NCT), Heidelberg, Germany
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40
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Dietrich S, Oleś M, Lu J, Sellner L, Anders S, Velten B, Wu B, Hüllein J, da Silva Liberio M, Walther T, Wagner L, Rabe S, Ghidelli-Disse S, Bantscheff M, Oleś AK, Słabicki M, Mock A, Oakes CC, Wang S, Oppermann S, Lukas M, Kim V, Sill M, Benner A, Jauch A, Sutton LA, Young E, Rosenquist R, Liu X, Jethwa A, Lee KS, Lewis J, Putzker K, Lutz C, Rossi D, Mokhir A, Oellerich T, Zirlik K, Herling M, Nguyen-Khac F, Plass C, Andersson E, Mustjoki S, von Kalle C, Ho AD, Hensel M, Dürig J, Ringshausen I, Zapatka M, Huber W, Zenz T. Drug-perturbation-based stratification of blood cancer. J Clin Invest 2018; 128:427-445. [PMID: 29227286 PMCID: PMC5749541 DOI: 10.1172/jci93801] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [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: 03/08/2017] [Accepted: 10/31/2017] [Indexed: 12/11/2022] Open
Abstract
As new generations of targeted therapies emerge and tumor genome sequencing discovers increasingly comprehensive mutation repertoires, the functional relationships of mutations to tumor phenotypes remain largely unknown. Here, we measured ex vivo sensitivity of 246 blood cancers to 63 drugs alongside genome, transcriptome, and DNA methylome analysis to understand determinants of drug response. We assembled a primary blood cancer cell encyclopedia data set that revealed disease-specific sensitivities for each cancer. Within chronic lymphocytic leukemia (CLL), responses to 62% of drugs were associated with 2 or more mutations, and linked the B cell receptor (BCR) pathway to trisomy 12, an important driver of CLL. Based on drug responses, the disease could be organized into phenotypic subgroups characterized by exploitable dependencies on BCR, mTOR, or MEK signaling and associated with mutations, gene expression, and DNA methylation. Fourteen percent of CLLs were driven by mTOR signaling in a non-BCR-dependent manner. Multivariate modeling revealed immunoglobulin heavy chain variable gene (IGHV) mutation status and trisomy 12 as the most important modulators of response to kinase inhibitors in CLL. Ex vivo drug responses were associated with outcome. This study overcomes the perception that most mutations do not influence drug response of cancer, and points to an updated approach to understanding tumor biology, with implications for biomarker discovery and cancer care.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 12/metabolism
- Databases, Factual
- Female
- Hematologic Neoplasms/classification
- Hematologic Neoplasms/drug therapy
- Hematologic Neoplasms/genetics
- Hematologic Neoplasms/pathology
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/classification
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Models, Biological
- Neoplasm Proteins/genetics
- Neoplasm Proteins/metabolism
- Signal Transduction
- Trisomy/genetics
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Affiliation(s)
- Sascha Dietrich
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Małgorzata Oleś
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Junyan Lu
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Leopold Sellner
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Simon Anders
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Britta Velten
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Bian Wu
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Jennifer Hüllein
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Michelle da Silva Liberio
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Tatjana Walther
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Lena Wagner
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Sophie Rabe
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | | | | | - Andrzej K. Oleś
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Mikołaj Słabicki
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Andreas Mock
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Christopher C. Oakes
- Division of Hematology, Departments of Internal Medicine and Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Centre, Heidelberg, Germany
| | - Shihui Wang
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Sina Oppermann
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Marina Lukas
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Vladislav Kim
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Martin Sill
- Division of Biostatistics, German Cancer Research Centre, Heidelberg, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Centre, Heidelberg, Germany
| | - Anna Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Lesley Ann Sutton
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Emma Young
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Xiyang Liu
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Alexander Jethwa
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Kwang Seok Lee
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
| | - Joe Lewis
- European Molecular Biology Laboratory (EMBL), Chemical Biology Core Facility, Heidelberg, Germany
| | - Kerstin Putzker
- European Molecular Biology Laboratory (EMBL), Chemical Biology Core Facility, Heidelberg, Germany
| | - Christoph Lutz
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | - Davide Rossi
- Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy; Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Andriy Mokhir
- Friedrich-Alexander-University of Erlangen-Nürnberg, Department of Chemistry and Pharmacy, Organic Chemistry II, Erlangen, Germany
| | - Thomas Oellerich
- Hematology/Oncology, Department of Medicine, Johann Wolfgang Goethe University, Frankfurt, Germany; Department of Haematology, Cambridge Institute of Medical Research, University of Cambridge, Cambridge, United Kingdom
