51
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Szymczyk A, Chocholska S, Macheta A, Szczepanek D, Hus M, Podhorecka M. Assessment of microRNA expression in leukemic cells as predictors of sensitivity to purine nucleoside analogs, fludarabine and cladribine, in chronic lymphocytic leukemia patients. Cancer Manag Res 2019; 11:5021-5031. [PMID: 31239767 PMCID: PMC6551592 DOI: 10.2147/cmar.s191311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/18/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Great progress has been achieved lately in the therapy for chronic lymphocytic leukemia (CLL), one of the most frequently diagnosed adult leukemias. New classes of drugs, such as kinase inhibitors and BCL-2 protein antagonists, have been approved for treatment of CLL patients. Despite the abovementioned therapies the disease can still be effectively treated with purine nucleoside analogs (PNA). However, some patients, for example, those with TP53 gene abnormalities, become resistant, and the other factors involved in the therapy resistance are still being investigated. This study was aimed at analyzing the possible role of microRNAs as markers predicting the outcome of chemotherapy based on PNA – fludarabine and cladribine in CLL patients. Methods: The expression of miR-21, miR-34a, miR-181a and miR-221 in previously separated leukemic cells was assessed with the use of qRQ-PCR technique at the moment of diagnosis in 40 CLL patients. In turn, apoptosis induced by fludarabine and cladribine in 24-hour cell culture was evaluated by determining the increase in the percentage of apoptotic cells of CD5+/CD19+/Cas3+ phenotype, using a flow cytometry method. Nine of the 40 studied subjects were treated with fludarabine-based regimens and were analyzed with regards to in vivo response to PNA. Results: We detected a significantly higher PNA-induced apoptosis rate in patients with high miR-34a expression in comparison to low expression ones. Interestingly, such differences were detected particularly in standard cytogenetic patients. Conclusions: These results may prove an important role of miR-34a expression as a predictor of apoptosis, even in cases when other risk factors like cytogenetic abnormalities are absent. An assessment of microRNAs expression seems to be useful as an indicator of sensitivity to PNA and may help to predict PNA-based therapy outcome.
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Affiliation(s)
- Agnieszka Szymczyk
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.,Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Arkadiusz Macheta
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Dariusz Szczepanek
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Monika Podhorecka
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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52
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Yin S, Gambe RG, Sun J, Martinez AZ, Cartun ZJ, Regis FFD, Wan Y, Fan J, Brooks AN, Herman SEM, Ten Hacken E, Taylor-Weiner A, Rassenti LZ, Ghia EM, Kipps TJ, Obeng EA, Cibulskis CL, Neuberg D, Campagna DR, Fleming MD, Ebert BL, Wiestner A, Leshchiner I, DeCaprio JA, Getz G, Reed R, Carrasco RD, Wu CJ, Wang L. A Murine Model of Chronic Lymphocytic Leukemia Based on B Cell-Restricted Expression of Sf3b1 Mutation and Atm Deletion. Cancer Cell 2019; 35:283-296.e5. [PMID: 30712845 PMCID: PMC6372356 DOI: 10.1016/j.ccell.2018.12.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 10/24/2018] [Accepted: 12/28/2018] [Indexed: 12/26/2022]
Abstract
SF3B1 is recurrently mutated in chronic lymphocytic leukemia (CLL), but its role in the pathogenesis of CLL remains elusive. Here, we show that conditional expression of Sf3b1-K700E mutation in mouse B cells disrupts pre-mRNA splicing, alters cell development, and induces a state of cellular senescence. Combination with Atm deletion leads to the overcoming of cellular senescence and the development of CLL-like disease in elderly mice. These CLL-like cells show genome instability and dysregulation of multiple CLL-associated cellular processes, including deregulated B cell receptor signaling, which we also identified in human CLL cases. Notably, human CLLs harboring SF3B1 mutations exhibit altered response to BTK inhibition. Our murine model of CLL thus provides insights into human CLL disease mechanisms and treatment.
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MESH Headings
- Adenine/analogs & derivatives
- Agammaglobulinaemia Tyrosine Kinase/antagonists & inhibitors
- Agammaglobulinaemia Tyrosine Kinase/metabolism
- Alternative Splicing
- Animals
- Antineoplastic Agents/pharmacology
- Ataxia Telangiectasia Mutated Proteins/deficiency
- Ataxia Telangiectasia Mutated Proteins/genetics
- Ataxia Telangiectasia Mutated Proteins/metabolism
- B-Lymphocytes/drug effects
- B-Lymphocytes/immunology
- B-Lymphocytes/metabolism
- Cellular Senescence/drug effects
- DNA Damage
- Gene Deletion
- Genetic Predisposition to Disease
- Genomic Instability
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Mice, 129 Strain
- Mice, Inbred C57BL
- Mice, Knockout
- Mice, Mutant Strains
- Mutation
- Neoplasms, Experimental/drug therapy
- Neoplasms, Experimental/genetics
- Neoplasms, Experimental/immunology
- Neoplasms, Experimental/metabolism
- Phenotype
- Phosphoproteins/genetics
- Phosphoproteins/metabolism
- Piperidines
- Protein Kinase Inhibitors/pharmacology
- Pyrazoles/pharmacology
- Pyrimidines/pharmacology
- RNA Splicing Factors/genetics
- RNA Splicing Factors/metabolism
- Receptors, Antigen, B-Cell/immunology
- Receptors, Antigen, B-Cell/metabolism
- Signal Transduction
- Tumor Cells, Cultured
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Affiliation(s)
- Shanye Yin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - Rutendo G Gambe
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jing Sun
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Zachary J Cartun
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Fara Faye D Regis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Youzhong Wan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jean Fan
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | | | - Sarah E M Herman
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Elisa Ten Hacken
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Laura Z Rassenti
- Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Emanuela M Ghia
- Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | - Thomas J Kipps
- Moores Cancer Center, University of California, San Diego, La Jolla, CA 92093, USA
| | | | | | - Donna Neuberg
- Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dean R Campagna
- Department of Pathology, Boston Children's Hospital, Boston, MA, USA
| | - Mark D Fleming
- Department of Pathology, Boston Children's Hospital, Boston, MA, USA
| | - Benjamin L Ebert
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Adrian Wiestner
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - James A DeCaprio
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gad Getz
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Robin Reed
- Department of Cell Biology, Harvard Medical School, Boston, MA, USA
| | - Ruben D Carrasco
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Catherine J Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
| | - Lili Wang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Systems Biology, Beckman Research Institute, City of Hope, Monrovia, CA, USA.
