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Paietta E, Neuberg D, Bennett JM, Dewald G, Rowe JM, Cassileth PA, Cripe L, Tallman MS, Wiernik PH. Low expression of the myeloid differentiation antigen CD65s, a feature of poorly differentiated AML in older adults: study of 711 patients enrolled in ECOG trials. Leukemia 2003; 17:1544-50. [PMID: 12886241 DOI: 10.1038/sj.leu.2402999] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CD65s appears when the progenitor antigen CD34 disappears, suggesting that this sialylated carbohydrate antigen marks a turning point in normal myeloid differentiation. We characterized acute myeloid leukemia (AML) with low CD65s expression (CD65s(low) AML) in 711 patients entered on seven Eastern Cooperative Oncology Group AML treatment trials (1986-1999). Of those, 198 (28%) qualified as having CD65s(low) AML. Morphologically, CD65s(low) AML was more common in FAB subgroups with minimal differentiation, M0/M1 (P=<0.0001). Early precursor antigens CD34, CD117 and terminal transferase were more frequent in CD65s(low) than CD65s(high) AML (P=<0.0001). Myeloperoxidase was present in fewer CD65s(low) myeloblasts, and the more mature myeloid antigens, CD15 and CD11b, were rarely detected (P=<0.0001). Yet, the two diagnoses did not differ in the distribution of cytogenetic prognostic groups or the occurrence of the multidrug-resistance mediator, P-glycoprotein. CD65s(low) AML patients were significantly older than CD65s(high) cases (P<0.0001). Furthermore, the incidence of CD65s(low) cases increased with age, from 20% in patients under the age of 50 years to 67% in patients older than 80 years (P<0.0001). Overall, complete remission (CR) rate and overall survival were comparable in CD65s(low) and CD65s(high) AML. However, among patients >55 years of age, CD65s(low) AML had a decreased CR rate of 33 vs 44% in CD65s(high) AML (P=0.055). Thus, CD65s(low) AML represents immunophenotypically undifferentiated disease and occurs predominantly in older adults. Although not statistically significant, the observed association between low CD65s expression and decreased CR rate only in patients over the age of 55 is intriguing.
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Hasle H, Niemeyer CM, Chessells JM, Baumann I, Bennett JM, Kerndrup G, Head DR. A pediatric approach to the WHO classification of myelodysplastic and myeloproliferative diseases. Leukemia 2003; 17:277-82. [PMID: 12592323 DOI: 10.1038/sj.leu.2402765] [Citation(s) in RCA: 255] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2002] [Accepted: 08/07/2002] [Indexed: 11/08/2022]
Abstract
Myelodysplastic and myeloproliferative disorders are rare in childhood and there is no widely accepted system for their diagnosis and classification. We propose minimal diagnostic criteria and a simple classification scheme which, while based on accepted morphological features and conforming with the recent suggestions of the WHO, allows for the special problems of myelodysplastic diseases in children. The classification recognizes three major diagnostic groups: (1) juvenile myelomonocytic leukemia (JMML), previously named chronic myelomonocytic leukemia (CMML) or juvenile chronic myeloid leukemia (JCML); (2) myeloid leukemia of Down syndrome, a disease with distinct clinical and biological features, encompassing both MDS and AML occurring in Down syndrome; and (3) MDS occurring both de novo and as a complication of previous therapy or pre-existing bone marrow disorder (secondary MDS). The main subtypes of MDS are refractory cytopenia (RC) and refractory anemia with excess of blasts (RAEB). It is suggested retaining the subtype of RAEB-T with 20-30% blasts in the marrow until more data are available. Cytogenetics and serial assessments of the patients are essential adjuncts to morphology both in diagnosis and classification.
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Larson RA, Boogaerts M, Estey E, Karanes C, Stadtmauer EA, Sievers EL, Mineur P, Bennett JM, Berger MS, Eten CB, Munteanu M, Loken MR, Van Dongen JJM, Bernstein ID, Appelbaum FR. Antibody-targeted chemotherapy of older patients with acute myeloid leukemia in first relapse using Mylotarg (gemtuzumab ozogamicin). Leukemia 2002; 16:1627-36. [PMID: 12200674 DOI: 10.1038/sj.leu.2402677] [Citation(s) in RCA: 180] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2002] [Accepted: 05/30/2002] [Indexed: 11/08/2022]
Abstract
We analyzed the safety and efficacy of Mylotarg (gemtuzumab ozogamicin, an antibody-targeted chemotherapy consisting of a humanized anti-CD33 antibody linked to calicheamicin, a potent antitumor antibiotic) in the treatment of 101 patients > or =60 years of age with acute myeloid leukemia (AML) in untreated first relapse in three open-label trials. Mylotarg is administered as a 2-h intravenous infusion at 9 mg/m(2) for two doses with 14 days between doses. The overall remission rate was 28%, with complete remission (CR) in 13% of patients and complete remission with incomplete platelet recovery (CRp) in 15%. Median survival was 5.4 months for all patients and 14.5 months and 11.8 months for patients achieving CR and CRp, respectively. CD33 antigen is present on normal hematopoietic progenitor cells; thus, an expected high incidence of grade 3 or 4 neutropenia (99%) and thrombocytopenia (99%) was observed. The incidences of grade 3 or 4 elevations of bilirubin and hepatic transaminases were 24% and 15%, respectively. There was a low incidence of grade 3 or 4 mucositis (4%) and infections (27%) and no treatment-related cardiotoxicity, cerebellar toxicity, or alopecia. Mylotarg is an effective treatment for older patients with CD33-positive AML in first relapse and has acceptable toxicity.