- German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Katja Zirlik
- German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Hematology/Oncology, University Hospital Freiburg, Freiburg, Germany and Tumorzentrum ZeTuP Chur, Chur, Schweiz
| | - Marco Herling
- Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - Florence Nguyen-Khac
- INSERM U1138, Université Pierre et Marie Curie-Paris and Service d’Hématologie Biologique, Hôpital Pitié-Salpêtrière, Paris, France
| | - Christoph Plass
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Centre, Heidelberg, Germany
- German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Emma Andersson
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland and Department of Hematology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
| | - Satu Mustjoki
- Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland and Department of Hematology, Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki, Finland
| | - Christof von Kalle
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
- German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Heidelberg Centre for Personalized Oncology, DKFZ-HIPO, DKFZ, Heidelberg, Germany
| | - Anthony D. Ho
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Jan Dürig
- German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Hematology, University Hospital Essen, Essen, Germany
| | - Ingo Ringshausen
- Department of Hematology, University of Cambridge, Cambridge, United Kingdom
| | - Marc Zapatka
- Division of Molecular Genetics, German Cancer Research Centre, Heidelberg, Germany
| | - Wolfgang Huber
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Thorsten Zenz
- Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany
- Molecular Therapy in Hematology and Oncology, and Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Centre, Heidelberg, Germany
- German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
- Department of Hematology, University of Zürich, Zürich, Switzerland
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41
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Baertsch MA, Kriegsmann K, Pavel P, Bruckner T, Hundemer M, Kriegsmann M, Ho AD, Goldschmidt H, Wuchter P. Platelet Count before Peripheral Blood Stem Cell Mobilization Is Associated with the Need for Plerixafor But Not with the Collection Result. Transfus Med Hemother 2018; 45:24-31. [PMID: 29593457 PMCID: PMC5836245 DOI: 10.1159/000478911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 06/15/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A low platelet count before mobilization has recurrently been identified as risk factor for poor mobilization. METHODS To determine the relevance of this finding for peripheral blood stem cell (PBSC) mobilization, including pre-emptive or rescue plerixafor in the case of poor mobilization, we retrospectively analyzed all patients undergoing PBSC collection at our institution between January 2014 and December 2015 (n = 380). RESULTS In total, 99% of the patients (377/380) successfully collected a minimum of 2 × 106 CD34+ cells/kg body weight sufficient for a single transplant. Rescue or pre-emptive plerixafor was administered to 11% of the patients (42/380). No correlations between the platelet count before mobilization and the number of peripheral blood CD34+ cells or the CD34+ cell collection result were detected in the entire population or the subgroups according to diagnosis (newly diagnosed multiple myeloma, relapsed multiple myeloma, lymphoma, amyloid light-chain amyloidosis, sarcoma, or germ cell tumor). However, patients requiring pre-emptive or rescue plerixafor had a significantly lower platelet count before mobilization (217/nl vs. 245/nl; p = 0.004). CONCLUSION With the current state of the art PBSC mobilization strategies, the platelet count before mobilization was not associated with the CD34+ cell collection result but was associated with the need for pre-emptive or rescue application of plerixafor.
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Affiliation(s)
- Marc-Andrea Baertsch
- Department of Medicine V (Hematology, Oncology and Rheumatology), University Hospital Heidelberg, Heidelberg, Germany
| | - Katharina Kriegsmann
- Department of Medicine V (Hematology, Oncology and Rheumatology), University Hospital Heidelberg, Heidelberg, Germany
| | - Petra Pavel
- Stem Cell Laboratory, IKTZ Heidelberg GmbH, Heidelberg, Germany
| | - Thomas Bruckner
- Institute of Medical Biometry und Informatics, Heidelberg University, Heidelberg, Germany
| | - Michael Hundemer
- Department of Medicine V (Hematology, Oncology and Rheumatology), University Hospital Heidelberg, Heidelberg, Germany
| | - Mark Kriegsmann
- Institute of Pathology, Heidelberg University, Heidelberg, Germany
| | - Anthony D. Ho
- Department of Medicine V (Hematology, Oncology and Rheumatology), University Hospital Heidelberg, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Medicine V (Hematology, Oncology and Rheumatology), University Hospital Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg – Hesse, Mannheim, Germany
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42
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Raffel S, Falcone M, Kneisel N, Hansson J, Wang W, Lutz C, Bullinger L, Poschet G, Nonnenmacher Y, Barnert A, Bahr C, Zeisberger P, Przybylla A, Sohn M, Tönjes M, Erez A, Adler L, Jensen P, Scholl C, Fröhling S, Cocciardi S, Wuchter P, Thiede C, Flörcken A, Westermann J, Ehninger G, Lichter P, Hiller K, Hell R, Herrmann C, Ho AD, Krijgsveld J, Radlwimmer B, Trumpp A. BCAT1 restricts αKG levels in AML stem cells leading to IDHmut-like DNA hypermethylation. Nature 2017; 551:384-388. [PMID: 29144447 DOI: 10.1038/nature24294] [Citation(s) in RCA: 223] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/19/2017] [Indexed: 12/27/2022]
