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Composite Lymphomas and the Relationship of Hodgkin Lymphoma to Non-Hodgkin Lymphomas. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/978-3-319-68094-1_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
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52
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Horton SJ, Giotopoulos G, Yun H, Vohra S, Sheppard O, Bashford-Rogers R, Rashid M, Clipson A, Chan WI, Sasca D, Yiangou L, Osaki H, Basheer F, Gallipoli P, Burrows N, Erdem A, Sybirna A, Foerster S, Zhao W, Sustic T, Petrunkina Harrison A, Laurenti E, Okosun J, Hodson D, Wright P, Smith KG, Maxwell P, Fitzgibbon J, Du MQ, Adams DJ, Huntly BJP. Early loss of Crebbp confers malignant stem cell properties on lymphoid progenitors. Nat Cell Biol 2017; 19:1093-1104. [PMID: 28825697 PMCID: PMC5633079 DOI: 10.1038/ncb3597] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 07/20/2017] [Indexed: 12/13/2022]
Abstract
Loss-of-function mutations of cyclic-AMP response element binding protein, binding protein (CREBBP) are prevalent in lymphoid malignancies. However, the tumour suppressor functions of CREBBP remain unclear. We demonstrate that loss of Crebbp in murine haematopoietic stem and progenitor cells (HSPCs) leads to increased development of B-cell lymphomas. This is preceded by accumulation of hyperproliferative lymphoid progenitors with a defective DNA damage response (DDR) due to a failure to acetylate p53. We identify a premalignant lymphoma stem cell population with decreased H3K27ac, which undergoes transcriptional and genetic evolution due to the altered DDR, resulting in lymphomagenesis. Importantly, when Crebbp is lost later in lymphopoiesis, cellular abnormalities are lost and tumour generation is attenuated. We also document that CREBBP mutations may occur in HSPCs from patients with CREBBP-mutated lymphoma. These data suggest that earlier loss of Crebbp is advantageous for lymphoid transformation and inform the cellular origins and subsequent evolution of lymphoid malignancies.
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Affiliation(s)
- Sarah J Horton
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - George Giotopoulos
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Haiyang Yun
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Shabana Vohra
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Olivia Sheppard
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Rachael Bashford-Rogers
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Mamunur Rashid
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton CB10 1SA, UK
| | - Alexandra Clipson
- Department of Pathology, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
| | - Wai-In Chan
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Daniel Sasca
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Loukia Yiangou
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
| | - Hikari Osaki
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Faisal Basheer
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Paolo Gallipoli
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Natalie Burrows
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Ayşegül Erdem
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | | | - Sarah Foerster
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
| | - Wanfeng Zhao
- Department of Pathology, Cambridge University Hospitals, Hills Road, Cambridge CB2 0QQ, UK
| | - Tonci Sustic
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | | | - Elisa Laurenti
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - Jessica Okosun
- Barts Cancer Institute, Charterhouse Square, London EC1M 6BQ, UK
| | - Daniel Hodson
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - Penny Wright
- Department of Pathology, Cambridge University Hospitals, Hills Road, Cambridge CB2 0QQ, UK
| | - Ken G Smith
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Patrick Maxwell
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
| | - Jude Fitzgibbon
- Barts Cancer Institute, Charterhouse Square, London EC1M 6BQ, UK
| | - Ming Q Du
- Department of Pathology, University of Cambridge, Hills Road, Cambridge CB2 0QQ, UK
| | - David J Adams
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Hinxton CB10 1SA, UK
| | - Brian J P Huntly
- Wellcome Trust-MRC Cambridge Stem Cell Institute, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- Cambridge Institute for Medical Research, Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0XY, UK
- Department of Haematology, Cambridge University Hospitals, Hills Road, Cambridge CB2 0QQ, UK
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53
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A somatic mutation in erythro-myeloid progenitors causes neurodegenerative disease. Nature 2017; 549:389-393. [PMID: 28854169 PMCID: PMC6047345 DOI: 10.1038/nature23672] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 07/26/2017] [Indexed: 12/23/2022]
Abstract
The pathophysiology of neurodegenerative diseases is poorly understood, and therapeutic options are few. Neurodegenerative diseases are hallmarked by progressive neuronal dysfunction and loss, associated with chronic glial activation1. Whether microglial activation, which is viewed in general as a secondary process, is detrimental or protective in neurodegeneration remains unclear1–8. Late-onset neurodegenerative disease observed in patients with histiocytoses9–12, which are clonal myeloid diseases associated with somatic mutations in the RAS/MEK/ERK pathway such as BRAFV600E 13–17, suggests a possible role of somatic mutations in myeloid cells in neurodegeneration. Yet expression of BRAFV600E in the hematopoietic stem cell (HSC) lineage causes leukemic and tumoral diseases but not neurodegenerative disease18,19. Microglia belong to a lineage of adult tissue-resident myeloid cells that develop during organogenesis from yolk sac erythro-myeloid progenitors (EMP) distinct from HSC20–23. We thus hypothesized that a somatic BRAFV600E mutation in the EMP lineage may cause neurodegeneration. Here we show that mosaic expression of BRAFV600E in EMP results in clonal expansion of tissue-resident macrophages and a severe late-onset neurodegenerative disorder, associated with accumulation of ERK-activated amoeboid microglia in mice, also observed in human histiocytoses patients. In the murine model, neurobehavioral signs, astrogliosis, amyloid precursor protein deposition, synaptic loss and neuronal death were driven by ERK-activated microglia and were preventable by BRAF inhibition. These results identify the fetal precursors of tissue-resident macrophages as a potential cell-of-origin for histiocytoses, and demonstrate in mice that a somatic mutation in the EMP lineage can drive late-onset neurodegeneration. Moreover, these data identify activation of the MAP kinase pathway in microglia as a cause of neurodegeneration, and provide opportunities for therapeutic intervention aimed at preventing neuronal death in neurodegenerative diseases.
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54
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Clonality and mutational profiling of a case of composite hairy cell leukemia and chronic lymphocytic leukemia. J Hematop 2017. [DOI: 10.1007/s12308-017-0301-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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55
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Milne P, Bigley V, Bacon CM, Néel A, McGovern N, Bomken S, Haniffa M, Diamond EL, Durham BH, Visser J, Hunt D, Gunawardena H, Macheta M, McClain KL, Allen C, Abdel-Wahab O, Collin M. Hematopoietic origin of Langerhans cell histiocytosis and Erdheim-Chester disease in adults. Blood 2017; 130:167-175. [PMID: 28512190 PMCID: PMC5524529 DOI: 10.1182/blood-2016-12-757823] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/24/2017] [Indexed: 12/15/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) and Erdheim-Chester disease (ECD) are rare histiocytic disorders induced by somatic mutation of MAPK pathway genes. BRAFV600E mutation is the most common mutation in both conditions and also occurs in the hematopoietic neoplasm hairy cell leukemia (HCL). It is not known if adult LCH or ECD arises from hematopoietic stem cells (HSCs), nor which potential blood borne precursors lead to the formation of histiocytic lesions. In this study, BRAFV600E allele-specific polymerase chain reaction was used to map the neoplastic clone in 20 adults with LCH, ECD, and HCL. BRAFV600E was tracked to classical monocytes, nonclassical monocytes, and CD1c+ myeloid dendritic cells (DCs) in the blood, and mutations were observed in HSCs and myeloid progenitors in the bone marrow of 4 patients. The pattern of involvement of peripheral blood myeloid cells was indistinguishable between LCH and ECD, although the histiocytic disorders were distinct to HCL. As reported in children, detection of BRAFV600E in peripheral blood of adults was a marker of active multisystem LCH. The healthy counterparts of myeloid cells affected by BRAF mutation had a range of differentiation potentials depending on exogenous signals. CD1c+ DCs acquired high langerin and CD1a with granulocyte-macrophage colony-stimulating factor and transforming growth factor β alone, whereas CD14+ classical monocytes required additional notch ligation. Both classical and nonclassical monocytes, but not CD1c+ DCs, made foamy macrophages easily in vitro with macrophage colony-stimulating factor and human serum. These studies are consistent with a hematopoietic origin and >1 immediate cellular precursor in both LCH and ECD.