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MESH Headings
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Aminoglycosides
- Anti-Bacterial Agents/therapeutic use
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Disease-Free Survival
- Female
- Gemtuzumab
- Humans
- Immunotoxins/therapeutic use
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/mortality
- Leukemia, Myeloid/pathology
- Male
- Middle Aged
- Monitoring, Physiologic
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Sialic Acid Binding Ig-like Lectin 3
- Survival Rate
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Hill PC, Hicking J, Bennett JM, Mohammed A, Stewart JM, Simmons G. Geographically separate outbreaks of shigellosis in Auckland, New Zealand, linked by molecular subtyping to cases returning from Samoa. THE NEW ZEALAND MEDICAL JOURNAL 2002; 115:281-3. [PMID: 12199002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
AIM To investigate simultaneous outbreaks of Shigella sonnei gastroenteritis occurring in February 2001 at a health camp for socially deprived children and an elderly care facility. METHODS Those with symptoms were interviewed using a standardised questionnaire. Cases were defined as having at least three loose stools over a 24 hour period and stool samples requested. A case-control study investigating routes of transmission was performed at the health camp. Environmental investigations of food safety and hygiene were conducted at each facility. RESULTS At the camp, 15 (37%) students and 15 (28%) staff met case criteria. Contact with human faeces (OR 4.0; 95% confidence interval 1.0-16.3; p = 0.05) and, for staff, eating camp food (OR 6.9; 1.0-5.0; p = 0.06) were shown to be independent risk factors for illness. At the elderly care facility, four (19%) residents and four (25%) staff met case criteria. Molecular subtyping confirmed that the outbreaks were related to each other and to other cases in travellers returning from Samoa to Auckland and other New Zealand cities over a four month period. CONCLUSION Molecular subtyping is of considerable use in communicable disease investigation, providing strong evidence for links between outbreaks. With expanded technological capability, New Zealand could perform routine molecular subtyping of selected organisms to improve the detection and the investigation of regional and inter-regional outbreaks of infection.
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30
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Bennett JM. Observation and measurement of surface relief of diffraction gratings using electron microscopy techniques. ACTA ACUST UNITED AC 2002. [DOI: 10.1088/0022-3735/2/9/420] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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31
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Liang J, Krause NM, Bennett JM. Social exchange and well-being: is giving better than receiving? Psychol Aging 2002. [PMID: 11554527 DOI: 10.1037//0882-7974.16.3.511] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This research examined the effects of giving and receiving assistance on psychological well-being while taking into account other salient dimensions of social support including negative interaction and anticipated support. Structural equation models were evaluated by using data derived from a national probability sample of 1,103 individuals aged 65 years or older. Results indicate that the major dimensions of social support are significantly interrelated, not only directly but also indirectly. Giving and receiving support have both positive and negative consequences on well-being. With reference to the role of reciprocity, the evidence provides some support for the hypothesis of esteem enhancement instead of social exchange and equity theories.
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Abstract
The burden of cancer is felt disproportionately among the elderly with the majority of cancers occurring in adults over the age of 65. Dr. Bennett briefly examines the implications of this fact, and acknowledges the growing evidence that clinicians are ill equipped to handle the complex management issues of their elderly patients. CA will continue this series on geriatric oncology in future issues.
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Cheson BD, Bennett JM, Kantarjian H, Schiffer CA, Nimer SD, Löwenberg B, Stone RM, Mittelman M, Sanz GF, Wijermans PW, Greenberg PL. Myelodysplastic syndromes standardized response criteria: further definition. Blood 2001; 98:1985. [PMID: 11535540 DOI: 10.1182/blood.v98.6.1985] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
This research examined the effects of giving and receiving assistance on psychological well-being while taking into account other salient dimensions of social support including negative interaction and anticipated support. Structural equation models were evaluated by using data derived from a national probability sample of 1,103 individuals aged 65 years or older. Results indicate that the major dimensions of social support are significantly interrelated, not only directly but also indirectly. Giving and receiving support have both positive and negative consequences on well-being. With reference to the role of reciprocity, the evidence provides some support for the hypothesis of esteem enhancement instead of social exchange and equity theories.