Abstract
The branched-chain amino acid (BCAA) pathway and high levels of BCAA transaminase 1 (BCAT1) have recently been associated with aggressiveness in several cancer entities. However, the mechanistic role of BCAT1 in this process remains largely uncertain. Here, by performing high-resolution proteomic analysis of human acute myeloid leukaemia (AML) stem-cell and non-stem-cell populations, we find the BCAA pathway enriched and BCAT1 protein and transcripts overexpressed in leukaemia stem cells. We show that BCAT1, which transfers α-amino groups from BCAAs to α-ketoglutarate (αKG), is a critical regulator of intracellular αKG homeostasis. Further to its role in the tricarboxylic acid cycle, αKG is an essential cofactor for αKG-dependent dioxygenases such as Egl-9 family hypoxia inducible factor 1 (EGLN1) and the ten-eleven translocation (TET) family of DNA demethylases. Knockdown of BCAT1 in leukaemia cells caused accumulation of αKG, leading to EGLN1-mediated HIF1α protein degradation. This resulted in a growth and survival defect and abrogated leukaemia-initiating potential. By contrast, overexpression of BCAT1 in leukaemia cells decreased intracellular αKG levels and caused DNA hypermethylation through altered TET activity. AML with high levels of BCAT1 (BCAT1high) displayed a DNA hypermethylation phenotype similar to cases carrying a mutant isocitrate dehydrogenase (IDHmut), in which TET2 is inhibited by the oncometabolite 2-hydroxyglutarate. High levels of BCAT1 strongly correlate with shorter overall survival in IDHWTTET2WT, but not IDHmut or TET2mut AML. Gene sets characteristic for IDHmut AML were enriched in samples from patients with an IDHWTTET2WTBCAT1high status. BCAT1high AML showed robust enrichment for leukaemia stem-cell signatures, and paired sample analysis showed a significant increase in BCAT1 levels upon disease relapse. In summary, by limiting intracellular αKG, BCAT1 links BCAA catabolism to HIF1α stability and regulation of the epigenomic landscape, mimicking the effects of IDH mutations. Our results suggest the BCAA-BCAT1-αKG pathway as a therapeutic target to compromise leukaemia stem-cell function in patients with IDHWTTET2WT AML.
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Affiliation(s)
- Simon Raffel
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany.,Department of Internal Medicine V, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Mattia Falcone
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany
| | - Niclas Kneisel
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Jenny Hansson
- Genome Biology Unit, European Molecular Biology Laboratory (EMBL), 69117 Heidelberg, Germany
| | - Wei Wang
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Christoph Lutz
- Department of Internal Medicine V, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Lars Bullinger
- Department of Internal Medicine III, University Hospital Ulm, 89081 Ulm, Germany
| | - Gernot Poschet
- Centre for Organismal Studies (COS), University of Heidelberg, 69120 Heidelberg, Germany
| | - Yannic Nonnenmacher
- Department of Bioinfomatics and Biochemistry and Braunschweig Integrated Center of Systems Biology (BRICS), Technical University Braunschweig, 38106 Braunschweig, Germany.,Luxemburg Centre for Systems Biomedicine, University of Luxemburg, L-4367 Belvaux, Luxemburg
| | - Andrea Barnert
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany
| | - Carsten Bahr
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany
| | - Petra Zeisberger
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany
| | - Adriana Przybylla
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany
| | - Markus Sohn
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany
| | - Martje Tönjes
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Ayelet Erez
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Lital Adler
- Department of Biological Regulation, Weizmann Institute of Science, Rehovot, Israel
| | - Patrizia Jensen
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Claudia Scholl
- Division of Applied Functional Genomics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120 Heidelberg, Germany
| | - Stefan Fröhling
- Department of Translational Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Section for Personalized Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120 Heidelberg, Germany
| | - Sibylle Cocciardi
- Department of Internal Medicine III, University Hospital Ulm, 89081 Ulm, Germany
| | - Patrick Wuchter
- Department of Internal Medicine V, Heidelberg University Hospital, 69120 Heidelberg, Germany.,Institute of Transfusion Medicine and Immunology Mannheim, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, 68167 Mannheim, Germany
| | - Christian Thiede
- Medical Department 1, University Hospital Carl Gustav Carus, 01307 Dresden, Germany
| | - Anne Flörcken
- Department of Hematology, Oncology and Tumor Immunology; Charité-University Medicine Berlin, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - Jörg Westermann
- Department of Hematology, Oncology and Tumor Immunology; Charité-University Medicine Berlin, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - Gerhard Ehninger
- Department of Hematology, Oncology and Tumor Immunology; Charité-University Medicine Berlin, Campus Virchow Klinikum, 13353 Berlin, Germany
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120 Heidelberg, Germany
| | - Karsten Hiller
- Department of Bioinfomatics and Biochemistry and Braunschweig Integrated Center of Systems Biology (BRICS), Technical University Braunschweig, 38106 Braunschweig, Germany.,Luxemburg Centre for Systems Biomedicine, University of Luxemburg, L-4367 Belvaux, Luxemburg
