1
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Lin WY, Fordham SE, Hungate E, Sunter NJ, Elstob C, Xu Y, Park C, Quante A, Strauch K, Gieger C, Skol A, Rahman T, Sucheston-Campbell L, Wang J, Hahn T, Clay-Gilmour AI, Jones GL, Marr HJ, Jackson GH, Menne T, Collin M, Ivey A, Hills RK, Burnett AK, Russell NH, Fitzgibbon J, Larson RA, Le Beau MM, Stock W, Heidenreich O, Alharbi A, Allsup DJ, Houlston RS, Norden J, Dickinson AM, Douglas E, Lendrem C, Daly AK, Palm L, Piechocki K, Jeffries S, Bornhäuser M, Röllig C, Altmann H, Ruhnke L, Kunadt D, Wagenführ L, Cordell HJ, Darlay R, Andersen MK, Fontana MC, Martinelli G, Marconi G, Sanz MA, Cervera J, Gómez-Seguí I, Cluzeau T, Moreilhon C, Raynaud S, Sill H, Voso MT, Lo-Coco F, Dombret H, Cheok M, Preudhomme C, Gale RE, Linch D, Gaal-Wesinger J, Masszi A, Nowak D, Hofmann WK, Gilkes A, Porkka K, Milosevic Feenstra JD, Kralovics R, Grimwade D, Meggendorfer M, Haferlach T, Krizsán S, Bödör C, Stölzel F, Onel K, Allan JM. Author Correction: Genome-wide association study identifies susceptibility loci for acute myeloid leukemia. Nat Commun 2022; 13:2. [PMID: 34983928 PMCID: PMC8727612 DOI: 10.1038/s41467-021-27679-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Wei-Yu Lin
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Sarah E Fordham
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Eric Hungate
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Nicola J Sunter
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Elstob
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Yaobo Xu
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Park
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Anne Quante
- Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Ludwig-Maximilians-Universität München, Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Munich, Germany
| | - Konstantin Strauch
- Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Ludwig-Maximilians-Universität München, Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Munich, Germany
| | - Christian Gieger
- Ludwig-Maximilians-Universität München, Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Munich, Germany
| | - Andrew Skol
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Thahira Rahman
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Junke Wang
- College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Theresa Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Alyssa I Clay-Gilmour
- Arnold School of Public Health, Department of Epidemiology & Biostatistics, University of South Carolina, Greenville, SC, USA
| | - Gail L Jones
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Helen J Marr
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Graham H Jackson
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Mathew Collin
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Adam Ivey
- Department of Medical and Molecular Genetics, King's College Medical School, London, UK
| | - Robert K Hills
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alan K Burnett
- Paul O'Gorman Leukaemia Research Centre, University of Glasgow, Glasgow, UK
| | - Nigel H Russell
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jude Fitzgibbon
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Richard A Larson
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Michelle M Le Beau
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Wendy Stock
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Olaf Heidenreich
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Abrar Alharbi
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - David J Allsup
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, Hull, UK
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Jean Norden
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Anne M Dickinson
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Elisabeth Douglas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Lendrem
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ann K Daly
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Palm
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - Kim Piechocki
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - Sally Jeffries
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - Martin Bornhäuser
- Department of Haematological Medicine, The Rayne Institute, King's College London, London, UK.,National Center for Tumor Diseases NCT, Partner site Dresden, Dresden, Germany.,Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Christoph Röllig
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Heidi Altmann
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Leo Ruhnke
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Desiree Kunadt
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Lisa Wagenführ
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Heather J Cordell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rebecca Darlay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mette K Andersen
- Department of Clinical Genetics, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Maria C Fontana
- Institute of Hematology "L. and A. Seràgnoli", University of Bologna, Bologna, Italy.,IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giovanni Martinelli
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giovanni Marconi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Miguel A Sanz
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - José Cervera
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Gómez-Seguí
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Thomas Cluzeau
- Hematology department, Cote d'Azur University, CHU of Nice, Nice, France
| | - Chimène Moreilhon
- Hematology department, Cote d'Azur University, CHU of Nice, Nice, France
| | - Sophie Raynaud
- Hematology department, Cote d'Azur University, CHU of Nice, Nice, France
| | - Heinz Sill
- Division of Hematology, Medical University of Graz, Graz, Austria
| | - Maria Teresa Voso
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Francesco Lo-Coco
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Hervé Dombret
- Hôpital Saint-Louis, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France
| | - Meyling Cheok
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, F-59000, Lille, France
| | - Claude Preudhomme
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, F-59000, Lille, France
| | - Rosemary E Gale
- Department of Haematology, University College London Cancer Institute, London, UK
| | - David Linch
- Department of Haematology, University College London Cancer Institute, London, UK
| | - Julia Gaal-Wesinger
- 1st Department of Internal Medicine, Semmewleis University, Budapest, Hungary
| | - Andras Masszi
- 3rd Department of Internal Medicine, Semmewleis University, Budapest, Hungary
| | - Daniel Nowak
- Department of Hematology and Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Amanda Gilkes
- Department of Haematology, University of Cardiff, Cardiff, UK
| | - Kimmo Porkka
- Helsinki University Hospital Comprehensive Cancer Center, Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland
| | | | - Robert Kralovics
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - David Grimwade
- Department of Medical and Molecular Genetics, King's College Medical School, London, UK
| | | | | | - Szilvia Krizsán
- HCEMM-SE Molecular Oncohematology Research Group, 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Friedrich Stölzel
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany.
| | - Kenan Onel
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - James M Allan
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
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2
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Lin WY, Fordham SE, Hungate E, Sunter NJ, Elstob C, Xu Y, Park C, Quante A, Strauch K, Gieger C, Skol A, Rahman T, Sucheston-Campbell L, Wang J, Hahn T, Clay-Gilmour AI, Jones GL, Marr HJ, Jackson GH, Menne T, Collin M, Ivey A, Hills RK, Burnett AK, Russell NH, Fitzgibbon J, Larson RA, Le Beau MM, Stock W, Heidenreich O, Alharbi A, Allsup DJ, Houlston RS, Norden J, Dickinson AM, Douglas E, Lendrem C, Daly AK, Palm L, Piechocki K, Jeffries S, Bornhäuser M, Röllig C, Altmann H, Ruhnke L, Kunadt D, Wagenführ L, Cordell HJ, Darlay R, Andersen MK, Fontana MC, Martinelli G, Marconi G, Sanz MA, Cervera J, Gómez-Seguí I, Cluzeau T, Moreilhon C, Raynaud S, Sill H, Voso MT, Lo-Coco F, Dombret H, Cheok M, Preudhomme C, Gale RE, Linch D, Gaal-Wesinger J, Masszi A, Nowak D, Hofmann WK, Gilkes A, Porkka K, Milosevic Feenstra JD, Kralovics R, Grimwade D, Meggendorfer M, Haferlach T, Krizsán S, Bödör C, Stölzel F, Onel K, Allan JM. Genome-wide association study identifies susceptibility loci for acute myeloid leukemia. Nat Commun 2021; 12:6233. [PMID: 34716350 PMCID: PMC8556284 DOI: 10.1038/s41467-021-26551-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 10/01/2021] [Indexed: 12/17/2022] Open
Abstract
Acute myeloid leukemia (AML) is a hematological malignancy with an undefined heritable risk. Here we perform a meta-analysis of three genome-wide association studies, with replication in a fourth study, incorporating a total of 4018 AML cases and 10488 controls. We identify a genome-wide significant risk locus for AML at 11q13.2 (rs4930561; P = 2.15 × 10-8; KMT5B). We also identify a genome-wide significant risk locus for the cytogenetically normal AML sub-group (N = 1287) at 6p21.32 (rs3916765; P = 1.51 × 10-10; HLA). Our results inform on AML etiology and identify putative functional genes operating in histone methylation (KMT5B) and immune function (HLA).
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Affiliation(s)
- Wei-Yu Lin
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Sarah E Fordham
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Eric Hungate
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Nicola J Sunter
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Claire Elstob
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Yaobo Xu
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Catherine Park
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Anne Quante
- Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Ludwig-Maximilians-Universität München, Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Munich, Germany
| | - Konstantin Strauch
- Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Ludwig-Maximilians-Universität München, Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Munich, Germany
| | - Christian Gieger
- Ludwig-Maximilians-Universität München, Chair of Genetic Epidemiology, IBE, Faculty of Medicine, Munich, Germany
| | - Andrew Skol
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Thahira Rahman
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | | | - Junke Wang
- College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Theresa Hahn
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Alyssa I Clay-Gilmour
- Arnold School of Public Health, Department of Epidemiology & Biostatistics, University of South Carolina, Greenville, USA
| | - Gail L Jones
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Helen J Marr
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Graham H Jackson
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Tobias Menne
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Mathew Collin
- Department of Haematology, Freeman Hospital, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, UK
| | - Adam Ivey
- Department of Medical and Molecular Genetics, King's College Medical School, London, UK
| | - Robert K Hills
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Alan K Burnett
- Paul O'Gorman Leukaemia Research Centre, University of Glasgow, Glasgow, UK
| | - Nigel H Russell
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jude Fitzgibbon
- Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Richard A Larson
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Michelle M Le Beau
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Wendy Stock
- Section of Pediatric Hematology and Oncology, University of Chicago, Chicago, IL, USA
| | - Olaf Heidenreich
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Abrar Alharbi
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - David J Allsup
- Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, Hull, UK
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Jean Norden
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Anne M Dickinson
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Elisabeth Douglas
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Lendrem
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ann K Daly
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Louise Palm
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - Kim Piechocki
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - Sally Jeffries
- West Midlands Regional Genetics Laboratory, Birmingham Women's Hospital, Birmingham, UK
| | - Martin Bornhäuser
- Department of Haematological Medicine, The Rayne Institute, King's College London, London, UK
- National Center for Tumor Diseases NCT, Partner site Dresden, Dresden, Germany
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Christoph Röllig
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Heidi Altmann
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Leo Ruhnke
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Desiree Kunadt
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Lisa Wagenführ
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany
| | - Heather J Cordell
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Rebecca Darlay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Mette K Andersen
- Department of Clinical Genetics, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Maria C Fontana
- Institute of Hematology "L. and A. Seràgnoli", University of Bologna, Bologna, Italy
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giovanni Martinelli
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Giovanni Marconi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Miguel A Sanz
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - José Cervera
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Inés Gómez-Seguí
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Thomas Cluzeau
- Hematology department, Cote d'Azur University, CHU of Nice, Nice, France
| | - Chimène Moreilhon
- Hematology department, Cote d'Azur University, CHU of Nice, Nice, France
| | - Sophie Raynaud
- Hematology department, Cote d'Azur University, CHU of Nice, Nice, France
| | - Heinz Sill
- Division of Hematology, Medical University of Graz, Graz, Austria
| | - Maria Teresa Voso
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Francesco Lo-Coco
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Hervé Dombret
- Hôpital Saint-Louis, Institut Universitaire d'Hématologie, Université Paris Diderot, Paris, France
| | - Meyling Cheok
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, F-59000, Lille, France
| | - Claude Preudhomme
- Univ. Lille, Inserm, CHU Lille, UMR-S 1172 - JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer, F-59000, Lille, France
| | - Rosemary E Gale
- Department of Haematology, University College London Cancer Institute, London, UK
| | - David Linch
- Department of Haematology, University College London Cancer Institute, London, UK
| | - Julia Gaal-Wesinger
- 1st Department of Internal Medicine, Semmewleis University, Budapest, Hungary
| | - Andras Masszi
- 3rd Department of Internal Medicine, Semmewleis University, Budapest, Hungary
| | - Daniel Nowak
- Department of Hematology and Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Amanda Gilkes
- Department of Haematology, University of Cardiff, Cardiff, UK
| | - Kimmo Porkka
- Helsinki University Hospital Comprehensive Cancer Center, Hematology Research Unit Helsinki, University of Helsinki, Helsinki, Finland
| | | | - Robert Kralovics
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - David Grimwade
- Department of Medical and Molecular Genetics, King's College Medical School, London, UK
| | | | | | - Szilvia Krizsán
- HCEMM-SE Molecular Oncohematology Research Group, 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Friedrich Stölzel
- Medizinische Klinik und Poliklinik I, University Hospital Carl Gustav Carus Dresden, Technical University of Dresden, Dresden, Germany.
| | - Kenan Onel
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - James M Allan
- Translational and Clinical Research Institute, Newcastle University Centre for Cancer, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
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3
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Cicconi L, Testi AM, Montesinos P, Rego E, Zhu HH, Takahashi H, Dworzak M, Estey E, Schwarer A, Esteve J, Annibali O, Castelli R, Mirabile M, Angelini M, Lazarevic V, Kumar J, Avvisati G, Gurnari C, Locatelli F, Voso MT, Sanz MA, Lo-Coco F, Abla O. Characteristics and outcome of acute myeloid leukemia with uncommon retinoic acid receptor-alpha (RARA) fusion variants. Blood Cancer J 2021; 11:167. [PMID: 34657125 PMCID: PMC8520532 DOI: 10.1038/s41408-021-00561-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 02/16/2021] [Revised: 06/03/2021] [Accepted: 06/16/2021] [Indexed: 01/09/2023] Open
Affiliation(s)
- Laura Cicconi
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy. .,UOSD Ematologia, ASL Roma 1, Rome, Italy.