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53
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Providing both autologous and allogeneic hematopoietic stem cell transplants (HSCT) may have a stronger impact on the outcome of autologous HSCT in adult patients than activity levels or implementation of JACIE at Belgian transplant centres. Bone Marrow Transplant 2019; 54:1434-1442. [PMID: 30696999 DOI: 10.1038/s41409-019-0458-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 12/29/2022]
Abstract
While performance since the introduction of the JACIE quality management system has been shown to be improved for allogeneic hematopoietic stem cell transplants (HSCT), impact on autologous-HSCT remains unclear in Europe. Our study on 2697 autologous-HSCT performed in adults in 17 Belgian centres (2007-2013) aims at comparing the adjusted 1 and 3-yr survival between the different centres & investigating the impact of 3 centre-related factors on performance (time between JACIE accreditation achievement by the centre and the considered transplant, centre activity volume and type of HSCT performed by centres: exclusively autologous vs both autologous & allogeneic). We showed a relatively homogeneous performance between Belgian centres before national completeness of JACIE implementation. The 3 centre-related factors had a significant impact on the 1-yr survival, while activity volume and type of HSCT impacted the 3-yr survival of autologous-HSCT patients in univariable analyses. Only activity volume (impact on 1-yr survival only) and type of HSCT (impact on 1 and 3-yr survivals) remained significant in multivariable analysis. This is explained by the strong relationship between these 3 variables. An extended transplantation experience, i.e., performing both auto & allo-HSCT, appears to be a newly informative quality indicator potentially conveying a multitude of underlying complex factors.
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54
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Lim WH, Mayson E, Lamaro VP. Chronic lymphocytic leukaemia masquerading as a labial lump. BMJ Case Rep 2019; 12:12/1/bcr-2018-227328. [PMID: 30642861 DOI: 10.1136/bcr-2018-227328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We report a case of an 82-year-old woman who presented with a 2-week history of a left labial lump. She had a history of chronic lymphocytic leukaemia (CLL) for several years and remained stable without clinical evidence of disease progression. She was observed with regular blood tests and clinical assessment. She was hypogammaglobulinaemic from the CLL and due to frequent symptomatic infections requiring hospitalisation, was commenced on monthly intravenous immunoglobulin. A tissue biopsy of the labial lump confirmed involved CLL in the genital area and further investigations and management followed.
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Affiliation(s)
- Wei How Lim
- Department of Gynaecology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.,UNSW Medicine, St Vincent's Clinical School, Darlinghurst, New South Wales, Australia
| | - Eleni Mayson
- UNSW Medicine, St Vincent's Clinical School, Darlinghurst, New South Wales, Australia.,Department of Haematology, The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia
| | - Vincent P Lamaro
- Department of Gynaecology, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.,UNSW Medicine, St Vincent's Clinical School, Darlinghurst, New South Wales, Australia.,Clinic 404, St Vincent's Clinic, Darlinghurst, New South Wales, Australia
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55
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Wdowiak K, Gallego-Colon E, Francuz T, Czajka-Francuz P, Ruiz-Agamez N, Kubeczko M, Grochoła I, Wybraniec MT, Chudek J, Wojnar J. Increased serum levels of Galectin-9 in patients with chronic lymphocytic leukemia. Oncol Lett 2019; 17:1019-1029. [PMID: 30655861 PMCID: PMC6313089 DOI: 10.3892/ol.2018.9656] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 09/11/2018] [Indexed: 12/20/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is the most common type of leukemia in adults. Despite improvements in treatment, CLL is still considered an incurable disease. The aim of the present study was to evaluate galectin-1, -3 and -9 (Gal-1, -3 and -9) and Gal-3 binding protein (Gal-3BP) as prognostic and predictive factors in patients with CLL. Serum concentrations of Gal-1, -3 and -9 and Gal-3BP were measured in 48 patients with CLL and 30 control patients, using multiplex bead arrays. In patients with CLL, galectin concentrations were assessed prior to, during and following treatment. In patients with CLL who were untreated, galectin concentrations were measured twice with a 6-month interval. The serum level of Gal-9 was significantly increased (P<0.0001) in patients with CLL compared with the control group, and was associated with the clinical stage according to Binet classification, as well as poor cytogenetic and serum CLL prognostic factors. In addition, patients with CLL, who exhibited treatment failure, exhibited higher concentrations of Gal-9 (P=0.06) and Gal-3BP (P=0.009) at the end of the treatment when compared with patients under complete remission or stabilization of the disease. The serum level of Gal-3 was significantly decreased (P=0.012) in patients with CLL compared with the control group. These results suggest that Gal-9 is a potential prognostic factor in patients with CLL. The predictive value of Gal-9 requires further study in larger cohorts of patients.
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Affiliation(s)
- Kamil Wdowiak
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice 40-027, Poland
| | | | - Tomasz Francuz
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice 40-027, Poland
- Department of Biochemistry, Silesian Medical University, Katowice 40-752, Poland
| | - Paulina Czajka-Francuz
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice 40-027, Poland
| | - Natalia Ruiz-Agamez
- Department of Biochemistry, Silesian Medical University, Katowice 40-752, Poland
| | - Marcin Kubeczko
- Clinical and Experimental Oncology Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice 44-101, Poland
| | - Iga Grochoła
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice 40-027, Poland
| | - Maciej T. Wybraniec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice 40-635, Poland
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice 40-027, Poland
| | - Jerzy Wojnar
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice 40-027, Poland
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56
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Hallek M. On the architecture of translational research designed to control chronic lymphocytic leukemia. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2018; 2018:1-8. [PMID: 30504285 PMCID: PMC6245981 DOI: 10.1182/asheducation-2018.1.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Chronic lymphocytic leukemia (CLL) has been 1 of the most dynamic fields of clinical research over the last 2 decades. Important advances in understanding the biology of CLL have led to the development of new prognostic and diagnostic tools. Concurrently, several recently approved new agents hold the potential to fundamentally change the management of this leukemia and have started to improve clinical outcomes for patients. This conceptual review summarizes the major recent insights regarding the biology of CLL, the technological advances that have allowed refinement of the prognostication of the clinical course, and the new therapeutic strategies that are currently under investigation to further ameliorate the outcome for patients with CLL.