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35
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Linenberger ML, Hong T, Flowers D, Sievers EL, Gooley TA, Bennett JM, Berger MS, Leopold LH, Appelbaum FR, Bernstein ID. Multidrug-resistance phenotype and clinical responses to gemtuzumab ozogamicin. Blood 2001; 98:988-94. [PMID: 11493443 DOI: 10.1182/blood.v98.4.988] [Citation(s) in RCA: 146] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Expression of multidrug resistance (MDR) features by acute myeloid leukemia (AML) cells predicts a poor response to many treatments. The MDR phenotype often correlates with expression of P-glycoprotein (Pgp), and Pgp antagonists such as cyclosporine (CSA) have been used as chemosensitizing agents in AML. Gemtuzumab ozogamicin, an immunoconjugate of an anti-CD33 antibody linked to calicheamicin, is effective monotherapy for CD33(+) relapsed AML. However, the contribution of Pgp to gemtuzumab ozogamicin resistance is poorly defined. In this study, blast cell samples from relapsed AML patients eligible for gemtuzumab ozogamicin clinical trials were assayed for Pgp surface expression and Pgp function using a dye efflux assay. In most cases, surface expression of Pgp correlated with Pgp function, as indicated by elevated dye efflux that was inhibited by CSA. Among samples from patients who either failed to clear marrow blasts or failed to achieve remission, 72% or 52%, respectively, exhibited CSA-sensitive dye efflux compared with 29% (P =.003) or 24% (P <.001) among samples from responders. In vitro gemtuzumab ozogamicin--induced apoptosis was also evaluated using an annexin V--based assay. Low levels of drug-induced apoptosis were associated with CSA-sensitive dye efflux, whereas higher levels correlated strongly with achievement of remission and marrow blast clearance. In vitro drug-induced apoptosis could be increased by CSA in 14 (29%) of 49 samples exhibiting low apoptosis in the absence of CSA. Together, these findings indicate that Pgp plays a role in clinical resistance to gemtuzumab ozogamicin and suggest that treatment trials combining gemtuzumab ozogamicin with MDR reversal agents are warranted. (Blood. 2001;98:988-994)
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MESH Headings
- ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism
- ATP Binding Cassette Transporter, Subfamily B, Member 1/physiology
- Acute Disease
- Aminoglycosides
- Anti-Bacterial Agents/pharmacology
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal, Humanized
- Apoptosis/drug effects
- Bone Marrow/pathology
- Carbocyanines/pharmacokinetics
- Clinical Trials, Phase II as Topic
- Cyclosporine/pharmacology
- Drug Resistance, Multiple/genetics
- Drug Resistance, Multiple/immunology
- Drug Synergism
- Fluorescent Dyes
- Gemtuzumab
- Humans
- Immunotoxins/pharmacology
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/pathology
- Leukocytes, Mononuclear/pathology
- Phenotype
- Regression Analysis
- Remission Induction
- Treatment Outcome
- Tumor Cells, Cultured/drug effects
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36
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Valent P, Horny HP, Escribano L, Longley BJ, Li CY, Schwartz LB, Marone G, Nuñez R, Akin C, Sotlar K, Sperr WR, Wolff K, Brunning RD, Parwaresch RM, Austen KF, Lennert K, Metcalfe DD, Vardiman JW, Bennett JM. Diagnostic criteria and classification of mastocytosis: a consensus proposal. Leuk Res 2001; 25:603-25. [PMID: 11377686 DOI: 10.1016/s0145-2126(01)00038-8] [Citation(s) in RCA: 764] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The term 'mastocytosis' denotes a heterogeneous group of disorders characterized by abnormal growth and accumulation of mast cells (MC) in one or more organ systems. Over the last 20 years, there has been an evolution in accepted classification systems for this disease. In light of such developments and novel useful markers, it seems appropriate now to re-evaluate and update the classification of mastocytosis. Here, we propose criteria to delineate categories of mastocytosis together with an updated consensus classification system. In this proposal, the diagnosis cutaneous mastocytosis (CM) is based on typical clinical and histological skin lesions and absence of definitive signs (criteria) of systemic involvement. Most patients with CM are children and present with maculopapular cutaneous mastocytosis (=urticaria pigmentosa, UP). Other less frequent forms of CM are diffuse cutaneous mastocytosis (DCM) and mastocytoma of skin. Systemic mastocytosis (SM) is commonly seen in adults and defined by multifocal histological lesions in the bone marrow (affected almost invariably) or other extracutaneous organs (major criteria) together with cytological and biochemical signs (minor criteria) of systemic disease (SM-criteria). SM is further divided into the following categories: indolent systemic mastocytosis (ISM), SM with an associated clonal hematologic non-mast cell lineage disease (AHNMD), aggressive systemic mastocytosis (ASM), and mast cell leukemia (MCL). Patients with ISM usually have maculopapular skin lesions and a good prognosis. In the group with associated hematologic disease, the AHNMD should be classified according to FAB/WHO criteria. ASM is characterized by impaired organ-function due to infiltration of the bone marrow, liver, spleen, GI-tract, or skeletal system, by pathologic MC. MCL is a 'high-grade' leukemic disease defined by increased numbers of MC in bone marrow smears (>or=20%) and peripheral blood, absence of skin lesions, multiorgan failure, and a short survival. In typical cases, circulating MC amount to >or=10% of leukocytes (classical form of MCL). Mast cell sarcoma is a unifocal tumor that consists of atypical MC and shows a destructive growth without (primary) systemic involvement. This high-grade malignant MC disease has to be distinguished from a localized benign mastocytoma in either extracutaneous organs (=extracutaneous mastocytoma) or skin. Depending on the clinical course of mastocytosis and development of an AHNMD, patients can shift from one category of MC disease into another. In all categories, mediator-related symptoms may occur and may represent a serious clinical problem. All categories of mastocytosis should be distinctively separated from reactive MC hyperplasia, MC activation syndromes, and a more or less pronounced increase in MC in myelogenous malignancies other than mastocytosis. Criteria proposed in this article should be helpful in this regard.