| | - Anna Maria Testi
- Department of Translational and Precision Medicine and Hematology, 'Sapienza' University, Rome, Italy
| | - Pau Montesinos
- Department of Hematology, Hospital Universitari i Politècnico la Fe, València, Spain
| | - Eduardo Rego
- Department of Internal Medicine, Medical School of Ribeirao Preto, Ribeirao Preto, Brazil
| | - Hong Hu Zhu
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | | | - Michael Dworzak
- Children's Cancer Research Institute and St Anna Children's Hospital, Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Elihu Estey
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Anthony Schwarer
- Department of Hematology and Oncology, Eastern School, Monash University, Melbourne, VIC, Australia
| | - Jordi Esteve
- Servicio de Hematología, Instituto Clínic de Enfermedades Hematológicas y Oncológicas, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ombretta Annibali
- Hematology and Stem Cells Transplantation Unit, University Campus Bio-Medico, Rome, Italy
| | - Roberto Castelli
- Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Luigi Sacco Hospital, Milano, Italy
| | - Milena Mirabile
- HematologyUnit, Ospedale di Civitanova Marche, Macerata, Italy
| | | | - Vladimir Lazarevic
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Jeevan Kumar
- Department of Clinical Haematology and BMT Tata Medical Center, Kolkata, India
| | - Giuseppe Avvisati
- Hematology and Stem Cells Transplantation Unit, University Campus Bio-Medico, Rome, Italy
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Franco Locatelli
- Department of Pediatric Hematology/Oncology, IRCCS Ospedale Pediatrico Bambino Gesu, Rome, Italy.,Department of Pediatrics, Sapienza, University of Rome, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Miguel Angel Sanz
- Department of Hematology, Hospital Universitari i Politècnico la Fe, València, Spain
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Oussama Abla
- Division of Hematology/Oncology, Department of Pediatrics, the Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
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4
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Fabiani E, Cicconi L, Nardozza AM, Cristiano A, Rossi M, Ottone T, Falconi G, Divona M, Testi AM, Annibali O, Castelli R, Lazarevic V, Rego E, Montesinos P, Esteve J, Venditti A, Della Porta M, Arcese W, Lo-Coco F, Voso MT. Mutational profile of ZBTB16-RARA-positive acute myeloid leukemia. Cancer Med 2021; 10:3839-3847. [PMID: 34042280 PMCID: PMC8209618 DOI: 10.1002/cam4.3904] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/02/2021] [Accepted: 03/28/2021] [Indexed: 12/31/2022] Open
Abstract
Background The ZBTB16‐RARA fusion gene, resulting from the reciprocal translocation between ZBTB16 on chromosome 11 and RARA genes on chromosome 17 [t(11;17)(q23;q21)], is rarely observed in acute myeloid leukemia (AML), and accounts for about 1% of retinoic acid receptor‐α (RARA) rearrangements. AML with this rare translocation shows unusual bone marrow (BM) morphology, with intermediate aspects between acute promyelocytic leukemia (APL) and AML with maturation. Patients may have a high incidence of disseminated intravascular coagulation at diagnosis, are poorly responsive to all‐trans retinoic acid (ATRA) and arsenic tryoxyde, and are reported to have an overall poor prognosis. Aims The mutational profile of ZBTB16‐RARA rearranged AML has not been described so far. Materials and methods We performed targeted next‐generation sequencing of 24 myeloid genes in BM diagnostic samples from seven ZBTB16‐RARA+AML, 103 non‐RARA rearranged AML, and 46 APL. The seven ZBTB16‐RARA‐positive patients were then screened for additional mutations using whole exome sequencing (n = 3) or an extended cancer panel including 409 genes (n = 4). Results ZBTB16‐RARA+AML showed an intermediate number of mutations per patient and involvement of different genes, as compared to APL and other AMLs. In particular, we found a high incidence of ARID1A mutations in ZBTB16‐RARA+AML (five of seven cases, 71%). Mutations in ARID2 and SMARCA4, other tumor suppressor genes also belonging to SWI/SNF chromatin remodeling complexes, were also identified in one case (14%). Discussion and conclusion Our data suggest the association of mutations of the ARID1A gene and of the other members of the SWI/SNF chromatin remodeling complexes with ZBTB16‐RARA+AMLs, where they may support the peculiar disease phenotype.
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Affiliation(s)
- Emiliano Fabiani
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy.,UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Laura Cicconi
- Unit of Hematology, Santo Spirito Hospital, Rome, Italy
| | - Anna Maria Nardozza
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Antonio Cristiano
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Marianna Rossi
- Cancer Center - IRCCS Humanitas Clinical & Research Hospital and Humanitas University, Milan, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Giulia Falconi
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Anna Maria Testi
- Department of Translational and Precision Medicine and Hematology, Sapienza University, Rome, Italy
| | - Ombretta Annibali
- Hematology and Stem Cell Transplantation Unit, University Campus Biomedico, Rome, Italy
| | - Roberto Castelli
- Department of Biomedical and Clinical Sciences, Luigi Sacco Hospital, Milan, Italy
| | - Vladimir Lazarevic
- Department of Hematology, Oncology and Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Eduardo Rego
- Department of Internal Medicine, Medical School of Ribeirao Preto, Sau Paulo, Brazil
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnico la Fe, Valencia, Spain
| | - Jordi Esteve
- Department of Hematology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Adriano Venditti
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Matteo Della Porta
- Cancer Center - IRCCS Humanitas Clinical & Research Hospital and Humanitas University, Milan, Italy
| | - William Arcese
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy
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5
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Travaglini S, Angelini DF, Alfonso V, Guerrera G, Lavorgna S, Divona M, Nardozza AM, Consalvo MI, Fabiani E, De Bardi M, Neri B, Forghieri F, Marchesi F, Paterno G, Cerretti R, Barragan E, Fiori V, Dominici S, Del Principe MI, Venditti A, Battistini L, Arcese W, Lo-Coco F, Voso MT, Ottone T. Characterization of FLT3-ITD mut acute myeloid leukemia: molecular profiling of leukemic precursor cells. Blood Cancer J 2020; 10:85. [PMID: 32843624 PMCID: PMC7447750 DOI: 10.1038/s41408-020-00352-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 12/17/2022] Open
Abstract
Acute myeloid leukemia (AML) with FLT3-ITD mutations (FLT3-ITDmut) remains a therapeutic challenge, with a still high relapse rate, despite targeted treatment with tyrosine kinase inhibitors. In this disease, the CD34/CD123/CD25/CD99+ leukemic precursor cells (LPCs) phenotype predicts for FLT3-ITD-positivity. The aim of this study was to characterize the distribution of FLT3-ITD mutation in different progenitor cell subsets to shed light on the subclonal architecture of FLT3-ITDmut AML. Using high-speed cell sorting, we sequentially purified LPCs and CD34+ progenitors in samples from patients with FLT3-ITDmut AML (n = 12). A higher FLT3-ITDmut load was observed within CD34/CD123/CD25/CD99+ LPCs, as compared to CD34+ progenitors (CD123+/-,CD25-,CD99low/-) (p = 0.0005) and mononuclear cells (MNCs) (p < 0.0001). This was associated with significantly increased CD99 mean fluorescence intensity in LPCs. Significantly higher FLT3-ITDmut burden was also observed in LPCs of AML patients with a small FLT3-ITDmut clones at diagnosis. On the contrary, the mutation burden of other myeloid genes was similar in MNCs, highly purified LPCs and/or CD34+ progenitors. Treatment with an anti-CD99 mAb was cytotoxic on LPCs in two patients, whereas there was no effect on CD34+ cells from healthy donors. Our study shows that FLT3-ITD mutations occur early in LPCs, which represent the leukemic reservoir. CD99 may represent a new therapeutic target in FLT3-ITDmut AML.
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Affiliation(s)
- Serena Travaglini
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | | | - Valentina Alfonso
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Gisella Guerrera
- Santa Lucia Foundation, I.R.C.C.S., Neuro-Oncohematology, Rome, Italy
| | - Serena Lavorgna
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Anna Maria Nardozza
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Maria Irno Consalvo
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Emiliano Fabiani
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Marco De Bardi
- Santa Lucia Foundation, I.R.C.C.S., Neuro-Oncohematology, Rome, Italy
| | - Benedetta Neri
- Ematologia, Ospedale S. Eugenio, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Fabio Forghieri
- University of Modena and Reggio Emilia, Azienda Ospedaliera di Modena, Modena, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Raffaella Cerretti
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Eva Barragan
- Hospital Universitari i Politècnic La Fe, Valencia, Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain
| | - Valentina Fiori
- Diatheva srl, via Sant'Anna 131, 61030, Cartoceto, (PU), Italy
| | | | | | - Adriano Venditti
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Luca Battistini
- Santa Lucia Foundation, I.R.C.C.S., Neuro-Oncohematology, Rome, Italy
| | - William Arcese
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy.
- Santa Lucia Foundation, I.R.C.C.S., Neuro-Oncohematology, Rome, Italy.
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
- Santa Lucia Foundation, I.R.C.C.S., Neuro-Oncohematology, Rome, Italy
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6
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Gurnari C, Breccia M, Di Giuliano F, Scalzulli E, Divona M, Piciocchi A, Cicconi L, De Bellis E, Venditti A, Del Principe MI, Arcese W, Lo-Coco F, Garaci F, Voso MT. Early intracranial haemorrhages in acute promyelocytic leukaemia: analysis of neuroradiological and clinico-biological parameters. Br J Haematol 2020; 193:129-132. [PMID: 32808672 DOI: 10.1111/bjh.17018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022]
Abstract
Acute promyelocytic leukaemia (APL) represents a modern success of precision medicine. However, fatalities occurring within the first 30 days of induction treatment, in particular intracranial haemorrhage (ICH), remain the main causes of death. We studied the clinico-biological characteristics of 13 patients with APL who experienced ICH. Compared to 85 patients without this complication, patients with ICH were older and more frequently had high-risk APL. Moreover, positivity for the 'swirl' sign at neuroradiological imaging and hydrocephalus were predictors of a fatal outcome, together with lower fibrinogen, prolonged international normalized ratio (INR) and higher lactate dehydrogenase levels.
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Affiliation(s)
- Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Breccia
- Department of Translational and Precision Medicine, University 'La Sapienza' of Rome, Rome, Italy
| | - Francesca Di Giuliano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Emilia Scalzulli
- Department of Translational and Precision Medicine, University 'La Sapienza' of Rome, Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Saint Camillus International, University of Health Sciences, Rome, Italy
| | | | - Laura Cicconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Eleonora De Bellis
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Adriano Venditti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - William Arcese
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Preventio, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Cassino, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratorio di Neuro-Oncoematologia, Fondazione Santa Lucia, Rome, Italy
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7
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Banella C, Catalano G, Travaglini S, Divona M, Masciarelli S, Guerrera G, Fazi F, Lo-Coco F, Voso MT, Noguera NI. PML/RARa Interferes with NRF2 Transcriptional Activity Increasing the Sensitivity to Ascorbate of Acute Promyelocytic Leukemia Cells. Cancers (Basel) 2019; 12:cancers12010095. [PMID: 31905996 PMCID: PMC7016898 DOI: 10.3390/cancers12010095] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 12/27/2019] [Indexed: 12/30/2022] Open
Abstract
NRF2 (NF-E2 p45-related factor 2) orchestrates cellular adaptive responses to stress. Its quantity and subcellular location is controlled through a complex network and its activity increases during redox perturbation, inflammation, growth factor stimulation, and energy fluxes. Even before all-trans retinoic acid (ATRA) treatment era it was a common experience that acute promyelocytic leukemia (APL) cells are highly sensitive to first line chemotherapy. Since we demonstrated how high doses of ascorbate (ASC) preferentially kill leukemic blast cells from APL patients, we aimed to define the underlying mechanism and found that promyelocytic leukemia/retinoic acid receptor α (PML/RARa) inhibits NRF2 function, impedes its transfer to the nucleus and enhances its degradation in the cytoplasm. Such loss of NRF2 function alters cell metabolism, demarcating APL tissue from both normal promyelocytes and other acute myeloide leukemia (AML) blast cells. Resistance to ATRA/arsenic trioxide (ATO) treatment is rare but grave and the metabolically-oriented treatment with high doses of ASC, which is highly effective on APL cells and harmless on normal hematopoietic stem cells (HSCs), could be of use in preventing clonal evolution and in rescuing APL-resistant patients.
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Affiliation(s)
- Cristina Banella
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; (C.B.); (G.C.); (S.T.); (F.L.-C.); (M.T.V.)
- Neuro-Oncohematology Unit, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00143 Rome, Italy
| | - Gianfranco Catalano
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; (C.B.); (G.C.); (S.T.); (F.L.-C.); (M.T.V.)
- Neuro-Oncohematology Unit, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00143 Rome, Italy
| | - Serena Travaglini
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; (C.B.); (G.C.); (S.T.); (F.L.-C.); (M.T.V.)
| | | | - Silvia Masciarelli
- Istituto di Istologia ed Embriologia, Universita Cattolica del Sacro Cuore, 00168 Rome, Italy;
- Fondazione Policlinico Universitario A. Gemelli, I.R.C.C.S., 00168 Rome, Italy
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, 00161 Rome, Italy;
| | - Gisella Guerrera
- Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia I.R.C.C.S., 00143 Rome, Italy;
| | - Francesco Fazi
- Department of Anatomical, Histological, Forensic & Orthopedic Sciences, Sapienza University of Rome, Laboratory Affiliated to Istituto Pasteur Italia-Fondazione Cenci Bolognetti, 00161 Rome, Italy;
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; (C.B.); (G.C.); (S.T.); (F.L.-C.); (M.T.V.)
- Neuro-Oncohematology Unit, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00143 Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; (C.B.); (G.C.); (S.T.); (F.L.-C.); (M.T.V.)
- Neuro-Oncohematology Unit, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00143 Rome, Italy
| | - Nelida Ines Noguera
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, 00133 Rome, Italy; (C.B.); (G.C.); (S.T.); (F.L.-C.); (M.T.V.)