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MESH Headings
- Adult
- Alleles
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antigens, CD1/genetics
- Antigens, CD1/immunology
- Bone Marrow Cells/immunology
- Bone Marrow Cells/pathology
- Cell Differentiation
- Dendritic Cells/immunology
- Dendritic Cells/pathology
- Diagnosis, Differential
- Erdheim-Chester Disease/diagnosis
- Erdheim-Chester Disease/genetics
- Erdheim-Chester Disease/immunology
- Erdheim-Chester Disease/pathology
- Female
- Foam Cells/immunology
- Foam Cells/pathology
- Gene Expression
- Glycoproteins/genetics
- Glycoproteins/immunology
- Granulocyte-Macrophage Colony-Stimulating Factor/genetics
- Granulocyte-Macrophage Colony-Stimulating Factor/immunology
- Hematopoietic Stem Cells/immunology
- Hematopoietic Stem Cells/pathology
- Histiocytosis, Langerhans-Cell/diagnosis
- Histiocytosis, Langerhans-Cell/genetics
- Histiocytosis, Langerhans-Cell/immunology
- Histiocytosis, Langerhans-Cell/pathology
- Humans
- Immunophenotyping
- Lectins, C-Type/genetics
- Lectins, C-Type/immunology
- Lipopolysaccharide Receptors/genetics
- Lipopolysaccharide Receptors/immunology
- Male
- Mannose-Binding Lectins/genetics
- Mannose-Binding Lectins/immunology
- Monocytes/immunology
- Monocytes/pathology
- Mutation
- Proto-Oncogene Proteins B-raf/genetics
- Proto-Oncogene Proteins B-raf/immunology
- Receptors, Notch/genetics
- Receptors, Notch/immunology
- Transforming Growth Factor beta/genetics
- Transforming Growth Factor beta/immunology
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Affiliation(s)
| | | | - Chris M Bacon
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Antoine Néel
- Internal Medicine Department, Hôtel-Dieu University Hopital, Nantes, France
| | | | - Simon Bomken
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Eli L Diamond
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Johannes Visser
- East Midlands Children's and Young Persons' Integrated Cancer Service, Leicester Children's Hospital, Leicester, United Kingdom
| | - David Hunt
- Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Harsha Gunawardena
- Rheumatology Department, North Bristol National Health Service Trust, Bristol, United Kingdom
| | - Mac Macheta
- Blackpool Teaching Hospitals National Health Service Foundation Trust, Blackpool, United Kingdom; and
| | - Kenneth L McClain
- Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX
| | - Carl Allen
- Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX
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56
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Kandarpa M, Wu YM, Robinson D, Burke PW, Chinnaiyan AM, Talpaz M. Clinical characteristics and whole exome/transcriptome sequencing of coexisting chronic myeloid leukemia and myelofibrosis. Am J Hematol 2017; 92:555-561. [PMID: 28335073 DOI: 10.1002/ajh.24728] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 03/17/2017] [Indexed: 12/15/2022]
Abstract
Myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell (HSC) disorders that can be classified on the basis of genetic, clinical, phenotypic features. Genetic lesions such as JAK2 mutations and BCR-ABL translocation are often mutually exclusive in MPN patients and lead to essential thrombocythemia, polycythemia vera, or myelofibrosis or chronic myeloid leukemia, respectively. Nevertheless, coexistence of these genetic aberrations in the same patient has been reported. Whether these aberrations occur in the same stem cell or a different cell is unclear, but an unstable genome in the HSCs seems to be the common antecedent. In an effort to characterize the underlying genetic events that might contribute to the appearance of more than one MPN in a patient, we studied neoplastic cells from patients with dual MPNs by next-generation sequencing. We observed that most patients with two MPNs harbored mutations in genes known to contribute to clonal hematopoiesis through altered epigenetic regulation such as TET2, ASXL1/2, SRSF2, and IDH2 at varying frequencies (1%-47%). In addition, we found that some patients also harbored oncogenic mutations in N/KRAS, TP53, BRAF, EZH2, and GNAS at low frequencies, which probably represent clonal evolution. These findings support the hypothesis that hematopoietic cells from MPN patients harbor multiple genetic aberrations, some of which can contribute to clonal dominance. Acquiring mutations in JAK2/CALR/MPL or the BCR-ABL translocation probably drive the oncogenic phenotype towards a specific MPN. Further, we propose that the acquisition of BCR-ABL in these patients is frequently a secondary event resulting from an unstable genome.
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Affiliation(s)
- Malathi Kandarpa
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109 USA
- Division of Hematology/Oncology; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109 USA
| | - Yi-Mi Wu
- Michigan Center for Translational Pathology, University of Michigan Medical School; Ann Arbor Michigan 48109 USA
| | - Dan Robinson
- Michigan Center for Translational Pathology, University of Michigan Medical School; Ann Arbor Michigan 48109 USA
| | - Patrick William Burke
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109 USA
- Division of Hematology/Oncology; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109 USA
| | - Arul M. Chinnaiyan
- Michigan Center for Translational Pathology, University of Michigan Medical School; Ann Arbor Michigan 48109 USA
| | - Moshe Talpaz
- Department of Internal Medicine; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109 USA
- Division of Hematology/Oncology; University of Michigan Comprehensive Cancer Center; Ann Arbor Michigan 48109 USA
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57
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Abstract
Hairy cell leukemia (HCL) is a chronic mature B-cell neoplasm with unique clinicopathologic features and an initial exquisite sensitivity to chemotherapy with purine analogs; however, the disease relapses, often repeatedly. The enigmatic pathogenesis of HCL was recently clarified by the discovery of its underlying genetic cause, the BRAF-V600E kinase-activating mutation, which is somatically and clonally present in almost all patients through the entire disease spectrum and clinical course. By aberrantly activating the RAF-MEK-ERK signaling pathway, BRAF-V600E shapes key biologic features of HCL, including its specific expression signature, hairy morphology, and antiapoptotic behavior. Accompanying mutations of the KLF2 transcription factor or the CDKN1B/p27 cell cycle inhibitor are recurrent in 16% of patients with HCL and likely cooperate with BRAF-V600E in HCL pathogenesis. Conversely, BRAF-V600E is absent in other B-cell neoplasms, including mimickers of HCL that require different treatments (eg, HCL-variant and splenic marginal zone lymphoma). Thus, testing for BRAF-V600E allows for a genetics-based differential diagnosis between HCL and HCL-like tumors, even noninvasively in routine blood samples. BRAF-V600E also represents a new therapeutic target. Patients' leukemic cells exposed ex vivo to BRAF inhibitors are spoiled of their HCL identity and then undergo apoptosis. In clinical trials of patients with HCL who have experienced multiple relapses after purine analogs or who are refractory to purine analogs, a short course of the oral BRAF inhibitor vemurafenib produced an almost 100% response rate, including complete remission rates of 35% to 42%, without myelotoxicity. To further improve on these results, it will be important to clarify the mechanisms of incomplete leukemic cell eradication by vemurafenib and to explore chemotherapy-free combinations of a BRAF inhibitor with other targeted agents (eg, a MEK inhibitor and/or an anti-CD20 monoclonal antibody).
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Affiliation(s)
- Enrico Tiacci
- All authors: Institute of Hematology and Center for Hemato-Oncology Research, University and Hospital of Perugia, Perugia, Italy
| | - Valentina Pettirossi
- All authors: Institute of Hematology and Center for Hemato-Oncology Research, University and Hospital of Perugia, Perugia, Italy
| | - Gianluca Schiavoni
- All authors: Institute of Hematology and Center for Hemato-Oncology Research, University and Hospital of Perugia, Perugia, Italy
| | - Brunangelo Falini
- All authors: Institute of Hematology and Center for Hemato-Oncology Research, University and Hospital of Perugia, Perugia, Italy
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58
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Grever MR, Abdel-Wahab O, Andritsos LA, Banerji V, Barrientos J, Blachly JS, Call TG, Catovsky D, Dearden C, Demeter J, Else M, Forconi F, Gozzetti A, Ho AD, Johnston JB, Jones J, Juliusson G, Kraut E, Kreitman RJ, Larratt L, Lauria F, Lozanski G, Montserrat E, Parikh SA, Park JH, Polliack A, Quest GR, Rai KR, Ravandi F, Robak T, Saven A, Seymour JF, Tadmor T, Tallman MS, Tam C, Tiacci E, Troussard X, Zent CS, Zenz T, Zinzani PL, Falini B. Consensus guidelines for the diagnosis and management of patients with classic hairy cell leukemia. Blood 2017; 129:553-560. [PMID: 27903528 PMCID: PMC5290982 DOI: 10.1182/blood-2016-01-689422] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 11/06/2016] [Indexed: 12/20/2022] Open
Abstract
Hairy cell leukemia is an uncommon hematologic malignancy characterized by pancytopenia and marked susceptibility to infection. Tremendous progress in the management of patients with this disease has resulted in high response rates and improved survival, yet relapse and an appropriate approach to re-treatment present continuing areas for research. The disease and its effective treatment are associated with immunosuppression. Because more patients are being treated with alternative programs, comparison of results will require general agreement on definitions of response, relapse, and methods of determining minimal residual disease. The development of internationally accepted, reproducible criteria is of paramount importance in evaluating and comparing clinical trials to provide optimal care. Despite the success achieved in managing these patients, continued participation in available clinical trials in the first-line and particularly in the relapse setting is highly recommended. The Hairy Cell Leukemia Foundation convened an international conference to provide common definitions and structure to guide current management. There is substantial opportunity for continued research in this disease. In addition to the importance of optimizing the prevention and management of the serious risk of infection, organized evaluations of minimal residual disease and treatment at relapse offer ample opportunities for clinical research. Finally, a scholarly evaluation of quality of life in the increasing number of survivors of this now manageable chronic illness merits further study. The development of consensus guidelines for this disease offers a framework for continued enhancement of the outcome for patients.
