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Yap P, Riley LG, Kakadia PM, Bohlander SK, Curran B, Rahimi MJ, Alburaiky S, Hayes I, Oppermann H, Print C, Cooper ST, Le Quesne Stabej P. Biallelic ATP2B1 variants as a likely cause of a novel neurodevelopmental malformation syndrome with primary hypoparathyroidism. Eur J Hum Genet 2024; 32:125-129. [PMID: 37926713 PMCID: PMC10772071 DOI: 10.1038/s41431-023-01484-9] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/22/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
ATP2B1 encodes plasma membrane calcium-transporting-ATPase1 and plays an essential role in maintaining intracellular calcium homeostasis that regulates diverse signaling pathways. Heterozygous de novo missense and truncating ATP2B1 variants are associated with a neurodevelopmental phenotype of variable expressivity. We describe a proband with distinctive craniofacial gestalt, Pierre-Robin sequence, neurodevelopmental and growth deficit, periventricular heterotopia, brachymesophalangy, cutaneous syndactyly, and persistent hypocalcemia from primary hypoparathyroidism. Proband-parent trio exome sequencing identified compound heterozygous ATP2B1 variants: a maternally inherited splice-site (c.3060+2 T > G) and paternally inherited missense c.2938 G > T; p.(Val980Leu). Reverse-transcription-PCR on the proband's fibroblast-derived mRNA showed aberrantly spliced ATP2B1 transcripts targeted for nonsense-mediated decay. All correctly-spliced ATP2B1 mRNA encoding p.(Val980Leu) functionally causes decreased cellular Ca2+ extrusion. Immunoblotting showed reduced fibroblast ATP2B1. We conclude that biallelic ATP2B1 variants are the likely cause of the proband's phenotype, strengthening the association of ATP2B1 as a neurodevelopmental gene and expanding the phenotypic characterization of a biallelic loss-of-function genotype.
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Affiliation(s)
- Patrick Yap
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand.
- Genetic Health Service New Zealand - Northern hub, Auckland, New Zealand.
| | - Lisa G Riley
- Rare Diseases Functional Genomics, Kids Research, The Children's Hospital at Westmead and The Children's Medical Research Institute, Sydney, NSW, 2145, Australia
- Specialty of Child & Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
| | - Purvi M Kakadia
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Stefan K Bohlander
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Ben Curran
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Meer Jacob Rahimi
- Institute of Human Genetics, University of Leipzig Hospitals and Clinics, Leipzig, 04103, Germany
| | - Salam Alburaiky
- Genetic Health Service New Zealand - Northern hub, Auckland, New Zealand
| | - Ian Hayes
- Genetic Health Service New Zealand - Northern hub, Auckland, New Zealand
| | - Henry Oppermann
- Institute of Human Genetics, University of Leipzig Hospitals and Clinics, Leipzig, 04103, Germany
| | - Cristin Print
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Sandra T Cooper
- Specialty of Child & Adolescent Health, Sydney Medical School, University of Sydney, Sydney, NSW, 2006, Australia
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Sydney, NSW, 2145, Australia
- The Children's Medical Research Institute, 214 Hawkesbury Road, Westmead, NSW, 2145, Australia
| | - Polona Le Quesne Stabej
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
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2
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Schnegg-Kaufmann AS, Thoms JAI, Bhuyan GS, Hampton HR, Vaughan L, Rutherford K, Kakadia PM, Lee HM, Johansson EMV, Failes TW, Arndt GM, Koval J, Lindeman R, Warburton P, Rodriguez-Meira A, Mead AJ, Unnikrishnan A, Davidson S, Polizzotto MN, Hertzberg M, Papaemmanuil E, Bohlander SK, Faridani OR, Jolly CJ, Zanini F, Pimanda JE. Contribution of mutant HSC clones to immature and mature cells in MDS and CMML, and variations with AZA therapy. Blood 2023; 141:1316-1321. [PMID: 36493342 PMCID: PMC10651766 DOI: 10.1182/blood.2022018602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Myelodysplastic neoplasms (MDSs) and chronic myelomonocytic leukemia (CMML) are clonal disorders driven by progressively acquired somatic mutations in hematopoietic stem cells (HSCs). Hypomethylating agents (HMAs) can modify the clinical course of MDS and CMML. Clinical improvement does not require eradication of mutated cells and may be related to improved differentiation capacity of mutated HSCs. However, in patients with established disease it is unclear whether (1) HSCs with multiple mutations progress through differentiation with comparable frequency to their less mutated counterparts or (2) improvements in peripheral blood counts following HMA therapy are driven by residual wild-type HSCs or by clones with particular combinations of mutations. To address these questions, the somatic mutations of individual stem cells, progenitors (common myeloid progenitors, granulocyte monocyte progenitors, and megakaryocyte erythroid progenitors), and matched circulating hematopoietic cells (monocytes, neutrophils, and naïve B cells) in MDS and CMML were characterized via high-throughput single-cell genotyping, followed by bulk analysis in immature and mature cells before and after AZA treatment. The mutational burden was similar throughout differentiation, with even the most mutated stem and progenitor clones maintaining their capacity to differentiate to mature cell types in vivo. Increased contributions from productive mutant progenitors appear to underlie improved hematopoiesis in MDS following HMA therapy.