- Neuro-Oncohematology Unit, Fondazione Santa Lucia, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), 00143 Rome, Italy
- Correspondence: ; Tel.: +39-065-0170-3214; Fax: +39-065-0170-3318
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8
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Falconi G, Fabiani E, Ottone T, Piciocchi A, Lavorgna S, Criscuolo M, Fianchi L, Gurnari C, Postorino M, Picardi A, Palmieri R, Lo-Coco F, Voso MT. WT1 evaluation in higher-risk myelodysplastic syndrome patients treated with azacitidine. Leuk Lymphoma 2019; 61:979-982. [PMID: 31797711 DOI: 10.1080/10428194.2019.1699078] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Giulia Falconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Emiliano Fabiani
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratorio di Neuro-Oncoematologia, Fondazione Santa Lucia, Rome, Italy
| | | | - Serena Lavorgna
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Marianna Criscuolo
- Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma
| | - Luana Fianchi
- Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Alessandra Picardi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Raffaele Palmieri
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratorio di Neuro-Oncoematologia, Fondazione Santa Lucia, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratorio di Neuro-Oncoematologia, Fondazione Santa Lucia, Rome, Italy
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9
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Cicconi L, Platzbecker U, Avvisati G, Paoloni F, Thiede C, Vignetti M, Fazi P, Ferrara F, Divona M, Albano F, Efficace F, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Annibali O, Wattad M, Lubbert M, Brandts CH, Hanel M, Rollig C, Schmitz N, Link H, Frairia C, Fozza C, Maria D'Arco A, Di Renzo N, Cortelezzi A, Fabbiano F, Dohner K, Ganser A, Dohner H, Amadori S, Mandelli F, Voso MT, Ehninger G, Schlenk RF, Lo-Coco F. Long-term results of all-trans retinoic acid and arsenic trioxide in non-high-risk acute promyelocytic leukemia: update of the APL0406 Italian-German randomized trial. Leukemia 2019; 34:914-918. [PMID: 31611624 DOI: 10.1038/s41375-019-0589-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/31/2019] [Accepted: 08/13/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Laura Cicconi
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | | | - Giuseppe Avvisati
- Ematologia e Trapianto di cellule staminali, Università Campus Bio-Medico, Rome, Italy
| | | | - Christian Thiede
- Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Germany
| | | | | | - Felicetto Ferrara
- Dipartimento di Ematologia e Trapianto di Cellule Staminali, Ospedale Cardarelli, Napoli, Italy
| | | | | | | | | | - Eros Di Bona
- Dipartimento di Terapie cellulari ed Ematologia, Unità Operativa di Ematologia, Ospedale S. Bortolo, Vicenza, Italy
| | - Massimo Breccia
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Università La Sapienza, Rome, Italy
| | | | - Roberto Cairoli
- Grande Ospedale Metropolitano Niguarda, SC Ematologia, Milan, Italy
| | | | - Lorella Melillo
- Casa Sollievo della Sofferenza Hospital, IRCCS, San Giovanni Rotondo, Italy
| | - Giorgio La Nasa
- Centro Trapianti Midollo Osseo, Ospedale R. Binaghi, Università di Cagliari, Cagliari, Italy
| | | | - Peter Brossart
- Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, CIO Bonn, Bonn, Germany
| | | | | | - Ombretta Annibali
- Ematologia e Trapianto di cellule staminali, Università Campus Bio-Medico, Rome, Italy
| | | | | | | | | | - Christoph Rollig
- Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Germany
| | | | - Hartmut Link
- Klinik für Innere Medizin I, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Chiara Frairia
- Città della Salute e della Scienza, Hematology, Torino, Italy
| | | | - Alfonso Maria D'Arco
- U.O. Medicina Interna e Onco-Ematologica P.O. Umberto I, Nocera Inferiore, Nocera Inferiore, Italy
| | | | - Agostino Cortelezzi
- Foundation Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Francesco Fabbiano
- Divisione di Ematologia e Unità di Trapianti di Midollo Osseo, Ospedale Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | | | | | | | | | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy. .,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Roma, Italy.
| | - Gerhard Ehninger
- Universitätsklinikum Carl Gustav Carus der Technischen Universität, Dresden, Germany
| | - Richard F Schlenk
- NCT Trial Center, National Center for Tumor Diseases Heidelberg, Heidelberg, Germany
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy.,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Roma, Italy
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10
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Falconi G, Fabiani E, Criscuolo M, Fianchi L, Finelli C, Cerqui E, Pelosi E, Screnci M, Gurnari C, Zangrilli I, Postorino M, Laurenti L, Piciocchi A, Testa U, Lo-Coco F, Voso MT. Transcription factors implicated in late megakaryopoiesis as markers of outcome after azacitidine and allogeneic stem cell transplantation in myelodysplastic syndrome. Leuk Res 2019; 84:106191. [DOI: 10.1016/j.leukres.2019.106191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/25/2019] [Accepted: 07/14/2019] [Indexed: 01/07/2023]
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11
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Voso MT, Ottone T, Lavorgna S, Venditti A, Maurillo L, Lo-Coco F, Buccisano F. MRD in AML: The Role of New Techniques. Front Oncol 2019; 9:655. [PMID: 31396481 PMCID: PMC6664148 DOI: 10.3389/fonc.2019.00655] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [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: 01/17/2019] [Accepted: 07/04/2019] [Indexed: 11/17/2022] Open
Abstract
In the context of precision medicine, assessment of minimal residual disease (MRD) has been used in acute myeloid leukemia (AML) to direct individual treatment programs, including allogeneic stem cell transplantation in patients at high-risk of relapse. One of the limits of this approach has been in the past the paucity of AML markers suitable for MRD assessment. Recently, the number of biomarkers has increased, due to the identification of highly specific leukemia-associated immunophenotypes by multicolor flow-cytometry, and of rare mutated gene sequences by digital droplet PCR, or next-generation sequencing (NGS). In addition, NGS allowed unraveling of clonal heterogeneity, present in AML at initial diagnosis or developing during treatment, which influences reliability of specific biomarkers, that may be unstable during the disease course. The technological advances have increased the application of MRD-based strategies to a significantly higher number of AML patients, and the information deriving from MRD assessment has been used to design individual post-remission protocols and pre-emptive treatments in patients with sub-clinical relapse. This led to the definition of MRD-negative complete remission as outcome definition in the recently published European Leukemianet MRD guidelines. In this review, we summarized the principles of modern technologies and their clinical applications for MRD detection in AML patients, according to the specific leukemic markers.
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Affiliation(s)
- Maria Teresa Voso
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
- Santa Lucia Foundation, IRCCS, Neuro-Oncohematology, Rome, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
- Santa Lucia Foundation, IRCCS, Neuro-Oncohematology, Rome, Italy
| | - Serena Lavorgna
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Adriano Venditti
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Luca Maurillo
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
| | - Francesco Buccisano
- Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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12
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Döhner K, Thiede C, Jahn N, Ekaterina P, Gambietz A, Prior T, Marcucci G, Jones D, Krauter J, Michael H, Lo-Coco F, Ottone T, Nomdedeu J, Mandrekar S, Huebner L, Laumann K, Geyer S, Klisovic R, Wei A, Sierra J, Sanz M, Brandwein J, de Witte T, Jansen J, Niederwieser D, Appelbaum F, Medeiros B, Tallman M, Schlenk R, Ganser A, Serve H, Ehninger G, Amadori S, Gathmann I, Axel B, Pallaud C, Larson R, Stone R, Döhner H, Bloomfield C. PF260 PROGNOSTIC AND PREDICTIVE IMPACT OF NPM1/FLT3-ITD GENOTYPES AS DEFINED BY 2017 EUROPEAN LEUKEMIANET RISK CATEGORIZATION FROM AML PATIENTS TREATED WITHIN THE INTERNATIONAL RATIFY STUDY. Hemasphere 2019. [DOI: 10.1097/01.hs9.0000559252.96061.3e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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13
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Efficace F, Breccia M, Avvisati G, Cottone F, Intermesoli T, Borlenghi E, Carluccio P, Rodeghiero F, Fabbiano F, Luppi M, Romani C, Sborgia M, D'Ardia S, Nobile F, Cantore N, Crugnola M, Nadali G, Amadori S, Vignetti M, Lo-Coco F. Fatigue in long-term survivors of acute promyelocytic leukemia (APL) and its association with other symptoms and functional limitations. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e23073] [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
e23073 Background: Despite cancer survivorship research for patients with solid tumours is increasing, there is paucity of data for patients with hematologic malignancies. We aimed to: 1) investigate factors associated with development of fatigue in long-term APL survivors; 2) describe prevalence of other key symptoms and functional limitations by fatigue severity. Methods: The current analysis is based on 244 APL survivors with a median follow-up from diagnosis of 14.3 years, who were recruited in a large multicenter study. Fatigue was evaluated with the validated FACIT-Fatigue scale. Multivariate linear regression analysis was used to investigate factors associated with self-reported fatigue and key clinical and treatment-related variables were also considered in the analysis. Patients were also divided into two groups based on the FACIT-Fatigue median score identifying a low fatigue (LF) and a high fatigue (HF) group. Prevalence (i.e., not present, mild and moderate to severe) of key symptoms and functional limitations, measured with the EORTC QLQ-C30, were also analyzed by fatigue severity. Results: Multivariate analysis showed that a lower age at diagnosis (p = .002), absence of comorbidities (p = .001) and a greater social support (p = .004) were independently associated with lower fatigue. Patients in the HF group had a significantly higher prevalence of many symptoms, including: pain (p < .001), dyspnea (p < .001), insomnia (p < .001), appetite loss (p = .010), nausea and vomiting (p = .026) and diarrhea (p = .002) than patients in the LF group. As an example, whilst in the HF group there were 61% of patients also reporting pain (with any level of concern), in the LF group there were only 26% of patients reporting pain. Also, HF patients reported a significantly higher prevalence of functional limitations including: physical, role, social, emotional and cognitive functioning (each with p < .001). Conclusions: Our data provides novel information of factors that are independently associated with fatigue severity in long-term APL survivors. Greater fatigue is also associated with a substantial burden of other symptoms and functional limitations.
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Affiliation(s)
- Fabio Efficace
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Massimo Breccia
- Department of Cellular Biotechnologies and Hematology, “Sapienza” University of Rome, Rome, Italy
| | - Giuseppe Avvisati
- Hematology and Stem Cell Transplantation Unit, University Campus Bio-Medico, Roma, Italy
| | - Francesco Cottone
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Tamara Intermesoli
- University of Milan, Hematology and BMT Unit, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Erika Borlenghi
- Department of Hematology, ASST Spedali Civili, Brescia, Italy
| | - Paola Carluccio
- Hematology Section, Department of Emergency and Organ Transplantation (DETO), University of Bari, Bari, Italy
| | | | - Francesco Fabbiano
- Division of Hematology and Bone Marrow Transplantation, Ospedali Riuniti Villa Sofia - Cervello, Palermo, Italy
| | - Mario Luppi
- Department Medical and Surgical Sciences Section of Hematology Azienda Ospedaliero-Universitaria Policlinico University of Modena and Reggio Emilia, Modena, Italy
| | - Claudio Romani
- U.O. Ematologia e Centro TMO, Ospedale Armando Businco, Cagliari, Italy
| | - Marco Sborgia
- Department of Hematology, Bone Marrow Transplant Center, Pescara, Italy
| | - Stefano D'Ardia
- Division of Hematology, Città della Salute e della Scienza Hospital, Torino, Italy
| | - Francesco Nobile
- Hematology Unit, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Nicola Cantore
- Hematology and Hematopoietic Transplantation Unit, San G. Moscati Hospital, Avellino, Italy
| | | | - Gianpaolo Nadali
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Sergio Amadori
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Marco Vignetti
- Italian Group for Adult Hematologic Diseases (GIMEMA), Data Center and Health Outcomes Research Unit, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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14
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Mugoni V, Panella R, Cheloni G, Chen M, Pozdnyakova O, Stroopinsky D, Guarnerio J, Monteleone E, Lee JD, Mendez L, Menon AV, Aster JC, Lane AA, Stone RM, Galinsky I, Zamora JC, Lo-Coco F, Bhasin MK, Avigan D, Longo L, Clohessy JG, Pandolfi PP. Vulnerabilities in mIDH2 AML confer sensitivity to APL-like targeted combination therapy. Cell Res 2019; 29:446-459. [PMID: 31024166 DOI: 10.1038/s41422-019-0162-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 03/12/2019] [Indexed: 12/14/2022] Open
Abstract
Although targeted therapies have proven effective and even curative in human leukaemia, resistance often ensues. IDH enzymes are mutated in ~20% of human AML, with targeted therapies under clinical evaluation. We here characterize leukaemia evolution from mutant IDH2 (mIDH2)-dependence to independence identifying key targetable vulnerabilities of mIDH2 leukaemia that are retained during evolution and progression from early to late stages. Mechanistically, we find that mIDH2 leukaemia are metastable and vulnerable at two distinct levels. On the one hand, they are characterized by oxidative and genotoxic stress, in spite of increased 1-carbon metabolism and glutathione levels. On the other hand, mIDH2 leukaemia display inhibition of LSD1 and a resulting transcriptional signature of all-trans retinoic acid (ATRA) sensitization, in spite of a state of suppressed ATRA signalling due to increased levels of PIN1. We further identify GSH/ROS and PIN1/LSD1 as critical nodes for leukaemia maintenance and the combination of ATRA and arsenic trioxide (ATO) as a key therapeutic modality to target these vulnerabilities. Strikingly, we demonstrate that the combination of ATRA and ATO proves to be a powerfully synergistic and effective therapy in a number of mouse and human mIDH1/2 leukemic models. Thus, our findings pave the way towards the treatment of a sizable fraction of human AMLs through targeted APL-like combinatorial therapies.
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Affiliation(s)
- Vera Mugoni
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Riccardo Panella
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Giulia Cheloni
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Ming Chen
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Olga Pozdnyakova
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Dina Stroopinsky
- Division of Hematology and Hematologic Malignancies, Department of Medicine, Beth Israel Deaconess Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jlenia Guarnerio
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Emanuele Monteleone
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA.,Molecular Biotechnology Center and Department of Molecular Biotechnology and Health Sciences, University of Turin, Via Nizza 52, 10126, Turin, Italy
| | - Jonathan David Lee
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Lourdes Mendez
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Archita Venugopal Menon
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - Jon Christopher Aster
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Andrew A Lane
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Richard Maury Stone
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Ilene Galinsky
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - José Cervera Zamora
- Biobanco La Fe - Instituto de Investigation Sanitaria La Fe (IIS-LA FE), Avda. de Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - Manoj Kumar Bhasin
- Division of IMBIO, Department of Medicine, BIDMC Genomics, Proteomics, Bioinformatics and Systems Biology Center, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David Avigan
- Division of Hematology and Hematologic Malignancies, Department of Medicine, Beth Israel Deaconess Cancer Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Letizia Longo
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA
| | - John Gerard Clohessy
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA.,Preclinical Murine Pharmacogenetics Core, Beth Israel Deaconess Cancer Center, Dana Farber/Harvard Cancer Center, Boston, USA
| | - Pier Paolo Pandolfi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center; Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Ludwig Center at Harvard, Harvard Medical School, Boston, MA, USA.