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Affiliation(s)
- Michael R Grever
- Division of Hematology, Department of Internal Medicine, The Ohio State University James Cancer Hospital, Columbus, OH
| | - Omar Abdel-Wahab
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Leslie A Andritsos
- Division of Hematology, Department of Internal Medicine, The Ohio State University James Cancer Hospital, Columbus, OH
| | - Versha Banerji
- Section of Hematology/Oncology, University of Manitoba, Winnipeg, MB, Canada
| | - Jacqueline Barrientos
- Department of Medicine, Hofstra North Shore-Long Island Jewish School of Medicine, Hofstra University, Hempstead, NY
| | - James S Blachly
- Division of Hematology, Department of Internal Medicine, The Ohio State University James Cancer Hospital, Columbus, OH
| | | | - Daniel Catovsky
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Claire Dearden
- Department of Haemato-Oncology, Royal Marsden Biomedical Research Centre, London, United Kingdom
| | - Judit Demeter
- First Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Monica Else
- Division of Molecular Pathology, The Institute of Cancer Research, London, United Kingdom
| | - Francesco Forconi
- Haematology Department, University Hospital Trust and Cancer Sciences Unit, Cancer Research UK and National Institute for Health Research Experimental Cancer Medicine Centres, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Anthony D Ho
- Department of Medicine V, University of Heidelberg, Heidelberg, Germany
| | - James B Johnston
- Section of Hematology/Oncology, University of Manitoba, Winnipeg, MB, Canada
| | - Jeffrey Jones
- Division of Hematology, Department of Internal Medicine, The Ohio State University James Cancer Hospital, Columbus, OH
| | - Gunnar Juliusson
- Department of Hematology, Skåne University Hospital and Stem Cell Center, Lund University, Lund, Sweden
| | - Eric Kraut
- Division of Hematology, Department of Internal Medicine, The Ohio State University James Cancer Hospital, Columbus, OH
| | - Robert J Kreitman
- Laboratory of Molecular Biology, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Loree Larratt
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Francesco Lauria
- Hematology, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Gerard Lozanski
- Department of Pathology, The Ohio State University, Columbus, OH
| | - Emili Montserrat
- Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | - Jae H Park
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Aaron Polliack
- Department of Hematology, Hadassah University Hospital and Hebrew University Medical School, Jerusalem, Israel
| | - Graeme R Quest
- Department of Laboratory Medicine and Pathology, University Health Network, Toronto, ON, Canada
| | - Kanti R Rai
- Department of Medicine, Hofstra North Shore-Long Island Jewish School of Medicine, Hofstra University, Hempstead, NY
| | - Farhad Ravandi
- Section of Developmental Therapeutics, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Alan Saven
- Division of Hematology and Oncology, Scripps Clinic, La Jolla, CA
| | - John F Seymour
- Haematology Department, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Tamar Tadmor
- Hematology Unit, Bnai-Zion Medical Center, and the Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Martin S Tallman
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Constantine Tam
- Haematology Department, Peter MacCallum Cancer Centre, University of Melbourne, Melbourne, VIC, Australia
| | - Enrico Tiacci
- Institute of Hematology, Department of Medicine, University and Hospital of Perugia, Perugia, Italy
| | - Xavier Troussard
- Department of Hematology, Centre Hospitalier Universitaire Côte de Nacre, Caen, France
| | - Clive S Zent
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY
| | - Thorsten Zenz
- Department of Molecular Therapy in Hematology and Oncology, National Center for Tumor Diseases and German Cancer Research Center (DKFZ), Heidelberg, Germany; and
| | - Pier Luigi Zinzani
- Institute of Hematology "Seràgnoli," University of Bologna, Bologna, Italy
| | - Brunangelo Falini
- Institute of Hematology, Department of Medicine, University and Hospital of Perugia, Perugia, Italy
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59
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Raess PW, Cascio MJ, Fan G, Press R, Druker BJ, Brewer D, Spurgeon SE. Concurrent STAT3, DNMT3A, and TET2 mutations in T-LGL leukemia with molecularly distinct clonal hematopoiesis of indeterminate potential. Am J Hematol 2017; 92:E6-E8. [PMID: 27761930 DOI: 10.1002/ajh.24586] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/10/2016] [Accepted: 10/17/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Philipp W. Raess
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Michael J. Cascio
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Guang Fan
- Department of Pathology; Oregon Health and Science University; Portland Oregon
| | - Richard Press
- Department of Pathology; Oregon Health and Science University; Portland Oregon
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
| | - Brian J. Druker
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
| | - Diana Brewer
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
| | - Stephen E. Spurgeon
- Knight Cancer Institute, Oregon Health and Science University; Portland Oregon
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60
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Abstract
Cancer results from multistep pathogenesis, yet the pre-malignant states that precede the development of many hematologic malignancies have been difficult to identify. Recent genomic studies of blood DNA from tens of thousands of people have revealed the presence of remarkably common, age-associated somatic mutations in genes associated with hematologic malignancies. These somatic mutations drive the expansion from a single founding cell to a detectable hematopoietic clone. Owing to the admixed nature of blood that provides a sampling of blood cell production throughout the body, clonal hematopoiesis is a rare view into the biology of pre-malignancy and the direct effects of pre-cancerous lesions on organ dysfunction. Indeed, clonal hematopoiesis is associated not only with increased risk of hematologic malignancy, but also with cardiovascular disease and overall mortality. Here we review rapid advances in the genetic understanding of clonal hematopoiesis and nascent evidence implicating clonal hematopoiesis in malignant and non-malignant age-related disease.
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Affiliation(s)
- Max Jan
- Department of Pathology, Massachusetts General Hospital, Boston, MA
| | - Benjamin L Ebert
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Broad Institute of MIT and Harvard, Cambridge, MA.
| | - Siddhartha Jaiswal
- Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
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61
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BRAF V600E mutation in hairy cell leukemia: from bench to bedside. Blood 2016; 128:1918-1927. [DOI: 10.1182/blood-2016-07-418434] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/15/2016] [Indexed: 12/13/2022] Open
Abstract
AbstractHairy cell leukemia (HCL) is a distinct clinicopathological entity whose underlying genetic lesion has remained a mystery for over half a century. The BRAF V600E mutation is now recognized as the causal genetic event of HCL because it is somatic, present in the entire tumor clone, detectable in almost all cases at diagnosis (encompassing the whole disease spectrum), and stable at relapse. BRAF V600E leads to the constitutive activation of the RAF-MEK-extracellular signal-regulated kinase (ERK) signaling pathway which represents the key event in the molecular pathogenesis of HCL. KLF2 and CDNK1B (p27) mutations may cooperate with BRAF V600E in promoting leukemic transformation. Sensitive molecular assays for detecting BRAF V600E allow HCL (highly responsive to purine analogs) to be better distinguished from HCL-like disorders, which are treated differently. In vitro preclinical studies on purified HCL cells proved that BRAF and MEK inhibitors can induce marked dephosphorylation of MEK/ERK, silencing of RAF-MEK-ERK pathway transcriptional output, loss of the HCL-specific gene expression profile signature, change of morphology from “hairy” to “smooth,” and eventually apoptosis. The overall response rate of refractory/relapsed HCL patients to the BRAF inhibitor vemurafenib approached 100%, with 35% to 40% complete remissions (CRs). The median relapse free-survival was about 19 months in patients who had achieved CR and 6 months in those who had obtained a partial response. Future therapeutic perspectives include: (1) combining BRAF inhibitors with MEK inhibitors or immunotherapy (anti-CD20 monoclonal antibody) to increase the percentage of CRs and (2) better understanding of the molecular mechanisms underlying resistance of HCL cells to BRAF inhibitors.