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Affiliation(s)
- Michael Hallek
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
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57
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Brander DM, Friedman DR, Volkheimer AD, Christensen DJ, Rassenti LZ, Kipps TJ, Guadalupe E, Chen Y, Zhang D, Wang X, Davis C, Owzar K, Weinberg JB. SET alpha and SET beta mRNA isoforms in chronic lymphocytic leukaemia. Br J Haematol 2018; 184:605-615. [PMID: 30443898 DOI: 10.1111/bjh.15677] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/04/2018] [Indexed: 01/01/2023]
Abstract
Alteration in RNA splicing is implicated in carcinogenesis and progression. Mutations in spliceosome genes and alternative splicing of other genes have been noted in chronic lymphocytic leukaemia (CLL), a common B cell malignancy with heterogeneous outcomes. We previously demonstrated that differences in the amount of SET oncoprotein (a physiological inhibitor of the serine/threonine phosphatase, PP2A) is associated with clinical aggressiveness in patients with CLL. It is unknown if alternative splicing of gene transcripts regulating kinases and phosphatases affects disease pathobiology and CLL progression. We show here for the first time that mRNA levels of the alternatively spliced SET isoforms, SETA and SETB (SETα and SETβ), significantly correlate with disease severity (overall survival and time-to-first-treatment) in CLL patients. In addition, we demonstrate that relative increase of SETA to SETB mRNA can discriminate patients with a more aggressive disease course within the otherwise favourable CLL risk classifications of IGHV mutated and favourable hierarchical fluorescence in situ hybridisation groups. We validate our finding by showing comparable relationships of SET mRNA with disease outcomes using samples from an independent CLL cohort from a separate institution. These findings indicate that alternative splicing of SET, and potentially other signalling cascade molecules, influences CLL biology and patient outcomes.
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Affiliation(s)
- Danielle M Brander
- Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Daphne R Friedman
- Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA
| | | | | | - Laura Z Rassenti
- University of California San Diego Moores Cancer Center, San Diego, CA, USA
| | - Thomas J Kipps
- University of California San Diego Moores Cancer Center, San Diego, CA, USA
| | | | - Youwei Chen
- Duke University Medical Center, Durham, NC, USA
| | - Dadong Zhang
- Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - Xi Wang
- Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | | | - Kouros Owzar
- Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA
| | - J Brice Weinberg
- Duke University Medical Center, Durham, NC, USA.,Duke Cancer Institute, Durham, NC, USA.,Durham VA Medical Center, Durham, NC, USA
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58
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Abstract
INTRODUCTION Hypoxia-inducible transcription factors have been identified as regulators of adaptive responses to hypoxia. Over the past 20 years, more than 8000 papers have described their increasingly complex role and regulation in cancer. Presently, it is recognized that hypoxia-inducible factors (HIFs) are regulated by oxygen-dependent and oxygen-independent mechanisms in cancer development; the list of their targets has increased to include more than 500 genes involved in most hallmarks of cancer. Areas covered: Most literature describes the function of HIF factors in solid tumors; however, in the past 10 years, evidence has steadily accumulated to indicate that HIFs are implicated in hematological malignancies. This review summarizes our current understanding of the function and regulation of HIF factors in hematopoiesis and leukemia. Moreover, we provide an update on pharmacological inhibitors of this pathway that have shown promising therapeutic effects in clinical trials or leukemia pre-clinical models. Expert opinion: The inhibition of the function of HIF factors may provide an interesting approach for treating leukemia. We posit that before moving into the clinic, we should (i) fully characterize the outcome of HIF inhibition in specific leukemia contexts (ii) test the possibility of combining HIF-targeting strategies with cytotoxic compounds and (iii) consider patient selection to increase therapeutic efficacy.
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Affiliation(s)
- Daniela Magliulo
- a Vita-Salute San Raffaele University , Milan , Italy.,b Preclinical Models of Cancer Laboratory, Division of Experimental Oncology , San Raffaele Scientific Institute , Milan , Italy
| | - Rosa Bernardi
- b Preclinical Models of Cancer Laboratory, Division of Experimental Oncology , San Raffaele Scientific Institute , Milan , Italy
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59
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Bertilaccio MTS, Zhang R, Banerjee P, Gandhi V. In Vitro Assay to Study CLL and Monocyte Interactions. Methods Mol Biol 2018; 1881:113-119. [PMID: 30350201 DOI: 10.1007/978-1-4939-8876-1_9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Investigations focusing on CLL and microenvironment interaction allow understanding role of each component of the microenvironment. In vitro cell depletion assay we described here enables us to evaluate the depletion of CLL cells and monocyte populations upon treatment with drugs targeting the interactions between CLL cells and monocytes. The assay is based on a quantitative multi-color flow cytometry analysis and, when combined to fluorescence-activated cell sorting and RT-PCR, it allows the isolation of CLL/monocyte cells and the further characterization of apoptotic and/or inflammatory pathways induced eventually on CLL cells and on monocytes.
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Affiliation(s)
| | - Ronghua Zhang
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Priyanka Banerjee
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Varsha Gandhi
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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60
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Ho N, Myles JL, Johnston DR, Eicher DM, Kwon DH, Klein AL, Collier P. Pericardial Involvement with Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: A Rare Case of Constrictive Pericarditis. ACTA ACUST UNITED AC 2018; 2:147-150. [PMID: 30140781 PMCID: PMC6104145 DOI: 10.1016/j.case.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
CLL/SLL can involve the pericardium and may present as constrictive pericarditis. Echocardiography and cardiac MRI can aid in diagnosing constrictive pericarditis. Radical pericardiectomy is a treatment option for malignant pericardial involvement.