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Affiliation(s)
- Annatina S. Schnegg-Kaufmann
- School of Biomedical Sciences, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for Biomedical Research, University of Bern, Bern, Switzerland
| | - Julie A. I. Thoms
- School of Biomedical Sciences, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Golam Sarower Bhuyan
- School of Clinical Medicine, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Henry R. Hampton
- School of Biomedical Sciences, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Lachlin Vaughan
- School of Clinical Medicine, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Institute of Clinical Pathology and Medical Research, Westmead Hospital, Sydney, NSW, Australia
- Haematology Department, Westmead Hospital, Sydney, NSW, Australia
| | - Kayleigh Rutherford
- Department of Epidemiology and Biostatistics, Computational Oncology Service, Center for Computational Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Purvi M. Kakadia
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Hui Mei Lee
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Emma M. V. Johansson
- Flow Cytometry Facility, Mark Wainwright Analytical Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Timothy W. Failes
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Australian Cancer Research Foundation (ACRF) Drug Discovery Centre for Childhood Cancer, Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Greg M. Arndt
- School of Clinical Medicine, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Australian Cancer Research Foundation (ACRF) Drug Discovery Centre for Childhood Cancer, Children’s Cancer Institute, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Jason Koval
- Ramaciotti Centre for Genomics, UNSW Sydney, Sydney, NSW, Australia
| | - Robert Lindeman
- Department of Clinical Haematology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Pauline Warburton
- Department of Haematology, Wollongong Hospital, Wollongong, NSW, Australia
| | - Alba Rodriguez-Meira
- Haematopoietic Stem Cell Biology Laboratory, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Adam J. Mead
- Haematopoietic Stem Cell Biology Laboratory, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Ashwin Unnikrishnan
- School of Clinical Medicine, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Sarah Davidson
- ANU Clinical Hub for Interventional Research (CHOIR), John Curtin School of Medical Research, Canberra, Australia
| | - Mark N. Polizzotto
- ANU Clinical Hub for Interventional Research (CHOIR), John Curtin School of Medical Research, Canberra, Australia
| | - Mark Hertzberg
- Department of Clinical Haematology, Prince of Wales Hospital, Sydney, NSW, Australia
| | - Elli Papaemmanuil
- Department of Epidemiology and Biostatistics, Computational Oncology Service, Center for Computational Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stefan K. Bohlander
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Omid R. Faridani
- School of Biomedical Sciences, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Garvan-Weizmann Centre for Cellular Genomics, Sydney, NSW, Australia
- Cellular Genomics Futures Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Christopher J. Jolly
- School of Biomedical Sciences, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Fabio Zanini
- School of Clinical Medicine, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Garvan-Weizmann Centre for Cellular Genomics, Sydney, NSW, Australia
- Cellular Genomics Futures Institute, UNSW Sydney, Sydney, NSW, Australia
| | - John E. Pimanda
- School of Biomedical Sciences, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- School of Clinical Medicine, Lowy Cancer Research Centre, UNSW Sydney, Sydney, NSW, Australia
- Department of Clinical Haematology, Prince of Wales Hospital, Sydney, NSW, Australia
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3
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Jamieson SM, Tsai P, Kondratyev MK, Budhani P, Liu A, Senzer NN, Chiorean EG, Jalal SI, Nemunaitis JJ, Kee D, Shome A, Wong WW, Li D, Poonawala-Lohani N, Kakadia PM, Knowlton NS, Lynch CR, Hong CR, Lee TW, Grénman RA, Caporiccio L, McKee TD, Zaidi M, Butt S, Macann AM, McIvor NP, Chaplin JM, Hicks KO, Bohlander SK, Wouters BG, Hart CP, Print CG, Wilson WR, Curran MA, Hunter FW. Evofosfamide for the treatment of human papillomavirus-negative head and neck squamous cell carcinoma. JCI Insight 2023; 8:169136. [PMID: 36810255 PMCID: PMC9990753 DOI: 10.1172/jci.insight.169136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
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4
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Britto DD, He J, Misa JP, Chen W, Kakadia PM, Grimm L, Herbert CD, Crosier KE, Crosier PS, Bohlander SK, Hogan BM, Hall CJ, Torres-Vázquez J, Astin JW. Plexin D1 negatively regulates zebrafish lymphatic development. Development 2022; 149:dev200560. [PMID: 36205097 PMCID: PMC9720674 DOI: 10.1242/dev.200560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
Lymphangiogenesis is a dynamic process that involves the directed migration of lymphatic endothelial cells (LECs) to form lymphatic vessels. The molecular mechanisms that underpin lymphatic vessel patterning are not fully elucidated and, to date, no global regulator of lymphatic vessel guidance is known. In this study, we identify the transmembrane cell signalling receptor Plexin D1 (Plxnd1) as a negative regulator of both lymphatic vessel guidance and lymphangiogenesis in zebrafish. plxnd1 is expressed in developing lymphatics and is required for the guidance of both the trunk and facial lymphatic networks. Loss of plxnd1 is associated with misguided intersegmental lymphatic vessel growth and aberrant facial lymphatic branches. Lymphatic guidance in the trunk is mediated, at least in part, by the Plxnd1 ligands, Semaphorin 3AA and Semaphorin 3C. Finally, we show that Plxnd1 normally antagonises Vegfr/Erk signalling to ensure the correct number of facial LECs and that loss of plxnd1 results in facial lymphatic hyperplasia. As a global negative regulator of lymphatic vessel development, the Sema/Plxnd1 signalling pathway is a potential therapeutic target for treating diseases associated with dysregulated lymphatic growth.
