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Zhang C, Stelloo E, Barrans S, Cucco F, Jiang D, Tzioni MM, Chen Z, Li Y, Swennenhuis JF, Makker J, Rásó-Barnett L, Liu H, El-Daly H, Soilleux E, Shah N, Nagumantry SK, Kyaw M, Prahladan MP, Tooze R, Westhead DR, Feitsma H, Davies AJ, Burton C, Johnson PWM, Du MQ. Non-IG::MYC in diffuse large B-cell lymphoma confers variable genomic configurations and MYC transactivation potential. Leukemia 2024; 38:621-629. [PMID: 38184753 PMCID: PMC10912016 DOI: 10.1038/s41375-023-02134-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
MYC translocation occurs in 8-14% of diffuse large B-cell lymphoma (DLBCL), and may concur with BCL2 and/or BCL6 translocation, known as double-hit (DH) or triple-hit (TH). DLBCL-MYC/BCL2-DH/TH are largely germinal centre B-cell like subtype, but show variable clinical outcome, with IG::MYC fusion significantly associated with inferior survival. While DLBCL-MYC/BCL6-DH are variable in their cell-of-origin subtypes and clinical outcome. Intriguingly, only 40-50% of DLBCL with MYC translocation show high MYC protein expression (>70%). We studied 186 DLBCLs with MYC translocation including 32 MYC/BCL2/BCL6-TH, 75 MYC/BCL2-DH and 26 MYC/BCL6-DH. FISH revealed a MYC/BCL6 fusion in 59% of DLBCL-MYC/BCL2/BCL6-TH and 27% of DLBCL-MYC/BCL6-DH. Targeted NGS showed a similar mutation profile and LymphGen genetic subtype between DLBCL-MYC/BCL2/BCL6-TH and DLBCL-MYC/BCL2-DH, but variable LymphGen subtypes among DLBCL-MYC/BCL6-DH. MYC protein expression is uniformly high in DLBCL with IG::MYC, but variable in those with non-IG::MYC including MYC/BCL6-fusion. Translocation breakpoint analyses of 8 cases by TLC-based NGS showed no obvious genomic configuration that enables MYC transactivation in 3 of the 4 cases with non-IG::MYC, while a typical promoter substitution or IGH super enhancer juxtaposition in the remaining cases. The findings potentially explain variable MYC expression in DLBCL with MYC translocation, and also bear practical implications in its routine assessment.
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Affiliation(s)
- Chunye Zhang
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | | | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
| | - Francesco Cucco
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
- Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Dan Jiang
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
- East Genomic Laboratory Hub, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Maria-Myrsini Tzioni
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Zi Chen
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Yan Li
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
- Department of Haematology, Hebei General Hospital, Shijiazhuang, PR China
| | | | - Jasmine Makker
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Lívia Rásó-Barnett
- The Haematopathology and Oncology Diagnostic Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Hongxiang Liu
- East Genomic Laboratory Hub, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Hesham El-Daly
- Cellular Pathology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Elizabeth Soilleux
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Nimish Shah
- Department of Haematology, Norfolk and Norwich University Foundation Hospital, Norwich, UK
| | | | - Maw Kyaw
- Department of Haematology, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, UK
| | | | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
- Division of Haematology and Immunology, Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - David R Westhead
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | | | - Andrew J Davies
- Southampton NIHR/Cancer Research UK Experimental Cancer Medicine Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
| | - Peter W M Johnson
- Southampton NIHR/Cancer Research UK Experimental Cancer Medicine Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge, UK.
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Lamb M, Painter D, Howell D, Barrans S, Cargo C, de Tute R, Tooze R, Burton C, Patmore R, Roman E, Smith A. Lymphoid blood cancers, incidence and survival 2005-2023: A report from the UK's Haematological Malignancy Research Network. Cancer Epidemiol 2024; 88:102513. [PMID: 38160571 DOI: 10.1016/j.canep.2023.102513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Population-based information on cancer incidence and outcome are required to inform clinical practice and research; but contemporary data are lacking for many lymphoid cancer subtypes. METHODS Set within a socio-demographically representative UK population of ∼4 million, data are from an established UK patient cohort (N = 22,414 diagnoses). Information on incidence (crude and age-standardised) and survival (overall and net) is presented for > 40 subtypes. RESULTS The median diagnostic age was 69.9 years (interquartile range 59.1-78.3), but unlike many other cancers, lymphoid malignancies can be diagnosed at any age; different subtypes dominating at different ages. Males were more likely to be diagnosed than females (age-standardised sex rate ratio: 1.55 (95% Confidence Interval: 1.50,1.59)), and most subtypes had a male predominance, some more than three-fold (e.g. Burkitt lymphoma 3.26 (2.42, 4.40)). Five-year net survival estimates varied hugely, ranging from 97.4% (95% CI: 56.5, 99.9) in patients with hairy cell leukaemia to 31.6% (95% CI: 2.5, 69.8) in those with T-cell prolymphocytic leukaemia. No significant sex difference in survival were observed for the majority of diagnoses; one exception being classical Hodgkin lymphoma, where males had a higher mortality (Excess Mortality Ratio: 1.44 (95% CI: 1.11, 1.87)). An improvement in survival over time was observed for some, but not all, of the major diagnostic groups. CONCLUSIONS Marked incidence and survival variations by subtype, sex and age confirm the heterogeneity of lymphoid neoplasms and highlight the importance of accurately characterising disease entities. Despite recent improvements, routine cancer registration of lymphoid neoplasms remains challenging and new issues continue to emerge; including the lack of an international consensus on classification and the recording of progressions and transformations. Furthermore, the increasing need for additional molecular and genomic information required for accurate classification is likely to impact negatively on the quality of cancer registration data, especially in low income countries.
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Affiliation(s)
- Maxine Lamb
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Daniel Painter
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Debra Howell
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Catherine Cargo
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Ruth de Tute
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Cathy Burton
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds, United Kingdom
| | - Russell Patmore
- Queen's Centre for Oncology and Haematology, Castle Hill Hospital, Cottingham, United Kingdom
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom
| | - Alexandra Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom.
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3
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Davies JR, Hilton LK, Jiang A, Barrans S, Burton C, Johnson PWM, Davies AJ, Du MQ, Tooze R, Cucco F, Care MA, Morin RD, Steidl C, Sha C, Westhead DR, Scott DW. Comparison of MHG and DZsig reveals shared biology and a core overlap group with inferior prognosis in DLBCL. Blood Adv 2023; 7:6156-6162. [PMID: 37595057 PMCID: PMC10582343 DOI: 10.1182/bloodadvances.2023010673] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/13/2023] [Accepted: 07/30/2023] [Indexed: 08/20/2023] Open
Affiliation(s)
- John R. Davies
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Laura K. Hilton
- BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
| | - Aixiang Jiang
- BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Peter W. M. Johnson
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Andrew J. Davies
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ming-Qing Du
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Reuben Tooze
- Section of Experimental Haematology, University of Leeds, Leeds, United Kingdom
| | - Francesco Cucco
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
- Institute of Clinical Physiology (IFC), Consiglio Nazionale delle Ricerche, Pisa, Italy
| | - Matthew A. Care
- Section of Experimental Haematology, University of Leeds, Leeds, United Kingdom
| | - Ryan D. Morin
- BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
- Canada’s Michael Smith Genome Sciences Centre, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Christian Steidl
- BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chulin Sha
- Institute of Basic Medicine and Cancer, Chinese Academy of Science, Hangzhou, China
| | - David R. Westhead
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - David W. Scott
- BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
- Division of Medical Oncology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
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4
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Davies AJ, Barrans S, Stanton L, Caddy J, Wilding S, Saunders G, Mamot C, Novak U, McMillan A, Fields P, Collins GP, Stephens R, Cucco F, Sha C, van Hoppe M, Tooze R, Davies JR, Griffiths G, Schuh A, Burton C, Westhead DR, Du MQ, Johnson PW. Differential Efficacy From the Addition of Bortezomib to R-CHOP in Diffuse Large B-Cell Lymphoma According to the Molecular Subgroup in the REMoDL-B Study With a 5-Year Follow-Up. J Clin Oncol 2023; 41:2718-2723. [PMID: 36972491 PMCID: PMC10414744 DOI: 10.1200/jco.23.00033] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [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: 01/09/2023] [Accepted: 02/10/2023] [Indexed: 03/29/2023] Open
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.The REMoDL-B phase III adaptive trial compared rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) versus R-CHOP + bortezomib (RB-CHOP) in patients with diffuse large B-cell lymphoma (DLBCL), stratified by molecular subtype. Primary analysis at a median follow-up of 30 months found no effect of bortezomib on progression-free survival (PFS) or overall survival (OS). Retrospective analysis using a gene expression-based classifier identified a molecular high-grade (MHG) group with worse outcomes. We present an updated analysis for patients successfully classified by the gene expression profile (GEP). Eligible patients were age older than 18 years with untreated DLBCL, fit enough for full-dose chemotherapy, and with adequate biopsies for GEP. Of 1,077 patients registered, 801 were identified with Activated B-Cell (ABC), Germinal Center B-cell, or MHG lymphoma. At a median follow-up of 64 months, there was no overall benefit of bortezomib on PFS or OS (5-year PFS hazard ratio [HR], 0.81; P = .085; OS HR, 0.86; P = .32). However, improved PFS and OS were seen in ABC lymphomas after RB-CHOP: 5-year OS 67% with R-CHOP versus 80% with RB-CHOP (HR, 0.58; 95% CI, 0.35 to 0.95; P = .032). Five-year PFS was higher in MHG lymphomas: 29% versus 55% (HR, 0.46; 95% CI, 0.26 to 0.84). Patients with ABC and MHG DLBCL may benefit from the addition of bortezomib to R-CHOP in initial therapy.
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Affiliation(s)
- Andrew J. Davies
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Louise Stanton
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Josh Caddy
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Sam Wilding
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Geoff Saunders
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | | | - Urban Novak
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andrew McMillan
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
| | - Paul Fields
- Department of Haematology, Guy's and St Thomas's Hospitals NHS Trust, Kings Health Partners, London, United Kingdom
| | - Graham P. Collins
- Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, United Kingdom
| | - Richard Stephens
- National Cancer Research Institute Consumer Forum, London, United Kingdom
| | - Francesco Cucco
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Chulin Sha
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Moniek van Hoppe
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Reuben Tooze
- Section of Experimental Haematology, University of Leeds, Leeds, United Kingdom
| | - John R. Davies
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Anna Schuh
- Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - David R. Westhead
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Ming-Qing Du
- Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Peter W.M. Johnson
- School of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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5
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Bewicke-Copley F, Korfi K, Araf S, Hodkinson B, Kumar E, Cummin T, Ashton-Key M, Barrans S, van Hoppe S, Burton C, Elshiekh M, Rule S, Crosbie N, Clear A, Calaminici M, Runge H, Hills RK, Scott DW, Rimsza LM, Menon G, Sha C, Davies JR, Nagano A, Davies A, Painter D, Smith A, Gribben J, Naresh KN, Westhead DR, Okosun J, Steele A, Hodson DJ, Balasubramanian S, Johnson P, Wang J, Fitzgibbon J. Longitudinal expression profiling identifies a poor risk subset of patients with ABC-type diffuse large B-cell lymphoma. Blood Adv 2023; 7:845-855. [PMID: 35947123 PMCID: PMC9986713 DOI: 10.1182/bloodadvances.2022007536] [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: 03/18/2022] [Revised: 07/05/2022] [Accepted: 07/25/2022] [Indexed: 11/20/2022] Open
Abstract
Despite the effectiveness of immuno-chemotherapy, 40% of patients with diffuse large B-cell lymphoma (DLBCL) experience relapse or refractory disease. Longitudinal studies have previously focused on the mutational landscape of relapse but fell short of providing a consistent relapse-specific genetic signature. In our study, we have focused attention on the changes in GEP accompanying DLBCL relapse using archival paired diagnostic/relapse specimens from 38 de novo patients with DLBCL. COO remained stable from diagnosis to relapse in 80% of patients, with only a single patient showing COO switching from activated B-cell-like (ABC) to germinal center B-cell-like (GCB). Analysis of the transcriptomic changes that occur following relapse suggest ABC and GCB relapses are mediated via different mechanisms. We developed a 30-gene discriminator for ABC-DLBCLs derived from relapse-associated genes that defined clinically distinct high- and low-risk subgroups in ABC-DLBCLs at diagnosis in datasets comprising both population-based and clinical trial cohorts. This signature also identified a population of <60-year-old patients with superior PFS and OS treated with ibrutinib-R-CHOP as part of the PHOENIX trial. Altogether this new signature adds to the existing toolkit of putative genetic predictors now available in DLBCL that can be readily assessed as part of prospective clinical trials.
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Affiliation(s)
- Findlay Bewicke-Copley
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Koorosh Korfi
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Shamzah Araf
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Brendan Hodkinson
- Oncology Translational Research, Janssen Research & Development, Spring House, PA
| | - Emil Kumar
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Thomas Cummin
- Cancer Research UK Centre, University of Southampton, Southampton, UK
| | - Margaret Ashton-Key
- Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James’s Institute of Oncology, Leeds, UK
| | - Suzan van Hoppe
- Haematological Malignancy Diagnostic Service, St. James’s Institute of Oncology, Leeds, UK
| | - Cathy Burton
- Haematological Malignancy Diagnostic Service, St. James’s Institute of Oncology, Leeds, UK
| | - Mohamed Elshiekh
- Cellular & Molecular Pathology, Imperial College NHS Trust & Imperial College London, London, UK
| | - Simon Rule
- Department of Haematology, Derriford Hospital, University of Plymouth, Plymouth, UK
| | - Nicola Crosbie
- Department of Haematology, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Andrew Clear
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Hendrik Runge
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - Robert K. Hills
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David W. Scott
- BC Cancer Centre for Lymphoid Cancer and Department of Medicine, University of British Columbia, Vancouver, BC Canada
| | - Lisa M. Rimsza
- Department of Laboratory Medicine and Pathology, Mayo Clinic Arizona, Phoenix AZ
| | - Geetha Menon
- Haemato-Oncology Diagnostic Service, Liverpool Clinical Laboratories, Liverpool, UK
| | - Chulin Sha
- School of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - John R. Davies
- School of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Ai Nagano
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Andrew Davies
- Cancer Research UK Centre, University of Southampton, Southampton, UK
| | - Daniel Painter
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Alexandra Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - John Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Kikkeri N. Naresh
- Cellular & Molecular Pathology, Imperial College NHS Trust & Imperial College London, London, UK
| | - David R. Westhead
- School of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Andrew Steele
- Oncology Translational Research, Janssen Research & Development, San Diego, CA
| | - Daniel J. Hodson
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | | | - Peter Johnson
- Cancer Research UK Centre, University of Southampton, Southampton, UK
| | - Jun Wang
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
| | - Jude Fitzgibbon
- Centre for Cancer Genomics and Computational Biology, Barts Cancer Institute, Queen Mary University, London, UK
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6
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Kizhakeyil A, Zaini NBM, Poh ZS, Wong BHS, Loh X, Ng AS, Low ZS, Prasannan P, Gong C, Tan MGK, Nagarajan C, Huang D, Lu PW, Lim JQ, Barrans S, Ong CK, Lim ST, Chng WJ, Follows G, Hodson DJ, Du MQ, Goh YT, Tan SH, Grigoropoulos NF, Verma NK. DDX3X loss is an adverse prognostic marker in diffuse large B-cell lymphoma and is associated with chemoresistance in aggressive non-Hodgkin lymphoma subtypes. Mol Cancer 2021; 20:134. [PMID: 34654425 PMCID: PMC8520256 DOI: 10.1186/s12943-021-01437-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/24/2021] [Indexed: 01/03/2023] Open
Affiliation(s)
- Atish Kizhakeyil
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore
| | | | - Zhi Sheng Poh
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Brandon Han Siang Wong
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Xinpeng Loh
- School of Biological Sciences, Nanyang Technological University Singapore, 60 Nanyang Dr, Singapore, 637551, Singapore
| | - Aik Seng Ng
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Zun Siong Low
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Praseetha Prasannan
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore
| | - Chun Gong
- Wellcome MRC Cambridge Stem Cell Institute, Cambridge, UK
| | - Michelle Guet Khim Tan
- Clinical Translational Sciences, Singapore General Hospital, The Academia Level 9, 20 College Road, Singapore, 169856, Singapore
| | - Chandramouli Nagarajan
- Department of Haematology, Singapore General Hospital, The Academia, Level 3, 20 College Road, Singapore, 169856, Singapore
| | - Dachuan Huang
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Pang Wan Lu
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Jing Quan Lim
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service (HMDS), St. James's Institute of Oncology, Leeds, UK
| | - Choon Kiat Ong
- Lymphoma Genomic Translational Research Laboratory, Division of Cellular and Molecular Research, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore.,Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Genome Institute of Singapore, 60 Biopolis Street Genome, Singapore, 138672, Singapore
| | - Soon Thye Lim
- Director's office, National Cancer Centre Singapore, 11 Hospital Drive, Singapore, 169610, Singapore.,Office of Education, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Wee Joo Chng
- National University Cancer Institute, Singapore, Singapore.,Cancer Science Institute of Singapore, National University of Singapore, Singapore, Singapore.,NUS Center for Cancer Research (N2CR) and Dept of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - George Follows
- Addenbrooke's Hospital NHS Foundation Trust, Cambridge, UK
| | | | - Ming Qing Du
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Yeow Tee Goh
- Department of Haematology, Singapore General Hospital, The Academia, Level 3, 20 College Road, Singapore, 169856, Singapore
| | - Suat Hoon Tan
- National Skin Centre Singapore, 1 Mandalay Road, Singapore, 308205, Singapore
| | - Nicholas Francis Grigoropoulos
- Department of Haematology, Singapore General Hospital, The Academia, Level 3, 20 College Road, Singapore, 169856, Singapore. .,Cancer and Stem Cell Biology, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
| | - Navin Kumar Verma
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Clinical Sciences Building, Singapore, 308232, Singapore. .,National Skin Centre Singapore, 1 Mandalay Road, Singapore, 308205, Singapore.
