51
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van der Straten L, Levin MD, Dinnessen MAW, Visser O, Posthuma EFM, Doorduijn JK, Langerak AW, Kater AP, Dinmohamed AG. Risk of second primary malignancies in patients with chronic lymphocytic leukemia: a population-based study in the Netherlands, 1989-2019. Blood Cancer J 2023; 13:15. [PMID: 36635262 PMCID: PMC9837130 DOI: 10.1038/s41408-023-00784-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/14/2023] Open
Abstract
The longevity of patients with chronic lymphocytic leukemia (CLL) has improved progressively over the past decades, making it essential to understand long-term health outcomes, such as second primary malignancies (SPMs). Therefore, this nationwide, population-based study assessed the risk of SPM development in CLL patients diagnosed during 1989-2019 in the Netherlands compared to the expected number of malignancies in an age-, sex-, and period-matched group from the general Dutch population. In 24,815 CLL patients followed for 162,698.49 person-years, 4369 SPMs were diagnosed with a standardized incidence ratio (SIR) of 1.63 (95% confidence interval [CI] 1.59-1.68). This elevated risk was observed for solid (SIR, 1.67; 95% CI, 1.65-1.75) and hematological SPMs (SIR 1.42; 95% CI, 1.24-1.62). The highest risk for SPMs was noted beyond five years post-diagnosis (SIR, 1.70; 95% CI, 1.62-1.77), for male individuals (SIR, 1.70; 95% CI, 1.64-1.77), and patients aged 18-69 years (SIR, 1.92; 95% CI, 1.79-2.05). The risk of SPMs was higher in CLL patients who received anti-neoplastic therapy (SIR, 2.12; 95% CI, 1.96-2.28), as compared with those who did not (SIR, 1.58; 95% CI, 1.53-1.63). Routine surveillance activities and tailored interventions to counteract the increased morbidity and excess mortality associated with SPMs are essential for improving long-term outcomes in CLL patients.
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Affiliation(s)
- Lina van der Straten
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands. .,Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands. .,Department of Immunology, Erasmus MC, Rotterdam, The Netherlands.
| | - Mark-David Levin
- grid.413972.a0000 0004 0396 792XDepartment of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - Manette A. W. Dinnessen
- grid.470266.10000 0004 0501 9982Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands ,Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands
| | - Otto Visser
- grid.470266.10000 0004 0501 9982Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Eduardus F. M. Posthuma
- grid.415868.60000 0004 0624 5690Department of Internal Medicine, Reinier The Graaf Hospital, Delft, The Netherlands ,grid.10419.3d0000000089452978Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jeanette K. Doorduijn
- grid.5645.2000000040459992XErasmus MC Cancer Institute, Department of Hematology, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anton W. Langerak
- grid.5645.2000000040459992XDepartment of Immunology, Erasmus MC, Rotterdam, The Netherlands
| | - Arnon P. Kater
- Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands
| | - Avinash G. Dinmohamed
- grid.470266.10000 0004 0501 9982Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands ,Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Lymphoma and Myeloma Center Amsterdam, Amsterdam, The Netherlands ,grid.5645.2000000040459992XErasmus MC, Department of Public Health, University Medical Center Rotterdam, Rotterdam, The Netherlands ,grid.12380.380000 0004 1754 9227Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands
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52
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Hing ZA, Walker JS, Whipp EC, Brinton L, Cannon M, Zhang P, Sher S, Cempre CB, Brown F, Smith PL, Agostinelli C, Pileri SA, Skinner JN, Williams K, Phillips H, Shaffer J, Beaver LP, Pan A, Shin K, Gregory CT, Ozer GH, Yilmaz SA, Harrington BK, Lehman AM, Yu L, Coppola V, Yan P, Scherle P, Wang M, Pitis P, Xu C, Vaddi K, Chen-Kiang S, Woyach J, Blachly JS, Alinari L, Yang Y, Byrd JC, Baiocchi RA, Blaser BW, Lapalombella R. Dysregulation of PRMT5 in chronic lymphocytic leukemia promotes progression with high risk of Richter's transformation. Nat Commun 2023; 14:97. [PMID: 36609611 PMCID: PMC9823097 DOI: 10.1038/s41467-022-35778-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 12/22/2022] [Indexed: 01/08/2023] Open
Abstract
Richter's Transformation (RT) is a poorly understood and fatal progression of chronic lymphocytic leukemia (CLL) manifesting histologically as diffuse large B-cell lymphoma. Protein arginine methyltransferase 5 (PRMT5) is implicated in lymphomagenesis, but its role in CLL or RT progression is unknown. We demonstrate herein that tumors uniformly overexpress PRMT5 in patients with progression to RT. Furthermore, mice with B-specific overexpression of hPRMT5 develop a B-lymphoid expansion with increased risk of death, and Eµ-PRMT5/TCL1 double transgenic mice develop a highly aggressive disease with transformation that histologically resembles RT; where large-scale transcriptional profiling identifies oncogenic pathways mediating PRMT5-driven disease progression. Lastly, we report the development of a SAM-competitive PRMT5 inhibitor, PRT382, with exclusive selectivity and optimal in vitro and in vivo activity compared to available PRMT5 inhibitors. Taken together, the discovery that PRMT5 drives oncogenic pathways promoting RT provides a compelling rationale for clinical investigation of PRMT5 inhibitors such as PRT382 in aggressive CLL/RT cases.
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Affiliation(s)
- Zachary A Hing
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Janek S Walker
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Ethan C Whipp
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Lindsey Brinton
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Matthew Cannon
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Pu Zhang
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Steven Sher
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Casey B Cempre
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Fiona Brown
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Porsha L Smith
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Claudio Agostinelli
- Haematopathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Stefano A Pileri
- European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy
- Department of Specialized, Experimental and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Jordan N Skinner
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Katie Williams
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Hannah Phillips
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Jami Shaffer
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Larry P Beaver
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Alexander Pan
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Kyle Shin
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Charles T Gregory
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Gulcin H Ozer
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA
| | - Selen A Yilmaz
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA
| | - Bonnie K Harrington
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
- Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, USA
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Amy M Lehman
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Lianbo Yu
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Vincenzo Coppola
- Department of Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA
| | - Pearlly Yan
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | | | - Min Wang
- Prelude Therapeutics, Wilmington, DE, USA
| | | | - Chaoyi Xu
- Prelude Therapeutics, Wilmington, DE, USA
| | - Kris Vaddi
- Prelude Therapeutics, Wilmington, DE, USA
| | - Selina Chen-Kiang
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Jennifer Woyach
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - James S Blachly
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Lapo Alinari
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Yiping Yang
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - John C Byrd
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Robert A Baiocchi
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Bradley W Blaser
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Rosa Lapalombella
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA.
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53
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Hampel PJ, Parikh SA. Correction: Chronic lymphocytic leukemia treatment algorithm 2022. Blood Cancer J 2022; 12:172. [PMID: 36543762 PMCID: PMC9772411 DOI: 10.1038/s41408-022-00775-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Paul J. Hampel
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Sameer A. Parikh
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
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54
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Haselager MV, Thijssen R, Bax D, Both D, De Boer F, Mackay S, Dubois J, Mellink C, Kater AP, Eldering E. JAK-STAT signalling shapes the NF-κB response in CLL towards venetoclax sensitivity or resistance via Bcl-XL. Mol Oncol 2022. [PMID: 36550750 DOI: 10.1002/1878-0261.13364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/02/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
Preventing or overcoming resistance to the Bcl-2 inhibitor venetoclax is an emerging unmet clinical need in patients with chronic lymphocytic leukaemia (CLL). The upregulation of anti-apoptotic Bcl-2 members through signalling pathways within the tumor microenvironment appears as a major factor leading to resistance to venetoclax. Previously, we reported that T cells can drive resistance through CD40 and non-canonical NF-κB activation and subsequent Bcl-XL induction. Moreover, the T cell-derived cytokines IL-21 and IL-4 differentially affect Bcl-XL expression and sensitivity to venetoclax via unknown mechanisms. Here, we mechanistically dissected how Bcl-XL is regulated in the context of JAK-STAT signalling in primary CLL. First, we demonstrated a clear antagonistic role of IL-21/STAT3 signalling in the NF-κB-mediated expression of Bcl-XL, whereas IL-4/STAT6 further promoted the expression of Bcl-XL. In comparison, Bfl-1, another NF-κB target, was not differentially affected by either cytokine. Second, STAT3 and STAT6 affected Bcl-XL transcription by binding to its promoter without disrupting the DNA-binding activity of NF-κB. Third, in situ proximity ligation assays (isPLAs) indicated crosstalk between JAK-STAT signalling and NF-κB, in which STAT3 inhibited canonical NF-κB by accelerating nuclear export, and STAT6 promoted non-canonical NF-κB. Finally, NF-κB inducing kinase (NIK) inhibition interrupted the NF-κB/STAT crosstalk and resensitized CLL cells to venetoclax. In conclusion, we uncovered distinct crosstalk mechanisms that shape the NF-κB response in CLL towards venetoclax sensitivity or resistance via Bcl-XL, thereby revealing new potential therapeutic targets.
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Affiliation(s)
- Marco V Haselager
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands.,Amsterdam institute for Infection & Immunity, The Netherlands.,Cancer Immunology, Cancer Center Amsterdam, The Netherlands.,Lymphoma and Myeloma Center Amsterdam, LYMMCARE, Amsterdam, The Netherlands
| | - Rachel Thijssen
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands.,Department of Hematology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Danique Bax
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands.,Amsterdam institute for Infection & Immunity, The Netherlands.,Cancer Immunology, Cancer Center Amsterdam, The Netherlands.,Lymphoma and Myeloma Center Amsterdam, LYMMCARE, Amsterdam, The Netherlands
| | - Demi Both
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands.,Amsterdam institute for Infection & Immunity, The Netherlands.,Cancer Immunology, Cancer Center Amsterdam, The Netherlands.,Lymphoma and Myeloma Center Amsterdam, LYMMCARE, Amsterdam, The Netherlands
| | | | - Simon Mackay
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Julie Dubois
- Department of Hematology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Clemens Mellink
- Department of Clinical Genetics, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Arnon P Kater
- Amsterdam institute for Infection & Immunity, The Netherlands.,Cancer Immunology, Cancer Center Amsterdam, The Netherlands.,Lymphoma and Myeloma Center Amsterdam, LYMMCARE, Amsterdam, The Netherlands.,Department of Hematology, Amsterdam UMC location University of Amsterdam, The Netherlands
| | - Eric Eldering
- Department of Experimental Immunology, Amsterdam UMC location University of Amsterdam, The Netherlands.,Amsterdam institute for Infection & Immunity, The Netherlands.,Cancer Immunology, Cancer Center Amsterdam, The Netherlands.,Lymphoma and Myeloma Center Amsterdam, LYMMCARE, Amsterdam, The Netherlands
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55
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Sorcini D, De Falco F, Gargaro M, Bozza S, Guarente V, Cardinali V, Stella A, Adamo FM, Silva Barcelos EC, Rompietti C, Dorillo E, Geraci C, Esposito A, Arcaleni R, Capoccia S, Mameli MG, Graziani A, Moretti L, Cipiciani A, Riccardi C, Mencacci A, Fallarino F, Rosati E, Sportoletti P. Immune correlates of protection by vaccine against SARS-CoV-2 in patients with chronic lymphocytic leukaemia. Br J Haematol 2022; 201:45-57. [PMID: 36484163 PMCID: PMC9878216 DOI: 10.1111/bjh.18602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/25/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
In chronic lymphocytic leukaemia (CLL) the efficacy of SARS-CoV-2 vaccination remains unclear as most studies have focused on humoral responses. Here we comprehensively examined humoral and cellular responses to vaccine in CLL patients. Seroconversion was observed in 55.2% of CLL with lower rate and antibody titres in treated patients. T-cell responses were detected in a significant fraction of patients. CD4+ and CD8+ frequencies were significantly increased independent of serology with higher levels of CD4+ cells in patients under a Bruton tyrosine kinase (BTK) or a B-cell lymphoma 2 (BCL-2) inhibitor. Vaccination skewed CD8+ cells towards a highly cytotoxic phenotype, more pronounced in seroconverted patients. A high proportion of patients showed spike-specific CD4+ and CD8+ cells producing interferon gamma (IFNγ) and tumour necrosis factor alpha (TNFα). Patients under a BTK inhibitor showed increased production of IFNγ and TNFα by CD4+ cells. Vaccination induced a Th1 polarization reverting the Th2 CLL T-cell profile in the majority of patients with lower IL-4 production in untreated and BTK-inhibitor-treated patients. Such robust T-cell responses may have contributed to remarkable protection against hospitalization and death in a cohort of 540 patients. Combining T-cell metrics with seroprevalence may yield a more accurate measure of population immunity in CLL, providing consequential insights for public health.
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Affiliation(s)
- Daniele Sorcini
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Filomena De Falco
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Marco Gargaro
- Pharmacology Section, Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Silvia Bozza
- Microbiology and Clinical Microbiology Section, Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Valerio Guarente
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Valeria Cardinali
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Arianna Stella
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Francesco Maria Adamo
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Estevao Carlos Silva Barcelos
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Chiara Rompietti
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Erica Dorillo
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Clelia Geraci
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Angela Esposito
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Roberta Arcaleni
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Silvia Capoccia
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Maria Grazia Mameli
- Institute of Hematology, Santa Maria della Misericordia HospitalPerugiaItaly
| | - Alessandro Graziani
- Microbiology and Clinical Microbiology Section, Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Lorenzo Moretti
- Institute of Hematology, Santa Maria della Misericordia HospitalPerugiaItaly
| | - Alessandra Cipiciani
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
| | - Carlo Riccardi
- Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Antonella Mencacci
- Microbiology and Clinical Microbiology Section, Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Francesca Fallarino
- Pharmacology Section, Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Emanuela Rosati
- Biosciences and Medical Embryology Section, Department of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Paolo Sportoletti
- Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato‐Oncologica (CREO)University of PerugiaPerugiaItaly
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Royo R, Magnano L, Delgado J, Ruiz-Gil S, Gelpí JL, Heyn H, Taylor MA, Stankovic T, Puente XS, Nadeu F, Campo E. Correction: ATM germline variants in a young adult with chronic lymphocytic leukemia: 8 years of genomic evolution. Blood Cancer J 2022; 12:163. [PMID: 36470887 PMCID: PMC9722687 DOI: 10.1038/s41408-022-00762-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Romina Royo
- grid.10097.3f0000 0004 0387 1602Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Laura Magnano
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hospital Clínic of Barcelona, Barcelona, Spain
| | - Julio Delgado
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hospital Clínic of Barcelona, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Universitat de Barcelona, Barcelona, Spain
| | - Sara Ruiz-Gil
- grid.473715.30000 0004 6475 7299CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Josep Ll. Gelpí
- grid.10097.3f0000 0004 0387 1602Barcelona Supercomputing Center (BSC), Barcelona, Spain ,grid.5841.80000 0004 1937 0247Universitat de Barcelona, Barcelona, Spain
| | - Holger Heyn
- grid.473715.30000 0004 6475 7299CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Malcom A. Taylor
- grid.6572.60000 0004 1936 7486Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, UK
| | - Tatjana Stankovic
- grid.6572.60000 0004 1936 7486Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, UK
| | - Xose S. Puente
- grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain ,grid.10863.3c0000 0001 2164 6351Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Spain
| | - Ferran Nadeu
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Elías Campo
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hospital Clínic of Barcelona, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Universitat de Barcelona, Barcelona, Spain
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57
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Hampel PJ, Parikh SA. Chronic lymphocytic leukemia treatment algorithm 2022. Blood Cancer J 2022; 12:161. [PMID: 36446777 DOI: 10.1038/s41408-022-00756-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/08/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
The treatment landscape for patients with chronic lymphocytic leukemia (CLL) has changed considerably with the introduction of very effective oral targeted therapies (such as Bruton tyrosine kinase inhibitors and venetoclax) and next-generation anti-CD20 monoclonal antibodies (such as obinutuzumab). These agents lead to improved outcomes in patients with CLL, even among those with high-risk features, such as del17p13 or TP53 mutation and unmutated immunoglobulin heavy chain (IGHV) genes. Selecting the right treatment for the right patient requires consideration of disease characteristics and prior treatment sequence, as well as patient preferences and comorbidities. The CLL-International Prognostic Index (CLL-IPI) remains the best-validated tool in predicting the time to first therapy among previously untreated patients, which guides selection for early intervention efforts. This review summarizes our current approach to the management of CLL, right from the time of diagnosis through relapsed disease.