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15
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Faraoni I, Giansanti M, Voso MT, Lo-Coco F, Graziani G. Targeting ADP-ribosylation by PARP inhibitors in acute myeloid leukaemia and related disorders. Biochem Pharmacol 2019; 167:133-148. [PMID: 31028744 DOI: 10.1016/j.bcp.2019.04.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/16/2019] [Indexed: 12/17/2022]
Abstract
Acute myeloid leukaemia (AML) is a highly heterogeneous disease characterized by uncontrolled proliferation, block in myeloid differentiation and recurrent genetic abnormalities. In the search of new effective therapies, identification of synthetic lethal partners of AML genetic alterations might represent a suitable approach to tailor patient treatment. Genetic mutations directly affecting DNA repair genes are not commonly present in AML. Nevertheless, several studies indicate that AML cells show high levels of DNA lesions and genomic instability. Leukaemia-driving oncogenes (e.g., RUNX1-RUNXT1, PML-RARA, TCF3-HLF, IDH1/2, TET2) or treatment with targeted agents directed against aberrant kinases (e.g., JAK1/2 and FLT3 inhibitors) have been associated with reduced DNA repair gene expression/activity that would render leukaemia blasts selectively sensitive to synthetic lethality induced by poly(ADP-ribose) polymerase inhibitors (PARPi). Thus, specific oncogenic chimeric proteins or gene mutations, rare or typically distinctive of certain leukaemia subtypes, may allow tagging cancer cells for destruction by PARPi. In this review, we will discuss the rationale for using PARPi in AML subtypes characterized by a specific genetic background and summarize the preclinical and clinical evidence reported so far on their activity when used as single agents or in combination with classical cytotoxic chemotherapy or with agents targeting AML-associated mutated proteins.
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Affiliation(s)
- Isabella Faraoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
| | - Manuela Giansanti
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy; Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Unit of Neuro-Oncohematology, Santa Lucia Foundation-I.R.C.C.S., Rome, Italy
| | - Grazia Graziani
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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16
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Gurnari C, Lombardi AM, Cosi E, Biagetti G, Buccisano F, Franceschini L, Di Veroli A, Falconi G, Fabiani E, Cantonetti M, Nasso D, Lo-Coco F, Randi ML, Voso MT. Genetic analysis of erythrocytosis reveals possible causative and modifier gene mutations. Br J Haematol 2019; 186:e100-e103. [PMID: 31016714 DOI: 10.1111/bjh.15931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Anna M Lombardi
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Elisabetta Cosi
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Giacomo Biagetti
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Francesco Buccisano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luca Franceschini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Ambra Di Veroli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Giulia Falconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Emiliano Fabiani
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maria Cantonetti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Daniela Nasso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maria L Randi
- Department of Medicine, University of Padua Medical School, Padua, Italy
| | - Maria T Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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17
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Sanz MA, Fenaux P, Tallman MS, Estey EH, Löwenberg B, Naoe T, Lengfelder E, Döhner H, Burnett AK, Chen SJ, Mathews V, Iland H, Rego E, Kantarjian H, Adès L, Avvisati G, Montesinos P, Platzbecker U, Ravandi F, Russell NH, Lo-Coco F. Management of acute promyelocytic leukemia: updated recommendations from an expert panel of the European LeukemiaNet. Blood 2019; 133:1630-1643. [PMID: 30803991 PMCID: PMC6509567 DOI: 10.1182/blood-2019-01-894980] [Citation(s) in RCA: 327] [Impact Index Per Article: 65.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/20/2019] [Indexed: 12/17/2022] Open
Abstract
Since the comprehensive recommendations for the management of acute promyelocytic leukemia (APL) reported in 2009, several studies have provided important insights, particularly regarding the role of arsenic trioxide (ATO) in frontline therapy. Ten years later, a European LeukemiaNet expert panel has reviewed the recent advances in the management of APL in both frontline and relapse settings in order to develop updated evidence- and expert opinion-based recommendations on the management of this disease. Together with providing current indications on genetic diagnosis, modern risk-adapted frontline therapy, and salvage treatment, the review contains specific recommendations for the identification and management of the most important complications such as the bleeding disorder APL differentiation syndrome, QT prolongation, and other all-trans retinoic acid- and ATO-related toxicities, as well as recommendations for molecular assessment of the response to treatment. Finally, the approach to special situations is also discussed, including management of APL in children, elderly patients, and pregnant women. The most important challenges remaining in APL include early death, which still occurs before and during induction therapy, and optimizing treatment in patients with high-risk disease.
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Affiliation(s)
- Miguel A Sanz
- Departamento de Hematologia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain
| | - Pierre Fenaux
- Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
- Department of Hematology, Université Paris Diderot, Paris, France
| | | | | | - Bob Löwenberg
- Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tomoki Naoe
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Eva Lengfelder
- Department of Haematology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
| | - Hartmut Döhner
- Department of Internal Medicine III, Ulm University Hospital, Ulm, Germany
| | - Alan K Burnett
- Department of Haematology, Glasgow University, Glasgow, United Kingdom
| | - Sai-Juan Chen
- State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Vikram Mathews
- Department of Hematology, Christian Medical College, Vellore, India
| | - Harry Iland
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Eduardo Rego
- Hematology Division and
- Clinical Oncology Division, Department of Internal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Lionel Adès
- Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris, Paris, France
- Department of Hematology, Université Paris Diderot, Paris, France
| | | | - Pau Montesinos
- Departamento de Hematologia, Hospital Universitari i Politècnic La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain
| | - Uwe Platzbecker
- Medical Clinic and Polyclinic I, Hematology and Cellular Therapy, University Hospital Leipzig, Leipzig, Germany
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Nigel H Russell
- Centre for Clinical Haematology, Department of Haematology, Nottingham University Hospital, Nottingham, United Kingdom; and
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
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18
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Alfonso V, Iaccarino L, Ottone T, Cicconi L, Lavorgna S, Divona M, Cairoli R, Cristiano A, Ciardi C, Travaglini S, Falconi G, Hasan SK, Venditti A, Arcese W, Voso MT, Lo-Coco F. Early and sensitive detection of PML-A216V mutation by droplet digital PCR in ATO-resistant acute promyelocytic leukemia. Leukemia 2019; 33:1527-1530. [PMID: 30651632 DOI: 10.1038/s41375-018-0298-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/18/2018] [Indexed: 01/05/2023]
Affiliation(s)
- V Alfonso
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - L Iaccarino
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - T Ottone
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy.,Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S, Rome, Italy
| | - L Cicconi
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - S Lavorgna
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy.,Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S, Rome, Italy
| | - M Divona
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - R Cairoli
- Division of Hematology, Niguarda Hospital, Milan, Italy
| | - A Cristiano
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - C Ciardi
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - S Travaglini
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - G Falconi
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - S K Hasan
- CRI Lab 2, ACTREC, Homi Bhabha National Institute, Mumbai, India
| | - A Venditti
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - W Arcese
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - M T Voso
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - F Lo-Coco
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy. .,Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S, Rome, Italy.
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19
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Piredda ML, Gaur G, Catalano G, Divona M, Banella C, Travaglini S, Puzzangara MC, Voso MT, Lo-Coco F, Noguera NI. PML/RARA inhibits expression of HSP90 and its target AKT. Br J Haematol 2018; 184:937-948. [PMID: 30536958 DOI: 10.1111/bjh.15715] [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] [Received: 08/09/2018] [Accepted: 11/05/2018] [Indexed: 12/29/2022]
Abstract
Essential for cell survival, the 90 kD Heat Shock Proteins (HSP90) are molecular chaperons required for conformational stabilization and trafficking of numerous client proteins. Functional HSP90 is required for the stability of AKT, a serine-threonine kinase phosphorylated in response to growth factor stimulation. AKT plays a crucial regulatory role in differentiation, cell cycle, transcription, translation, metabolism and apoptosis. Acute promyelocytic leukaemia (APL) is characterized by the presence of the promyelocytic leukaemia/retinoic acid receptor alpha (PML/RARA) fusion protein, which deregulates expression of several genes involved in differentiation and apoptosis. Here, we report inhibition of HSP90AA1 and HSP90AB1 isomer transcription in blasts isolated from patients with APL, associated with reduction of HSP90 protein expression and loss of control on AKT protein phosphorylation. We show that in vitro treatment of PML/RARA expressing cells with all-trans retinoic acid (ATRA) up-regulates HSP90 expression and stabilizes AKT. Addition of the HSP90-inhibitor 17-(allylamino)-17-demethoxygeldanamycin in combination with ATRA, blocks upregulation of AKT protein, indicating that HSP90 is necessary for ATRA action on AKT. This is the first report proving that expression of HSP90 isomers are directly and differentially repressed by PML/RARA, with critical results on cellular homeostasis of target proteins, such as AKT, in APL blasts.
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Affiliation(s)
- Maria Liliana Piredda
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
| | - Girish Gaur
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
| | - Gianfranco Catalano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Cristina Banella
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
| | - Serena Travaglini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
| | - Nelida Ines Noguera
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
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20
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Iaccarino L, Divona M, Ottone T, Cicconi L, Lavorgna S, Ciardi C, Alfonso V, Travaglini S, Facchini L, Cimino G, Di Bona E, Voso MT, Lo-Coco F. Identification and monitoring of atypical PML/RARA fusion transcripts in acute promyelocytic leukemia. Genes Chromosomes Cancer 2018; 58:60-65. [PMID: 30421475 DOI: 10.1002/gcc.22708] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 11/11/2022] Open
Abstract
Once the diagnostic suspicion of acute promyelocytic leukemia (APL) has been raised, international guidelines recommend prompt initiation of tailored therapy and supportive care, while awaiting for genetic confirmation of the diagnosis, and the identification of the specific PML/RARA isoform by reverse transcriptase polymerase chain reaction (RT-PCR). Depending on the PML break point, usually located within intron 6, exon 6, or intron 3, different PML/RARA transcript isoforms may be generated, that is, long (bcr1), variant (bcr2), and short (bcr3), respectively. We report here the characterization of three APL cases harboring atypical PML/RARA transcripts, which were not clearly detectable after standard RT-PCR amplification. In all three cases, clinical, morphological, and immunophenotypic features were consistent with APL. Direct sequencing allowed the identification of atypical break points within the PML and RARA genes. Then, we designed a patient-specific quantitative real-time PCR for the atypical transcripts, which allowed for specific quantitative evaluation of minimal residual disease (MRD) during follow-up. Despite the rarity of APL cases with an atypical PML/RARA fusion, our study indicates that an integrated laboratory approach, employing several diagnostic techniques is crucial to timely diagnose APL. This approach allows prompt initiation of specific targeted treatment and reliable MRD monitoring in atypical APL cases.
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Affiliation(s)
- Licia Iaccarino
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Laura Cicconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Serena Lavorgna
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Claudia Ciardi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Alfonso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Serena Travaglini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Giuseppe Cimino
- Hematology Unit, Maria Goretti Hospital, Latina, Italy.,Department of Cellular Biotechnology and Hematology, University La Sapienza, Rome
| | - Eros Di Bona
- Hematology Unit, San Bortolo Hospital, Vicenza, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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21
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Falconi G, Fabiani E, Piciocchi A, Criscuolo M, Fianchi L, Lindfors Rossi EL, Finelli C, Cerqui E, Ottone T, Molteni A, Parma M, Santarone S, Candoni A, Sica S, Leone G, Lo-Coco F, Voso MT. Somatic mutations as markers of outcome after azacitidine and allogeneic stem cell transplantation in higher-risk myelodysplastic syndromes. Leukemia 2018; 33:785-790. [PMID: 30291338 PMCID: PMC6462855 DOI: 10.1038/s41375-018-0284-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 07/03/2018] [Revised: 09/05/2018] [Accepted: 09/12/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Giulia Falconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | - Emiliano Fabiani
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | | | - Marianna Criscuolo
- Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Luana Fianchi
- Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | | | - Carlo Finelli
- Department of Hematology, Ospedale Sant'Orsola Malpighi, University of Bologna, Bologna, Italy
| | - Elisa Cerqui
- Department of Hematology, A.O. Spedali Civili, Brescia, Italy
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy
| | | | - Matteo Parma
- Department of Hematology, HSCT Adult Unit, San Gerardo Hospital, Monza, Italy
| | - Stella Santarone
- Department of Hematology, Centro Trapianti Midollo Osseo, Pescara, Italy
| | - Anna Candoni
- Division of Hematology and BMT, Department of Experimental and Clinical Medical Sciences, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy
| | - Simona Sica
- Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Giuseppe Leone
- Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy.,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Roma, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy.