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Gong C, Krupka JA, Gao J, Grigoropoulos NF, Giotopoulos G, Asby R, Screen M, Usheva Z, Cucco F, Barrans S, Painter D, Zaini NBM, Haupl B, Bornelöv S, Ruiz De Los Mozos I, Meng W, Zhou P, Blain AE, Forde S, Matthews J, Khim Tan MG, Burke GAA, Sze SK, Beer P, Burton C, Campbell P, Rand V, Turner SD, Ule J, Roman E, Tooze R, Oellerich T, Huntly BJ, Turner M, Du MQ, Samarajiwa SA, Hodson DJ. Sequential inverse dysregulation of the RNA helicases DDX3X and DDX3Y facilitates MYC-driven lymphomagenesis. Mol Cell 2021; 81:4059-4075.e11. [PMID: 34437837 DOI: 10.1016/j.molcel.2021.07.041] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/17/2021] [Accepted: 07/28/2021] [Indexed: 12/23/2022]
Abstract
DDX3X is a ubiquitously expressed RNA helicase involved in multiple stages of RNA biogenesis. DDX3X is frequently mutated in Burkitt lymphoma, but the functional basis for this is unknown. Here, we show that loss-of-function DDX3X mutations are also enriched in MYC-translocated diffuse large B cell lymphoma and reveal functional cooperation between mutant DDX3X and MYC. DDX3X promotes the translation of mRNA encoding components of the core translational machinery, thereby driving global protein synthesis. Loss-of-function DDX3X mutations moderate MYC-driven global protein synthesis, thereby buffering MYC-induced proteotoxic stress during early lymphomagenesis. Established lymphoma cells restore full protein synthetic capacity by aberrant expression of DDX3Y, a Y chromosome homolog, the expression of which is normally restricted to the testis. These findings show that DDX3X loss of function can buffer MYC-driven proteotoxic stress and highlight the capacity of male B cell lymphomas to then compensate for this loss by ectopic DDX3Y expression.
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Affiliation(s)
- Chun Gong
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK
| | - Joanna A Krupka
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK; MRC Cancer Unit, University of Cambridge, Hutchison/MRC Research Centre, Cambridge CB2 0XZ, UK
| | - Jie Gao
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK
| | | | - George Giotopoulos
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK
| | - Ryan Asby
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK
| | - Michael Screen
- Immunology Programme, The Babraham Institute, Cambridge CB22 3AT, UK
| | - Zelvera Usheva
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK
| | - Francesco Cucco
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge CB20QQ, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds LS9 7TF, UK
| | - Daniel Painter
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York YO10 5DD, UK
| | | | - Björn Haupl
- Department of Medicine II, Hematology/Oncology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany; German Cancer Research Center and German Cancer Consortium, Heidelberg, Germany; Frankfurt Cancer Institute, Goethe University Frankfurt, 60596 Frankfurt, Germany
| | - Susanne Bornelöv
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK
| | - Igor Ruiz De Los Mozos
- The Francis Crick Institute, London NW1 1AT, UK; Department for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Wei Meng
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore, Singapore
| | - Peixun Zhou
- National Horizons Centre, Teesside University, 38 John Dixon Lane, Darlington DL1 1HG, UK; School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
| | - Alex E Blain
- National Horizons Centre, Teesside University, 38 John Dixon Lane, Darlington DL1 1HG, UK; Wolfson Childhood Cancer Research Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK; School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
| | - Sorcha Forde
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge CB20QQ, UK
| | - Jamie Matthews
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge CB20QQ, UK
| | - Michelle Guet Khim Tan
- Department of Clinical Translational Research, Singapore General Hospital, Outram Road, Singapore 169856, Singapore
| | - G A Amos Burke
- Department of Paediatric Oncology, Addenbrooke's Hospital, Cambridge, UK
| | - Siu Kwan Sze
- School of Biological Sciences, Nanyang Technological University, 60 Nanyang Drive, Singapore, Singapore
| | - Philip Beer
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
| | - Cathy Burton
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds LS9 7TF, UK
| | - Peter Campbell
- Wellcome Trust Sanger Institute, Hinxton, Cambridge CB10 1SA, UK
| | - Vikki Rand
- National Horizons Centre, Teesside University, 38 John Dixon Lane, Darlington DL1 1HG, UK; School of Health & Life Sciences, Teesside University, Middlesbrough TS1 3BA, UK
| | - Suzanne D Turner
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge CB20QQ, UK; CEITEC, Masaryk University, Brno, Czech Republic
| | - Jernej Ule
- The Francis Crick Institute, London NW1 1AT, UK; Department for Neuromuscular Diseases, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York YO10 5DD, UK
| | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds LS9 7TF, UK; Section of Experimental Haematology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds LS2 9JT, UK
| | - Thomas Oellerich
- Department of Medicine II, Hematology/Oncology, Goethe University, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany; German Cancer Research Center and German Cancer Consortium, Heidelberg, Germany; Frankfurt Cancer Institute, Goethe University Frankfurt, 60596 Frankfurt, Germany
| | - Brian J Huntly
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK
| | - Martin Turner
- Immunology Programme, The Babraham Institute, Cambridge CB22 3AT, UK
| | - Ming-Qing Du
- Division of Cellular and Molecular Pathology, Department of Pathology, University of Cambridge, Cambridge CB20QQ, UK
| | - Shamith A Samarajiwa
- MRC Cancer Unit, University of Cambridge, Hutchison/MRC Research Centre, Cambridge CB2 0XZ, UK
| | - Daniel J Hodson
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Puddicombe Way, Cambridge CB2 0AW, UK; Department of Haematology, University of Cambridge, Cambridge CB2 0AW, UK.
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Crouch S, Painter D, Barrans S, Roman E, Beer P, Lacy S, Cooke S, Webster N, Glover P, Hoppe S, Campbell PJ, Hodson DJ, Patmore R, Burton C, Smith AG, Tooze R. MOLECULAR SUBCLUSTERS OF FOLLICULAR LYMPHOMA: A REPORT FROM THE UK'S HAEMATOLOGICAL MALIGNANCY RESEARCH NETWORK. Hematol Oncol 2021. [DOI: 10.1002/hon.40_2879] [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: 11/10/2022]
Affiliation(s)
- S. Crouch
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - D. Painter
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - S. Barrans
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - E. Roman
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - P. Beer
- University of Glasgow Glasgow Precision Oncology Laboratory Glasgow UK
| | - S. Lacy
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - S. Cooke
- University of Glasgow Glasgow Precision Oncology Laboratory Glasgow UK
| | - N. Webster
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - P. Glover
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - S. Hoppe
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - P. J. Campbell
- Wellcome Trust Sanger Institute, Cancer Ageing and Somatic Mutation Programme Cambridge UK
| | - D. J. Hodson
- University of Cambridge Wellcome–MRC CambridgeStem Cell Institute Cambridge UK
| | - R. Patmore
- Hull University Teaching Hospitals NHS Trust Queen's Centre for Oncology and Haematology Hull UK
| | - C. Burton
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
| | - A. G. Smith
- University of York Epidemiology and Cancer Statistics Group Department of Health Sciences York UK
| | - R. Tooze
- Leeds Teaching Hospitals NHS Trust Haematological Malignancy Diagnostic Service Leeds UK
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Runge HFP, Lacy S, Barrans S, Beer PA, Painter D, Smith A, Roman E, Burton C, Crouch S, Tooze R, Hodson DJ. Application of the LymphGen classification tool to 928 clinically and genetically-characterised cases of diffuse large B cell lymphoma (DLBCL). Br J Haematol 2021; 192:216-220. [PMID: 33010029 DOI: 10.1111/bjh.17132] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/06/2020] [Indexed: 01/13/2023]
Affiliation(s)
- Hendrik F P Runge
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - Stuart Lacy
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, UK
| | - Philip A Beer
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
| | - Daniel Painter
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Alexandra Smith
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Eve Roman
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Cathy Burton
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, UK
| | - Simon Crouch
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, UK
- Section of Experimental Haematology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, UK
| | - Daniel J Hodson
- Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
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10
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Gong C, Krupka JA, Gao J, Grigoropoulos NF, Cucco F, Barrans S, Igor DLM, Peixun Z, Sorca F, Jamie M, Amos B, Kwan SS, Philip B, Cathy B, Peter C, Vikki R, Suzanne T, Jernej U, Eve R, Reuben T, Thomas O, Ming D, Shamith S, Hodson DJ. Abstract PO-19: Sequential inverse dysregulation of the RNA helicases DDX3X and DDX3Y facilitates MYC-driven lymphomagenesis. Blood Cancer Discov 2020. [DOI: 10.1158/2643-3249.lymphoma20-po-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
DDX3X is a ubiquitously expressed RNA helicase involved in multiple stages of RNA biogenesis. DDX3X is frequently mutated in Burkitt lymphoma, but the functional basis for this is unknown. Here, we show that loss-of-function DDX3X mutations are also commonly found in MYC-translocated diffuse large B-cell lymphoma. We reveal functional cooperation between mutant DDX3X and MYC in ex vivo cultured human germinal center B cells. By integrating results of iCLIP, ribosome profiling, and proteomics, we show WT DDX3X promotes the translation of mRNAs encoding components of the core translational machinery, thereby driving global protein synthesis. Loss-of-function DDX3X mutations act to buffer the effect of abrupt MYC expression and moderate MYC-driven global protein synthesis, thereby buffering MYC-induced proteotoxic stress during early lymphomagenesis. Established lymphoma cells subsequently restore full protein synthetic capacity by aberrant expression of DDX3Y, a Y-chromosome homologue that is normally expressed exclusively in testis. These findings show how sequential dysregulation of DDX3X and DDX3Y acts to titrate global protein synthesis to suit the stage-specific needs of developing lymphoma cells and identify DDX3Y as an attractive, male-specific therapeutic target absent from normal human B cells but required for the survival of male lymphomas.
Citation Format: Chun Gong, Joanna A. Krupka, Jane Gao, Nicholas F. Grigoropoulos, Francesco Cucco, Sharon Barrans, De Los Mozos Igor, Zhou Peixun, Forde Sorca, Matthews Jamie, Burke Amos, Sze Siu Kwan, Beer Philip, Burton Cathy, Campbell Peter, Rand Vikki, Turner Suzanne, Ule Jernej, Roman Eve, Tooze Reuben, Oellerich Thomas, Du Ming, Samarajiwa Shamith, Daniel J. Hodson. Sequential inverse dysregulation of the RNA helicases DDX3X and DDX3Y facilitates MYC-driven lymphomagenesis [abstract]. In: Proceedings of the AACR Virtual Meeting: Advances in Malignant Lymphoma; 2020 Aug 17-19. Philadelphia (PA): AACR; Blood Cancer Discov 2020;1(3_Suppl):Abstract nr PO-19.
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Affiliation(s)
- Chun Gong
- 1University of Cambridge, Cambridge, United Kingdom,
| | | | - Jane Gao
- 1University of Cambridge, Cambridge, United Kingdom,
| | | | | | - Sharon Barrans
- 3St. James Institute of Oncology, Leeds, United Kingdom,
| | | | - Zhou Peixun
- 5Teesside University, Middlesbrough, United Kingdom,
| | - Forde Sorca
- 1University of Cambridge, Cambridge, United Kingdom,
| | | | - Burke Amos
- 1University of Cambridge, Cambridge, United Kingdom,
| | - Sze Siu Kwan
- 6Nanyang Technological University, Singapore, Singapore,
| | - Beer Philip
- 7Wellcome Trust Sanger Institute, Cambridge, United Kingdom,
| | - Burton Cathy
- 3St. James Institute of Oncology, Leeds, United Kingdom,
| | - Campbell Peter
- 7Wellcome Trust Sanger Institute, Cambridge, United Kingdom,
| | - Rand Vikki
- 5Teesside University, Middlesbrough, United Kingdom,
| | | | - Ule Jernej
- 4The Francis Crick Institute, London, United Kingdom,
| | - Roman Eve
- 8University of York, York, United Kingdom,
| | | | | | - Du Ming
- 1University of Cambridge, Cambridge, United Kingdom,
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Davies A, Barrans S, Burton C, Mercer K, Caddy J, Chinnery F, Day L, Fernando D, Ardeshna K, Collins G, Radford J, Rule S, McMillan A, Johnson P, Griffiths G. ACCEPT - combining acalabrutinib with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) for Diffuse Large B-cell Lymphoma (DLBCL): study protocol for a Phase Ib/II open-label non-randomised clinical trial. F1000Res 2020; 9:941. [PMID: 33093947 PMCID: PMC7551525 DOI: 10.12688/f1000research.22318.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Over 13,000 new cases of non-Hodgkin's lymphoma (NHL) are diagnosed in the UK, with approximately 4,900 attributable deaths each year. Diffuse Large B-cell Lymphoma (DLBCL) is the most common NHL comprising one third of adult NHL cases. R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisolone) is accepted as the international standard first-line regimen, but improvement in first line treatment is needed. Dysregulated B-cell receptor (BCR) signalling has been identified as a feature of DLBCL. Inhibition of Bruton's tyrosine kinase (Btk), downstream of the BCR has proven efficacious in other B-cell malignancies and in combination with R-CHOP. The second generation Btk inhibitor, acalabrutinib, may have improved target potency and specificity, and therefore better efficacy and tolerability. Methods: ACCEPT is an open-label non-randomised Phase Ib/II trial testing the addition of acalabrutinib to conventional R-CHOP therapy. ACCEPT incorporates an initial 6+6 modified Phase I design of up to 24 participants followed by 15 participant single arm Phase II expansion cohort in treatment naive patients with histologically confirmed DLBCL expressing CD20. Participants are recruited from UK secondary care sites. Phase I will establish the recommended Phase II dose (RP2D, primary endpoint) of acalabrutinib in combination with R-CHOP. Phase II will gain additional information on safety and efficacy on the RP2D. The primary endpoints of Phase II are overall response rate and toxicity profile. Secondary endpoints include duration of response (progression-free survival and overall survival OS) in relation to cell of origin. Analyses are not powered for formal statistical comparisons; descriptive statistics will describe rates of toxicity, efficacy and translational endpoints. Discussion: ACCEPT will provide evidence for whether acalabrutinib in combination with R-CHOP is safe and biologically effective prior to future Phase II/III trials in patients with previously untreated CD20 positive DLBCL. Trial registration: EudraCT Number: 2015-003213-18 (issued 16 July 2015); ISRCTN 13626902 (registered 07 March 2017).