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58
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Parikh SA, Achenbach SJ, Rabe KG, Norman AD, Boddicker NJ, Olson JE, Call TG, Cerhan JR, Vachon CM, Kay NE, Braggio E, Hanson CA, Slager SL, Shanafelt TD. The risk of coronavirus disease 2019 (COVID-19) among individuals with monoclonal B cell lymphocytosis. Blood Cancer J 2022; 12:159. [PMID: 36418344 PMCID: PMC9684458 DOI: 10.1038/s41408-022-00754-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
| | - Sara J Achenbach
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Kari G Rabe
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Aaron D Norman
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA
| | | | - Janet E Olson
- Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | | | - James R Cerhan
- Division of Epidemiology, Mayo Clinic, Rochester, MN, USA
| | | | - Neil E Kay
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Esteban Braggio
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Curtis A Hanson
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Susan L Slager
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
- Division of Computational Biology, Mayo Clinic, Rochester, MN, USA
| | - Tait D Shanafelt
- Department of Medicine, Division of Hematology, Stanford University, Stanford, CA, USA
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59
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Robbe P, Ridout KE, Vavoulis DV, Dréau H, Kinnersley B, Denny N, Chubb D, Appleby N, Cutts A, Cornish AJ, Lopez-Pascua L, Clifford R, Burns A, Stamatopoulos B, Cabes M, Alsolami R, Antoniou P, Oates M, Cavalieri D, Gibson J, Prabhu AV, Schwessinger R, Jennings D, James T, Maheswari U, Duran-Ferrer M, Carninci P, Knight SJL, Månsson R, Hughes J, Davies J, Ross M, Bentley D, Strefford JC, Devereux S, Pettitt AR, Hillmen P, Caulfield MJ, Houlston RS, Martín-Subero JI, Schuh A. Whole-genome sequencing of chronic lymphocytic leukemia identifies subgroups with distinct biological and clinical features. Nat Genet 2022; 54:1675-1689. [PMID: 36333502 PMCID: PMC9649442 DOI: 10.1038/s41588-022-01211-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/16/2022] [Indexed: 11/06/2022]
Abstract
The value of genome-wide over targeted driver analyses for predicting clinical outcomes of cancer patients is debated. Here, we report the whole-genome sequencing of 485 chronic lymphocytic leukemia patients enrolled in clinical trials as part of the United Kingdom's 100,000 Genomes Project. We identify an extended catalog of recurrent coding and noncoding genetic mutations that represents a source for future studies and provide the most complete high-resolution map of structural variants, copy number changes and global genome features including telomere length, mutational signatures and genomic complexity. We demonstrate the relationship of these features with clinical outcome and show that integration of 186 distinct recurrent genomic alterations defines five genomic subgroups that associate with response to therapy, refining conventional outcome prediction. While requiring independent validation, our findings highlight the potential of whole-genome sequencing to inform future risk stratification in chronic lymphocytic leukemia.
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Affiliation(s)
- Pauline Robbe
- Department of Oncology, University of Oxford, Oxford, UK
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Kate E Ridout
- Department of Oncology, University of Oxford, Oxford, UK
| | | | - Helene Dréau
- Department of Oncology, University of Oxford, Oxford, UK
| | - Ben Kinnersley
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Nicholas Denny
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Daniel Chubb
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - Niamh Appleby
- Department of Oncology, University of Oxford, Oxford, UK
| | - Anthony Cutts
- Department of Oncology, University of Oxford, Oxford, UK
| | - Alex J Cornish
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | | | - Ruth Clifford
- Department of Haematology, University Hospital Limerick, Limerick, Ireland
- Limerick Digital Cancer Research Centre, School of Medicine,University of Limerick, Limerick, Ireland
| | - Adam Burns
- Department of Oncology, University of Oxford, Oxford, UK
| | - Basile Stamatopoulos
- Laboratory of Clinical Cell Therapy, Jules Bordet Institute, ULB Cancer Research Center (U-CRC)- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Maite Cabes
- Oxford Molecular Diagnostics Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Reem Alsolami
- Department of Medical Laboratory Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | - Doriane Cavalieri
- Department of Haematology, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jane Gibson
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Anika V Prabhu
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Ron Schwessinger
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Daisy Jennings
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | | | - Martí Duran-Ferrer
- Biomedical Epigenomics Group, Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Piero Carninci
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Human Technopole, Milan, Italy
| | - Samantha J L Knight
- Oxford University Clinical Academic Graduate School, University of Oxford Medical Sciences Division, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Robert Månsson
- Center for Hematology and Regenerative Medicine Huddinge, Karolinska Institute, Stockholm, Sweden
| | - Jim Hughes
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - James Davies
- Department of Medicine, Medical Research Council Molecular Haematology Unit, Medical Research Council Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Mark Ross
- Illumina Cambridge Ltd., Cambridge, UK
| | | | - Jonathan C Strefford
- Cancer Genomics, Cancer Sciences, Faculty of Medicine, Group University of Southampton, Southampton, UK
| | - Stephen Devereux
- King's College Hospital, NHS Foundation Trust, London, UK
- Kings College London, London, UK
| | - Andrew R Pettitt
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | | | - Mark J Caulfield
- Genomics England, London, UK
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Richard S Houlston
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - José I Martín-Subero
- Human Technopole, Milan, Italy
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Anna Schuh
- Department of Oncology, University of Oxford, Oxford, UK.
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60
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Herbst SA, Vesterlund M, Helmboldt AJ, Jafari R, Siavelis I, Stahl M, Schitter EC, Liebers N, Brinkmann BJ, Czernilofsky F, Roider T, Bruch PM, Iskar M, Kittai A, Huang Y, Lu J, Richter S, Mermelekas G, Umer HM, Knoll M, Kolb C, Lenze A, Cao X, Österholm C, Wahnschaffe L, Herling C, Scheinost S, Ganzinger M, Mansouri L, Kriegsmann K, Kriegsmann M, Anders S, Zapatka M, Del Poeta G, Zucchetto A, Bomben R, Gattei V, Dreger P, Woyach J, Herling M, Müller-Tidow C, Rosenquist R, Stilgenbauer S, Zenz T, Huber W, Tausch E, Lehtiö J, Dietrich S. Proteogenomics refines the molecular classification of chronic lymphocytic leukemia. Nat Commun 2022; 13:6226. [PMID: 36266272 PMCID: PMC9584885 DOI: 10.1038/s41467-022-33385-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 09/14/2022] [Indexed: 12/24/2022] Open
Abstract
Cancer heterogeneity at the proteome level may explain differences in therapy response and prognosis beyond the currently established genomic and transcriptomic-based diagnostics. The relevance of proteomics for disease classifications remains to be established in clinically heterogeneous cancer entities such as chronic lymphocytic leukemia (CLL). Here, we characterize the proteome and transcriptome alongside genetic and ex-vivo drug response profiling in a clinically annotated CLL discovery cohort (n = 68). Unsupervised clustering of the proteome data reveals six subgroups. Five of these proteomic groups are associated with genetic features, while one group is only detectable at the proteome level. This new group is characterized by accelerated disease progression, high spliceosomal protein abundances associated with aberrant splicing, and low B cell receptor signaling protein abundances (ASB-CLL). Classifiers developed to identify ASB-CLL based on its characteristic proteome or splicing signature in two independent cohorts (n = 165, n = 169) confirm that ASB-CLL comprises about 20% of CLL patients. The inferior overall survival in ASB-CLL is also independent of both TP53- and IGHV mutation status. Our multi-omics analysis refines the classification of CLL and highlights the potential of proteomics to improve cancer patient stratification beyond genetic and transcriptomic profiling.
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Affiliation(s)
- Sophie A. Herbst
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany ,grid.461742.20000 0000 8855 0365Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Faculty of Biosciences, University of Heidelberg, Heidelberg, Germany
| | - Mattias Vesterlund
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Alexander J. Helmboldt
- grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany
| | - Rozbeh Jafari
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Ioannis Siavelis
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Matthias Stahl
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Eva C. Schitter
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Nora Liebers
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany ,grid.461742.20000 0000 8855 0365Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Berit J. Brinkmann
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany ,grid.7700.00000 0001 2190 4373Faculty of Biosciences, University of Heidelberg, Heidelberg, Germany ,grid.7497.d0000 0004 0492 0584Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Czernilofsky
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Tobias Roider
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Peter-Martin Bruch
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Murat Iskar
- grid.7497.d0000 0004 0492 0584Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Adam Kittai
- grid.261331.40000 0001 2285 7943Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH USA
| | - Ying Huang
- grid.261331.40000 0001 2285 7943Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH USA
| | - Junyan Lu
- grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Sarah Richter
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Georgios Mermelekas
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Husen Muhammad Umer
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Mareike Knoll
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Carolin Kolb
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Angela Lenze
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Xiaofang Cao
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Cecilia Österholm
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Linus Wahnschaffe
- grid.6190.e0000 0000 8580 3777Department I of Internal Medicine, Center for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Carmen Herling
- grid.6190.e0000 0000 8580 3777Department I of Internal Medicine, Center for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Sebastian Scheinost
- grid.461742.20000 0000 8855 0365Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Ganzinger
- grid.7700.00000 0001 2190 4373Institute of Medical Biometry and Informatics, Heidelberg University, Heidelberg, Germany
| | - Larry Mansouri
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Katharina Kriegsmann
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Mark Kriegsmann
- grid.7700.00000 0001 2190 4373Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Simon Anders
- grid.7700.00000 0001 2190 4373Center for Molecular Biology of the University of Heidelberg (ZMBH), Heidelberg, Germany
| | - Marc Zapatka
- grid.7497.d0000 0004 0492 0584Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Giovanni Del Poeta
- grid.6530.00000 0001 2300 0941Division of Hematology, University of Tor Vergata, Rome, Italy
| | - Antonella Zucchetto
- grid.418321.d0000 0004 1757 9741Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Riccardo Bomben
- grid.418321.d0000 0004 1757 9741Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Valter Gattei
- grid.418321.d0000 0004 1757 9741Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Peter Dreger
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Jennifer Woyach
- grid.261331.40000 0001 2285 7943Department of Internal Medicine, Division of Hematology, The Ohio State University, Columbus, OH USA
| | - Marco Herling
- grid.6190.e0000 0000 8580 3777Department I of Internal Medicine, Center for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf (CIO ABCD), Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases (CECAD), Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - Carsten Müller-Tidow
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Richard Rosenquist
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Clinical Genetics, Karolinska University Laboratory, Karolinska University Hospital, Stockholm, Sweden
| | - Stephan Stilgenbauer
- grid.6582.90000 0004 1936 9748Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Thorsten Zenz
- grid.461742.20000 0000 8855 0365Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.412004.30000 0004 0478 9977Department of Medical Oncology and Hematology, University Hospital Zürich, Zürich, Switzerland
| | - Wolfgang Huber
- grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Eugen Tausch
- grid.6582.90000 0004 1936 9748Department of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Janne Lehtiö
- grid.452834.c0000 0004 5911 2402Department of Oncology-Pathology, Karolinska Institute and Science for Life Laboratory, Stockholm, Sweden
| | - Sascha Dietrich
- grid.7700.00000 0001 2190 4373Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany ,grid.4709.a0000 0004 0495 846XEuropean Molecular Biology Laboratory (EMBL), Heidelberg, Germany ,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany ,grid.461742.20000 0000 8855 0365Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany ,grid.14778.3d0000 0000 8922 7789Department of Hematolgy, Oncology and Immunolgy, University Hospital of Düsseldorf, Düsseldorf, Germany
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61
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Mangolini M, Maiques-Diaz A, Charalampopoulou S, Gerhard-Hartmann E, Bloehdorn J, Moore A, Giachetti G, Lu J, Roamio Franklin VN, Chilamakuri CSR, Moutsopoulos I, Rosenwald A, Stilgenbauer S, Zenz T, Mohorianu I, D'Santos C, Deaglio S, Hodson DJ, Martin-Subero JI, Ringshausen I. Viral transduction of primary human lymphoma B cells reveals mechanisms of NOTCH-mediated immune escape. Nat Commun 2022; 13:6220. [PMID: 36266281 PMCID: PMC9585083 DOI: 10.1038/s41467-022-33739-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/30/2022] [Indexed: 12/24/2022] Open
Abstract
Hotspot mutations in the PEST-domain of NOTCH1 and NOTCH2 are recurrently identified in B cell malignancies. To address how NOTCH-mutations contribute to a dismal prognosis, we have generated isogenic primary human tumor cells from patients with Chronic Lymphocytic Leukemia (CLL) and Mantle Cell Lymphoma (MCL), differing only in their expression of the intracellular domain (ICD) of NOTCH1 or NOTCH2. Our data demonstrate that both NOTCH-paralogs facilitate immune-escape of malignant B cells by up-regulating PD-L1, partly dependent on autocrine interferon-γ signaling. In addition, NOTCH-activation causes silencing of the entire HLA-class II locus via epigenetic regulation of the transcriptional co-activator CIITA. Notably, while NOTCH1 and NOTCH2 govern similar transcriptional programs, disease-specific differences in their expression levels can favor paralog-specific selection. Importantly, NOTCH-ICD also strongly down-regulates the expression of CD19, possibly limiting the effectiveness of immune-therapies. These NOTCH-mediated immune escape mechanisms are associated with the expansion of exhausted CD8+ T cells in vivo.