| | - Rüdiger Hell
- Centre for Organismal Studies (COS), University of Heidelberg, 69120 Heidelberg, Germany
| | - Carl Herrmann
- Division of Theoretical Bioinformatics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Institute of Pharmacy and Molecular Biotechnology, and Bioquant Center, University of Heidelberg, 69120 Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Jeroen Krijgsveld
- Genome Biology Unit, European Molecular Biology Laboratory (EMBL), 69117 Heidelberg, Germany
| | - Bernhard Radlwimmer
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120 Heidelberg, Germany
| | - Andreas Trumpp
- Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM gGmbH), 69120 Heidelberg, Germany.,Division of Stem Cells and Cancer, German Cancer Research Center (DKFZ) and DKFZ-ZMBH Alliance, 69120 Heidelberg, Germany.,German Cancer Consortium (DKTK), DKFZ, 69120 Heidelberg, Germany
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43
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Kayser S, Krzykalla J, Elliott MA, Norsworthy K, Gonzales P, Hills RK, Baer MR, Ráčil Z, Mayer J, Novak J, Žák P, Szotkowski T, Grimwade D, Russell NH, Walter RB, Estey EH, Westermann J, Görner M, Benner A, Krämer A, Smith BD, Burnett AK, Thiede C, Röllig C, Ho AD, Ehninger G, Schlenk RF, Tallman MS, Levis MJ, Platzbecker U. Characteristics and outcome of patients with therapy-related acute promyelocytic leukemia front-line treated with or without arsenic trioxide. Leukemia 2017; 31:2347-2354. [PMID: 28322237 PMCID: PMC6037311 DOI: 10.1038/leu.2017.92] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [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: 01/24/2017] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 02/08/2023]
Abstract
Therapy-related acute promyelocytic leukemia (t-APL) is relatively rare, with limited data on outcome after treatment with arsenic trioxide (ATO) compared to standard intensive chemotherapy (CTX). We evaluated 103 adult t-APL patients undergoing treatment with all-trans retinoic acid (ATRA) alone (n=7) or in combination with ATO (n=24), CTX (n=53), or both (n=19). Complete remissions were achieved after induction therapy in 57% with ATRA, 100% with ATO/ATRA, 78% with CTX/ATRA, and 95% with CTX/ATO/ATRA. Early death rates were 43% for ATRA, 0% for ATO/ATRA, 12% for CTX/ATRA and 5% for CTX/ATO/ATRA. Three patients relapsed, two developed therapy-related acute myeloid leukemia and 13 died in remission including seven patients with recurrence of the prior malignancy. Median follow-up for survival was 3.7 years. None of the patients treated with ATRA alone survived beyond one year. Event-free survival was significantly higher after ATO-based therapy (95%, 95% CI, 82-99%) as compared to CTX/ATRA (78%, 95% CI, 64-87%; P=0.042), if deaths due to recurrence of the prior malignancy were censored. The estimated 2-year overall survival in intensively treated patients was 88% (95% CI, 80-93%) without difference according to treatment (P=0.47). ATO when added to ATRA or CTX/ATRA is feasible and leads to better outcomes as compared to CTX/ATRA in t-APL.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Arsenic Trioxide
- Arsenicals/therapeutic use
- Female
- Humans
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/etiology
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Middle Aged
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/genetics
- Oxides/therapeutic use
- Remission Induction
- Survival Analysis
- Treatment Outcome
- Young Adult
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Affiliation(s)
- S Kayser
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
- Department of Internal Medicine V, Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - J Krzykalla
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - MA Elliott
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - K Norsworthy
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - P Gonzales
- Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - RK Hills
- Cardiff University School of Medicine, Cardiff, UK
| | - MR Baer
- University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Z Ráčil
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - J Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - J Novak
- 3rd Faculty of Medicine, Department of Internal Medicine and Haematology, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - P Žák
- Faculty of Medicine, 4th Department of Internal Medicine-Hematology, Charles University and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - T Szotkowski
- Faculty of Medicine and Dentistry, Department of Hemato-Oncology, Palacky University Olomouc and University Hospital Olomouc, Olomouc, Czech Republic
| | - D Grimwade
- Faculty of Life Sciences and Medicine, Department of Medical & Molecular Genetics, King’s College London, London, UK
| | - NH Russell
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - RB Walter
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - EH Estey
- Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Division of Hematology/Department of Medicine, University of Washington, Seattle, WA, USA
| | - J Westermann
- Department of Hematology, Oncology and Tumor Immunology, Charité-University Medical Center, Campus Virchow Clinic, Berlin, Germany
| | - M Görner
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum Bielefeld Mitte, Bielefeld, Germany
| | - A Benner
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - A Krämer
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
- Department of Internal Medicine V, Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - BD Smith
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - AK Burnett
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - C Thiede