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37
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38
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Sievers EL, Larson RA, Stadtmauer EA, Estey E, Löwenberg B, Dombret H, Karanes C, Theobald M, Bennett JM, Sherman ML, Berger MS, Eten CB, Loken MR, van Dongen JJ, Bernstein ID, Appelbaum FR. Efficacy and safety of gemtuzumab ozogamicin in patients with CD33-positive acute myeloid leukemia in first relapse. J Clin Oncol 2001; 19:3244-54. [PMID: 11432892 DOI: 10.1200/jco.2001.19.13.3244] [Citation(s) in RCA: 605] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Three open-label, multicenter trials were conducted to evaluate the efficacy and safety of single-agent Mylotarg (gemtuzumab ozogamicin; CMA-676; Wyeth Laboratories, Philadelphia, PA), an antibody-targeted chemotherapy agent, in patients with CD33-positive acute myeloid leukemia (AML) in untreated first relapse. PATIENTS AND METHODS The study population comprised 142 patients with AML in first relapse with no history of an antecedent hematologic disorder and a median age of 61 years. All patients received Mylotarg as a 2-hour intravenous infusion, at a dose of 9 mg/m(2), at 2-week intervals for two doses. Patients were evaluated for remission, survival, and treatment-emergent adverse events. RESULTS Thirty percent of patients treated with Mylotarg obtained remission as characterized by 5% or less blasts in the marrow, recovery of neutrophils to at least 1,500/microL, and RBC and platelet transfusion independence. Although patients treated with Mylotarg had relatively high incidences of myelosuppression, grade 3 or 4 hyperbilirubinemia (23%), and elevated hepatic transaminase levels (17%), the incidences of grade 3 or 4 mucositis (4%) and infections (28%) were relatively low. There was a low incidence of severe nausea and vomiting (11%) and no treatment-related cardiotoxicity, cerebellar toxicity, or alopecia. Many patients received Mylotarg on an outpatient basis (38% and 41% of patients for the first and second doses, respectively). Among the 142 patients, the median total duration of hospitalization was 24 days; 16% of patients required 7 days of hospitalization or less. CONCLUSION Administration of the antibody-targeted chemotherapy agent Mylotarg to patients with CD33-positive AML in first relapse induces complete remissions with what appears to be a favorable safety profile.
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MESH Headings
- Acute Disease
- Adult
- Aged
- Aged, 80 and over
- Aminoglycosides
- Anti-Bacterial Agents/adverse effects
- Anti-Bacterial Agents/pharmacology
- Anti-Bacterial Agents/therapeutic use
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Disease-Free Survival
- Europe/epidemiology
- Female
- Gemtuzumab
- Humans
- Immunotoxins/adverse effects
- Immunotoxins/pharmacology
- Immunotoxins/therapeutic use
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/drug therapy
- Leukemia, Myeloid/mortality
- Male
- Middle Aged
- Multivariate Analysis
- North America/epidemiology
- Prognosis
- Recurrence
- Sialic Acid Binding Ig-like Lectin 3
- Survival Rate
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39
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Valent P, Sperr WR, Samorapoompichit P, Geissler K, Lechner K, Horny HP, Bennett JM. Myelomastocytic overlap syndromes: biology, criteria, and relationship to mastocytosis. Leuk Res 2001; 25:595-602. [PMID: 11377685 DOI: 10.1016/s0145-2126(01)00040-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Although mast cells (MC) appear to be myeloid cells, MC lineage involvement in myelogenous malignancies has been described only rarely. Based on clonal evolution, biology of afflicted cells, and disease criteria, three major groups of patients have been recognized: The first meets criteria for both diagnoses 'systemic mastocytosis' and 'associated hematologic clonal non-mast cell lineage disease (AHNMD)'. In such patients, myeloproliferative (MPS) or myelodysplastic syndromes (MDS), or acute myeloid leukemia (AML) is diagnosed apart from mastocytosis. In a second group of patients, large numbers of very immature MC-lineage cells (metachromatically granulated blast-like cells) are detectable, but the criteria to diagnose mastocytosis are not met. These patients have advanced myeloid neoplasms (MDS or MPS with blast cell increase, or AML) and variably suffer from mediator-related symptoms (flush, GI-tract ulcer, diarrhoea, coagulopathy). In some cases, the disease mimics mast cell- or basophilic leukemia. In contrast to basophilic leukemia, however, the metachromatic cells are strongly KIT+ and tryptase+. In contrast to true mast cell leukemia (MCL), MC do not form multifocal dense infiltrates in the bone marrow. Also, MC lack CD2 and CD25, and the C-KIT mutation Asp-816-Val. We propose the term 'myelomastocytic leukemia' or 'myelodysplastic mast cell syndrome' for these cases. In a third group of patients, myeloid neoplasms (MDS, MPS, AML) show constitutive expression of MC-associated antigens (tryptase, histamine) or mastocytosis-related gene defects (mutated C-KIT) without significant increase in metachromatic cells or criteria of mastocytosis. Whether these neoplasms display aberrant gene expression (or gene defects) or represent 'pre-pre-mast cell leukemias', remains unknown.