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22
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Gurnari C, Latagliata R, Buccisano F, Piciocchi A, Fenu S, Mancini S, Fianchi L, Criscuolo M, Sarlo C, Romano A, Falconi G, Niscola P, Di Veroli A, Breccia M, Piccioni A, Aloe-Spiriti MA, Lo-Coco F, Voso MT. Erythropoietin levels and erythroid differentiation parameters in patients with lower-risk myelodysplastic syndromes. Leuk Res 2018; 71:89-91. [PMID: 30029156 DOI: 10.1016/j.leukres.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/04/2018] [Indexed: 11/18/2022]
Affiliation(s)
- C Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - R Latagliata
- Department of Cellular Biotechnologies and Haematology, Sapienza University, Rome, Italy
| | - F Buccisano
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - S Fenu
- Hematology Dep. Az. Osp., San Giovanni-Addolorata, Rome, Italy
| | - S Mancini
- Hematology Unit Az. Osp., San Camillo-Forlanini, Rome, Italy
| | - L Fianchi
- Department of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche Fondazione Policlinico Universitario A.Gemelli IRCCS
| | - M Criscuolo
- Department of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy; Dipartimento Scienze Radiologiche Radioterapiche ed Ematologiche Fondazione Policlinico Universitario A.Gemelli IRCCS
| | - C Sarlo
- Ematologia, Università Campus Biomedico, Rome, Italy
| | - A Romano
- Hematology Unit, Regina Elena, Rome, Italy
| | - G Falconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - P Niscola
- Hematology Unit, S Eugenio Hospital, Rome, Italy
| | - A Di Veroli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Breccia
- Department of Cellular Biotechnologies and Haematology, Sapienza University, Rome, Italy
| | - A Piccioni
- Hematology Dep. Az. Osp., San Giovanni-Addolorata, Rome, Italy
| | | | - F Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M T Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
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23
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Strocchio L, Gurnari C, Santoro N, Putti MC, Micalizzi C, Zecca M, Cuccurullo R, Girardi K, Diverio D, Testi AM, Lo-Coco F, Locatelli F. Arsenic trioxide and all-trans retinoic acid treatment for childhood acute promyelocytic leukaemia. Br J Haematol 2018; 185:360-363. [PMID: 30028005 DOI: 10.1111/bjh.15507] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Luisa Strocchio
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Carmelo Gurnari
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,University of Tor Vergata, Rome, Italy
| | - Nicola Santoro
- Paediatric Haematology/Oncology, Policlinico di Bari, Bari, Italy
| | - Maria C Putti
- Department of Women's and Children's Health, University of Padova, Padua, Italy
| | - Concetta Micalizzi
- Clinical Experimental Haematology Unit, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Marco Zecca
- Paediatric Haematology/Oncology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosanna Cuccurullo
- Department of Paediatric Haemato-Oncology, Santobono-Pausilipon Hospital, Naples, Italy
| | - Katia Girardi
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Daniela Diverio
- Department of Cellular Biotechnologies and Haematology, La Sapienza University, Rome, Italy
| | - Anna M Testi
- Department of Cellular Biotechnologies and Haematology, La Sapienza University, Rome, Italy
| | | | - Franco Locatelli
- Department of Paediatric Haematology/Oncology, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.,Department of Paediatric Sciences, University of Pavia, Pavia, Italy
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24
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Efficace F, Cottone F, Sparano F, Lo-Coco F. Patient-reported outcome assessment in acute leukemias: Moving beyond the barriers. Cancer 2018; 124:3066-3067. [PMID: 29710399 DOI: 10.1002/cncr.31521] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/30/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Fabio Efficace
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases, Rome, Italy
| | - Francesco Cottone
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases, Rome, Italy
| | - Francesco Sparano
- Data Center and Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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25
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Cicconi L, Breccia M, Franceschini L, Latagliata R, Molica M, Divona M, Diverio D, Rizzo M, Ottone T, Iaccarino L, Alfonso V, Foa R, Voso MT, Lo-Coco F. Prolonged treatment with arsenic trioxide (ATO) and all-trans-retinoic acid (ATRA) for relapsed acute promyelocytic leukemia previously treated with ATRA and chemotherapy. Ann Hematol 2018; 97:1797-1802. [DOI: 10.1007/s00277-018-3400-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 06/12/2018] [Indexed: 10/28/2022]
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26
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Ottone T, Alfonso V, Iaccarino L, Hasan SK, Mancini M, Divona M, Lavorgna S, Cicconi L, Panetta P, Maurillo L, Del Principe MI, Irno Consalvo M, Franceschini L, Angelini DF, Battistini L, Guerrera G, De Bardi M, Fabiani E, Falconi G, Arcese W, Amadori S, Buccisano F, Venditti A, Voso MT, Lo-Coco F. Longitudinal detection of DNMT3A R882H transcripts in patients with acute myeloid leukemia. Am J Hematol 2018; 93:E120-E123. [PMID: 29417611 DOI: 10.1002/ajh.25061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 02/05/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Tiziana Ottone
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
- Laboratorio di Neuro-Oncoematologia; , Fondazione Santa Lucia I.R.C.C.S.; Rome Italy
| | - Valentina Alfonso
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Licia Iaccarino
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | | | - Melissa Mancini
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | | | - Serena Lavorgna
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Laura Cicconi
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Paola Panetta
- Laboratorio di Oncoematologia, Policlinico Tor Vergata; Roma Italy
| | - Luca Maurillo
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | | | | | - Luca Franceschini
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Daniela F. Angelini
- Laboratorio di Neuro-Immunologia e Citofluorimetria; Fondazione Santa Lucia-I.R.C.C.S.; Rome Italy
| | - Luca Battistini
- Laboratorio di Neuro-Immunologia e Citofluorimetria; Fondazione Santa Lucia-I.R.C.C.S.; Rome Italy
| | - Gisella Guerrera
- Laboratorio di Neuro-Immunologia e Citofluorimetria; Fondazione Santa Lucia-I.R.C.C.S.; Rome Italy
| | - Marco De Bardi
- Laboratorio di Neuro-Immunologia e Citofluorimetria; Fondazione Santa Lucia-I.R.C.C.S.; Rome Italy
| | - Emiliano Fabiani
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Giulia Falconi
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - William Arcese
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Sergio Amadori
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Francesco Buccisano
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Adriano Venditti
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Maria Teresa Voso
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
| | - Francesco Lo-Coco
- Dipartimento di Biomedicina e Prevenzione; Università degli studi Tor Vergata; Rome Italy
- Laboratorio di Neuro-Oncoematologia; , Fondazione Santa Lucia I.R.C.C.S.; Rome Italy
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27
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Noguera NI, Pelosi E, Angelini DF, Piredda ML, Guerrera G, Piras E, Battistini L, Massai L, Berardi A, Catalano G, Cicconi L, Castelli G, D'Angiò A, Pasquini L, Graziani G, Fioritoni G, Voso MT, Mastrangelo D, Testa U, Lo-Coco F. High-dose ascorbate and arsenic trioxide selectively kill acute myeloid leukemia and acute promyelocytic leukemia blasts in vitro. Oncotarget 2018; 8:32550-32565. [PMID: 28427227 PMCID: PMC5464808 DOI: 10.18632/oncotarget.15925] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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: 09/22/2016] [Accepted: 02/06/2017] [Indexed: 12/22/2022] Open
Abstract
The use of high-dose ascorbate (ASC) for the treatment of human cancer has been attempted several decades ago and has been recently revived by several in vitro and in vivo studies in solid tumors. We tested the cytotoxic effects of ASC, alone or in combination with arsenic trioxide (ATO) in acute myeloid leukemia (AML) and acute promyelocytic leukemia (APL). Leukemic cell lines and primary blasts from AML and APL patients were treated with graded concentrations of ASC, alone or in association with standard concentration (1 μM) of ATO. The ASC/ATO combination killed myeloid blasts, including leukemic CD34+ cells, while sparing CD34+ progenitors obtained from normal cord blood and bone marrow. Actually, approximately one-third (11/36) of primary AML cases were highly sensitive to the ASC/ATO combination. The mechanism of cell killing appeared to be related to increased oxidative stress and overproduction of ROS in a non-quantitative fashion, which resulted in induction of apoptosis. These effects were reverted by the addition of the antioxidant N-Acetyl-Cysteine (NAC). In the APL NB4 model, ASC induced direct degradation of the PML and PML/RARA proteins via caspase activation, while the transcriptional repressor DAXX was recruited in re-constituted PML nuclear bodies. Our findings encourage the design of pilot studies to explore the potential clinical benefit of ASC alone or in combination with ATO in advanced AML and APL.
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Affiliation(s)
- Nélida I Noguera
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S. Via del Fosso di Fiorano, Rome, Italy
| | - Elvira Pelosi
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Daniela F Angelini
- Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S., Rome, Italy
| | - Maria Liliana Piredda
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S. Via del Fosso di Fiorano, Rome, Italy
| | - Gisella Guerrera
- Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S., Rome, Italy
| | - Eleonora Piras
- Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S., Rome, Italy
| | - Luca Battistini
- Neuroimmunology and Flow Cytometry Units, Fondazione Santa Lucia-I.R.C.C.S., Rome, Italy
| | - Lauretta Massai
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Polo Scientifico San Miniato, Siena, Italy
| | - Anna Berardi
- Pescara Cell Factory Foundation Onlus, Pescara, Italy
| | | | - Laura Cicconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Germana Castelli
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Agnese D'Angiò
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Pasquini
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Grazia Graziani
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Domenico Mastrangelo
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Polo Scientifico San Miniato, Siena, Italy
| | - Ugo Testa
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Santa Lucia Foundation, I.R.C.C.S. Via del Fosso di Fiorano, Rome, Italy
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28
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Martínez-Losada C, Serrano-López J, Serrano-López J, Noguera NI, Garza E, Piredda L, Lavorgna S, Consalvo MAI, Ottone T, Alfonso V, Peinado JR, Garcia-Ortiz MV, Morales-Ruiz T, Jérez A, Hurtado AM, Montesinos P, Cervera J, Such E, Ibañez M, Sempere A, Sanz MÁ, Lo-Coco F, Sánchez-García J. Clonal genetic evolution at relapse of favorable-risk acute myeloid leukemia with NPM1 mutation is associated with phenotypic changes and worse outcomes. Haematologica 2018; 103:e400-e403. [PMID: 29622659 DOI: 10.3324/haematol.2018.188433] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Carmen Martínez-Losada
- Hematology Department, Reina Sofía University Hospital/Maimonides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba, Spain
| | - Juana Serrano-López
- Hematology Department, Reina Sofía University Hospital/Maimonides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba, Spain
| | - Josefina Serrano-López
- Hematology Department, Reina Sofía University Hospital/Maimonides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba, Spain
| | - Nelida I Noguera
- Department of Biomedicine and Prevention, "Tor Vergata" University, Rome, Italy.,Laboratory of Neuro-Oncohematology, Santa Lucia Foundation, Rome, Italy
| | | | - Liliana Piredda
- Department of Biomedicine and Prevention, "Tor Vergata" University, Rome, Italy
| | - Serena Lavorgna
- Department of Biomedicine and Prevention, "Tor Vergata" University, Rome, Italy
| | | | - Tiziana Ottone
- Department of Biomedicine and Prevention, "Tor Vergata" University, Rome, Italy
| | - Valentina Alfonso
- Department of Biomedicine and Prevention, "Tor Vergata" University, Rome, Italy
| | - Juan Ramón Peinado
- Medical Sciences Department, Faculty of Medicine/University of Ciudad Real (UCLM), Spain
| | - María Victoria Garcia-Ortiz
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba/Reina Sofia University Hospital, Spain
| | - Teresa Morales-Ruiz
- Maimónides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba/Reina Sofia University Hospital, Spain
| | - Andrés Jérez
- Hematology Department University Hospital Morales Meseguer-IMIB, Spain
| | - Ana María Hurtado
- Hematology Department University Hospital Morales Meseguer-IMIB, Spain
| | - Pau Montesinos
- Hematology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - José Cervera
- Hematology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Esperanza Such
- Hematology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Marian Ibañez
- Hematology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Amparo Sempere
- Hematology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Miguel Ángel Sanz
- Hematology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, "Tor Vergata" University, Rome, Italy.,Laboratory of Neuro-Oncohematology, Santa Lucia Foundation, Rome, Italy
| | - Joaquín Sánchez-García
- Hematology Department, Reina Sofía University Hospital/Maimonides Biomedical Research Institute of Córdoba (IMIBIC)/University of Córdoba, Spain
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29
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Buccisano F, Maurillo L, Del Principe MI, Di Veroli A, De Bellis E, Biagi A, Zizzari A, Rossi V, Rapisarda V, Amadori S, Voso MT, Lo-Coco F, Arcese W, Venditti A. Minimal residual disease as a biomarker for outcome prediction and therapy optimization in acute myeloid leukemia. Expert Rev Hematol 2018; 11:307-313. [PMID: 29495904 DOI: 10.1080/17474086.2018.1447378] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Response to therapy is affected by the genetic heterogeneity of acute myeloid leukemia (AML) and persistence of leukemic cells below the threshold of morphological complete remission (mCR). Such persistence is called minimal (or measurable) residual disease (MRD). Areas covered: MRD assessment allows early identification of patients who are at high risk of relapse and who should timely receive aggressive therapy (e.g. allogeneic stem cell transplantation) and of those with a good quality mCR in whom an aggressive front-line therapy can be spared, avoiding the harm of excessive treatment toxicity. The most exploited methods to assess MRD are multiparameter flow cytometry (via identification of immunophenotypic aberrancies) or PCR-based assays (via identification of cytogenetic/molecular abnormalities). Expert commentary: A growing body of evidences demonstrates that positive MRD-testing at various time-points throughout the treatment course identifies patients at high risk of relapse. We will focus on the role of MRD as a biomarker to refine risk assessment and to prospectively direct treatment choices in adult with AML.
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Affiliation(s)
- Francesco Buccisano
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Luca Maurillo
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | | | - Ambra Di Veroli
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Eleonora De Bellis
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Annalisa Biagi
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Annagiulia Zizzari
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Valentina Rossi
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Vito Rapisarda
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Sergio Amadori
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Maria Teresa Voso
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Francesco Lo-Coco
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - William Arcese
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
| | - Adriano Venditti
- a Department of Biomedicine and Prevention , University Tor Vergata of Rome , Rome , Italy
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30
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Gurnari C, Panetta P, Fabiani E, Nardone AM, Postorivo D, Falconi G, Franceschini L, Rizzo M, Rapisarda VM, De Bellis E, Lo-Coco F, Voso MT. Identification of i(X)(p10) as the sole molecular abnormality in atypical chronic myeloid leukemia evolved into acute myeloid leukemia. Mol Clin Oncol 2018; 8:463-465. [PMID: 29468060 DOI: 10.3892/mco.2017.1543] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 12/27/2017] [Indexed: 11/06/2022] Open
Abstract
The World Health Organization classifies atypical chronic myeloid leukemia (aCML) as a myeloproliferative/myelodisplastic hematological disorder. The primary manifestations are leukocytosis with disgranulopoiesis, absence of basophilia and/or monocytosis, splenomegaly and absence of Philadelphia chromosome or BCR/ABL fusion. Overall 50-65% of patients demonstrate karyotypic abnormalities, although no specific cytogenetic alterations have been associated with this disease. X chromosome alterations have been rarely reported in myeloid malignancies. Although Isodicentric X, idic(X)(q13) is well known in females with myelodysplastic syndromes (MDS), little data are available on X isochromosome and its pathogenetic potential in these disorders. i(X)(p10) is observed in a variety of hematologic malignancies, both myeloid and lymphoid, as a unique abnormality, as well as part of a more complex karyotype, in females and less frequently in male patients. The present report describes the first patient with aCML, with documented isolated i(X)(p10), who developed a secondary acute myeloid leukemia (sAML).