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - C Röllig
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - AD Ho
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - G Ehninger
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - RF Schlenk
- National Center for Tumor Diseases, Heidelberg University Hospital, Heidelberg, Germany
| | - MS Tallman
- Department of Medicine, Leukemia Service, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA
| | - MJ Levis
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA
| | - U Platzbecker
- Department of Internal Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
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44
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Kayser S, Feszler M, Krzykalla J, Schick M, Kramer M, Benner A, Thol F, Platzbecker U, Müller-Tidow C, Ho AD, Ehninger G, Heuser M, Schlenk RF, Thiede C, Röllig C, Krämer A. Clinical impact of KMT2C and SPRY4 expression levels in intensively treated younger adult acute myeloid leukemia patients. Eur J Haematol 2017; 99:544-552. [PMID: 28940816 DOI: 10.1111/ejh.12972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To evaluate the prognostic impact of gene expression levels (ELs) of two tumor suppressor genes, sprouty 4 (SPRY4, located on 5q) and lysine methyltransferase 2C (KMT2C, located on 7q) in correlation with clinical characteristics and genetic abnormalities assessed at initial diagnosis in acute myeloid leukemia (AML). METHOD Gene expression levels were measured on cDNA by RT-qPCR from diagnostic bone marrow samples of 275 intensively treated adult AML patients (median age, 48 years). RESULTS KMT2C ELs were significantly lower in abn7q/-7 (P = .001), whereas SPRY4 ELs were not associated with abn5q/-5. Higher KMT2C and SPRY4 ELs were significantly associated with lower genetic risk groups as defined by the European LeukemiaNet classification. Additionally, KMT2C ELs were lower in cytogenetically normal patients with DNMT3A (P = .01) or FLT3-ITD mutations (P = .05). KMT2C ELs were not associated with prognosis, whereas higher SPRY4 ELs showed a favorable impact on event-free (EFS, P = .01), relapse-free (RFS, P = .01) and in-trend on overall survival (P = .06) for cytogenetically abnormal patients, which was confirmed in multivariable analysis for EFS (HR, 0.84; 95%-CI, 0.73-0.97; P = .02) and RFS (HR, 0.85; 95%-CI, 0.73-0.98; P = .02). CONCLUSION Our data indicate that KMT2C ELs are associated with specific genetic features and that SPRY4 ELs may add prognostic information.
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Affiliation(s)
- Sabine Kayser
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Maximilian Feszler
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
| | - Julia Krzykalla
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Schick
- Genomics & Proteomics Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Kramer
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felicitas Thol
- Department of Hematology, Hemostasis, Oncology and Stem cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Uwe Platzbecker
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Carsten Müller-Tidow
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Gerhard Ehninger
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Michael Heuser
- Department of Hematology, Hemostasis, Oncology and Stem cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Richard F Schlenk
- NCT Trial Center, National Center for Tumor Diseases, Heidelberg, Germany
| | - Christian Thiede
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Christoph Röllig
- Department of Medicine I, University Hospital Carl-Gustav-Carus, Dresden, Germany
| | - Alwin Krämer
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center, Heidelberg, Germany
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45
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Neuber B, Dai J, Waraich WA, Awwad MHS, Engelhardt M, Schmitt M, Medenhoff S, Witzens-Harig M, Ho AD, Goldschmidt H, Hundemer M. Lenalidomide overcomes the immunosuppression of regulatory CD8 +CD28 - T-cells. Oncotarget 2017; 8:98200-98214. [PMID: 29228683 PMCID: PMC5716723 DOI: 10.18632/oncotarget.21516] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 09/21/2017] [Indexed: 11/29/2022] Open
Abstract
Although lenalidomide and pomalidomide are well-established treatment options in patients with multiple myeloma, their immune-modulating effects are not fully understood. While CD8+CD28− regulatory T-cells in patients with hematologic disorders display a known immune-escape mechanism, we show that lenalidomide can overcome the immunosuppressive impact of CD8+CD28− T-cells. We analyzed in vitro the antigen-specific T-cell responses of healthy donors and patients with multiple myeloma with or without the addition of autologous CD8+CD28− T-cells in the absence and presence of lenalidomide. We found that lenalidomide enhances the antigen-specific secretion of IFN-γ and Granzyme B despite the addition of CD8+CD28− T-cells. Furthermore, we showed that lenalidomide inhibits the IL-6 secretion of mononuclear cells, triggered by CD8+CD28− T-cells. The addition of IL-6 counteracts the action of lenalidomide based stimulation of IFN-γ secretion and induction of T-cell maturation but not the secretion of Granzyme B. Surprisingly, pomalidomide failed to induce IL-6 suppression and displayed immunostimulating effects only after a prolonged incubation time. Analysis of the IL-6 modulating cereblon-binding protein KPNA2 showed the similar degradation capacity of lenalidomide and pomalidomide without explaining the divergent effects. In conclusion, we showed that IL-6 and lenalidomide, but not pomalidomide, are opponents in a myeloma-antigen specific T-cell model.