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Affiliation(s)
- Andrew Davies
- Southampton Experimental Cancer Medicine Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southhampton, UK
| | | | | | - Katy Mercer
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Joshua Caddy
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Fay Chinnery
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Laura Day
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Diana Fernando
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Kirit Ardeshna
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | - Simon Rule
- Plymouth Hospitals NHS Trust and Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
| | | | - Peter Johnson
- Southampton Experimental Cancer Medicine Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southhampton, UK
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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McMillan AK, Phillips EH, Kirkwood AA, Barrans S, Burton C, Rule S, Patmore R, Pettengell R, Ardeshna KM, Lawrie A, Montoto S, Paneesha S, Clifton-Hadley L, Linch DC. Favourable outcomes for high-risk diffuse large B-cell lymphoma (IPI 3-5) treated with front-line R-CODOX-M/R-IVAC chemotherapy: results of a phase 2 UK NCRI trial. Ann Oncol 2020; 31:1251-1259. [PMID: 32464282 PMCID: PMC7487775 DOI: 10.1016/j.annonc.2020.05.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/05/2020] [Accepted: 05/07/2020] [Indexed: 12/28/2022] Open
Abstract
Background Outcomes for patients with high-risk diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP chemotherapy are suboptimal but, to date, no alternative regimen has been shown to improve survival rates. This phase 2 trial aimed to assess the efficacy of a Burkitt-like approach for high-risk DLBCL using the dose-intense R-CODOX-M/R-IVAC regimen. Patients and methods Eligible patients were aged 18–65 years with stage II–IV untreated DLBCL and an International Prognostic Index (IPI) score of 3–5. Patients received alternating cycles of CODOX-M (cyclophosphamide, vincristine, doxorubicin and high-dose methotrexate) alternating with IVAC chemotherapy (ifosfamide, etoposide and high-dose cytarabine) plus eight doses of rituximab. Response was assessed by computed tomography after completing all four cycles of chemotherapy. The primary end point was 2-year progression-free survival (PFS). Results A total of 111 eligible patients were registered; median age was 50 years, IPI score was 3 (60.4%) or 4/5 (39.6%), 54% had a performance status ≥2 and 9% had central nervous system involvement. A total of 85 patients (76.6%) completed all four cycles of chemotherapy. There were five treatment-related deaths (4.3%), all in patients with performance status of 3 and aged >50 years. Two-year PFS for the whole cohort was 67.9% [90% confidence interval (CI) 59.9–74.6] and 2-year overall survival was 76.0% (90% CI 68.5–82.0). The ability to tolerate and complete treatment was lower in patients with performance status ≥2 who were aged >50 years, where 2-year PFS was 43.5% (90% CI 27.9–58.0). Conclusions This trial demonstrates that R-CODOX-M/R-IVAC is a feasible and effective regimen for the treatment of younger and/or fit patients with high-risk DLBCL. These encouraging survival rates demonstrate that this regimen warrants further investigation against standard of care. Trial Registration ClinicalTrials.gov (NCT00974792) and EudraCT (2005-003479-19). R-CODOX-M/R-IVAC is an effective regimen for treatment of high-risk DLBCL and high-grade B-cell lymphoma (IPI score 3–5). Treatment was well tolerated in patients aged <50 years, or aged 50–65 with performance status 0 or 1. The 2-year PFS was 67.9% (90% CI: 59.9–74.6) for the whole cohort. This regimen warrants further evaluation against standard of care in high-risk DLBCL.
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Affiliation(s)
- A K McMillan
- Haematology Department, Nottingham University Hospitals NHS Trust, Nottingham, UK.
| | - E H Phillips
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK; Division of Cancer Sciences, University of Manchester and The Christie Hospital NHS Trust, Manchester, UK
| | - A A Kirkwood
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK
| | - S Barrans
- HMDS, St James' University Hospital, Leeds, UK
| | - C Burton
- HMDS, St James' University Hospital, Leeds, UK
| | - S Rule
- Plymouth University Medical School, Plymouth, UK
| | - R Patmore
- Haematology Department, Castle Hill Hospital, Hull, UK
| | - R Pettengell
- Clinical Sciences, St George's University of London, London, UK
| | - K M Ardeshna
- Haematology Department, University College Hospital London, London, UK
| | - A Lawrie
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK
| | - S Montoto
- Centre for Haemato-oncology, Barts Health NHS Trust, London, UK
| | - S Paneesha
- Haematology Department, Heart of England NHS Trust, Birmingham, UK
| | - L Clifton-Hadley
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer Institute, University College London, London, UK
| | - D C Linch
- Haematology Department, University College Hospital London, London, UK; UCL Cancer Institute, University College London, UK
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13
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Cucco F, Barrans S, Sha C, Clipson A, Crouch S, Dobson R, Chen Z, Thompson JS, Care MA, Cummin T, Caddy J, Liu H, Robinson A, Schuh A, Fitzgibbon J, Painter D, Smith A, Roman E, Tooze R, Burton C, Davies AJ, Westhead DR, Johnson PWM, Du MQ. Distinct genetic changes reveal evolutionary history and heterogeneous molecular grade of DLBCL with MYC/BCL2 double-hit. Leukemia 2020; 34:1329-1341. [PMID: 31844144 PMCID: PMC7192846 DOI: 10.1038/s41375-019-0691-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 11/22/2019] [Accepted: 12/06/2019] [Indexed: 12/11/2022]
Abstract
Using a Burkitt lymphoma-like gene expression signature, we recently defined a high-risk molecular high-grade (MHG) group mainly within germinal centre B-cell like diffuse large B-cell lymphomas (GCB-DLBCL), which was enriched for MYC/BCL2 double-hit (MYC/BCL2-DH). The genetic basis underlying MHG-DLBCL and their aggressive clinical behaviour remain unknown. We investigated 697 cases of DLBCL, particularly those with MYC/BCL2-DH (n = 62) by targeted sequencing and gene expression profiling. We showed that DLBCL with MYC/BCL2-DH, and those with BCL2 translocation, harbour the characteristic mutation signatures that are associated with follicular lymphoma and its high-grade transformation. We identified frequent MYC hotspot mutations that affect the phosphorylation site (T58) and its adjacent amino acids, which are important for MYC protein degradation. These MYC mutations were seen in a subset of cases with MYC translocation, but predominantly in those of MHG. The mutations were more frequent in double-hit lymphomas with IG as the MYC translocation partner, and were associated with higher MYC protein expression and poor patient survival. DLBCL with MYC/BCL2-DH and those with BCL2 translocation alone are most likely derived from follicular lymphoma or its precursor lesion, and acquisition of MYC pathogenic mutations may augment MYC function, resulting in aggressive clinical behaviour.
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Affiliation(s)
- Francesco Cucco
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
| | - Chulin Sha
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | | | - Simon Crouch
- Department of Health Sciences, University of York, York, UK
| | - Rachel Dobson
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Zi Chen
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | - Matthew A Care
- Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Thomas Cummin
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Josh Caddy
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Hongxiang Liu
- Haematopathology and Oncology Diagnostics Service, Cambridge University NHS Foundation Trust, Cambridge, UK
| | - Anne Robinson
- Haematopathology and Oncology Diagnostics Service, Cambridge University NHS Foundation Trust, Cambridge, UK
| | - Anna Schuh
- Department of Oncology, University of Oxford, Oxford, UK
| | - Jude Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute, London, UK
| | - Daniel Painter
- Department of Health Sciences, University of York, York, UK
| | | | - Eve Roman
- Department of Health Sciences, University of York, York, UK
| | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
| | - Andrew J Davies
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | | | - Peter W M Johnson
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Ming-Qing Du
- Department of Pathology, University of Cambridge, Cambridge, UK.
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14
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Phillips EH, Burton C, Kirkwood AA, Barrans S, Lawrie A, Rule S, Patmore R, Pettengell R, Ardeshna KM, Montoto S, Paneesha S, Clifton‐Hadley L, Linch DC, McMillan AK. Favourable outcomes for high‐risk Burkitt lymphoma patients (IPI 3‐5) treated with rituximab plus CODOX‐M/IVAC: Results of a phase 2 UK NCRI trial. ACTA ACUST UNITED AC 2020; 1:133-141. [PMID: 35847742 PMCID: PMC9176097 DOI: 10.1002/jha2.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 01/17/2023]
Abstract
Introduction Outcomes after frontline treatment of Burkitt lymphoma (BL) have improved with the introduction of dose‐intense chemotherapy regimens, such as CODOX‐M/IVAC. While rituximab has increased survival rates for most forms of high‐grade B‐cell lymphoma, there has previously been hesitancy about incorporating it into BL treatment, partly due to concerns about increased toxicity. Prospective data using the standard dose CODOX‐M/IVAC regimen in combination with rituximab are lacking. We conducted a single‐arm phase 2 trial to assess the efficacy and toxicity of R‐CODOX‐M/R‐IVAC. Methods Eligible patients were aged 18–65 years, with newly diagnosed BL with MYC rearrangement as the sole cytogenetic abnormality, and high‐risk disease, defined by an International Prognostic Index (IPI) score of 3‐5. Patients received two cycles of R‐CODOX‐M chemotherapy alternating with two cycles of R‐IVAC, followed by two further cycles of rituximab alone. The primary endpoint was 2‐year progression‐free survival. Results Thirty‐eight patients were registered but after central pathology review, 27 patients had confirmed BL and commenced study treatment. Median age was 35 years, 14.8% patients had central nervous system involvement and 18.5% were HIV positive. Twenty‐two (81.4%) patients completed four cycles of chemotherapy. There were two treatment‐related deaths (7.4%). Two‐year progression‐free and overall survival rates were 77.2% (90% confidence interval [CI]: 56.0‐89.0) and 80.7% (90% CI: 59.6‐91.5), respectively. Conclusions This prospective trial demonstrates excellent survival rates with R‐CODOX‐M/R‐IVAC in a high‐risk BL cohort. It provides reassuring evidence regarding the feasibility of this regimen and also provides a benchmark for future studies.
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Affiliation(s)
- Elizabeth H. Phillips
- Division of Cancer Sciencesthe University of Manchester Manchester UK
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer InstituteUniversity College London London UK
| | | | - Amy A. Kirkwood
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer InstituteUniversity College London London UK
| | | | - Anthony Lawrie
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer InstituteUniversity College London London UK
| | - Simon Rule
- Plymouth University Medical School Plymouth UK
| | | | - Ruth Pettengell
- Clinical Sciences Department, St George's University of London London UK
| | | | - Silvia Montoto
- Haemato‐oncology DepartmentBarts Health NHS Trust London UK
| | | | - Laura Clifton‐Hadley
- Cancer Research UK and UCL Cancer Trials Centre, UCL Cancer InstituteUniversity College London London UK
| | | | - Andrew K. McMillan
- Haematology DepartmentNottingham University Hospitals NHS Trust Nottingham UK
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15
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Eyre TA, Hildyard C, Hamblin A, Ali AS, Houlton A, Hopkins L, Royston D, Linton KM, Pettitt A, Rule S, Cwynarski K, Barrington SF, Warbey V, Wrench D, Barrans S, Hirst CS, Panchal A, Roudier MP, Harrington EA, Davies A, Collins GP. A phase II study to assess the safety and efficacy of the dual mTORC1/2 inhibitor vistusertib in relapsed, refractory DLBCL. Hematol Oncol 2019; 37:352-359. [PMID: 31385336 DOI: 10.1002/hon.2662] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 07/23/2019] [Accepted: 07/30/2019] [Indexed: 02/11/2024]
Abstract
Patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who are unfit for or relapsed postautologous stem-cell transplantation have poor outcomes. Historically, mTORC1 inhibitors have produced responses in approximately 30% of patients in this setting. mTORC1 inhibitor efficacy may be limited by resistance mechanisms including AKT activation by mTORC2. To date, dual mTORC1/2 inhibitors targeting both the TORC1 and TORC2 complexes have not been investigated in DLBCL. This phase II trial investigated the oral dual mTORC1/2 inhibitor vistusertib in an intermittent dosing schedule of 125 mg b.d. for 2 days per week. Thirty patients received vistusertib and six received vistusertib-rituximab for up to six cycles (28-day cycles). Two partial responses were achieved on monotherapy. Durations of response were 57 and 62 days, respectively, for these patients. 19% had stable disease within six cycles. In the monotherapy arm, the median progression-free survival was1.69 (95% confidence interval [CI] 1.61-2.14) months and median overall survival was 6.58 (95% CI 3.81-not reached) months, respectively. The median duration of response or stable disease across the trial duration was 153 days (95% CI 112-not reached). Tumour responses according to positron emission tomography/computed tomography versus computed tomography were concordant. There were no differences noted in tumour volume response according to cell of origin by either gene expression profiling or immunohistochemistry. Vistusertib ± rituximab was well tolerated; across 36 patients 86% of adverse events were grade (G) 1-2. Common vistusertib-related adverse events were similar to those described with mTORC1 inhibitors: nausea (47% G1-2), diarrhoea (27% G1-2, 6% G3), fatigue (30% G1-2, 3% G3), mucositis (25% G1-2, 6% G3), vomiting (17% G1-2), and dyspepsia (14% G1-2). Dual mTORC1/2 inhibitors do not clearly confer an advantage over mTORC1 inhibitors in relapsed or refractory DLBCL. Potential resistance mechanisms are discussed within.