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Affiliation(s)
- Natalie Ho
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jonathan L Myles
- Department of Pathology, Robert J. Tomsich Institute of Pathology and Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Douglas R Johnston
- Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Donald M Eicher
- Department of Hematology and Oncology, Cleveland Clinic Taussig Cancer Center, Cleveland, Ohio
| | - Deborah H Kwon
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Allan L Klein
- Section of Cardiovascular Imaging, Center for the Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Patrick Collier
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
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61
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Palma M, Hansson L, Mulder TA, Adamson L, Näsman-Glaser B, Eriksson I, Heimersson K, Ryblom H, Mozaffari F, Svensson A, Gentilcore G, Österborg A, Mellstedt H. Lenalidomide as immune adjuvant to a dendritic cell vaccine in chronic lymphocytic leukemia patients. Eur J Haematol 2018; 101:68-77. [PMID: 29569742 DOI: 10.1111/ejh.13065] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES We previously showed that immunization with ex vivo- generated autologous dendritic cells loaded with apoptotic tumor cells (Apo-DC) potentiated tumor-specific immunity in chronic lymphocytic leukemia (CLL) patients. Here, we evaluated safety and immunogenicity of Apo-DC in combination with lenalidomide, granulocyte-macrophage colony-stimulating factor (GM-CSF), and low-dose cyclophosphamide (CTX). METHODS Ten previously untreated patients with slowly progressing CLL received 5 Apo-DC vaccinations and lenalidomide orally for 24 weeks either alone (cohort I, n = 5) or together with subcutaneous GM-CSF and intravenous CTX (cohort II, n = 5). Tumor-specific T-cell responses were measured by proliferation and IFN-γ ELISPOT assays. Immune monitoring was performed by flow cytometry. RESULTS Dose-limiting toxicity was observed in 3/10 patients, 2 in cohort I and one in cohort II. One patient developed autoimmune hemolytic anemia and another grade 4 thrombocytopenia. Vaccine-induced immune responses were seen in 5/5 and 4/5 patients in cohort I and II, respectively. The expression of immune checkpoints on T cells did not change significantly. CONCLUSIONS Lenalidomide alone or in combination with GM-CSF and low-dose CTX as immune adjuvant to the Apo-DC vaccine elicited tumor-specific T-cell responses in CLL patients. However, unexpected toxicity was observed and caution is suggested in further exploring this drug as immune adjuvant in CLL.
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Affiliation(s)
- Marzia Palma
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lotta Hansson
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Tom A Mulder
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lars Adamson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | | | - Ingrid Eriksson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Kia Heimersson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Harriet Ryblom
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Fariba Mozaffari
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Ann Svensson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Giusy Gentilcore
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Anders Österborg
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Håkan Mellstedt
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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62
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Andersen BL, Goyal NG, Weiss DM, Westbrook TD, Maddocks KJ, Byrd JC, Johnson AJ. Cells, cytokines, chemokines, and cancer stress: A biobehavioral study of patients with chronic lymphocytic leukemia. Cancer 2018; 124:3240-3248. [PMID: 29757455 DOI: 10.1002/cncr.31538] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 03/21/2018] [Accepted: 04/05/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia, with profound disease-related cellular, humoral, and innate immune suppression. The objective of this study was to study the correlations between stress and disease-specific, negative prognostic cellular, cytokine, and chemokine markers in patients with CLL. METHODS A single-group, observational design was used. Patients with relapsed/refractory CLL (N = 96) who were entering a phase 2 trial of an experimental therapy (ibrutinib) were studied. Before the first dose, a validated self-report measure of stress (the Impact of Event Scale) was completed, and blood was drawn for absolute lymphocyte counts (ALCs) and for cytokine and chemokine enzyme-linked immunosorbent assays. Multiple linear regression models tested stress as a concurrent predictor of ALCs; of cytokines (tumor necrosis factor α [TNFα], a proliferation-inducing ligand [APRIL], B-cell activating factor [BAFF], interleukin 6 [IL-6], IL-10, IL-16, and vascular endothelial growth factor [VEGF]); and of the chemokine (C-C motif) ligand 3 (CCL3). RESULTS Controlling for relevant demographic variables, comorbidities, CLL genetic risk (deletion of the short arm of chromosome 17 [del17p]), and correlates of inflammation, stress predicted higher ALCs (P < .05), and higher levels of TNFα (P < .05), IL-16 (P < .01), and CCL3 (P < .05). Stress was not associated with APRIL, BAFF, IL-6, IL-10, or VEGF. CONCLUSIONS Novel biobehavioral data from patients with relapsed/refractory CLL demonstrate that stress is related to heightened levels of cellular, cytokine, and chemokine markers associated previously with progressive disease in CLL. The current results indicate that stress is related to immune and inflammatory processes that contribute to cancer cell proliferation and survival. These data provide a first look into these processes. Cancer 2018. © 2018 American Cancer Society.
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Affiliation(s)
| | | | - David M Weiss
- Department of Psychology, The Ohio State University, Columbus, Ohio
| | | | - Kami J Maddocks
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - John C Byrd
- The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Amy J Johnson
- The Ohio State University Wexner Medical Center, Columbus, Ohio
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Assessment of micro RNAs expression in leukemic cells as prognostic markers in chronic lymphocytic leukemia: micro RNAs can predict survival in a course of the disease. Oncotarget 2018; 9:19136-19146. [PMID: 29721189 PMCID: PMC5922383 DOI: 10.18632/oncotarget.24927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 03/07/2018] [Indexed: 01/06/2023] Open
Abstract
Numerous genetic alterations predicting prognosis and clinical outcome are revealed recently in chronic lymphocytic leukemia (CLL). Among them the deregulated expression of micro RNAs that can induce tumor growth, or act as tumor suppressors seem to be of great importance. This study aimed to analyze the possible role of chosen micro RNAs as markers of prognosis in patients with CLL. We assessed the expression of miR-21, miR-34a, miR-181a, miR-199a/b and miR-221 in previously separated leukemic cells with the use of qRQ-PCR technique at the moment of diagnosis. The results were then analyzed in regards to presence of prognostic factors, clinical data and the end points like progression free survival (PFS), time to progression (TP) and overall survival time (OS). We detected significant correlations between expression of the analyzed micro RNAs and CLL prognostic markers particularly as far as miR-221 and miR-181a were concerned. The subsequent analysis revealed that high expression of miR-34a and miR-181a as well as low miR-21 expression indicated longer TTP, while miR-221 was predictor of OS. The obtained results prove the role of micro RNAs as CLL prognostic markers, particularly as factors predicting survival in a course of the disease.