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Affiliation(s)
- Brigitte Neuber
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Jingying Dai
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
| | - Wjahat A Waraich
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Mohamed H S Awwad
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Melanie Engelhardt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Michael Schmitt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Sergej Medenhoff
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | | | - Anthony D Ho
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Hartmut Goldschmidt
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany.,National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - Michael Hundemer
- Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
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46
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Rühle A, Perez RL, Glowa C, Weber KJ, Ho AD, Debus J, Saffrich R, Huber PE, Nicolay NH. Cisplatin radiosensitizes radioresistant human mesenchymal stem cells. Oncotarget 2017; 8:87809-87820. [PMID: 29152122 PMCID: PMC5675674 DOI: 10.18632/oncotarget.21214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 08/17/2017] [Indexed: 12/31/2022] Open
Abstract
Cisplatin-based chemo-radiotherapy is widely used to treat cancers with often severe therapy-associated late toxicities. While mesenchymal stem cells (MSCs) were shown to aid regeneration of cisplatin- or radiation-induced tissue lesions, the effect of the combined treatment on the stem cells remains unknown. Here we demonstrate that cisplatin treatment radiosensitized human bone marrow-derived MSCs in a dose-dependent manner and increased levels of radiation-induced apoptosis. However, the defining stem cell properties of MSCs remained largely intact after cisplatin-based chemo-radiation, and stem cell motility, adhesion, surface marker expression and the characteristic differentiation potential were not significantly influenced. The increased cisplatin-mediated radiosensitivity was associated with a cell cycle shift of MSCs towards the radiosensitive G2/M phase and increased residual DNA double-strand breaks. These data demonstrate for the first time a dose-dependent radiosensitization effect of MSCs by cisplatin. Clinically, the observed increase in radiation sensitivity and subsequent loss of regenerative MSCs may contribute to the often severe late toxicities observed after cisplatin-based chemo-radiotherapy in cancer patients.
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Affiliation(s)
- Alexander Rühle
- Department of Molecular and Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany
| | - Ramon Lopez Perez
- Department of Molecular and Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany
| | - Christin Glowa
- Department of Molecular and Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany
| | - Klaus-Josef Weber
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology and Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Jürgen Debus
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Rainer Saffrich
- Department of Hematology and Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Peter E Huber
- Department of Molecular and Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany
| | - Nils H Nicolay
- Department of Molecular and Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany.,Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology, 69120 Heidelberg, Germany.,Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany
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47
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Wang W, Bochtler T, Wuchter P, Manta L, He H, Eckstein V, Ho AD, Lutz C. Mesenchymal stromal cells contribute to quiescence of therapy-resistant leukemic cells in acute myeloid leukemia. Eur J Haematol 2017; 99:392-398. [PMID: 28800175 DOI: 10.1111/ejh.12934] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2017] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Persistence of leukemic cells after induction therapy has been shown to correlate with poor survival in acute myeloid leukemia (AML). In this study, we tested if human mesenchymal stromal cells (hMSCs) have protective effects on leukemic cells undergoing chemotherapy. METHODS Persistent disease was used as marker to identify cases with therapy-resistant leukemic cells in 95 patients with AML. Immunophenotyping, cell cycle, and apoptosis assays were assessed by flow cytometry. AML coculture studies were performed with hMSC of healthy donors. RESULTS Samples from patients with persistent disease had increased fractions of CD34+ CD38- and quiescent leukemic cells. Comparison of sample series collected at time points of diagnosis and blast persistence showed a relative therapy resistance of quiescent leukemic cells. Consistent with these observations, relapsed disease always displayed higher proportions of quiescent cells compared to samples of first diagnosis suggesting that quiescence is an important therapy escape mechanism of resistant cells. Co-culture studies demonstrated that hMSC protect leukemic cells from the effect of AraC treatment by enriching for quiescent cells, mimicking the effects observed in patients. This effect was even detectable when no direct stromal contact was established. CONCLUSIONS Our data suggest that hMSC contribute to quiescence and therapy resistance of persistent AML cells.