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MESH Headings
- Antigens, Differentiation/analysis
- Biomarkers
- Bone Marrow/pathology
- Cell Lineage
- Diagnosis, Differential
- Humans
- Inflammation Mediators/physiology
- Leukemia, Basophilic, Acute/classification
- Leukemia, Basophilic, Acute/diagnosis
- Leukemia, Basophilic, Acute/metabolism
- Leukemia, Basophilic, Acute/pathology
- Leukemia, Mast-Cell/classification
- Leukemia, Mast-Cell/diagnosis
- Leukemia, Mast-Cell/metabolism
- Leukemia, Mast-Cell/pathology
- Leukemia, Myeloid/classification
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/metabolism
- Leukemia, Myeloid/pathology
- Mast Cells/pathology
- Mastocytosis/classification
- Mastocytosis/diagnosis
- Mastocytosis/metabolism
- Mastocytosis/pathology
- Mutation
- Myelodysplastic Syndromes/classification
- Myelodysplastic Syndromes/diagnosis
- Myelodysplastic Syndromes/metabolism
- Myelodysplastic Syndromes/pathology
- Myeloproliferative Disorders/classification
- Myeloproliferative Disorders/diagnosis
- Myeloproliferative Disorders/metabolism
- Myeloproliferative Disorders/pathology
- Proto-Oncogene Proteins c-kit/analysis
- Proto-Oncogene Proteins c-kit/genetics
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Woodward TL, Mienaltowski AS, Modi RR, Bennett JM, Haslam SZ. Fibronectin and the alpha(5)beta(1) integrin are under developmental and ovarian steroid regulation in the normal mouse mammary gland. Endocrinology 2001; 142:3214-22. [PMID: 11416044 DOI: 10.1210/endo.142.7.8273] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Extracellular matrix (ECM) proteins have been shown to regulate mammary epithelial cell proliferation, differentiation, and apoptosis in vitro. However, little is known about the hormonal regulation and functional role of ECM proteins and integrins during mammary gland development in vivo. We examined the temporal and spatial localization and hormone regulation of collagen I, collagen IV, laminin, and fibronectin. Among these ECM proteins only fibronectin changed appreciably. Fibronectin levels increased 3-fold between the onset of puberty and sexual maturity, remaining high during pregnancy and lactation. This increase occurred specifically in the epithelial basement membrane. Fibronectin was decreased 70% by ovariectomy and increased 1.5- and 2-fold by estrogen or estrogen plus progesterone treatment, respectively. The fibronectin-specific integrin, alpha(5)beta(1), was localized in myoepithelial cells; it increased 2.2-fold between puberty and sexual maturity and decreased in late pregnancy and lactation. The basal localization of alpha(5)beta(1) was notably increased in pubertal and adult virgin mice. alpha(5)beta(1) concentrations decreased 40-50% after ovariectomy in pubertal and adult mice, which was reversed by estrogen plus progesterone treatment in adult mice. The high basal expression of alpha(5)beta(1) during active proliferation and the low expression in nonproliferating and lactating glands indicate that fibronectin signaling may be required for hormone-dependent proliferation in the mammary gland.
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Hadaway JB, Ahmad A, Pezzaniti JL, Chipman RA, Wilkes DR, Hummer LL, Crandall DG, Bennett JM. Real-time total integrated scattering measurements on the Mir spacecraft to evaluate sample degradation in space. APPLIED OPTICS 2001; 40:2755-2768. [PMID: 18357293 DOI: 10.1364/ao.40.002755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
An instrument to measure total integrated scattering (TIS) in space was built as part of the Optical Properties Monitor instrument package and flown on the Russian Mir Space Station in a low Earth orbit. TIS at two wavelengths was measured in space at approximately weekly intervals from 29 April to 26 December 1997 and telemetered to Earth during the mission. Of the 20 TIS samples, 13 are described here to illustrate the performance of the TIS instrument. These include ten optical samples and three thermal control samples. Two optical samples and one thermal control sample were severely degraded by atomic oxygen. All samples received a light dusting of particles during the mission and an additional heavier layer after the samples returned to Earth. The initial brassboard instrument and the validation tests of the flight instrument are also described.
