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Obeidi N, Darzipour Babolei M, Khamisipour G, Mohammadi SA, Farhangdost F, Valipor S. The Effect of Sargassum Angustifolium-derived AgNPs on Apoptosis-associated Genes in Acute Lymphoblastic Leukemia Cells. Asian Pac J Cancer Prev 2023; 24:2691-2696. [PMID: 37642055 PMCID: PMC10685235 DOI: 10.31557/apjcp.2023.24.8.2691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Acute lymphoblastic leukemia (ALL) is among the most prevalent child cancers. Moreover, chemotherapy and bone marrow transplantation have failed to secure the survival of patients in some cases. Various researches have revealed that glycogen synthase kinase 3 (GSK-3) inhibitors can contain the growth of some cancers. Furthermore, inositol trisphosphate receptor (IP3R) exists in all cell types and is implicated in metastasis. The application of organic, natural substances offers new prospects for the treatment of this condition. Accordingly, the aim of this study was to examine the silver nanoparticles synthesized from Sargassum Angustifolium on the expression of IP3 and GSK receptors in ALL Jurkat cells. METHODS We isolated Sargassum Angustifolium extract and mixed it with silver nanoparticles (NPs) and treated the cells with the mixture. The changes in the expression of GSKα, IP3R3 and GSKβ genes in the Jurkat cell line were studied. In this research, quantitative mRNA expression of the target gene was measured using a real-time polymerase chain reaction (PCR). Hypoxanthine phosphoribosyltransferase (HPRT) genes were studied as the internal control. The experiments were replicated 3 times. Data analysis was performed through one-way ANOVA and t-test. The significance level was considered less than 0.05. RESULTS The results of this study revealed that different concentrations of the extracts significantly decreased the expression levels of GSKα, IP3R3 and GSKβ gene in Jurkat cells compared to control groups. The combination of algae extract and AgNPs was consistently the most effective group. CONCLUSION silver nanoparticles synthesized from sargassum algae in the Persian Gulf could be utilized to treat ALL cancers and even other tumors.
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Affiliation(s)
- Narjes Obeidi
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Maedeh Darzipour Babolei
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Gholamreza Khamisipour
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Seyed Amin Mohammadi
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Farzad Farhangdost
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Sepideh Valipor
- Student Research Committee, Bushehr University of Medical Sciences, Bushehr, Iran.
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Płotka A, Przybyłowicz-Chalecka A, Korolczuk M, Kanduła Z, Ratajczak B, Kiernicka-Parulska J, Mierzwa A, Godziewska K, Jarmuż-Szymczak M, Gil L, Lewandowski K. BCR::ABL1-like acute lymphoblastic leukaemia: a single institution experience on identification of potentially therapeutic targetable cases. Mol Cytogenet 2023; 16:14. [PMID: 37400842 DOI: 10.1186/s13039-023-00645-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/19/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND BCR::ABL1-like acute lymphoblastic leukaemia (BCR::ABL1-like ALL) is characterized by inferior outcomes. Current efforts concentrate on the identification of molecular targets to improve the therapy results. The accessibility to next generation sequencing, a recommended diagnostic method, is limited. We present our experience in the BCR::ABL1-like ALL diagnostics, using a simplified algorithm. RESULTS Out of 102 B-ALL adult patients admitted to our Department in the years 2008-2022, 71 patients with available genetic material were included. The diagnostic algorithm comprised flow cytometry, fluorescent in-situ hybridization, karyotype analysis and molecular testing with high resolution melt analysis and Sanger Sequencing. We recognized recurring cytogenetic abnormalities in 32 patients. The remaining 39 patients were screened for BCR::ABL1-like features. Among them, we identified 6 patients with BCR::ABL1-like features (15.4%). Notably, we documented CRLF2-rearranged (CRLF2-r) BCR::ABL1-like ALL occurrence in a patient with long-term remission of previously CRLF2-r negative ALL. CONCLUSIONS An algorithm implementing widely available techniques enables the identification of BCR::ABL1-like ALL cases in settings with limited resources.
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Affiliation(s)
- Anna Płotka
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland.
| | - Anna Przybyłowicz-Chalecka
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Maria Korolczuk
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Zuzanna Kanduła
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Błażej Ratajczak
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Jolanta Kiernicka-Parulska
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Anna Mierzwa
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Katarzyna Godziewska
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Małgorzata Jarmuż-Szymczak
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
- Institute of Human Genetics, Polish Academy of Sciences, Poznań, Poland
| | - Lidia Gil
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
| | - Krzysztof Lewandowski
- Department of Haematology and Bone Marrow Transplantation, Poznań University of Medical Sciences, Poznań, Poland
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Mohammadi M, Asgarian-Omran H, Najafi A, Valadan R, Karami H, Naderisoraki M, Zaboli E, Eslami M, Tehrani M. Evaluation of mRNA Expression of CD244 and Its Adapter Molecules in CD8+ T Cells in Acute Leukemia. IRANIAN BIOMEDICAL JOURNAL 2023; 27:214-8. [PMID: 37634081 PMCID: PMC10507292 DOI: 10.61186/ibj.3843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/25/2023] [Indexed: 12/17/2023]
Abstract
Background This study investigated the role of the immune-checkpoint receptor (ICR), CD244, and its adapter molecules, in CD8+ T cells in acute leukemia. Methods Blood samples were obtained from 21 acute lymphoblastic leukemia (ALL) and 6 acute myeloid leukemia (AML) patients and 20 control subjects. Relative gene expression of CD244, immune receptor tyrosine-based switch motif-associated protein (SA), EWS/FLI1-activated transcript 2 (EAT-2), and LncRNA-GSTT1-AS1 were evaluated using quantitative reverse transcription polymerase chain reaction. Results Expression of CD244, SAP, and EAT-2 were significantly lower in CD8+ T cells from ALL patients than those from control subjects. Interestingly, the expression of SAP was much lower than that of CD244, indicating a lower ratio of SAP to CD244. Also, SAP expression was significantly lower in AML patients compared to the control group. Expression of LncRNA-GSTT1-AS1 showed no significant difference in ALL and AML patients compared to control subjects. Conclusion The low SAP/CD244 expression ratio in CD8+ T cells in ALL suggests an inhibitory role for CD244 in ALL.
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Affiliation(s)
- Maryam Mohammadi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Asgarian-Omran
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Najafi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Valadan
- Molecular and Cell-Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Karami
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran
| | - Mohammad Naderisoraki
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran
| | - Ehsan Zaboli
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Hematology and Oncology, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran
| | - Mohammad Eslami
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Hematology and Oncology, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran
| | - Mohsen Tehrani
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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104
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Pottosin I, Olivas-Aguirre M, Dobrovinskaya O. In vitro simulation of the acute lymphoblastic leukemia niche: a critical view on the optimal approximation for drug testing. J Leukoc Biol 2023; 114:21-41. [PMID: 37039524 DOI: 10.1093/jleuko/qiad039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/12/2023] Open
Abstract
Acute lymphoblastic leukemia with the worst prognosis is related to minimal residual disease. Minimal residual disease not only depends on the individual peculiarities of leukemic clones but also reflects the protective role of the acute lymphoblastic leukemia microenvironment. In this review, we discuss in detail cell-to-cell interactions in the 2 leukemic niches, more explored bone marrow and less studied extramedullary adipose tissue. A special emphasis is given to multiple ways of interactions of acute lymphoblastic leukemia cells with the bone marrow or extramedullary adipose tissue microenvironment, indicating observed differences in B- and T-cell-derived acute lymphoblastic leukemia behavior. This analysis argued for the usage of coculture systems for drug testing. Starting with a review of available sources and characteristics of acute lymphoblastic leukemia cells, mesenchymal stromal cells, endothelial cells, and adipocytes, we have then made an update of the available 2-dimensional and 3-dimensional systems, which bring together cellular elements, components of the extracellular matrix, or its imitation. We discussed the most complex available 3-dimensional systems like "leukemia-on-a-chip," which include either a prefabricated microfluidics platform or, alternatively, the microarchitecture, designed by using the 3-dimensional bioprinting technologies. From our analysis, it follows that for preclinical antileukemic drug testing, in most cases, intermediately complex in vitro cell systems are optimal, such as a "2.5-dimensional" coculture of acute lymphoblastic leukemia cells with niche cells (mesenchymal stromal cells, endothelial cells) plus matrix components or scaffold-free mesenchymal stromal cell organoids, populated by acute lymphoblastic leukemia cells. Due to emerging evidence for the correlation of obesity and poor prognosis, a coculture of adipocytes with acute lymphoblastic leukemia cells as a drug testing system is gaining shape.
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Affiliation(s)
- Igor Pottosin
- Laboratory of Immunobiology and Ionic Transport Regulation, University Center for Biomedical Research, University of Colima, Av. Enrique Arreola Silva 883, Guzmán City, Jalisco, 49000, Mexico
| | - Miguel Olivas-Aguirre
- Laboratory of Immunobiology and Ionic Transport Regulation, University Center for Biomedical Research, University of Colima, Av. Enrique Arreola Silva 883, Guzmán City, Jalisco, 49000, Mexico
- Division of Exact, Natural and Technological Sciences, South University Center (CUSUR), University of Guadalajara, Jalisco, Mexico
| | - Oxana Dobrovinskaya
- Laboratory of Immunobiology and Ionic Transport Regulation, University Center for Biomedical Research, University of Colima, Av. Enrique Arreola Silva 883, Guzmán City, Jalisco, 49000, Mexico
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105
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Neto MPDQ, da Costa L, Lisboa ESA, Silva SNB, de Azambuja AP, Nunes EC, Bendlin RM. Survival benefit of pediatric-based regimen for adults with acute lymphoblastic leukemia: A single-center retrospective cohort. Hematol Transfus Cell Ther 2023; 45 Suppl 2:S18-S24. [PMID: 35216959 PMCID: PMC10433303 DOI: 10.1016/j.htct.2021.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/13/2021] [Accepted: 08/24/2021] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Improving survival of Acute Lymphoblastic Leukemia (ALL) in adult patients has been a challenge. Despite intensive chemotherapy treatment, overall survival is poor. However, several studies demonstrate that young adult patients have better survival when treated with pediatric-based intensive regimens. Considering these results, We decided to treat newly diagnosed ALL patients according to age and risk factors. The goal of this study was to describe the results of this intensive chemotherapy treatment approach for ALL adult patients diagnosed at our institution. METHODS Fifty-eight ALL patients, diagnosed from 2004 to 2013, were included in the analysis. Patients were assigned to either the St. Jude Total Therapy XIIIB high-risk arm (St Jude) or the CALGB 8811 (CALGB). The Kaplan-Meier survival curve was used for the survival analyses and the Cox proportional hazard regression, for multivariable analysis. RESULTS The overall survival was 22.9% at 10 years. The St. Jude improved survival, compared to the CALGB (p = 0.007), with 32.6% vs. 7.4% survival rate at 10 years. However, no survival benefit was found for patients younger than 20 years old (p = 0.32). The multivariable analysis demonstrated that undetectable minimal residual disease (MRD) and hematopoietic stem cell transplantation (HSCT) had beneficial impact on survival (p = 0.0007 and p = 0.004, respectively). CONCLUSION ALL is a disease of poor prognosis for adults. The joint effort to standardize treatment and seek solutions is the way to start improving this scenario.
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Affiliation(s)
| | - Larissa da Costa
- Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brazil
| | | | | | - Ana Paula de Azambuja
- Hospital de Clínicas da Universidade Federal do Paraná (HC-UFPR), Curitiba, PR, Brazil
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106
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Mohammadi M, Asgarian-Omran H, Najafi A, Valadan R, Karami H, Naderisoraki M, Zaboli E, Eslami M, Tehrani M. Evaluation of mRNA Expression of CD244 and Its Adapter Molecules in CD8+ T Cells in Acute Leukemia. IRANIAN BIOMEDICAL JOURNAL 2023; 27:214-8. [PMID: 37634081 PMCID: PMC10507292 DOI: 10.52547/ibj.3843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 06/25/2023] [Indexed: 08/28/2023]
Abstract
Background This study investigated the role of the immune-checkpoint receptor (ICR), CD244, and its adapter molecules, in CD8+ T cells in acute leukemia. Methods Blood samples were obtained from 21 acute lymphoblastic leukemia (ALL) and 6 acute myeloid leukemia (AML) patients and 20 control subjects. Relative gene expression of CD244, immune receptor tyrosine-based switch motif-associated protein (SA), EWS/FLI1-activated transcript 2 (EAT-2), and LncRNA-GSTT1-AS1 were evaluated using quantitative reverse transcription polymerase chain reaction. Results Expression of CD244, SAP, and EAT-2 were significantly lower in CD8+ T cells from ALL patients than those from control subjects. Interestingly, the expression of SAP was much lower than that of CD244, indicating a lower ratio of SAP to CD244. Also, SAP expression was significantly lower in AML patients compared to the control group. Expression of LncRNA-GSTT1-AS1 showed no significant difference in ALL and AML patients compared to control subjects. Conclusion The low SAP/CD244 expression ratio in CD8+ T cells in ALL suggests an inhibitory role for CD244 in ALL.
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Affiliation(s)
- Maryam Mohammadi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Asgarian-Omran
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Najafi
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Valadan
- Molecular and Cell-Biology Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hossein Karami
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran
| | - Mohammad Naderisoraki
- Thalassemia Research Center (TRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran
| | - Ehsan Zaboli
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Hematology and Oncology, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran
| | - Mohammad Eslami
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Hematology and Oncology, Imam Khomeini hospital, Mazandaran university of Medical Sciences, Sari, Iran
| | - Mohsen Tehrani
- Department of Immunology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Riazat-Kesh YJRA, Mascarenhas J, Bar-Natan M. 'Secondary' acute lymphoblastic/lymphocytic leukemia - done playing second fiddle? Blood Rev 2023; 60:101070. [PMID: 36894417 DOI: 10.1016/j.blre.2023.101070] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Acute lymphoblastic/lymphocytic leukemia (ALL) occurring post-cancer diagnosis (secondary ALL - sALL) is increasingly recognized as a discrete entity, constituting up to as much as 5-10% of all new ALL diagnoses, and carrying its own biologic, prognostic and therapeutic significance. In this review, we will outline the history and current state of research into sALL. We will explore the evidence for differences underlining its existence as a distinct subgroup, as well as examining what might be driving such differences etiologically, including prior chemotherapy. We will examine these distinctions on population-, chromosomal-, and molecular-levels, and we will consider whether they translate to differences in clinical outcome, and whether they do - or should - warrant differences in treatment selection.
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Affiliation(s)
| | - John Mascarenhas
- Ruttenberg Treatment Center, Tisch Cancer Institute, 1470 Madison Avenue, 3rd Floor, New York, NY, 10029., United States of America.
| | - Michal Bar-Natan
- Ruttenberg Treatment Center, Tisch Cancer Institute, 1470 Madison Avenue, 3rd Floor, New York, NY, 10029., United States of America.