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62
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Brown G, Sanchez-Garcia I. Is lineage decision-making restricted during tumoral reprograming of haematopoietic stem cells? Oncotarget 2016; 6:43326-41. [PMID: 26498146 PMCID: PMC4791235 DOI: 10.18632/oncotarget.6145] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 09/29/2015] [Indexed: 01/11/2023] Open
Abstract
Within the past years there have been substantial changes to our understanding of haematopoiesis and cells that initiate and sustain leukemia. Recent studies have revealed that developing haematopoietic stem and progenitor cells are much more heterogeneous and versatile than has been previously thought. This versatility includes cells using more than one route to a fate and cells having progressed some way towards a cell type retaining other lineage options as clandestine. These notions impact substantially on our understanding of the origin and nature of leukemia. An important question is whether leukemia stem cells are as versatile as their cell of origin as an abundance of cells belonging to a lineage is often a feature of overt leukemia. In this regard, we examine the coming of age of the "leukemia stem cell" theory and the notion that leukemia, like normal haematopoiesis, is a hierarchically organized tissue. We examine evidence to support the notion that whilst cells that initiate leukemia have multi-lineage potential, leukemia stem cells are reprogrammed by further oncogenic insults to restrict their lineage decision-making. Accordingly, evolution of a sub-clone of lineage-restricted malignant cells is a key feature of overt leukemia.
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Affiliation(s)
- Geoffrey Brown
- School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Isidro Sanchez-Garcia
- Experimental Therapeutics and Translational Oncology Program, Instituto de Biología Molecular y Celular del Cáncer, CSIC/Universidad de Salamanca, Campus M. de Unamuno s/n, Salamanca, Spain.,Institute of Biomedical Research of Salamanca (IBSAL), Salamanca, Spain
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63
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Abstract
PURPOSE OF REVIEW Aggressive transformation, a frequent event in the natural history of follicular lymphoma, is associated with increased lymphoma-related mortality and yet the underlying biology remains poorly defined. This review outlines recent advances in our understanding of the genetic basis and evolutionary process leading to transformation. RECENT FINDINGS Both the antecedent indolent and transformed follicular lymphoma (tFL) arise through branched divergent evolution with tumors emerging from a founder precursor population, the common progenitor cell. Although the majority of tFLs maintain a germinal center B-cell gene expression signature, an activated B-cell-type (ABC-type) profile appears to predominate in BCL2-translocation negative cases. It does not appear that a single unifying genetic or epigenetic event promotes a fitter and more aggressive clone. SUMMARY Transformed follicular tumors are genetically heterogeneous perhaps reflecting the varying clinical behavior and outcomes of this disease event. Follicular lymphoma and tFL remain incurable tumors highlighted by our inability to eradicate the founder common progenitor cell population with current therapies. Progress has now been made in defining the genetic events and evolutionary pathways responsible for transformation. Although more research is required in predicting and understanding the biology of transformation, there are opportunities to improve outcomes by preferentially directing targeted therapies toward 'actionable' early and transformation-specific aberrations.
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Affiliation(s)
- Jessica Okosun
- aCentre for Haemato-Oncology, Barts Cancer Institute bDepartment of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
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64
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Roos-Weil D, Nguyen-Khac F, Bernard OA. Chronic lymphocytic leukemia: Time to go past genomics? Am J Hematol 2016; 91:518-28. [PMID: 26800490 DOI: 10.1002/ajh.24301] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Revised: 01/11/2016] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
Abstract
Recent advances in massively parallel sequencing technologies have provided a detailed picture of the mutational landscape in CLL and underscored the vast degree of interpatient and intratumor heterogeneities. These studies have led to the characterization of novel putative driver genes and recurrently affected biological pathways, and to the modeling of CLL clonal evolution. We herein review selected aspects including recent advances in the biology of CLL and present cellular and biological processes involved in the development of CLL and potentially other mature B-cell lymphoproliferative neoplasms.
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Affiliation(s)
- Damien Roos-Weil
- Institut National De La Santé Et De La Recherche Médicale (INSERM) U1170; Villejuif France
- Gustave Roussy, Villejuif, France
- Université Paris Saclay; France
- Equipe Labellisée Ligue Nationale Contre Le Cancer
| | - Florence Nguyen-Khac
- INSERM U1138; Paris France
- Université Pierre Et Marie Curie-Paris 6; France
- Service D'hématologie Biologique, Hôpital Pitié-Salpêtrière, APHP; Paris France
| | - Olivier A. Bernard
- Institut National De La Santé Et De La Recherche Médicale (INSERM) U1170; Villejuif France
- Gustave Roussy, Villejuif, France
- Université Paris Saclay; France
- Equipe Labellisée Ligue Nationale Contre Le Cancer
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65
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Clonal hematopoiesis in acquired aplastic anemia. Blood 2016; 128:337-47. [PMID: 27121470 DOI: 10.1182/blood-2016-01-636381] [Citation(s) in RCA: 124] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/20/2016] [Indexed: 11/20/2022] Open
Abstract
Clonal hematopoiesis (CH) in aplastic anemia (AA) has been closely linked to the evolution of late clonal disorders, including paroxysmal nocturnal hemoglobinuria and myelodysplastic syndromes (MDS)/acute myeloid leukemia (AML), which are common complications after successful immunosuppressive therapy (IST). With the advent of high-throughput sequencing of recent years, the molecular aspect of CH in AA has been clarified by comprehensive detection of somatic mutations that drive clonal evolution. Genetic abnormalities are found in ∼50% of patients with AA and, except for PIGA mutations and copy-neutral loss-of-heterozygosity, or uniparental disomy (UPD) in 6p (6pUPD), are most frequently represented by mutations involving genes commonly mutated in myeloid malignancies, including DNMT3A, ASXL1, and BCOR/BCORL1 Mutations exhibit distinct chronological profiles and clinical impacts. BCOR/BCORL1 and PIGA mutations tend to disappear or show stable clone size and predict a better response to IST and a significantly better clinical outcome compared with mutations in DNMT3A, ASXL1, and other genes, which are likely to increase their clone size, are associated with a faster progression to MDS/AML, and predict an unfavorable survival. High frequency of 6pUPD and overrepresentation of PIGA and BCOR/BCORL1 mutations are unique to AA, suggesting the role of autoimmunity in clonal selection. By contrast, DNMT3A and ASXL1 mutations, also commonly seen in CH in the general population, indicate a close link to CH in the aged bone marrow, in terms of the mechanism for selection. Detection and close monitoring of somatic mutations/evolution may help with prediction and diagnosis of clonal evolution of MDS/AML and better management of patients with AA.
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66
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Bogusz AM, Bagg A. Genetic aberrations in small B-cell lymphomas and leukemias: molecular pathology, clinical relevance and therapeutic targets. Leuk Lymphoma 2016; 57:1991-2013. [PMID: 27121112 DOI: 10.3109/10428194.2016.1173212] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Small B-cell lymphomas and leukemias (SBCLs) are a clinically, morphologically, immunophenotypically and genetically heterogeneous group of clonal lymphoid neoplasms, including entities such as chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), mantle cell lymphoma (MCL), follicular lymphoma (FL), lymphoplasmacytic lymphoma (LPL), marginal zone lymphoma (MZL) and hairy cell leukemia (HCL). The pathogenesis of some of these lymphoid malignancies is characterized by distinct translocations, for example t(11;14) in the majority of cases of MCL and t(14;18) in most cases of FL, whereas other entities are associated with a variety of recurrent but nonspecific numeric chromosomal abnormalities, as exemplified by del(13q14), del(11q22), and +12 in CLL, and yet others such as LPL and HCL that lack recurrent or specific cytogenetic aberrations. The recent surge in next generation sequencing (NGS) technology has shed more light on the genetic landscape of SBCLs through characterization of numerous driver mutations including SF3B1 and NOTCH1 in CLL, ATM and CCND1 in MCL, KMT2D and EPHA7 in FL, MYD88 (L265P) in LPL, KLF2 and NOTCH2 in splenic MZL (SMZL) and BRAF (V600E) in HCL. The identification of distinct genetic lesions not only provides greater insight into the molecular pathogenesis of these disorders but also identifies potential valuable biomarkers for prognostic stratification, as well as specific targets for directed therapy. This review discusses the well-established and recently identified molecular lesions underlying the pathogenesis of SBCLs, highlights their clinical relevance and summarizes novel targeted therapies.