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Affiliation(s)
- Denver D. Britto
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Jia He
- Skirball Institute of Biomolecular Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - June P. Misa
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Wenxuan Chen
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Purvi M. Kakadia
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Lin Grimm
- Organogenesis and Cancer Program, Peter MacCallum Cancer Centre, Melbourne 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3010, Australia
- Department of Anatomy and Physiology, University of Melbourne, Melbourne 3010, Australia
| | - Caitlin D. Herbert
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Kathryn E. Crosier
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Philip S. Crosier
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Stefan K. Bohlander
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
- Leukaemia and Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1023, New Zealand
| | - Benjamin M. Hogan
- Organogenesis and Cancer Program, Peter MacCallum Cancer Centre, Melbourne 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3010, Australia
- Department of Anatomy and Physiology, University of Melbourne, Melbourne 3010, Australia
| | - Christopher J. Hall
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
| | - Jesús Torres-Vázquez
- Skirball Institute of Biomolecular Medicine, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Jonathan W. Astin
- Department of Molecular Medicine and Pathology, School of Medical Sciences, University of Auckland, Auckland 1023, New Zealand
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5
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Das AB, Kakadia PM, Wojcik D, Pemberton L, Browett PJ, Bohlander SK, Vissers MCM. Clinical remission following ascorbate treatment in a case of acute myeloid leukemia with mutations in TET2 and WT1. Blood Cancer J 2019; 9:82. [PMID: 31578317 PMCID: PMC6775073 DOI: 10.1038/s41408-019-0242-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/06/2019] [Accepted: 09/17/2019] [Indexed: 12/21/2022] Open
Affiliation(s)
- Andrew B Das
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch, Christchurch, New Zealand
| | - Purvi M Kakadia
- Leukaemia & Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Damian Wojcik
- Northland Environmental Health Clinic, 2 Dip Rd, Kamo, Whangarei, New Zealand
| | - Lucy Pemberton
- Southern Blood and Cancer Service, Southern District Health Board, Dunedin Hospital, Dunedin, New Zealand
| | - Peter J Browett
- Leukaemia & Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Stefan K Bohlander
- Leukaemia & Blood Cancer Research Unit, Department of Molecular Medicine and Pathology, The University of Auckland, Auckland, New Zealand
| | - Margreet C M Vissers
- Centre for Free Radical Research, Department of Pathology and Biomedical Science, University of Otago, Christchurch, Christchurch, New Zealand.
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6
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Hunter FW, Devaux JBL, Meng F, Hong CR, Khan A, Tsai P, Ketela TW, Sharma I, Kakadia PM, Marastoni S, Shalev Z, Hickey AJR, Print CG, Bohlander SK, Hart CP, Wouters BG, Wilson WR. Functional CRISPR and shRNA Screens Identify Involvement of Mitochondrial Electron Transport in the Activation of Evofosfamide. Mol Pharmacol 2019; 95:638-651. [PMID: 30979813 DOI: 10.1124/mol.118.115196] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 04/08/2019] [Indexed: 01/29/2023] Open
Abstract
Evofosfamide (TH-302) is a hypoxia-activated DNA-crosslinking prodrug currently in clinical development for cancer therapy. Oxygen-sensitive activation of evofosfamide depends on one-electron reduction, yet the reductases that catalyze this process in tumors are unknown. We used RNA sequencing, whole-genome CRISPR knockout, and reductase-focused short hairpin RNA screens to interrogate modifiers of evofosfamide activation in cancer cell lines. Involvement of mitochondrial electron transport in the activation of evofosfamide and the related nitroaromatic compounds EF5 and FSL-61 was investigated using 143B ρ 0 (ρ zero) cells devoid of mitochondrial DNA and biochemical assays in UT-SCC-74B cells. The potency of evofosfamide in 30 genetically diverse cancer cell lines correlated with the expression of genes involved in mitochondrial electron transfer. A whole-genome CRISPR screen in KBM-7 cells identified the DNA damage-response factors SLX4IP, C10orf90 (FATS), and SLFN11, in addition to the key regulator of mitochondrial function, YME1L1, and several complex I constituents as modifiers of evofosfamide sensitivity. A reductase-focused shRNA screen in UT-SCC-74B cells similarly identified mitochondrial respiratory chain factors. Surprisingly, 143B ρ 0 cells showed enhanced evofosfamide activation and sensitivity but had global transcriptional changes, including increased expression of nonmitochondrial flavoreductases. In UT-SCC-74B cells, evofosfamide oxidized cytochromes a, b, and c and inhibited respiration at complexes I, II, and IV without quenching reactive oxygen species production. Our results suggest that the mitochondrial electron transport chain contributes to evofosfamide activation and that predicting evofosfamide sensitivity in patients by measuring the expression of canonical bioreductive enzymes such as cytochrome P450 oxidoreductase is likely to be futile.