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108
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Aureli A, Marziani B, Venditti A, Sconocchia T, Sconocchia G. Acute Lymphoblastic Leukemia Immunotherapy Treatment: Now, Next, and Beyond. Cancers (Basel) 2023; 15:3346. [PMID: 37444456 DOI: 10.3390/cancers15133346] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/14/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Acute lymphoblastic leukemia (ALL) is a blood cancer that primarily affects children but also adults. It is due to the malignant proliferation of lymphoid precursor cells that invade the bone marrow and can spread to extramedullary sites. ALL is divided into B cell (85%) and T cell lineages (10 to 15%); rare cases are associated with the natural killer (NK) cell lineage (<1%). To date, the survival rate in children with ALL is excellent while in adults continues to be poor. Despite the therapeutic progress, there are subsets of patients that still have high relapse rates after chemotherapy or hematopoietic stem cell transplantation (HSCT) and an unsatisfactory cure rate. Hence, the identification of more effective and safer therapy choices represents a primary issue. In this review, we will discuss novel therapeutic options including bispecific antibodies, antibody-drug conjugates, chimeric antigen receptor (CAR)-based therapies, and other promising treatments for both pediatric and adult patients.
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Affiliation(s)
- Anna Aureli
- CNR Institute of Translational Pharmacology, Via Carducci 32, 67100 L'Aquila, Italy
| | - Beatrice Marziani
- Emergency Medicine Department, Sant'Anna University Hospital, Via A. Moro, 8, Cona, 44124 Ferrara, Italy
| | - Adriano Venditti
- Department of Biomedicine and Prevention, The University of Rome "Tor Vergata", 00133 Rome, Italy
| | - Tommaso Sconocchia
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Giuseppe Sconocchia
- CNR Institute of Translational Pharmacology, Via Carducci 32, 67100 L'Aquila, Italy
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Saadi MI, Nikandish M, Ghahramani Z, Valandani FM, Ahmadyan M, Hosseini F, Rahimian Z, Jalali H, Tavasolian F, Abdolyousefi EN, Kheradmand N, Ramzi M. miR-155 and miR-92 levels in ALL, post-transplant aGVHD, and CMV: possible new treatment options. J Egypt Natl Canc Inst 2023; 35:18. [PMID: 37332027 DOI: 10.1186/s43046-023-00174-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/22/2023] [Indexed: 06/20/2023] Open
Abstract
BACKGROUND Acute lymphoblastic leukemia (ALL) is a malignancy that leads to altered blast cell proliferation, survival, and maturation and eventually to the lethal accumulation of leukemic cells. Recently, dysregulated expression of various micro-RNAs (miRNAs) has been reported in hematologic malignancies, especially ALL. Cytomegalovirus infection can induce ALL in otherwise healthy individuals, so a more detailed evaluation of its role in ALL-endemic areas like Iran is required. METHODS In this cross-sectional study, 70 newly diagnosed adults with ALL were recruited. The expression level of microRNA-155(miR-155) and microRNA-92(miR-92) was evaluated by real-time SYBR Green PCR. The correlations between the miRNAs mentioned above and the severity of disease, CMV infection, and acute graft vs. host disease after hematopoietic stem cell transplantation (HSCT) were assessed. B cell and T cell ALL distinction in the level of miRNAs was provided. RESULTS After the statistical analysis, our results indicated a marked increase in the expression of miR-155 and miR-92 in ALL patients vs. healthy controls (*P = 0.002-*P = 0.03, respectively). Also, it was shown that the expression of miR-155 and miR-92 was higher in T cell ALL compared to B cell ALL (P = 0.01-P = 0.004, respectively), CMV seropositivity, and aGVHD. CONCLUSION Our study suggests that the plasma signature of microRNA expression may act as a powerful marker for diagnosis and prognosis, providing knowledge outside cytogenetics. Elevation of miR-155 in plasma can be a beneficial therapeutic target for ALL patients, with consideration of higher plasma levels of miR-92 and miR-155 in CMV + and post-HSCT aGVHD patients.
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Affiliation(s)
- Mahdiyar Iravani Saadi
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Mohsen Nikandish
- Hematology, Oncology and Bone Marrow Transplantation Department, Shiraz University of Medical Sciences, Namazi Sq., Zand St., Shiraz, Iran
| | - Zahra Ghahramani
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Fatemeh Mardani Valandani
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Maryam Ahmadyan
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Fakhroddin Hosseini
- Hematology, Oncology and Bone Marrow Transplantation Department, Shiraz University of Medical Sciences, Namazi Sq., Zand St., Shiraz, Iran
| | - Zahra Rahimian
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Heeva Jalali
- Department of Animal Science, Faculty of Agriculture, University of Kurdistan, Pasdaran Blvd, Sanandaj, Kurdistan, Iran
| | - Fataneh Tavasolian
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Ehsan Nabi Abdolyousefi
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran
| | - Nadiya Kheradmand
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran.
| | - Mani Ramzi
- Hematology Research Center, Shiraz University of Medical Sciences, Mohammad Rasul Allah Research Tower, Opposite the Education School, Khalili Ave, Shiraz, Fars, Iran.
- Hematology, Oncology and Bone Marrow Transplantation Department, Shiraz University of Medical Sciences, Namazi Sq., Zand St., Shiraz, Iran.
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Mok TKS, Cheong BKC, Huang KHK. Unmasking Acute Lymphoblastic Leukemia in a Chiropractic Patient With Musculoskeletal Complaints. Cureus 2023; 15:e40675. [PMID: 37485144 PMCID: PMC10357392 DOI: 10.7759/cureus.40675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
A 67-year-old woman presented to a chiropractor with a four-week history of neck and low back pain, lower extremity paresthesia, profound fatigue, and cutaneous pallor. Previous cervical radiographs had revealed multilevel degenerative spondylosis. However, abnormal hematological indices, including severe thrombocytopenia and anemia, prompted concerns of an underlying hematopoietic malignancy. Interdisciplinary collaboration facilitated expedient hematological assessment, confirming acute lymphoblastic leukemia (ALL), as evidenced by lymphoblasts in a peripheral blood smear and bone marrow biopsy. Karyotyping detected a Philadelphia chromosomal mutation; the patient therefore received oral targeted tyrosine kinase inhibition coupled with serial intrathecal chemotherapy. Complete remission was achieved. However, sensorimotor symptoms persisted due to herpetic neuralgia secondary to immunosuppression. This complex case underscores the role of chiropractors as primary contact clinicians in identifying sinister pathologies underlying musculoskeletal complaints via judicious history-taking, physical evaluation, and interpretation of investigational findings. Interprofessional collaboration is pivotal in formulating an effective therapeutic strategy to improve the prognosis of patients with this disease.
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Affiliation(s)
- Tze Kwan Sharon Mok
- Chiropractic, New York Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
| | - Benjamin Kah Chun Cheong
- Chiropractic, New York Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
| | - Kevin Hsu Kai Huang
- Chiropractic, New York Chiropractic and Physiotherapy Centre, New York Medical Group, Hong Kong, CHN
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Ghelli Luserna Di Rorà A, Ghetti M, Ledda L, Ferrari A, Bocconcelli M, Padella A, Napolitano R, Fontana MC, Liverani C, Imbrogno E, Bochicchio MT, Paganelli M, Robustelli V, Sanogo S, Cerchione C, Fumagalli M, Rondoni M, Imovilli A, Musuraca G, Martinelli G, Simonetti G. Exploring the ATR-CHK1 pathway in the response of doxorubicin-induced DNA damages in acute lymphoblastic leukemia cells. Cell Biol Toxicol 2023; 39:795-811. [PMID: 34519926 PMCID: PMC10406704 DOI: 10.1007/s10565-021-09640-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022]
Abstract
Doxorubicin (Dox) is one of the most commonly used anthracyclines for the treatment of solid and hematological tumors such as B-/T cell acute lymphoblastic leukemia (ALL). Dox compromises topoisomerase II enzyme functionality, thus inducing structural damages during DNA replication and causes direct damages intercalating into DNA double helix. Eukaryotic cells respond to DNA damages by activating the ATM-CHK2 and/or ATR-CHK1 pathway, whose function is to regulate cell cycle progression, to promote damage repair, and to control apoptosis. We evaluated the efficacy of a new drug schedule combining Dox and specific ATR (VE-821) or CHK1 (prexasertib, PX) inhibitors in the treatment of human B-/T cell precursor ALL cell lines and primary ALL leukemic cells. We found that ALL cell lines respond to Dox activating the G2/M cell cycle checkpoint. Exposure of Dox-pretreated ALL cell lines to VE-821 or PX enhanced Dox cytotoxic effect. This phenomenon was associated with the abrogation of the G2/M cell cycle checkpoint with changes in the expression pCDK1 and cyclin B1, and cell entry in mitosis, followed by the induction of apoptosis. Indeed, the inhibition of the G2/M checkpoint led to a significant increment of normal and aberrant mitotic cells, including those showing tripolar spindles, metaphases with lagging chromosomes, and massive chromosomes fragmentation. In conclusion, we found that the ATR-CHK1 pathway is involved in the response to Dox-induced DNA damages and we demonstrated that our new in vitro drug schedule that combines Dox followed by ATR/CHK1 inhibitors can increase Dox cytotoxicity against ALL cells, while using lower drug doses. • Doxorubicin activates the G2/M cell cycle checkpoint in acute lymphoblastic leukemia (ALL) cells. • ALL cells respond to doxorubicin-induced DNA damages by activating the ATR-CHK1 pathway. • The inhibition of the ATR-CHK1 pathway synergizes with doxorubicin in the induction of cytotoxicity in ALL cells. • The inhibition of ATR-CHK1 pathway induces aberrant chromosome segregation and mitotic spindle defects in doxorubicin-pretreated ALL cells.
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Affiliation(s)
- Andrea Ghelli Luserna Di Rorà
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy.
| | - Martina Ghetti
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Lorenzo Ledda
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Anna Ferrari
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Matteo Bocconcelli
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Antonella Padella
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Roberta Napolitano
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Maria Chiara Fontana
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Chiara Liverani
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Enrica Imbrogno
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Maria Teresa Bochicchio
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Matteo Paganelli
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Valentina Robustelli
- Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology "L. e A. Seràgnoli", University of Bologna, Bologna, Italy
| | - Seydou Sanogo
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
| | - Claudio Cerchione
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, FC, Italy
| | - Monica Fumagalli
- Hematology Division and Bone Marrow Transplantation Unit, San Gerardo Hospital, Monza, Italy
| | - Michela Rondoni
- Hematology Unit, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | | | - Gerardo Musuraca
- Hematology Unit, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, FC, Italy
| | - Giovanni Martinelli
- Scientific Directorate, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, FC, Italy
| | - Giorgia Simonetti
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Via Piero Maroncelli, 40, 47014, Meldola, FC, Italy
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Salama H, Eldadah S, Omer MH, Alhejazi A, Bin Dayil L, Almozaini A, Khalil RR, Mugairi AA, Snnallah M, Damlaj M, Alaskar A, Alsaeed A, Bakkar MM, Alahmari B, Alzahrani M, Elhemaidi I, Alahmadi M, Alamoudi S, Rajkhan W, Khalil M, Kanfar SS, Saleh ASA, Raizah AA, Ibrahim A, Absi A. Comparison of a modified pediatric protocol versus a hyper-CVAD protocol in adolescents and young adults with Philadelphia-negative acute lymphoblastic leukemia: A multicenter retrospective analysis. Leuk Res 2023; 130:107316. [PMID: 37245332 DOI: 10.1016/j.leukres.2023.107316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/06/2023] [Accepted: 05/19/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The outcomes of Pediatric acute lymphoblastic leukemia (ALL) have improved dramatically whereas outcomes for ALL amongst adolescents and young adults (AYA) have lagged behind. The introduction of pediatric-like regimens to manage adult ALL has shown promising outcomes across several analyses. MATERIALS AND METHODS In this analysis, we aimed to retrospectively compare the differences in outcomes among patients aged 14-40 years with Philadelphia-negative ALL treated with a Hyper-CVAD protocol versus a modified pediatric protocol. RESULTS A total of 103 patients were identified with 58 (56.3%) in the modified ABFM group and 45 (43.7%) in the hyper-CVAD group. The median duration of follow-up for the cohort was 39 months (range 1-93). There were significantly lower rates of MRD persistence after consolidation (10.3% vs. 26.7%, P = 0.031) and transplantation (15.5% vs. 46.6%, P < 0.001) in the modified ABFM group. 5-year OS rates (83.9% vs. 65.3%, P = 0.036) and DFS rates (67.4% vs. 44%, P = 0.014) were higher in the modified ABFM groups. The incidence of grade 3 and 4 hepatotoxicity (24.1% vs. 13.3%, P < 0.001) and osteonecrosis (20.6% vs. 2.2%, P = 0.005) were higher in the modified ABFM group. CONCLUSION Our analysis demonstrates that the use of a pediatric modified ABFM protocol demonstrated superior outcomes compared to the hyper-CVAD regimen in the treatment of Philadelphia-negative ALL amongst AYA patients. However, the modified ABFM protocol was associated with an increased risk of certain toxicities including high grade liver toxicity and osteonecrosis.
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Affiliation(s)
- Hind Salama
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia.
| | - Saleem Eldadah
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Mohamed H Omer
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Ayman Alhejazi
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Luluh Bin Dayil
- Department of Adult Nursing, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ayman Almozaini
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Roaa Reda Khalil
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia
| | - Areej Al Mugairi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed Snnallah
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Moussab Damlaj
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia; Department of Hematology Oncology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Ahmed Alaskar
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Ahmad Alsaeed
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Mohammed Mosa Bakkar
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Bader Alahmari
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Mohsen Alzahrani
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Ihab Elhemaidi
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Majed Alahmadi
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Sameer Alamoudi
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Walaa Rajkhan
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Manar Khalil
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Solaf Sami Kanfar
- Department of Adult Hematology and Stem Cell Transplantation, King Faisal Specialist Hospital, Dammam, Saudi Arabia
| | - Abdullah S Al Saleh
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Abdulrahman Al Raizah
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Ayman Ibrahim
- Department of Oncology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
| | - Ahmed Absi
- Department of Adult Hematology and Stem Cell Transplantation, Princess Noorah Oncology Center, Ministry of the National Guard Health Affairs, Jeddah, Saudi Arabia; College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Saudi Arabia; King Abdullah International Medical Research Center, Saudi Arabia; Saudi Society of Blood and Bone Marrow Transplantation (SSBMT), Saudi Arabia
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Zhou KI, Lin C, Neff JL, Galal A. Dasatinib-associated follicular lymphoma in a patient with B-cell acute lymphoblastic leukaemia. BMJ Case Rep 2023; 16:e252739. [PMID: 37197831 PMCID: PMC10193045 DOI: 10.1136/bcr-2022-252739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
The tyrosine kinase inhibitor dasatinib is approved for the treatment of chronic myeloid leukaemia and Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukaemia (ALL). Patients on dasatinib can rarely develop a form of benign reversible reactive lymphadenopathy termed follicular lymphoid hyperplasia (FLH). Here, we describe a patient with Ph+ ALL who developed follicular lymphoma (FL) after prolonged treatment with dasatinib and who had complete remission of FL after discontinuation of dasatinib. This case suggests that dasatinib-associated FLH could be a premalignant condition that can transform into FL. Moreover, withdrawal of dasatinib may be sufficient for remission of dasatinib-associated FL.