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Affiliation(s)
- Maurizio Mangolini
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK
- Department of Haematology, University of Cambridge, Cambridge, CB2 0AH, UK
| | - Alba Maiques-Diaz
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Johannes Bloehdorn
- Department of Internal Medicine III, Division of CLL, Ulm University, Ulm, Germany
| | - Andrew Moore
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK
- Department of Haematology, University of Cambridge, Cambridge, CB2 0AH, UK
| | - Giorgia Giachetti
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK
- Department of Haematology, University of Cambridge, Cambridge, CB2 0AH, UK
| | - Junyan Lu
- European Molecular Biology Laboratory (EMBL), Heidelberg, Germany
- Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | | | | | - Ilias Moutsopoulos
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK
| | - Andreas Rosenwald
- Pathologisches Institut Universität Würzburg, 97080, Würzburg, Germany
| | - Stephan Stilgenbauer
- Department of Internal Medicine III, Division of CLL, Ulm University, Ulm, Germany
| | - Thorsten Zenz
- Department of Medical Oncology and Hematology, University Hospital Zürich and University of Zürich, Zürich, Switzerland
- Molecular Therapy in Hematology and Oncology, National Center for Tumor Diseases and German Cancer, Research Centre, Heidelberg, Germany
| | - Irina Mohorianu
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK
| | - Clive D'Santos
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - Silvia Deaglio
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Daniel J Hodson
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK
- Department of Haematology, University of Cambridge, Cambridge, CB2 0AH, UK
| | - Jose I Martin-Subero
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Ingo Ringshausen
- Wellcome/MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, CB2 0AW, UK.
- Department of Haematology, University of Cambridge, Cambridge, CB2 0AH, UK.
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62
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Avsec D, Škrlj Miklavčič M, Burnik T, Kandušer M, Bizjak M, Podgornik H, Mlinarič-Raščan I. Inhibition of p38 MAPK or immunoproteasome overcomes resistance of chronic lymphocytic leukemia cells to Bcl-2 antagonist venetoclax. Cell Death Dis 2022; 13:860. [PMID: 36209148 PMCID: PMC9547871 DOI: 10.1038/s41419-022-05287-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/14/2022] [Accepted: 09/20/2022] [Indexed: 01/23/2023]
Abstract
Chronic lymphocytic leukemia (CLL) is a hematological neoplasm of CD19-positive mature-appearing B lymphocytes. Despite the clinical success of targeted therapies in CLL, the development of resistance diminishes their therapeutic activity. This is also true for the Bcl-2 antagonist venetoclax. We investigated the molecular mechanisms that drive venetoclax resistance in CLL, with a clear focus to provide new strategies to successfully combat it. Activation of CLL cells with IFNγ, PMA/ionomycin, and sCD40L diminished the cytotoxicity of venetoclax. We demonstrated that the metabolic activity of cells treated with 1 nM venetoclax alone was 48% of untreated cells, and was higher for cells co-treated with IFNγ (110%), PMA/ionomycin (78%), and sCD40L (62%). As of molecular mechanism, we showed that PMA/ionomycin and sCD40L triggered translocation of NFκB in primary CLL cells, while IFNγ activated p38 MAPK, suppressed spontaneous and venetoclax-induced apoptosis and induced formation of the immunoproteasome. Inhibition of immunoproteasome with ONX-0914 suppressed activity of immunoproteasome and synergized with venetoclax against primary CLL cells. On the other hand, inhibition of p38 MAPK abolished cytoprotective effects of IFNγ. We demonstrated that venetoclax-resistant (MEC-1 VER) cells overexpressed p38 MAPK and p-Bcl-2 (Ser70), and underexpressed Mcl-1, Bax, and Bak. Inhibition of p38 MAPK or immunoproteasome triggered apoptosis in CLL cells and overcame the resistance to venetoclax of MEC-1 VER cells and venetoclax-insensitive primary CLL cells. In conclusion, the p38 MAPK pathway and immunoproteasome represent novel targets to combat venetoclax resistance in CLL.
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Affiliation(s)
- Damjan Avsec
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia
| | - Marja Škrlj Miklavčič
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia
| | - Tilen Burnik
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia
| | - Maša Kandušer
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia
| | - Maruša Bizjak
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia
| | - Helena Podgornik
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia ,grid.29524.380000 0004 0571 7705University Medical Centre Ljubljana, Department of Haematology, SI-1000 Ljubljana, Slovenia
| | - Irena Mlinarič-Raščan
- grid.8954.00000 0001 0721 6013University of Ljubljana, Faculty of Pharmacy, SI-1000 Ljubljana, Slovenia
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63
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Messori A. Long-term progression-free survival in patients with chronic lymphocytic leukaemia treated with novel agents: an analysis based on indirect comparisons. Eur J Haematol 2022; 110:60-66. [PMID: 36193009 DOI: 10.1111/ejh.13873] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE In chronic lymphocytic leukaemia, growing evidence has accumulated about long-term outcomes of first-line treatments. Our objective was to perform indirect comparisons across first-line treatments. METHODS We applied the Shiny method, an artificial intelligence technique that analyses Kaplan-Meier curves and reconstructs patient-level data. Reconstructed patient data were then evaluated through standard survival statistics and indirect head-o-head comparisons. The endpoint was progression-free survival (PFS). RESULTS Seven first-line treatments were studied (1,983 patients). Three treatments based on either ibrutinib or venetoclax (i.e. ibrutinib monotherapy, ibrutinib+ rituximab/obinutuzumab and venetoclax+obinutuzumab) showed a very similar survival pattern. The PFS for these 3 treatments was significantly better than that of the remaining 4 treatments (fludarabine+cyclophosphamide+rituximab, chlorambucil+obinutuzumab, bendamustine+rituximab, and chlorambucil monotherapy). Regarding chlorambucil+ obinutuzumab, a significant between-trial variability was found. CONCLUSIONS Long-term results are particularly favorable to ibrutinib (alone or in combination) and discourage further use of chlorambucil. As in other studies based on the Shiny method, the multi-treatment Kaplan-Meier graph summarized the available evidence in comparative terms. The evidence generated this way contributes to define the place in therapy of individual agents.
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64
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Lee AC, Pingali SR, Pinilla-Ibarz JA, Atchison ML, Koumenis C, Argon Y, Thomas-Tikhonenko A, De Trez C, Hu CCA, Tang CHA. Loss of AID exacerbates the malignant progression of CLL. Leukemia 2022; 36:2430-2442. [PMID: 36042317 PMCID: PMC9522595 DOI: 10.1038/s41375-022-01663-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 01/16/2023]
Abstract
Activation-induced cytidine deaminase (AID) has been implicated as both a positive and a negative factor in the progression of B cell chronic lymphocytic leukemia (CLL), but the role that it plays in the development and progression of this disease is still unclear. We generated an AID knockout CLL mouse model, AID-/-/Eμ-TCL1, and found that these mice die significantly earlier than their AID-proficient counterparts. AID-deficient CLL cells exhibit a higher ER stress response compared to Eμ-TCL1 controls, particularly through activation of the IRE1/XBP1s pathway. The increased production of secretory IgM in AID-deficient CLL cells contributes to their elevated expression levels of XBP1s, while secretory IgM-deficient CLL cells express less XBP1s. This increase in XBP1s in turn leads AID-deficient CLL cells to exhibit higher levels of B cell receptor signaling, supporting leukemic growth and survival. Further, AID-/-/Eμ-TCL1 CLL cells downregulate the tumor suppressive SMAD1/S1PR2 pathway and have altered homing to non-lymphoid organs. Notably, CLL cells from patients with IgHV-unmutated disease express higher levels of XBP1s mRNA compared to those from patients with IgHV-mutated CLL. Our studies thus reveal novel mechanisms by which the loss of AID leads to worsened CLL and may explain why unmutated CLL is more aggressive than mutated CLL.
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Affiliation(s)
- Avery C Lee
- Center for Translational Research in Hematologic Malignancies, Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, TX, USA
- Cell & Molecular Biology Graduate Group, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sai Ravi Pingali
- Center for Translational Research in Hematologic Malignancies, Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, TX, USA
| | - Javier A Pinilla-Ibarz
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Michael L Atchison
- Department of Biomedical Sciences, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Constantinos Koumenis
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yair Argon
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Cell Pathology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Andrei Thomas-Tikhonenko
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Cancer Pathobiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Carl De Trez
- Laboratory of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Chih-Chi Andrew Hu
- Center for Translational Research in Hematologic Malignancies, Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, TX, USA.
| | - Chih-Hang Anthony Tang
- Center for Translational Research in Hematologic Malignancies, Houston Methodist Cancer Center, Houston Methodist Research Institute, Houston, TX, USA.
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65
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De Falco F, Rompietti C, Sorcini D, Esposito A, Scialdone A, Baldoni S, Del Papa B, Adamo FM, Silva Barcelos EC, Dorillo E, Stella A, Di Ianni M, Screpanti I, Sportoletti P, Rosati E. GSK3β is a critical, druggable component of the network regulating the active NOTCH1 protein and cell viability in CLL. Cell Death Dis 2022; 13:755. [PMID: 36050315 PMCID: PMC9436923 DOI: 10.1038/s41419-022-05178-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 01/21/2023]
Abstract
NOTCH1 alterations have been associated with chronic lymphocytic leukemia (CLL), but the molecular mechanisms underlying NOTCH1 activation in CLL cells are not completely understood. Here, we show that GSK3β downregulates the constitutive levels of the active NOTCH1 intracellular domain (N1-ICD) in CLL cells. Indeed, GSK3β silencing by small interfering RNA increases N1-ICD levels, whereas expression of an active GSK3β mutant reduces them. Additionally, the GSK3β inhibitor SB216763 enhances N1-ICD stability at a concentration at which it also increases CLL cell viability. We also show that N1-ICD is physically associated with GSK3β in CLL cells. SB216763 reduces GSK3β/N1-ICD interactions and the levels of ubiquitinated N1-ICD, indicating a reduction in N1-ICD proteasomal degradation when GSK3β is less active. We then modulated the activity of two upstream regulators of GSK3β and examined the impact on N1-ICD levels and CLL cell viability. Specifically, we inhibited AKT that is a negative regulator of GSK3β and is constitutively active in CLL cells. Furthermore, we activated the protein phosphatase 2 A (PP2A) that is a positive regulator of GSK3β, and has an impaired activity in CLL. Results show that either AKT inhibition or PP2A activation reduce N1-ICD expression and CLL cell viability in vitro, through mechanisms mediated by GSK3β activity. Notably, for PP2A activation, we used the highly specific activator DT-061, that also reduces leukemic burden in peripheral blood, spleen and bone marrow in the Eµ-TCL1 adoptive transfer model of CLL, with a concomitant decrease in N1-ICD expression. Overall, we identify in GSK3β a key component of the network regulating N1-ICD stability in CLL, and in AKT and PP2A new druggable targets for disrupting NOTCH1 signaling with therapeutic potential.
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Affiliation(s)
- Filomena De Falco
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Chiara Rompietti
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Daniele Sorcini
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Angela Esposito
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Annarita Scialdone
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Stefano Baldoni
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy ,grid.412451.70000 0001 2181 4941Department of Medicine and Sciences of Aging, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Beatrice Del Papa
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Francesco Maria Adamo
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Estevão Carlos Silva Barcelos
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Erica Dorillo
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Arianna Stella
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Mauro Di Ianni
- grid.412451.70000 0001 2181 4941Department of Medicine and Sciences of Aging, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy ,grid.461844.bDepartment of Oncology and Hematology, Ospedale Civile “Santo Spirito”, ASL Pescara, Pescara, Italy
| | - Isabella Screpanti
- grid.7841.aDepartment of Molecular Medicine, University of Rome “La Sapienza”, Rome, Italy
| | - Paolo Sportoletti
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, Institute of Hematology, Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy
| | - Emanuela Rosati
- grid.9027.c0000 0004 1757 3630Department of Medicine and Surgery, University of Perugia, Perugia, Italy
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66
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Bruch PM, Giles HA, Kolb C, Herbst SA, Becirovic T, Roider T, Lu J, Scheinost S, Wagner L, Huellein J, Berest I, Kriegsmann M, Kriegsmann K, Zgorzelski C, Dreger P, Zaugg JB, Müller-Tidow C, Zenz T, Huber W, Dietrich S. Drug-microenvironment perturbations reveal resistance mechanisms and prognostic subgroups in CLL. Mol Syst Biol 2022; 18:e10855. [PMID: 35959629 PMCID: PMC9372727 DOI: 10.15252/msb.202110855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022] Open
Abstract
The tumour microenvironment and genetic alterations collectively influence drug efficacy in cancer, but current evidence is limited and systematic analyses are lacking. Using chronic lymphocytic leukaemia (CLL) as a model disease, we investigated the influence of 17 microenvironmental stimuli on 12 drugs in 192 genetically characterised patient samples. Based on microenvironmental response, we identified four subgroups with distinct clinical outcomes beyond known prognostic markers. Response to multiple microenvironmental stimuli was amplified in trisomy 12 samples. Trisomy 12 was associated with a distinct epigenetic signature. Bromodomain inhibition reversed this epigenetic profile and could be used to target microenvironmental signalling in trisomy 12 CLL. We quantified the impact of microenvironmental stimuli on drug response and their dependence on genetic alterations, identifying interleukin 4 (IL4) and Toll‐like receptor (TLR) stimulation as the strongest actuators of drug resistance. IL4 and TLR signalling activity was increased in CLL‐infiltrated lymph nodes compared with healthy samples. High IL4 activity correlated with faster disease progression. The publicly available dataset can facilitate the investigation of cell‐extrinsic mechanisms of drug resistance and disease progression.