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Affiliation(s)
- Toby A Eyre
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
| | - Catherine Hildyard
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
| | - Angela Hamblin
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
| | - Ayesha S Ali
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Aimee Houlton
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Louise Hopkins
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Daniel Royston
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
| | - Kim M Linton
- Department of Medical Oncology, The Christie Hospital NHS Trust, Manchester, UK
| | - Andrew Pettitt
- Department of Haematology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - Simon Rule
- Department of Haematology, University of Plymouth Medical School, Plymouth, UK
| | - Kate Cwynarski
- Department of Haematology, University College London, London, UK
| | | | | | - David Wrench
- Department of Haematology, Guy's and St Thomas' Hospital, London, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St James' University Hospital, Leeds, UK
| | - Caroline S Hirst
- Translational Medicine, AstraZeneca Oncology R&D I Research and Early Development, Cambridge, UK
| | - Anesh Panchal
- Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - Martine P Roudier
- Translational Medicine, AstraZeneca Oncology R&D I Research and Early Development, Cambridge, UK
| | - Elizabeth A Harrington
- Translational Medicine, AstraZeneca Oncology R&D I Research and Early Development, Cambridge, UK
| | - Andrew Davies
- Cancer Research UK Centre, Cancer Sciences Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Graham P Collins
- Department of Haematology, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
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16
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Rosenwald A, Bens S, Advani R, Barrans S, Copie-Bergman C, Elsensohn MH, Natkunam Y, Calaminici M, Sander B, Baia M, Smith A, Painter D, Pham L, Zhao S, Ziepert M, Jordanova ES, Molina TJ, Kersten MJ, Kimby E, Klapper W, Raemaekers J, Schmitz N, Jardin F, Stevens WBC, Hoster E, Hagenbeek A, Gribben JG, Siebert R, Gascoyne RD, Scott DW, Gaulard P, Salles G, Burton C, de Jong D, Sehn LH, Maucort-Boulch D. Prognostic Significance of MYC Rearrangement and Translocation Partner in Diffuse Large B-Cell Lymphoma: A Study by the Lunenburg Lymphoma Biomarker Consortium. J Clin Oncol 2019; 37:3359-3368. [PMID: 31498031 DOI: 10.1200/jco.19.00743] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE MYC rearrangement (MYC-R) occurs in approximately 10% of diffuse large B-cell lymphomas (DLBCLs) and has been associated with poor prognosis in many studies. The impact of MYC-R on prognosis may be influenced by the MYC partner gene (immunoglobulin [IG] or a non-IG gene). We evaluated a large cohort of patients through the Lunenburg Lymphoma Biomarker Consortium to validate the prognostic significance of MYC-R (single-, double-, and triple-hit status) in DLBCL within the context of the MYC partner gene. METHODS The study cohort included patients with histologically confirmed DLBCL morphology derived from large prospective trials and patient registries in Europe and North America who were uniformly treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone therapy or the like. Fluorescence in situ hybridization for the MYC, BCL2, BCL6, and IG heavy and light chain loci was used, and results were correlated with clinical outcomes. RESULTS A total of 5,117 patients were identified of whom 2,383 (47%) had biopsy material available to assess for MYC-R. MYC-R was present in 264 (11%) of 2,383 patients and was associated with a significantly shorter progression-free and overall survival, with a strong time-dependent effect within the first 24 months after diagnosis. The adverse prognostic impact of MYC-R was only evident in patients with a concurrent rearrangement of BCL2 and/or BCL6 and an IG partner (hazard ratio, 2.4; 95% CI, 1.6 to 3.6; P < .001). CONCLUSION The negative prognostic impact of MYC-R in DLBCL is largely observed in patients with MYC double hit/triple-hit disease in which MYC is translocated to an IG partner, and this effect is restricted to the first 2 years after diagnosis. Our results suggest that diagnostic strategies should be adopted to identify this high-risk cohort, and risk-adjusted therapeutic approaches should be refined further.
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Affiliation(s)
- Andreas Rosenwald
- University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Susanne Bens
- Ulm University and Ulm University Medical Center, Ulm, Germany
| | | | | | | | - Mad-Helenie Elsensohn
- Hospices Civils de Lyon and Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France
| | - Yaso Natkunam
- Stanford University School of Medicine, Stanford, CA
| | | | - Birgitta Sander
- Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Stockholm, Sweden
| | | | | | | | - Luu Pham
- Stanford Cancer Institute, Stanford, CA
| | - Shuchun Zhao
- Stanford University School of Medicine, Stanford, CA
| | | | | | | | - Marie José Kersten
- Amsterdam University Medical Center, Amsterdam, the Netherlands.,University of Amsterdam and Lymphoma and Myeloma Center Amsterdam, Amsterdam, the Netherlands
| | - Eva Kimby
- Karolinska Institutet, Stockholm, Sweden
| | | | - John Raemaekers
- European Organisation for Research and Treatment of Cancer, Brussels, Belgium
| | | | | | | | - Eva Hoster
- Ludwig Maximilian University of Munich, Munich, Germany
| | - Anton Hagenbeek
- Amsterdam University Medical Center, Amsterdam, the Netherlands.,University of Amsterdam and Lymphoma and Myeloma Center Amsterdam, Amsterdam, the Netherlands
| | | | - Reiner Siebert
- Ulm University and Ulm University Medical Center, Ulm, Germany
| | | | | | | | | | | | - Daphne de Jong
- Amsterdam University Medical Center, Amsterdam, the Netherlands.,Vrije Universiteit University Medical Center, Amsterdam, the Netherlands
| | | | - Delphine Maucort-Boulch
- Hospices Civils de Lyon and Université de Lyon, Lyon, France.,Université Lyon 1, Villeurbanne, France
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17
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Cummin T, Caddy J, Mercer K, Maishman T, Schuh A, Lopez Pascua L, Collins G, McMillan A, Ardeshna K, Galanopoulous A, Burton C, Barrans S, Griffiths G, Johnson P, Davies A. ACCEPT: A PHASE IB/II COMBINATION OF ACALABRUTINIB WITH RITUXIMAB, CYCLOPHOSPHAMIDE, DOXORUBICIN, VINCRISTINE AND PREDNISOLONE (R-CHOP) FOR PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA (DLBCL). Hematol Oncol 2019. [DOI: 10.1002/hon.39_2629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- T.E. Cummin
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - J. Caddy
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - K. Mercer
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - T. Maishman
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - A. Schuh
- Oxford Molecular Diagnostics Centre; University of Oxford; Oxford United Kingdom
| | - L. Lopez Pascua
- Oxford Molecular Diagnostics Centre; University of Oxford; Oxford United Kingdom
| | - G. Collins
- Lymphoma Service; Oxford Univeristy Hospitals; Oxford United Kingdom
| | - A. McMillan
- Department of Haematology; Nottingham University Hospitals NHS Trust; Nottingham United Kingdom
| | - K. Ardeshna
- Department of Haematology; Univeristy College Hospitals London; London United Kingdom
| | - A. Galanopoulous
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - C. Burton
- Haematological Malignancies Diagnostic Service; Leeds Cancer Centre; Leeds United Kingdom
| | - S. Barrans
- Haematological Malignancies Diagnostic Service; Leeds Cancer Centre; Leeds United Kingdom
| | - G. Griffiths
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - P. Johnson
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - A.J. Davies
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK/ Southampton CRUK Clinical Trials Unit; University of Southampton; Southampton United Kingdom
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18
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Barrans S, Painter D, van Hoppe S, Smith A, Sha C, Cucco F, Du M, Westhead D, Davies A, Johnson P, Roman E, Burton C. DEFINING BURKITT-LIKE LYMPHOMA WITH 11Q ABERRATION IN A SPECIALISED UK HAEMATOPATHOLOGY DIAGNOSTIC SERVICE. Hematol Oncol 2019. [DOI: 10.1002/hon.101_2629] [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: 11/09/2022]
Affiliation(s)
- S. Barrans
- HMDS; Leeds Cancer Centre; Leeds United Kingdom
| | - D. Painter
- ECSG; Health Sciences, University of York; York United Kingdom
| | | | - A. Smith
- ECSG; Health Sciences, University of York; York United Kingdom
| | - C. Sha
- School of Molecular and Cellular Biology (Faculty of Biological Sciences); University of Leeds; Leeds United Kingdom
| | - F. Cucco
- Department of Pathology; University of Cambridge; Cambridge United Kingdom
| | - M. Du
- Department of Pathology; University of Cambridge; Cambridge United Kingdom
| | - D. Westhead
- School of Molecular and Cellular Biology (Faculty of Biological Sciences); University of Leeds; Leeds United Kingdom
| | - A. Davies
- Faculty of Medicine; University of Southampton; Southampton United Kingdom
| | - P. Johnson
- Faculty of Medicine; University of Southampton; Southampton United Kingdom
| | - E. Roman
- ECSG; Health Sciences, University of York; York United Kingdom
| | - C. Burton
- HMDS; Leeds Cancer Centre; Leeds United Kingdom
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19
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Cummin T, Cox K, Murray T, Barrans S, Sha C, Westhead D, Burton C, Davies A, Cragg M, Johnson P, Carter M. HIGH EXPRESSION OF BCL-2 AND BCL-XL IN DIFFUSE LARGE B-CELL LYMPHOMA CONFER POOR PROGNOSIS BUT MAY BE REVERSIBLE BY COMBINED INHIBITION WITH BET INHIBITORS AND BH3 MIMETICS. Hematol Oncol 2019. [DOI: 10.1002/hon.84_2629] [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: 11/11/2022]
Affiliation(s)
- T.E. Cummin
- Cancer Sciences; University of Southampton; Southampton United Kingdom
| | - K. Cox
- Cancer Sciences; University of Southampton; Southampton United Kingdom
| | - T. Murray
- Cancer Sciences; University of Southampton; Southampton United Kingdom
| | - S. Barrans
- Haematalogical Malignancies Diagnostic Service; University of Leeds; Leeds United Kingdom
| | - C. Sha
- Faculty of Biological Sciences; University of Leeds; Leeds United Kingdom
| | - D. Westhead
- Faculty of Biological Sciences; University of Leeds; Leeds United Kingdom
| | - C. Burton
- Haematalogical Malignancies Diagnostic Service; University of Leeds; Leeds United Kingdom
| | - A. Davies
- Southampton Clinical Trials Unit; University of Southampton; Southampton United Kingdom
| | - M. Cragg
- Cancer Sciences; University of Southampton; Southampton United Kingdom
| | - P. Johnson
- Cancer Sciences; University of Southampton; Southampton United Kingdom
| | - M. Carter
- Cancer Sciences; University of Southampton; Southampton United Kingdom
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20
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Davies A, Tansley Hancock O, Cummin T, Caddy J, Stanton L, Burton C, Barrans S, Coleman A, Osborne W, McKay P, Griffiths G, Johnson P. ARGO: A RANDOMISED PHASE II STUDY OF ATEZOLIZUMAB WITH RITUXIMAB, GEMCITABINE AND OXALIPLATIN IN PATIENTS WITH RELAPSED OR REFRACTORY DIFFUSE LARGE B-CELL LYMPHOMA WHO ARE NOT CANDIDATES FOR HIGH-DOSE THERAPY. Hematol Oncol 2019. [DOI: 10.1002/hon.1_2632] [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: 11/09/2022]
Affiliation(s)
- A.J. Davies
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - O. Tansley Hancock
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - T. Cummin
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - J. Caddy
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - L. Stanton
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - C. Burton
- Haematological Malignancies Diagnostic Service; St James's University Hospital; Leeds United Kingdom
| | - S. Barrans
- Haematological Malignancies Diagnostic Service; St James's University Hospital; Leeds United Kingdom
| | - A. Coleman
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - W. Osborne
- Freeman Hospital; Newcastle United Kingdom
| | - P. McKay
- Beatson West of Scotland Cancer Centre; Glasgow United Kingdom
| | - G. Griffiths
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
| | - P. Johnson
- Southampton Cancer Research UK (CRUK) Centre/CRUK Southampton Clinical Trials Unit/CRUK Experimental Cancer Medicines Centre UK; University of Southampton; Southampton United Kingdom
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21
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Korfi K, Araf S, Bewicke-Copley F, Kumar E, Cummin T, Ashton-Key M, Barrans S, Van Hoppe S, Burton C, Elshiekh M, Rule S, Crosbie N, Clear A, Calaminici M, Menon G, Sha C, Bentley M, Nagano A, Davies A, Painter D, Smith A, Okosun J, Gribben J, Naresh K, Westhead D, Wang J, Johnson P, Fitzgibbon J. LONGITUDINAL ANALYSES OF DIAGNOSTIC-RELAPSE BIOPSIES OF DIFFUSE LARGE B CELL LYMPHOMA SUGGEST THAT RELAPSE IS MEDIATED BY DISTINCT MECHANISMS IN ABC AND GCB LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.100_2629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- K. Korfi
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - S. Araf
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - F. Bewicke-Copley
- Centre for Molecular Oncology; Barts Cancer Institute; London United Kingdom
| | - E. Kumar
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - T. Cummin
- Cancer Research UK Centre; University of Southampton; Southampton United Kingdom
| | - M. Ashton-Key
- Cellular Pathology; University Hospital Southampton NHS Foundation Trust; Southampton United Kingdom
| | - S. Barrans
- HMDS; Leeds Teaching Hospitals NHS Trust; Leeds United Kingdom
| | - S. Van Hoppe
- HMDS; Leeds Teaching Hospitals NHS Trust; Leeds United Kingdom
| | - C. Burton
- HMDS; Leeds Teaching Hospitals NHS Trust; Leeds United Kingdom
| | - M. Elshiekh
- Cellular & Molecular Pathology; Imperial College NHS Trust & Imperial College London; London United Kingdom
| | - S. Rule
- Department of Haematology; Derriford Hospital, University of Plymouth; Plymouth United Kingdom
| | - N. Crosbie
- Department of Haematology; University Hospitals Plymouth NHS Trust; Plymouth United Kingdom
| | - A. Clear
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - M. Calaminici
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - G. Menon
- Haemato-Oncology Diagnostic Service; Liverpool Clinical Laboratories; Liverpool United Kingdom
| | - C. Sha
- School of Molecular and Cellular Biology; University of Leeds; Leeds United Kingdom
| | - M. Bentley
- School of Molecular and Cellular Biology; University of Leeds; Leeds United Kingdom
| | - A. Nagano
- Centre for Molecular Oncology; Barts Cancer Institute; London United Kingdom
| | - A. Davies
- Cancer Research UK Centre; University of Southampton; Southampton United Kingdom
| | - D. Painter
- Epidemiology and Cancer Statistics Group; University of York; York United Kingdom
| | - A. Smith
- Epidemiology and Cancer Statistics Group; University of York; York United Kingdom
| | - J. Okosun
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - J. Gribben
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
| | - K.N. Naresh
- Cellular & Molecular Pathology; Imperial College NHS Trust & Imperial College London; London United Kingdom
| | - D. Westhead
- School of Molecular and Cellular Biology; University of Leeds; Leeds United Kingdom
| | - J. Wang
- Centre for Molecular Oncology; Barts Cancer Institute; London United Kingdom
| | - P. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton United Kingdom
| | - J. Fitzgibbon
- Centre for Haemato-Oncology; Barts Cancer Institute; London United Kingdom
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22
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Lim S, Burton C, Barrans S, Kirkwood A, Patrick P, Stevens L, Clifton-Hadley L, Johnson P, Thirdborough S. TRANSCRIPTIONAL NETWORKS ASSOCIATED WITH TREATMENT FAILURE IN ADVANCED-STAGE HODGKIN LYMPHOMA: DATA FROM THE RATHL TRIAL (CRUK/07/033). Hematol Oncol 2019. [DOI: 10.1002/hon.103_2630] [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: 11/08/2022]
Affiliation(s)
- S.H. Lim
- Centre for Cancer Immunology & CRUK Centre; University of Southampton; Southampton United Kingdom
| | - C. Burton
- HMDS; Leeds Cancer Centre; Leeds United Kingdom
| | - S. Barrans
- HMDS; Leeds Cancer Centre; Leeds United Kingdom
| | - A. Kirkwood
- CR UK & UCL Cancer Trials Centre; UCL Cancer Institute, University College London; London United Kingdom
| | - P. Patrick
- CR UK & UCL Cancer Trials Centre; UCL Cancer Institute, University College London; London United Kingdom
| | - L. Stevens
- CR UK & UCL Cancer Trials Centre; UCL Cancer Institute, University College London; London United Kingdom
| | - L. Clifton-Hadley
- CR UK & UCL Cancer Trials Centre; UCL Cancer Institute, University College London; London United Kingdom
| | - P.W. Johnson
- Centre for Cancer Immunology & CRUK Centre; University of Southampton; Southampton United Kingdom
| | - S.M. Thirdborough
- Centre for Cancer Immunology & CRUK Centre; University of Southampton; Southampton United Kingdom