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Affiliation(s)
- Katherine Ismei Zhou
- Division of Medical Oncology, Duke University Health System, Durham, North Carolina, USA
| | - Chenyu Lin
- Division of Hematologic Malignancies & Cellular Therapy, Duke University Health System, Durham, North Carolina, USA
| | - Jadee Lee Neff
- Department of Pathology, Duke University Health System, Durham, North Carolina, USA
| | - Ahmed Galal
- Division of Hematologic Malignancies & Cellular Therapy, Duke University Health System, Durham, North Carolina, USA
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Pardhi E, Yadav R, Chaurasiya A, Madan J, Guru SK, Singh SB, Mehra NK. Multifunctional targetable liposomal drug delivery system in the management of leukemia: Potential, opportunities, and emerging strategies. Life Sci 2023; 325:121771. [PMID: 37182551 DOI: 10.1016/j.lfs.2023.121771] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/06/2023] [Accepted: 05/07/2023] [Indexed: 05/16/2023]
Abstract
The concern impeding the success of chemotherapy in leukemia treatment is descending efficacy of drugs because of multiple drug resistance (MDR). The previous failure of traditional treatment methods is primarily responsible for the present era of innovative agents to treat leukemia effectively. The treatment option is a chemotherapeutic agent in most available treatment strategies, which unfortunately leads to high unavoidable toxicities. As a result of the recent surge in marketed products, theranostic nanoparticles, i.e., multifunctional targetable liposomes (MFTL), have been approved for improved and more successful leukemia treatment that blends therapeutic and diagnostic characteristics. Since they broadly offer the required characteristics to get past the traditional/previous limitations, such as the absence of site-specific anti-cancer therapeutic delivery and ongoing real-time surveillance of the leukemia target sites while administering therapeutic activities. To prepare MFTL, suitable targeting ligands or tumor-specific antibodies are required to attach to the surface of the liposomes. This review exhaustively covered and summarized the liposomal-based formulation in leukemia treatment, emphasizing leukemia types; regulatory considerations, patents, and clinical portfolios to overcome clinical translation hurdles have all been explored.
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Affiliation(s)
- Ekta Pardhi
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad 500037, Telangana, India
| | - Rati Yadav
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad 500037, Telangana, India
| | - Akash Chaurasiya
- Department of Pharmaceutics, BITS-Pilani, Hyderabad Campus, Jawahar Nagar, Shameerpet Mandal, District. RR, Hyderabad, India
| | - Jitender Madan
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad 500037, Telangana, India
| | - Santosh Kumar Guru
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500037, Telangana, India
| | - Shashi Bala Singh
- Department of Biological Sciences, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad 500037, Telangana, India
| | - Neelesh Kumar Mehra
- Pharmaceutical Nanotechnology Research Laboratory, Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Hyderabad 500037, Telangana, India.
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Norkaew C, Roytrakul S, Charoenlappanit S, Thaisakun S, Tanyong D. Pinostrobin induces acute leukemia cell apoptosis via the regulation of miR-410-5p and SFRP5. Life Sci 2023; 325:121739. [PMID: 37164308 DOI: 10.1016/j.lfs.2023.121739] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/16/2023] [Accepted: 04/24/2023] [Indexed: 05/12/2023]
Abstract
AIMS This study attempted to explore the mechanisms involved in pinostrobin (PN)-mediated acute leukemia cell apoptosis regulated by miR-410-5p. MATERIAL AND METHODS NB4 and MOLT-4 cells were cultured and treated with PN at the IC50 concentration. Apoptosis was examined by Annexin V-FITC/PI staining. RT-qPCR was used to measure the expression of caspase-3, BAK, BCL-W, and MCL-1. The target protein of PN was identified using LC-MS/MS followed by bioinformatic analysis. TargetScan, DIANA, and miRDB were used for the prediction of miRNAs involved in the PN-induced apoptosis mechanism. miRNA mimic transfection, RT-qPCR, and western blot analysis were performed to evaluate the regulatory effect of miRNA on its target and the involvement of miRNA in apoptosis induction by PN. In addition, the synergistic effect of PN and daunorubicin (DNR) were investigated by using the MTT assay. KEY FINDINGS The results showed that PN reduced cell viability and induced apoptosis in both leukemia cell lines. From the LC-MS/MS and bioinformatics analysis, SFRP5 and miR-410-5p were selected as a potential PN target protein and miRNA, respectively. After miRNA mimic transfection, miR-410-5p, which is an onco-miRNA, was decreased and led to increased apoptosis in both cell lines, indicating that this miRNA is involved in PN-mediated apoptosis mechanisms. Moreover, PN demonstrated a synergistic effect with DNR, suggesting that PN may be used in combination with conventional chemotherapy drugs. SIGNIFICANCE PN regulates the expression of miR-410-5p and SFRP5 to promote apoptosis in acute leukemia cells. It could be developed as an alternative treatment for leukemia in the future.
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Affiliation(s)
- Chosita Norkaew
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Sittiruk Roytrakul
- Functional Proteomics Technology Laboratory, Functional Ingredients and Food Innovation Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology for Development Agency, Pathum Thani 12120, Thailand
| | - Sawanya Charoenlappanit
- Functional Proteomics Technology Laboratory, Functional Ingredients and Food Innovation Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology for Development Agency, Pathum Thani 12120, Thailand
| | - Siriwan Thaisakun
- Functional Proteomics Technology Laboratory, Functional Ingredients and Food Innovation Research Group, National Center for Genetic Engineering and Biotechnology, National Science and Technology for Development Agency, Pathum Thani 12120, Thailand
| | - Dalina Tanyong
- Department of Clinical Microscopy, Faculty of Medical Technology, Mahidol University, Nakhon Pathom 73170, Thailand.
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Shreteh E, Boulet S, Milliron ML, Karns C. An Emergency Department Patient With Pharyngitis and Final Diagnosis of Rare T-cell Acute Lymphoblastic Leukemia With a Copy of Retinoic Acid Receptor Alpha Gene. Cureus 2023; 15:e39483. [PMID: 37378217 PMCID: PMC10292075 DOI: 10.7759/cureus.39483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
A 21-year-old female with a past medical history of chronic tonsilitis presented to the emergency department (ED) with a sore throat and swelling in her neck for a two-week duration. The patient was noted to have pancytopenia with blasts on peripheral blood differential, so she was transferred for admission at an outside facility for further evaluation and management. Bone marrow biopsy revealed T-cell acute lymphoblastic leukemia (ALL) with 39.5% blasts. CALGB 10403 treatment protocol was initiated two days after her presentation to the ED. The patient also had an extra copy of the retinoic acid receptor alpha (RARA) gene. One year later, the patient was in remission, and cytogenetic results showed a normal female karyotype indicating that the patient no longer had ALL or RARA gene abnormalities. While a sore throat can be a common chief complaint in the ED, ED providers need to keep a broad differential as there are many serious and potentially life-threatening etiologies such as T-cell ALL. T-cell ALL diagnosis is established with the presence of >20% of lymphoblasts in the bone marrow or peripheral blood draw. Cytogenetic changes play a significant role in determining the prognostic factors and management of ALL.
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Affiliation(s)
- Eman Shreteh
- Emergency Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Susannah Boulet
- Emergency Medicine, Allegheny Health Network - St. Vincent Hospital, Erie, USA
| | - Melody L Milliron
- Emergency Medicine, Allegheny Health Network - St. Vincent Hospital, Erie, USA
| | - Christopher Karns
- Emergency Medicine, Allegheny Health Network - St. Vincent Hospital, Erie, USA
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Crawford R, Sikirica S, Morrison R, Cappelleri JC, Russell-Smith A, Shah R, Chadwick H, Doward L. The Patient Experience of Acute Lymphoblastic Leukemia and Its Treatment: Social Media Review. JMIR Cancer 2023; 9:e39852. [PMID: 37126376 PMCID: PMC10186186 DOI: 10.2196/39852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/27/2022] [Accepted: 11/14/2022] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Adult patients with acute lymphoblastic leukemia (ALL) report substantial disease- and treatment-related impacts on their health-related quality of life (HRQOL). Patient-reported information (PRI) shared on social media may provide a distinct opportunity to understand the patient experience outside of formal research contexts and help inform the development of novel therapies. OBJECTIVE This qualitative social media review aimed to assess PRI shared on social media websites to gain a better understanding of the symptom, HRQOL, and treatment impacts on individuals with ALL. METHODS We identified English-language posts on 3 patient advocacy websites (Patient Power, The Patient Story, and Leukaemia Care) and YouTube that included PRI about experiences with ALL or ALL treatments shared by adults (aged ≥18 years) with a self-reported ALL diagnosis. Patients' demographic and disease characteristics were extracted from posts (where available), and the posts were analyzed thematically. A network analysis was conducted to delineate possible associations among ALL symptoms, HRQOL impacts, and treatment-related symptoms and impacts. RESULTS Of the 935 social media posts identified, 63 (7%) met the review criteria, including 40 (63%) videos, 5 (8%) comments posted in response to videos, and 18 (29%) blog posts. The 63 posts were contributed by 41 patients comprised of 21 (51%) males, 18 females (44%), and 2 (5%) whose gender was not reported. Among the patients, 13 (32%) contributed >1 source of data. Fatigue (n=20, 49%), shortness of breath (n=13, 32%), and bruising (n=12, 29%) were the symptoms prior to treatment most frequently discussed by patients. Patients also reported impacts on personal relationships (n=26, 63%), psychological and emotional well-being (n=25, 61%), and work (n=16, 39%). Although inpatient treatment reportedly restricted patients' independence and social functioning, it also provided a few patients with a sense of safety. Patients frequently relied on their doctors to drive their treatment decisions but were also influenced by family members. The network analysis indicated that disease-related symptoms were primarily associated with patients' physical functioning, activities of daily living, and ability to work, while treatment-related symptoms were primarily associated with emotional well-being. CONCLUSIONS This social media review explored PRI through a thematic analysis of patient-contributed content on patient advocacy websites and YouTube to identify and contextualize emergent themes in patient experiences with ALL and its treatments. To our knowledge, this is the first study to leverage this novel tool to generate new insights into patients' experiences with ALL. Patients' social media posts suggest that inpatient care for ALL is associated with restricted independence and social functioning. However, inpatient care also provided a sense of safety for some patients. Studies such as this one that capture patients' experiences in their own words are valuable tools to further our knowledge of patient outcomes with ALL.
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Affiliation(s)
- Rebecca Crawford
- Research Triangle Institute Health Solutions, Manchester, United Kingdom
| | | | - Ross Morrison
- Research Triangle Institute Health Solutions, Manchester, United Kingdom
| | | | | | - Richa Shah
- Pfizer Inc, New York City, NY, United States
| | - Helen Chadwick
- Research Triangle Institute Health Solutions, Manchester, United Kingdom
| | - Lynda Doward
- Research Triangle Institute Health Solutions, Manchester, United Kingdom
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Kumar A, Taghi Khani A, Duault C, Aramburo S, Sanchez Ortiz A, Lee SJ, Chan A, McDonald T, Huang M, Lacayo NJ, Sakamoto KM, Yu J, Hurtz C, Carroll M, Tasian SK, Ghoda L, Marcucci G, Gu Z, Rosen ST, Armenian S, Izraeli S, Chen CW, Caligiuri MA, Forman SJ, Maecker HT, Swaminathan S. Intrinsic suppression of type I interferon production underlies the therapeutic efficacy of IL-15-producing natural killer cells in B-cell acute lymphoblastic leukemia. J Immunother Cancer 2023; 11:jitc-2022-006649. [PMID: 37217248 DOI: 10.1136/jitc-2022-006649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Type I interferons (IFN-Is), secreted by hematopoietic cells, drive immune surveillance of solid tumors. However, the mechanisms of suppression of IFN-I-driven immune responses in hematopoietic malignancies including B-cell acute lymphoblastic leukemia (B-ALL) are unknown. METHODS Using high-dimensional cytometry, we delineate the defects in IFN-I production and IFN-I-driven immune responses in high-grade primary human and mouse B-ALLs. We develop natural killer (NK) cells as therapies to counter the intrinsic suppression of IFN-I production in B-ALL. RESULTS We find that high expression of IFN-I signaling genes predicts favorable clinical outcome in patients with B-ALL, underscoring the importance of the IFN-I pathway in this malignancy. We show that human and mouse B-ALL microenvironments harbor an intrinsic defect in paracrine (plasmacytoid dendritic cell) and/or autocrine (B-cell) IFN-I production and IFN-I-driven immune responses. Reduced IFN-I production is sufficient for suppressing the immune system and promoting leukemia development in mice prone to MYC-driven B-ALL. Among anti-leukemia immune subsets, suppression of IFN-I production most markedly lowers the transcription of IL-15 and reduces NK-cell number and effector maturation in B-ALL microenvironments. Adoptive transfer of healthy NK cells significantly prolongs survival of overt ALL-bearing transgenic mice. Administration of IFN-Is to B-ALL-prone mice reduces leukemia progression and increases the frequencies of total NK and NK-cell effectors in circulation. Ex vivo treatment of malignant and non-malignant immune cells in primary mouse B-ALL microenvironments with IFN-Is fully restores proximal IFN-I signaling and partially restores IL-15 production. In B-ALL patients, the suppression of IL-15 is the most severe in difficult-to-treat subtypes with MYC overexpression. MYC overexpression promotes sensitivity of B-ALL to NK cell-mediated killing. To counter the suppressed IFN-I-induced IL-15 production in MYChigh human B-ALL, we CRISPRa-engineered a novel human NK-cell line that secretes IL-15. CRISPRa IL-15-secreting human NK cells kill high-grade human B-ALL in vitro and block leukemia progression in vivo more effectively than NK cells that do not produce IL-15. CONCLUSION We find that restoration of the intrinsically suppressed IFN-I production in B-ALL underlies the therapeutic efficacy of IL-15-producing NK cells and that such NK cells represent an attractive therapeutic solution for the problem of drugging MYC in high-grade B-ALL.