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Affiliation(s)
- Peter-Martin Bruch
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Holly Ar Giles
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany.,EMBL Heidelberg, Heidelberg, Germany.,Collaboration for Joint PhD Degree between EMBL and Heidelberg University, Faculty of Biosciences, Heidelberg, Germany
| | - Carolin Kolb
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Sophie A Herbst
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany.,EMBL Heidelberg, Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tina Becirovic
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Roider
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany.,EMBL Heidelberg, Heidelberg, Germany
| | - Junyan Lu
- EMBL Heidelberg, Heidelberg, Germany
| | - Sebastian Scheinost
- German Cancer Research Center (DKFZ), Heidelberg, Germany.,National Center for Tumour Diseases, Heidelberg, Germany
| | - Lena Wagner
- German Cancer Research Center (DKFZ), Heidelberg, Germany.,National Center for Tumour Diseases, Heidelberg, Germany
| | | | | | - Mark Kriegsmann
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | | | | | - Peter Dreger
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany
| | - Judith B Zaugg
- Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany.,EMBL Heidelberg, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany
| | - Thorsten Zenz
- Department of Hematology, University of Zürich, Zürich, Switzerland
| | - Wolfgang Huber
- Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany.,EMBL Heidelberg, Heidelberg, Germany
| | - Sascha Dietrich
- Department of Medicine V, Heidelberg University Hospital, Heidelberg, Germany.,Molecular Medicine Partnership Unit (MMPU), Heidelberg, Germany.,EMBL Heidelberg, Heidelberg, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
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67
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Russell NH, Hills RK, Kjeldsen L, Clark RE, Ali S, Cahalin P, Thomas IF, Burnett AK. A randomised comparison of FLAG-Ida versus daunorubicin combined with clofarabine in relapsed or refractory acute myeloid leukaemia: Results from the UK NCRI AML17 trial. Br J Haematol 2022; 198:528-534. [PMID: 35388465 DOI: 10.1111/bjh.18195] [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: 02/24/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/01/2022]
Abstract
The prognosis for younger patients with relapsed acute myeloid leukaemia (AML) is generally dismal. Allogeneic stem cell transplantation is the preferred therapy for these patients. As part of the UK NCRI AML17 trial, daunorubicin/clofarabine (DClo) was compared with fludarabine, cytarabine, granulocyte colony-stimulating factor with idarubicin (FLAG-Ida) in 311 patients designated high-risk following course one of induction therapy, which has previously been reported. We now report the results of the same randomisation in patients who were refractory to two induction courses or subsequently relapsed. A total of 94 relapsed or refractory AML patients, usually less than 60 years of age and with mainly favourable or intermediate-risk cytogenetics, were randomised to receive up to three courses of DClo or FLAG-Ida, with the aim of proceeding to transplant. Complete remission was achieved in 74% of patients with no difference between the arms. Overall, 57% of patients received a transplant with no difference between the arms, likewise overall survival at five years showed no significant difference (21% for DClo vs. 22% for FLAG-Ida). No patient who did not receive a transplant survived beyond 21months. A stratified analysis including the 311 post course 1 high-risk patients who underwent the same randomisation showed a consistent treatment benefit for FLAG-Ida.
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Affiliation(s)
| | - Robert K Hills
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Lars Kjeldsen
- Department of Haematology, Rigshospitalet, Copenhagen, Denmark
| | - Richard E Clark
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, UK
| | - Sahra Ali
- Department of Haematology, Castle Hill Hospital, Hull, UK
| | - Paul Cahalin
- Department of Haematology, Blackpool Victoria Hospital, Blackpool, UK
| | - Ian F Thomas
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Alan K Burnett
- Paul O'Gorman Leukaemia Centre, University of Glasgow, Glasgow, UK
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68
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Hampel PJ, Rabe KG, Call TG, Ding W, Leis JF, Kenderian SS, Muchtar E, Wang Y, Koehler AB, Parrondo R, Schwager SM, Shi M, Braggio E, Slager SL, Kay NE, Parikh SA. Combined ibrutinib and venetoclax for treatment of patients with ibrutinib-resistant or double-refractory chronic lymphocytic leukaemia. Br J Haematol 2022; 199:239-244. [PMID: 35841338 DOI: 10.1111/bjh.18357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/24/2022] [Accepted: 07/01/2022] [Indexed: 11/29/2022]
Abstract
Patients with chronic lymphocytic leukaemia (CLL) disease progression on ibrutinib or after sequential ibrutinib and venetoclax-based treatments (double-refractory) have poor outcomes. In this retrospective study, we analysed outcomes with combined ibrutinib and venetoclax treatment in these groups of patients. The median treatment-free and overall survival for 22 patients with prior progression on ibrutinib (venetoclax-naïve) were 23.7 and 47.1 months respectively. In 11 patients with double-refractory CLL, the median treatment-free and overall survival were 11.2 and 27.0 months respectively. The combination of ibrutinib and venetoclax may help bridge the current gap in options for patients with disease refractory to the most commonly used novel agents.
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Affiliation(s)
- Paul J Hampel
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Kari G Rabe
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy G Call
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Wei Ding
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jose F Leis
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, Arizona, USA
| | - Saad S Kenderian
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Eli Muchtar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Yucai Wang
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Amber B Koehler
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ricardo Parrondo
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Susan M Schwager
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Min Shi
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Esteban Braggio
- Department of Hematology and Oncology, Mayo Clinic, Phoenix, Arizona, USA
| | - Susan L Slager
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Neil E Kay
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA
| | - Sameer A Parikh
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
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69
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Wu Z, Wang L, Fan L, Tang H, Zuo X, Gu D, Lu X, Li Y, Wu J, Qin S, Xia Y, Zhu H, Wang L, Xu W, Li J, Jin H. Exploring the significance of PAK1 through chromosome conformation signatures in ibrutinib-resistant chronic lymphocytic leukaemia. Mol Oncol 2022; 16:2920-2935. [PMID: 35811334 PMCID: PMC9394240 DOI: 10.1002/1878-0261.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/06/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Ibrutinib exerts promising anticancer effects in chronic lymphocytic leukaemia (CLL). However, acquired resistance occurs during treatment, necessitating the exploration of underlying mechanisms. Although three‐dimensional genome organization has been identified as a major player in the development and progression of cancer, including drug resistance, little is known regarding its role in CLL. Therefore, we investigated the molecular mechanisms underlying ibrutinib resistance through multi‐omics analysis, including high‐throughput chromosome conformation capture (Hi‐C) technology. We demonstrated that the therapeutic response to ibrutinib is associated with the expression of p21‐activated kinase 1 (PAK1). PAK1, which was up‐regulated in CLL and associated with patients' survival, was involved in cell proliferation, glycolysis and oxidative phosphorylation. Furthermore, the PAK1 inhibitor IPA‐3 exerted an anti‐tumour effect and its combination with ibrutinib exhibited a synergistic effect in ibrutinib‐sensitive and ‐resistant cells. These findings suggest the oncogenic role of PAK1 in CLL progression and drug resistance, highlighting PAK1 as a potential diagnostic marker and therapeutic target in CLL including ibrutinib‐resistant CLL.
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Affiliation(s)
- Zijuan Wu
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Luqiao Wang
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Lei Fan
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Hanning Tang
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Xiaoling Zuo
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Danling Gu
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Xueying Lu
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Yue Li
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Jiazhu Wu
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Shuchao Qin
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Yi Xia
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Huayuan Zhu
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Li Wang
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Wei Xu
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China
| | - Jianyong Li
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China.,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hui Jin
- Department of Hematology, Pukou CLL Center, Jiangsu Province Hospital, The First Affiliated Hospital of Nanjing Medical University, China.,Key Laboratory of Hematology of Nanjing Medical University, China.,Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Personalized Cancer Medicine, Nanjing Medical University, China.,National Clinical Research Center for Hematologic Diseases, The First Affiliated Hospital of Soochow University, Suzhou, China
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70
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Catherwood MA, Wren D, Chiecchio L, Cavalieri D, Donaldson D, Lawless S, ElHassadi E, Hayat A, Cahill MR, O’Shea D, Sargent J, Stewart P, Maurya M, Quinn J, Murphy P, de Castro DG, Mills K, Cross NCP, Forconi F, Iyengar S, Schuh A, Thornton P. TP53 Mutations Identified Using NGS Comprise the Overwhelming Majority of TP53 Disruptions in CLL: Results From a Multicentre Study. Front Oncol 2022; 12:909615. [PMID: 35837095 PMCID: PMC9273895 DOI: 10.3389/fonc.2022.909615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022] Open
Abstract
Limited data exists to show the correlation of (tumour protein 53) TP53 mutation detected by Next generation sequencing (NGS) and the presence/absence of deletions of 17p13 detected by FISH. The study which is the largest series to date includes 2332 CLL patients referred for analysis of del(17p) by FISH and TP53 mutations by NGS before treatment. Using a 10% variant allele frequency (VAF) threshold, cases were segregated into high burden mutations (≥10%) and low burden mutations (<10%). TP53 aberrations (17p [del(17p)] and/or TP53 mutation) were detected in 320/2332 patients (13.7%). Using NGS analysis, 429 TP53 mutations were identified in 303 patients (13%). Of these 238 (79%) and 65 (21%) were cases with high burden and low burden mutations respectively. In our cohort, 2012 cases did not demonstrate a TP53 aberration (86.3%). A total of 159 cases showed TP53 mutations in the absence of del(17p) (49/159 with low burden TP53 mutations) and 144 cases had both TP53 mutation and del(17p) (16/144 with low burden mutations). Only 17/2332 (0.7%) cases demonstrated del(17p) with no TP53 mutation. Validated NGS protocols should be used in clinical decision making to avoid missing low-burden TP53 mutations and can detect the vast majority of TP53 aberrations.
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Affiliation(s)
- Mark A. Catherwood
- Haematology Department, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Dorte Wren
- The Royal Marsden Hospital and the Institute of Cancer Research, Biomedical Research Centre, London, United Kingdom
| | - Laura Chiecchio
- Wessex Regional Genetics Laboratory, Salisbury National Health Service (NHS) Foundation Trust, Salisbury, United Kingdom
| | - Doriane Cavalieri
- Oxford Molecular Diagnostics Centre, Oxford University Hospitals, Oxford, United Kingdom
| | - David Donaldson
- Haematology Department, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Sarah Lawless
- Haematology Department, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Ezzat ElHassadi
- Department of Haematology, University Hospital Waterford, Waterford, Ireland
| | - Amjad Hayat
- Department of Haematology, University Hospital Galway, Galway, Ireland
| | - Mary R. Cahill
- Department of Haematology, Cork University Hospital, Cork, Ireland
| | - Derville O’Shea
- Department of Haematology, Cork University Hospital, Cork, Ireland
| | - Jeremy Sargent
- Department of Haematology, Our Lady of Lourdes Hospital, Queens University Belfast, Drogheda, Ireland
| | - Peter Stewart
- Centre for Cancer Research and Cell Biology (CCRCB), Queen’s University Belfast, Belfast, United Kingdom
| | - Manisha Maurya
- Centre for Cancer Research and Cell Biology (CCRCB), Queen’s University Belfast, Belfast, United Kingdom
| | - John Quinn
- Department of Haematology, Beaumont Hospital, Dublin, Ireland
| | - Philip Murphy
- Department of Haematology, Beaumont Hospital, Dublin, Ireland
| | - David Gonzalez de Castro
- Centre for Cancer Research and Cell Biology (CCRCB), Queen’s University Belfast, Belfast, United Kingdom
| | - Ken Mills
- Centre for Cancer Research and Cell Biology (CCRCB), Queen’s University Belfast, Belfast, United Kingdom
| | - Nicholas C. P. Cross
- Wessex Regional Genetics Laboratory, Salisbury National Health Service (NHS) Foundation Trust, Salisbury, United Kingdom
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Francesco Forconi
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sunil Iyengar
- The Royal Marsden Hospital and the Institute of Cancer Research, Biomedical Research Centre, London, United Kingdom
| | - Anna Schuh
- Oxford Molecular Diagnostics Centre, Oxford University Hospitals, Oxford, United Kingdom
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71
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Royo R, Magnano L, Delgado J, Ruiz-Gil S, Gelpí JL, Heyn H, Taylor MA, Stankovic T, Puente XS, Nadeu F, Campo E. ATM germline variants in a young adult with chronic lymphocytic leukemia: 8 years of genomic evolution. Blood Cancer J 2022; 12:90. [PMID: 35672297 PMCID: PMC9174185 DOI: 10.1038/s41408-022-00686-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/13/2022] [Accepted: 05/25/2022] [Indexed: 01/14/2023] Open
Affiliation(s)
- Romina Royo
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
| | - Laura Magnano
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hospital Clínic of Barcelona, Barcelona, Spain
| | - Julio Delgado
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Sara Ruiz-Gil
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Josep Ll Gelpí
- Barcelona Supercomputing Center (BSC), Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Holger Heyn
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Malcom A Taylor
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, UK
| | - Tatjana Stankovic
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, UK
| | - Xose S Puente
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Departamento de Bioquímica y Biología Molecular, Instituto Universitario de Oncología, Universidad de Oviedo, Oviedo, Spain
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Elías Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain.
- Hospital Clínic of Barcelona, Barcelona, Spain.
- Universitat de Barcelona, Barcelona, Spain.
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72
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Chen R, Chen Y, Xiong P, Zheleva D, Blake D, Keating MJ, Wierda WG, Plunkett W. Cyclin-dependent kinase inhibitor fadraciclib (CYC065) depletes anti-apoptotic protein and synergizes with venetoclax in primary chronic lymphocytic leukemia cells. Leukemia 2022; 36:1596-1608. [PMID: 35383271 PMCID: PMC9162916 DOI: 10.1038/s41375-022-01553-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/10/2022] [Accepted: 03/18/2022] [Indexed: 12/24/2022]
Abstract
Fadraciclib (CYC065) is a second-generation aminopurine CDK2/9 inhibitor with increased potency and selectivity toward CDK2 and CDK9 compared to seliciclib (R-roscovitine). In chronic lymphocytic leukemia (CLL), a disease that depends on the over-expression of anti-apoptotic proteins for its survival, inhibition of CDK9 by fadraciclib reduced phosphorylation of the C-terminal domain of RNA polymerase II and blocked transcription in vitro; these actions depleted the intrinsically short-lived anti-apoptotic protein Mcl-1 and induced apoptosis. While the simulated bone marrow and lymph node microenvironments induced Mcl-1 expression and protected CLL cells from apoptosis, these conditions did not prolong the turnover rate of Mcl-1, and fadraciclib efficiently abrogated the protective effect. Further, fadraciclib was synergistic with the Bcl-2 antagonist venetoclax, inducing more profound CLL cell death, especially in samples with 17p deletion. While fadraciclib, venetoclax, and the combination each had distinct kinetics of cell death induction, their activities were reversible, as no additional cell death was induced upon removal of the drugs. The best combination effects were achieved when both drugs were maintained together. Altogether, this study provides a rationale for the clinical development of fadraciclib in CLL, either alone or in combination with a Bcl-2 antagonist.
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Affiliation(s)
- Rong Chen
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yuling Chen
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Ping Xiong
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | | | - Michael J Keating
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William Plunkett
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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73
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Devi A, Thielemans L, Ladikou EE, Nandra TK, Chevassut T. Lymphocytosis and chronic lymphocytic leukaemia: investigation and management. Clin Med (Lond) 2022; 22:225-229. [PMID: 35584829 DOI: 10.7861/clinmed.2022-0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Lymphocytosis is a common blood-test finding. Establishing whether the cause of lymphocytosis is benign or malignant is key to managing patients appropriately. A lymphocytosis should always prompt clinical review including a thorough history, examination and appropriate preliminary investigations (blood tests, blood film). The majority of patients with chronic lymphocytic leukaemia (CLL) present incidentally due to a lymphocytosis found on routine blood tests. Patient outcomes vary considerably based on genetic pre-disposition and various prognostic markers (age, Binet or Rai staging, and B2-microglobulin). Although not curative, chemo-immunotherapy is an effective treatment strategy for the majority of CLL patients with progressive disease. More recently, novel oral therapies have been developed that target key signalling and apoptosis pathways and that are being used in relapse settings and as first-line treatments for certain patients.