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Affiliation(s)
- Agata M Bogusz
- a Department of Pathology and Laboratory Medicine, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA
| | - Adam Bagg
- a Department of Pathology and Laboratory Medicine, Perelman School of Medicine , University of Pennsylvania , Philadelphia , PA , USA
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67
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Ipek YH, Fehmi H, Meliha N. Hairy cell leukemia followed by polycythemia vera: report of the first case. Oxf Med Case Reports 2016; 2016:28-30. [PMID: 26941958 PMCID: PMC4773848 DOI: 10.1093/omcr/omw005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 01/19/2016] [Accepted: 01/21/2016] [Indexed: 11/23/2022] Open
Affiliation(s)
- Yonal-Hindilerden Ipek
- Istanbul University Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul , Turkey
| | - Hindilerden Fehmi
- Istanbul Bakırkoy Sadi Konuk Training and Research Hospital , Hematology Clinic , Istanbul , Turkey
| | - Nalcaci Meliha
- Istanbul University Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul , Turkey
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Abstract
PURPOSE OF REVIEW In this review, we discuss the pathogenesis and standard therapeutic approach to hairy cell leukaemia (HCL) as well as newer targeted therapies under investigation showing promising end-points in treating HCL. RECENT FINDINGS HCL is an indolent B-cell leukaemia. Historically, HCL patients have achieved excellent response to purine nucleoside analogues and single purine analogue treatment with pentostatin or cladribine is currently the standard of care for initial treatment. Most patients achieve complete remission with this form of therapy. However, long-term follow-up has demonstrated that a large number of patients eventually develop relapsed disease. Relapse disease tends to be more difficult to treat and refractory to the same purine analogues. Development of relapsing and refractory disease after initially achieving complete remission with purine analogue treatment has generated a need for alternative therapies. SUMMARY Identification of the BRAFV600E mutation in nearly 100% of HCL patients has provided rationale for inclusion of BRAF inhibitors into the therapeutic armamentarium to treat HCL. Clinical trials are currently underway measuring efficacy of vemurafenib in achieving clinical response in relapsed/refractory HCL and also toxicity. Other novel therapies with monoclonal and immunotoxin-conjugated antibodies have also shown promising response in recent investigational studies.
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Weston-Bell NJ, Tapper W, Gibson J, Bryant D, Moreno Y, John M, Ennis S, Kluin-Nelemans HC, Collins AR, Sahota SS. Exome Sequencing in Classic Hairy Cell Leukaemia Reveals Widespread Variation in Acquired Somatic Mutations between Individual Tumours Apart from the Signature BRAF V(600)E Lesion. PLoS One 2016; 11:e0149162. [PMID: 26871591 PMCID: PMC4752330 DOI: 10.1371/journal.pone.0149162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/28/2016] [Indexed: 11/19/2022] Open
Abstract
In classic Hairy cell leukaemia (HCLc), a single case has thus far been interrogated by whole exome sequencing (WES) in a treatment naive patient, in which BRAF V(600)E was identified as an acquired somatic mutation and confirmed as occurring near-universally in this form of disease by conventional PCR-based cohort screens. It left open however the question whether other genome-wide mutations may also commonly occur at high frequency in presentation HCLc disease. To address this, we have carried out WES of 5 such typical HCLc cases, using highly purified splenic tumour cells paired with autologous T cells for germline. Apart from BRAF V(600)E, no other recurrent somatic mutation was identified in these HCLc exomes, thereby excluding additional acquired mutations as also prevalent at a near-universal frequency in this form of the disease. These data then place mutant BRAF at the centre of the neoplastic drive in HCLc. A comparison of our exome data with emerging genetic findings in HCL indicates that additional somatic mutations may however occur recurrently in smaller subsets of disease. As mutant BRAF alone is insufficient to drive malignant transformation in other histological cancers, it suggests that individual tumours utilise largely differing patterns of genetic somatic mutations to coalesce with BRAF V(600)E to drive pathogenesis of malignant HCLc disease.
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Affiliation(s)
- Nicola J. Weston-Bell
- Tumour Immunogenetics Group, Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Will Tapper
- Genetic Epidemiology and Genomic Informatics Group, Human Genetics, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Jane Gibson
- Centre for Biological Sciences, Faculty of Natural and Environmental Studies, University of Southampton, Southampton, United Kingdom
| | - Dean Bryant
- Tumour Immunogenetics Group, Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Yurany Moreno
- Tumour Immunogenetics Group, Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Melford John
- Department of Preclinical Sciences, Faculty of Medical Sciences, University of The West Indies, St. Augustine, Trinidad and Tobago
| | - Sarah Ennis
- Genetic Epidemiology and Genomic Informatics Group, Human Genetics, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Hanneke C. Kluin-Nelemans
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Andrew R. Collins
- Genetic Epidemiology and Genomic Informatics Group, Human Genetics, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Surinder S. Sahota
- Tumour Immunogenetics Group, Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- * E-mail:
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Garza-Ledezma M, Tellez-Hinojosa C, González-López E, Gómez-Almaguer D. Hairy cell leukemia, an uncommon B-cell lymphoid neoplasia. MEDICINA UNIVERSITARIA 2016. [DOI: 10.1016/j.rmu.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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71
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Tiacci E, Park JH, De Carolis L, Chung SS, Broccoli A, Scott S, Zaja F, Devlin S, Pulsoni A, Chung YR, Cimminiello M, Kim E, Rossi D, Stone RM, Motta G, Saven A, Varettoni M, Altman JK, Anastasia A, Grever MR, Ambrosetti A, Rai KR, Fraticelli V, Lacouture ME, Carella AM, Levine RL, Leoni P, Rambaldi A, Falzetti F, Ascani S, Capponi M, Martelli MP, Park CY, Pileri SA, Rosen N, Foà R, Berger MF, Zinzani PL, Abdel-Wahab O, Falini B, Tallman MS. Targeting Mutant BRAF in Relapsed or Refractory Hairy-Cell Leukemia. N Engl J Med 2015; 373:1733-47. [PMID: 26352686 PMCID: PMC4811324 DOI: 10.1056/nejmoa1506583] [Citation(s) in RCA: 232] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND BRAF V600E is the genetic lesion underlying hairy-cell leukemia. We assessed the safety and activity of the oral BRAF inhibitor vemurafenib in patients with hairy-cell leukemia that had relapsed after treatment with a purine analogue or who had disease that was refractory to purine analogues. METHODS We conducted two phase 2, single-group, multicenter studies of vemurafenib (at a dose of 960 mg twice daily)--one in Italy and one in the United States. The therapy was administered for a median of 16 weeks in the Italian study and 18 weeks in the U.S. study. Primary end points were the complete response rate (in the Italian trial) and the overall response rate (in the U.S. trial). Enrollment was completed (28 patients) in the Italian trial in April 2013 and is still open (26 of 36 planned patients) in the U.S. trial. RESULTS The overall response rates were 96% (25 of 26 patients who could be evaluated) after a median of 8 weeks in the Italian study and 100% (24 of 24) after a median of 12 weeks in the U.S. study. The rates of complete response were 35% (9 of 26 patients) and 42% (10 of 24) in the two trials, respectively. In the Italian trial, after a median follow-up of 23 months, the median relapse-free survival was 19 months among patients with a complete response and 6 months among those with a partial response; the median treatment-free survival was 25 months and 18 months, respectively. In the U.S. trial, at 1 year, the progression-free survival rate was 73% and the overall survival rate was 91%. Drug-related adverse events were usually of grade 1 or 2, and the events most frequently leading to dose reductions were rash and arthralgia or arthritis. Secondary cutaneous tumors (treated with simple excision) developed in 7 of 50 patients. The frequent persistence of phosphorylated ERK-positive leukemic cells in bone marrow at the end of treatment suggests bypass reactivation of MEK and ERK as a resistance mechanism. CONCLUSIONS A short oral course of vemurafenib was highly effective in patients with relapsed or refractory hairy-cell leukemia. (Funded by the Associazione Italiana per la Ricerca sul Cancro and others; EudraCT number, 2011-005487-13; ClinicalTrials.gov number NCT01711632.).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Brunangelo Falini
- Corresponding author: Dr. Brunangelo Falini, Institute of Hematology-CREO (Centro di Ricerche Emato-Oncologiche), Ospedale S. Maria della Misericordia, University of Perugia, 06132 Perugia, Italy,
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Couronné L, Bastard C, Gaulard P, Hermine O, Bernard O. [Molecular pathogenesis of peripheral T-cell lymphoma (1): angioimmunoblastic T-cell lymphoma, peripheral T-cell lymphoma, not otherwise specified and anaplastic large cell lymphoma]. Med Sci (Paris) 2015; 31:841-52. [PMID: 26481023 DOI: 10.1051/medsci/20153110010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Peripheral T-cell lymphomas (PTCL) belong to the group of non-Hodgkin lymphoma and particularly that of mature T/NK cells lymphoproliferative neoplasms. The 2008 WHO classification describes different PTCL entities with varying prevalence. With the exception of the histological subtype "ALK positive anaplastic large cell lymphoma", PTCL are characterized by a poor prognosis. The mechanisms underlying the pathogenesis of these lymphomas are not yet fully understood, but development of genomic high-throughput analysis techniques now allows to extensively identify the molecular abnormalities present in tumor cells. This review aims to summarize the current knowledge and recent advances about the molecular events occurring at the origin or during the natural history of main entities of PTCL. It will be published in two parts : the first is focused on the three more frequent entities, angioimmunoblastic T-cell lymphoma, peripheral T-cell lymphoma, not otherwise specified, and anaplastic large cell lymphoma. The second (which will appear in the november issue) will describe other subtypes less frequent and of poor prognosis : extranodal NK/T-cell lymphoma, nasal type, adult T-cell leukemia/lymphoma, and enteropathy-associated T-cell lymphoma. T or NK cell lymphoproliferative disorders with leukemic presentation, primary cutaneous T-cell lymphoma and very rare subtypes of PTCL whose prevalence is less than 5% (hepatosplenic T-cell lymphoma and subcutaneous panniculitis-like T cell lymphoma) will not be discussed herein.