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Affiliation(s)
- Anil Kumar
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Adeleh Taghi Khani
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Caroline Duault
- The Human Immune Monitoring Center (HIMC), Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California, USA
| | - Soraya Aramburo
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Ashly Sanchez Ortiz
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Sung June Lee
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Anthony Chan
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Tinisha McDonald
- The Hematopoietic Tissue Biorepository/Research Pathology Shared Resources, City of Hope, Duarte, California, USA
| | - Min Huang
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Norman J Lacayo
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Kathleen M Sakamoto
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Jianhua Yu
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Christian Hurtz
- Department of Cancer and Cellular Biology, Fels Cancer Institute for Personalized Medicine Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Martin Carroll
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sarah K Tasian
- Department of Pediatrics, Division of Oncology, The Children's Hospital, Philadelphia, Pennsylvania, USA
| | - Lucy Ghoda
- Hematological Malignancies Translational Science, City of Hope, Duarte, California, USA
| | - Guido Marcucci
- The Hematopoietic Tissue Biorepository/Research Pathology Shared Resources, City of Hope, Duarte, California, USA
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
- Hematological Malignancies Translational Science, City of Hope, Duarte, California, USA
| | - Zhaohui Gu
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Steven T Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Saro Armenian
- Department of Pediatrics, City of Hope, Duarte, California, USA
| | - Shai Izraeli
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
- Hematology-Oncology Department, Tel Aviv University, Tel Aviv, Israel
| | - Chun-Wei Chen
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
| | - Michael A Caligiuri
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Stephen J Forman
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, California, USA
| | - Holden T Maecker
- The Human Immune Monitoring Center (HIMC), Institute for Immunity, Transplantation and Infection, Stanford University School of Medicine, Stanford, California, USA
| | - Srividya Swaminathan
- Department of Systems Biology, City of Hope Beckman Research Institute, Monrovia, California, USA
- Department of Pediatrics, City of Hope, Duarte, California, USA
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Zanjirband M, Rahgozar S, Aberuyi N. miR-16-5p enhances sensitivity to RG7388 through targeting PPM1D expression (WIP1) in Childhood Acute Lymphoblastic Leukemia. CANCER DRUG RESISTANCE (ALHAMBRA, CALIF.) 2023; 6:242-256. [PMID: 37457129 PMCID: PMC10344722 DOI: 10.20517/cdr.2022.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 03/02/2023] [Accepted: 04/28/2023] [Indexed: 07/18/2023]
Abstract
Aim: Given the encouraging results of the p53-Mdm2 inhibitor RG7388 in clinical trials and the vital function of miR-16-5p in suppressing cell proliferation, the aim of the present study was to investigate the combined impact of RG7388 and miR-16-5p overexpression on the childhood acute lymphoblastic leukemia (chALL). Methods: miRTarBase and miRDB, along with KEGG and STRING databases, were used to predict miR-16-5p target genes and explore protein-protein interaction networks, respectively. B- and T-lymphoblastic cell lines, in addition to patient primary cells, were treated with RG7388. Ectopic overexpression of miR-16-5p in Nalm6 cell line was induced through cell electroporation and transfection of microRNA mimics was confirmed by qRT-PCR. Cell viability was evaluated using the MTT assay. Western blot analyses were performed to evaluate the effects of RG7388 and miR-16-5p upregulation on the protein levels of p53 and its downstream target genes in chALL cells. Paired sample t-test was employed for statistical analyses. Results: MTT assay showed RG7388-induced cytotoxicity in wild-type p53 Nalm6 cell line and p53 functional patient primary cells. However, CCRF-CEM and p53 non-functional leukemic cells indicated drug resistance. Western blot analyses validated the bioinformatics results, confirming the downregulation of WIP1, p53 stabilization, as well as overexpression of p21WAF1 and Mdm2 proteins in Nalm6 cells transfected with miR-16-5p. Moreover, enhanced sensitivity to RG7388 was observed in the transfected cells. Conclusion: This is the first study indicating the mechanistic importance of miR-16-5p overexpression in chALL and its inhibitory role in leukemia treatment when combined with the p53-Mdm2 antagonist, RG7388. These findings might be useful for researchers and clinicians to pave the way for better management of chALL.
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Affiliation(s)
- Maryam Zanjirband
- Correspondence to: Dr. Soheila Rahgozar, Dr. Maryam Zanjirband, Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Hezar Jerib Avenue, Isfahan 15100, Iran. E-mail: ;
| | - Soheila Rahgozar
- Correspondence to: Dr. Soheila Rahgozar, Dr. Maryam Zanjirband, Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Hezar Jerib Avenue, Isfahan 15100, Iran. E-mail: ;
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Yang Y, Wang C, Chen Y, Wang X, Jiao Z, Wang Z. External evaluation and systematic review of population pharmacokinetic models for high-dose methotrexate in cancer patients. Eur J Pharm Sci 2023; 186:106416. [PMID: 37119861 DOI: 10.1016/j.ejps.2023.106416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/26/2023] [Accepted: 02/28/2023] [Indexed: 05/01/2023]
Abstract
Several population pharmacokinetic (PPK) models have been established to optimize the therapeutic regimen and reduce the toxicity of high-dose methotrexate (HDMTX) in patients with cancer. However, their predictive performance when extrapolated to different clinical centers was unknown. In this study, we aimed to externally evaluate the predictive ability of HDMTX PPK models and determine the potential influencing factors. We searched the literature and determined the predictive performance of the selected models using methotrexate concentrations in 721 samples from 60 patients in the First Affiliated Hospital of the Navy Medical University. Prediction-based diagnostics and simulation-based normalized prediction distribution errors (NPDE) were used to evaluate the predictive performance of the models. The influence of prior information was also assessed using Bayesian forecasting, and the potential factors affecting model predictability were investigated. Thirty models extracted from published PPK studies were assessed. Prediction-based diagnostics showed that the number of compartments potentially influenced model transferability, and simulation-based NPDE indicated model misspecification. Bayesian forecasting significantly improved the predictive performance of the models. Various factors, including bioassays, covariates, and population diagnosis, influence model extrapolation. The published models were unsatisfactory for all prediction-based diagnostics, except for the 24 h methotrexate concentration monitoring and simulation-based diagnostics, making them inappropriate for direct extrapolation. Moreover, Bayesian forecasting combined therapeutic drug monitoring could improve the predictive performance of the models.
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Affiliation(s)
- Yunyun Yang
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China; Department of Pharmacy, Shanghai Changhai Hospital, First Affiliated Hospital of Navy Medical University, Shanghai 200433, China
| | - Chenyu Wang
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yueting Chen
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xuebin Wang
- Department of Pharmacy, Shanghai Changhai Hospital, First Affiliated Hospital of Navy Medical University, Shanghai 200433, China
| | - Zheng Jiao
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai 200030, China.
| | - Zhuo Wang
- Department of Pharmacy, Shanghai Changhai Hospital, First Affiliated Hospital of Navy Medical University, Shanghai 200433, China.
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Nunes Duarte AC, Barbosa AN, Saito CPB, Paula EVD, Saito D. Oral mucositis and microbial status in acute lymphoblastic leukemia subjects undergoing high-dose chemotherapy. BRAZILIAN JOURNAL OF ORAL SCIENCES 2023. [DOI: 10.20396/bjos.v22i00.8667697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Aim: To assess oral microbial status in patients with acute lymphoblastic leukemia (ALL) undergoing high-dose chemotherapy and to unravel possible associations between nosocomial pathogens and the establishment of chemotherapy-induced oral mucositis (CIOM). Methods: Oral mucosa, saliva, and peripheral blood samples were collected from 46 ALL subjects one day prior to chemotherapy (D0) and 2 weeks after treatment initiation (D14). Clinical intraoral inspection was performed by a single practitioner, with mucositis classification performed according to the WHO oral toxicity scale. Blood components were quantified by automatic flow cytometry, while oral Staphylococcus aureus and Pseudomonas aeruginosa were detected by Polymerase Chain Reaction with species-specific primers. Associations among bacteria and clinical findings were determined by Fisher’s Exact test, longitudinal bacterial changes by paired Macnemar, and correlations among blood parameters and mucositis status or bacteria via Mann-Whitney. Results: S. aureus displayed higher detection rates at D14 (p < 0.05) and was positively associated with mucositis, adoption of a non-solid diet (all p < 0.001), nausea and fever (all p < 0.05). Conversely, P. aeruginosa did not correlate to CIOM clinical parameters. At the systemic standpoint, lower hemoglobin levels associated with CIOM and fever events (all p < 0.01). Conclusion: The study evidences S. aureus as a potential pathogen in ALL-CIOM, reaffirming microbial control as an important preventive measure during high-dose immunosuppressive therapy. The weight of non-white-blood-cell parameters should be validated as novel CIOM biomarkers in prospective research.
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Tejera Nevado P, Tešan Tomić T, Atefyekta A, Fehr A, Stenman G, Andersson MK. Synthetic oleanane triterpenoids suppress MYB oncogene activity and sensitize T-cell acute lymphoblastic leukemia cells to chemotherapy. Front Oncol 2023; 13:1126354. [PMID: 37077825 PMCID: PMC10106619 DOI: 10.3389/fonc.2023.1126354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematologic malignancy with poor prognosis. The MYB oncogene encodes a master transcription factor that is activated in the majority of human T-ALLs. In the present study, we have performed a large-scale screening with small-molecule drugs to find clinically useful inhibitors of MYB gene expression in T-ALL. We identified several pharmacological agents that potentially could be used to treat MYB-driven malignancies. In particular, treatment with the synthetic oleanane triterpenoids (OTs) bardoxolone methyl and omaveloxolone decreased MYB gene activity and expression of MYB downstream target genes in T-ALL cells with constitutive MYB gene activation. Notably, treatment with bardoxolone methyl and omaveloxolone led to a dose-dependent reduction in cell viability and induction of apoptosis at low nanomolar concentrations. In contrast, normal bone marrow-derived cells were unaffected at these concentrations. Bardoxolone methyl and omaveloxolone treatment downregulated the expression of DNA repair genes and sensitized T-ALL cells to doxorubicin, a drug that is part of the standard therapy of T-ALL. OT treatment may thus potentiate DNA-damaging chemotherapy through attenuation of DNA repair. Taken together, our results indicate that synthetic OTs may be useful in the treatment of T-ALL and potentially also in other MYB-driven malignancies.
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Chen Z, Zhou K, Xue J, Small A, Xiao G, Nguyen LXT, Zhang Z, Prince E, Weng H, Huang H, Zhao Z, Qing Y, Shen C, Li W, Han L, Tan B, Su R, Qin H, Li Y, Wu D, Gu Z, Ngo VN, He X, Chao J, Leung K, Wang K, Dong L, Qin X, Cai Z, Sheng Y, Chen Y, Wu X, Zhang B, Shi Y, Marcucci G, Qian Z, Xu M, Müschen M, Chen J, Deng X. Phosphorylation stabilized TET1 acts as an oncoprotein and therapeutic target in B cell acute lymphoblastic leukemia. Sci Transl Med 2023; 15:eabq8513. [PMID: 36989375 PMCID: PMC11163962 DOI: 10.1126/scitranslmed.abq8513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023]
Abstract
Although the overall survival rate of B cell acute lymphoblastic leukemia (B-ALL) in childhood is more than 80%, it is merely 30% in refractory/relapsed and adult patients with B-ALL. This demonstrates a need for improved therapy targeting this subgroup of B-ALL. Here, we show that the ten-eleven translocation 1 (TET1) protein, a dioxygenase involved in DNA demethylation, is overexpressed and plays a crucial oncogenic role independent of its catalytic activity in B-ALL. Consistent with its oncogenic role in B-ALL, overexpression of TET1 alone in normal precursor B cells is sufficient to transform the cells and cause B-ALL in mice within 3 to 4 months. We found that TET1 protein is stabilized and overexpressed because of its phosphorylation mediated by protein kinase C epsilon (PRKCE) and ATM serine/threonine kinase (ATM), which are also overexpressed in B-ALL. Mechanistically, TET1 recruits STAT5B to the promoters of CD72 and JCHAIN and promotes their transcription, which in turn promotes B-ALL development. Destabilization of TET1 protein by treatment with PKC or ATM inhibitors (staurosporine or AZD0156; both tested in clinical trials), or by pharmacological targeting of STAT5B, greatly decreases B-ALL cell viability and inhibits B-ALL progression in vitro and in vivo. The combination of AZD0156 with staurosporine or vincristine exhibits a synergistic effect on inhibition of refractory/relapsed B-ALL cell survival and leukemia progression in PDX models. Collectively, our study reveals an oncogenic role of the phosphorylated TET1 protein in B-ALL independent of its catalytic activity and highlights the therapeutic potential of targeting TET1 signaling for the treatment of refractory/relapsed B-ALL.