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Affiliation(s)
- Amarpreet Devi
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | | | | | - Taran K Nandra
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Timothy Chevassut
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK and Brighton and Sussex Medical School, Falmer, UK
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74
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Khan S, Molica S, Allsup D. Immunomodulation mediated by polyclonal IgG replacement in patients with CLL may be important in infection prevention. Hematol Oncol 2022; 40:528-529. [PMID: 35488852 DOI: 10.1002/hon.3011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
We read with interest the article by Idanna Innocenti and colleagues where a fixed dose of 10g hyaluronidase-free SCIg (subcutaneous immunoglobulin IgG) was administered every two weeks for one year to 10 patients with chronic lymphocytic leukaemia (CLL) and was highly effective in preventing infections [1]. It is generally accepted that frequency of infusions with hyaluronidase-free SCIg preparations are once weekly to maintain 'adequate' trough IgG [2], but this has been extrapolated from use in primary immunodeficient patients who typically have a complete antibody deficiency in contrast to the deficit observed in CLL This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Sujoy Khan
- Department of Immunology & Allergy, Castle Hill Hospital, Hull University Teaching Hospital NHS Trust, Cottingham, HU16 5JQ, United Kingdom
| | - Stefano Molica
- Department of Haematology, Castle Hill Hospital, Hull University Teaching Hospital NHS Trust, Cottingham, HU16 5JQ, United Kingdom
| | - David Allsup
- Department of Haematology, Castle Hill Hospital, Hull University Teaching Hospital NHS Trust, Cottingham, HU16 5JQ, United Kingdom.,Centre for Atherothrombosis and Metabolic Disease, Hull York Medical School, University of Hull, Cottingham, Hull, HU6 7RX, United Kingdom
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75
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Rössler I, Weigl S, Fernández-Fernández J, Martín-Villanueva S, Strauss D, Hurt E, de la Cruz J, Pertschy B. The C-terminal tail of ribosomal protein Rps15 is engaged in cytoplasmic pre-40S maturation. RNA Biol 2022; 19:560-574. [PMID: 35438042 PMCID: PMC9037480 DOI: 10.1080/15476286.2022.2064073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The small ribosomal subunit protein Rps15/uS19 is involved in early nucleolar ribosome biogenesis and subsequent nuclear export of pre-40S particles to the cytoplasm. In addition, the C-terminal tail of Rps15 was suggested to play a role in mature ribosomes, namely during translation elongation. Here, we show that Rps15 not only functions in nucleolar ribosome assembly but also in cytoplasmic pre-40S maturation, which is indicated by a strong genetic interaction between Rps15 and the 40S assembly factor Ltv1. Specifically, mutations either in the globular or C-terminal domain of Rps15 when combined with the non-essential ltv1 null allele are lethal or display a strong growth defect. However, not only rps15 ltv1 double mutants but also single rps15 C-terminal deletion mutants exhibit an accumulation of the 20S pre-rRNA in the cytoplasm, indicative of a cytoplasmic pre-40S maturation defect. Since in pre-40S particles, the C-terminal tail of Rps15 is positioned between assembly factors Rio2 and Tsr1, we further tested whether Tsr1 is genetically linked to Rps15, which indeed could be demonstrated. Thus, the integrity of the Rps15 C-terminal tail plays an important role during late pre-40S maturation, perhaps in a quality control step to ensure that only 40S ribosomal subunits with functional Rps15 C-terminal tail can efficiently enter translation. As mutations in the C-terminal tail of human RPS15 have been observed in connection with chronic lymphocytic leukaemia, it is possible that apart from defects in translation, an impaired late pre-40S maturation step in the cytoplasm could also be a reason for this disease.
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Affiliation(s)
- Ingrid Rössler
- Institute of Molecular Biosciences, University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
| | - Sarah Weigl
- Institute of Molecular Biosciences, University of Graz, Graz, Austria
| | - José Fernández-Fernández
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Departamento de Genética, Facultad de Biología, Universidad de Sevilla, Seville, Spain
| | - Sara Martín-Villanueva
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Daniela Strauss
- Biochemistry Center BZH, Heidelberg University, Heidelberg, Germany
| | - Ed Hurt
- Biochemistry Center BZH, Heidelberg University, Heidelberg, Germany
| | - Jesús de la Cruz
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Departamento de Genética, Facultad de Biología, Universidad de Sevilla, Seville, Spain
| | - Brigitte Pertschy
- Institute of Molecular Biosciences, University of Graz, Graz, Austria.,BioTechMed-Graz, Graz, Austria
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76
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Claxton DF. Clonal haematopoiesis as a risk factor for therapy-related myeloid neoplasms in patients with chronic lymphocytic leukaemia treated with chemo-(immuno)therapy. Br J Haematol 2022; 198:9-10. [PMID: 35362550 DOI: 10.1111/bjh.18174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
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77
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Poppova L, Pavlova S, Gonzalez B, Kotaskova J, Plevova K, Dumbovic G, Janovska P, Bystry V, Panovska A, Bezdekova L, Maslejova S, Brychtova Y, Doubek M, Krzyzankova M, Borsky M, Mayer J, Bryja V, Alonso S, Pospisilova S. Memory B-cell like chronic lymphocytic leukaemia is associated with specific methylation profile of WNT5A promoter and undetectable expression of WNT5A gene. Epigenetics 2022; 17:1628-1635. [PMID: 35333703 PMCID: PMC9621079 DOI: 10.1080/15592294.2022.2050004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Genome methylation profiles define naïve-like (n-CLL), memory-like (m-CLL), and intermediate (i-CLL) subsets of chronic lymphocytic leukaemia (CLL). The profiles can be easily determined by the analysis of the five-CpG signature. m-CLL, i-CLL, and n-CLL with the good, intermediate, and poor prognoses, respectively, differ by the somatic hypermutation status of the immunoglobulin heavy chain variable gene (IGHV), a widely used prognostic predictor in CLL. We have previously shown that the expression of WNT5A, encoding a ROR1 ligand, distinguishes patients with the worse outcome within the prognostically favourable IGHV-mutated subgroup. To analyse the mechanisms controlling WNT5A expression, we investigated the methylation status of 54 CpG sites within the WNT5A promoter and its relation to the WNT5A gene expression. In a cohort of 59 CLL patients balanced for combinations of IGHV and WNT5A statuses, we identified three promoter CpG sites whose methylation level correlated with the WNT5A expression within the IGHV-mutated subgroup. Further, we complemented our data with the methylation status of the five-CpG signature. IGHV-mutated/WNT5A-negative and IGHV-mutated/WNT5A-positive cases overlapped with m‑CLL and i‑CLL methylation subgroups, respectively, while most IGHV‑unmutated samples were assigned to n-CLL. Median methylation levels of all the three CpG sites in the WNT5A promoter were lowest in i-CLL. Finally, a detailed analysis of m-CLL and i-CLL showed that undetectable WNT5A expression predicts longer treatment-free survival with higher statistical significance than the classification according to the five-CpG signature. To conclude, a favourable m-CLL subgroup is associated with mutated IGHV and undetectable WNT5A expression due to its promoter methylation.
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Affiliation(s)
- Lucie Poppova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Sarka Pavlova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Beatriz Gonzalez
- IGTP-PMPPC: Program of Predictive and Personalized Medicine of Cancer, Germans Trias I Pujol Research Institute, Badalona, Spain
| | - Jana Kotaskova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Karla Plevova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.,Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Gabrijela Dumbovic
- IGTP-PMPPC: Program of Predictive and Personalized Medicine of Cancer, Germans Trias I Pujol Research Institute, Badalona, Spain.,Institute for Cardiovascular Regeneration, Center for Molecular Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Pavlina Janovska
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Vojtech Bystry
- Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Anna Panovska
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Lucie Bezdekova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Stanislava Maslejova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Yvona Brychtova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Michael Doubek
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.,Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marcela Krzyzankova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Marek Borsky
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Mayer
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic
| | - Vitezslav Bryja
- Department of Experimental Biology, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Sergio Alonso
- IGTP-PMPPC: Program of Predictive and Personalized Medicine of Cancer, Germans Trias I Pujol Research Institute, Badalona, Spain
| | - Sarka Pospisilova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Central European Institute of Technology (CEITEC), Masaryk University, Brno, Czech Republic.,Institute of Medical Genetics and Genomics, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
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78
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Moia R, Gaidano G. Updated revision of the British Society of Haematology guidelines for chronic lymphocytic leukaemia. Br J Haematol 2022; 197:513-514. [PMID: 35313005 DOI: 10.1111/bjh.18119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Riccardo Moia
- Division of Haematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
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79
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Jobson D, McCormack CJ, Mar V, Tam C, Henderson MA. Impact of chronic lymphocytic leukaemia on melanoma outcomes: A retrospective case-control study. Br J Haematol 2022; 197:320-325. [PMID: 35286715 PMCID: PMC9314657 DOI: 10.1111/bjh.18090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/29/2022] [Accepted: 01/31/2022] [Indexed: 11/30/2022]
Abstract
With new, effective treatments for chronic lymphocytic leukaemia (CLL) the impact of second malignancies is increasingly important. We performed a retrospective case‐controlled study examining the effect of CLL and its treatment on melanoma‐specific survival and recurrence. A total of 56 patients with melanoma with CLL were matched 1:1 to patients without CLL for age, date of diagnosis, gender and melanoma tumour, node, metastasis (TNM) stage. Multivariate analysis found CLL was associated with significantly worse melanoma‐specific mortality (hazard ratio [HR] 2.46, 95% confidence interval [CI] 1.27–4.74, p = 0.007) and recurrence (HR 3.44, 95% CI 1.79–6.63, p < 0.001). Patients with CLL had poor immunotherapy tolerance and prior CLL treatment was not associated with melanoma outcomes.
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Affiliation(s)
- Dale Jobson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia
| | | | - Victoria Mar
- Victorian Melanoma Service, Alfred Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Constantine Tam
- Haematology Department, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael A Henderson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
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80
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Lew TE, Anderson MA. Health-related quality of life for patients with chronic lymphocytic leukaemia - A critical outcome measure in the era of highly effective therapies. Br J Haematol 2022; 197:394-396. [PMID: 35262916 DOI: 10.1111/bjh.18118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Thomas E Lew
- Department of Haematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia.,Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
| | - Mary Ann Anderson
- Department of Haematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Melbourne, Australia.,Blood Cells and Blood Cancer Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
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81
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Oerlemans S, Efficace F, Kieffer JM, Kyriakou C, Xochelli A, Levedahl K, Petranovic D, Borges FC, Bredart A, Shamieh O, Gziskevicius L, Lehmann J, Scholz CW, Caocci G, Molica S, Stamatopoulos K, Panteliadou AK, Papaioannou M, Alrjoob W, Baliakas P, Rosenquist R, Malak S, Miranda A, Cocks K, van de Poll-Franse L. International validation of the EORTC QLQ-CLL17 questionnaire for assessment of health-related quality of life for patients with chronic lymphocytic leukaemia. Br J Haematol 2022; 197:431-441. [PMID: 35255152 DOI: 10.1111/bjh.18072] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/18/2022] [Accepted: 01/21/2022] [Indexed: 11/26/2022]
Abstract
Selecting the most appropriate chronic lymphocytic leukaemia (CLL) treatment is challenging. Patient-reported health-related quality of life (HRQoL) is therefore a critical aspect to consider. This international study by the European Organization for Research and Treatment of Cancer (EORTC) tested the psychometric properties of a newly developed measure for CLL patients: the EORTC QLQ-CLL17 to supplement the core questionnaire (EORTC QLQ-C30). Patients with CLL (n = 341) from 12 countries completed the QLQ-C30, QLQ-CLL17 and a debriefing questionnaire. Sociodemographic and clinical data were recorded from medical records. A high percentage (30%-66%) reported symptoms and/or worries (e.g. aches/pains in muscles, lack of energy and worry/fears about health). Confirmatory factor analysis showed an acceptable to good fit of the 17 items on the three scales (i.e. symptom burden, physical condition/fatigue and worries/fears about health and functioning). Completion took on average 8 min. Test-retest and convergent validity was demonstrated. The QLQ-CLL17 differentiated between patients with an Eastern Cooperative Oncology group (ECOG) performance of 0 versus 1-3 (p's < 0.01 and clinically relevant). The newly developed EORTC QLQ-CLL17 will increase sensitivity of HRQoL assessment in patients with CLL. Implementation of this questionnaire both in clinical research and practice will help to generate unique clinically relevant data to better inform CLL treatment decision-making.
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Affiliation(s)
- Simone Oerlemans
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Fabio Efficace
- Health Outcomes Research Unit, Italian Group for Adult Hematologic Diseases (GIMEMA) Data Centre, Rome, Italy
| | - Jacobien M Kieffer
- Department of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Aliki Xochelli
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - Kerstin Levedahl
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Duska Petranovic
- Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Fabio Cardoso Borges
- Department of Epidemiology and National Cancer Registry (RON), Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E, Lisbon, Portugal
| | - Anne Bredart
- Institut Curie - Psycho-Oncology Unit, Paris University, Paris, France.,Psychopathology and Health Process Laboratory (LPPS) (UR 4057), PSL University, Paris, France
| | - Omar Shamieh
- Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan
| | | | - Jens Lehmann
- University Hospital of Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Giovanni Caocci
- Hematology, Businco Hospital, University of Cagliari, Cagliari, Italy
| | | | - Kostas Stamatopoulos
- Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | | | - Maria Papaioannou
- Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece
| | - Waleed Alrjoob
- Department of Palliative Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Malak
- Hôpital René Huguenin-Institut Curie - Hématologie, Saint-Cloud, France
| | - Ana Miranda
- Department of Epidemiology and National Cancer Registry (RON), Instituto Português de Oncologia de Lisboa Francisco Gentil, E.P.E, Lisbon, Portugal
| | - Kim Cocks
- York Trials Unit, University of York, York & Adelphi Values, Cheshire, UK
| | - Lonneke van de Poll-Franse
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
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82
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Zarobkiewicz MK, Bojarska-Junak AA. The Mysterious Actor-γδ T Lymphocytes in Chronic Lymphocytic Leukaemia (CLL). Cells 2022; 11:cells11040661. [PMID: 35203309 PMCID: PMC8870520 DOI: 10.3390/cells11040661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 02/06/2022] [Accepted: 02/08/2022] [Indexed: 02/07/2023] Open
Abstract
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia among adults. It is the clonal expansion of B cells expressing CD19 and CD5. Despite significant progress in treatment, CLL is still incurable. γδ T cells comprise an important subset of the cytotoxic T cells. Although γδ T cells in CLL are dysfunctional, they still can possibly be used for immunotherapy. The current paper reviews our understanding of γδ T lymphocytes in CLL.