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Abstract
Chronic lymphocytic leukemia (CLL), the most frequent type of leukemia in western countries, is characterized by the progressive accumulation in blood, bone marrow and lymphoid tissues of monoclonal B lymphocytes with a characteristic immunophenotype. Despite advances in therapy and improved outcome, in most instances CLL is an incurable disorder. Signaling via the B-cell receptor (BCR), the upregulation of anti-apoptotic proteins, and the cross-talk between CLL cells and microenvironment constitute key factors in the pathogenesis of CLL. Currently, inhibitors of kinases like BTK or PI3K blocking BCR signaling, and molecules that mimic the BH3 domain to compete with BCL-2 are established tools in the treatment of CLL. As the complex biology of CLL is rapidly unfolding, the number of small molecules targeting CLL molecular pathways is increasing and it is likely that they will further improve the outcome of patients with this form of leukemia.
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Affiliation(s)
- Gerardo Ferrer
- Karches Center for Oncology Research, The Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Emili Montserrat
- Department of Hematology, Institute of Hematology and Oncology, University of Barcelona, Hospital Clínic, Villarroel 170, 08036, Barcelona, Spain.
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65
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The International Prognostic Index for Patients with Chronic Lymphocytic Leukemia Has the Higher Value in Predicting Overall Outcome Compared with the Barcelona-Brno Biomarkers Only Prognostic Model and the MD Anderson Cancer Center Prognostic Index. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9506979. [PMID: 29736400 PMCID: PMC5874971 DOI: 10.1155/2018/9506979] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/17/2018] [Indexed: 12/31/2022]
Abstract
In recent years, new prognostic indexes (PIs) for chronic lymphocytic leukemia (CLL), which include clinical, biological, and genetic variables, have been validated, highlighting the MD Anderson Cancer Center prognostic index (MDACC PI), the CLL-international prognostic index (CLL-IPI), and the Barcelona-Brno biomarkers only prognostic model. The aim of this study is to compare the utility of these PIs in a cohort of Spanish patients. A retrospective analysis of 696 unselected CLL patients newly diagnosed and previously untreated from different Spanish institutions was performed. The MDACC PI, the CLL-IPI, and the biomarkers only PI were applied to these patients, and a comparison of the three PIs was performed. With a median follow-up time of 46 months, 394 patients were alive and 187 had received treatment. The median overall survival (OS) was 173 months and the median time to first therapy (TTFT) was 32 months. Significant differences were obtained in OS and TTFT for all subgroups when applying these PIs, with the CLL-IPI being the one with the higher c-index (0.676 for OS and 0.757 for TTFT). The three PIs were able to discriminate patients in different prognostic subgroups. In our cohort, the CLL-IPI showed higher power in predicting TTFT and OS.
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66
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Gentile M, Shanafelt TD, Mauro FR, Laurenti L, Rossi D, Molica S, Vincelli I, Cutrona G, Uccello G, Pepe S, Vigna E, Tripepi G, Chaffee KG, Parikh SA, Bossio S, Recchia AG, Innocenti I, Pasquale R, Neri A, Ferrarini M, Gaidano G, Foà R, Morabito F. Comparison between the CLL-IPI and the Barcelona-Brno prognostic model: Analysis of 1299 newly diagnosed cases. Am J Hematol 2018; 93:E35-E37. [PMID: 29098721 DOI: 10.1002/ajh.24960] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Massimo Gentile
- Department of Onco-hematology, Hematology Unit; AO of Cosenza; Italy
| | - Tait D. Shanafelt
- Department of Internal Medicine; Mayo Clinic; Rochester Minnesota
- Division of Hematology; Mayo Clinic; Rochester Minnesota
| | - Francesca R. Mauro
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - Luca Laurenti
- Department of Hematology; Catholic University Hospital, Agostino Gemelli; Rome Italy
| | - Davide Rossi
- Department of Oncology and Hematology; Oncology Institute of Southern Switzerland and Institute of Oncology Research; Bellinzona Switzerland
| | - Stefano Molica
- Department of Oncology and Haematology; Pugliese-Ciaccio Hospital; Catanzaro Italy
| | - Iolanda Vincelli
- Department of Oncology and Hematology; Hematology Unit of Reggio; Calabria Italy
| | - Giovanna Cutrona
- Department of Oncology and Hematology; UO Molecular Pathology, Ospedale Policlinico, San Martino, IRCCS; Genova Italy
| | | | - Sara Pepe
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - Ernesto Vigna
- Department of Onco-hematology, Hematology Unit; AO of Cosenza; Italy
| | - Giovanni Tripepi
- Consiglio Nazionale delle Ricerche, Istituto di Biomedicina ed Immunologia Molecolare; Reggio Calabria Italy
| | - Kari G. Chaffee
- Division of Biomedical Statistics and Informatics; Mayo Clinic; Rochester Minnesota
| | - Sameer A. Parikh
- Department of Internal Medicine; Mayo Clinic; Rochester Minnesota
| | - Sabrina Bossio
- Biotechnology Research Unit; Department of Oncology and Hematology; Azienda Sanitaria Provinciale di Cosenza; Aprigliano (CS) Italy
| | - Anna Grazia Recchia
- Biotechnology Research Unit; Department of Oncology and Hematology; Azienda Sanitaria Provinciale di Cosenza; Aprigliano (CS) Italy
| | - Idanna Innocenti
- Department of Hematology; Catholic University Hospital, Agostino Gemelli; Rome Italy
| | - Raffaella Pasquale
- Department of Hematology; Catholic University Hospital, Agostino Gemelli; Rome Italy
| | - Antonino Neri
- Department of Oncology and Hemato-oncology; University of Milano and Hematology CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Manlio Ferrarini
- Department of Oncology and Hematology; Direzione Scientifica, Ospedale Policlinico, San Martino, IRCCS; Genova Italy
| | - Gianluca Gaidano
- Division of Haematology; Università del Piemonte Orientale; Novara Italy
- Department of Translational Medicine; Università del Piemonte Orientale; Novara Italy
| | - Robin Foà
- Department of Cellular Biotechnologies and Hematology; Sapienza University; Rome Italy
| | - Fortunato Morabito