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Davies A, Cummin TE, Barrans S, Maishman T, Mamot C, Novak U, Caddy J, Stanton L, Kazmi-Stokes S, McMillan A, Fields P, Pocock C, Collins GP, Stephens R, Cucco F, Clipson A, Sha C, Tooze R, Care MA, Griffiths G, Du MQ, Westhead DR, Burton C, Johnson PWM. Gene-expression profiling of bortezomib added to standard chemoimmunotherapy for diffuse large B-cell lymphoma (REMoDL-B): an open-label, randomised, phase 3 trial. Lancet Oncol 2019; 20:649-662. [PMID: 30948276 PMCID: PMC6494978 DOI: 10.1016/s1470-2045(18)30935-5] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/04/2018] [Accepted: 12/07/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Biologically distinct subtypes of diffuse large B-cell lymphoma can be identified using gene-expression analysis to determine their cell of origin, corresponding to germinal centre or activated B cell. We aimed to investigate whether adding bortezomib to standard therapy could improve outcomes in patients with these subtypes. METHODS In a randomised evaluation of molecular guided therapy for diffuse large B-cell lymphoma with bortezomib (REMoDL-B), an open-label, adaptive, randomised controlled, phase 3 superiority trial, participants were recruited from 107 cancer centres in the UK (n=94) and Switzerland (n=13). Eligible patients had previously untreated, histologically confirmed diffuse large B-cell lymphoma with sufficient diagnostic material from initial biopsies for gene-expression profiling and pathology review; were aged 18 years or older; had ECOG performance status of 2 or less; had bulky stage I or stage II-IV disease requiring full-course chemotherapy; had measurable disease; and had cardiac, lung, renal, and liver function sufficient to tolerate chemotherapy. Patients initially received one 21-day cycle of standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP; rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1·4 mg/m2 [to a maximum of 2 mg total dose] intravenously on day 1 of the cycle, and prednisolone 100 mg orally once daily on days 1-5). During this time, we did gene-expression profiling using whole genome cDNA-mediated annealing, selection, extension, and ligation assay of tissue from routine diagnostic biopsy samples to determine the cell-of-origin subtype of each participant (germinal centre B cell, activated B cell, or unclassified). Patients were then centrally randomly assigned (1:1) via a web-based system, with block randomisation stratified by international prognostic index score and cell-of-origin subtype, to continue R-CHOP alone (R-CHOP group; control), or with bortezomib (RB-CHOP group; experimental; 1·3 mg/m2 intravenously or 1·6 mg/m2 subcutaneously) on days 1 and 8 for cycles two to six. If RNA extracted from the diagnostic tissues was of insufficient quality or quantity, participants were given R-CHOP as per the control group. The primary endpoint was 30-month progression-free survival, for the germinal centre and activated B-cell population. The primary analysis was on the modified intention-to-treat population of activated and germinal centre B-cell population. Safety was assessed in all participants who were given at least one dose of study drug. We report the progression-free survival and safety outcomes for patients in the follow-up phase after the required number of events occurred. This study was registered at ClinicalTrials.gov, number NCT01324596, and recruitment and treatment has completed for all participants, with long-term follow-up ongoing. FINDINGS Between June 2, 2011, and June 10, 2015, 1128 eligible patients were registered, of whom 918 (81%) were randomly assigned to receive treatment (n=459 to R-CHOP, n=459 to RB-CHOP), comprising 244 (26·6%) with activated B-cell disease, 475 (51·7%) with germinal centre B cell disease, and 199 (21·7%) with unclassified disease. At a median follow-up of 29·7 months (95% CI 29·0-32·0), we saw no evidence for a difference in progression-free survival in the combined germinal centre and activated B-cell population between R-CHOP and RB-CHOP (30-month progression-free survival 70·1%, 95% CI 65·0-74·7 vs 74·3%, 69·3-78·7; hazard ratio 0·86, 95% CI 0·65-1·13; p=0·28). The most common grade 3 or worse adverse event was haematological toxicity, reported in 178 (39·8%) of 447 patients given R-CHOP and 187 (42·1%) of 444 given RB-CHOP. However, RB-CHOP was not associated with increased haematological toxicity and 398 [87·1%] of 459 participants assigned to receive RB-CHOP completed six cycles of treatment. Grade 3 or worse neuropathy occurred in 17 (3·8%) patients given RB-CHOP versus eight (1·8%) given R-CHOP. Serious adverse events occurred in 190 (42·5%) patients given R-CHOP, including five treatment-related deaths, and 223 (50·2%) given RB-CHOP, including four treatment-related deaths. INTERPRETATION This is the first large-scale study in diffuse large B-cell lymphoma to use real-time molecular characterisation for prospective stratification, randomisation, and subsequent analysis of biologically distinct subgroups of patients. The addition of bortezomib did not improve progression-free survival. FUNDING Janssen-Cilag, Bloodwise, and Cancer Research UK.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Biomarkers, Tumor/genetics
- Bortezomib/administration & dosage
- Bortezomib/adverse effects
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- Disease Progression
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Female
- Gene Expression Profiling
- Humans
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/mortality
- Male
- Middle Aged
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Progression-Free Survival
- Proteasome Inhibitors/administration & dosage
- Proteasome Inhibitors/adverse effects
- Rituximab/administration & dosage
- Rituximab/adverse effects
- Switzerland
- Time Factors
- Transcriptome
- United Kingdom
- Vincristine/administration & dosage
- Vincristine/adverse effects
- Young Adult
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Affiliation(s)
- Andrew Davies
- Cancer Research UK Centre, University of Southampton, Southampton, UK; Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Thomas E Cummin
- Cancer Research UK Centre, University of Southampton, Southampton, UK; Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, UK
| | - Tom Maishman
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | | | - Urban Novak
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Josh Caddy
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Louise Stanton
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | | | - Andrew McMillan
- Department of Haematology, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Paul Fields
- Department of Haematology, Guy's and St Thomas' Hospitals NHS Trust, Kings Health Partners, London, UK
| | - Christopher Pocock
- Department of Haematology, East Kent Hospitals University Foundation Trust, Canterbury, UK
| | - Graham P Collins
- Oxford Cancer and Haematology Centre, Churchill Hospital, Oxford, UK
| | | | - Francesco Cucco
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | - Chulin Sha
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Reuben Tooze
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, UK; Section of Experimental Haematology, University of Leeds, Leeds, UK
| | - Matthew A Care
- Section of Experimental Haematology, University of Leeds, Leeds, UK
| | - Gareth Griffiths
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Ming-Qing Du
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - David R Westhead
- School of Molecular and Cellular Biology, Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - Catherine Burton
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals, Leeds, UK
| | - Peter W M Johnson
- Cancer Research UK Centre, University of Southampton, Southampton, UK.
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24
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Araf S, Wang J, Ashton-Key M, Korfi K, Di Bella D, Rio-Machin A, Odabashian M, Foria V, Du MQ, Cucco F, Barrans S, Johnson P, Laird SR, Fisher AM, Cullis JO, Graham TA, Okosun J, Fitzgibbon J, Chiecchio L. Transmission of diffuse large B-cell lymphoma by an allogeneic stem-cell transplant. Haematologica 2019; 104:e174-e177. [PMID: 29976740 PMCID: PMC6442949 DOI: 10.3324/haematol.2018.196907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
MESH Headings
- Adult
- Allografts
- Child
- Hematopoietic Stem Cell Transplantation
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/etiology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
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Affiliation(s)
- Shamzah Araf
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Jun Wang
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London
| | | | - Koorosh Korfi
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Doriana Di Bella
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Ana Rio-Machin
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Mariette Odabashian
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Vipul Foria
- University Hospital Southampton NHS Foundation Trust, Southampton
| | - Ming-Qing Du
- University of Cambridge, Cancer Research UK Centre
| | | | - Sharon Barrans
- Haematological Malignancy Diagnostic Service (HMDS), Leeds Cancer Centre
| | - Peter Johnson
- Univesity of Southampton, Cancer Sciences Unit, Cancer Research UK Centre
| | - Sophie R Laird
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital
| | - Andrew M Fisher
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital
| | - Jonathan O Cullis
- Haematology Department, Salisbury NHS Foundation Trust, Salisbury District Hospital
| | - Trevor A Graham
- Evolution and Cancer Laboratory, Barts Cancer Institute, Queen Mary University of London, UK
| | - Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Jude Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London
| | - Laura Chiecchio
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury District Hospital
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25
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Merron B, Kazmi-Stokes S, Cummin T, Barrans S, Araf S, Korfi K, Pascua LDL, Caddy J, Cozens K, Cucco F, Uddin R, Sha C, Tooze R, Griffiths G, Du MQ, Burton C, Westhead D, Fitzgibbon J, Schuh A, Davies A, Johnson P. Precision medicine for patients with lymphoma; the Bloodwise Precision Medicine for Aggressive Lymphomas (PMAL) consortium. Clin Med (Lond) 2019. [DOI: 10.7861/clinmedicine.19-2-s100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Sha C, Barrans S, Cucco F, Bentley MA, Care MA, Cummin T, Kennedy H, Thompson JS, Uddin R, Worrillow L, Chalkley R, van Hoppe M, Ahmed S, Maishman T, Caddy J, Schuh A, Mamot C, Burton C, Tooze R, Davies A, Du MQ, Johnson PW, Westhead DR. Molecular High-Grade B-Cell Lymphoma: Defining a Poor-Risk Group That Requires Different Approaches to Therapy. J Clin Oncol 2019; 37:202-212. [PMID: 30523719 PMCID: PMC6338391 DOI: 10.1200/jco.18.01314] [Citation(s) in RCA: 160] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2018] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Biologic heterogeneity is a feature of diffuse large B-cell lymphoma (DLBCL), and the existence of a subgroup with poor prognosis and phenotypic proximity to Burkitt lymphoma is well known. Conventional cytogenetics identifies some patients with rearrangements of MYC and BCL2 and/or BCL6 (double-hit lymphomas) who are increasingly treated with more intensive chemotherapy, but a more biologically coherent and clinically useful definition of this group is required. PATIENTS AND METHODS We defined a molecular high-grade (MHG) group by applying a gene expression-based classifier to 928 patients with DLBCL from a clinical trial that investigated the addition of bortezomib to standard rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. The prognostic significance of MHG was compared with existing biomarkers. We performed targeted sequencing of 70 genes in 400 patients and explored molecular pathology using gene expression signature databases. Findings were validated in an independent data set. RESULTS The MHG group comprised 83 patients (9%), with 75 in the cell-of-origin germinal center B-cell-like group. MYC rearranged and double-hit groups were strongly over-represented in MHG but comprised only one half of the total. Gene expression analysis revealed a proliferative phenotype with a relationship to centroblasts. Progression-free survival rate at 36 months after R-CHOP in the MHG group was 37% (95% CI, 24% to 55%) compared with 72% (95% CI, 68% to 77%) for others, and an analysis of treatment effects suggested a possible positive effect of bortezomib. Double-hit lymphomas lacking the MHG signature showed no evidence of worse outcome than other germinal center B-cell-like cases. CONCLUSION MHG defines a biologically coherent high-grade B-cell lymphoma group with distinct molecular features and clinical outcomes that effectively doubles the size of the poor-prognosis, double-hit group. Patients with MHG may benefit from intensified chemotherapy or novel targeted therapies.
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MESH Headings
- Antibodies, Monoclonal, Murine-Derived/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Bortezomib/administration & dosage
- Cyclophosphamide/administration & dosage
- Databases, Genetic
- Doxorubicin/administration & dosage
- Female
- Humans
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/metabolism
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Middle Aged
- Neoplasm Grading
- Prednisone/administration & dosage
- Proportional Hazards Models
- Randomized Controlled Trials as Topic
- Retrospective Studies
- Rituximab/administration & dosage
- Transcriptome
- Vincristine/administration & dosage
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Affiliation(s)
- Chulin Sha
- University of Leeds, Leeds, United Kingdom
| | | | | | | | | | - Thomas Cummin
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | | | | | | | | | | | | | | | - Tom Maishman
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Josh Caddy
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Anna Schuh
- University of Oxford, Oxford, United Kingdom
| | - Christoph Mamot
- Cantonal Hospital Aarau, Aarau/Swiss Group for Clinical Cancer Research, Switzerland
| | | | | | - Andrew Davies
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
| | - Ming-Qing Du
- University of Cambridge, Cambridge, United Kingdom
| | - Peter W.M. Johnson
- Cancer Research UK Centre and Southampton Clinical Trials Unit, University of Southampton, Southampton, United Kingdom
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27
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Painter D, Barrans S, Lacy S, Smith A, Crouch S, Westhead D, Sha C, Patmore R, Tooze R, Burton C, Roman E. Cell-of-origin in diffuse large B-cell lymphoma: findings from the UK's population-based Haematological Malignancy Research Network. Br J Haematol 2018; 185:781-784. [PMID: 30408148 DOI: 10.1111/bjh.15619] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Daniel Painter
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - Stuart Lacy
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Alexandra Smith
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - Simon Crouch
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
| | - David Westhead
- Bioinfomatics Group, Institute of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Chulin Sha
- Bioinfomatics Group, Institute of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Russell Patmore
- Queen's Centre for Oncology and Haematology, Hull and East Yorkshire Hospitals, Cottingham, UK
| | - Reuben Tooze
- Section of Experimental Haematology, University of Leeds, Leeds, UK
| | - Cathy Burton
- Haematological Malignancy Diagnostic Service, St James's University Hospital, Leeds, UK
| | - Eve Roman
- Epidemiology & Cancer Statistics Group, Department of Health Sciences, University of York, York, UK
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28
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Cucco F, Clipson A, Kennedy H, Sneath Thompson J, Wang M, Barrans S, van Hoppe M, Ochoa Ruiz E, Caddy J, Hamid D, Cummin T, Burton C, Davies AJ, Johnson P, Du MQ. Mutation screening using formalin-fixed paraffin-embedded tissues: a stratified approach according to DNA quality. J Transl Med 2018; 98:1084-1092. [PMID: 29769698 DOI: 10.1038/s41374-018-0066-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/28/2018] [Accepted: 03/29/2018] [Indexed: 12/30/2022] Open
Abstract
DNA samples from formalin-fixed paraffin-embedded tissues are highly degraded with variable quality, and this imposes a big challenge for targeted sequencing due to false positives, largely caused by PCR errors and cytosine deamination. To eliminate false positives, a common practice is to validate the detected variants by Sanger sequencing or perform targeted sequencing in duplicate. Technically, PCR errors could be removed by molecular barcoding of template DNA prior to amplification as in the HaloPlexHS design. Nonetheless, it is uncertain to what extent variants detected using this approach should be further validated. Here, we addressed this question by correlating variant reproducibility with DNA quality using HaloPlexHS target enrichment and Illumina HiSeq4000, together with an in-house validated variant calling algorithm. The overall sequencing coverage, as shown by analyses of 70 genes in 266 cases of large B-cell lymphoma, was excellent (98%) in DNA samples amenable for PCR of ≥400 bp, but suboptimal (92%) and poor (80%) in those amenable for PCR of 300 bp and 200 bp respectively. By mutation analysis in duplicate in 93 cases, we demonstrated that 20 alternative allele depth (AAD) was an optimal cut-off value for separating reproducible from non-reproducible variants in DNA samples amenable for PCR of ≥300 bp, with 97% sensitivity and 100% specificity. By cross validation with a previously established targeted sequencing protocol by Fluidigm-PCR and Illumina MiSeq, the HaloPlexHS protocol was shown to be highly sensitive and specific in mutation screening. To conclude, we proposed a stratified approach for mutation screening by HaloplexHS and Illumina HiSeq4000 according to DNA quality. DNA samples with good quality (≥400 bp) are amenable for mutation analysis with a single replicate, with only variants at 15-20 AAD requiring for further validation, while those with suboptimal quality (300 bp) are better analysed in duplicate with reproducible variants at >15 AAD regarded as true genetic changes.
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Affiliation(s)
- Francesco Cucco
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | - Hannah Kennedy
- Department of Pathology, University of Cambridge, Cambridge, UK
| | | | - Ming Wang
- Department of Pathology, University of Cambridge, Cambridge, UK
| | - Sharon Barrans
- HMDS, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Moniek van Hoppe
- HMDS, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Josh Caddy
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Debbie Hamid
- Southampton Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Thomas Cummin
- Cancer Research UK Clinical Centre, University of Southampton, Southampton, UK
| | - Cathy Burton
- HMDS, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Andrew J Davies
- Cancer Research UK Clinical Centre, University of Southampton, Southampton, UK
| | - Peter Johnson
- Cancer Research UK Clinical Centre, University of Southampton, Southampton, UK
| | - Ming-Qing Du
- Department of Pathology, University of Cambridge, Cambridge, UK.