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Affiliation(s)
- Zhenhua Chen
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Keren Zhou
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Jianhuang Xue
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Frontier Science Center for Stem Cell Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Andrew Small
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Gang Xiao
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Institute of Immunology, Zhejiang University School of Medicine, Hangzhou 310058, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou 311121, China
| | - Le Xuan Truong Nguyen
- Department of Hematological Malignancies Translational Science, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Gehr Family Center for Leukemia Research, City of Hope Medical Center and Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Zheng Zhang
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Emily Prince
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Hengyou Weng
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Guangzhou Laboratory, Guangzhou, Guangdong 510005, China
| | - Huilin Huang
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong 510060, China
| | - Zhicong Zhao
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Department of Liver Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Ying Qing
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Chao Shen
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Wei Li
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Li Han
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Brandon Tan
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Rui Su
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Hanjun Qin
- Integrative Genomics Core, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Yangchan Li
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Department of Radiation Oncology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Dong Wu
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Zhaohui Gu
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Department of Computational and Quantitative Medicine, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Vu N. Ngo
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Xin He
- Department of Hematological Malignancies Translational Science, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Jianfei Chao
- Division of Stem Cell Biology Research, Department of Developmental and Stem Cell Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Keith Leung
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Kitty Wang
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Lei Dong
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Xi Qin
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
| | - Zhenming Cai
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases, Nanjing Medical University, Nanjing 211166, China
| | - Yue Sheng
- Department of Medicine and Department of Biochemistry and Molecular Biology, UF Health Cancer Center, University of Florida, Gainesville, FL 32611, USA
- Department of Hematology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Yu Chen
- Molecular Instrumentation Center, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Xiwei Wu
- Integrative Genomics Core, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Bin Zhang
- Department of Hematological Malignancies Translational Science, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Gehr Family Center for Leukemia Research, City of Hope Medical Center and Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Yanhong Shi
- Division of Stem Cell Biology Research, Department of Developmental and Stem Cell Biology, Beckman Research Institute of City of Hope, Duarte, CA 91010, USA
| | - Guido Marcucci
- Department of Hematological Malignancies Translational Science, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Gehr Family Center for Leukemia Research, City of Hope Medical Center and Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Zhijian Qian
- Department of Medicine and Department of Biochemistry and Molecular Biology, UF Health Cancer Center, University of Florida, Gainesville, FL 32611, USA
| | - Mingjiang Xu
- Department of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
| | - Markus Müschen
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Center of Molecular and Cellular Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA
| | - Jianjun Chen
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
- Gehr Family Center for Leukemia Research, City of Hope Medical Center and Comprehensive Cancer Center, Duarte, CA 91010, USA
| | - Xiaolan Deng
- Department of Systems Biology, Beckman Research Institute of City of Hope, Monrovia, CA 91016, USA
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Lorenzo-Anota HY, Reyes-Ruiz A, Calvillo-Rodríguez KM, Mendoza-Reveles R, Urdaneta-Peinado AP, Alvarez-Valadez KM, Martínez-Torres AC, Rodríguez-Padilla C. IMMUNEPOTENT CRP increases intracellular calcium through ER-calcium channels, leading to ROS production and cell death in breast cancer and leukemic cell lines. EXCLI JOURNAL 2023; 22:352-366. [PMID: 37223080 PMCID: PMC10201010 DOI: 10.17179/excli2022-5568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/08/2023] [Indexed: 05/25/2023]
Abstract
IMMUNEPOTENT CRP (ICRP) is an immunotherapy that induces cell death in cancer cell lines. However, the molecular mechanisms of death are not completely elucidated. Here, we evaluated the implication of intracellular Ca2+ augmentation in the cell death induced by ICRP on T-ALL and breast cancer cell lines. Cell death induction and the molecular characteristics of cell death were evaluated in T-ALL and breast cancer cell lines by assessing autophagosome formation, ROS production, loss of mitochondrial membrane potential, ER stress and intracellular Ca2+ levels. We assessed the involvement of extracellular Ca2+, and the implication of the ER-receptors, IP3R and RyR, in the cell death induced by ICRP, by using an extracellular calcium chelator and pharmacological inhibitors. Our results show that ICRP increases intracellular Ca2+ levels as the first step of the cell death mechanism that provokes ROS production and loss of mitochondrial membrane potential. In addition, blocking the IP3 and ryanodine receptors inhibited ER-Ca2+ release, ROS production and ICRP-induced cell death. Taken together our results demonstrate that ICRP triggers intracellular Ca2+-increase leading to different regulated cell death modalities in T-ALL and breast cancer cell lines. See also Figure 1(Fig. 1).
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Affiliation(s)
- Helen Y. Lorenzo-Anota
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
- Tecnológico de Monterrey, The Institute for Obesity Research, Monterrey, México
| | - Alejandra Reyes-Ruiz
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Kenny M. Calvillo-Rodríguez
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Rodolfo Mendoza-Reveles
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Andrea P. Urdaneta-Peinado
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Karla M. Alvarez-Valadez
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Ana Carolina Martínez-Torres
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
| | - Cristina Rodríguez-Padilla
- Laboratorio de Inmunología y Virología, Facultad de Ciencias Biológicas, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, México
- LONGEVEDEN S.A. de C.V
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Weng Y, Shen H, Mei L, Liu L, Yao Y, Li R, Wei S, Yan R, Ruan X, Wang D, Wei Y, Deng Y, Zhou Y, Xiao T, Goda K, Liu S, Zhou F, Lei C. Typing of acute leukemia by intelligent optical time-stretch imaging flow cytometry on a chip. LAB ON A CHIP 2023; 23:1703-1712. [PMID: 36799214 DOI: 10.1039/d2lc01048h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Acute leukemia (AL) is one of the top life-threatening diseases. Accurate typing of AL can significantly improve its prognosis. However, conventional methods for AL typing often require cell staining, which is time-consuming and labor-intensive. Furthermore, their performance is highly limited by the specificity and availability of fluorescent labels, which can hardly meet the requirements of AL typing in clinical settings. Here, we demonstrate AL typing by intelligent optical time-stretch (OTS) imaging flow cytometry on a microfluidic chip. Specifically, we employ OTS microscopy to capture the images of cells in clinical bone marrow samples with a spatial resolution of 780 nm at a high flowing speed of 1 m s-1 in a label-free manner. Then, to show the clinical utility of our method for which the features of clinical samples are diverse, we design and construct a deep convolutional neural network (CNN) to analyze the cellular images and determine the AL type of each sample. We measure 30 clinical samples composed of 7 acute lymphoblastic leukemia (ALL) samples, 17 acute myelogenous leukemia (AML) samples, and 6 samples from healthy donors, resulting in a total of 227 620 images acquired. Results show that our method can distinguish ALL and AML with an accuracy of 95.03%, which, to the best of our knowledge, is a record in label-free AL typing. In addition to AL typing, we believe that the high throughput, high accuracy, and label-free operation of our method make it a potential solution for cell analysis in scientific research and clinical settings.
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Affiliation(s)
- Yueyun Weng
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
- The Key Laboratory of Transients in Hydraulic Machinery of Ministry of Education, School of Power and Mechanical Engineering, Wuhan University, Wuhan, China
| | - Hui Shen
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Liye Mei
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
| | - Li Liu
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Yifan Yao
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
| | - Rubing Li
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
| | - Shubin Wei
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
| | - Ruopeng Yan
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
| | - Xiaolan Ruan
- Department of Hematology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Du Wang
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
| | - Yongchang Wei
- Department of Radiation & Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yunjie Deng
- Department of Chemistry, University of Tokyo, Tokyo, Japan
| | - Yuqi Zhou
- Department of Chemistry, University of Tokyo, Tokyo, Japan
| | - Tinghui Xiao
- Department of Chemistry, University of Tokyo, Tokyo, Japan
| | - Keisuke Goda
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
- Department of Chemistry, University of Tokyo, Tokyo, Japan
- Department of bioengineering, University of California, Los Angeles, USA
| | - Sheng Liu
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
- The Key Laboratory of Transients in Hydraulic Machinery of Ministry of Education, School of Power and Mechanical Engineering, Wuhan University, Wuhan, China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, China.
| | - Cheng Lei
- The Institute of Technological Sciences, Wuhan University, Wuhan, China.
- Department of Chemistry, University of Tokyo, Tokyo, Japan
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da Mota THA, Camargo R, Biojone ER, Guimarães AFR, Pittella-Silva F, de Oliveira DM. The Relevance of Telomerase and Telomere-Associated Proteins in B-Acute Lymphoblastic Leukemia. Genes (Basel) 2023; 14:genes14030691. [PMID: 36980962 PMCID: PMC10048576 DOI: 10.3390/genes14030691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/04/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Telomeres and telomerase are closely linked to uncontrolled cellular proliferation, immortalization and carcinogenesis. Telomerase has been largely studied in the context of cancer, including leukemias. Deregulation of human telomerase gene hTERT is a well-established step in leukemia development. B-acute lymphoblastic leukemia (B-ALL) recovery rates exceed 90% in children; however, the relapse rate is around 20% among treated patients, and 10% of these are still incurable. This review highlights the biological and clinical relevance of telomerase for B-ALL and the implications of its canonical and non-canonical action on signaling pathways in the context of disease and treatment. The physiological role of telomerase in lymphocytes makes the study of its biomarker potential a great challenge. Nevertheless, many works have demonstrated that high telomerase activity or hTERT expression, as well as short telomeres, correlate with poor prognosis in B-ALL. Telomerase and related proteins have been proven to be promising pharmacological targets. Likewise, combined therapy with telomerase inhibitors may turn out to be an alternative strategy for B-ALL.
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Affiliation(s)
- Tales Henrique Andrade da Mota
- Laboratory of Molecular Pathology of Cancer, University of Brasilia, Brasilia 70910-900, Brazil
- Laboratory of Molecular Analysis, Faculty of Ceilândia, University of Brasilia, Brasilia 72220-275, Brazil
- Correspondence:
| | - Ricardo Camargo
- Brasília Children’s Hospital José Alencar, Brasilia 70684-831, Brazil
| | | | - Ana Flávia Reis Guimarães
- Laboratory of Molecular Analysis, Faculty of Ceilândia, University of Brasilia, Brasilia 72220-275, Brazil
| | - Fabio Pittella-Silva
- Laboratory of Molecular Pathology of Cancer, University of Brasilia, Brasilia 70910-900, Brazil
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Pinchinat A, Gupta S, Cooper SL, Rau RE. SOHO State of the Art Updates and Next Questions | Optimal Timing of Blinatumomab for the Treatment of B-Acute Lymphoblastic Leukemia. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:159-167. [PMID: 36642665 DOI: 10.1016/j.clml.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/17/2022] [Accepted: 12/19/2022] [Indexed: 12/26/2022]
Abstract
Blinatumomab is a CD19 targeting bi-specific T-cell engager antibody construct developed for the treatment of CD19 expressing B-cell malignancies. Numerous adult and pediatric B-ALL clinical trials have demonstrated blinatumomab's efficacy in the relapse setting as well as in patients with residual disease after upfront chemotherapy. The safety profile of blinatumomab is also favorable, making it a feasible option for most patients. Several key questions remain, including the role of blinatumomab as a replacement for toxic elements of standard chemotherapy regimens in the upfront setting, its role as a bridge to hematopoietic stem cell transplantation, or whether previous blinatumomab impacts the efficacy of subsequent CAR-T cell therapy.
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Affiliation(s)
- Ashley Pinchinat
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Hassenfeld Children's Hospital at NYU Langone Health, NYU Grossman School of Medicine, New York, NY
| | - Sumit Gupta
- Division of Haematology/Oncology, Hospital for Sick Children, Toronto, Canada and Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stacy L Cooper
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Rachel E Rau
- Department of Pediatrics, Baylor College of Medicine Texas Children's Hospital, Houston, TX.
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Zhang Y, Nguyen L, Lu CM, Wang E, Lauw MIS, Ball S, Dong N, Moscinski L, Chan O, Yun S, Sallman D, Sokol L, Shah B, Knepper T, Lancet J, Komrokji R, Padron E, Kuykendall A, Zhang L. Clinical Response to Upfront Targeted Tyrosine Kinase Inhibitors among Patients with Myeloid/Lymphoid Neoplasms with Eosinophilia and Tyrosine Kinase Gene Fusion. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:e150-e163. [PMID: 36624015 DOI: 10.1016/j.clml.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusion (MLN-TK) is an entity encompassed of a heterogeneous group of rare hematopoietic neoplasms that are driven by gene fusion involving PDGDRA/B, FGFR1, JAK2, FLT3 or ETV6::ABL1. Though patients presenting with chronic phase MLN-TK with PDGFRA fusion display a favorable outcome in response to upfront TK inhibitor (TKI) therapy, the outcomes of MLNs driven by other TK fusions are not well described. In this study, we aimed to critically analyze the treatment outcomes of patients with MLN-TK, focusing on the role of upfront TKIs in both chronic- and blast-phase diseases. METHODS The retrospective study included patients with confirmed MLN-TK from 3 centers and assessed demographic and clinical variables, treatment, and outcomes. RESULTS Forty-two patients with confirmed MLN-TK [PDGFRA (n = 22), PDGFRB (n = 4), FGFR1(n = 10), JAK2 (n = 2); and FLT3 (n = 3)] were included. Fifteen of 25 (60%) chronic-phased patients received upfront TKI therapy had a long-term remission. Nine of 16 (60%) blast-phase patients with upfront TKIs also achieved complete remission and remained alive at a median follow-up of 20 months. All 3 patients with blast phase disease who received upfront chemotherapy without positive response did not respond to subsequent TKI therapy, emphasizing the importance of initiating TKI therapy early. Upfront TKI therapy was associated with longer overall survival in univariate analyses (HR, 0.054 [95% CI, 0.007-0.42]) and multivariate analyses (HR, 0.03 [95% CI, 0.002-0.47]). CONCLUSION The outcomes of upfront TKI therapy are excellent for MLN-TK in both chronic and blast phases, regardless of gene abnormalities.
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Affiliation(s)
- Yumeng Zhang
- Morsani College of Medicine, University of South Florida, Tampa, FL; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Lynn Nguyen
- Department of Pathology, James A. Haley Veterans' Hospital, Tampa, FL
| | - Chuanyi M Lu
- Department of Laboratory Medicine, University of California, San Francisco, CA
| | - Endi Wang
- Department of Pathology, Duke University School of Medicine, Durham, NC
| | - Marietya I S Lauw
- Department of Laboratory Medicine, University of California, San Francisco, CA
| | - Somedeb Ball
- Morsani College of Medicine, University of South Florida, Tampa, FL; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Ning Dong
- Morsani College of Medicine, University of South Florida, Tampa, FL; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Lynn Moscinski
- Department of Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Onyee Chan
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Seongseok Yun
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - David Sallman
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Lubomir Sokol
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Bijal Shah
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Todd Knepper
- MMG Personalized Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Jeffery Lancet
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Rami Komrokji
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Eric Padron
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Andrew Kuykendall
- Department of Hematologic Malignancies, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
| | - Ling Zhang
- Department of Hematopathology and Laboratory Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
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Sarvarian P, Samadi P, Gholipour E, khodadadi M, Pourakbari R, Akbarzadelale P, Shamsasenjan K. Fisetin-loaded grape-derived nanoparticles improve anticancer efficacy in MOLT-4 cells. Biochem Biophys Res Commun 2023; 658:69-79. [PMID: 37027907 DOI: 10.1016/j.bbrc.2023.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 03/17/2023]
Abstract
PURPOSE Fisetin (FIS) is a natural flavonoid with anti-proliferative and anti-apoptotic effects on different human cancer cell lines and can be considered a therapeutic agent for ALL treatment. However, FIS has little aqueous solubility and bioavailability, limiting its therapeutic applications. Thus, novel drug delivery systems are needed to improve solubility and bioavailability of FIS. Plant-derived nanoparticles (PDNPs) could be considered a great delivery system for FIS to the target tissues. In this study, we investigated the anti-proliferative and anti-apoptotic effect of free FIS and FIS-loaded Grape-derived Nanoparticles (GDN) FIS-GDN in MOLT-4 cells. MATERIALS/METHODS In this study, MOLT-4 cells were treated with increasing concentration of FIS and FIS-GDN and viability of cells were assessed by MTT assay. Additionally, cellular apoptosis rate and related genes expression were evaluated using flow cytometry and Real Time-PCR methods, respectively. RESULTS FIS and FIS-GDN decreased cells viability and increased cells apoptosis dose-dependently, but not time dependently. Treatment of MOLT-4 cells with increasing concentrations of FIS and FIS-GDN considerably increased the expression of caspase 3, 8 and 9 and Bax level, and also decreased the expression of Bcl-2. Results indicated an increased apoptosis after increased concentration of FIS and FIS-GDN at 24, 48 and 72 h. CONCLUSIONS Our data proposed that FIS and FIS-GDN can induce apoptosis and have antitumor properties in MOLT-4 cells. Furthermore, compared to FIS, FIS-GDN induced more apoptosis in these cells by increasing the solubility and efficiency of FIS. Additionally, GDNs increased FIS effectiveness in proliferation inhibition and apoptosis induction.