- Biotechnology Research Unit; Department of Oncology and Hematology; Azienda Sanitaria Provinciale di Cosenza; Aprigliano (CS) Italy
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Microenvironment-induced CD44v6 promotes early disease progression in chronic lymphocytic leukemia. Blood 2018; 131:1337-1349. [PMID: 29352038 DOI: 10.1182/blood-2017-08-802462] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 01/11/2018] [Indexed: 01/01/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) outgrowth depends on signals from the microenvironment. We have previously found that in vitro reconstitution of this microenvironment induces specific variant isoforms of the adhesion molecule CD44, which confer human CLL with high affinity to hyaluronan (HA). Here, we determined the in vivo contribution of standard CD44 and its variants to leukemic B-cell homing and proliferation in Tcl1 transgenic mice with a B-cell-specific CD44 deficiency. In these mice, leukemia onset was delayed and leukemic infiltration of spleen, liver, and lungs, but not of bone marrow, was decreased. Competitive transplantation revealed that CLL homing to spleen and bone marrow required functional CD44. Notably, enrichment of CD44v6 variants particularly in spleen enhanced CLL engraftment and proliferation, along with increased HA binding. We recapitulated CD44v6 induction in the human disease and revealed the involvement of MAPK and NF-κB signaling upon CD40 ligand and B-cell receptor stimulation by in vitro inhibition experiments and chromatin immunoprecipitation assays. The investigation of downstream signaling after CD44v6-HA engagement uncovered the activation of extracellular signal-regulated kinase and p65. Consequently, anti-CD44v6 treatment reduced leukemic cell proliferation in vitro in human and mouse, confirming the general nature of the findings. In summary, we propose a CD44-NF-κB-CD44v6 circuit in CLL, allowing tumor cells to gain HA binding capacity and supporting their proliferation.
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68
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Till KJ, Allen JC, Talab F, Lin K, Allsup D, Cawkwell L, Bentley A, Ringshausen I, Duckworth AD, Pettitt AR, Kalakonda N, Slupsky JR. Lck is a relevant target in chronic lymphocytic leukaemia cells whose expression variance is unrelated to disease outcome. Sci Rep 2017; 7:16784. [PMID: 29196709 PMCID: PMC5711840 DOI: 10.1038/s41598-017-17021-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/21/2017] [Indexed: 11/09/2022] Open
Abstract
Pathogenesis of chronic lymphocytic leukaemia (CLL) is contingent upon antigen receptor (BCR) expressed by malignant cells of this disease. Studies on somatic hypermutation of the antigen binding region, receptor expression levels and signal capacity have all linked BCR on CLL cells to disease prognosis. Our previous work showed that the src-family kinase Lck is a targetable mediator of BCR signalling in CLL cells, and that variance in Lck expression associated with ability of BCR to induce signal upon engagement. This latter finding makes Lck similar to ZAP70, another T-cell kinase whose aberrant expression in CLL cells also associates with BCR signalling capacity, but also different because ZAP70 is not easily pharmacologically targetable. Here we describe a robust method of measuring Lck expression in CLL cells using flow cytometry. However, unlike ZAP70 whose expression in CLL cells predicts prognosis, we find Lck expression and disease outcome in CLL are unrelated despite observations that its inhibition produces effects that biologically resemble the egress phenotype taken on by CLL cells treated with idelalisib. Taken together, our findings provide insight into the pathobiology of CLL to suggest a more complex relationship between expression of molecules within the BCR signalling pathway and disease outcome.
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Affiliation(s)
- Kathleen J Till
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - John C Allen
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Fatima Talab
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Ke Lin
- Department of Haematology, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - David Allsup
- Department of Haematology, Queens Centre for Oncology and Haematology, Hull and East Yorkshire Hospitals NHS Trust, Yorkshire, UK
| | - Lynn Cawkwell
- School of Life Sciences, University of Hull, Hull, UK
- Hull York Medical School, University of Hull, Hull, UK
| | | | - Ingo Ringshausen
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - Andrew D Duckworth
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Andrew R Pettitt
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Nagesh Kalakonda
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK
| | - Joseph R Slupsky
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
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69
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Revisiting the role of interleukin-8 in chronic lymphocytic leukemia. Sci Rep 2017; 7:15714. [PMID: 29146966 PMCID: PMC5691131 DOI: 10.1038/s41598-017-15953-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/03/2017] [Indexed: 11/23/2022] Open
Abstract
The proliferation and survival of malignant B cells in chronic lymphocytic leukemia (CLL) depend on signals from the microenvironment in lymphoid tissues. Among a plethora of soluble factors, IL-8 has been considered one of the most relevant to support CLL B cell progression in an autocrine fashion, even though the expression of IL-8 receptors, CXCR1 and CXCR2, on leukemic B cells has not been reported. Here we show that circulating CLL B cells neither express CXCR1 or CXCR2 nor they respond to exogenous IL-8 when cultured in vitro alone or in the presence of monocytes/nurse-like cells. By intracellular staining and ELISA we show that highly purified CLL B cells do not produce IL-8 spontaneously or upon activation through the B cell receptor. By contrast, we found that a minor proportion (<0.5%) of contaminating monocytes in enriched suspensions of leukemic cells might be the actual source of IL-8 due to their strong capacity to release this cytokine. Altogether our results indicate that CLL B cells are not able to secrete or respond to IL-8 and highlight the importance of methodological details in in vitro experiments.