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Affiliation(s)
- Francis W Hunter
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Jules B L Devaux
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Fanying Meng
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Cho Rong Hong
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Aziza Khan
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Peter Tsai
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Troy W Ketela
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Indumati Sharma
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Purvi M Kakadia
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Stefano Marastoni
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Zvi Shalev
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Anthony J R Hickey
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Cristin G Print
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Stefan K Bohlander
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Charles P Hart
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - Bradly G Wouters
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
| | - William R Wilson
- Auckland Cancer Society Research Centre, School of Medical Sciences, Faculty of Medical and Health Sciences (F.W.H., C.R.H., A.K., I.S., W.R.W.), Maurice Wilkins Centre for Molecular Biodiscovery (F.W.H., A.J.R.H., C.G.P., W.R.W.), School of Biological Sciences, Faculty of Science (J.B.L.D., A.J.R.H.), and Department of Molecular Medicine and Pathology, School of Medical Sciences, Faculty of Medical and Health Sciences (P.T., P.M.K., C.G.P., S.K.B.), University of Auckland, Auckland, New Zealand; Threshold Pharmaceuticals, South San Francisco, California (F.M., C.P.H.); Princess Margaret Genomics Centre (T.W.K.) and Princess Margaret Cancer Centre (S.M., Z.S., B.G.W.), University Health Network, and Departments of Radiation Oncology (B.G.W.) and Medical Biophysics (B.G.W.), University of Toronto, Toronto, Ontario, Canada
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7
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Leung EY, Askarian-Amiri ME, Singleton DC, Ferraro-Peyret C, Joseph WR, Finlay GJ, Broom RJ, Kakadia PM, Bohlander SK, Marshall E, Baguley BC. Derivation of Breast Cancer Cell Lines Under Physiological (5%) Oxygen Concentrations. Front Oncol 2018; 8:425. [PMID: 30370249 PMCID: PMC6194255 DOI: 10.3389/fonc.2018.00425] [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: 04/04/2018] [Accepted: 09/11/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Most human breast cancer cell lines currently in use were developed and are cultured under ambient (21%) oxygen conditions. While this is convenient in practical terms, higher ambient oxygen could increase oxygen radical production, potentially modulating signaling pathways. We have derived and grown a series of four human breast cancer cell lines under 5% oxygen, and have compared their properties to those of established breast cancer lines growing under ambient oxygen. Methods: Cell lines were characterized in terms of appearance, cellular DNA content, mutation spectrum, hormone receptor status, pathway utilization and drug sensitivity. Results: Three of the four lines (NZBR1, NZBR2, and NZBR4) were triple negative (ER-, PR-, HER2-), with NZBR1 also over-expressing EGFR. NZBR3 was HER2+ and ER+ and also over-expressed EGFR. Cell lines grown in 5% oxygen showed increased expression of the hypoxia-inducible factor 1 (HIF-1) target gene carbonic anhydrase 9 (CA9) and decreased levels of ROS. As determined by protein phosphorylation, NZBR1 showed low AKT pathway utilization while NZBR2 and NZBR4 showed low p70S6K and rpS6 pathway utilization. The lines were characterized for sensitivity to 7-hydroxytamoxifen, doxorubicin, paclitaxel, the PI3K inhibitor BEZ235 and the HER inhibitors lapatinib, afatinib, dacomitinib, and ARRY-380. In some cases they were compared to established breast cancer lines. Of particular note was the high sensitivity of NZBR3 to HER inhibitors. The spectrum of mutations in the NZBR lines was generally similar to that found in commonly used breast cancer cell lines but TP53 mutations were absent and mutations in EVI2B, LRP1B, and PMS2, which have not been reported in other breast cancer lines, were detected. The results suggest that the properties of cell lines developed under low oxygen conditions (5% O2) are similar to those of commonly used breast cancer cell lines. Although reduced ROS production and increased HIF-1 activity under 5% oxygen can potentially influence experimental outcomes, no difference in sensitivity to estrogen or doxorubicin was observed between cell lines cultured in 5 vs. 21% oxygen.