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130
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Drug-tolerant persister B-cell precursor acute lymphoblastic leukemia cells. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.02.28.530540. [PMID: 36909619 PMCID: PMC10002708 DOI: 10.1101/2023.02.28.530540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Reduced responsiveness of precursor B-acute lymphoblastic leukemia (BCP-ALL) to chemotherapy can be inferred when leukemia cells persist after 28 days of initial treatment. Survival of these long-term persister (LTP) / minimal residual disease (MRD) cells is partly due to bone marrow stromal cells that protect them under conditions of chemotherapy stress. We used RNA-seq to analyse BCP-ALL cells that survived a long-term, 30-day vincristine chemotherapy treatment while in co-culture with bone marrow stromal cells. RNAs of as many as 10% of the protein-encoding genes were differentially expressed. There was substantial overlap with genes associated with MRD cell persistence reported in other studies. The top pathway regulated in the LTP cells was that involving p53, a master regulator of a spectrum of responses relevant to drug resistance and cytotoxic drug exposure including control of autophagy. We tested a select number of genes for contribution to BCP-ALL cell survival using Cas9/CRISPR in a 2-step selection, initially for overall effect on cell fitness, followed by 21 days of exposure to vincristine. Many genes involved in autophagy and lysosomal function were found to contribute to survival both at steady-state and during drug treatment. We also identified MYH9, NCSTN and KIAA2013 as specific genes contributing to fitness of BCP-ALL cells. CD44 was not essential for growth under steady state conditions but was needed for survival of vincristine treatment. Finally, although the drug transporter ABCC1/MRP1 is not overexpressed in BCP-ALL, a functional gene was needed for DTP cells to survive treatment with vincristine. This suggests that addition of possible ABCC1 inhibitors during induction therapy could provide benefit in eradication of minimal residual disease in patients treated with a chemotherapy regimen that includes vincristine.
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Lagunas-Rangel FA, Liu W, Schiöth HB. Interaction between environmental pollutants and cancer drug efficacy: Bisphenol A, Bisphenol A diglycidyl ether and Perfluorooctanoic acid reduce vincristine cytotoxicity in acute lymphoblastic leukemia cells. J Appl Toxicol 2023; 43:458-469. [PMID: 36181250 DOI: 10.1002/jat.4398] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/15/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022]
Abstract
Every day, we are exposed to many environmental pollutants that can enter our body through different routes and cause adverse effects on our health. Epidemiological studies suggest that these pollutants are responsible for approximately nine million deaths per year. Acute lymphoblastic leukemia (ALL) represents one of the major cancers affecting children, and although substantial progress has been made in its treatment, relapses are frequent after initial treatment and are now one of the leading causes of cancer-related death in pediatric patients. Currently, relatively little attention is paid to pollutant exposure during drug treatment and this is not taken into account for dose setting or regulatory purposes. In this work, we investigated how bisphenol A (BPA), its derivative bisphenol A diglycidyl ether (BADGE), and perfluorooctanoic acid (PFOA) alter vincristine treatment in ALL when administered before or together with the drug. We found that these three pollutants at nanomolar concentrations, lower than those established by current regulations, can reduce the cytotoxic effects of vincristine on ALL cells. Interestingly, we found that this is only achieved when exposure to pollutants occurs prior to administration of the chemotherapeutic drug. Moreover, we found that this effect could be mediated by activation of the PI3K/AKT pathway and stabilization of microtubules. This work strengthens the idea of starting to take into account exposure to pollutants to improve the efficacy of chemotherapy treatments.
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Affiliation(s)
| | - Wen Liu
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Uppsala, Sweden
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Korkmaz S. Clinical use of CAR T-cells in treating acute lymphoblastic leukemia. Transfus Apher Sci 2023; 62:103666. [PMID: 36868895 DOI: 10.1016/j.transci.2023.103666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
Chimeric antigen receptor (CAR) T-cell therapy has transformed the treatment landscape for adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). However CAR T-cell therapy of R/R T-ALL has unique challenges, such as the lack of specific tumor antigens, cell fratricide and T cell aplasia, in comparison with that of R/R B-ALL. Despite promising therapeutic outcomes in R/R B-ALL, application of this therapy is limited by high relapse rates and immunological toxicities. Recent studies suggest patients who underwent allogeneic hematopoietic stem cell transplantation post-CAR T-cell therapy would achieve durable remission and better survival, but this remains controversial. Herein, I briefly review published data on the clinical use of CAR T-cells in treating ALL.
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Affiliation(s)
- Serdal Korkmaz
- University of Health Sciences, Kayseri Faculty of Medicine, Department of Hematology, Apheresis & BMT Unit, Kayseri, Turkey.
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Venvertloh E, Karp D, Ghantarchyan HH, Raoufi K. A Rare Case: Acute Liver Injury Uncovering a Diagnosis of B-cell Acute Lymphoblastic Leukemia in a Young Adult. Cureus 2023; 15:e35274. [PMID: 36968926 PMCID: PMC10036135 DOI: 10.7759/cureus.35274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Acute liver injury can be seen in a myriad of disease states such as chronic alcoholism, hepatitis, and hepatocellular carcinoma. When considering acute liver injury in a young adult, the list of differential diagnoses is much more narrow. One rare cause can be acute lymphoblastic leukemia (ALL), a hematologic malignancy that can be seen in the young adult population. We present a rare case of an 18-year-old male with no prior medical history who presented with abdominal pain and nausea. A complete workup for acute liver injury aided us in uncovering a diagnosis of B-cell ALL. This case highlights the importance of a broad differential in acute liver injury and consideration of ALL as a cause of acute liver injury, especially in young adults.
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El Marabti E, Abdel-Wahab O. Enhancing CD19 Chimeric Antigen Receptor T Cells Through Memory-Enriched T Cells. Clin Cancer Res 2023; 29:694-696. [PMID: 36507801 PMCID: PMC9957814 DOI: 10.1158/1078-0432.ccr-22-3232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/22/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
Chimeric antigen receptor T (CAR-T) cells directed against CD19 have transformed the therapy of relapsed/refractory B-cell acute lymphoblastic leukemia (R/R B-ALL). A recent study reports promising activity and safety of CD19 CAR-T cells generated from naïve, stem, and central memory T cells in adults with R/R B-ALL. See related article by Aldoss et al., p. 742.
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Affiliation(s)
- Ettaib El Marabti
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, NY, USA
| | - Omar Abdel-Wahab
- Molecular Pharmacology Program, Sloan Kettering Institute, New York, NY, USA
- Leukemia Service, Dept. of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Powers SB, Ahmed NG, Jose R, Brezgiel M, Aryal S, Bowman WP, Mathew PA, Mathew SO. Differential Expression of LLT1, SLAM Receptors CS1 and 2B4 and NCR Receptors NKp46 and NKp30 in Pediatric Acute Lymphoblastic Leukemia (ALL). Int J Mol Sci 2023; 24:ijms24043860. [PMID: 36835271 PMCID: PMC9959214 DOI: 10.3390/ijms24043860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/10/2023] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
Acute lymphoblastic leukemia (ALL) represents the most common pediatric cancer. Most patients (85%) develop B-cell ALL; however, T-cell ALL tends to be more aggressive. We have previously identified 2B4 (SLAMF4), CS1 (SLAMF7) and LLT1 (CLEC2D) that can activate or inhibit NK cells upon the interaction with their ligands. In this study, the expression of 2B4, CS1, LLT1, NKp30 and NKp46 was determined. The expression profiles of these immune receptors were analyzed in the peripheral blood mononuclear cells of B-ALL and T-ALL subjects by single-cell RNA sequencing data obtained from the St. Jude PeCan data portal that showed increased expression of LLT1 in B-ALL and T-ALL subjects. Whole blood was collected from 42 pediatric ALL subjects at diagnosis and post-induction chemotherapy and 20 healthy subjects, and expression was determined at the mRNA and cell surface protein level. A significant increase in cell surface LLT1 expression in T cells, monocytes and NK cells was observed. Increased expression of CS1 and NKp46 was observed on monocytes of ALL subjects at diagnosis. A decrease of LLT1, 2B4, CS1 and NKp46 on T cells of ALL subjects was also observed post-induction chemotherapy. Furthermore, mRNA data showed altered expression of receptors in ALL subjects pre- and post-induction chemotherapy treatment. The results indicate that the differential expression of the receptors/ligand may play a role in the T-cell- and NK-cell-mediated immune surveillance of pediatric ALL.
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Affiliation(s)
- Sheila B. Powers
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Nourhan G. Ahmed
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Roslin Jose
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Marissa Brezgiel
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Subhash Aryal
- School of Nursing, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - W. Paul Bowman
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Cook Children’s Medical Center, 801 7th Avenue, Fort Worth, TX 76104, USA
| | - Porunelloor A. Mathew
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Stephen O. Mathew
- Department of Microbiology, Immunology and Genetics, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Correspondence:
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Bai L, Zhou L, Han W, Chen J, Gu X, Hu Z, Yang Y, Li W, Zhang X, Niu C, Chen Y, Li H, Cui J. BAX as the mediator of C-MYC sensitizes acute lymphoblastic leukemia to TLR9 agonists. J Transl Med 2023; 21:108. [PMID: 36765389 PMCID: PMC9921080 DOI: 10.1186/s12967-023-03969-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/04/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND The prognosis of B-cell acute lymphoblastic leukemia (B-ALL) has improved significantly with current first-line therapy, although the recurrence of B-ALL is still a problem. Toll-like receptor 9 (TLR9) agonists have shown good safety and efficiency as immune adjuvants. Apart from their immune regulatory effect, the direct effect of TLR9 agonists on cancer cells with TLR9 expression cannot be ignored. However, the direct effect of TLR9 agonists on B-ALL remains unknown. METHODS We discussed the relationship between TLR9 expression and the clinical characteristics of B-ALL and explored whether CpG 685 exerts direct apoptotic effect on B-ALL without inhibiting normal B-cell function. By using western blot, co-immunoprecipitation, immunofluorescence co-localization, and chromatin immunoprecipitation, we explored the mechanism of the apoptosis-inducing effect of CpG 685 in treating B-ALL cells. By exploring the mechanism of CpG 685 on B-ALL, the predictive biomarkers of the efficacy of CpG 685 in treating B-ALL were explored. These efficiencies were also confirmed in mouse model as well as clinical samples. RESULTS High expression of TLR9 in B-ALL patients showed good prognosis. C-MYC-induced BAX activation was the key to the effect of CpG oligodeoxynucleotides against B-ALL. C-MYC overexpression promoted P53 stabilization, enhanced Bcl-2 associated X-protein (BAX) activation, and mediated transcription of the BAX gene. Moreover, combination therapy using CpG 685 and imatinib, a BCR-ABL kinase inhibitor, could reverse resistance to CpG 685 or imatinib alone by promoting BAX activation and overcoming BCR-ABL1-independent PI3K/AKT activation. CONCLUSION TLR9 is not only a prognostic biomarker but also a potential target for B-ALL therapy. CpG 685 monotherapy might be applicable to Ph- B-ALL patients with C-MYC overexpression and without BAX deletion. CpG 685 may also serve as an effective combinational therapy against Ph+ B-ALL.
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Affiliation(s)
- Ling Bai
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Lei Zhou
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Wei Han
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Jingtao Chen
- grid.430605.40000 0004 1758 4110Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, 130021 China
| | - Xiaoyi Gu
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China ,grid.430605.40000 0004 1758 4110Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, 130021 China ,grid.64924.3d0000 0004 1760 5735International Center of Future Science, Jilin University, Changchun, 130021 China
| | - Zheng Hu
- grid.430605.40000 0004 1758 4110Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, 130021 China ,grid.64924.3d0000 0004 1760 5735International Center of Future Science, Jilin University, Changchun, 130021 China
| | - Yongguang Yang
- grid.430605.40000 0004 1758 4110Institute of Translational Medicine, The First Hospital of Jilin University, Changchun, 130021 China ,grid.64924.3d0000 0004 1760 5735International Center of Future Science, Jilin University, Changchun, 130021 China
| | - Wei Li
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Xiaoying Zhang
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Chao Niu
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Yongchong Chen
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Hui Li
- grid.430605.40000 0004 1758 4110Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021 China
| | - Jiuwei Cui
- Cancer Center, The First Hospital of Jilin University, 1 Xinmin Street, Changchun, 130021, China.
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137
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Qin X, Costa-Silva TA, Pessoa A, Long PF. A scoping review to compare and contrast quality assurance aspects of l-asparaginase biosimilars. Int J Pharm 2023; 632:122523. [PMID: 36581108 DOI: 10.1016/j.ijpharm.2022.122523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022]
Abstract
l-asparaginase is a first-line medicine used for the treatment of acute lymphoblastic leukemia. Differing quality of marketed l-asparaginase biosimilars has been reported to adversely influence treatment outcomes. Herein, the quality of l-asparaginase biosimilars intended for clinical use was reviewed in sight of quality assurance parameters using English and Chinese language database searching, which provided information for possible improvements to the manufacture of this medicine. Ten articles met inclusion criteria, and quality attributes that measured potency, specific activity, purity and host cell proteins (HCPs) were identified. Biosimilars manufactured in high-income countries represented good quality in all aspects. Biosimilars manufactured in high-middle/middle-income countries, however, suggested poorer quality control particularly over removal of HCPs. Future work should now focus on establishing pharmacopeia monographs to establish equivalent quality assurance for l-asparaginase biosimilars manufactured between countries. Standardization of the quality profile, analytical methods and the limits of critical quality parameters, are essential to ensure appropriated efficacy and safety of clinical grade l-asparaginase.
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Affiliation(s)
- Xianwei Qin
- Institute of Pharmaceutical Science, King's College London, London, UK
| | - Tales A Costa-Silva
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Santo André, Brazil
| | - Adalberto Pessoa
- Institute of Pharmaceutical Science, King's College London, London, UK; Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil
| | - Paul F Long
- Institute of Pharmaceutical Science, King's College London, London, UK; Faculdade de Ciências Farmacêuticas, Universidade de São Paulo, São Paulo, Brazil.