- Department of Histopathology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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29
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Burton C, Barrans S, Ahmed S, Bentley M, Clipson A, Wang M, Taylor J, Detute R, Westhead D, Care M, Du M, Davies A, Johnson P. CROSS-PLATFORM VALIDATION OF GENE EXPRESSION PROFILING (GEP) BASED CELL OF ORIGIN (COO) CLASSIFICATION IN a CLINICAL LABORATORY SETTING. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_96] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - S. Ahmed
- HMDS; Leeds Cancer Centre; Leeds UK
| | - M.A. Bentley
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - A. Clipson
- Division of Molecular Histopathology; University of Cambridge; Cambridge UK
| | - M. Wang
- Division of Molecular Histopathology; University of Cambridge; Cambridge UK
| | | | | | - D.R. Westhead
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - M.A. Care
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - M.Q. Du
- Division of Molecular Histopathology; University of Cambridge; Cambridge UK
| | - A. Davies
- University of Southampton; Cancer Research UK Centre; Southampton UK
| | - P.W. Johnson
- University of Southampton; Cancer Research UK Centre; Southampton UK
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30
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Cummin T, Araf S, Du M, Barrans S, Bentley M, Clipson A, Wang M, Ahmed S, Rahim T, Shah C, Hamid D, Dhondt J, Maishman T, Vaughan-Spickers N, Pocock C, Forbes A, O'Callaghan A, Westhead D, Griffiths G, Fitzgibbon J, Tooze R, Care M, Burton C, Davies A, Johnson P. PROGNOSTIC SIGNIFICANCE AND CORRELATION TO GENE EXPRESSION PROFILE OF EZH2
MUTATIONS IN DIFFUSE LARGE B-CELL LYMPHOMA (DLBL) IN 2 LARGE PROSPECTIVE STUDIES. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- T.E. Cummin
- Cancer Sciences; University of Southampton; Southampton UK
| | - S. Araf
- Centre for Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - M. Du
- Division of Molecular Histopathology Department of Pathology; University of Cambridge; Cambridge UK
| | - S. Barrans
- Haematological Malignancy Diagnostic Service, Haematological Malignancy Diagnostic Service; St. James's Institute of Oncology; Leeds UK
| | - M.A. Bentley
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - A. Clipson
- Division of Molecular Histopathology Department of Pathology; University of Cambridge; Cambridge UK
| | - M. Wang
- Division of Molecular Histopathology Department of Pathology; University of Cambridge; Cambridge UK
| | - S. Ahmed
- Haematological Malignancy Diagnostic Service, Haematological Malignancy Diagnostic Service; St. James's Institute of Oncology; Leeds UK
| | - T. Rahim
- Centre for Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - C. Shah
- Bioinformatics group,IMCB; University of Leeds; Leeds UK
| | - D. Hamid
- Southampton Clinical Trials Unit, Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - J. Dhondt
- Southampton Clinical Trials Unit, Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - T. Maishman
- Southampton Clinical Trials Unit, Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - N. Vaughan-Spickers
- Southampton Clinical Trials Unit, Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - C. Pocock
- Haematology Department; East Kent Hospitals University NHS Foundation Trust; Canterbury UK
| | - A. Forbes
- Haematology Department; Royal Cornwall Hospital; Truro UK
| | - A. O'Callaghan
- Haematology Department; Queen Alexandra Hospital, PO6 3LY; Portsmouth UK
| | - D. Westhead
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - G.O. Griffiths
- Southampton Clinical Trials Unit, Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - J. Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute; Queen Mary University of London; London UK
| | - R.M. Tooze
- Faculty of Medicine and Health, Leeds Institute of Cancer & Pathology; University of Leeds; Leeds UK
| | - M.A. Care
- Faculty of Medicine and Health, Leeds Institute of Cancer & Pathology; University of Leeds; Leeds UK
| | - C.H. Burton
- Haematological Malignancy Diagnostic Service, Haematological Malignancy Diagnostic Service; St. James's Institute of Oncology; Leeds UK
| | - A.J. Davies
- Cancer Research UK Centre; University of Southampton; Southampton UK
| | - P.W. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton UK
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31
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Davies A, Barrans S, Maishman T, Cummin T, Bentley M, Mamot C, Novak U, Caddy J, Hamid D, Kazmi-Stokes S, Mcmillan A, Fields P, Pocock C, Kruger A, Collins G, Sha C, Clipson A, Wang M, Tooze R, Care M, Griffiths G, Du M, Westhead D, Burton C, Jack A, Johnson P. DIFFERENTIAL EFFICACY OF BORTEZOMIB IN SUBTYPES OF DIFFUSE LARGE B-CELL LYMPHOMA (DLBL): a PROSPECTIVE RANDOMISED STUDY STRATIFIED BY TRANSCRIPTOME PROFILING: REMODL-B. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_120] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A.J. Davies
- Cancer Research UK Centre; University of Southampton (PMAL Consortium); Southampton UK
| | - S. Barrans
- Haematological Malignancy Diagnostic Service, Haematological Malignancy Diagnostic Service; St. James's Institute of Oncology, Leeds; Leeds UK
| | - T. Maishman
- Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - T.E. Cummin
- Cancer Research UK Centre; University of Southampton (PMAL Consortium); Southampton UK
| | - M. Bentley
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - C. Mamot
- Swiss Group for Clinical Cancer Research (SAKK); Kantonsspital Aarau; Bern Switzerland
| | - U. Novak
- Swiss Group for Clinical Cancer Research (SAKK); Inselspital / Bern University Hospital; Bern Switzerland
| | - J. Caddy
- Cancer Research UK Centre; University of Southampton (PMAL Consortium); Southampton UK
| | - D. Hamid
- Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - S.H. Kazmi-Stokes
- Cancer Research UK Centre; University of Southampton (PMAL Consortium); Southampton UK
| | - A. Mcmillan
- Haematology; Nottingham City Hospital; Nottingham UK
| | - P.A. Fields
- Haematology; Guy's and St Thomas' and King's College Hospitals; London UK
| | - C. Pocock
- Haematology; East Kent Hospitals University NHS Trust; Canterbury UK
| | - A. Kruger
- Haematology; Royal Cornwall Hospital; Truro UK
| | - G. Collins
- Clinical Haematology; Churchill Hospital; Oxford UK
| | - C. Sha
- Bioinformatics group, IMCB; University of Leeds; Leeds UK
| | - A. Clipson
- Division of Molecular Histopathology; University of Cambridge; Cambridge UK
| | - M. Wang
- Division of Molecular Histopathology; University of Cambridge; Cambridge UK
| | - R.M. Tooze
- Faculty of Medicine and Health; University of Leeds; Leeds UK
| | - M.A. Care
- Faculty of Medicine and Health; University of Leeds; Leeds UK
| | - G.O. Griffiths
- Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - M. Du
- Division of Molecular Histopathology; University of Cambridge; Cambridge UK
| | - D.R. Westhead
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - C. Burton
- Haematological Malignancy Diagnostic Service, Haematological Malignancy Diagnostic Service; St. James's Institute of Oncology, Leeds; Leeds UK
| | - A. Jack
- Haematological Malignancy Diagnostic Service, Haematological Malignancy Diagnostic Service; St. James's Institute of Oncology, Leeds; Leeds UK
| | - P.W. Johnson
- Cancer Research UK Centre; University of Southampton (PMAL Consortium); Southampton UK
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Burton C, Barrans S, Van Hoppe S, Sha C, Taylor J, Evans P, Painter D, Smith A, Crouch S, Goodlad J, Roman E, Westhead D, Davies A, Johnson P. GENE EXPRESSION PROFILING AND MUTATION ANALYSIS CAN AID TREATMENT DECISION MAKING IN AGGRESSIVE B CELL LYMPHOMA PATIENTS. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_10] [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: 11/10/2022]
Affiliation(s)
| | | | | | - C. Sha
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | | | - P. Evans
- HMDS; Leeds Cancer Centre; Leeds UK
| | - D. Painter
- Epidemiology & Cancer Statistics Group; University of York; York UK
| | - A. Smith
- Epidemiology & Cancer Statistics Group; University of York; York UK
| | - S. Crouch
- Epidemiology & Cancer Statistics Group; University of York; York UK
| | | | - E. Roman
- Epidemiology & Cancer Statistics Group; University of York; York UK
| | - D. Westhead
- School of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - A. Davies
- Cancer Research UK Centre; University of Southampton; Southampton UK
| | - P.W. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton UK
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Bentley M, Barrans S, Ahmed S, Taylor J, Burton C, Care M, Sha C, Westhead D. Pan-lymphoma classification. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_31] [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: 11/08/2022]
Affiliation(s)
- M.A. Bentley
- Institute of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - S. Barrans
- PNH National Service; Haematology Malignancy Diagnostic Service; Leeds UK
| | - S.M. Ahmed
- PNH National Service; Haematology Malignancy Diagnostic Service; Leeds UK
| | - J. Taylor
- PNH National Service; Haematology Malignancy Diagnostic Service; Leeds UK
| | - C. Burton
- PNH National Service; Haematology Malignancy Diagnostic Service; Leeds UK
| | - M.A. Care
- Institute of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - C. Sha
- Institute of Molecular and Cellular Biology; University of Leeds; Leeds UK
| | - D. Westhead
- Institute of Molecular and Cellular Biology; University of Leeds; Leeds UK
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Burton C, Sha C, Barrans S, Jack A, Painter D, Smith A, Roman E, Crouch S, Care M, Tooze R, Westhead D. A category-free approach to prognostic modelling in aggressive non-Hodgkin B cell lymphomas based on large patient databases. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_70] [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: 11/09/2022]
Affiliation(s)
- C. Burton
- Leeds Cancer Centre; Haematology Malignancy Diagnostic Service; Leeds UK
| | - C. Sha
- University of Leeds; Institute of Molecular and Cellular Biology; Leeds UK
| | - S. Barrans
- Leeds Cancer Centre; Haematology Malignancy Diagnostic Service; Leeds UK
| | - A. Jack
- Leeds Cancer Centre; Haematology Malignancy Diagnostic Service; Leeds UK
| | - D. Painter
- University of York; Epidemiology and Cancer Statistics Group; York UK
| | - A. Smith
- University of York; Epidemiology and Cancer Statistics Group; York UK
| | - E. Roman
- University of York; Epidemiology and Cancer Statistics Group; York UK
| | - S. Crouch
- University of York; Epidemiology and Cancer Statistics Group; York UK
| | - M. Care
- University of Leeds; Leeds Institute of Cancer and Pathology; Leeds UK
| | - R. Tooze
- University of Leeds; Leeds Institute of Cancer and Pathology; Leeds UK
| | - D. Westhead
- University of Leeds; Institute of Molecular and Cellular Biology; Leeds UK
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Lopez Pascua L, Ahmed S, Barrans S, Burton C, Clipson A, Cucco F, Cutts A, Dreau H, Du M, Joke D, Mizani R, Salminen O, Van Hoppe M, Vaughan-Spickers N, Schuh A, Johnson P. Identifying somatic mutations in cell-free DNA of aggressive lymphoma patients: First cell-free DNA results from the molecular profiling for lymphoma (MaPLe) study. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_6] [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: 11/10/2022]
Affiliation(s)
| | - S.M. Ahmed
- HMDS; St James' Institute of Oncology; Leeds UK
| | - S. Barrans
- HMDS; St James' Institute of Oncology; Leeds UK
| | - C. Burton
- HMDS; St James' Institute of Oncology; Leeds UK
| | - A.J. Clipson
- Pathology; University of Cambridge; Cambridge UK
| | - F. Cucco
- Pathology; University of Cambridge; Cambridge UK
| | - A. Cutts
- Department of Oncology; University of Oxford; Oxford UK
| | - H. Dreau
- Department of Oncology; University of Oxford; Oxford UK
| | - M. Du
- Pathology; University of Cambridge; Cambridge UK
| | - D. Joke
- Southampton Clinical Trials Unit; University of Southampton; Southampton UK
| | - R.T. Mizani
- Department of Oncology; University of Oxford; Oxford UK
| | | | | | | | - A. Schuh
- Department of Oncology; University of Oxford; Oxford UK
| | - P.W. Johnson
- Cancer Research UK Centre; University of Southampton; Southampton UK
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Kuhnl A, Shaikh R, Cunningham D, Counsell N, Barrans S, Burton C, Bentley M, Gleeson M, Edwards L, Ulrich L, Smith P, Clifton-Hadley L, Schofield O, Lawrie A, Linch D, Hubank M, Kaiser M. DNMT3A-2
EXPRESSION LEVELS CHARACTERISE DIFFUSE LARGE B-CELL LYMPHOMA WITH DISTINCT METHYLATION PATTERNS AND OUTCOME. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_7] [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: 11/07/2022]
Affiliation(s)
- A. Kuhnl
- Department of Medicine; Royal Marsden Hospital; London UK
| | - R. Shaikh
- Centre for Molecular Pathology; Royal Marsden Hospital; London UK
| | - D. Cunningham
- Department of Medicine; Royal Marsden Hospital; London UK
| | - N. Counsell
- Cancer Research UK and UCL Cancer Trials Centre; University College London; London UK
| | - S. Barrans
- HMDS St James's Institute of Oncology; St James's University Hospital; Leeds UK
| | - C. Burton
- HMDS St James's Institute of Oncology; St James's University Hospital; Leeds UK
| | - M. Bentley
- HMDS St James's Institute of Oncology; St James's University Hospital; Leeds UK
| | - M. Gleeson
- Department of Medicine; Royal Marsden Hospital; London UK
| | - L. Edwards
- Department of Medicine; Royal Marsden Hospital; London UK
| | - L. Ulrich
- Department of Medicine; Royal Marsden Hospital; London UK
| | - P. Smith
- Cancer Research UK and UCL Cancer Trials Centre; University College London; London UK
| | - L. Clifton-Hadley
- Cancer Research UK and UCL Cancer Trials Centre; University College London; London UK
| | - O. Schofield
- Cancer Research UK and UCL Cancer Trials Centre; University College London; London UK
| | - A. Lawrie
- Cancer Research UK and UCL Cancer Trials Centre; University College London; London UK
| | - D. Linch
- Department of Hematology; University College London; London UK
| | - M. Hubank
- Centre for Molecular Pathology; Royal Marsden Hospital; London UK
| | - M. Kaiser
- Division of Molecular Pathology; The Institute of Cancer Research; Sutton UK
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Cullen M, Turner K, Evans P, Taylor J, Martin-Cabrera P, Barrans S, Cargo C. SNP Array is not a Direct Replacement for Conventional Cytogenetics in MDS But can Identify Additional Prognostically Relevant Abnormalities. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30285-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Ruth Medlock
- Department of Haematology, Leeds Teaching Hospitals, Leeds, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, Leeds Teaching Hospitals, Leeds, UK
| | - Catherine Cargo
- Haematological Malignancy Diagnostic Service, Leeds Teaching Hospitals, Leeds, UK
| | - Richard Kelly
- Department of Haematology, Leeds Teaching Hospitals, Leeds, UK
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Brown PJ, Gascoyne DM, Lyne L, Spearman H, Felce SL, McFadden N, Chakravarty P, Barrans S, Lynham S, Calado DP, Ward M, Banham AH. N-terminally truncated FOXP1 protein expression and alternate internal FOXP1 promoter usage in normal and malignant B cells. Haematologica 2016; 101:861-71. [PMID: 27056922 PMCID: PMC5004466 DOI: 10.3324/haematol.2016.142141] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/04/2016] [Indexed: 12/20/2022] Open
Abstract
Strong FOXP1 protein expression is a poor risk factor in diffuse large B-cell lymphoma and has been linked to an activated B-cell-like subtype, which preferentially expresses short FOXP1 (FOXP1S) proteins. However, both short isoform generation and function are incompletely understood. Here we prove by mass spectrometry and N-terminal antibody staining that FOXP1S proteins in activated B-cell-like diffuse large B-cell lymphoma are N-terminally truncated. Furthermore, a rare strongly FOXP1-expressing population of normal germinal center B cells lacking the N-terminus of the regular long protein (FOXP1L) was identified. Exon-targeted silencing and transcript analyses identified three alternate 5' non-coding exons [FOXP1-Ex6b(s), FOXP1-Ex7b and FOXP1-Ex7c], downstream of at least two predicted promoters, giving rise to FOXP1S proteins. These were differentially controlled by B-cell activation and methylation, conserved in murine lymphoma cells, and significantly correlated with FOXP1S protein expression in primary diffuse large B-cell lymphoma samples. Alternatively spliced isoforms lacking exon 9 (e.g. isoform 3) did not encode FOXP1S, and an alternate long human FOXP1 protein (FOXP1AL) likely generated from a FOXP1-Ex6b(L) transcript was detected. The ratio of FOXP1L:FOXP1S isoforms correlated with differential expression of plasmacytic differentiation markers in U-2932 subpopulations, and altering this ratio was sufficient to modulate CD19 expression in diffuse large B-cell lymphoma cell lines. Thus, the activity of multiple alternate FOXP1 promoters to produce multiple protein isoforms is likely to regulate B-cell maturation.