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Affiliation(s)
- Lucile Couronné
- Service d'hématologie adultes, Assistance publique-hôpitaux de Paris (APHP), hôpital Necker, Paris, France - Inserm UMR1163, CNRS ERL 8254, Institut Imagine, Paris, France - Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Christian Bastard
- Service d'anatomo-pathologie, AP-HP, groupe hospitalier Henri Mondor-Albert Chenevier, Créteil, France; Université Paris-Est, faculté de médecine, Créteil, France ; Inserm U955, institut Mondor de recherche biomédicale, Créteil, France
| | - Philippe Gaulard
- Inserm, U918 ; Université de Rouen ; centre Henri Becquerel, Rouen, France
| | - Olivier Hermine
- Service d'hématologie adultes, Assistance publique-hôpitaux de Paris (APHP), hôpital Necker, Paris, France - Inserm UMR1163, CNRS ERL 8254, Institut Imagine, Paris, France - Université Paris Descartes-Sorbonne Paris Cité, Paris, France
| | - Olivier Bernard
- UMR 1170 ; Institut Gustave Roussy, 94805 Villejuif, France ; Université Paris Sud 11, Orsay, France
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Sutton LA, Rosenquist R. Deciphering the molecular landscape in chronic lymphocytic leukemia: time frame of disease evolution. Haematologica 2015; 100:7-16. [PMID: 25552678 DOI: 10.3324/haematol.2014.115923] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Dramatic advances in next generation sequencing technologies have provided a novel opportunity to understand the molecular genetics of chronic lymphocytic leukemia through the comprehensive detection of genetic lesions. While progress is being made in elucidating the clinical significance of recurrently mutated genes, layers of complexity have been added to our understanding of chronic lymphocytic leukemia pathogenesis in the guise of the molecular evolution and (sub)clonal architecture of the disease. As we prepare for an era of tailored therapy, we need to appreciate not only the effect mutations have on drug response but also the impact subclones containing specific mutations have at initial presentation, during therapy and upon relapse. Therefore, although the wealth of emerging genetic data has great potential in helping us devise strategies to improve the therapy and prognosis of patients, focused efforts will be required to follow disease evolution, particularly in the context of novel therapies, in order to translate this knowledge into clinical settings.
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Affiliation(s)
- Lesley-Ann Sutton
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - Richard Rosenquist
- Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Sweden
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Cavalli M, Ilari C, Del Giudice I, Marinelli M, Della Starza I, De Propris MS, De Novi LA, Nunes V, Cafforio L, Raponi S, Mancini F, Mauro FR, Tiacci E, Falini B, Guarini A, Foà R. A case of concomitant chronic lymphocytic leukaemia and hairy cell leukaemia evaluated forIGHV-D-Jrearrangements andBRAF-V600E mutation: lack of evidence for a common origin. Br J Haematol 2015; 174:329-31. [DOI: 10.1111/bjh.13770] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Marzia Cavalli
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Caterina Ilari
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Ilaria Del Giudice
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Marilisa Marinelli
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Irene Della Starza
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | | | - Lucia Anna De Novi
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Vittorio Nunes
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Luciana Cafforio
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Sara Raponi
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Francesca Mancini
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Francesca Romana Mauro
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Enrico Tiacci
- Institute of Haematology and Centre for Haemato-Oncology Research (C.R.E.O.); University and Hospital of Perugia; Perugia Italy
| | - Brunangelo Falini
- Institute of Haematology and Centre for Haemato-Oncology Research (C.R.E.O.); University and Hospital of Perugia; Perugia Italy
| | - Anna Guarini
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
| | - Robin Foà
- Department of Cellular Biotechnologies and Haematology; “Sapienza” University of Rome; Rome Italy
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The importance of the tissue microenvironment in hairy cell leukemia. Best Pract Res Clin Haematol 2015; 28:208-16. [PMID: 26614899 DOI: 10.1016/j.beha.2015.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 09/24/2015] [Accepted: 09/29/2015] [Indexed: 12/23/2022]
Abstract
Hairy cell leukemia (HCL) cells engage in complex cellular and molecular interactions with accessory cells, matrix proteins, and various cytokines in the bone marrow and spleen, collectively referred to as the tissue microenvironment. Chemokine receptors and adhesion molecules are critical players for homing and retention within these microenvironments. Engagement of B cell antigen receptors and CD40 on HCL cells promote survival and proliferation. In this chapter, we summarize the current knowledge about the cellular and molecular interactions between HCL cells and their supportive tissue microenvironment, and provide insight into new therapeutic approaches targeting B cell receptor signaling in HCL.
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76
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Abstract
Langerhans cell histiocytosis (LCH) is heterogeneous disease characterized by common histology of inflammatory lesions containing Langerin(+) (CD207) histiocytes. Emerging data support a model in which MAPK activation in self-renewing hematopoietic progenitors may drive disseminated high-risk disease, whereas MAPK activation in more differentiated committed myeloid populations may induce low-risk LCH. The heterogeneous clinical manifestations with shared histology may represent the final common pathway of an acquired defect of differentiation, initiated at more than one point. Implications of this model include re-definition of LCH as a myeloid neoplasia and re-focusing therapeutic strategies on the cells and lineages of origin.
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Affiliation(s)
- Matthew Collin
- Human Dendritic Cell Laboratory, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Venetia Bigley
- Human Dendritic Cell Laboratory, Institute of Cellular Medicine, Newcastle University, Framlington Place, Newcastle upon Tyne NE2 4HH, UK
| | - Kenneth L McClain
- Texas Children's Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Carl E Allen
- Texas Children's Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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77
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Blachly JS, Lozanski G, Lucas DM, Grever MR, Kendra K, Andritsos LA. Cotreatment of hairy cell leukemia and melanoma with the BRAF inhibitor dabrafenib. J Natl Compr Canc Netw 2015; 13:9-13; quiz 13. [PMID: 25583765 DOI: 10.6004/jnccn.2015.0004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The activating BRAF mutation p.V600E has been identified in many cancers, including colon and lung adenocarcinomas, papillary thyroid cancer, malignant melanoma, and hairy cell leukemia (HCL). Malignant melanoma and HCL are of particular interest because of both the high proportion of cases harboring the mutation and the dramatic responses to BRAF inhibitor therapy reported in the literature. This report presents a patient with HCL and malignant melanoma with the BRAF p.V600E mutation, and discusses the successful treatment of both cancers with the BRAF inhibitor dabrafenib.
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Affiliation(s)
- James S Blachly
- From the Division of Hematology, Department of Internal Medicine, Department of Pathology, and Division of Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Gerard Lozanski
- From the Division of Hematology, Department of Internal Medicine, Department of Pathology, and Division of Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - David M Lucas
- From the Division of Hematology, Department of Internal Medicine, Department of Pathology, and Division of Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Michael R Grever
- From the Division of Hematology, Department of Internal Medicine, Department of Pathology, and Division of Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Kari Kendra
- From the Division of Hematology, Department of Internal Medicine, Department of Pathology, and Division of Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Leslie A Andritsos
- From the Division of Hematology, Department of Internal Medicine, Department of Pathology, and Division of Oncology, Department of Internal Medicine, The Ohio State University, Columbus, Ohio
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78
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Tsai YT, Lozanski G, Lehman A, Sass EJ, Hertlein E, Salunke SB, Chen CS, Grever MR, Byrd JC, Lucas DM. BRAF V600E induces ABCB1/P-glycoprotein expression and drug resistance in B-cells via AP-1 activation. Leuk Res 2015; 39:S0145-2126(15)30371-4. [PMID: 26350141 PMCID: PMC4779435 DOI: 10.1016/j.leukres.2015.08.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 08/25/2015] [Indexed: 12/15/2022]
Abstract
A subset of patients with chronic lymphocytic leukemia (CLL) and nearly all patients with classic hairy cell leukemia (HCL) harbor somatic BRAF activating mutations. However, the pathological role of activated BRAF in B-cell leukemia development and progression remains unclear. In addition, although HCL patients respond well to the BRAFV600E inhibitor vemurafenib, relapses are being observed, suggesting the development of drug resistance in patients with this mutation. To investigate the biological role of BRAFV600E in B-cell leukemia, we generated a CLL-like B-cell line, OSUCLL, with doxycycline-inducible BRAFV600E expression. Microarray and real-time PCR analysis showed that ABCB1 mRNA is upregulated in these cells, and P-glycoprotein (P-gp) expression as well as function were confirmed by immunoblot and rhodamine exclusion assays. Additionally, pharmacological inhibition of BRAFV600E and MEK alleviated the BRAFV600E-induced ABCB1/P-gp expression. ABCB1 reporter assays and gel shift assays demonstrated that AP-1 activity is crucial in this mechanism. This study, uncovers a pathological role for BRAFV600E in B-cell leukemia, and provides further evidence that combination strategies with inhibitors of BRAFV600E and MEK can be used to delay disease progression and occurrence of resistance.