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Affiliation(s)
- Wenwen Wang
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Tilmann Bochtler
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Molecular Hematology/Oncology, Department of Internal Medicine V, German Cancer Research Center (DKFZ), University of Heidelberg, Heidelberg, Germany
| | - Patrick Wuchter
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Linda Manta
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Haiju He
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Volker Eckstein
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Anthony D Ho
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - Christoph Lutz
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
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48
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Lisenko K, Wuchter P, Hansberg M, Mangatter A, Benner A, Ho AD, Goldschmidt H, Hegenbart U, Schönland S. Comparison of Different Stem Cell Mobilization Regimens in AL Amyloidosis Patients. Biol Blood Marrow Transplant 2017; 23:1870-1878. [PMID: 28754546 DOI: 10.1016/j.bbmt.2017.07.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 07/14/2017] [Indexed: 12/14/2022]
Abstract
High-dose melphalan (HDM) and autologous blood stem cell transplantation (ABSCT) is an effective treatment for transplantation-eligible patients with systemic light chain (AL) amyloidosis. Whereas most centers use granulocyte colony-stimulating factor (G-CSF) alone for mobilization of peripheral blood stem cells (PBSC), the application of mobilization chemotherapy might offer specific advantages. We retrospectively analyzed 110 patients with AL amyloidosis who underwent PBSC collection. Major eligibility criteria included age <70 years and cardiac insufficiency New York Heart Association ≤III°. Before mobilization, 67 patients (61%) had been pretreated with induction therapy, including 17 (15%) patients who had received melphalan. Chemo-mobilization was performed with either cyclophosphamide, doxorubicin, dexamethasone (CAD)/G-CSF (n = 78, 71%); ifosfamide/G-CSF (n = 14, 13%); or other regimens (n = 8, 7%). AL amyloidosis patients with predominant heart involvement and/or status post heart transplantation were mobilized with G-CSF only (n = 10, 9%). PBSC collection was successful in 101 patients (92%) at first attempt. The median number of CD34+ cells was 8.7 (range, 2.1 to 45.5) × 106 CD34+/kg collected in a median of 1 leukapheresis (LP) session. Compared with G-CSF-only mobilization, a chemo-mobilization with CAD/G-CSF or ifosfamide/G-CSF had a positive impact on the number of collected CD34+ cell number/kg per LP (P <.001, multivariate). Melphalan-containing previous therapy and higher age had a significant negative impact on quantity of collected CD34+ cells. Median common toxicity criteria (CTC) grade of nonhematologic toxicity was II (range, 0 to IV). Life-threatening CTC grade IV adverse events were observed in 3 patients with no fatalities. Cardiovascular events were observed in 17 patients (22%) upon CAD/G-CSF mobilization (median CTC: grade 3; range, 1 to 4). Toxicity in patients undergoing ifosfamide/G-CSF mobilization was higher than in with those who received G-CSF-only mobilization. HDM and ABSCT were performed in 100 patients. Compared with >6.5 × 106 transplanted CD34+ cells/kg, an ABSCT with <3 × 106 CD34+ cells/kg was associated with a longer duration to leukocyte reconstitution >1 × 109/L and a reduced platelet count <150 × 109/L 1 year after ASCT. Our results show that CAD chemotherapy is very effective in PBSC mobilization and has a tolerable toxicity profile in AL amyloidosis patients. A further toxicity reduction by omission of doxorubicin might be considered. Because of advanced nonhematologic toxicity, ifosfamide administration cannot be recommended. However, G-CSF mobilization alone is also safe and effective. Considering the hematopoietic reconstitution and long-term stem cell function, our results provide a rationale to collect and transplant as many as >6.5 × 106 CD34+ cells/kg, if feasible with reasonable effort.
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Affiliation(s)
- Katharina Lisenko
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany
| | - Patrick Wuchter
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany; Institute of Transfusion Medicine and Immunology, German Red Cross Blood Service Baden-Württemberg-Hessen, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Marion Hansberg
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany
| | - Anja Mangatter
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany
| | - Axel Benner
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - Anthony D Ho
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany
| | - Hartmut Goldschmidt
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany; National Center for Tumor Diseases, University Hospital, Heidelberg, Germany
| | - Ute Hegenbart
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany; Amyloidosis Center, Heidelberg University, Germany.