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70
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Bagacean C, Tempescul A, Le Dantec C, Bordron A, Mohr A, Saad H, Olivier V, Zdrenghea M, Cristea V, Cartron PF, Douet-Guilbert N, Berthou C, Renaudineau Y. Alterations in DNA methylation/demethylation intermediates predict clinical outcome in chronic lymphocytic leukemia. Oncotarget 2017; 8:65699-65716. [PMID: 29029465 PMCID: PMC5630365 DOI: 10.18632/oncotarget.20081] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/26/2017] [Indexed: 12/12/2022] Open
Abstract
Cytosine derivative dysregulations represent important epigenetic modifications whose impact on the clinical outcome in chronic lymphocytic leukemia (CLL) is incompletely understood. Hence, global levels of 5-methylcytosine (5-mCyt), 5-hydroxymethylcytosine (5-hmCyt), 5-carboxylcytosine (5-CaCyt) and 5-hydroxymethyluracil were tested in purified B cells from CLL patients (n = 55) and controls (n = 17). The DNA methylation 'writers' (DNA methyltransferases [DNMT1/3A/3B]), 'readers' (methyl-CpG-binding domain [MBD2/4]), 'editors' (ten-eleven translocation [TET1/2/3]) and 'modulators' (SAT1) were also evaluated. Accordingly, patients were stratified into three subgroups. First, a subgroup with a global deficit in cytosine derivatives characterized by hyperlymphocytosis, reduced median progression free survival (PFS = 52 months) and shorter treatment free survival (TFS = 112 months) was identified. In this subgroup, major epigenetic modifications were highlighted including a reduction of 5-mCyt, 5-hmCyt, 5-CaCyt associated with DNMT3A, MBD2/4 and TET1/2 downregulation. Second, the cytosine derivative analysis revealed a subgroup with a partial deficit (PFS = 84, TFS = 120 months), mainly affecting DNA demethylation (5-hmCyt reduction, SAT1 induction). Third, a subgroup epigenetically similar to controls was identified (PFS and TFS > 120 months). The prognostic impact of stratifying CLL patients within three epigenetic subgroups was confirmed in a validation cohort. In conclusion, our results suggest that dysregulations of cytosine derivative regulators represent major events acquired during CLL progression and are independent from IGHV mutational status.
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Affiliation(s)
- Cristina Bagacean
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
- Laboratory of Immunology and Immunotherapy, Brest University Medical School Hospital, Brest, France
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Adrian Tempescul
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
- Department of Hematology, Brest University Medical School Hospital, Brest, France
| | - Christelle Le Dantec
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
| | - Anne Bordron
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
| | - Audrey Mohr
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
| | - Hussam Saad
- Department of Hematology, Brest University Medical School Hospital, Brest, France
| | - Valerie Olivier
- Laboratory of Immunology and Immunotherapy, Brest University Medical School Hospital, Brest, France
| | - Mihnea Zdrenghea
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
- Department of Hematology, ‘Ion Chiricuta’ Oncology Institute, Cluj-Napoca, Romania
| | - Victor Cristea
- Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | | | - Christian Berthou
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
- Department of Hematology, Brest University Medical School Hospital, Brest, France
| | - Yves Renaudineau
- U1227 B Lymphocytes and Autoimmunity, University of Brest, INSERM, IBSAM, Labex IGO, Networks IC-CGO and REpiCGO from Cancéropôle Grand Ouest, Brest, France
- Laboratory of Immunology and Immunotherapy, Brest University Medical School Hospital, Brest, France
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71
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Xochelli A, Baliakas P, Kavakiotis I, Agathangelidis A, Sutton LA, Minga E, Ntoufa S, Tausch E, Yan XJ, Shanafelt T, Plevova K, Boudjogra M, Rossi D, Davis Z, Navarro A, Sandberg Y, Vojdeman FJ, Scarfo L, Stavroyianni N, Sudarikov A, Veronese S, Tzenou T, Karan-Djurasevic T, Catherwood M, Kienle D, Chatzouli M, Facco M, Bahlo J, Pott C, Pedersen LB, Mansouri L, Smedby KE, Chu CC, Giudicelli V, Lefranc MP, Panagiotidis P, Juliusson G, Anagnostopoulos A, Vlahavas I, Antic D, Trentin L, Montillo M, Niemann C, Döhner H, Langerak AW, Pospisilova S, Hallek M, Campo E, Chiorazzi N, Maglaveras N, Oscier D, Gaidano G, Jelinek DF, Stilgenbauer S, Chouvarda I, Darzentas N, Belessi C, Davi F, Hadzidimitriou A, Rosenquist R, Ghia P, Stamatopoulos K. Chronic Lymphocytic Leukemia with Mutated IGHV4-34 Receptors: Shared and Distinct Immunogenetic Features and Clinical Outcomes. Clin Cancer Res 2017; 23:5292-5301. [PMID: 28536306 DOI: 10.1158/1078-0432.ccr-16-3100] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/11/2017] [Accepted: 05/18/2017] [Indexed: 11/16/2022]
Abstract
Purpose: We sought to investigate whether B cell receptor immunoglobulin (BcR IG) stereotypy is associated with particular clinicobiological features among chronic lymphocytic leukemia (CLL) patients expressing mutated BcR IG (M-CLL) encoded by the IGHV4-34 gene, and also ascertain whether these associations could refine prognostication.Experimental Design: In a series of 19,907 CLL cases with available immunogenetic information, we identified 339 IGHV4-34-expressing cases assigned to one of the four largest stereotyped M-CLL subsets, namely subsets #4, #16, #29 and #201, and investigated in detail their clinicobiological characteristics and disease outcomes.Results: We identified shared and subset-specific patterns of somatic hypermutation (SHM) among patients assigned to these subsets. The greatest similarity was observed between subsets #4 and #16, both including IgG-switched cases (IgG-CLL). In contrast, the least similarity was detected between subsets #16 and #201, the latter concerning IgM/D-expressing CLL. Significant differences between subsets also involved disease stage at diagnosis and the presence of specific genomic aberrations. IgG subsets #4 and #16 emerged as particularly indolent with a significantly (P < 0.05) longer time-to-first-treatment (TTFT; median TTFT: not yet reached) compared with the IgM/D subsets #29 and #201 (median TTFT: 11 and 12 years, respectively).Conclusions: Our findings support the notion that BcR IG stereotypy further refines prognostication in CLL, superseding the immunogenetic distinction based solely on SHM load. In addition, the observed distinct genetic aberration landscapes and clinical heterogeneity suggest that not all M-CLL cases are equal, prompting further research into the underlying biological background with the ultimate aim of tailored patient management. Clin Cancer Res; 23(17); 5292-301. ©2017 AACR.