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Affiliation(s)
- Yo-Ting Tsai
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Gerard Lozanski
- Department of Pathology, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Amy Lehman
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Ellen J Sass
- Department of Internal Medicine, College of Medicine; The Ohio State University, Columbus, OH, USA
| | - Erin Hertlein
- Department of Internal Medicine, College of Medicine; The Ohio State University, Columbus, OH, USA
| | - Santosh B Salunke
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Ching-Shih Chen
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Michael R Grever
- Department of Internal Medicine, College of Medicine; The Ohio State University, Columbus, OH, USA
| | - John C Byrd
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, College of Medicine; The Ohio State University, Columbus, OH, USA
| | - David M Lucas
- Division of Medicinal Chemistry & Pharmacognosy, College of Pharmacy, The Ohio State University, Columbus, OH, USA; Department of Internal Medicine, College of Medicine; The Ohio State University, Columbus, OH, USA.
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79
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Robak T, Wolska A, Robak P. Potential breakthroughs with investigational drugs for hairy cell leukemia. Expert Opin Investig Drugs 2015; 24:1419-31. [DOI: 10.1517/13543784.2015.1081895] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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80
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Cornet E, Damaj G, Troussard X. New insights in the management of patients with hairy cell leukemia. Curr Opin Oncol 2015; 27:371-6. [PMID: 26154707 DOI: 10.1097/cco.0000000000000214] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Although hairy cell leukemia (HCL) was identified in 1958 by Bouroncle and colleagues, HCL remains in 2015 a mysterious disease. Accurate diagnosis of HCL relies on the recognition of hairy cells by morphology and flow cytometry in blood and/or bone marrow. However, there are cases difficult to diagnose, particularly in variants of HCL. Furthermore, some diseases such as splenic diffuse red pulp small B-cell lymphoma are very close to HCL and may be misdiagnosed. Major advances in the management of patients who have HCL have been made following the use of purine nucleoside analogs. However, new treatment options can be available in relapsed/refractory HCL: monoclonal antibody therapy, BRAF inhibitors, or immunotoxins. RECENT FINDINGS The presence of the BRAFV600E mutation was recently identified in most cases of HCL and its absence in variants of HCL and in other B-cell chronic lymphoproliferative disorders. The precise cellular origin of HCL remains elusive but BRAF mutations were detected in hematopoietic stem cells of patients with HCL. Assessment for minimal residual disease is important in clinical trials. Minimal residual disease detection can clearly predict inferior long-term outcomes or early relapses in patients with HCL. Recent reports have shown that inhibition of BRAF kinase by drugs such as vemurafenib is effective in relapsed/refractory HCL. Immunotoxins offer new opportunities even in patients without BRAF mutations. SUMMARY All these findings have major implications for diagnosis, monitoring, and treatment of HCL and variant forms of HCL.
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Affiliation(s)
- Edouard Cornet
- aLaboratoire Hématologie bService Hématologie Clinique, CHU Côte de Nacre, Caen, France
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81
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Metabolic Rewiring by Oncogenic BRAF V600E Links Ketogenesis Pathway to BRAF-MEK1 Signaling. Mol Cell 2015; 59:345-358. [PMID: 26145173 DOI: 10.1016/j.molcel.2015.05.037] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/17/2015] [Accepted: 05/28/2015] [Indexed: 01/02/2023]
Abstract
Many human cancers share similar metabolic alterations, including the Warburg effect. However, it remains unclear whether oncogene-specific metabolic alterations are required for tumor development. Here we demonstrate a "synthetic lethal" interaction between oncogenic BRAF V600E and a ketogenic enzyme 3-hydroxy-3-methylglutaryl-CoA lyase (HMGCL). HMGCL expression is upregulated in BRAF V600E-expressing human primary melanoma and hairy cell leukemia cells. Suppression of HMGCL specifically attenuates proliferation and tumor growth potential of human melanoma cells expressing BRAF V600E. Mechanistically, active BRAF upregulates HMGCL through an octamer transcription factor Oct-1, leading to increased intracellular levels of HMGCL product, acetoacetate, which selectively enhances binding of BRAF V600E but not BRAF wild-type to MEK1 in V600E-positive cancer cells to promote activation of MEK-ERK signaling. These findings reveal a mutation-specific mechanism by which oncogenic BRAF V600E "rewires" metabolic and cell signaling networks and signals through the Oct-1-HMGCL-acetoacetate axis to selectively promote BRAF V600E-dependent tumor development.
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82
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Lin S, Zhao R, Xiao Y, Li P. Mechanisms determining the fate of hematopoietic stem cells. Stem Cell Investig 2015; 2:10. [PMID: 27358878 DOI: 10.3978/j.issn.2306-9759.2015.05.01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 04/28/2015] [Indexed: 12/21/2022]
Abstract
Successful in vitro expansion of hematopoietic stem cells (HSCs) will facilitate the application of HSC transplantation for the treatment of various diseases, including hematological malignancies. To achieve this expansion, the molecular mechanisms that control the fate of HSCs must be deciphered. Leukemia-initiating cells (LICs) or leukemia stem cells (LSCs) may originate from normal HSCs, which suggest that the dysregulation of the mechanisms that regulate the cell fate of HSCs may underlie leukemogenesis. Here we review the recent progress in the application of HSCs, the regulatory mechanisms of the fate of HSCs, and the origins of leukemia.
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Affiliation(s)
- Shouheng Lin
- 1 Key Laboratory of Regenerative Biology, 2 Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China
| | - Ruocong Zhao
- 1 Key Laboratory of Regenerative Biology, 2 Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China
| | - Yiren Xiao
- 1 Key Laboratory of Regenerative Biology, 2 Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China
| | - Peng Li
- 1 Key Laboratory of Regenerative Biology, 2 Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine, South China Institute for Stem Cell Biology and Regenerative Medicine, Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou 510530, China
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83
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Removing a hair of doubt about BRAF targeting. Blood 2015; 125:1199-200. [PMID: 25700421 DOI: 10.1182/blood-2014-12-616318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In this issue of Blood, Pettirossi et al, including Drs Tiacci and Falini, who led the effort in 2011 defining the BRAF-V600E driving mutation in hairy cell leukemia (HCL),provide extensive laboratory studies showing that inhibitors of BRAF-V600E and/or mitogen-activated protein kinase kinase (MEK) reach their targets and cause HCL cell death
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84
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T memory stem cells are the hierarchical apex of adult T-cell leukemia. Blood 2015; 125:3527-35. [PMID: 25847015 DOI: 10.1182/blood-2014-10-607465] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 03/16/2015] [Indexed: 01/14/2023] Open
Abstract
Adult T-cell leukemia (ATL) is a peripheral CD4(+) T-cell neoplasm caused by human T-cell leukemia virus type 1 (HTLV-1). Despite several investigations using human specimens and mice models, the exact origin of ATL cells remains unclear. Here we provide a new insight into the hierarchical architecture of ATL cells. HTLV-1-infected cells and dominant ATL clones are successfully traced back to CD45RA(+) T memory stem (TSCM) cells, which were recently identified as a unique population with stemlike properties, despite the fact that the majority of ATL cells are CD45RA(-)CD45RO(+) conventional memory T cells. TSCM cells from ATL patients are capable of both sustaining themselves in less proliferative mode and differentiating into other memory T-cell populations in the rapidly propagating phase. In a xenograft model, a low number of TSCM cells efficiently repopulate identical ATL clones and replenish downstream CD45RO(+) memory T cells, whereas other populations have no such capacities. Taken together, these findings demonstrate the phenotypic and functional heterogeneity and the hierarchy of ATL cells. TSCM cells are identified as the hierarchical apex capable of reconstituting identical ATL clones. Thus, this is the first report to demonstrate the association of a T-cell malignancy with TSCM cells.