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Affiliation(s)
- Euphemia Y Leung
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Marjan E Askarian-Amiri
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Dean C Singleton
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Carole Ferraro-Peyret
- Univ Lyon, Claude Bernard University, Cancer Research Center of Lyon, INSERM 1052, CNRS5286, Faculty of Pharmacy, Lyon, France.,Hospices Civils de Lyon, Molecular Biology of Tumors, GHE Hospital, Bron, France
| | - Wayne R Joseph
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Graeme J Finlay
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Reuben J Broom
- Auckland City Hospital-Oncology, Grafton, Auckland, New Zealand
| | - Purvi M Kakadia
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Stefan K Bohlander
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Elaine Marshall
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Bruce C Baguley
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
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8
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Jamieson SM, Tsai P, Kondratyev MK, Budhani P, Liu A, Senzer NN, Chiorean EG, Jalal SI, Nemunaitis JJ, Kee D, Shome A, Wong WW, Li D, Poonawala-Lohani N, Kakadia PM, Knowlton NS, Lynch CR, Hong CR, Lee TW, Grénman RA, Caporiccio L, McKee TD, Zaidi M, Butt S, Macann AM, McIvor NP, Chaplin JM, Hicks KO, Bohlander SK, Wouters BG, Hart CP, Print CG, Wilson WR, Curran MA, Hunter FW. Evofosfamide for the treatment of human papillomavirus-negative head and neck squamous cell carcinoma. JCI Insight 2018; 3:122204. [PMID: 30135316 PMCID: PMC6141174 DOI: 10.1172/jci.insight.122204] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [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: 05/14/2018] [Accepted: 07/13/2018] [Indexed: 01/10/2023] Open
Abstract
Evofosfamide (TH-302) is a clinical-stage hypoxia-activated prodrug of a DNA-crosslinking nitrogen mustard that has potential utility for human papillomavirus (HPV) negative head and neck squamous cell carcinoma (HNSCC), in which tumor hypoxia limits treatment outcome. We report the preclinical efficacy, target engagement, preliminary predictive biomarkers and initial clinical activity of evofosfamide for HPV-negative HNSCC. Evofosfamide was assessed in 22 genomically characterized cell lines and 7 cell line-derived xenograft (CDX), patient-derived xenograft (PDX), orthotopic, and syngeneic tumor models. Biomarker analysis used RNA sequencing, whole-exome sequencing, and whole-genome CRISPR knockout screens. Five advanced/metastatic HNSCC patients received evofosfamide monotherapy (480 mg/m2 qw × 3 each month) in a phase 2 study. Evofosfamide was potent and highly selective for hypoxic HNSCC cells. Proliferative rate was a predominant evofosfamide sensitivity determinant and a proliferation metagene correlated with activity in CDX models. Evofosfamide showed efficacy as monotherapy and with radiotherapy in PDX models, augmented CTLA-4 blockade in syngeneic tumors, and reduced hypoxia in nodes disseminated from an orthotopic model. Of 5 advanced HNSCC patients treated with evofosfamide, 2 showed partial responses while 3 had stable disease. In conclusion, evofosfamide shows promising efficacy in aggressive HPV-negative HNSCC, with predictive biomarkers in development to support further clinical evaluation in this indication.
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Affiliation(s)
- Stephen Mf Jamieson
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand.,Department of Pharmacology and Clinical Pharmacology, University of Auckland, Auckland, New Zealand
| | - Peter Tsai
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Maria K Kondratyev
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Pratha Budhani
- Department of Immunology, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Arthur Liu
- Department of Immunology, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Neil N Senzer
- Mary Crowley Cancer Research Center, Dallas, Texas, USA
| | - E Gabriela Chiorean
- Indiana University Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana, USA.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle, Washington, USA
| | - Shadia I Jalal
- Indiana University Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, Indiana, USA
| | - John J Nemunaitis
- Department of Medicine, University of Toledo College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio, USA
| | - Dennis Kee
- LabPLUS, Auckland City Hospital, Auckland, New Zealand
| | - Avik Shome
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Way W Wong
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Dan Li
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | | | - Purvi M Kakadia
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Nicholas S Knowlton
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Courtney Rh Lynch
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Cho R Hong
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
| | - Tet Woo Lee
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
| | - Reidar A Grénman
- Department of Otolaryngology-Head and Neck Surgery, Turku University Hospital, Turku, Finland
| | - Laura Caporiccio
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Trevor D McKee
- STTARR Innovation Centre, University Health Network, Toronto, Ontario, Canada
| | - Mark Zaidi
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,STTARR Innovation Centre, University Health Network, Toronto, Ontario, Canada
| | - Sehrish Butt
- STTARR Innovation Centre, University Health Network, Toronto, Ontario, Canada
| | - Andrew Mj Macann
- Department of Radiation Oncology, Auckland City Hospital, Auckland, New Zealand
| | - Nicholas P McIvor
- Department of Otolaryngology-Head and Neck Surgery, Auckland City Hospital, Auckland, New Zealand
| | - John M Chaplin
- Department of Otolaryngology-Head and Neck Surgery, Auckland City Hospital, Auckland, New Zealand
| | - Kevin O Hicks
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
| | - Stefan K Bohlander
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Bradly G Wouters
- Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Charles P Hart
- Threshold Pharmaceuticals, South San Francisco, California, USA
| | - Cristin G Print
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand.,Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - William R Wilson
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
| | - Michael A Curran
- Department of Immunology, University of Texas, MD Anderson Cancer Center, Houston, Texas, USA
| | - Francis W Hunter
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
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9
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Hunter FW, Tsai P, Kakadia PM, Bohlander SK, Print CG, Wilson WR. Development of capability for genome-scale CRISPR-Cas9 knockout screens in New Zealand. J R Soc N Z 2017. [DOI: 10.1080/03036758.2017.1400984] [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: 10/18/2022]
Affiliation(s)
- Francis W. Hunter
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
| | - Peter Tsai
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Bioinformatics Institute, University of Auckland, Auckland, New Zealand
| | - Purvi M. Kakadia
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Stefan K. Bohlander
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
| | - Cristin G. Print
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
- Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand
- Bioinformatics Institute, University of Auckland, Auckland, New Zealand
| | - William R. Wilson
- Auckland Cancer Society Research Centre, University of Auckland, Auckland, New Zealand
- Maurice Wilkins Centre for Molecular Biodiscovery, University of Auckland, Auckland, New Zealand
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10
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Sandhöfer N, Metzeler KH, Kakadia PM, Pasalic Z, Hiddemann W, Neusser M, Steinlein O, Fiegl M, Subklewe M, Spiekermann K, Bohlander SK, Schneider S, Braess J. A fluorescence in situ hybridization-based screen allows rapid detection of adverse cytogenetic alterations in patients with acute myeloid leukemia. Genes Chromosomes Cancer 2017; 56:632-638. [PMID: 28420034 DOI: 10.1002/gcc.22466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 04/11/2017] [Accepted: 04/11/2017] [Indexed: 11/12/2022] Open
Abstract
In adult acute myeloid leukemia (AML), the karyotype of the leukemic cell is among the strongest prognostic factors. The Medical Research Council (MRC) and the European LeukemiaNet (ELN) classifications distinguish between favorable, intermediate and adverse cytogenetic risk patients who differ in their treatment response and overall survival. Conventional cytogenetic analyses are a mandatory component of AML diagnostics but they are time-consuming; therefore, therapeutic decisions in elderly patients are often delayed. We investigated whether a screening approach using a panel of seven fluorescence in situ hybridization (FISH) probes would allow rapid identification of adverse chromosomal changes. In a cohort of 334 AML patients, our targeted FISH screening approach identified 80% of adverse risk AML patients with a specificity of 99%. Incorporating FISH screening into diagnostic workup has the potential to accelerate risk stratification and treatment selection, particularly in older patients. This approach may allow therapeutic decisions more quickly, which benefits both patients and physicians and might save costs.