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MESH Headings
- Alternative Splicing
- Animals
- Antigens, CD19/genetics
- Antigens, CD19/metabolism
- B-Lymphocytes/metabolism
- Cell Line, Tumor
- Exons
- Forkhead Transcription Factors/chemistry
- Forkhead Transcription Factors/genetics
- Forkhead Transcription Factors/metabolism
- Gene Expression Regulation, Neoplastic
- Humans
- Lymphocyte Activation/genetics
- Lymphocyte Activation/immunology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Mice
- Promoter Regions, Genetic
- Protein Interaction Domains and Motifs/genetics
- Protein Isoforms
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Repressor Proteins/chemistry
- Repressor Proteins/genetics
- Repressor Proteins/metabolism
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Affiliation(s)
- Philip J Brown
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, London, UK
| | - Duncan M Gascoyne
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, London, UK
| | - Linden Lyne
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, London, UK
| | - Hayley Spearman
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, London, UK
| | - Suet Ling Felce
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, London, UK
| | - Nora McFadden
- Immunity and Cancer Laboratory, The Francis Crick Institute, Lincoln's Inn Fields Laboratory, Lincoln's Inn Fields, London, UK
| | - Probir Chakravarty
- Computational Biology Laboratory, The Francis Crick Institute, Lincoln's Inn Fields Laboratory, Lincoln's Inn Fields, London, UK
| | - Sharon Barrans
- Leeds Teaching Hospitals NHS Trust, HMDS, Leeds Cancer Centre, Kings College London, UK
| | - Steven Lynham
- Centre of Excellence for Mass Spectrometry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Dinis P Calado
- Immunity and Cancer Laboratory, The Francis Crick Institute, Lincoln's Inn Fields Laboratory, Lincoln's Inn Fields, London, UK Peter Gorer Department of Immunobiology, Kings College London, UK
| | - Malcolm Ward
- Centre of Excellence for Mass Spectrometry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Alison H Banham
- Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, Oxford University, London, UK
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Okosun J, Wolfson RL, Wang J, Araf S, Wilkins L, Castellano BM, Escudero-Ibarz L, Al Seraihi AF, Richter J, Bernhart SH, Efeyan A, Iqbal S, Matthews J, Clear A, Guerra-Assunção JA, Bödör C, Quentmeier H, Mansbridge C, Johnson P, Davies A, Strefford JC, Packham G, Barrans S, Jack A, Du MQ, Calaminici M, Lister TA, Auer R, Montoto S, Gribben JG, Siebert R, Chelala C, Zoncu R, Sabatini DM, Fitzgibbon J. Recurrent mTORC1-activating RRAGC mutations in follicular lymphoma. Nat Genet 2016; 48:183-8. [PMID: 26691987 PMCID: PMC4731318 DOI: 10.1038/ng.3473] [Citation(s) in RCA: 123] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 11/23/2015] [Indexed: 12/13/2022]
Abstract
Follicular lymphoma is an incurable B cell malignancy characterized by the t(14;18) translocation and mutations affecting the epigenome. Although frequent gene mutations in key signaling pathways, including JAK-STAT, NOTCH and NF-κB, have also been defined, the spectrum of these mutations typically overlaps with that in the closely related diffuse large B cell lymphoma (DLBCL). Using a combination of discovery exome and extended targeted sequencing, we identified recurrent somatic mutations in RRAGC uniquely enriched in patients with follicular lymphoma (17%). More than half of the mutations preferentially co-occurred with mutations in ATP6V1B2 and ATP6AP1, which encode components of the vacuolar H(+)-ATP ATPase (V-ATPase) known to be necessary for amino acid-induced activation of mTORC1. The RagC variants increased raptor binding while rendering mTORC1 signaling resistant to amino acid deprivation. The activating nature of the RRAGC mutations, their existence in the dominant clone and their stability during disease progression support their potential as an excellent candidate for therapeutic targeting.
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Affiliation(s)
- Jessica Okosun
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Rachel L Wolfson
- Whitehead Institute for Biomedical Research and Massachusetts Institute of Technology, Department of Biology, Cambridge, Massachusetts, USA
- Howard Hughes Medical Institute, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Jun Wang
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Shamzah Araf
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Lucy Wilkins
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Brian M Castellano
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, California, USA
| | - Leire Escudero-Ibarz
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Ahad Fahad Al Seraihi
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Julia Richter
- Institute of Human Genetics, University Hospital Schleswig-Holstein Campus Kiel and Christian Albrechts University Kiel, Kiel, Germany
| | - Stephan H Bernhart
- Transcriptome Bioinformatics, LIFE Research Center for Civilization Diseases, Leipzig, Germany
- Interdisciplinary Center for Bioinformatics, University of Leipzig, Leipzig, Germany
- Bioinformatics Group, Department of Computer Science, University of Leipzig, Leipzig, Germany
| | - Alejo Efeyan
- Whitehead Institute for Biomedical Research and Massachusetts Institute of Technology, Department of Biology, Cambridge, Massachusetts, USA
- Howard Hughes Medical Institute, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Sameena Iqbal
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Janet Matthews
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Andrew Clear
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | | | - Csaba Bödör
- MTA-SE Lendulet Molecular Oncohematology Research Group, 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Hilmar Quentmeier
- Leibniz Institute DSMZ, German Collection of Microorganisms and Cell Cultures, Braunschweig, Germany
| | | | - Peter Johnson
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Andrew Davies
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Jonathan C Strefford
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Graham Packham
- Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, UK
| | - Andrew Jack
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, UK
| | - Ming-Qing Du
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Maria Calaminici
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - T Andrew Lister
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Rebecca Auer
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Silvia Montoto
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - John G Gribben
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Reiner Siebert
- Institute of Human Genetics, University Hospital Schleswig-Holstein Campus Kiel and Christian Albrechts University Kiel, Kiel, Germany
| | - Claude Chelala
- Centre for Molecular Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Roberto Zoncu
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, California, USA
| | - David M Sabatini
- Whitehead Institute for Biomedical Research and Massachusetts Institute of Technology, Department of Biology, Cambridge, Massachusetts, USA
- Howard Hughes Medical Institute, Department of Biology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Koch Institute for Integrative Cancer Research, Cambridge, Massachusetts, USA
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Jude Fitzgibbon
- Centre for Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
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Wang M, Escudero-Ibarz L, Moody S, Zeng N, Clipson A, Huang Y, Xue X, Grigoropoulos NF, Barrans S, Worrillow L, Forshew T, Su J, Firth A, Martin H, Jack A, Brugger K, Du MQ. Somatic Mutation Screening Using Archival Formalin-Fixed, Paraffin-Embedded Tissues by Fluidigm Multiplex PCR and Illumina Sequencing. J Mol Diagn 2015; 17:521-32. [PMID: 26165823 DOI: 10.1016/j.jmoldx.2015.04.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/02/2015] [Accepted: 04/27/2015] [Indexed: 01/03/2023] Open
Abstract
High-throughput somatic mutation screening using FFPE tissues is a major challenge because of a lack of established methods and validated variant calling algorithms. We aimed to develop a targeted sequencing protocol by Fluidigm multiplex PCR and Illumina sequencing and to establish a companion variant calling algorithm. The experimental protocol and variant calling algorithm were first developed and optimized against a series of somatic mutations (147 substitutions, 12 indels ranging from 1 to 33 bp) in seven genes, previously detected by Sanger sequencing of DNA from 163 FFPE lymphoma biopsy specimens. The optimized experimental protocol and variant calling algorithm were further ascertained in two separate experiments by including the seven genes as a part of larger gene panels (22 or 13 genes) using FFPE and high-molecular-weight lymphoma DNAs, respectively. We found that most false-positive variants were due to DNA degradation, deamination, and Taq polymerase errors, but they were nonreproducible and could be efficiently eliminated by duplicate experiments. A small fraction of false-positive variants appeared in duplicate, but they were at low alternative allele frequencies and could be separated from mutations when appropriate threshold value was used. In conclusion, we established a robust practical approach for high-throughput mutation screening using archival FFPE tissues.
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Affiliation(s)
- Ming Wang
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Leire Escudero-Ibarz
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Moody
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Naiyan Zeng
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Alexandra Clipson
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Yuanxue Huang
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Xuemin Xue
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Nicholas F Grigoropoulos
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, United Kingdom
| | - Lisa Worrillow
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, United Kingdom
| | - Tim Forshew
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Jing Su
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
| | - Andrew Firth
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Howard Martin
- Department of Molecular Genetics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Andrew Jack
- Haematological Malignancy Diagnostic Service, St. James's Institute of Oncology, Leeds, United Kingdom
| | - Kim Brugger
- Department of Molecular Genetics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Ming-Qing Du
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
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Sha C, Barrans S, Care MA, Cunningham D, Tooze RM, Jack A, Westhead DR. Transferring genomics to the clinic: distinguishing Burkitt and diffuse large B cell lymphomas. Genome Med 2015; 7:64. [PMID: 26207141 PMCID: PMC4512160 DOI: 10.1186/s13073-015-0187-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/15/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Classifiers based on molecular criteria such as gene expression signatures have been developed to distinguish Burkitt lymphoma and diffuse large B cell lymphoma, which help to explore the intermediate cases where traditional diagnosis is difficult. Transfer of these research classifiers into a clinical setting is challenging because there are competing classifiers in the literature based on different methodology and gene sets with no clear best choice; classifiers based on one expression measurement platform may not transfer effectively to another; and, classifiers developed using fresh frozen samples may not work effectively with the commonly used and more convenient formalin fixed paraffin-embedded samples used in routine diagnosis. METHODS Here we thoroughly compared two published high profile classifiers developed on data from different Affymetrix array platforms and fresh-frozen tissue, examining their transferability and concordance. Based on this analysis, a new Burkitt and diffuse large B cell lymphoma classifier (BDC) was developed and employed on Illumina DASL data from our own paraffin-embedded samples, allowing comparison with the diagnosis made in a central haematopathology laboratory and evaluation of clinical relevance. RESULTS We show that both previous classifiers can be recapitulated using very much smaller gene sets than originally employed, and that the classification result is closely dependent on the Burkitt lymphoma criteria applied in the training set. The BDC classification on our data exhibits high agreement (~95 %) with the original diagnosis. A simple outcome comparison in the patients presenting intermediate features on conventional criteria suggests that the cases classified as Burkitt lymphoma by BDC have worse response to standard diffuse large B cell lymphoma treatment than those classified as diffuse large B cell lymphoma. CONCLUSIONS In this study, we comprehensively investigate two previous Burkitt lymphoma molecular classifiers, and implement a new gene expression classifier, BDC, that works effectively on paraffin-embedded samples and provides useful information for treatment decisions. The classifier is available as a free software package under the GNU public licence within the R statistical software environment through the link http://www.bioinformatics.leeds.ac.uk/labpages/softwares/ or on github https://github.com/Sharlene/BDC.
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Affiliation(s)
- Chulin Sha
- />School of Molecular and Cellular Biology, Garstang Building, University of Leeds, Leeds, LS2 9JT UK
| | - Sharon Barrans
- />Haematological, Malignancy Diagnostic Service, St James’s University Hospital, Leeds, UK
| | - Matthew A. Care
- />Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | | | - Reuben M. Tooze
- />Haematological, Malignancy Diagnostic Service, St James’s University Hospital, Leeds, UK
- />Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Andrew Jack
- />Haematological, Malignancy Diagnostic Service, St James’s University Hospital, Leeds, UK
| | - David R. Westhead
- />School of Molecular and Cellular Biology, Garstang Building, University of Leeds, Leeds, LS2 9JT UK
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Clipson A, Barrans S, Zeng N, Crouch S, Grigoropoulos NF, Liu H, Kocialkowski S, Wang M, Huang Y, Worrillow L, Goodlad J, Buxton J, Neat M, Fields P, Wilkins B, Grant JW, Wright P, Ei-Daly H, Follows GA, Roman E, Watkins AJ, Johnson PWM, Jack A, Du MQ. The prognosis of MYC translocation positive diffuse large B-cell lymphoma depends on the second hit. J Pathol Clin Res 2015; 1:125-133. [PMID: 27347428 PMCID: PMC4915334 DOI: 10.1002/cjp2.10] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/23/2014] [Indexed: 12/14/2022]
Abstract
A proportion of MYC translocation positive diffuse large B‐cell lymphomas (DLBCL) harbour a BCL2 and/or BCL6 translocation, known as double‐hit DLBCL, and are clinically aggressive. It is unknown whether there are other genetic abnormalities that cooperate with MYC translocation and form double‐hit DLBCL, and whether there is a difference in clinical outcome between the double‐hit DLBCL and those with an isolated MYC translocation. We investigated TP53 gene mutations along with BCL2 and BCL6 translocations in a total of 234 cases of DLBCL, including 81 with MYC translocation. TP53 mutations were investigated by PCR and sequencing, while BCL2 and BCL6 translocation was studied by interphase fluorescence in situ hybridization. The majority of MYC translocation positive DLBCLs (60/81 = 74%) had at least one additional genetic hit. In MYC translocation positive DLBCL treated by R‐CHOP (n = 67), TP53 mutation and BCL2, but not BCL6 translocation had an adverse effect on patient overall survival. In comparison with DLBCL with an isolated MYC translocation, cases with MYC/TP53 double‐hits had the worst overall survival, followed by those with MYC/BCL2 double‐hits. In MYC translocation negative DLBCL treated by R‐CHOP (n = 101), TP53 mutation, BCL2 and BCL6 translocation had no impact on patient survival. The prognosis of MYC translocation positive DLBCL critically depends on the second hit, with TP53 mutations and BCL2 translocation contributing to an adverse prognosis. It is pivotal to investigate both TP53 mutations and BCL2 translocations in MYC translocation positive DLBCL, and to distinguish double‐hit DLBCLs from those with an isolated MYC translocation.