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Affiliation(s)
- Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Paola Panetta
- Hematology Department, Tor Vergata University Hospital, Rome, Italy
| | - Emiliano Fabiani
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Diana Postorivo
- Laboratory of Medical Genetics, Tor Vergata Clinic, Rome, Italy
| | - Giulia Falconi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luca Franceschini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Manuela Rizzo
- Hematology Department, Tor Vergata University Hospital, Rome, Italy
| | - Vito Mario Rapisarda
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Eleonora De Bellis
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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31
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Del Principe MI, Buccisano F, Soddu S, Maurillo L, Cefalo M, Piciocchi A, Consalvo MI, Paterno G, Sarlo C, De Bellis E, Zizzari A, De Angelis G, Fraboni D, Divona M, Voso MT, Sconocchia G, Del Poeta G, Lo-Coco F, Arcese W, Amadori S, Venditti A. Involvement of central nervous system in adult patients with acute myeloid leukemia: Incidence and impact on outcome. Semin Hematol 2018; 55:209-214. [PMID: 30502849 DOI: 10.1053/j.seminhematol.2018.02.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/23/2017] [Accepted: 02/17/2018] [Indexed: 12/21/2022]
Abstract
Incidence and effect on outcome of central nervous system (CNS) involvement in adult patients with acute myeloid leukemia (AML) is not clearly defined. To address this issue, 103 consecutive adult patients with newly diagnosed AML, regardless of neurologic symptoms, were submitted to a routine explorative lumbar puncture. Cerebrospinal fluid (CSF) samples were collected from 65 males and 38 females. All 103 CSF samples were examined by conventional cytology (CC) whereas 95 (92%) also by flow cytometry (FCM). At diagnosis, 70 patients (68%) were CNS negative (CNS-), whereas 33 (32%) were CNS positive (CNS+). In 11 of 33 (33%), CNS infiltration was documented either by CC or FCM , in 21 (67%) only by FCM. CNS positivity was significantly associated with a M4-M5 phenotype of the underlying AML (P = .0003) and with high levels of lactate dehydrogenase (P = .006). Overall, 80 of 103 (78%) achieved complete remission with no significant differences between CNS+ and CNS- patients. Five-year disease-free survival and overall survival were found to be shorter in CNS+ patients than in those CNS- (18% vs 50%, P = .006 and 19% vs 46%, P = .02, respectively). In multivariate analysis, CNS status and age were found to affect independently overall survival. In conclusion, the incidence of CNS involvement in adult patients with newly diagnosed AML is higher than expected. Regardless of neurologic symptoms, it should always be searched at diagnosis; CSF samples should routinely be investigated by FCM since a certain proportion of CNS involvements might remain undetected if examination is exclusively CC based.
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Affiliation(s)
- Maria Ilaria Del Principe
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| | - Francesco Buccisano
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | | | - Luca Maurillo
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Mariagiovanna Cefalo
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | | | - Maria Irno Consalvo
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Giovangiacinto Paterno
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Chiara Sarlo
- Hematology, University Campus Biomedico, Rome, Italy
| | - Eleonora De Bellis
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Annagiulia Zizzari
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Gottardo De Angelis
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Daniela Fraboni
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Mariadomenica Divona
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Teresa Voso
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe Sconocchia
- Laboratoy of Tumor Immunology and Immunotherapy, Institute of Translation Pharmacology, Department of Medicine, National Research Council of Italy (CNR), Rome, Italy
| | - Giovanni Del Poeta
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Lo-Coco
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - William Arcese
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Sergio Amadori
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Adriano Venditti
- Hematology, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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32
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Noguera NI, Piredda ML, Taulli R, Catalano G, Angelini G, Gaur G, Nervi C, Voso MT, Lunardi A, Pandolfi PP, Lo-Coco F. PML/RARa inhibits PTEN expression in hematopoietic cells by competing with PU.1 transcriptional activity. Oncotarget 2018; 7:66386-66397. [PMID: 27626703 PMCID: PMC5341808 DOI: 10.18632/oncotarget.11964] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 07/27/2016] [Indexed: 12/25/2022] Open
Abstract
Acute promyelocitic leukemia (APL) is characterized by the pathognomonic presence in leukemic blasts of the hybrid protein PML/RARA, that acts as a transcriptional repressor impairing the expression of genes that are critical to myeloid differentiation. Here, we show that primary blasts from APL patients express lower levels of the oncosuppressor protein PTEN, as compared to blast cells from other AML subtypes or normal bone marrow, and demonstrate that PML-RARA directly inhibits PTEN expression. We show that All-Trans Retinoic Acid (ATRA) triggers in APL cells an active chromatin status at the core regulatory region of the PTEN promoter, that allows the binding of the myeloid-regulating transcription factor PU.1, and, in turn, the transcriptional induction of PTEN. ATRA, via PML/RARA degradation, also promotes PTEN nuclear re-localization and decreases expression of the PTEN target Aurora A kinase. In conclusion, our findings support the notion that PTEN is one of the primary targets of PML/RARA in APL
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Affiliation(s)
- Nélida Inés Noguera
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - Maria Liliana Piredda
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - Riccardo Taulli
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Gianfranco Catalano
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Giulia Angelini
- Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - Girish Gaur
- Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - Clara Nervi
- Department of Medical and Surgical Sciences and Biotechnologies, University of Roma "La Sapienza", Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Andrea Lunardi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.,Centre for Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Pier Paolo Pandolfi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
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33
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Lo-Coco F, Cicconi L, Voso MT. Progress and criticalities in the management of acute promyelocytic leukemia. Oncotarget 2017; 8:99221-99222. [PMID: 29245895 PMCID: PMC5725086 DOI: 10.18632/oncotarget.22385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 11/09/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Francesco Lo-Coco
- Francesco Lo-Coco: Department of Biomedicine and prevention, University Tor Vergata, Rome, Italy
| | - Laura Cicconi
- Francesco Lo-Coco: Department of Biomedicine and prevention, University Tor Vergata, Rome, Italy
| | - Maria Teresa Voso
- Francesco Lo-Coco: Department of Biomedicine and prevention, University Tor Vergata, Rome, Italy
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34
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Fabiani E, Falconi G, Fianchi L, Criscuolo M, Ottone T, Cicconi L, Hohaus S, Sica S, Postorino M, Neri A, Lionetti M, Leone G, Lo-Coco F, Voso MT. Clonal evolution in therapy-related neoplasms. Oncotarget 2017; 8:12031-12040. [PMID: 28076841 PMCID: PMC5355323 DOI: 10.18632/oncotarget.14509] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 12/26/2016] [Indexed: 12/17/2022] Open
Abstract
Therapy-related myeloid neoplasms (t-MN) may occur as a late effect of cytotoxic therapy for a primary malignancy or autoimmune diseases in susceptible individuals. We studied the development of somatic mutations in t-MN, using a collection of follow-up samples from 14 patients with a primary hematologic malignancy, who developed a secondary leukemia (13 t-MN and 1 t-acute lymphoblastic leukemia), at a median latency of 73 months (range 18-108) from primary cancer diagnosis. Using Sanger and next generation sequencing (NGS) approaches we identified 8 mutations (IDH1 R132H, ASXL1 Y591*, ASXL1 S689*, ASXL1 R693*, SRSF2 P95H, SF3B1 K700E, SETBP1 G870R and TP53 Y220C) in seven of thirteen t-MN patients (54%), whereas the t-ALL patient had a t(4,11) translocation, resulting in the KMT2A/AFF1 fusion gene. These mutations were then tracked backwards in marrow samples preceding secondary leukemia occurrence, using pyrosequencing and a NGS protocol that allows the detection of low variant allele frequencies (≥0.1%). Somatic mutations were detectable in the BM harvested at the primary diagnosis, prior to any cytotoxic treatment in three patients, while they were not detectable and apparently acquired by the t-MN clone in five patients. These data show that clonal evolution in t-MN is heterogeneous, with some somatic mutations preceding cytotoxic treatment and possibly favoring leukemic development.
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Affiliation(s)
- Emiliano Fabiani
- Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy.,Department of Hematology, Universita' Cattolica S. Cuore, Rome, Italy
| | - Giulia Falconi
- Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy.,Department of Hematology, Universita' Cattolica S. Cuore, Rome, Italy
| | - Luana Fianchi
- Department of Hematology, Universita' Cattolica S. Cuore, Rome, Italy
| | | | - Tiziana Ottone
- Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy
| | - Laura Cicconi
- Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy
| | - Stefan Hohaus
- Department of Hematology, Universita' Cattolica S. Cuore, Rome, Italy
| | - Simona Sica
- Department of Hematology, Universita' Cattolica S. Cuore, Rome, Italy
| | | | - Antonino Neri
- Department of Clinical Sciences and Community Health, Università degli studi di Milano, Italy
| | - Marta Lionetti
- Department of Clinical Sciences and Community Health, Università degli studi di Milano, Italy
| | - Giuseppe Leone
- Department of Hematology, Universita' Cattolica S. Cuore, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy
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35
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Mastrangelo D, Pelosi E, Castelli G, Lo-Coco F, Testa U. Mechanisms of anti-cancer effects of ascorbate: Cytotoxic activity and epigenetic modulation. Blood Cells Mol Dis 2017; 69:57-64. [PMID: 28954710 DOI: 10.1016/j.bcmd.2017.09.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 09/20/2017] [Indexed: 12/16/2022]
Abstract
Vitamin C (Vit C or Ascorbate) is essential for many fundamental biochemical processes. Vit C is an essential nutrient with redox functions at normal physiologic concentrations. The main physiologic function of this vitamin is related to its capacity to act as a co-factor for a large family of enzymes, collectively known as Fe and 2-oxoglutarate-dependent dioxygenases. It also modulates epigenetic gene expression through the control of TET enzymes activity. Vit C also has several biological properties allowing to restore the deregulated epigenetic response observed in many tumors. High-dose Vit C has been investigated as a treatment for cancer patients since the 1969. Pharmacologic ascorbate acts as a pro-drug for hydrogen peroxide formation (H2O2) and, through this mechanism, kills cancer cells. To achieve high in vivo concentrations, Ascorbate must be injected by i.v. route. Initial clinical studies of Ascorbate cancer treatment have provided encouraging results, not confirmed in subsequent studies. Recent clinical studies using i.v. injection of high-dose Ascorbate have renewed the interest in the field, showing that significant anti-tumor activity. Pre-clinical studies have led to identify tumors sensitive to Ascorbate that could potentially benefit from this treatment either through an epigenetic modulator effect or through tumor killing by oxidative stress.
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Affiliation(s)
- Domenico Mastrangelo
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Polo Scientifico San Miniato, Siena, Italy
| | - Elvira Pelosi
- Department of Oncology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Germana Castelli
- Department of Oncology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Santa Lucia Foundation, I.R.C.C.S., Via del Fosso di Fiorano, Rome, Italy
| | - Ugo Testa
- Department of Oncology, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy.
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36
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Fabiani E, Falconi G, Noguera NI, Saulle E, Cicconi L, Divona M, Banella C, Picardi A, Cerio AM, Boe L, Sanchez M, Pelosi E, Testa U, Lo-Coco F, Voso MT. The forkhead box C1 (FOXC1) transcription factor is downregulated in acute promyelocytic leukemia. Oncotarget 2017; 8:84074-84085. [PMID: 29137406 PMCID: PMC5663578 DOI: 10.18632/oncotarget.21101] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 08/31/2017] [Indexed: 01/01/2023] Open
Abstract
Forkhead box (FOX) genes encode transcription factors, which regulate embryogenesis and play an important role in hematopoietic differentiation and in mesenchymal niche maintenance. Overexpression of the family member FOXC1 has been reported in solid tumors and acute myeloid leukemia (AML). We studied FOXC1 expression and function in acute promyelocytic leukemia (APL) and normal hematopoietic progenitors. FOXC1 mRNA and protein levels were significantly lower in primary marrow samples from 27 APL patients, as compared to samples obtained from 27 patients with other AML subtypes, and 5 normal CD34+ hematopoietic cells. FOXC1 expression significantly increased in APL samples at the time of remission following consolidation treatment. In cell lines overexpressing PML-RARA, and in the NB4 t(15;17)-positive cell line, FOXC1 expression was lower than in other non-APL cell lines, and increased following treatment with all-trans retinoic acid (ATRA), due to functional binding of ATRA to the FOXC1 promoter region. Reduced FOXC1 expression was also associated to DNA hypermethylation of the +354 to +568 FOXC1 region, both in primary APL, and in NB4 cells. Treatment of NB4 cells with decitabine demethylated FOXC1 and upregulated its expression. Our findings indicate that FOXC1 is consistently repressed in APL due to hypermethylation and the presence of the PML-RARA rearrangement. A potential role of hypomethylating treatment in advanced APL remains to be established.
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Affiliation(s)
- Emiliano Fabiani
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Giulia Falconi
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Nélida Inés Noguera
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy.,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Rome, Italy
| | - Ernestina Saulle
- Istituto Superiore di Sanità, Centro Nazionale per la Ricerca e la Valutazione Preclinica e Clinica dei Farmaci, Rome, Italy
| | - Laura Cicconi
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Mariadomenica Divona
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Cristina Banella
- Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Rome, Italy
| | - Alessandra Picardi
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
| | - Anna Maria Cerio
- Istituto Superiore di Sanità, Dipartimento di Ematologia ed Oncologia, Rome, Italy
| | - Letizia Boe
- Istituto Superiore di Sanità, Grandi Strumentazioni e Core Facilities, Rome, Italy
| | - Massimo Sanchez
- Istituto Superiore di Sanità, Grandi Strumentazioni e Core Facilities, Rome, Italy
| | - Elvira Pelosi
- Istituto Superiore di Sanità, Dipartimento di Ematologia ed Oncologia, Rome, Italy
| | - Ugo Testa
- Istituto Superiore di Sanità, Dipartimento di Ematologia ed Oncologia, Rome, Italy
| | - Francesco Lo-Coco
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy.,Fondazione Santa Lucia, Laboratorio di Neuro-Oncoematologia, Rome, Italy
| | - Maria Teresa Voso
- Università di Roma Tor Vergata, Dipartimento di Biomedicina e Prevenzione, Rome, Italy
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37
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Iaccarino L, Ottone T, Hasan SK, Divona M, Cicconi L, Lavorgna S, Alfonso V, Basso G, Barragán E, Bocchia M, Rego EM, Grimwade D, Voso MT, Lo-Coco F. Comparative genomic analysis of PML and RARA breakpoints in paired diagnosis/relapse samples of patients with acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy. Leuk Lymphoma 2017; 59:1268-1270. [PMID: 28838264 DOI: 10.1080/10428194.2017.1369067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Licia Iaccarino
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Tiziana Ottone
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Syed Khizer Hasan
- b Department of Medical Oncology ACTREC , Tata Memorial Centre , Navi Mumbai , India
| | - Mariadomenica Divona
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Laura Cicconi
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Serena Lavorgna
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Valentina Alfonso
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Giuseppe Basso
- c Department of Women's and Children's Health , University of Padova , Padova , Italy
| | - Eva Barragán
- d Department of Clinical Chemistry, Laboratory of Molecular Biology , Hospital Universitario La Fe , Valencia , Spain
| | - Monica Bocchia
- e Department of Medicine and Immunological Sciences, Division of Hematology and Transplants , University of Siena , Siena , Italy
| | - Eduardo Magalhaes Rego
- f Department of Internal Medicine, Medical School of Ribeirao Preto and Center for Cell Based Therapy , University of São Paulo , Ribeirao Preto , Brazil
| | - David Grimwade
- g Department of Medical and Molecular Genetics , King's College London School of Medicine , London , UK
| | - Maria Teresa Voso
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
| | - Francesco Lo-Coco
- a Department of Biomedicine and Prevention , Università di Roma "Tor Vergata" , Rome , Italy
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Masciarelli S, Capuano E, Ottone T, Divona M, De Panfilis S, Banella C, Noguera NI, Picardi A, Fontemaggi G, Blandino G, Lo-Coco F, Fazi F. Retinoic acid and arsenic trioxide sensitize acute promyelocytic leukemia cells to ER stress. Leukemia 2017; 32:285-294. [PMID: 28776567 PMCID: PMC5808088 DOI: 10.1038/leu.2017.231] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/10/2017] [Accepted: 06/20/2017] [Indexed: 01/03/2023]
Abstract
Retinoic acid (RA) in association with chemotherapy or with arsenic trioxide (ATO) results in high cure rates of acute promyelocytic leukemia (APL). We show that RA-induced differentiation of human leukemic cell lines and primary blasts dramatically increases their sensitivity to endoplasmic reticulum (ER) stress-inducing drugs at doses that are not toxic in the absence of RA. In addition, we demonstrate that the PERK pathway, triggered in response to ER stress, has a major protective role. Moreover, low amounts of pharmacologically induced ER stress are sufficient to strongly increase ATO toxicity. Indeed, in the presence of ER stress, ATO efficiently induced apoptosis in RA-sensitive and RA-resistant APL cell lines, at doses ineffective in the absence of ER stress. Our findings identify the ER stress-related pathways as potential targets in the search for novel therapeutic strategies in AML.