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Affiliation(s)
- Nadine Sandhöfer
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Klaus H Metzeler
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Purvi M Kakadia
- Department of Molecular Medicine and Pathology, University of Auckland, New Zealand
| | - Zlatana Pasalic
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfgang Hiddemann
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Michaela Neusser
- Institute of Human Genetics, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Ortrud Steinlein
- Institute of Human Genetics, University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Michael Fiegl
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Marion Subklewe
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Karsten Spiekermann
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Stefan K Bohlander
- Department of Molecular Medicine and Pathology, University of Auckland, New Zealand
| | - Stephanie Schneider
- Department of Internal Medicine III, Laboratory for Leukemia Diagnostics, Ludwig-Maximilians-University, Munich, Germany
| | - Jan Braess
- Department of Oncology and Hematology, Hospital Barmherzige Brüder, Regensburg, Germany
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11
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Pastore F, Dufour A, Benthaus T, Metzeler KH, Maharry KS, Schneider S, Ksienzyk B, Mellert G, Zellmeier E, Kakadia PM, Unterhalt M, Feuring-Buske M, Buske C, Braess J, Sauerland MC, Heinecke A, Krug U, Berdel WE, Buechner T, Woermann B, Hiddemann W, Bohlander SK, Marcucci G, Spiekermann K, Bloomfield CD, Hoster E. Combined molecular and clinical prognostic index for relapse and survival in cytogenetically normal acute myeloid leukemia. J Clin Oncol 2014; 32:1586-94. [PMID: 24711548 DOI: 10.1200/jco.2013.52.3480] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Cytogenetically normal (CN) acute myeloid leukemia (AML) is the largest and most heterogeneous cytogenetic AML subgroup. For the practicing clinician, it is difficult to summarize the prognostic information of the growing number of clinical and molecular markers. Our purpose was to develop a widely applicable prognostic model by combining well-established pretreatment patient and disease characteristics. PATIENTS AND METHODS Two prognostic indices for CN-AML (PINA), one regarding overall survival (OS; PINAOS) and the other regarding relapse-free survival (RFS; PINARFS), were derived from data of 572 patients with CN-AML treated within the AML Cooperative Group 99 study (www.aml-score.org). RESULTS On the basis of age (median, 60 years; range, 17 to 85 years), performance status, WBC count, and mutation status of NPM1, CEBPA, and FLT3-internal tandem duplication, patients were classified into the following three risk groups according to PINAOS and PINARFS: 29% of all patients and 32% of 381 responding patients had low-risk disease (5-year OS, 74%; 5-year RFS, 55%); 56% of all patients and 39% of responding patients had intermediate-risk disease (5-year OS, 28%; 5-year RFS, 27%), and 15% of all patients and 29% of responding patients had high-risk disease (5-year OS, 3%; 5-year RFS, 5%), respectively. PINAOS and PINARFS stratified outcome within European LeukemiaNet genetic groups. Both indices were confirmed on independent data from Cancer and Leukemia Group B/Alliance trials. CONCLUSION We have developed and validated, to our knowledge, the first prognostic indices specifically designed for adult patients of all ages with CN-AML that combine well-established molecular and clinical variables and that are easily applicable in routine clinical care. The integration of both clinical and molecular markers could provide a basis for individualized patient care through risk-adapted therapy of CN-AML.
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Affiliation(s)
- Friederike Pastore
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand.