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83
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Blixt L, Bogdanovic G, Buggert M, Gao Y, Hober S, Healy K, Johansson H, Kjellander C, Mravinacova S, Muschiol S, Nilsson P, Palma M, Pin E, Smith CIE, Stromberg O, Sällberg Chen M, Zain R, Hansson L, Österborg A. Covid-19 in patients with chronic lymphocytic leukemia: clinical outcome and B- and T-cell immunity during 13 months in consecutive patients. Leukemia 2022; 36:476-481. [PMID: 34564699 PMCID: PMC8475381 DOI: 10.1038/s41375-021-01424-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 01/01/2023]
Abstract
We studied clinical and immunological outcome of Covid-19 in consecutive CLL patients from a well-defined area during month 1-13 of the pandemic. Sixty patients (median age 71 y, range 43-97) were identified. Median CIRS was eight (4-20). Patients had indolent CLL (n = 38), had completed (n = 12) or ongoing therapy (n = 10). Forty-six patients (77%) were hospitalized due to severe Covid-19 and 11 were admitted to ICU. Severe Covid-19 was equally distributed across subgroups irrespective of age, gender, BMI, CLL status except CIRS (p < 0.05). Fourteen patients (23%) died; age ≥75 y was the only significant risk factor (p < 0.05, multivariate analysis with limited power). Comparing month 1-6 vs 7-13 of the pandemic, deaths were numerically reduced from 32% to 18%, ICU admission from 37% to 15% whereas hospitalizations remained frequent (86% vs 71%). Seroconversion occurred in 33/40 patients (82%) and anti-SARS-CoV-2 antibodies were detectable at six and 12 months in 17/22 and 8/11 patients, respectively. Most (13/17) had neutralizing antibodies and 19/28 had antibodies in saliva. SARS-CoV-2-specific T-cells (ELISpot) were detected in 14/17 patients. Covid-19 continued to result in high admission even among consecutive and young early- stage CLL patients. A robust and durable B and/or T cell immunity was observed in most convalescents.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antibodies, Neutralizing/blood
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- B-Lymphocytes/immunology
- COVID-19/complications
- COVID-19/immunology
- COVID-19/transmission
- COVID-19/virology
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/virology
- Male
- Middle Aged
- Prognosis
- SARS-CoV-2/immunology
- SARS-CoV-2/isolation & purification
- T-Lymphocytes/immunology
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Affiliation(s)
- Lisa Blixt
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Gordana Bogdanovic
- Department of Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Marcus Buggert
- Center for Infectious Medicine, Dept of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Yu Gao
- Center for Infectious Medicine, Dept of Medicine Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Sophia Hober
- Department of Protein Science, SciLifeLab and KTH Royal Institute of Technology, Stockholm, Sweden
| | - Katie Healy
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | | | - Sara Mravinacova
- Department of Protein Science, SciLifeLab and KTH Royal Institute of Technology, Stockholm, Sweden
| | - Sandra Muschiol
- Department of Microbiology, Karolinska University Hospital, Stockholm, Sweden
| | - Peter Nilsson
- Department of Protein Science, SciLifeLab and KTH Royal Institute of Technology, Stockholm, Sweden
| | - Marzia Palma
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Elisa Pin
- Department of Protein Science, SciLifeLab and KTH Royal Institute of Technology, Stockholm, Sweden
| | - C I Edvard Smith
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Olga Stromberg
- Department of Internal Medicine, Södersjukhuset, Stockholm, Sweden
| | | | - Rula Zain
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Rare Diseases, Department of Clinical Genetics, Karolinska University, Hospital, Stockholm, Sweden
| | - Lotta Hansson
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden.
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
| | - Anders Österborg
- Department of Hematology, Karolinska University Hospital Solna, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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84
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Shen Y, Coyle L, Kerridge I, Stevenson W, Arthur C, McKinlay N, Fay K, Ward C, Greenwood M, Best OG, Solterbeck A, Guminski A, Shumack S, Mulligan SP. Second primary malignancies in chronic lymphocytic leukaemia: Skin, solid organ, haematological and Richter's syndrome. EJHaem 2022; 3:129-138. [PMID: 35846218 PMCID: PMC9175984 DOI: 10.1002/jha2.366] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 05/12/2023]
Abstract
Chronic lymphocytic leukaemia (CLL) is invariably accompanied by some degree of immune failure, and CLL patients have a high rate of second primary malignancy (SPM) compared to the general population. We comprehensively documented the incidence of all forms of SPM including skin cancer (SC), solid organ malignancy (SOM), second haematological malignancy (SHM) and separately Richter's syndrome (RS) across all therapy eras. Among the 517 CLL/small lymphocytic lymphoma (SLL) patients, the overall incidence of SPMs with competing risks was SC 31.07%, SOM 25.99%, SHM 5.19% and RS 7.55%. Of the 216 treated patients, 106 (49.1%) had at least one form of SPM, and 63 of 106 (29.2% of treated patients) developed an SPM 1.5 years (median) after treatment for their CLL. Melanoma accounted for 30.3% of SC. Squamous cell carcinoma (SCC), including eight metastatic SCCs, was 1.8 times more than basal cell carcinoma (BCC), a reversal of the typical BCC:SCC ratio. The most common SOMs were prostate (6.4%) and breast (4.5%). SHM included seven acute myeloid leukaemia (AML) and five myelodysplasia (MDS) of which eight (four AML, four MDS) were therapy-related. Any SPM occurred in 32.1% of 53 Monoclonal B-lymphocytosis (MBL) patients. Age-adjusted standardised rates of SPM (per 100,000) for CLL, MBL and the general Australian population were 2648, 1855 and 486.9, respectively. SPMs are a major health burden with 44.9% of CLL patients with having at least one SPM, and apart from SC, associated with significantly reduced overall survival. Dramatic improvements in CLL treatment and survival have occurred with immunochemotherapy and targeted therapies, but mitigating SPM burden will be important to sustain further progress.
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Affiliation(s)
- Yandong Shen
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
- Kolling Institute of Medical ResearchRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Luke Coyle
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Ian Kerridge
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - William Stevenson
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Christopher Arthur
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Naomi McKinlay
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Keith Fay
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Christopher Ward
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Matthew Greenwood
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Oliver Giles Best
- College of Medicine and Public HealthFlinders UniversityBedford ParkSouth AustraliaAustralia
| | - Ann Solterbeck
- Statistical Revelations Pty LtdOcean GroveVictoriaAustralia
| | - Alexander Guminski
- Department of Medical OncologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Stephen Shumack
- Department of DermatologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
| | - Stephen P. Mulligan
- Department of HaematologyRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
- Kolling Institute of Medical ResearchRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
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85
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Allan JN, Shanafelt T, Wiestner A, Moreno C, O’Brien SM, Li J, Krigsfeld G, Dean JP, Ahn IE. Long-term efficacy of first-line ibrutinib treatment for chronic lymphocytic leukaemia in patients with TP53 aberrations: a pooled analysis from four clinical trials. Br J Haematol 2022; 196:947-953. [PMID: 34865212 PMCID: PMC9299890 DOI: 10.1111/bjh.17984] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/22/2021] [Indexed: 01/14/2023]
Abstract
TP53 aberrations [del(17p) or TP53 mutation] predict poor survival with chemoimmunotherapy in patients with chronic lymphocytic leukaemia (CLL). We evaluated long-term efficacy and safety of first-line ibrutinib-based therapy in patients with CLL bearing TP53 aberrations in a pooled analysis across four studies: PCYC-1122e, RESONATE-2 (PCYC-1115/16), iLLUMINATE (PCYC-1130) and ECOG-ACRIN E1912. The pooled analysis included 89 patients with TP53 aberrations receiving first-line treatment with single-agent ibrutinib (n = 45) or ibrutinib in combination with an anti-CD20 antibody (n = 44). All 89 patients had del(17p) (53% of 89 patients) and/or TP53 mutation (91% of 58 patients with TP53 sequencing results available). With a median follow-up of 49·8 months (range, 0·1-95·9), median progression-free survival was not reached. Progression-free survival rate and overall survival rate estimates at four years were 79% and 88%, respectively. Overall response rate was 93%, including complete response in 39% of patients. No new safety signals were identified in this analysis. Forty-six percent of patients remained on ibrutinib treatment at last follow-up. With median follow-up of four years (up to eight years), results from this large, pooled, multi-study data set suggest promising long-term outcomes of first-line ibrutinib-based therapy in patients with TP53 aberrations. Registered at ClinicalTrials.gov (NCT01500733, NCT01722487, NCT02264574 and NCT02048813).
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Affiliation(s)
| | | | | | - Carol Moreno
- Hospital de la Santa Creu i Sant PauAutonomous University of BarcelonaBarcelonaSpain
| | - Susan M. O’Brien
- Chao Family Comprehensive Cancer CenterUniversity of California IrvineIrvineCAUSA
| | - Jianling Li
- Pharmacyclics LLC, an AbbVie CompanySunnyvaleCAUSA
| | | | | | - Inhye E. Ahn
- National Heart, Lung, and Blood InstituteBethesdaMDUSA
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86
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Schenker C, Hirzel C, Walti LN, Zeerleder SS, Andres M, Ramette A, Barbani MT, Suter‐Riniker F, Holbro A, Tritschler T. Convalescent plasma and remdesivir for protracted COVID-19 in a patient with chronic lymphocytic leukaemia: a case report of late relapse after rapid initial response. Br J Haematol 2022; 196:e27-e29. [PMID: 34458995 PMCID: PMC8652702 DOI: 10.1111/bjh.17806] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Carla Schenker
- Department of General Internal MedicineInselspitalBern University HospitalUniversity of BernBernSwitzerland
| | - Cédric Hirzel
- Department of Infectious DiseaseInselspitalBern University HospitalUniversity of BernBernSwitzerland
| | - Laura N. Walti
- Department of Infectious DiseaseInselspitalBern University HospitalUniversity of BernBernSwitzerland
| | - Sacha S. Zeerleder
- Department of Hematology and Central Hematology LaboratoryInselspitalBern University HospitalUniversity of BernBernSwitzerland
- Department for BioMedical ResearchInselspitalBern University HospitalUniversity of BernBernSwitzerland
| | - Martin Andres
- Department of Hematology and Central Hematology LaboratoryInselspitalBern University HospitalUniversity of BernBernSwitzerland
| | - Alban Ramette
- Institute for Infectious DiseasesUniversity of BernBernSwitzerland
| | - Maria T. Barbani
- Institute for Infectious DiseasesUniversity of BernBernSwitzerland
| | | | - Andreas Holbro
- Division of HematologyBasel University HospitalUniversity of BaselBaselSwitzerland
- Regional Blood Transfusion ServiceSwiss Red CrossBaselSwitzerland
| | - Tobias Tritschler
- Department of General Internal MedicineInselspitalBern University HospitalUniversity of BernBernSwitzerland
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87
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Öztürk S, Paul Y, Afzal S, Gil-Farina I, Jauch A, Bruch PM, Kalter V, Hanna B, Arseni L, Roessner PM, Schmidt M, Stilgenbauer S, Dietrich S, Lichter P, Zapatka M, Seiffert M. Longitudinal analyses of CLL in mice identify leukemia-related clonal changes including a Myc gain predicting poor outcome in patients. Leukemia 2022; 36:464-475. [PMID: 34417556 PMCID: PMC8807396 DOI: 10.1038/s41375-021-01381-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/30/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023]
Abstract
Chronic lymphocytic leukemia (CLL) is a B-cell malignancy mainly occurring at an advanced age with no single major genetic driver. Transgenic expression of TCL1 in B cells leads after a long latency to a CLL-like disease in aged Eµ-TCL1 mice suggesting that TCL1 overexpression is not sufficient for full leukemic transformation. In search for secondary genetic events and to elucidate the clonal evolution of CLL, we performed whole exome and B-cell receptor sequencing of longitudinal leukemia samples of Eµ-TCL1 mice. We observed a B-cell receptor stereotypy, as described in patients, confirming that CLL is an antigen-driven disease. Deep sequencing showed that leukemia in Eµ-TCL1 mice is mostly monoclonal. Rare oligoclonality was associated with inability of tumors to develop disease upon adoptive transfer in mice. In addition, we identified clonal changes and a sequential acquisition of mutations with known relevance in CLL, which highlights the genetic similarities and therefore, suitability of the Eµ-TCL1 mouse model for progressive CLL. Among them, a recurrent gain of chromosome 15, where Myc is located, was identified in almost all tumors in Eµ-TCL1 mice. Interestingly, amplification of 8q24, the chromosomal region containing MYC in humans, was associated with worse outcome of patients with CLL.
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Affiliation(s)
- Selcen Öztürk
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Yashna Paul
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Saira Afzal
- Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
- GeneWerk GmbH, Heidelberg, Germany
| | - Irene Gil-Farina
- Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
- GeneWerk GmbH, Heidelberg, Germany
| | - Anna Jauch
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - Peter-Martin Bruch
- Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Verena Kalter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bola Hanna
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Lavinia Arseni
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Philipp M Roessner
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Manfred Schmidt
- Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany
- GeneWerk GmbH, Heidelberg, Germany
| | | | - Sascha Dietrich
- Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marc Zapatka
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Martina Seiffert
- Division of Molecular Genetics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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88
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van der Straten L, Levin M, Visser O, Posthuma EF, Doorduijn JK, Kater AP, Dinmohamed AG. Conditional relative survival among patients with chronic lymphocytic leukaemia: A population-based study in the Netherlands. EJHaem 2022; 3:180-183. [PMID: 35846209 PMCID: PMC9175753 DOI: 10.1002/jha2.368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 01/26/2023]
Abstract
Studies on conditional relative survival (CRS) in chronic lymphocytic leukaemia (CLL) have hitherto been lacking in the literature. We predicted up-to-date estimates of 5-year RS at diagnosis and for each additional year survived (i.e., CRS) up to 15 years post-diagnosis among CLL patients diagnosed during 2007-2020. We showed that 5-year CRS continues to decline gradually with each additional year survived in a contemporary era with access to novel-based agents, irrespective of age. This finding indicates that CLL patients continue to experience substantial excess mortality compared to an age- and sex-matched group from the general population.