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138
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Slouma M, Hannech E, Ghedira H, Dhahri R, Khrifech Y, Doghri R, Gharsallah I. Osteoarticular manifestation of acute lymphoblastic leukemia in adults: a literature review. Clin Rheumatol 2023; 42:607-620. [PMID: 36454343 DOI: 10.1007/s10067-022-06459-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/03/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022]
Abstract
Osteoarticular manifestations such as arthritis and bone pain are scarce among adults with acute lymphoblastic leukemia (ALL). We present a systematic review of osteoarticular first clinical manifestation related to ALL in adults, and we report a case of an adult patient with a B-cell ALL revealed by refractory pygalgia and arthritis. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline using the MEDLINE database, including case reports and case series describing osteoarticular manifestations revealing ALL in adults. There were 29 patients with osteoarticular manifestations, revealing ALL (including our case). The mean age was 34.00 ± 13.29 years. Osteoarticular manifestations were peripheral articular signs (7 cases), axial manifestations (17 cases), and osteolytic lesions (21 cases). Vertebral fractures were reported in 4 cases. MRI was performed in 15 cases, showing heterogeneous signal changes in the vertebra, skull, and sacroiliac bones. It showed avascular necrosis of the femoral head in one case. PET scan, performed in 7 cases, showed diffuse or localized FDG uptakes in the bone marrow. Hypercalcemia was noted in 9 cases. The treatment was based on chemotherapy (23 patients) and radiotherapy (4 cases). During the follow-up, remission was noted in 14 cases, death in 9 cases, and was not available in 6 patients. Our review showed that axial manifestations, joint swelling, bone pain, and hypercalcemia could be the first and only symptoms of ALL in adults, making the diagnosis of ALL difficult to recognize, leading to a diagnosis delay. Key Points • Acute lymphoblastic leukemia in adults revealed by osteoarticular manifestations can be misdiagnosed as rheumatic diseases. • Axial manifestations, joint swelling, bone pain, and hypercalcemia could be the first and only symptoms of acute lymphoblastic leukemia in adults. • Complete blood count and calcium blood test should be performed as first-line investigations in adults with axial or peripheral articular symptoms. • Physicians should be aware of this clinical presentation to avoid diagnosis delay and improve prognosis.
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Affiliation(s)
- Maroua Slouma
- Department of Rheumatology, Military Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Emna Hannech
- Department of Rheumatology, Military Hospital, Tunis, Tunisia. .,University of Tunis El Manar, Tunis, Tunisia.
| | - Hela Ghedira
- University of Tunis El Manar, Tunis, Tunisia.,Department of Hematology, Military Hospital, Tunis, Tunisia
| | - Rim Dhahri
- Department of Rheumatology, Military Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Yasmine Khrifech
- Department of Rheumatology, Military Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
| | - Raoudha Doghri
- University of Tunis El Manar, Tunis, Tunisia.,Department of Pathology, Salah Azaiez Institute, Tunis, Tunisia
| | - Imen Gharsallah
- Department of Rheumatology, Military Hospital, Tunis, Tunisia.,University of Tunis El Manar, Tunis, Tunisia
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139
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Monárrez‐Espino J, Romero‐Rodriguez L, Escamilla‐Asiain G, Ellis‐Irigoyen A, Cubría‐Juárez MDP, Sematimba D, Rodríguez‐Galindo C, Vega‐Vega L. Survival estimates of childhood malignancies treated at the Mexican telethon pediatric oncology hospital. Cancer Rep (Hoboken) 2023; 6:e1702. [PMID: 36054813 PMCID: PMC9939997 DOI: 10.1002/cnr2.1702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 07/08/2022] [Accepted: 07/20/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Pediatric cancer incidence in Mexico is ~160/million/year with leukemias making 49.8% of the cases. While survival rates have been reported in various Mexican studies, no data is available from the Telethon Pediatric Oncology Hospital-HITO, a nonprofit private institution specialized exclusively in comprehensive pediatric oncology care in the country that closely follows high-income countries' advanced standards of cancer care. AIM To determine overall survival (OS) and relapse-free survival (RFS) in patients treated at HITO between December 2013 and February 2018. METHODS AND RESULTS Secondary analysis of data extracted from medical records. It included 286 children aged 0-17 years diagnosed with various cancers grouped into three categories based on location: (1) Acute lymphoblastic leukemia (ALL), (2) tumors within the central nervous system (TWCNS), and (3) tumors outside the CNS (TOCNS). OS and RFS rates for patients who completed 1 (n = 230) and 3 (n = 132) years of follow-up after admission were computed by sex, age, and cancer location, and separately for a subsample (1-year = 191, 3-years = 110) who fulfilled the HITO criteria (no prior treatment, underwent surgery/chemotherapy when indicated, and initiated therapy). TOCNS accounted for 45.1%, but ALL was the most frequent single diagnosis with 28%. Three-year OS for patients with ALL, TWCNS, and TOCNS who fulfilled the HITO criteria were 91.9%, 86.7%, and 79.3%, respectively; for 3-year RFS these were 89.2%, 60%, and 72.4%. Boys showed slightly higher OS and RFS, but no major differences or trends were seen by age group. CONCLUSION This study sets a relevant reference in terms of survival and relapse for children with cancer in Mexico treated at a private oncology center that uses a comprehensive and integrated therapeutic model.
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Affiliation(s)
- Joel Monárrez‐Espino
- Department of Health Research, Christus Muguerza del Parque HospitalUniversity of MonterreyChihuahuaMexico
- PhD Program in Molecular Medicine, Human Medicine and Health Sciences Academic UnitZacatecas Autonomous UniversityZacatecasMexico
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140
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Arabi S, Yousefian S, Kavosh A, Mansourian M, Nematollahi P. The prognostic significance of hematogones in childhood B-cell acute lymphoblastic leukemia. Pediatr Blood Cancer 2023; 70:e30138. [PMID: 36495254 DOI: 10.1002/pbc.30138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/14/2022] [Accepted: 11/16/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Recent studies have demonstrated hematogones (HGs) expansion to be associated with favorable outcomes in hematological diseases, especially in patients with acute myeloid leukemia and patients undergoing hematopoietic stem cell transplantation. Acute lymphoblastic leukemia (ALL) is the most common form of cancer in children. As of now, minimal residual disease (MRD) remains the most compelling independent prognostic factor in childhood ALL. There is need for more prognostic tools for evaluating relapse risk. PROCEDURE The goal of this study was to assess the prognostic value of HGs on relapse-free survival (RFS) and overall survival (OS) in childhood ALL. In this prospective cohort study, a total of 122 subjects with definitive diagnosis of precursor B lymphoblastic leukemia were evaluated. Flow cytometric HG detection was performed in bone marrow aspirates after induction and consolidation therapy. RESULTS The median follow-up period of patients was 35.5 ± 9.4 (SD) months. Patients who had at least 1.0% HGs had a significantly better RFS (p = .023). Moreover, univariate and multivariate analyses confirmed that positive HGs were independently associated with longer RFS (unadjusted model: hazard ratio = 0.33, 95% CI = 0.12-0.91, p = .031; adjusted model: hazard ratio = 0.30, 95% CI = 0.11-0.82, p = .020). CONCLUSIONS Along with the role of MRD, our study shows the significance of HGs as an independent prognostic factor. The results indicate the independent prognostic value of HGs on RFS after adjustment for other prognostic factors, and can be beneficial for risk stratification and treatment modifications amongst pediatric B-cell ALL patients.
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Affiliation(s)
- Sina Arabi
- Applied Physiology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Yousefian
- Department of Pediatrics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aryan Kavosh
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Biomedical Engineering Research Centre (CREB), Automatic Control Department (ESAII), Universitat Politècnica de Catalunya-Barcelona, Barcelona, Spain
| | - Pardis Nematollahi
- Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Cancer Prevention Research Center, Omid Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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141
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Wang R, Wang W, Liu X, Wang H, Zhang B, Li S, Zhang H, Yang J, Zhao J, He Q, Zhang J, Liu D, Hao L. Treatment for a B-cell acute lymphoblastic leukemia patient carrying a rare TP53 c.C275T mutation: A case report. Front Oncol 2023; 12:1018250. [PMID: 36798689 PMCID: PMC9928200 DOI: 10.3389/fonc.2022.1018250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/17/2022] [Indexed: 02/03/2023] Open
Abstract
TP53 mutations are associated with poor prognosis in the vast majority of cancers. In this study, we present a pediatric B-cell acute lymphoblastic leukemia (B-ALL) patient carrying a rare TP53 c.C275T mutation. This extremely rare mutation affects an amino acid residue located between the TAD domain and the DNA-binding domain of p53. The patient was resistant to most conventional chemotherapy regimens and remained minimal residual disease (MRD)-positive after five rounds of such regimens. We tested the sensitivity of the patient's leukemic cells to 21 anti-cancer drugs by performing in vitro drug sensitivity assays. The results showed that bortezomib had a very strong killing effect on the patient's leukemic cells. Therefore, we subsequently treated the patient with bortezomib combined with vindesine, cytarabine, and fludarabine. After one course of treatment, the patient became MRD-negative, and there was no recurrence during a 9-month follow-up. In conclusion, our report suggests that the TP53 c.C275T mutation is associated with poor prognosis in B-ALL. Fortunately, bortezomib combined with chemotherapy could achieve a better therapeutic effect than conventional regimens in this type of ALL.
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Affiliation(s)
- Runan Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Wenliang Wang
- Precision Targeted Therapy Discovery Center, Institute of Technology Innovation, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Xuan Liu
- Hematology Laboratory, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Huan Wang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Bin Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Shuang Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Haining Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Jiawei Yang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Jishun Zhao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Qiuying He
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Jihong Zhang
- Hematology Laboratory, Shengjing Hospital of China Medical University, Shengyang, Liangning, China
| | - Danping Liu
- Precision Targeted Therapy Discovery Center, Institute of Technology Innovation, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, China
| | - Liangchun Hao
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shengyang, Liangning, China,*Correspondence: Liangchun Hao,
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142
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Zhang B, Jin X, Kuang X, Shen B, Qiu D, Peng J, Chen E, Dai X, Chen X, Wong CL. Effects of a Virtual Reality-Based Meditation Intervention on Anxiety and Depression Among Patients With Acute Leukemia During Induction Chemotherapy: A Randomized Controlled Trial. Cancer Nurs 2023; Publish Ahead of Print:00002820-990000000-00104. [PMID: 36693237 DOI: 10.1097/ncc.0000000000001206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Emerging evidence supports that virtual reality (VR)-based meditation interventions may improve anxiety and depression among patients with cancer. However, empirical studies involving patients with acute leukemia during induction chemotherapy are limited. OBJECTIVE This study aimed to examine the effects of VR-based meditation intervention on alleviating anxiety and depression and improving the quality of life among patients with acute leukemia during induction chemotherapy. METHODS This randomized controlled trial recruited 63 patients newly diagnosed with acute leukemia. Participants were randomly assigned to an intervention group (received VR-based meditation for 20 min daily for 14 days) and a control group. Anxiety, depression, and quality of life were measured using the State Anxiety Inventory, the Center for Epidemiological Studies Depression Scale, and the Functional Assessment of Cancer Therapy-Leukemia Questionnaire, respectively. All outcomes were measured at baseline and post-intervention. RESULTS Compared with patients in the control group, those in the intervention group demonstrated a significantly greater reduction in anxiety (P = .04) and improvement in quality of life (P = .04). However, no significant difference was noted in depression levels between groups (P = .09), although a decreasing trend was observed in the intervention group. CONCLUSION Virtual reality-based meditation intervention effectively alleviated anxiety and improved the quality of life among acute leukemia patients during induction chemotherapy. Future randomized controlled trials with larger sample sizes and longer follow-up periods are warranted. IMPLICATION FOR PRACTICE Virtual reality-based meditation can be applied in clinical practice virtually anytime and anywhere to provide a convenient intervention for anxiety reduction for acute leukemia patients during induction chemotherapy.
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Affiliation(s)
- Bixia Zhang
- Author Affiliations: The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong (Dr Jin and Dr Wong); The Second Clinical College of Guangzhou University of Chinese Medicine (Ms Zhang); Nursing Department, Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine (Ms Kuang); Nursing Department, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine (Ms Zhang and Dr Shen); Nursing Department, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangdong Provincial Hospital of Traditional Chinese Medicine (Ms Qiu); and Department of Hematology and Oncology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangdong Provincial Hospital of Traditional Chinese Medicine (Ms Peng, Ms X Chen, Dr Dai, and Mr E Chen), China
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143
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Liebig S, Neumann M, Silva P, Ortiz-Tanchez J, Schulze V, Isaakidis K, Schlee C, Schroeder MP, Beder T, Morris LGT, Chan TA, Bastian L, Burmeister T, Schwartz S, Gökbuget N, Mochmann LH, Baldus CD. FAT1 expression in T-cell acute lymphoblastic leukemia (T-ALL) modulates proliferation and WNT signaling. Sci Rep 2023; 13:972. [PMID: 36653435 PMCID: PMC9849452 DOI: 10.1038/s41598-023-27792-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023] Open
Abstract
FAT atypical cadherin 1 (FAT1), a transmembrane protein, is frequently mutated in various cancer types and has been described as context-dependent tumor suppressor or oncogene. The FAT1 gene is mutated in 12-16% of T-cell acute leukemia (T-ALL) and aberrantly expressed in about 54% of T-ALL cases contrasted with absent expression in normal T-cells. Here, we characterized FAT1 expression and profiled the methylation status from T-ALL patients. In our T-ALL cohort, 53% of patient samples were FAT1 positive (FAT1pos) compared to only 16% FAT1 positivity in early T-ALL patient samples. Aberrant expression of FAT1 was strongly associated with FAT1 promotor hypomethylation, yet a subset, mainly consisting of TLX1-driven T-ALL patient samples showed methylation-independent high FAT1 expression. Genes correlating with FAT1 expression revealed enrichment in WNT signaling genes representing the most enriched single pathway. FAT1 knockdown or knockout led to impaired proliferation and downregulation of WNT pathway target genes (CCND1, MYC, LEF1), while FAT1 overexpressing conveyed a proliferative advantage. To conclude, we characterized a subtype pattern of FAT1 gene expression in adult T-ALL patients correlating with promotor methylation status. FAT1 dependent proliferation and WNT signaling discloses an impact on deeper understanding of T-ALL leukemogenesis as a fundament for prospective therapeutic strategies.
