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Lange T, Niederwieser C, Gil A, Krahl R, von Grünhagen U, Al-Ali HK, Jentsch-Ullrich K, Spohn C, Lakner V, Assmann M, Junghanss C, Cross M, Hehlmann R, Deininger M, Pfirrmann M, Niederwieser D. No advantage of Imatinib in combination with hydroxyurea over Imatinib monotherapy: a study of the East German Study Group (OSHO) and the German CML study group. Leuk Lymphoma 2020; 61:2821-2830. [PMID: 32672489 DOI: 10.1080/10428194.2020.1786556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The combination of Imatinib (IM) and hydroxyurea (HU) was explored for the treatment of chronic myelogenous leukemia (CML). METHOD After in vitro testing and a phase I study (n = 20), 59 patients were randomized in the IM/HU and 29 in the IM arm. According to protocol, 49 propensity-score matched IM patients were included from the CML-IV study. RESULTS Additive specific inhibition of CML cells by IM/HU was detected in vitro. HU 500 mg qd in combination with IM 400 mg qd proved feasible in the phase I study. Overall, no significant difference with respect to major molecular response (MMR) at 18 months (IM/HU and IM 66%; primary endpoint) was observed. Significant differences were noted for MMR at 6 months (p = 0.04) and for cumulative incidences of adverse events (p = 0.03) in favor of IM monotherapy (secondary endpoints). CONCLUSION IM/HU combination was more potent in selectively inhibiting CML cells in vitro, but not superior to IM in vivo. (NCT02480608).
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Affiliation(s)
- Thoralf Lange
- Abteilung Hämatologie und Onkologie, Universität Leipzig, Leipzig, Germany.,Krankenhaus Weißenfels, Weißenfels, Germany
| | - Christian Niederwieser
- Klinik für Stammzelltransplantation, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - Arthur Gil
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Rainer Krahl
- Abteilung Hämatologie und Onkologie, Universität Leipzig, Leipzig, Germany
| | | | - Haifa Kathrin Al-Ali
- Abteilung Hämatologie und Onkologie, Universität Leipzig, Leipzig, Germany.,Krukenberg Cancer Center, University Hospital Halle, Halle, Germany
| | | | - Claudia Spohn
- Gemeinschaftspraxis für Hämatologie und Onkologie, Halle, Germany
| | - Volker Lakner
- Gemeinschaftspraxis für Hämatologie und Onkologie, Rostock, Germany
| | | | | | - Michael Cross
- Abteilung Hämatologie und Onkologie, Universität Leipzig, Leipzig, Germany
| | - Rüdiger Hehlmann
- III. Medizinische Klinik, Universität Heidelberg, Mannheim, Germany
| | - Michael Deininger
- Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Dietger Niederwieser
- School of Medicine, University Leipzig, Leipzig Germany.,Lithuanian University of Health Sciences, Kaunas, Lithuania.,Aichi Medical University, NagakuteAichi/Nagoya, Japan
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Lauseker M, Hasford J, Saussele S, Kremers S, Kraemer D, Lindemann W, Hehlmann R, Pfirrmann M. Smokers with chronic myeloid leukemia are at a higher risk of disease progression and premature death. Cancer 2017; 123:2467-2471. [DOI: 10.1002/cncr.30636] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/23/2017] [Accepted: 01/26/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Michael Lauseker
- Institute for Medical Information Sciences, Biometry, and Epidemiology (IBE); Ludwig-Maximilians University; Munich Germany
| | - Joerg Hasford
- Institute for Medical Information Sciences, Biometry, and Epidemiology (IBE); Ludwig-Maximilians University; Munich Germany
| | - Susanne Saussele
- Department of Medicine; University of Heidelberg; Mannheim Germany
| | - Stephan Kremers
- Department of Hematology/Oncology; Caritas-Krankenhaus Lebach; Lebach Germany
| | - Doris Kraemer
- Department of Oncology and Hematology; Oldenburg Clinic; Oldenburg Germany
| | - Walter Lindemann
- Hematology/Oncology Clinic, St. Marien Hospital, Katholisches Krankenhaus Hagen; Hagen Germany
| | - Rüdiger Hehlmann
- Department of Medicine; University of Heidelberg; Mannheim Germany
| | - Markus Pfirrmann
- Institute for Medical Information Sciences, Biometry, and Epidemiology (IBE); Ludwig-Maximilians University; Munich Germany
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Qin L, Deng HY, Chen SJ, Wei W. Relationship between cigarette smoking and risk of chronic myeloid leukaemia: a meta-analysis of epidemiological studies. Hematology 2016; 22:193-200. [PMID: 27806681 DOI: 10.1080/10245332.2016.1232011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Ling Qin
- Department of Hematology, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, China
| | - Hui-Yang Deng
- Department of Hematology, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, China
| | - Sheng-Jiang Chen
- Department of Ultrasound, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, China
| | - Wei Wei
- Department of Hematology, First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, China
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Belcheva A, Irrazabal T, Robertson SJ, Streutker C, Maughan H, Rubino S, Moriyama EH, Copeland JK, Surendra A, Kumar S, Green B, Geddes K, Pezo RC, Navarre WW, Milosevic M, Wilson BC, Girardin SE, Wolever TMS, Edelmann W, Guttman DS, Philpott DJ, Martin A. Gut microbial metabolism drives transformation of MSH2-deficient colon epithelial cells. Cell 2014; 158:288-299. [PMID: 25036629 DOI: 10.1016/j.cell.2014.04.051] [Citation(s) in RCA: 334] [Impact Index Per Article: 33.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Revised: 03/24/2014] [Accepted: 04/28/2014] [Indexed: 02/08/2023]
Abstract