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Affiliation(s)
- S Masciarelli
- Section of Histology and Medical Embryology, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - E Capuano
- Section of Histology and Medical Embryology, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - T Ottone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Divona
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - S De Panfilis
- Centre for Life Nano Science, Istituto Italiano di Tecnologia, Rome, Italy
| | - C Banella
- Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - N I Noguera
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - A Picardi
- Stem Cell Transplant Unit, Rome Transplant Network, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - G Fontemaggi
- Oncogenomic and Epigenetic Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - G Blandino
- Oncogenomic and Epigenetic Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - F Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - F Fazi
- Section of Histology and Medical Embryology, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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Stone RM, Mandrekar SJ, Sanford BL, Laumann K, Geyer S, Bloomfield CD, Thiede C, Prior TW, Döhner K, Marcucci G, Lo-Coco F, Klisovic RB, Wei A, Sierra J, Sanz MA, Brandwein JM, de Witte T, Niederwieser D, Appelbaum FR, Medeiros BC, Tallman MS, Krauter J, Schlenk RF, Ganser A, Serve H, Ehninger G, Amadori S, Larson RA, Döhner H. Midostaurin plus Chemotherapy for Acute Myeloid Leukemia with a FLT3 Mutation. N Engl J Med 2017; 377:454-464. [PMID: 28644114 PMCID: PMC5754190 DOI: 10.1056/nejmoa1614359] [Citation(s) in RCA: 1440] [Impact Index Per Article: 205.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Patients with acute myeloid leukemia (AML) and a FLT3 mutation have poor outcomes. We conducted a phase 3 trial to determine whether the addition of midostaurin - an oral multitargeted kinase inhibitor that is active in patients with a FLT3 mutation - to standard chemotherapy would prolong overall survival in this population. METHODS We screened 3277 patients, 18 to 59 years of age, who had newly diagnosed AML for FLT3 mutations. Patients were randomly assigned to receive standard chemotherapy (induction therapy with daunorubicin and cytarabine and consolidation therapy with high-dose cytarabine) plus either midostaurin or placebo; those who were in remission after consolidation therapy entered a maintenance phase in which they received either midostaurin or placebo. Randomization was stratified according to subtype of FLT3 mutation: point mutation in the tyrosine kinase domain (TKD) or internal tandem duplication (ITD) mutation with either a high ratio (>0.7) or a low ratio (0.05 to 0.7) of mutant to wild-type alleles (ITD [high] and ITD [low], respectively). Allogeneic transplantation was allowed. The primary end point was overall survival. RESULTS A total of 717 patients underwent randomization; 360 were assigned to the midostaurin group, and 357 to the placebo group. The FLT3 subtype was ITD (high) in 214 patients, ITD (low) in 341 patients, and TKD in 162 patients. The treatment groups were well balanced with respect to age, race, FLT3 subtype, cytogenetic risk, and blood counts but not with respect to sex (51.7% in the midostaurin group vs. 59.4% in the placebo group were women, P=0.04). Overall survival was significantly longer in the midostaurin group than in the placebo group (hazard ratio for death, 0.78; one-sided P=0.009), as was event-free survival (hazard ratio for event or death, 0.78; one-sided P=0.002). In both the primary analysis and an analysis in which data for patients who underwent transplantation were censored, the benefit of midostaurin was consistent across all FLT3 subtypes. The rate of severe adverse events was similar in the two groups. CONCLUSIONS The addition of the multitargeted kinase inhibitor midostaurin to standard chemotherapy significantly prolonged overall and event-free survival among patients with AML and a FLT3 mutation. (Funded by the National Cancer Institute and Novartis; ClinicalTrials.gov number, NCT00651261 .).
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Affiliation(s)
- Richard M Stone
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Sumithra J Mandrekar
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Ben L Sanford
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Kristina Laumann
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Susan Geyer
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Clara D Bloomfield
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Christian Thiede
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Thomas W Prior
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Konstanze Döhner
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Guido Marcucci
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Francesco Lo-Coco
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Rebecca B Klisovic
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Andrew Wei
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Jorge Sierra
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Miguel A Sanz
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Joseph M Brandwein
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Theo de Witte
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Dietger Niederwieser
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Frederick R Appelbaum
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Bruno C Medeiros
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Martin S Tallman
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Jürgen Krauter
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Richard F Schlenk
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Arnold Ganser
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Hubert Serve
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Gerhard Ehninger
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Sergio Amadori
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Richard A Larson
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
| | - Hartmut Döhner
- From the Department of Medical Oncology, Dana-Farber Cancer Institute, Boston (R.M.S.); the Division of Biomedical Statistics and Informatics (S.J.M., K.L.) and the Alliance Statistics and Data Center (S.J.M., K.L., S.G.), Mayo Clinic, Rochester, MN; the Alliance Statistics and Data Center, Duke University, Durham, NC (B.L.S.); the Ohio State University Comprehensive Cancer Center, Columbus (S.G., C.D.B., T.W.P., G.M., R.B.K.); Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Dresden (C.T., G.E.), Department of Internal Medicine III, University Hospital of Ulm, Ulm (K.D., R.F.S., H.D.), Hematology and Oncology, University of Leipzig, Leipzig (D.N.), Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover (J.K., A.G.), and Department of Medicine II, Hematology-Oncology, Goethe University Hospital Frankfurt, Frankfurt am Main (H.S.) - all in Germany; the Department of Biomedicine and Prevention, University Tor Vergata, Rome (F.L.-C., S.A.); the Department of Clinical Haematology, Alfred Hospital and Monash University, Melbourne, VIC, Australia (A.W.); Hospital de la Santa Creu i Sant Pau, Hematology Department, Autonomous University of Barcelona, Barcelona (J.S.), and Hospital Universitario la Fe, Hematology Department, Department of Medicine, University of Valencia, Valencia (M.A.S.) - both in Spain; the Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto (J.M.B.); Radboud Institute Molecular Studies, Radboud University Medical Center, Nijmegen, the Netherlands (T.W.); the Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle (F.R.A.); the Division of Hematology-Oncology, Stanford Comprehensive Cancer Center, Stanford University, Stanford, CA (B.C.M.); the Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York (M.S.T.); and the Department of Medicine, University of Chicago, Chicago (R.A.L.)
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Tang B, Gabriel S, Zhou J, Pathak AK, Irwin D, Riehle E, Lo-Coco F, Tallman MS. Treatment patterns and characteristics of acute promyelocytic leukemia (APL) patients receiving arsenic trioxide (ATO) therapy in a real-world setting. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e18522] [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
e18522 Background: Clinical trials have shown that low-risk APL patients had significantly better outcomes when receiving first-line all-trans retinoic acid (ATRA) + ATO compared with standard ATRA + chemotherapy. Few published studies have used real-world data to describe patients using ATO and their current treatment patterns. This study used United States (US) administrative claims data to describe treatment patterns and characteristics of patients receiving first-line ATO. Methods: This retrospective, observational cohort study used claims data from the MarketScan databases. As there is no ICD-9-CM diagnosis code for APL, ATO treatment was used as a surrogate for the diagnosis of APL since ATO is typically used only in APL patients. Patients were selected if they had ≥1 claims for ATO between January 1, 2000, and June 30, 2015. Date of first use was designated the index date. To identify first-line ATO initiation, patients with ATRA or other APL-indicated chemotherapy claims any time before the index date were excluded. Variable baseline and follow-up periods consisting of ≥3 months of pre-index and ≥30 days of post-index continuous enrollment in medical and pharmacy benefit were used. Results: In total, 331 patients were identified with a subset (n = 265) having ≥2 claims for ATO. The analysis focused on these 265 patients, 54% of whom were male. Mean age was 60.6 years; 45% were covered by Medicare. The most common comorbid conditions measured were diabetes (6%), chronic obstructive pulmonary disease (5%), and congestive heart failure (4%). The most commonly selected APL treatments administered during follow-up were ATRA (17%) and daunorubicin (9%) with the use of idarubicin, cytarabine, and mitoxantrone at less than 3%. Maintenance therapy with methotrexate or 6-mercaptopurine was observed in 7% and 6% of patients, respectively. Conclusions: This is one of the first studies to examine patient characteristics and treatment patterns for first-line ATO using real-world data. Further research is needed to evaluate outcomes for patients receiving ATO as first-line therapy and to re-evaluate treatment guidelines in light of these outcomes.
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Affiliation(s)
- Boxiong Tang
- Teva Pharmaceutical Industries, Ltd., Frazer, PA
| | | | - Jifang Zhou
- University of Illinois at Chicago, Chicago, IL
| | | | - Debra Irwin
- Truven Health Analytics, an IBM Company, Chapel Hill, NC
| | - Ellen Riehle
- Truven Health Analytics, an IBM Company, Ann Arbor, MI
| | | | - Martin S. Tallman
- Memorial Sloan-Kettering Cancer Center and Weil Cornell Medical College, New York, NY
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Platzbecker U, Avvisati G, Cicconi L, Thiede C, Paoloni F, Vignetti M, Ferrara F, Divona M, Albano F, Efficace F, Fazi P, Sborgia M, Di Bona E, Breccia M, Borlenghi E, Cairoli R, Rambaldi A, Melillo L, La Nasa G, Fiedler W, Brossart P, Hertenstein B, Salih HR, Wattad M, Lübbert M, Brandts CH, Hänel M, Röllig C, Schmitz N, Link H, Frairia C, Pogliani EM, Fozza C, D’Arco AM, Di Renzo N, Cortelezzi A, Fabbiano F, Döhner K, Ganser A, Döhner H, Amadori S, Mandelli F, Ehninger G, Schlenk RF, Lo-Coco F. Improved Outcomes With Retinoic Acid and Arsenic Trioxide Compared With Retinoic Acid and Chemotherapy in Non–High-Risk Acute Promyelocytic Leukemia: Final Results of the Randomized Italian-German APL0406 Trial. J Clin Oncol 2017; 35:605-612. [DOI: 10.1200/jco.2016.67.1982] [Citation(s) in RCA: 237] [Impact Index Per Article: 33.9] [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
Purpose The initial results of the APL0406 trial showed that the combination of all- trans-retinoic acid (ATRA) and arsenic trioxide (ATO) is at least not inferior to standard ATRA and chemotherapy (CHT) in first-line therapy of low- or intermediate-risk acute promyelocytic leukemia (APL). We herein report the final analysis on the complete series of patients enrolled onto this trial. Patients and Methods The APL0406 study was a prospective, randomized, multicenter, open-label, phase III noninferiority trial. Eligible patients were adults between 18 and 71 years of age with newly diagnosed, low- or intermediate-risk APL (WBC at diagnosis ≤ 10 × 109/L). Overall, 276 patients were randomly assigned to receive ATRA-ATO or ATRA-CHT between October 2007 and January 2013. Results Of 263 patients evaluable for response to induction, 127 (100%) of 127 patients and 132 (97%) of 136 patients achieved complete remission (CR) in the ATRA-ATO and ATRA-CHT arms, respectively ( P = .12). After a median follow-up of 40.6 months, the event-free survival, cumulative incidence of relapse, and overall survival at 50 months for patients in the ATRA-ATO versus ATRA-CHT arms were 97.3% v 80%, 1.9% v 13.9%, and 99.2% v 92.6%, respectively ( P < .001, P = .0013, and P = .0073, respectively). Postinduction events included two relapses and one death in CR in the ATRA-ATO arm and two instances of molecular resistance after third consolidation, 15 relapses, and five deaths in CR in the ATRA-CHT arm. Two patients in the ATRA-CHT arm developed a therapy-related myeloid neoplasm. Conclusion These results show that the advantages of ATRA-ATO over ATRA-CHT increase over time and that there is significantly greater and more sustained antileukemic efficacy of ATO-ATRA compared with ATRA-CHT in low- and intermediate-risk APL.