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Affiliation(s)
- Sven Liebig
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Martin Neumann
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Hematology and Oncology, Kiel, Germany
| | - Patricia Silva
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Jutta Ortiz-Tanchez
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Veronika Schulze
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Konstandina Isaakidis
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Cornelia Schlee
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Core Facility Genomics, Berlin, Germany
| | - Michael P Schroeder
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Thomas Beder
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Hematology and Oncology, Kiel, Germany
| | - Luc G T Morris
- Center for Immunotherapy and Precision Immuno-Oncology, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Timothy A Chan
- Center for Immunotherapy and Precision Immuno-Oncology, Cleveland Clinic, Cleveland, OH, 44195, USA
- Immunogenomics and Precision Oncology Platform, Memorial Sloan Kettering Cancer Center, New York, NY, 10064, USA
| | - Lorenz Bastian
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Hematology and Oncology, Kiel, Germany
| | - Thomas Burmeister
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Stefan Schwartz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Hematology, Oncology and Cancer Immunology, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Nicola Gökbuget
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Medicine II, Hematology/Oncology, Goethe University Hospital, Frankfurt/Main, Germany
| | - Liliana H Mochmann
- Institute of Pathology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Claudia D Baldus
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- University Hospital Schleswig-Holstein, Campus Kiel, Department of Hematology and Oncology, Kiel, Germany
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144
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Jeong JG, Ahn CH, Min YS, Kim SE, Kim JY, Jung TD. Electrophysiologic Patterns of Symptomatic Vincristine-Induced Peripheral Neuropathy in Children with Acute Lymphocytic Leukemia. J Clin Med 2023; 12:jcm12020686. [PMID: 36675615 PMCID: PMC9864890 DOI: 10.3390/jcm12020686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
Acute lymphocytic leukemia is one of the most common cancers in children. Multi-drug chemotherapy is used for treatment, and the representative drug is vincristine. Although various side effects may occur due to vincristine, the association with peripheral neuropathy is high compared to that of other drugs. This study focused on children under the age of 18 years of age with ALL who received chemotherapy containing vincristine. We retrospectively analyzed the results of a nerve conduction study and a cumulative dose of vincristine in 30 children diagnosed with peripheral neuropathy. The average cumulative dose until diagnosis of vincristine-induced peripheral neuropathy was 14.99 ± 1.21 mg/m2, and motor nerves were predominantly involved. Additionally, a marked decrease in average amplitude was also observed in motor nerves. In addition, when the relationship between the incidence of peripheral neuropathy and the cumulative dose was analyzed through the survival curve, about 50% of children developed peripheral neuropathy at a dose of 15.5 ± 1.77 mg/m2. Based on the electrophysiological characteristics of pediatric vincristine-induced peripheral neuropathy, as well as the relationship between the incidence rate and the cumulative dose, it is possible to observe more closely the vincristine-induced peripheral neuropathy occurrence in children with ALL at an appropriate time.
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Affiliation(s)
- Jae-Gyeong Jeong
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Chang-Hwan Ahn
- Department of Rehabilitation Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
| | - Yu-Sun Min
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Sung Eun Kim
- Department of Pediatrics, Kyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
| | - Ji Yoon Kim
- Department of Pediatrics, Kyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea
- Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Correspondence: (J.Y.K.); (T.-D.J.)
| | - Tae-Du Jung
- Department of Rehabilitation Medicine, Kyungpook National University Chilgok Hospital, Daegu 41404, Republic of Korea
- Department of Rehabilitation Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
- Correspondence: (J.Y.K.); (T.-D.J.)
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145
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Varadarajan I, Pierce E, Scheuing L, Morris A, El Chaer F, Keng M. Post-Hematopoietic Cell Transplantation Relapsed Acute Lymphoblastic Leukemia: Current Challenges and Future Directions. Onco Targets Ther 2023; 16:1-16. [PMID: 36685611 PMCID: PMC9849790 DOI: 10.2147/ott.s274551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 12/14/2022] [Indexed: 01/15/2023] Open
Abstract
Allogeneic hematopoietic cell transplantation (allo-HCT) represents an important and potentially curative treatment option for adult patients with acute lymphoblastic leukemia. Relapse continues to remain the most important factor influencing overall survival post allo-HCT. We discuss early identification, clinical manifestations, and management of relapsed disease. Routine evaluation of measurable residual disease (MRD) and change in donor chimerism play a crucial role in early detection. Pivotal clinical trials have led to FDA approval of multiple novel agents like blinatumomab and inotuzumab. Combining targeted therapy with cellular immunotherapy serves as the backbone for prolonging overall survival in these patients. Donor lymphocyte infusions have traditionally been used in relapsed disease with suboptimal outcomes. This review provides insight into use of cellular therapy in MRD positivity and decreasing donor chimerism. It also discusses various modalities of combining cellular therapy with novel agents and discussing the impact of chimeric antigen receptor T-cell therapy in the setting of post allo-HCT relapse both as consolidative therapy and as a bridge to second transplant.
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Affiliation(s)
- Indumathy Varadarajan
- Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
| | - Eric Pierce
- Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
| | - Lisa Scheuing
- Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
| | - Amy Morris
- Department of Pharmacy Services, University of Virginia, Charlottesville, VA, USA
| | - Firas El Chaer
- Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, VA, USA
| | - Michael Keng
- Department of Medicine, Division of Hematology and Oncology, University of Virginia, Charlottesville, VA, USA,Correspondence: Michael Keng, Division of Hematology & Oncology, University of Virginia Comprehensive Cancer Center, West Complex Room 6009, 1300 Jefferson Park Ave, PO Box 800716, Charlottesville, VA, 22908, USA, Tel +1 434 924 4257, Fax +1 434- 243 6068, Email
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146
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CAR T-Cell Immunotherapy Treating T-ALL: Challenges and Opportunities. Vaccines (Basel) 2023; 11:vaccines11010165. [PMID: 36680011 PMCID: PMC9861718 DOI: 10.3390/vaccines11010165] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/28/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
T-cell acute lymphoblastic leukemia (T-ALL), a form of T-cell malignancy, is a typically aggressive hematological malignancy with high rates of disease relapse and a poor prognosis. Current guidelines do not recommend any specific treatments for these patients, and only allogeneic stem cell transplant, which is associated with potential risks and toxicities, is a curative therapy. Recent clinical trials showed that immunotherapies, including monoclonal antibodies, checkpoint inhibitors, and CAR T therapies, are successful in treating hematologic malignancies. CAR T cells, which specifically target the B-cell surface antigen CD19, have demonstrated remarkable efficacy in the treatment of B-cell acute leukemia, and some progress has been made in the treatment of other hematologic malignancies. However, the development of CAR T-cell immunotherapy targeting T-cell malignancies appears more challenging due to the potential risks of fratricide, T-cell aplasia, immunosuppression, and product contamination. In this review, we discuss the current status of and challenges related to CAR T-cell immunotherapy for T-ALL and review potential strategies to overcome these limitations.
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147
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Olivas-Aguirre M, Pérez-Chávez J, Torres-López L, Hernández-Cruz A, Pottosin I, Dobrovinskaya O. Dexamethasone-Induced Fatty Acid Oxidation and Autophagy/Mitophagy Are Essential for T-ALL Glucocorticoid Resistance. Cancers (Basel) 2023; 15:cancers15020445. [PMID: 36672393 PMCID: PMC9856638 DOI: 10.3390/cancers15020445] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
ALL is a highly aggressive subtype of leukemia that affects children and adults. Glucocorticoids (GCs) are a critical component of the chemotherapeutic strategy against T-ALL. Cases of resistance to GC therapy and recurrent disease require novel strategies to overcome them. The present study analyzed the effects of Dex, one of the main GCs used in ALL treatment, on two T-ALL cell lines: resistant Jurkat and unselected CCRF-CEM, representing a mixture of sensitive and resistant clones. In addition to nuclear targeting, we observed a massive accumulation of Dex in mitochondria. Dex-treated leukemic cells suffered metabolic reprogramming from glycolysis and glutaminolysis towards lipolysis and increased FAO, along with increased membrane polarization and ROS production. Dex provoked mitochondrial fragmentation and induced autophagy/mitophagy. Mitophagy preceded cell death in susceptible populations of CCRF-CEM cells while serving as a pro-survival mechanism in resistant Jurkat. Accordingly, preventing FAO or autophagy greatly increased the Dex cytotoxicity and overcame GC resistance. Dex acted synergistically with mitochondria-targeted drugs, curcumin, and cannabidiol. Collectively, our data suggest that GCs treatment should not be neglected even in apparently GC-resistant clinical cases. Co-administration of drugs targeting mitochondria, FAO, or autophagy can help to overcome GC resistance.
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Affiliation(s)
- Miguel Olivas-Aguirre
- Laboratory of Immunology and Ionic Transport Regulation, Biomedical Research Centre, University of Colima, Av. 25 de Julio #965, Villas de San Sebastián, Colima 28045, Mexico
| | - Jesús Pérez-Chávez
- Medicine Faculty, University of Colima, Av. Universidad #333, Las Víboras, Colima 28040, Mexico
| | - Liliana Torres-López
- Laboratory of Immunology and Ionic Transport Regulation, Biomedical Research Centre, University of Colima, Av. 25 de Julio #965, Villas de San Sebastián, Colima 28045, Mexico
| | - Arturo Hernández-Cruz
- Department of Cognitive Neuroscience and National Laboratory of Channelopathies (LaNCa), Institute of Cellular Physiology, National Autonomous University of Mexico, Mexico 04510, Mexico
| | - Igor Pottosin
- Laboratory of Immunology and Ionic Transport Regulation, Biomedical Research Centre, University of Colima, Av. 25 de Julio #965, Villas de San Sebastián, Colima 28045, Mexico
- Correspondence: (I.P.); (O.D.); Tel.: +52-312-316-1000 (I.P. & O.D.)
| | - Oxana Dobrovinskaya
- Laboratory of Immunology and Ionic Transport Regulation, Biomedical Research Centre, University of Colima, Av. 25 de Julio #965, Villas de San Sebastián, Colima 28045, Mexico
- Correspondence: (I.P.); (O.D.); Tel.: +52-312-316-1000 (I.P. & O.D.)
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148
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Caracciolo D, Mancuso A, Polerà N, Froio C, D'Aquino G, Riillo C, Tagliaferri P, Tassone P. The emerging scenario of immunotherapy for T-cell Acute Lymphoblastic Leukemia: advances, challenges and future perspectives. Exp Hematol Oncol 2023; 12:5. [PMID: 36624522 PMCID: PMC9828428 DOI: 10.1186/s40164-022-00368-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023] Open
Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is a challenging pediatric and adult haematologic disease still associated with an unsatisfactory cure rate. Unlike B-ALL, the availability of novel therapeutic options to definitively improve the life expectancy for relapsed/resistant patients is poor. Indeed, the shared expression of surface targets among normal and neoplastic T-cells still limits the efficacy and may induce fratricide effects, hampering the use of innovative immunotherapeutic strategies. However, novel monoclonal antibodies, bispecific T-cell engagers (BTCEs), and chimeric antigen receptors (CAR) T-cells recently showed encouraging results and some of them are in an advanced stage of pre-clinical development or are currently under investigation in clinical trials. Here, we review this exciting scenario focusing on most relevant advances, challenges, and perspectives of the emerging landscape of immunotherapy of T-cell malignancies.
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Affiliation(s)
- Daniele Caracciolo
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Antonia Mancuso
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Nicoletta Polerà
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Caterina Froio
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Giuseppe D'Aquino
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Caterina Riillo
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | | | - Pierfrancesco Tassone
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy.
- Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, College of Science and Technology, Temple University, Philadelphia, PA, USA.
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PANAGOPOULOS IOANNIS, ANDERSEN KRISTIN, JOHANNSDOTTIR INGAMARIARINVOLL, MICCI FRANCESCA, HEIM SVERRE. Novel MYCBP::EHD2 and RUNX1::ZNF780A Fusion Genes in T-cell Acute Lymphoblastic Leukemia. Cancer Genomics Proteomics 2023; 20:51-63. [PMID: 36581344 PMCID: PMC9806666 DOI: 10.21873/cgp.20364] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/16/2022] [Accepted: 11/23/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND/AIM T-cell acute lymphoblastic leukemia (T-ALL) is a rare malignancy characterized by proliferation of early T-cell precursors that replace normal hematopoietic cells. T-ALL cells carry non-random chromosome aberrations, fusion genes, and gene mutations, often of prognostic significance. We herein report the genetic findings in cells from a T-ALL patient. MATERIALS AND METHODS Bone marrow cells from a patient with T-ALL were examined using G-banding, array comparative genomic hybridization (aCGH), RNA sequencing, reverse transcription polymerase chain reaction (RT-PCR), Sanger sequencing, and fluorescence in situ hybridization. RESULTS G-banding revealed del(1)(p34), add(5)(q14), trisomy 8, and monosomy 21 in the leukemic cells. aCGH detected the gross unbalances inferred from the karyotyping results, except that heterozygous loss of chromosome 21 did not include its distal part; 21q22.12-q22.3 was undeleted. In addition, aCGH detected a submicroscopic interstitial 7.56 Mbp deletion in the q arm of chromosome 19 from 19q13.2 to 19q13.33. RNA sequencing detected and RT-PCR/Sanger sequencing confirmed the presence of two novel chimeras, MYCBP::EHD2 and RUNX1::ZNF780A. They were generated from rearrangements involving subbands 1p34.3 (MYCBP), 19q13.2 (ZNF780A), 19q13.33 (EHD2), and 21q22.12 (RUNX1), i.e., at the breakpoints of chromosomal deletions. CONCLUSION The leukemic cells showed the heterozygous loss of many genes as well as the generation of MYCBP::EHD2 and RUNX1::ZNF780A chimeras. Because the partner genes in the chimeras were found at the breakpoints of the chromosomal deletions, we believe that both the heterozygous losses and the generation of the two chimeras occurred simultaneously, and that they were pathogenetically important.
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Affiliation(s)
- IOANNIS PANAGOPOULOS
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - KRISTIN ANDERSEN
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | - FRANCESCA MICCI
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - SVERRE HEIM
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
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150
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Gamaleldin MA, Imbaby SAE. Association of two ARID5B gene variant single nucleotide polymorphisms with acute lymphoblastic leukemia in the Egyptian population. Asian Pac J Cancer Prev 2023; 24:337-343. [PMID: 36708585 PMCID: PMC10152858 DOI: 10.31557/apjcp.2023.24.1.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND ARID5B SNPs have been linked to ALL in many research studies in which it was identified as a risk factor. From this context, we had great interest to investigate the relationship between ARID5B rs4948488 and ARID5B rs2893881 genotypes and ALL susceptibility and relapse in this study. MATERIALS AND METHODS Peripheral blood mononuclear cells were analyzed for ARID5B rs4948488 and rs2893881 gene polymorphisms by real-time quantitative polymerase chain reaction in 80 ALL patients and 80 controls. RESULTS Our results showed that the C/C genotype of ARID5B rs4948488 and A/G genotype and G-allele of rs2893881 were linked to higher ALL incidence. Regarding the relapse of ALL, rs4948488 C/C genotype and C-alleles were significantly associated with relapse of ALL. Meanwhile, rs4948488 C/C genotype and rs2893881 A/A genotype and A-allele are associated with T-ALL, while rs2893881 A/G genotype and G-allele are associated with B-ALL. CONCLUSION The results of our study suggested that ARID5B rs4948488 and rs2893881 SNPs might be used risk factors for genetic susceptibility for B-ALL and T-ALL, and that ARID5B s4948488 is related to relapse in ALL patients.<br />.
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