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85
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Abstract
Hairy cell leukemia was initially described as a distinct entity in 1958. It is rare B-cell malignancy characterized by an indolent course. Advances in the treatment and understanding of the biology of hairy cell leukemia have made the disease exquisitely amenable to treatment. This review summarizes the present understanding of hairy cell leukemia with a particular focus on the development of novel and targeted approaches to treatment.
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86
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Mutations in early follicular lymphoma progenitors are associated with suppressed antigen presentation. Proc Natl Acad Sci U S A 2015; 112:E1116-25. [PMID: 25713363 DOI: 10.1073/pnas.1501199112] [Citation(s) in RCA: 265] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Follicular lymphoma (FL) is incurable with conventional therapies and has a clinical course typified by multiple relapses after therapy. These tumors are genetically characterized by B-cell leukemia/lymphoma 2 (BCL2) translocation and mutation of genes involved in chromatin modification. By analyzing purified tumor cells, we identified additional novel recurrently mutated genes and confirmed mutations of one or more chromatin modifier genes within 96% of FL tumors and two or more in 76% of tumors. We defined the hierarchy of somatic mutations arising during tumor evolution by analyzing the phylogenetic relationship of somatic mutations across the coding genomes of 59 sequentially acquired biopsies from 22 patients. Among all somatically mutated genes, CREBBP mutations were most significantly enriched within the earliest inferable progenitor. These mutations were associated with a signature of decreased antigen presentation characterized by reduced transcript and protein abundance of MHC class II on tumor B cells, in line with the role of CREBBP in promoting class II transactivator (CIITA)-dependent transcriptional activation of these genes. CREBBP mutant B cells stimulated less proliferation of T cells in vitro compared with wild-type B cells from the same tumor. Transcriptional signatures of tumor-infiltrating T cells were indicative of reduced proliferation, and this corresponded to decreased frequencies of tumor-infiltrating CD4 helper T cells and CD8 memory cytotoxic T cells. These observations therefore implicate CREBBP mutation as an early event in FL evolution that contributes to immune evasion via decreased antigen presentation.
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87
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Arceci RJ. Dendritic Cell Disorders: Matters of Lineage and Clinical Drug Testing in Rare Diseases. J Clin Oncol 2015; 33:383-5. [DOI: 10.1200/jco.2014.58.9804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Robert J. Arceci
- Children's Center for Cancer and Blood Disorders, Ron Matricaria Institute of Molecular Medicine at Phoenix Children's Hospital, University of Arizona, College of Medicine, Phoenix, AZ
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88
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Kikushige Y, Miyamoto T. Pre-malignant lymphoid cells arise from hematopoietic stem/progenitor cells in chronic lymphocytic leukemia. Int J Hematol 2015; 102:528-35. [PMID: 25644149 DOI: 10.1007/s12185-015-1740-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Revised: 01/08/2015] [Accepted: 01/15/2015] [Indexed: 02/04/2023]
Abstract
Human malignancies progress through a multistep process that includes the development of critical somatic mutations over the clinical course. Recent novel findings have indicated that hematopoietic stem cells (HSCs), which have the potential to self-renew and differentiate into multilineage hematopoietic cells, are an important cellular target for the accumulation of critical somatic mutations in hematological malignancies and play a central role in myeloid malignancy development. In contrast to myeloid malignancies, mature lymphoid malignancies, such as chronic lymphocytic leukemia (CLL), are thought to originate directly from differentiated mature lymphocytes; however, recent compelling data have shown that primitive HSCs and hematopoietic progenitor cells contribute to the pathogenesis of mature lymphoid malignancies. Several representative mutations of hematological malignancies have been identified within the HSCs of CLL and lymphoma patients, indicating that the self-renewing long-lived fraction of HSCs can serve as a reservoir for the development of oncogenic events. Novel mice models have been established as human mature lymphoma models, in which specific oncogenic events target the HSCs and immature progenitor cells. These data collectively suggest that HSCs can be the cellular target involved in the accumulation of oncogenic events in the pathogenesis of mature lymphoid and myeloid malignancies.
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MESH Headings
- Animals
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Hematopoietic Stem Cells/metabolism
- Hematopoietic Stem Cells/pathology
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphocytes/metabolism
- Lymphocytes/pathology
- Mice
- Neoplastic Stem Cells/metabolism
- Neoplastic Stem Cells/pathology
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Affiliation(s)
- Yoshikane Kikushige
- Department of Medicine and Biosystemic Sciences, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
| | - Toshihiro Miyamoto
- Department of Medicine and Biosystemic Sciences, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
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89
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Berres ML, Merad M, Allen CE. Progress in understanding the pathogenesis of Langerhans cell histiocytosis: back to Histiocytosis X? Br J Haematol 2014; 169:3-13. [PMID: 25430560 DOI: 10.1111/bjh.13247] [Citation(s) in RCA: 101] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Langerhans cell histiocytosis (LCH), the most common histiocytic disorder, is characterized by the accumulation of CD1A(+) /CD207(+) mononuclear phagocytes within granulomatous lesions that can affect nearly all organ systems. Historically, LCH has been presumed to arise from transformed or pathologically activated epidermal dendritic cells called Langerhans cells. However, new evidence supports a model in which LCH occurs as a consequence of a misguided differentiation programme of myeloid dendritic cell precursors. Genetic, molecular and functional data implicate activation of the ERK signalling pathway at critical stages in myeloid differentiation as an essential and universal driver of LCH pathology. Based on these findings, we propose that LCH should be re-defined as an inflammatory myeloid neoplasia. Increased understanding of LCH pathogenesis will provide opportunities to optimize and personalize therapy through improved risk-stratification, targeted therapy and assessment of therapy response based on specific molecular features and origin of the pathological myeloid cells.
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Affiliation(s)
- Marie-Luise Berres
- Department of Oncological Sciences, Mount Sinai School of Medicine, New York, NY, USA; Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY, USA; Immunology Institute, Mount Sinai School of Medicine, New York, NY, USA; Department of Internal Medicine III, University Hospital, RWTH Aachen, Aachen, Germany
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90
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Abdel-Wahab O, Park CY. BRAF-mutant hematopoietic malignancies. Oncotarget 2014; 5:7980-1. [PMID: 25478626 PMCID: PMC4226659 DOI: 10.18632/oncotarget.2448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 09/04/2014] [Indexed: 11/29/2022] Open
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91
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Grever MR, Blachly JS, Andritsos LA. Hairy cell leukemia: Update on molecular profiling and therapeutic advances. Blood Rev 2014; 28:197-203. [PMID: 25110197 DOI: 10.1016/j.blre.2014.06.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 06/12/2014] [Accepted: 06/12/2014] [Indexed: 02/07/2023]
Abstract
Hairy cell leukemia was initially described as a clinicopathologic entity more than 50 years ago. We have subsequently discovered that HCL is really at least two diseases: classical HCL and the hairy cell leukemia variant. The former is among a small group of cancers exceptional for being (nearly) unified by a single genetic lesion, the BRAF V600E mutation. Over the past three decades, tremendous progress in both diagnostic and prognostic clarification has been accompanied by therapeutic advances in classical HCL. Consequently, this once uniformly fatal disease has been converted in most cases into a chronic illness enabling patients to live long and productive lives. In response to standard therapy, patients have high complete remission rates. Unfortunately, the long-term survival curves have not plateaued, revealing that this disease is controlled but not cured. Though rare and representing only about 10% of an already rare disease, those patients with the variant fare exceptionally poorly with standard therapy: complete response rates to purine nucleoside analogs are reported to be less than 50%, whereas the complete response rates in classical HCL are up to 90%. Novel small molecules targeting BRAF and the B-cell receptor signaling complex, and biologic agents like antibodies and immunotoxin conjugates are being explored for those patients who have relapsed. Substantial opportunities for continued research remain. This complex and multi-faceted disease incorporates challenges from altered immunity associated with the underlying disease and its treatments. Considering the rarity of this malignancy, optimization of patient management requires multi-institutional collaboration. The Hairy Cell Leukemia Foundation (www.hairycellleukemia.org) was formed to coordinate these efforts.
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Affiliation(s)
- Michael R Grever
- 395 W. 12th Ave, Room 392, Columbus, OH 43210, USA; Department of Internal Medicine, Division of Hematology at The Ohio State University, Columbus, OH, USA.
| | - James S Blachly
- 320 W. 10th Ave, 406C Starling Loving Hall, Columbus, OH 43210, USA; Department of Internal Medicine, Division of Hematology at The Ohio State University, Columbus, OH, USA.
| | - Leslie A Andritsos
- 320 W. 10th Ave, A352 Starling Loving Hall, Columbus, OH 43210, USA; Department of Internal Medicine, Division of Hematology at The Ohio State University, Columbus, OH, USA.
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92
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Niemitz E. Cell of origin of hairy cell leukemia. Nat Genet 2014. [DOI: 10.1038/ng.3025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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93
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