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42
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Widell S, Hast R, Cox C, Auer G, Bennett JM. DNA content of granulocytes, monocytes, and lymphocytes in the bone marrow smears of patients with myelodysplastic syndromes. Am J Hematol 2001; 67:112-8. [PMID: 11343383 DOI: 10.1002/ajh.1088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Recently, we have reported a high incidence of DNA hypodiploidy defined as DNA index (DI) in blasts/promyelocytes from 39 patients with myelodysplastic syndromes (MDS) found to be without a relationship to cytogenetics. In the present study the DNA content (DI) in granulocytes, monocytes, and lymphocytes measured in the same bone marrow smears from the above patients are reported. DNA hypodiploidy was found in mature cells, not only in myeloid cells (granulocytes and monocytes) but also in lymphocytes. A lower mean DI in each cell type of patients compared to controls was found. Pairwise comparison of the mean DI (+/-SE) in 32 patients with normal (n = 22) and abnormal (n = 10) cytogenetics and controls (n = 8) showed a significantly (P < 0.01) lower value for each group of patients, respectively, in all cell types. No difference was found between the two groups of patients. Presence of weak-Feulgen stained nuclei (DI < 0.40) in granulocytes and monocytes was more pronounced in patients expressing DNA hypodiploid immature cell populations, but only occasionally in lymphocytes, suggesting a link to an apoptotic event and intramedullary cell death. DNA hypodiploidy is shown to be a common feature even in mature cell populations in MDS bone marrows. Clonality, by means of DNA content, appears reasonable as regards the granulocytes and monocytes. DNA hypodiploid lymphocytes, on the other hand, might be small blasts (stem cells) or dying cell populations of unknown origin.
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43
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Raafat AM, Li S, Bennett JM, Hofseth LJ, Haslam SZ. Estrogen and estrogen plus progestin act directly on the mammary gland to increase proliferation in a postmenopausal mouse model. J Cell Physiol 2001; 187:81-9. [PMID: 11241352 DOI: 10.1002/1097-4652(2001)9999:9999<::aid-jcp1056>3.0.co;2-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Hormone replacement therapy (HRT) with ovarian hormones is an important therapeutic modality for postmenopausal women. However, a negative side effect of HRT is an increased risk of breast cancer. Surgical induction of menopause by ovariectomy (OVX) in mice is an experimental model that may provide insights into the effects of hormone replacement therapy on the human breast. We have developed a mouse model of early and late postmenopausal states to investigate the effects of HRT on the normal mammary gland. The purpose of this study was to determine if HRT-induced proliferation was due to the direct action of the hormones on the mammary gland, or mediated systemically by hormones or growth factors produced elsewhere in the body. Estrogen (E) or E plus the synthetic progestin, R5020, were implanted directly into the mammary glands of early (1 week post OVX) and late (5 week post OVX) postmenopausal mice instead of administration by injection. We report that responses of early and late postmenopausal mice to implanted hormones were the same as those observed previously with systemically administered hormones. Implanted E conferred an enhanced proliferative response in the late postmenopausal gland characterized morphologically by enlarged duct ends. E+R5020 implants induced similar degrees of cell proliferation in both postmenopausal states but the morphological responses differed. Ductal sidebranching was observed in early postmenopausal mice, whereas duct end enlargement was observed in late postmenopausal mice. The differences in morphological response to E+R5020 in 5 week post OVX were associated with an inability of E to induce progesterone receptors (PR) in the late postmenopausal gland. The responses of the late postmenopausal glands to E and E+P were very similar to that observed previously in immature pubertal glands in ovary-intact mice. In pubertal mice, PR cannot be induced by E unless the mammary gland is pre-treated with EGF-containing implants. Similarly, herein pre-treatment of the late postmenopausal mammary gland with EGF-containing implants restored PR induction by E. Thus, EGF may determine the sensitivity of the mammary gland to E and E+P in late postmenopause and at puberty.
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44
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Phipps RP, Pollock SJ, Kaur K, Kaufman J, Borrello MA, Graf BA, Nazarenko D, Roberts LJ, Morrow JD, Palis J, Ryan DJ, Bennett JM. Expression of cyclooxygenase-2 and prostaglandins by B-1 cells and B-CLL cells. Curr Top Microbiol Immunol 2001; 252:293-300. [PMID: 11187084 DOI: 10.1007/978-3-642-57284-5_30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