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Affiliation(s)
- Lina van der Straten
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
- Department of Internal MedicineAlbert Schweitzer HospitalDordrechtThe Netherlands
- Laboratory Medical Immunology, Department of ImmunologyErasmus MCRotterdamThe Netherlands
| | - Mark‐David Levin
- Department of Internal MedicineAlbert Schweitzer HospitalDordrechtThe Netherlands
| | - Otto Visser
- Department of RegistrationNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
| | - Eduardus F.M. Posthuma
- Department of Internal MedicineReinier The Graaf HospitalDelftThe Netherlands
- Department of HematologyLeiden University Medical CenterLeidenThe Netherlands
| | - Jeanette K. Doorduijn
- Erasmus MC Cancer Institute, Department of HematologyUniversity Medical Center RotterdamRotterdamThe Netherlands
| | - Arnon P. Kater
- Amsterdam UMC, University of Amsterdam, Department of HematologyCancer Center Amsterdam, Lymphoma and Myeloma Center AmsterdamAmsterdamThe Netherlands
| | - Avinash G. Dinmohamed
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organisation (IKNL)UtrechtThe Netherlands
- Amsterdam UMC, University of Amsterdam, Department of HematologyCancer Center Amsterdam, Lymphoma and Myeloma Center AmsterdamAmsterdamThe Netherlands
- Erasmus MC, Department of Public HealthUniversity Medical Center RotterdamRotterdamThe Netherlands
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of HematologyCancer Center AmsterdamAmsterdamThe Netherlands
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89
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King RL, Gupta A, Kurtin PJ, Ding W, Call TG, Rabe KG, Kenderian SS, Leis JF, Wang Y, Schwager SM, Slager SL, Kay NE, Koehler A, Ansell SM, Inwards DJ, Habermann TM, Shi M, Hanson CA, Howard MT, Parikh SA. Chronic lymphocytic leukemia (CLL) with Reed-Sternberg-like cells vs Classic Hodgkin lymphoma transformation of CLL: does this distinction matter? Blood Cancer J 2022; 12:18. [PMID: 35091549 PMCID: PMC8799721 DOI: 10.1038/s41408-022-00616-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 12/14/2022] Open
Abstract
The distinction between chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with isolated Hodgkin/Reed-Sternberg cells (CLL-HRS; background milieu with a paucity of inflammatory cells) and overt transformation to classic Hodgkin lymphoma (CLL-HL; mixed inflammatory background) is incompletely understood. This retrospective study examined the clinicopathologic features of CLL-HRS (n = 15) and CLL-HL (n = 31) patients seen over the past three decades from a single institution. The phenotypic features of Reed-Sternberg cells in both groups were similar, including expression of CD30, CD15, and PAX5, as well as EBV status. However, a spectrum of background CLL/SLL infiltration amongst the HRS cells was noted on pathologic review, and four patients had both diagnoses, either concurrently or in succession. The median overall survival (OS) of patients with CLL-HRS was 17.5 months compared to 33.5 months for patients with CLL-HL (P = 0.24). Among patients with CLL-HRS, those who received Hodgkin-directed therapy had a significantly longer median OS (57 months) compared to those who received CLL-directed therapy (8.4 months, P = 0.02). Our clinical and pathologic findings suggest a biologic continuum between CLL-HRS and CLL-HL and indicate that CLL-HRS patients may benefit from Hodgkin-directed therapy.
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Affiliation(s)
- Rebecca L. King
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Alia Gupta
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Paul J. Kurtin
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Wei Ding
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Timothy G. Call
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Kari G. Rabe
- Department of Quantitative Health Sciences, Rochester, MN USA
| | - Saad S. Kenderian
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Jose F. Leis
- grid.417468.80000 0000 8875 6339Department of Hematology/Oncology, Mayo Clinic, Scottsdale, AZ USA
| | - Yucai Wang
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Susan M. Schwager
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Susan L. Slager
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA ,Department of Quantitative Health Sciences, Rochester, MN USA
| | - Neil. E. Kay
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Amber Koehler
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Stephen M. Ansell
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - David J. Inwards
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Thomas M. Habermann
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
| | - Min Shi
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Curtis A. Hanson
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Matthew T. Howard
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Mayo Clinic, Rochester, MN USA
| | - Sameer A. Parikh
- grid.66875.3a0000 0004 0459 167XDivision of Hematology, Mayo Clinic, Rochester, MN USA
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90
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Pepper AGS, Zucchetto A, Norris K, Tissino E, Polesel J, Soe Z, Allsup D, Hockaday A, Ow PL, Hillmen P, Rawstron A, Catovsky D, Bulian P, Bomben R, Baird DM, Fegan CD, Gattei V, Pepper C. Combined analysis of IGHV mutations, telomere length and CD49d identifies long-term progression-free survivors in TP53 wild-type CLL treated with FCR-based therapies. Leukemia 2022; 36:271-274. [PMID: 34148055 PMCID: PMC8727296 DOI: 10.1038/s41375-021-01322-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 11/24/2022]
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/analysis
- Cyclophosphamide/administration & dosage
- Follow-Up Studies
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Integrin alpha4/genetics
- Integrin alpha4/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/mortality
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Mutation
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Rituximab/administration & dosage
- Survival Rate
- Telomere Homeostasis
- Tumor Suppressor Protein p53/genetics
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- Andrea G S Pepper
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Antonella Zucchetto
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Kevin Norris
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - Erika Tissino
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Zarni Soe
- Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - David Allsup
- Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Anna Hockaday
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Pei Loo Ow
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Peter Hillmen
- Section of Experimental Haematology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - Andrew Rawstron
- Section of Experimental Haematology, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | | | - Pietro Bulian
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Riccardo Bomben
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Duncan M Baird
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - Christopher D Fegan
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Chris Pepper
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom.
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff, United Kingdom.
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91
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Ghia EM, Rassenti LZ, Choi MY, Quijada-Álamo M, Chu E, Widhopf GF 2nd, Kipps TJ. High expression level of ROR1 and ROR1-signaling associates with venetoclax resistance in chronic lymphocytic leukemia. Leukemia 2022; 36:1609-18. [PMID: 35418613 DOI: 10.1038/s41375-022-01543-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/27/2022] [Accepted: 03/09/2022] [Indexed: 12/19/2022]
Abstract
Although the BH3-mimetic venetoclax is highly cytotoxic for chronic lymphocytic leukemia (CLL) cells, some patients with CLL fail to clear minimal residual disease (MRD). We examined the CLL cells of seven such patients (CLL1-7) and found each had high-level expression of ROR1. By examining the CLL cells from such patients prior to therapy at SC1 and then more than 1 year later (Sample Collection 2 (SC2)), when they had progressive increases in MRD despite continued venetoclax therapy, we found the levels of ROR1 expressed on CLL cells at SC2 were significantly higher than that on CLL cells collected at SC1. At SC2, we also observed upregulation of genes induced by Wnt5a-induced ROR1 signaling, including BCL2L1. Transduction of the CLL-cell-line MEC1 to express ROR1 enhanced expression of target genes induced by ROR1-signaling, increased expression of BCL-XL, and enhanced resistance to venetoclax, even in MEC1 made to express mutant forms of BCL2, which are associated with venetoclax resistance. Treatment of primary CLL cells with Wnt5a also increased their resistance to venetoclax, an effect that could be inhibited by the anti-ROR1 mAb (UC-961, zilovertamab). Collectively, these studies indicate that Wnt5a-induced ROR1-signaling can enhance resistance to venetoclax therapy.
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92
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Cull G, Burger JA, Opat S, Gottlieb D, Verner E, Trotman J, Marlton P, Munoz J, Johnston P, Simpson D, Stern JC, Prathikanti R, Wu K, Novotny W, Huang J, Tam CS. Zanubrutinib for treatment-naïve and relapsed/refractory chronic lymphocytic leukaemia: long-term follow-up of the phase I/II AU-003 study. Br J Haematol 2021; 196:1209-1218. [PMID: 34915592 PMCID: PMC9300083 DOI: 10.1111/bjh.17994] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/28/2022]
Abstract
The phase I/II AU-003 study in patients with treatment-naïve (TN) or relapsed/refractory (R/R) chronic lymphocytic leukaemia/small lymphocytic lymphoma demonstrated that zanubrutinib therapy results in clinically meaningful and durable responses with acceptable safety and tolerability. We report updated safety and efficacy data for 123 patients with a median follow-up of 47·2 months. Patients received zanubrutinib 160 mg twice daily (81 patients), 320 mg once daily (40), or 160 mg once daily (two). Discontinuations due to adverse events or disease progression were uncommon. The overall response rate (ORR) was 95·9% (TN, 100%; R/R, 95%) with 18·7% achieving complete response (CR). Ongoing response at 3 years was reported in 85·7%. The ORR in patients with del(17p)/tumour protein p53 mutation was 87·5% (CR 16·7%). The 2- and 3-year progression-free survival estimates were 90% (TN, 90%; R/R, 91%) and 83% (TN, 81%; R/R, 83%) respectively. The most reported Grade ≥3 adverse events were neutropenia (15·4%), pneumonia (9·8%), hypertension (8·9%) and anaemia (6·5%). The annual incidence of atrial fibrillation, major haemorrhage, Grade ≥3 neutropenia and Grade ≥3 infection decreased over time. With a median follow-up of ~4 years, responses remain clinically meaningful and durable and long-term tolerability to zanubrutinib therapy continues.
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Affiliation(s)
- Gavin Cull
- Sir Charles Gairdner Hospital, Perth, WA, Australia.,University of Western Australia, Perth, WA, Australia
| | - Jan A Burger
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Opat
- Monash Health, Clayton, VIC, Australia.,Monash University, Clayton, VIC, Australia
| | - David Gottlieb
- Faculty of Medicine and Health, University of Sydney, Westmead Hospital, Sydney, NSW, Australia
| | - Emma Verner
- Concord Repatriation Hospital, Concord, NSW, Australia.,The University of Sydney, Concord, NSW, Australia
| | - Judith Trotman
- Concord Repatriation Hospital, Concord, NSW, Australia.,The University of Sydney, Concord, NSW, Australia
| | - Paula Marlton
- Princess Alexandra Hospital, Brisbane, QLD, Australia.,University of Queensland, Brisbane, QLD, Australia
| | - Javier Munoz
- Banner MD Anderson Cancer Center, Gilbert, AZ, USA
| | | | - David Simpson
- North Shore Hospital, Auckland, New Zealand.,BeiGene USA, Inc, San Mateo, CA, USA
| | | | | | - Kenneth Wu
- BeiGene USA, Inc, San Mateo, CA, USA.,BeiGene (Beijing) Co, Ltd, Beijing, China
| | | | - Jane Huang
- BeiGene USA, Inc, San Mateo, CA, USA.,BeiGene (Beijing) Co, Ltd, Beijing, China
| | - Constantine S Tam
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,St Vincent's Hospital, Fitzroy, VIC, Australia.,University of Melbourne, Parkville, VIC, Australia.,Royal Melbourne Hospital, Parkville, VIC, Australia
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93
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McDonald C, Xanthopoulos C, Kostareli E. The role of Bruton's tyrosine kinase in the immune system and disease. Immunology 2021; 164:722-736. [PMID: 34534359 PMCID: PMC8561098 DOI: 10.1111/imm.13416] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [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: 05/19/2021] [Revised: 08/30/2021] [Accepted: 09/10/2021] [Indexed: 12/12/2022] Open
Abstract
Bruton's tyrosine kinase (BTK) is a TEC kinase with a multifaceted role in B-cell biology and function, highlighted by its position as a critical component of the B-cell receptor signalling pathway. Due to its role as a therapeutic target in several haematological malignancies including chronic lymphocytic leukaemia, BTK has been gaining tremendous momentum in recent years. Within the immune system, BTK plays a part in numerous pathways and cells beyond B cells (i.e. T cells, macrophages). Not surprisingly, BTK has been elucidated to be a driving factor not only in lymphoproliferative disorders but also in autoimmune diseases and response to infection. To extort this role, BTK inhibitors such as ibrutinib have been developed to target BTK in other diseases. However, due to rising levels of resistance, the urgency to develop new inhibitors with alternative modes of targeting BTK is high. To meet this demand, an expanding list of BTK inhibitors is currently being trialled. In this review, we synopsize recent discoveries regarding BTK and its role within different immune cells and pathways. Additionally, we discuss the broad significance and relevance of BTK for various diseases ranging from haematology and rheumatology to the COVID-19 pandemic. Overall, BTK signalling and its targetable nature have emerged as immensely important for a wide range of clinical applications. The development of novel, more specific and less toxic BTK inhibitors could be revolutionary for a significant number of diseases with yet unmet treatment needs.
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Affiliation(s)
- Charlotte McDonald
- The Wellcome‐Wolfson Institute for Experimental MedicineSchool of Medicine Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Charalampos Xanthopoulos
- The Wellcome‐Wolfson Institute for Experimental MedicineSchool of Medicine Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
| | - Efterpi Kostareli
- The Wellcome‐Wolfson Institute for Experimental MedicineSchool of Medicine Dentistry and Biomedical SciencesQueen's University BelfastBelfastUK
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94
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Vagos Mata A, Espada E, Alves D, Polo B, Costa MJ, Lopes C, F Lacerda J, Raposo J. Chronic lymphocytic leukaemia/small lymphocytic lymphoma treatment with rituximab and high-dose methylprednisolone, revisited. Cancer Med 2021; 10:8768-8776. [PMID: 34783174 PMCID: PMC8683540 DOI: 10.1002/cam4.4374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/14/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
High‐dose methylprednisolone plus rituximab (R‐HDMP) is a useful treatment in chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL) patients unfit for chemo‐immunotherapy and has proven its utility on the treatment of CLL/SLL complicated by auto‐immune cytopenias. We performed a retrospective, single‐centre study, of CLL/SLL patients treated with R‐HDMP for 9 years. Thirty‐nine patients were included, median age at time of treatment was 77 years. Most patients had stage Rai III/IV and Binet C disease. Twenty‐eight patients had relapsed/refractory disease at time of treatment with a median of 1 previous line of therapy; 53.8% had prior exposure to fludarabine and 25% to rituximab. Grade 3–4 neutropenia and thrombocytopenia were recorded in 10.2% and 17.9% patients, respectively. While on treatment, 51.3% had documented infectious complications, but no other non‐haematological toxicities grades 3–4 were identified. Overall response rate was 64%. Median overall survival and progression‐free survival were 24 and 13 months, respectively. Twenty four patients relapsed and 16 received another line of treatment after R‐HDMP, with median time to next treatment of 13.5 months. Thirteen out of the 24 patients improved performance status and were subsequently considered fit for chemo‐immunotherapy. R‐HDMP is a valuable option for elderly and frail patients, with low risk of severe myelotoxicity and other severe adverse events. It was shown to work as a bridge to other lines of treatment, including chemo‐immunotherapy.