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Affiliation(s)
- Aliki Xochelli
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Ioannis Kavakiotis
- Department of informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Agathangelidis
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece.,Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Eva Minga
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece
| | | | - Eugen Tausch
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Xiao-Jie Yan
- Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Tait Shanafelt
- Department of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Karla Plevova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Myriam Boudjogra
- Department of Hematology, Hopital Pitie-Salpetriere and University Pierre et Marie Curie, Paris, France
| | - Davide Rossi
- Division of Haematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Zadie Davis
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Alba Navarro
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Yorick Sandberg
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | | | - Lydia Scarfo
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Niki Stavroyianni
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - Silvio Veronese
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Tatiana Tzenou
- First Department of Propaedeutic Medicine, University of Athens, Athens, Greece
| | - Teodora Karan-Djurasevic
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia
| | - Mark Catherwood
- Department of Haemato-Oncology, Belfast City Hospital, Belfast, United Kingdom
| | - Dirk Kienle
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Maria Chatzouli
- Hematology Department, Nikea General Hospital, Piraeus, Greece
| | - Monica Facco
- Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Padova, Italy
| | - Jasmin Bahlo
- Department I of Internal Medicine and Center of Integrated Oncology, University Hospital Cologne, Cologne, Germany
| | - Christiane Pott
- Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | | | - Larry Mansouri
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Karin E Smedby
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
| | - Charles C Chu
- Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Véronique Giudicelli
- IMGT®, the international ImMunoGeneTics information system®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UPR CNRS 1142, Montpellier, France
| | - Marie-Paule Lefranc
- IMGT®, the international ImMunoGeneTics information system®, Université de Montpellier, LIGM, Institut de Génétique Humaine IGH, UPR CNRS 1142, Montpellier, France
| | | | - Gunnar Juliusson
- Lund University and Hospital Department of Hematology, Lund Stem Cell Center, Lund, Sweden
| | | | - Ioannis Vlahavas
- Department of informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Darko Antic
- Clinic for Hematology, Clinical Center, Belgrade, Serbia.,Medical faculty, University of Belgrade, Belgrade, Serbia
| | - Livio Trentin
- Department of Medicine, Hematology and Clinical Immunology Branch, Padua University School of Medicine, Padova, Italy
| | - Marco Montillo
- Molecular Pathology Unit and Haematology Department, Niguarda Cancer Center, Niguarda Ca' Granda Hospital, Milan, Italy
| | - Carsten Niemann
- Department of Hematology, Rigshospitalet, Copenhagen, Denmark
| | - Hartmut Döhner
- Department of Internal Medicine III, Ulm University, Ulm, Germany
| | - Anton W Langerak
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Sarka Pospisilova
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Michael Hallek
- Department I of Internal Medicine and Center of Integrated Oncology, University Hospital Cologne, Cologne, Germany
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Nicholas Chiorazzi
- Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York
| | - Nikos Maglaveras
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - David Oscier
- Department of Haematology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Diane F Jelinek
- Department of Immunology, Mayo Clinic, Rochester, Minnesota, United States
| | | | - Ioanna Chouvarda
- Laboratory of Medical Informatics, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikos Darzentas
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Frederic Davi
- Department of Hematology, Hopital Pitie-Salpetriere and University Pierre et Marie Curie, Paris, France
| | - Anastasia Hadzidimitriou
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece. .,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Ghia
- Division of Experimental Oncology and Department of Onco-Hematology, IRCCS San Raffaele Scientific Institute, Milan, Italy.,Università Vita-Salute San Raffaele and IRCCS Istituto Scientifico San Raffaele, Milan, Italy
| | - Kostas Stamatopoulos
- Institute of Applied Biosciences, CERTH, Thessaloniki, Greece.,Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden.,Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
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72
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Yu J, Chen L, Chen Y, Hasan MK, Ghia EM, Zhang L, Wu R, Rassenti LZ, Widhopf GF, Shen Z, Briggs SP, Kipps TJ. Wnt5a induces ROR1 to associate with 14-3-3ζ for enhanced chemotaxis and proliferation of chronic lymphocytic leukemia cells. Leukemia 2017; 31:2608-2614. [PMID: 28465528 PMCID: PMC5670032 DOI: 10.1038/leu.2017.132] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 03/03/2017] [Accepted: 03/21/2017] [Indexed: 11/09/2022]
Abstract
Wnt5a can activate Rho GTPases in chronic lymphocytic leukemia (CLL) cells by inducing the recruitment of ARHGEF2 to ROR1. Mass spectrometry on immune precipitates of Wnt5a-activated ROR1 identified 14-3-3ζ, which was confirmed by co-immunoprecipitation. The capacity of Wnt5a to induce ROR1 to complex with 14-3-3ζ could be blocked in CLL cells by treatment with cirmtuzumab, a humanized mAb targeting ROR1. Silencing 14-3-3ζ via small interfering RNA impaired the capacity of Wnt5a to: (1) induce recruitment of ARHGEF2 to ROR1, (2) enhance in vitro exchange activity of ARHGEF2 and (3) induce activation of RhoA and Rac1 in CLL cells. Furthermore, CRISPR/Cas9 deletion of 14-3-3ζ in ROR1-negative CLL cell-line MEC1, and in MEC1 cells transfected to express ROR1 (MEC1-ROR1), demonstrated that 14-3-3ζ was necessary for the growth/engraftment advantage of MEC1-ROR1 over MEC1 cells. We identified a binding motif (RSPS857SAS) in ROR1 for 14-3-3ζ. Site-directed mutagenesis of ROR1 demonstrated that serine-857 was required for the recruitment of 14-3-3ζ and ARHGEF2 to ROR1, and activation of RhoA and Rac1. Collectively, this study reveals that 14-3-3ζ plays a critical role in Wnt5a/ROR1 signaling, leading to enhanced CLL migration and proliferation.
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Affiliation(s)
- J Yu
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - L Chen
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - Y Chen
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - M K Hasan
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - E M Ghia
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - L Zhang
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - R Wu
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - L Z Rassenti
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - G F Widhopf
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
| | - Z Shen
- Section of Cell and Developmental Biology, University of California-San Diego, La Jolla, CA, USA
| | - S P Briggs
- Section of Cell and Developmental Biology, University of California-San Diego, La Jolla, CA, USA
| | - T J Kipps
- Moores Cancer Center, University of California-San Diego, La Jolla, CA, USA
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