| | - Stefan Schönland
- Department of Hematology, Oncology and Rheumatology, Heidelberg University, Germany; Amyloidosis Center, Heidelberg University, Germany
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49
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Lisenko K, Baertsch MA, Meiser R, Pavel P, Bruckner T, Kriegsmann M, Schmitt A, Witzens-Harig M, Ho AD, Hillengass J, Wuchter P. Comparison of biosimilar filgrastim, originator filgrastim, and lenograstim for autologous stem cell mobilization in patients with multiple myeloma. Transfusion 2017; 57:2359-2365. [PMID: 28653421 DOI: 10.1111/trf.14211] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 05/10/2017] [Accepted: 05/16/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Granulocyte-colony-stimulating factor (G-CSF) originators such as filgrastim (Neupogen) and lenograstim (Granocyte) are widely used for peripheral blood stem cell (PBSC) mobilization. In recent years, biosimilar agents have been approved for the same indications. The aim of this retrospective study was to compare the mobilization efficiency of the three G-CSF variants originator filgrastim, lenograstim, and the biosimilar Filgrastim Hexal in a homogeneous group of multiple myeloma (MM) patients in first-line therapy. STUDY DESIGN AND METHODS Overall mobilization data of 250 patients with MM were included. Of these patients, 74 (30%), 131 (52%), and 45 (18%) were mobilized with originator filgrastim, biosimilar Filgrastim Hexal, or lenograstim, respectively, at a dose of 5 to 10 µg/kg body weight subcutaneously starting from Day 5 after chemomobilization with CAD (cyclophosphamide, doxorubicin, dexamethasone) until completion of PBSC collection. RESULTS All but one patient reached the collection goal of a minimum of at least 2 × 106 CD34+ cells/kg body weight during a median of one (range, one to three) leukapheresis session. No significant differences in CD34+ mobilization and collection yields between the filgrastim-mobilized (median, 10.5; range, 2.7-40.4), Filgrastim Hexal-mobilized (median, 9.9; range, 0.2-26.0), and lenograstim-mobilized (median, 10.7; range, 3.1-27.9 CD34+ cells × 106 /kg body weight) patients were observed. CONCLUSION Concerning the clinically relevant efficiencies of PBSC mobilization and in terms of reaching the individual collection target, this retrospective study did not detect any significant differences between the three G-CSF variants in the analyzed patient cohort.
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Affiliation(s)
- Katharina Lisenko
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | | | - Renate Meiser
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Petra Pavel
- Stem Cell Laboratory, IKTZ Heidelberg GmbH, Heidelberg, Germany
| | - Thomas Bruckner
- Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Mark Kriegsmann
- Institute of Pathology, Heidelberg University, Heidelberg, Germany
| | - Anita Schmitt
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | | | - Anthony D Ho
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Jens Hillengass
- Department of Medicine V, Heidelberg University, Heidelberg, Germany
| | - Patrick Wuchter
- Institute of Transfusion Medicine and Immunology, Medical Faculty Mannheim, Heidelberg University, German Red Cross Blood Service Baden-Württemberg-Hessen, Mannheim, Germany
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50
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Zeisbrich M, Becker N, Benner A, Radujkovic A, Schmitt K, Beimler J, Ho AD, Zeier M, Dreger P, Luft T. Transplant-associated thrombotic microangiopathy is an endothelial complication associated with refractoriness of acute GvHD. Bone Marrow Transplant 2017. [PMID: 28650448 DOI: 10.1038/bmt.2017.119] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
There is increasing evidence that endothelial dysfunction is involved in refractoriness of acute GvHD (aGvHD). Here we investigated the hypothesis that another endothelial complication, transplant-associated thrombotic microangiopathy (TMA), contributes to the pathogenesis of aGvHD refractoriness. TMA was retrospectively assessed in 771 patients after allogeneic stem cell transplantation (alloSCT). Incidences of TMA and refractory aGvHD were correlated with biomarkers of endothelial damage obtained before alloSCT for patients receiving or not receiving statin-based endothelial prophylaxis (SEP). Diagnostic criteria for TMA and refractory aGvHD were met by 41 (5.3%) and 76 (10%) patients, respectively. TMA was overrepresented in patients with refractory aGvHD (45.0 vs 2.3% in all other patients, P<0.001). TMA independently increased mortality. Elevated pretransplant suppressor of tumorigenicity-2 and nitrates along with high-risk variants of the thrombomodulin gene were associated with increased risk of TMA. In contrast, SEP abolished the unfavorable outcome predicted by pretransplant biomarkers on TMA risk. Patients on SEP had a significantly lower risk of TMA (P=0.001) and refractory aGvHD (P=0.055) in a multivariate multistate model. Our data provide evidence that TMA contributes to the pathogenesis of aGvHD refractoriness. Patients with an increased TMA risk can be identified pretransplant and may benefit from pharmacological endothelium protection.
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Affiliation(s)
- M Zeisbrich
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - N Becker
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - A Benner
- Division of Biostatistics, German Cancer Research Center, Heidelberg, Germany
| | - A Radujkovic
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - K Schmitt
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - J Beimler
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - A D Ho
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - M Zeier
- Department of Nephrology, University of Heidelberg, Heidelberg, Germany
| | - P Dreger
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - T Luft
- Department of Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
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