MESH Headings
- Animals
- Antibodies, Anti-Idiotypic/pharmacology
- B-Lymphocyte Subsets/enzymology
- B-Lymphocyte Subsets/metabolism
- B-Lymphocyte Subsets/pathology
- CD40 Ligand/immunology
- Cell Differentiation
- Cyclooxygenase 1
- Cyclooxygenase 2
- Dinoprostone/biosynthesis
- Dinoprostone/genetics
- Enzyme Induction
- Gene Expression Regulation, Leukemic
- Humans
- Inflammation/enzymology
- Inflammation/metabolism
- Inflammation/pathology
- Interferon-gamma/pharmacology
- Isoenzymes/biosynthesis
- Isoenzymes/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/enzymology
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lipopolysaccharides/pharmacology
- Lymphocyte Activation/drug effects
- Macrophages/immunology
- Macrophages/pathology
- Membrane Proteins
- Mice
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Neoplastic Stem Cells/enzymology
- Neoplastic Stem Cells/metabolism
- Prostaglandin-Endoperoxide Synthases/biosynthesis
- Prostaglandin-Endoperoxide Synthases/genetics
- Prostaglandins/biosynthesis
- Prostaglandins/genetics
- RNA, Messenger/biosynthesis
- Th2 Cells/immunology
- Tumor Cells, Cultured/metabolism
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45
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Paietta E, Neuberg D, Richards S, Bennett JM, Han L, Racevskis J, Dewald G, Rowe JM, Wiernik PH. Rare adult acute lymphocytic leukemia with CD56 expression in the ECOG experience shows unexpected phenotypic and genotypic heterogeneity. Am J Hematol 2001; 66:189-96. [PMID: 11279625 DOI: 10.1002/1096-8652(200103)66:3<189::aid-ajh1043>3.0.co;2-a] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Expression of CD56, a marker of natural killer (NK) cells, in acute lymphocytic leukemia (ALL) is rare and, to date, has been described only in non-B lineage ALL. Among 194 patients with CD56 analysis on the ongoing Eastern Cooperative Oncology Group (ECOG) ALL trial, E2993, 6 cases of CD56+ ALL were found (3.1%) with a median of 95% of blast cells expressing CD56, compared with a median of 1% of blast cells in CD56- ALL (P = 0.0001). FAB-L2 characteristics dominated, without granulation. Blast cells from four CD56+ patients expressed T-cell antigens at variable levels of maturation. A clonal rearrangement of the T-cell receptor beta (TCRbeta) gene was detected only in one patient. TCRbeta variable gene usage studies in this and one other CD56+ ALL patient demonstrated a significantly perturbed usage pattern in both patients when compared with control lymphocytes. The two remaining cases typed as early pre-B ALL (CD19+, CD10+), with one case co-expressing CD7. Cytogenetically, 4 patients were normal, 1 complex abnormal, and 1 Philadelphia chromosome positive. Epstein-Barr virus (EBV) sequences were detected in one T- and both B-lymphoid cases. Our data suggest that CD56 is expressed at a precursor stage common to the T- and the B-cell lineage.
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46
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Bennett JM, Campbell AD, Campbell AJ, Carr MG, Dunsdon RM, Greening JR, Hurst DN, Jennings NS, Jones PS, Jordan S, Kay PB, O'Brien MA, King-Underwood J, Raynham TM, Wilkinson CS, Wilkinson TC, Wilson FX. The identification of alpha-ketoamides as potent inhibitors of hepatitis C virus NS3-4A proteinase. Bioorg Med Chem Lett 2001; 11:355-7. [PMID: 11212109 DOI: 10.1016/s0960-894x(00)00654-5] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Peptides based upon the non-prime side residues of the NS4A-4B cleavage site of hepatitis C virus (HCV) NS3-4A proteinase containing an alpha-ketoamide moiety in place of the scissile amide bond are potent inhibitors of this enzyme.
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47
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Bennett JM, Young MS, Liesveld JL, Paietta E, Miller KB, Lazarus HM, Marsh RD, Friedenberg WR, Saba HT, Hayes FA, Dewald GW, Hiddemann W, Rowe JM. Phase II study of combination human recombinant GM-CSF with intermediate-dose cytarabine and mitoxantrone chemotherapy in patients with high-risk myelodysplastic syndromes (RAEB, RAEBT, and CMML): an Eastern Cooperative Oncology Group Study. Am J Hematol 2001; 66:23-7. [PMID: 11426487 DOI: 10.1002/1096-8652(200101)66:1<23::aid-ajh1002>3.0.co;2-b] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A Phase II study of GM-CSF with intermediate-dose cytarabine and mitoxantrone was conducted in patients with high-risk myelodysplastic syndrome. It was designed to evaluate if priming with growth factor could increase the efficiency of chemotherapy. In this older population only two of 10 patients achieved a bone marrow CR, including one patient whose leukemic blasts had an "S" phase increase of 2.55x at 48 hr. Unexpected hepatotoxicity was noted. This regimen cannot be recommended for this elderly population of patients.