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Affiliation(s)
- Uwe Platzbecker
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Giuseppe Avvisati
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Laura Cicconi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Christian Thiede
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesca Paoloni
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Marco Vignetti
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Felicetto Ferrara
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Mariadomenica Divona
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesco Albano
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Fabio Efficace
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Paola Fazi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Marco Sborgia
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Eros Di Bona
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Massimo Breccia
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Erika Borlenghi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Roberto Cairoli
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Alessandro Rambaldi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Lorella Melillo
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Giorgio La Nasa
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Walter Fiedler
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Peter Brossart
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Bernd Hertenstein
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Helmut R. Salih
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Mohammed Wattad
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Michael Lübbert
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Christian H. Brandts
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Mathias Hänel
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Christoph Röllig
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Norbert Schmitz
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Hartmut Link
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Chiara Frairia
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Enrico Maria Pogliani
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Claudio Fozza
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Alfonso Maria D’Arco
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Nicola Di Renzo
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Agostino Cortelezzi
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesco Fabbiano
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Konstanze Döhner
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Arnold Ganser
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Hartmut Döhner
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Sergio Amadori
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Franco Mandelli
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Gerhard Ehninger
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Richard F. Schlenk
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
| | - Francesco Lo-Coco
- Uwe Platzbecker, Christian Thiede, Christoph Röllig, and Gerhard Ehninger, Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden; Uwe Platzbecker and Gerhard Ehninger, Study Alliance Leukemia, Dresden; Walter Fiedler, University Hospital Hamburg-Eppendorf; Norbert Schmitz, Asklepios Klinik St Georg Hamburg, Hamburg; Peter Brossart, Innere Medizin mit deSchwerpunkten Onkologie, Haematollogie un Rheumatologie, Bonn; Bernd Hertenstein, Klinikum Bremen Mitte, Bremen; Helmut R. Salih,
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Piredda ML, Catalano G, Ciardi C, Divona M, Cicconi L, Panetta P, Curzi P, Garza E, Martínez-Losada C, Postorino M, Lo-Coco F, Noguera NI. Identification of a potential topoisomerase II "hotspot" DNA region in the DEK gene in two t(6;9)-positive therapy-related myeloid neoplasms. Ann Hematol 2017; 96:155-157. [PMID: 27734129 DOI: 10.1007/s00277-016-2843-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 09/25/2016] [Indexed: 11/30/2022]
MESH Headings
- Base Sequence
- Chromosomal Proteins, Non-Histone/genetics
- DNA Topoisomerases, Type II/genetics
- Drug Resistance, Neoplasm
- Female
- Humans
- Leukemia, Myeloid, Acute/chemically induced
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Oncogene Proteins/genetics
- Poly-ADP-Ribose Binding Proteins
- Topoisomerase Inhibitors/therapeutic use
- Translocation, Genetic/genetics
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Affiliation(s)
- Maria Liliana Piredda
- Laboratory of Neuro-Oncoematology, Santa Lucia Foundation, Rome, Italy
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
| | - Gianfranco Catalano
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
| | | | | | - Laura Cicconi
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
| | | | | | - Eduardo Garza
- Laboratory of Neuro-Oncoematology, Santa Lucia Foundation, Rome, Italy
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
- Laboratorios Dr. Moreira, Monterrey, Mexico
| | - Carmen Martínez-Losada
- Laboratory of Neuro-Oncoematology, Santa Lucia Foundation, Rome, Italy
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
- Alfonso Martin Escudero Foundation, Madrid, Spain
| | - Massimiliano Postorino
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
| | - Francesco Lo-Coco
- Laboratory of Neuro-Oncoematology, Santa Lucia Foundation, Rome, Italy
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy
| | - Nélida I Noguera
- Laboratory of Neuro-Oncoematology, Santa Lucia Foundation, Rome, Italy.
- Department of Biomedicine, "Tor Vergata" University, Via Montpellier 1, 00133, Rome, Italy.
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Lange AP, Lima AS, Lucena-Araujo AR, Jácomo RH, Melo RA, Bittencourt RI, Pasquini R, Pagnano K, Fagundes EM, Chauffaille ML, Chiattone CS, Sanz MA, Lo-Coco F, Grimwade D, Rego EM. The experience of the International Consortium on Acute Promyelocytic Leukemia in monitoring minimal residual disease in acute promyelocytic leukaemia. Br J Haematol 2016; 180:915-918. [PMID: 28025822 DOI: 10.1111/bjh.14490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 10/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ana P Lange
- Haematology and Clinical Oncology Divisions, Department of Internal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil.,Center for Cell Based Therapy, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Ana S Lima
- Haematology and Clinical Oncology Divisions, Department of Internal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil.,Center for Cell Based Therapy, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | | | - Raul A Melo
- Fundação de Hematologia e Hemoterapia de Pernambuco (HEMOPE), Recife, PE, Brazil
| | - Rosane I Bittencourt
- Haematology Service, Federal University of Rio Grande do Sul University Hospital, Porto Alegre, Brazil
| | - Ricardo Pasquini
- Bone Marrow Transplantation Unit, Federal University of Parana University Hospital, Curitiba, Brazil
| | - Katia Pagnano
- Hemocentro, University of Campinas, Campinas, Brazil
| | - Evandro M Fagundes
- Haematology Service, Federal University of Minas Gerais University Hospital, Belo Horizonte, Brazil
| | | | | | - Miguel A Sanz
- Department of Haematology, Hospital Universitari i Politècnic La Fe and Departament de Medicina, Universitat de València, Valencia, Brazil
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Tor Vergata, and Santa Lucia Foundation, Rome, Italy
| | - David Grimwade
- Department of Medical & Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Eduardo M Rego
- Haematology and Clinical Oncology Divisions, Department of Internal Medicine, University of Sao Paulo, Ribeirao Preto, Brazil.,Center for Cell Based Therapy, Medical School of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil
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Affiliation(s)
- E Belloni
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
- Correspondence to E Belloni.
| | - M Trubia
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
| | - P Gasparini
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
| | - C Micucci
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
| | - C Tapinassi
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
| | - S Confalonieri
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
| | - P Nuciforo
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
| | - B Martino
- Divisione di Ematologia, Azienda Ospedaliera Bianchi-Malacrino-Morelli, Reggio Calabria, Italy
| | - F Lo-Coco
- Università di Roma Tor Vergata, Department of Biopatologia e Diagnostica per Immagini, Rome, Italy
| | - PP Di Fiore
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
- Dipartimento di Medicina, Chirurgia ed Odontoiatria, Universita’ degli Studi di Milano, Milan, Italy
| | - PG Pelicci
- Istituto Europeo di Oncologia, Milan, Italy
- Campus IFOM-IEO, Milan, Italy
- Dipartimento di Medicina, Chirurgia ed Odontoiatria, Universita’ degli Studi di Milano, Milan, Italy
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Abstract
Francesco Lo-Coco speaks to Sebastian Dennis-Beron, Commissioning Editor: Francesco Lo-Coco is currently a full professor of hematology and head of the Laboratory of Integrated Diagnosis of Oncohematologic Diseases at the Department of Biomedicine and Prevention of the University Tor Vergata of Roma. He obtained his MD degree from the University of Pisa in 1981, and his specialization in clinical and laboratory hematology is from the University La Sapienza of Rome in 1985. From 1992 to 1994, he has trained on molecular genetics of lymphomas at Columbia University, New York. His main scientific interest and research activities include genetic characterization, monitoring and treatment of hematologic tumors, particularly acute myeloid leukemia and acute promyelocytic leukemia (APL). He has published over 390 internationally peer-reviewed articles, mainly focused on molecular diagnosis and follow-up of leukemia as well as on treatment of APL. He chairs at present the APL subcommittee of the Italian National Cooperative Group, GIMEMA. He served as president of the Italian Society of Experimental Hematology, chairman of the Education Committee of the European Hematology Association, board member of the Italian Foundation for Cancer Research, member of the Committe on Health Research of the Italian Ministry of Health and member of the Editorial Board of the journals Leukemia, Journal of Clinical Oncology and Haematologica.
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Affiliation(s)
- Francesco Lo-Coco
- Department of Biomedicine & Prevention, University Tor Vergata, Rome, Italy
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Morabito F, Voso MT, Hohaus S, Gentile M, Vigna E, Recchia AG, Iovino L, Benedetti E, Lo-Coco F, Galimberti S. Panobinostat for the treatment of acute myelogenous leukemia. Expert Opin Investig Drugs 2016; 25:1117-31. [PMID: 27485472 DOI: 10.1080/13543784.2016.1216971] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Therapeutic strategies in patients with acute myeloid leukemia (AML) have not changed significantly over the last decades. Appropriate strategies are ultimately driven by the assessment of patients' fitness to define suitability for intensive induction chemotherapy, which produces high initial remission rates but, increased likelihood of relapse. Old/unfit AML patients still represent an urgent and unmet therapeutic need. Epigenetic deregulation represents a strategic characteristic of AML pathophysiology whereby aberrant gene transcription provides an advantage to leukemic cell survival. Efforts to re-establish impaired epigenetic regulation include hypomethylating agents and histone deacetylase inhibitors (HDACi). AREAS COVERED The review discusses the underlying mechanisms leading to disruption of lysine acetyltransferases (KAT or HAT)/deacetylase (KDAC or HDAC) balance and the rationale for using the HDACi panobinostat (LBH-589) in AML. EXPERT OPINION Although panobinostat has produced significant results in myeloma, its efficacy remains limited in AML. Panobinostat exerts pleiotropic activity and lack of specificity, which likely contributes to its inadequate safety in elderly AML patients. Phase I-II trials, utilizing panobinostat associated with well-known chemotherapeutic agents are ongoing and combinations with other druggable targets may likely be evaluated in future trials. The clinical use of this HDACi in AML the near future does not appearing promising.
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Affiliation(s)
- Fortunato Morabito
- a Hematology Unit, Department of Onco-Hematology , A.O. of Cosenza , Cosenza , Italy.,b Biotechnology Research Unit , ASP of Cosenza , Aprigliano (CS) , Italy
| | - Maria Teresa Voso
- c Department of Biomedicine and Prevention , Universita' Tor Vergata , Rome , Italy
| | - Stefan Hohaus
- d Department of Hematology , Universita' Cattolica S. Cuore , Rome , Italy
| | - Massimo Gentile
- a Hematology Unit, Department of Onco-Hematology , A.O. of Cosenza , Cosenza , Italy
| | - Ernesto Vigna
- a Hematology Unit, Department of Onco-Hematology , A.O. of Cosenza , Cosenza , Italy
| | | | - Lorenzo Iovino
- e Department of Clinical and Experimental Medicine, Hematology Division , University of Pisa , Pisa , Italy
| | - Edoardo Benedetti
- e Department of Clinical and Experimental Medicine, Hematology Division , University of Pisa , Pisa , Italy
| | - Francesco Lo-Coco
- c Department of Biomedicine and Prevention , Universita' Tor Vergata , Rome , Italy
| | - Sara Galimberti
- e Department of Clinical and Experimental Medicine, Hematology Division , University of Pisa , Pisa , Italy
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Guarnerio J, Bezzi M, Jeong JC, Paffenholz SV, Berry K, Naldini MM, Lo-Coco F, Tay Y, Beck AH, Pandolfi PP. Oncogenic Role of Fusion-circRNAs Derived from Cancer-Associated Chromosomal Translocations. Cell 2016; 166:1055-1056. [DOI: 10.1016/j.cell.2016.07.035] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cicconi L, Divona M, Ciardi C, Ottone T, Ferrantini A, Lavorgna S, Alfonso V, Paoloni F, Piciocchi A, Avvisati G, Ferrara F, Di Bona E, Albano F, Breccia M, Cerqui E, Sborgia M, Kropp MG, Santoro A, Levis A, Sica S, Amadori S, Voso MT, Mandelli F, Lo-Coco F. PML–RARα kinetics and impact of FLT3–ITD mutations in newly diagnosed acute promyelocytic leukaemia treated with ATRA and ATO or ATRA and chemotherapy. Leukemia 2016; 30:1987-1992. [DOI: 10.1038/leu.2016.122] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/05/2016] [Accepted: 04/12/2016] [Indexed: 11/09/2022]
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Abstract
The management of acute promyelocytic leukemia (APL) has considerably evolved during the past two decades. The advent of all-trans retinoic acid (ATRA) and its inclusion in combinatorial regimens with anthracycline chemotherapy has provided cure rates exceeding 80%; however, this widely adopted approach also conveys significant toxicity including severe myelosuppression and rare occurrence of secondary leukemias. More recently, the advent of arsenic trioxide (ATO) and its use in association with ATRA with or without chemotherapy has further improved patient outcome by allowing to minimize the intensity of chemotherapy, thus reducing serious toxicity while maintaining high anti-leukemic efficacy. The advantage of ATRA-ATO over ATRA chemotherapy has been recently demonstrated in two large randomized trials and this option has now become the new standard of care in low-risk (i.e. non-hyperleukocytic) patients. In light of its rarity, abrupt onset and high risk of early death and due to specific treatment requirements, APL remains a challenging condition that needs to be managed in highly experienced centers. We review here the results of large clinical studies conducted in newly diagnosed APL as well as the recommendations for appropriate diagnosis, prevention and management of the main complications associated with modern treatment of the disease.
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Affiliation(s)
- L Cicconi
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - F Lo-Coco
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
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Saulle E, Petronelli A, Pelosi E, Coppotelli E, Pasquini L, Ilari R, Lo-Coco F, Testa U. PML-RAR alpha induces the downmodulation of HHEX: a key event responsible for the induction of an angiogenetic response. J Hematol Oncol 2016; 9:33. [PMID: 27052408 PMCID: PMC4823896 DOI: 10.1186/s13045-016-0262-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 10/14/2015] [Accepted: 03/30/2016] [Indexed: 12/14/2022] Open
Abstract
Background Recent studies indicate that angiogenesis is important in the pathogenesis of acute myeloid leukemias (AMLs). Among the various AMLs, the bone marrow angiogenetic response is particularly pronounced in acute promyelocytic leukemia (APL). However, the molecular mechanisms responsible for this angiogenetic response are largely unknown. In the present study, we have explored the role of HHEX, a homeodomain transcription factor, as a possible mediator of the pro-angiogenetic response observed in APL. This transcription factor seems to represent an ideal candidate for this biologic function because it is targeted by PML-RARα, is capable of interaction with PML and PML-RARα, and acts as a regulator of the angiogenetic response. Methods We used various cellular systems of APL, including primary APL cells and leukemic cells engineered to express PML-RARα, to explore the role of the PML-RARα fusion protein on HHEX expression. Molecular and biochemical techniques have been used to investigate the mechanisms through which PML-RARα downmodulates HHEX and the functional consequences of this downmodulation at the level of the expression of various angiogenetic genes, cell proliferation and differentiation. Results Our results show that HHEX expression is clearly downmodulated in APL and that this effect is directly mediated by a repressive targeting of the HHEX gene promoter by PML-RARα. Studies carried out in primary APL cells and in a cell line model of APL with inducible PML-RARα expression directly support the view that this fusion protein through HHEX downmodulation stimulates the expression of various genes involved in angiogenesis and inhibits cell differentiation. Conclusions Our data suggest that HHEX downmodulation by PML-RARα is a key event during APL pathogenesis. Electronic supplementary material The online version of this article (doi:10.1186/s13045-016-0262-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ernestina Saulle
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Alessia Petronelli
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Elvira Pelosi
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Elena Coppotelli
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Luca Pasquini
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Ramona Ilari
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Lo-Coco
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata" and Fondazione Santa Lucia, Rome, Italy
| | - Ugo Testa
- Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy.
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