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Affiliation(s)
- Alexandra Clipson
- Division of Molecular Histopathology Department of Pathology University of Cambridge UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service St. James's Institute of Oncology Leeds UK
| | - Naiyan Zeng
- Division of Molecular Histopathology Department of Pathology University of Cambridge UK
| | - Simon Crouch
- Department of Health Sciences Epidemiology and Cancer Statistics Group University of York York UK
| | - Nicholas F Grigoropoulos
- Division of Molecular HistopathologyDepartment of PathologyUniversity of CambridgeUK; Department of HaematologyAddenbrooke's Hospital, Cambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Hongxiang Liu
- Department of Histopathology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust Cambridge UK
| | - Sylvia Kocialkowski
- Division of Molecular Histopathology Department of Pathology University of Cambridge UK
| | - Ming Wang
- Division of Molecular Histopathology Department of Pathology University of Cambridge UK
| | - Yuanxue Huang
- Division of Molecular Histopathology Department of Pathology University of Cambridge UK
| | - Lisa Worrillow
- Haematological Malignancy Diagnostic Service St. James's Institute of Oncology Leeds UK
| | - John Goodlad
- Department of Pathology Western General Hospital Edinburgh UK
| | - Jenny Buxton
- Department of Haematology Western General Hospital Edinburgh UK
| | - Michael Neat
- Department of Haematology and Department of Cytogenetics GSTS Pathology Guy's and St. Thomas NHS Foundation Trust London UK
| | - Paul Fields
- Department of Haematology GSST Kings Health Partners London UK
| | - Bridget Wilkins
- Histopathology Department St Thomas' Hospital and King's College London UK
| | - John W Grant
- Department of Histopathology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust Cambridge UK
| | - Penny Wright
- Department of Histopathology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust Cambridge UK
| | - Hesham Ei-Daly
- Department of Haematology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust Cambridge UK
| | - George A Follows
- Department of Haematology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust Cambridge UK
| | - Eve Roman
- Department of Health Sciences Epidemiology and Cancer Statistics Group University of York York UK
| | - A James Watkins
- Department of Haematology Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust Cambridge UK
| | - Peter W M Johnson
- Cancer Research UK Centre University of Southampton Southampton United Kingdom
| | - Andrew Jack
- Haematological Malignancy Diagnostic Service St. James's Institute of Oncology Leeds UK
| | - Ming-Qing Du
- Division of Molecular HistopathologyDepartment of PathologyUniversity of CambridgeUK; Department of HistopathologyAddenbrooke's Hospital, Cambridge University Hospitals NHS Foundation TrustCambridgeUK
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Care MA, Cocco M, Laye JP, Barnes N, Huang Y, Wang M, Barrans S, Du M, Jack A, Westhead DR, Doody GM, Tooze RM. SPIB and BATF provide alternate determinants of IRF4 occupancy in diffuse large B-cell lymphoma linked to disease heterogeneity. Nucleic Acids Res 2014; 42:7591-610. [PMID: 24875472 PMCID: PMC4081075 DOI: 10.1093/nar/gku451] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 05/06/2014] [Accepted: 05/08/2014] [Indexed: 01/31/2023] Open
Abstract
Interferon regulatory factor 4 (IRF4) is central to the transcriptional network of activated B-cell-like diffuse large B-cell lymphoma (ABC-DLBCL), an aggressive lymphoma subgroup defined by gene expression profiling. Since cofactor association modifies transcriptional regulatory input by IRF4, we assessed genome occupancy by IRF4 and endogenous cofactors in ABC-DLBCL cell lines. IRF4 partners with SPIB, PU.1 and BATF genome-wide, but SPIB provides the dominant IRF4 partner in this context. Upon SPIB knockdown IRF4 occupancy is depleted and neither PU.1 nor BATF acutely compensates. Integration with ENCODE data from lymphoblastoid cell line GM12878, demonstrates that IRF4 adopts either SPIB- or BATF-centric genome-wide distributions in related states of post-germinal centre B-cell transformation. In primary DLBCL high-SPIB and low-BATF or the reciprocal low-SPIB and high-BATF mRNA expression links to differential gene expression profiles across nine data sets, identifying distinct associations with SPIB occupancy, signatures of B-cell differentiation stage and potential pathogenetic mechanisms. In a population-based patient cohort, SPIBhigh/BATFlow-ABC-DLBCL is enriched for mutation of MYD88, and SPIBhigh/BATFlow-ABC-DLBCL with MYD88-L265P mutation identifies a small subgroup of patients among this otherwise aggressive disease subgroup with distinct favourable outcome. We conclude that differential expression of IRF4 cofactors SPIB and BATF identifies biologically and clinically significant heterogeneity among ABC-DLBCL.
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Affiliation(s)
- Matthew A Care
- Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK Bioinformatics Group, School of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Mario Cocco
- Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Jon P Laye
- Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Nicholas Barnes
- Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Yuanxue Huang
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Ming Wang
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ming Du
- Division of Molecular Histopathology, Department of Pathology, University of Cambridge, Cambridge, UK
| | - Andrew Jack
- Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - David R Westhead
- Bioinformatics Group, School of Molecular and Cellular Biology, University of Leeds, Leeds, UK
| | - Gina M Doody
- Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Reuben M Tooze
- Section of Experimental Haematology, Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK Haematological Malignancy Diagnostic Service, Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Maishman T, Stanton L, Davies A, Barrans S, Worrillow L, Mamot C, Care M, Immins T, Hamid D, McMillan A, Fields P, Jack A, Johnson P. A novel adaptive trial design: randomised evaluation of molecular guided therapy for diffuse large b-cell lymphoma with bortezomib (REMODL-B) with two interim analyses to explore safety and efficacy. Trials 2013. [PMCID: PMC3980503 DOI: 10.1186/1745-6215-14-s1-o77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Care MA, Barrans S, Worrillow L, Jack A, Westhead DR, Tooze RM. A microarray platform-independent classification tool for cell of origin class allows comparative analysis of gene expression in diffuse large B-cell lymphoma. PLoS One 2013; 8:e55895. [PMID: 23424639 PMCID: PMC3570548 DOI: 10.1371/journal.pone.0055895] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 01/07/2013] [Indexed: 12/22/2022] Open
Abstract
Cell of origin classification of diffuse large B-cell lymphoma (DLBCL) identifies subsets with biological and clinical significance. Despite the established nature of the classification existing studies display variability in classifier implementation, and a comparative analysis across multiple data sets is lacking. Here we describe the validation of a cell of origin classifier for DLBCL, based on balanced voting between 4 machine-learning tools: the DLBCL automatic classifier (DAC). This shows superior survival separation for assigned Activated B-cell (ABC) and Germinal Center B-cell (GCB) DLBCL classes relative to a range of other classifiers. DAC is effective on data derived from multiple microarray platforms and formalin fixed paraffin embedded samples and is parsimonious, using 20 classifier genes. We use DAC to perform a comparative analysis of gene expression in 10 data sets (2030 cases). We generate ranked meta-profiles of genes showing consistent class-association using ≥6 data sets as a cut-off: ABC (414 genes) and GCB (415 genes). The transcription factor ZBTB32 emerges as the most consistent and differentially expressed gene in ABC-DLBCL while other transcription factors such as ARID3A, BATF, and TCF4 are also amongst the 24 genes associated with this class in all datasets. Analysis of enrichment of 12323 gene signatures against meta-profiles and all data sets individually confirms consistent associations with signatures of molecular pathways, chromosomal cytobands, and transcription factor binding sites. We provide DAC as an open access Windows application, and the accompanying meta-analyses as a resource.
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Affiliation(s)
- Matthew A. Care
- Section of Experimental Haematology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United Kingdom
- Bioinformatics Group, Institute of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Sharon Barrans
- Haematological Malignancy Diagnostic Service (HMDS), St. James’s Institute of Oncology, Leeds, United Kingdom
| | - Lisa Worrillow
- Haematological Malignancy Diagnostic Service (HMDS), St. James’s Institute of Oncology, Leeds, United Kingdom
| | - Andrew Jack
- Haematological Malignancy Diagnostic Service (HMDS), St. James’s Institute of Oncology, Leeds, United Kingdom
| | - David R. Westhead
- Bioinformatics Group, Institute of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
- * E-mail: (RT); (DW)
| | - Reuben M. Tooze
- Section of Experimental Haematology, Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United Kingdom
- Haematological Malignancy Diagnostic Service (HMDS), St. James’s Institute of Oncology, Leeds, United Kingdom
- * E-mail: (RT); (DW)
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Jack A, Davies AJ, Barrans S, Dent L, Fields P, McMillan AK, Du M, Johnson PW. Abstract 1753: Prospective stratification using gene expression arrays in a randomised trial of R-CHOP +/− Bortezomib in diffuse large B-cell lymphoma (DLBL): The UK NCRI REMoDL-B study, ISRCTN 51837425. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-1753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
DLBL subtypes are recognised by patterns of gene expression, corresponding to Germinal Center (GCB) or activated peripheral blood (ABC) B-cells. They differ in frequency of mutation in the B-cell receptor signalling pathway and levels of expression of NF-kB target genes. Results of treatment with standard (R-CHOP) therapy are inferior for ABC type, and this study tests the use of bortezomib to downregulate NF-kB and reverse the deficit. This trial is the first to use gene expression profiling (GEP) to stratify cases into GCB and ABC at entry, with adaptive statistical design to analyse the outcome by subtype at predefined timepoints. Patients (pts) newly diagnosed with DLBL undergo staging and commence R-CHOP. During the first 3 week cycle formalin-fixed paraffin-embedded (FFPE) tissue undergoes extraction of messenger RNA for GEP of 24 000 probe sets using Illumina cDNA-mediated Annealing, Selection, extension, and Ligation (DASL®) array at the central laboratory. Cases are allocated to GCB, ABC or other type before the 2nd cycle. Thereafter, all pts are randomized to continue conventional R-CHOP or to add bortezomib 1.3mg/m2 days 1 + 8. The study will randomize a minimum 260 ABC type, to detect a difference in progression free survival (PFS) of 10% with bortezomib, with two-sided significance 5% & 90% power. The design allows closure of randomization for GCB cases if 6 month PFS is <80% after 55 receive R-CHOP-B. A second analysis for futility in GCB is planned after 73 treated with R-CHOP-B are followed for one year: if PFS is <85%, further exploration of bortezomib in this group is not warranted. Prior to trial opening, FFPE material from 200 pts with DLBL was analysed by DASL® protocol. Of 27 genes in a published (LLMPP) classification, 20 are present on the platform. Array data were standardised by converting to z-score. Four decision tree machine learning tools were trained on LLMPP data and combined into a meta-classifier using the Vote scheme with average of probabilities. This showed DLBL reproducibly classified using this platform with outcomes similar to those previously reported. Additional analyses of DNA extracted from tumour material will detect mutations in NF-kB pathway genes by combining the Fluidigm Access Array™ PCR System with next generation sequencing. Since trial opening in 2011, samples have been analysed from 39 pts. 30 (77%) biopsies were successfully classified; 3 cases had poor quality of RNA and in 6 there was insufficient tumour in the block. Cases classified include both surgical and needle core biopsies. Maximum laboratory turnround time was 12 working days. This study demonstrates it is possible to carry out GEP at diagnosis in a multicenter trial. It will address the relationship between response to treatment and molecular biomarkers, and serve as a model for future study design.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1753. doi:1538-7445.AM2012-1753
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Affiliation(s)
| | | | | | - Louise Dent
- 3Clinical Trials Unit, Southampton, United Kingdom
| | - Paul Fields
- 4Guys and St Thomas’ Hospitals, London, United Kingdom
| | | | - Ming Du
- 6University of Cambridge, Cambridge, United Kingdom
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Zhang H, Blunt L, Jiang X, Brown L, Barrans S. The Significance of the Micropores at the Stem–Cement Interface in Total Hip Replacement. Journal of Biomaterials Science, Polymer Edition 2012; 22:845-56. [DOI: 10.1163/092050610x540495] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- H. Zhang
- a State Key Laboratory of Tribology, School of Mechanical Engineering, Tsinghua University, Beijing 100084, P. R. China; Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield HD1 3DH, UK.
| | - L. Blunt
- b Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - X. Jiang
- c Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - L. Brown
- d Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield HD1 3DH, UK
| | - S. Barrans
- e Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield HD1 3DH, UK
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Barrans S, Crouch S, Smith A, Turner K, Owen R, Patmore R, Roman E, Jack A. Rearrangement of MYC Is Associated With Poor Prognosis in Patients With Diffuse Large B-Cell Lymphoma Treated in the Era of Rituximab. J Clin Oncol 2010; 28:3360-5. [DOI: 10.1200/jco.2009.26.3947] [Citation(s) in RCA: 448] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Rearrangement of MYC occurs in a proportion of diffuse large B-cell lymphomas (DLBCL), where they may be associated with an adverse clinical outcome. The aim of this study was to determine the frequency of MYC translocations in DLBCL and their prognostic impact in the era of cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (CHOP-R) therapy. Patients and Methods Three hundred three patients with previously untreated DLBCL, with no evidence of underlying follicular lymphoma, were investigated using immunohistochemistry and interphase fluorescent in situ hybridization for MYC, BCL6, and t(14;18)/BCL2 rearrangements. All patients (median age, 71.1 years; range, 23 to 96 years) were treated when CHOP-R was standard therapy for DLBCL and observed for a maximum of 4 years. Overall survival (OS) at 3 years was 49% (95% CI, 42% to 56%). Results MYC rearrangements were demonstrated in 35 (14%) of 245 biopsies with data available. Of these, 26 (74%) also had a t(14;18), 10 (26%) were BCL6 and MYC rearranged, and seven had all three abnormalities. Only age, International Prognostic Index, and MYC rearrangement retained prognostic significance in the final model. OS was significantly worse for patients with rearrangement of MYC (survival probability at 2 years = 0.35 in v 0.61 in the nonrearranged group). Conclusion The presence of a MYC rearrangement is a strongly adverse prognostic factor in CHOP-R–treated patients and can be used in combination with patients' age and IPI to accurately predict clinical outcome. In DLBCL, rearrangement of MYC is rarely found as the sole genetic abnormality and the poor prognosis of these patients is likely to reflect a synergistic effect alongside deregulation of BCL6 or BCL2.
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Affiliation(s)
- Sharon Barrans
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Simon Crouch
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Alex Smith
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Kathryn Turner
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Roger Owen
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Russell Patmore
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Eve Roman
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
| | - Andrew Jack
- From the Haematology Malignancy Diagnostic Service (HMDS), St James's Institute of Oncology, Leeds; Epidemiology & Genetics Unit, University of York; Queen's Center for Oncology and Haematology, Castle Hill Hospital, Cottingham; and Hull York Medical School, United Kingdom
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Zhang HY, Brown L, Barrans S, Blunt L, Jiang XQ. Investigation of relative micromotion at the stem—cement interface in total hip replacement. Proc Inst Mech Eng H 2009; 223:955-64. [DOI: 10.1243/09544119jeim594] [Citation(s) in RCA: 21] [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: 11/18/2022]
Abstract
Cemented total hip replacement has become a standard surgical technique to treat patients with osteoarthritis and osteonecrosis. The stem—cement interface experiences fretting wear in vivo due to low-amplitude oscillatory micromotion under physiological loading, and this wear is currently becoming important as a potential mechanism for the overall wear of cemented total hip replacements. However, the relative micromotion at the stem—cement interface has not been widely reported. In the present study, a new micromotion sensor is developed that is based on the deformation of a strain gauge, and this sensor is used to probe the migration of a polished Exeter stem within a Simplex P cement mantle through an in vitro wear simulation. It is demonstrated that the stem migration value generally increases with an increase in the number of loading cycles, with a gradual decrease of migration rate. Additionally, fretting wear is successfully replicated on the stem surface, and the micropores in the cement surface are considered to contribute to initiation and propagation of the fretting damage on the stem. This is confirmed by the observation that no evidence of fretting wear is detected on the stem where the surface is in contact with the pore-free areas on the cement. This study allows a deep insight into the micromotion at the stem—cement interface, and provides evidence highlighting the significance of the micropores in the cement surface in the generation of fretting wear on a polished femoral stem.
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Affiliation(s)
- H-Y Zhang
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - L Brown
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - S Barrans
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - L Blunt
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
| | - X-Q Jiang
- Centre for Precision Technologies, School of Computing and Engineering, University of Huddersfield, Huddersfield, UK
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