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MESH Headings
- Aged
- Anemia, Refractory, with Excess of Blasts/drug therapy
- Anemia, Refractory, with Excess of Blasts/mortality
- Anemia, Refractory, with Excess of Blasts/pathology
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow/pathology
- Chemical and Drug Induced Liver Injury/etiology
- Cytarabine/administration & dosage
- Cytarabine/adverse effects
- DNA Replication/drug effects
- Female
- Granulocyte-Macrophage Colony-Stimulating Factor/pharmacology
- Granulocyte-Macrophage Colony-Stimulating Factor/therapeutic use
- Humans
- Hyperbilirubinemia/chemically induced
- Leukemia, Myelomonocytic, Chronic/drug therapy
- Leukemia, Myelomonocytic, Chronic/mortality
- Leukemia, Myelomonocytic, Chronic/pathology
- Male
- Middle Aged
- Mitoxantrone/administration & dosage
- Mitoxantrone/adverse effects
- Myelodysplastic Syndromes/drug therapy
- Myelodysplastic Syndromes/mortality
- Myelodysplastic Syndromes/pathology
- Pancytopenia/chemically induced
- Pancytopenia/drug therapy
- Pilot Projects
- Recombinant Proteins
- Remission Induction
- S Phase/drug effects
- Treatment Failure
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48
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Douer D, Estey E, Santillana S, Bennett JM, Lopez-Bernstein G, Boehm K, Williams T. Treatment of newly diagnosed and relapsed acute promyelocytic leukemia with intravenous liposomal all-trans retinoic acid. Blood 2001; 97:73-80. [PMID: 11133744 DOI: 10.1182/blood.v97.1.73] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel intravenous liposomal formulation of all-trans retinoic acid (ATRA) was evaluated in 69 patients with acute promyelocytic leukemia (APL): 32 new diagnoses, 35 relapses, and 2 oral ATRA failures. Liposomal ATRA (90 mg/m(2)) was administered every other day until complete remission (CR) or a maximum of 56 days. Treatment following CR was liposomal ATRA with or without chemotherapy. In an intent-to-treat (ITT) analysis of all patients, CR rates were 62%, 70%, and 20% in newly diagnosed, group 1 first relapses (ATRA naive or off oral ATRA more than or equal to 1 year), or group 2 relapses (second or subsequent relapse or first relapses off oral ATRA less than 1 year), respectively. In 56 evaluable patients (receiving 4 or more doses), CR rates for the same groups were 87% (20 of 23), 78% (14 of 18), and 23% (3 of 13). Remission failure in newly diagnosed patients was not from resistant disease. Several patients in CR became polymerase chain reaction (PCR) negative for promyelocytic leukemia/retinoic acid receptor-alpha (PML/RARalpha) after liposomal ATRA alone. Toxicity was generally mild, most commonly headaches (67. 5%). Eighteen patients (26%) had ATRA syndrome develop during induction. One-year survival of ITT patients was 62%, 56%, and 20% for newly diagnosed, group 1, and group 2, respectively. The medium duration of CR has not yet been reached and was 18 and 5.5 months in the same groups. These results demonstrate that liposomal ATRA is effective in inducing CR in newly diagnosed or group 1 APL patients. It provides a reliable dosage of ATRA for patients with APL unable to swallow or absorb medications and can induce molecular remissions without chemotherapy.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bone Marrow/metabolism
- Child
- Child, Preschool
- DNA/metabolism
- Disease-Free Survival
- Drug Compounding/standards
- Female
- Humans
- Injections, Intravenous
- Leukemia, Promyelocytic, Acute/complications
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Liposomes/administration & dosage
- Liposomes/standards
- Male
- Middle Aged
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Prospective Studies
- Racial Groups
- Recurrence
- Remission Induction
- Risk Factors
- Treatment Outcome
- Tretinoin/administration & dosage
- Tretinoin/toxicity
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49
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Wiernik PH, Leong T, Oken MM, Neiman RS, Habermann TM, Bennett JM, Schuster S, Glick JH. Bleomycin, lomustine, cyclophosphamide, vincristine, procarbazine and prednisone (BLEO-CCVPP) in patients with Hodgkin's disease who relapsed after radiotherapy alone: a long-term follow-up study of the Eastern Cooperative Oncology Group (E3481). Leuk Lymphoma 2001; 40:357-63. [PMID: 11426558 DOI: 10.3109/10428190109057935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Thirty-three evaluable patients with Hodgkin's disease who failed radiotherapy were treated on this phase II study with bleomycin, lomustine, cyclophosphamide, vincristine, procarbazine and prednisone given every 28 days for a minimum of eight courses. Twenty-five patients (76%; 95% CI=55.6-87.1%) achieved a complete remission, the median duration of which cannot yet be determined, but the probability of remaining in continuous complete remission at 10 years is.64. The median survival from entry on this study for all evaluable patients is 10 years, and 12 patients were alive at the time of this analysis with a median follow-up for them of 15.5 years. Of the 22 patients who died, 11 died of progressive or recurrent Hodgkin's disease and 11 died of other causes including 7 second primary neoplasms and at least one myocardial infarction. Both are now well known late complications of Hodgkin's disease treatment.
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50
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Cheson BD, Bennett JM, Kantarjian H, Pinto A, Schiffer CA, Nimer SD, Löwenberg B, Beran M, de Witte TM, Stone RM, Mittelman M, Sanz GF, Wijermans PW, Gore S, Greenberg PL. Report of an international working group to standardize response criteria for myelodysplastic syndromes. Blood 2000; 96:3671-4. [PMID: 11090046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Standardized criteria for assessing response are essential to ensure comparability among clinical trials for patients with myelodysplastic syndromes (MDS). An international working group of experienced clinicians involved in the management of patients with MDS reviewed currently used response definitions and developed a uniform set of guidelines for future clinical trials in MDS. The MDS differ from many other hematologic malignancies in their chronicity and the morbidity and mortality caused by chronic cytopenias, often without disease progression to acute myeloid leukemia. Whereas response rates may be an important endpoint for phase 2 studies of new agents and may assist regulatory agencies in their evaluation and approval processes, an important goal of clinical trials in MDS should be to prolong patient survival. Therefore, these response criteria reflected 2 sets of goals in MDS: altering the natural history of the disease and alleviating disease-related complications with improved quality of life. It is anticipated that the recommendations presented will require modification as more is learned about the molecular biology and genetics of these disorders. Until then, it is hoped these guidelines will serve to improve communication among investigators and to ensure comparability among clinical trials. (Blood. 2000;96:3671-3674)
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