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Affiliation(s)
- Ana Vagos Mata
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Eduardo Espada
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Daniela Alves
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Blanca Polo
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Maria João Costa
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Conceição Lopes
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - João F Lacerda
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - João Raposo
- Hematology and Bone Marrow Transplant Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
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95
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Waldron C, O'Brien D, Brophy S, Perera K, Crotty GM, Dunlea E, Walsh A, Connolly M, Clifford R, O'Leary H, Khan A, Lee G, Atkinson E, Le G, Gillett A, Bacon CL, McElligott AM, Quinn F, Vandenberghe E. Epidemiology of chronic lymphocytic leukaemia in an Irish subpopulation with total case ascertainment: an additional tool for health economic planning. Br J Haematol 2021; 196:e47-e49. [PMID: 34783371 DOI: 10.1111/bjh.17929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Carmel Waldron
- Department of Haematology, Trinity St James's Cancer Institute, Dublin, Ireland
| | - David O'Brien
- Flow Cytometry Laboratory, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Sarah Brophy
- John Durkan Leukaemia Laboratories, Institute of Molecular Medicine, Trinity St. James's Cancer Institute, Dublin, Ireland
| | - Kanthi Perera
- Department of Haematology, Midlands Regional Hospital, Tullamore, Ireland
| | - Gerard M Crotty
- Department of Haematology, Midlands Regional Hospital, Tullamore, Ireland
| | - Eoghan Dunlea
- Department of Haematology, Midlands Regional Hospital, Tullamore, Ireland
| | - Aileen Walsh
- Department of Haematology, Midlands Regional Hospital, Tullamore, Ireland
| | - Michelle Connolly
- Department of Haematology, Midlands Regional Hospital, Tullamore, Ireland
| | - Ruth Clifford
- Department of Haematology, University Hospital Limerick, Limerick, Ireland
| | - Hilary O'Leary
- Department of Haematology, University Hospital Limerick, Limerick, Ireland
| | - Ashique Khan
- Department of Haematology, University Hospital Limerick, Limerick, Ireland
| | - Greg Lee
- Department of Haematology, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Emer Atkinson
- Cancer Molecular Diagnostics Laboratory, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Giao Le
- Department of Haematology, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Alexander Gillett
- Department of Haematology, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Christopher L Bacon
- Department of Haematology, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Anthony M McElligott
- John Durkan Leukaemia Laboratories, Institute of Molecular Medicine, Trinity St. James's Cancer Institute, Dublin, Ireland
| | - Fiona Quinn
- Cancer Molecular Diagnostics Laboratory, Trinity St James's Cancer Institute, Dublin, Ireland
| | - Elisabeth Vandenberghe
- Department of Haematology, Trinity St James's Cancer Institute, Dublin, Ireland.,Cancer Molecular Diagnostics Laboratory, Trinity St James's Cancer Institute, Dublin, Ireland
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96
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Kapoor I, Bodo J, Hill BT, Almasan A. Cooperative miRNA-dependent PTEN regulation drives resistance to BTK inhibition in B-cell lymphoid malignancies. Cell Death Dis 2021; 12:1061. [PMID: 34750354 DOI: 10.1038/s41419-021-04353-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/13/2021] [Accepted: 10/18/2021] [Indexed: 01/12/2023]
Abstract
Aberrant microRNA (miR) expression plays an important role in pathogenesis of different types of cancers, including B-cell lymphoid malignancies and in the development of chemo-sensitivity or -resistance in chronic lymphocytic leukemia (CLL) as well as diffuse large B-cell lymphoma (DLBCL). Ibrutinib is a first-in class, oral, covalent Bruton's tyrosine kinase (BTK) inhibitor (BTKi) that has shown impressive clinical activity, yet many ibrutinib-treated patients relapse or develop resistance over time. We have reported that acquired resistance to ibrutinib is associated with downregulation of tumor suppressor protein PTEN and activation of the PI3K/AKT pathway. Yet how PTEN mediates chemoresistance in B-cell malignancies is not clear. We now show that the BTKi ibrutinib and a second-generation compound, acalabrutinib downregulate miRNAs located in the 14q32 miRNA cluster region, including miR-494, miR-495, and miR-543. BTKi-resistant CLL and DLBCL cells had striking overexpression of miR-494, miR-495, miR-543, and reduced PTEN expression, indicating further regulation of the PI3K/AKT/mTOR pathway in acquired BTKi resistance. Additionally, unlike ibrutinib-sensitive CLL patient samples, those with resistance to ibrutinib treatment, demonstrated upregulation of 14q32 cluster miRNAs, including miR-494, miR-495, and miR-543 and decreased pten mRNA expression. Luciferase reporter gene assay showed that miR-494 directly targeted and suppressed PTEN expression by recognizing two conserved binding sites in the PTEN 3'-UTR, and subsequently activated AKTSer473. Importantly, overexpression of a miR-494 mimic abrogated both PTEN mRNA and protein levels, further indicating regulation of apoptosis by PTEN/AKT/mTOR. Conversely, overexpression of a miR-494 inhibitor in BTKi-resistant cells restored PTEN mRNA and protein levels, thereby sensitizing cells to BTKi-induced apoptosis. Inhibition of miR-494 and miR-495 sensitized cells by cooperative targeting of pten, with additional miRNAs in the 14q32 cluster that target pten able to contribute to its regulation. Therefore, targeting 14q32 cluster miRNAs may have therapeutic value in acquired BTK-resistant patients via regulation of the PTEN/AKT/mTOR signaling axis.
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97
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Walker JS, Hing ZA, Sher S, Cronin J, Williams K, Harrington B, Skinner JN, Cempre CB, Gregory CT, Pan A, Yano M, Beaver LP, Walker BR, Labanowska JM, Heerema NA, Mrózek K, Woyach JA, Ruppert AS, Lehman A, Ozer HG, Coppola V, Yan P, Byrd JC, Blachly JS, Lapalombella R. Rare t(X;14)(q28;q32) translocation reveals link between MTCP1 and chronic lymphocytic leukemia. Nat Commun 2021; 12:6338. [PMID: 34732719 DOI: 10.1038/s41467-021-26400-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 09/21/2021] [Indexed: 11/27/2022] Open
Abstract
Rare, recurrent balanced translocations occur in a variety of cancers but are often not functionally interrogated. Balanced translocations with the immunoglobulin heavy chain locus (IGH; 14q32) in chronic lymphocytic leukemia (CLL) are infrequent but have led to the discovery of pathogenic genes including CCND1, BCL2, and BCL3. Following identification of a t(X;14)(q28;q32) translocation that placed the mature T cell proliferation 1 gene (MTCP1) adjacent to the immunoglobulin locus in a CLL patient, we hypothesized that this gene may have previously unrecognized importance. Indeed, here we report overexpression of human MTCP1 restricted to the B cell compartment in mice produces a clonal CD5+/CD19+ leukemia recapitulating the major characteristics of human CLL and demonstrates favorable response to therapeutic intervention with ibrutinib. We reinforce the importance of genetic interrogation of rare, recurrent balanced translocations to identify cancer driving genes via the story of MTCP1 as a contributor to CLL pathogenesis.
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98
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Wierda WG, Rawstron A, Cymbalista F, Badoux X, Rossi D, Brown JR, Egle A, Abello V, Cervera Ceballos E, Herishanu Y, Mulligan SP, Niemann CU, Diong CP, Soysal T, Suzuki R, Tran HTT, Wu SJ, Owen C, Stilgenbauer S, Ghia P, Hillmen P. Measurable residual disease in chronic lymphocytic leukemia: expert review and consensus recommendations. Leukemia 2021; 35:3059-3072. [PMID: 34168283 PMCID: PMC8550962 DOI: 10.1038/s41375-021-01241-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [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: 04/17/2020] [Revised: 03/17/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022]
Abstract
Assessment of measurable residual disease (often referred to as "minimal residual disease") has emerged as a highly sensitive indicator of disease burden during and at the end of treatment and has been correlated with time-to-event outcomes in chronic lymphocytic leukemia. Undetectable-measurable residual disease status at the end of treatment demonstrated independent prognostic significance in chronic lymphocytic leukemia, correlating with favorable progression-free and overall survival with chemoimmunotherapy. Given its utility in evaluating depth of response, determining measurable residual disease status is now a focus of outcomes in chronic lymphocytic leukemia clinical trials. Increased adoption of measurable residual disease assessment calls for standards for nomenclature and outcomes data reporting. In addition, many basic questions have not been systematically addressed. Here, we present the work of an international, multidisciplinary, 174-member panel convened to identify critical questions on key issues pertaining to measurable residual disease in chronic lymphocytic leukemia, review evaluable data, develop unified answers in conjunction with local expert input, and provide recommendations for future studies. Recommendations are presented regarding methodology for measurable residual disease determination, assay requirements and in which tissue to assess measurable residual disease, timing and frequency of assessment, use of measurable residual disease in clinical practice versus clinical trials, and the future usefulness of measurable residual disease assessment. Nomenclature is also proposed. Adoption of these recommendations will work toward standardizing data acquisition and interpretation in future studies with new treatments with the ultimate objective of improving outcomes and curing chronic lymphocytic leukemia.
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Affiliation(s)
| | | | - Florence Cymbalista
- Hôpital Avicenne, AP-HP, UMR Université Paris13/INSERM U978, Bobigny, France
| | | | - Davide Rossi
- Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Jennifer R Brown
- Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Alexander Egle
- Department of Internal Medicine III with Haematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Cancer Cluster Salzburg, Salzburg, Austria
| | | | | | - Yair Herishanu
- Tel-Aviv Sourasky Medical Center and Sackler Medical School, Tel Aviv, Israel
| | | | | | | | - Teoman Soysal
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | | | - Shang-Ju Wu
- National Taiwan University Hospital, Taipei, Taiwan
| | | | - Stephan Stilgenbauer
- Internal Medicine III, Ulm University, Ulm and Internal Medicine 1, Saarland University, Homburg, Germany
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
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99
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Arrato NA, Valentine TR, Byrd JC, Jones JA, Maddocks KJ, Woyach JA, Andersen BL. Illness representations and psychological outcomes in chronic lymphocytic leukaemia. Br J Health Psychol 2021; 27:553-570. [PMID: 34608724 DOI: 10.1111/bjhp.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Chronic lymphocytic leukaemia (CLL) is a lifelong cancer with subtle symptoms. Treatment is not curative and often involves repeated relapses and retreatments. Illness perceptions - cognitive and emotional representations of illness stimuli - were studied in CLL patients to: 1) identify illness perception 'profiles' prior to treatment; and 2) test whether profile membership predicts psychological responses 12 months later as treatment continued. DESIGN CLL patients (N = 259), randomized to one of four cancer treatment trials testing targeted therapy, were assessed before starting treatment and at 12 months. METHODS The Brief Illness Perception Questionnaire (BIPQ) assessed perceived consequences, timeline, personal/treatment control, identity, comprehension, concern, and emotions toward CLL. Psychological outcomes were depressive symptoms (PHQ-9/BDI-II), negative mood (POMS), and cancer stress (IES-R). Latent profile analysis (LPA) determined number of profiles and differential BIPQ items for each profile. Multilevel models tested profiles as predictors of 12-month psychological outcomes. RESULTS LPA selected the three-profile model, with profiles revealing Low (n = 150; 57.9%), Moderate (n = 21; 8.1%), and High-impact (n = 88; 34.0%) illness representations. Profiles were defined by differences in consequences, identity, concern, and emotions. Profile membership predicted all psychological outcomes (ps<.038). Low-impact profile patients endorsed minimal psychological symptoms; High-impact profile patients reported substantial symptoms. CONCLUSIONS Results of the first CLL illness representation study provide directions for future clinical efforts. By identifying differences among patients' perceptions of CLL consequences, symptom burden, concerns, and emotional responses, an at-risk patient group might receive tailored psychological treatment. Treatments may address negative perceptions, to reduce psychological risk associated with chronic cancer.
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Affiliation(s)
- Nicole A Arrato
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Thomas R Valentine
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - John C Byrd
- Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA
| | - Jeffrey A Jones
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Kami J Maddocks
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Jennifer A Woyach
- The Ohio State University Comprehensive Cancer Center, Columbus, Ohio, USA
| | - Barbara L Andersen
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
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100
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Manukyan G, Mikulkova Z, Turcsanyi P, Savara J, Trajerová M, Kubova Z, Papajik T, Kriegova E. Towards a Better Characterisation of Leukemic Cells in Chronic Lymphocytic Leukaemia: Cell-Size Heterogeneity Reflects Their Activation Status and Migratory Abilities. Cancers (Basel) 2021; 13:cancers13194922. [PMID: 34638404 PMCID: PMC8508598 DOI: 10.3390/cancers13194922] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/21/2021] [Accepted: 09/27/2021] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Chronic lymphocytic leukaemia (CLL) is a heterogeneous chronic disease characterised by the clonal expansion of mature CD19+CD23+CD5+ B-cells in blood, bone marrow and lymphoid tissue. Despite the CLL tumour cell population showing considerable heterogeneity in cell size, the functional characteristics of leukemic cells that differ in size have not been explored. The results of our study demonstrate that differences in CLL cell size reflect their activation state, polarisation and migratory capacity, with large CLL cells being more activated, polarised and motile than the small CLL cells present in the CLL cell pool. Our data provide evidence of the importance of cell-size heterogeneity within the CLL cell pool and the dynamics of cell-size changes for disease pathogenesis. Abstract Chronic lymphocytic leukaemia (CLL) is a genetically, morphologically and phenotypically heterogeneous chronic disease with clinical variability between patients. Whether the significant heterogeneity of cell size within the CLL population contributes to the heterogeneous features of this disease has not been investigated. The present study aimed to characterise the phenotypic and functional properties of two subpopulations of typical CLL cells that differ in cell size: small (s-CLL) and large (l-CLL) CLL cells delineated by forward scatter cytometry. The s-CLL cells were characterised by the CD5lowCXCR4hi phenotype, while the l-CLL cells were characterised by the CD5hiCXCR4dim phenotype and indicated a higher expression of CXCR3, CD20, CD38 and HLA-DR. The l-CLL cells displayed higher migration activity towards CXCL12, a tendency towards a higher proliferation rate and an increased capacity to produce IgM in the presence of CpG compared with s-CLL cells. When stimulated with CpG and CXCL12, l-CLL cells were characterised by a higher polarisation phenotype and motility than s-CLL cells. Our study revealed that the differences in CLL cell size reflected their activation status, polarisation and migratory abilities. Our data provide evidence of the importance of cell-size heterogeneity within a CLL pool and the dynamics of cell-size changes for disease pathogenesis, thus deserving further investigation.
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Affiliation(s)
- Gayane Manukyan
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
- Laboratory of Molecular and Cellular Immunology, Institute of Molecular Biology NAS RA, Yerevan 0014, Armenia
| | - Zuzana Mikulkova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
| | - Peter Turcsanyi
- Department of Hematology-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (P.T.); (Z.K.); (T.P.)
| | - Jakub Savara
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
- Department of Computer Science, Faculty of Electrical Engineering and Computer Science, VSB-Technical University of Ostrava, 70800 Ostrava, Czech Republic
| | - Markéta Trajerová
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
| | - Zuzana Kubova
- Department of Hematology-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (P.T.); (Z.K.); (T.P.)
| | - Tomas Papajik
- Department of Hematology-Oncology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (P.T.); (Z.K.); (T.P.)
| | - Eva Kriegova
- Department of Immunology, Faculty of Medicine and Dentistry, Palacký University and University Hospital, 77900 Olomouc, Czech Republic; (G.M.); (Z.M.); (J.S.); (M.T.)
- Correspondence:
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