| | - Annika Dufour
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Tobias Benthaus
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Klaus H Metzeler
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Kati S Maharry
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Stephanie Schneider
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Bianka Ksienzyk
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Gudrun Mellert
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Evelyn Zellmeier
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Purvi M Kakadia
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Michael Unterhalt
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Michaela Feuring-Buske
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Christian Buske
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Jan Braess
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Maria Cristina Sauerland
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Achim Heinecke
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Utz Krug
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Wolfgang E Berdel
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Thomas Buechner
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Bernhard Woermann
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Wolfgang Hiddemann
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Stefan K Bohlander
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Guido Marcucci
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Karsten Spiekermann
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Clara D Bloomfield
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
| | - Eva Hoster
- Friederike Pastore, Annika Dufour, Tobias Benthaus, Klaus H. Metzeler, Stephanie Schneider, Bianka Ksienzyk, Gudrun Mellert, Evelyn Zellmeier, Purvi M. Kakadia, Michael Unterhalt, Wolfgang Hiddemann, Stefan K. Bohlander, Karsten Spiekermann, and Eva Hoster, University Hospital Munich Großhadern; Friederike Pastore, Klaus H. Metzeler, Wolfgang Hiddemann, Stefan K. Bohlander, and Karsten Spiekermann, Helmholtz Center Munich; Eva Hoster, University of Munich, Munich; Purvi M. Kakadia and Stefan K. Bohlander, University Hospital Marburg, Marburg; Michaela Feuring-Buske, University Hospital Ulm; Christian Buske, Comprehensive Cancer Center Ulm, University of Ulm, Ulm; Jan Braess, Klinikum Barmherzige Brüder, Regensburg; Maria Cristina Sauerland and Achim Heinecke, University of Muenster; Utz Krug, Wolfgang E. Berdel, and Thomas Buechner, University Hospital Muenster, Muenster; Bernhard Woermann, German Society of Hematology and Oncology, Berlin, Germany; Kati S. Maharry, Guido Marcucci, and Clara D. Bloomfield, The Ohio State University Comprehensive Cancer Center, Columbus, OH; Kati S. Maharry, Mayo Clinic, Rochester, MN; and Stefan K. Bohlander, University of Auckland, Auckland, New Zealand
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Herold T, Mulaw MA, Jurinovic V, Seiler T, Metzeler KH, Dufour A, Schneider S, Kakadia PM, Spiekermann K, Mansmann U, Hiddemann W, Buske C, Dreyling M, Bohlander SK. High expression of MZB1 predicts adverse prognosis in chronic lymphocytic leukemia, follicular lymphoma and diffuse large B-cell lymphoma and is associated with a unique gene expression signature. Leuk Lymphoma 2012. [PMID: 23189934 DOI: 10.3109/10428194.2012.753445] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract We recently identified the marginal zone B and B1 cell-specific protein (MZB1) as part of a gene expression signature associated with outcomes in chronic lymphocytic leukemia (CLL). MZB1 is important for B cell function as a key regulator of antibody secretion, calcium homeostasis and adhesion. Therefore, we analyzed the role of MZB1 expression levels in 139 patients with CLL using quantitative real-time polymerase chain reaction (qRT-PCR) and microarray data sets in CLL, follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), multiple myeloma (MM) and acute myeloid leukemia (AML). High MZB1 expression was associated with inferior survival in CLL (hazard ratio [HR]: 1.63 [confidence interval (CI): 1.14-2.33], p = 0.007), FL (221286_s_at HR: 1.16 [CI: 0.98-1.37], p = 0.086; 223565_at: HR: 1.3 [CI: 1.1-1.61], p = 0.015) and DLBCL (221286_s_at: HR: 1.17 [CI: 1.06-1.3], p = 0.003; 223565_at: HR: 1.21 [CI: 1.08-1.35], p = 0.001). In DLBCL MZB1 expression was an additive prognostic marker in a multivariate model including activated B-cell like (ABC) versus germinal center (GCB) subtype. Additionally, MZB1 expression correlated with a unique gene expression pattern. This study is the first to show that the expression level of a single gene has prognostic significance in different lymphoma subtypes. Due to its biological function, MZB1 may play a central role in B cell neoplasms and is a potential target for future therapeutic interventions.
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Affiliation(s)
- Tobias Herold
- Department of Internal Medicine III, University Hospital Grosshadern, Ludwig-Maximilians-University (LMU), Munich, Germany.
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Greif PA, Konstandin NP, Metzeler KH, Herold T, Pasalic Z, Ksienzyk B, Dufour A, Schneider F, Schneider S, Kakadia PM, Braess J, Sauerland MC, Berdel WE, Büchner T, Woermann BJ, Hiddemann W, Spiekermann K, Bohlander SK. RUNX1 mutations in cytogenetically normal acute myeloid leukemia are associated with a poor prognosis and up-regulation of lymphoid genes. Haematologica 2012; 97:1909-15. [PMID: 22689681 DOI: 10.3324/haematol.2012.064667] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The RUNX1 (AML1) gene is a frequent mutational target in myelodysplastic syndromes and acute myeloid leukemia. Previous studies suggested that RUNX1 mutations may have pathological and prognostic implications. DESIGN AND METHODS We screened 93 patients with cytogenetically normal acute myeloid leukemia for RUNX1 mutations by capillary sequencing of genomic DNA. Mutation status was then correlated with clinical data and gene expression profiles. RESULTS We found that 15 out of 93 (16.1%) patients with cytogenetically normal acute myeloid leukemia had RUNX1 mutations. Seventy-three patients were enrolled in the AMLCG-99 trial and carried ten RUNX1 mutations (13.7%). Among these 73 patients RUNX1 mutations were significantly associated with older age, male sex, absence of NPM1 mutations and presence of MLL-partial tandem duplications. Moreover, RUNX1-mutated patients had a lower complete remission rate (30% versus 73% P=0.01), lower relapse-free survival rate (3-year relapse-free survival 0% versus 30.4%; P=0.002) and lower overall survival rate (3-year overall survival 0% versus 34.4%; P<0.001) than patients with wild-type RUNX1. RUNX1 mutations remained associated with shorter overall survival in a multivariate model including age and the European Leukemia Net acute myeloid leukemia genetic classification as covariates. Patients with RUNX1 mutations showed a unique gene expression pattern with differential expression of 85 genes. The most prominently up-regulated genes in patients with RUNX1-mutated cytogenetically normal acute myeloid leukemia include lymphoid regulators such as HOP homeobox (HOPX), deoxynucleotidyltransferase (DNTT, terminal) and B-cell linker (BLNK), indicating lineage infidelity. CONCLUSIONS Our findings firmly establish that RUNX1 mutations are a marker of poor prognosis and provide insights into the pathogenesis of RUNX1 mutation-positive acute myeloid leukemia.
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Affiliation(s)
- Philipp A Greif
- Department of Internal Medicine 3, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Germany
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Kakadia PM, Tizazu B, Mellert G, Harbott J, Röttgers S, Quentmeier H, Spiekermann K, Bohlander SK. A novel ABL1 fusion to the SH2 containing inositol phosphatase-1 (SHIP1) in acute lymphoblastic leukemia (ALL). Leukemia 2011; 25:1645-9. [DOI: 10.1038/leu.2011.129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Herold T, Jurinovic V, Metzeler KH, Boulesteix AL, Bergmann M, Seiler T, Mulaw M, Thoene S, Dufour A, Pasalic Z, Schmidberger M, Schmidt M, Schneider S, Kakadia PM, Feuring-Buske M, Braess J, Spiekermann K, Mansmann U, Hiddemann W, Buske C, Bohlander SK. An eight-gene expression signature for the prediction of survival and time to treatment in chronic lymphocytic leukemia. Leukemia 2011; 25:1639-45. [PMID: 21625232 DOI: 10.1038/leu.2011.125] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Herold T, Jurinovic V, Mulaw M, Seiler T, Dufour A, Schneider S, Kakadia PM, Feuring-Buske M, Braess J, Spiekermann K, Mansmann U, Hiddemann W, Buske C, Bohlander SK. Expression analysis of genes located in the minimally deleted regions of 13q14 and 11q22-23 in chronic lymphocytic leukemia-unexpected expression pattern of the RHO GTPase activator ARHGAP20. Genes Chromosomes Cancer 2011; 50:546-58. [DOI: 10.1002/gcc.20879] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 03/21/2011] [Accepted: 03/21/2011] [Indexed: 12/31/2022] Open
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Benthaus T, Schneider F, Mellert G, Zellmeier E, Schneider S, Kakadia PM, Hiddemann W, Bohlander SK, Feuring-Buske M, Braess J, Spiekermann K, Dufour A. Rapid and sensitive screening for CEBPA mutations in acute myeloid leukaemia. Br J Haematol 2008; 143:230-9. [PMID: 18752591 DOI: 10.1111/j.1365-2141.2008.07328.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The presence of CCAAT/enhancer binding protein alpha (CEBPA) gene mutations in patients with cytogenetically normal acute myeloid leukaemia (CN-AML) confers a favourable prognosis. Routine screening of all CN-AML patients for CEBPA mutations is therefore important for individual risk-adapted post-remission therapy and requires a fast and easy screening method. CEBPA mutations are distributed over the entire CEBPA gene and the functional and clinical consequences of the different mutations are still largely unknown. Therefore, we developed a multiplex polymerase chain reaction-based fragment length analysis mutation screening method for the entire CEBPA coding region. We initially evaluated our method by analysing 120 CN-AML samples both by fragment analysis and nucleotide sequencing and reached a sensitivity of 100% and a specificity of 90%. 349 CN-AML samples were subsequently screened for CEBPA mutations by fragment length analysis. Among a total of 469 CN-AML patient samples, 58 CEBPA mutations were detected in 38 CN-AML patients (8.1%). In conclusion, we established a fast and sensitive CEBPA mutation screening method suitable for inclusion in routine AML diagnostics.
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Affiliation(s)
- Tobias Benthaus
- Laboratory for Leukaemia Diagnostics, Department of Medicine III, University of Munich-Grosshadern, Germany
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Bakshi SR, Dave BJ, Sanger W, Brahmbhatt MM, Trivedi PJ, Kakadia PM, Patel SJ. Characterization of a familial small supernumerary marker chromosome in a patient with adult-onset tongue cancer. Cytogenet Genome Res 2008; 121:14-7. [PMID: 18544921 DOI: 10.1159/000124376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2008] [Indexed: 11/19/2022] Open
Abstract
Cytogenetic analysis in peripheral blood lymphocytes of a 50-year-old female with tongue cancer showed the presence of one to three copies of a small supernumerary marker chromosome (sSMC) in a mosaic state. Family studies also revealed the marker in mosaic form in four (age <29 years) of eleven clinically normal individuals studied from her family of 16 individuals spanning three generations. Due to the extremely small size of the marker chromosome, identification by classical cytogenetics was not informative. Multicolor FISH followed by whole chromosome painting identified the marker as a derivative of chromosome 21. This is the first report of sSMC21 in an adult-onset tongue cancer patient and some of her family members with no clinical symptoms.
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Affiliation(s)
- S R Bakshi
- Cell Biology Division, The Gujarat Cancer Society, Ahmedabad, India.
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