The etiology of colorectal cancer (CRC) has been linked to deficiencies in mismatch repair and adenomatous polyposis coli (APC) proteins, diet, inflammatory processes, and gut microbiota. However, the mechanism through which the microbiota synergizes with these etiologic factors to promote CRC is not clear. We report that altering the microbiota composition reduces CRC in APC(Min/+)MSH2(-/-) mice, and that a diet reduced in carbohydrates phenocopies this effect. Gut microbes did not induce CRC in these mice through an inflammatory response or the production of DNA mutagens but rather by providing carbohydrate-derived metabolites such as butyrate that fuel hyperproliferation of MSH2(-/-) colon epithelial cells. Further, we provide evidence that the mismatch repair pathway has a role in regulating β-catenin activity and modulating the differentiation of transit-amplifying cells in the colon. These data thereby provide an explanation for the interaction between microbiota, diet, and mismatch repair deficiency in CRC induction. PAPERCLIP:
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Affiliation(s)
- Antoaneta Belcheva
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Thergiory Irrazabal
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Susan J Robertson
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Catherine Streutker
- Department of Laboratory Medicine, St. Michael's Hospital, Toronto, ON M5B 1W8, Canada
| | | | - Stephen Rubino
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Eduardo H Moriyama
- Princess Margaret Cancer Centre/University Health Network, Toronto, ON M5G 1L7, Canada
| | - Julia K Copeland
- Centre for the Analysis of Genome Evolution & Function, University of Toronto, Toronto, ON M5S 3B2, Canada
| | - Anu Surendra
- Centre for the Analysis of Genome Evolution & Function, University of Toronto, Toronto, ON M5S 3B2, Canada
| | - Sachin Kumar
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Blerta Green
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Kaoru Geddes
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Rossanna C Pezo
- Department of Medical Oncology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - William W Navarre
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Michael Milosevic
- Department of Radiation Oncology, Princess Margaret Hospital, Toronto, ON M5G 2M9, Canada
| | - Brian C Wilson
- Princess Margaret Cancer Centre/University Health Network, Toronto, ON M5G 1L7, Canada
| | - Stephen E Girardin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Thomas M S Wolever
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 3E2, Canada
| | - Winfried Edelmann
- Department of Cell Biology, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - David S Guttman
- Centre for the Analysis of Genome Evolution & Function, University of Toronto, Toronto, ON M5S 3B2, Canada
| | - Dana J Philpott
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Alberto Martin
- Department of Immunology, University of Toronto, Toronto, ON M5S 1A8, Canada.
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Affiliation(s)
- David Frame
- Oncology, BMT Specialist, Assistant Professor of Pharmacy, University of Michigan, 1500 Medical Center Drive, Department of Pharmacy, Ann Arbor, MI 48109
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Affiliation(s)
- Christopher A. Fausel
- Hematology/Oncology/Bone Marrow Transplant, Indiana University Cancer Center, 535 Barnhill Drive, Indianapolis, IN 46202
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Abstract
STUDY OBJECTIVES To determine whether there is an association between cigarette smoking and the development of pulmonary metastatic disease among women with breast cancer. DESIGN A case-control study. SETTING The University of California, Davis Medical Center. PARTICIPANTS Eighty-seven women patients with unilateral, invasive breast cancer and pulmonary metastatic disease were identified as cases, and each patient was matched with two control patients who did not have pulmonary metastatic disease. Case patients and control patients were matched for year of diagnosis, age at diagnosis, size of primary tumor, and nodal status. DATA ANALYSIS Multivariate analysis using conditional logistic regression was used to determine the odds of smoking among women with pulmonary metastatic disease compared to matched control patients without pulmonary metastatic disease, after correction for potential confounding factors. RESULTS Thirty-eight percent of the case patients vs 29% of the control patients were classified as ever-smokers; 24.1% of case patients were actively smoking at the time of breast cancer diagnosis vs 15.3% of the control patients. The unadjusted odds ratio for active smoking was 1.76 for women with pulmonary metastatic disease compared to women without pulmonary metastatic disease (p = 0.06). In the final multivariate model, the odds ratio for active smoking among women with pulmonary metastatic disease was 1.96 (p = 0.06). CONCLUSIONS There appears to be an association between cigarette smoking and the development of pulmonary metastatic disease among women with breast cancer. This may explain the previously noted higher breast cancer fatality rate among smokers. The relationship between smoking behavior and pulmonary metastasis from breast and other cancers warrants further investigation.
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Affiliation(s)
- S Murin
- University of California-Davis Medical Center, USA.
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Peach HG, Barnett NE. Critical review of epidemiological studies of the association between smoking and non-Hodgkin's lymphoma. Hematol Oncol 2001; 19:67-80. [PMID: 11438976 DOI: 10.1002/hon.677] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Smoking has been suggested to increase the risk of non-Hodgkin's lymphoma (NHL) but the results of epidemiological studies have been inconsistent. The aim of this work was to assess whether the findings of individual studies might have arisen by chance, bias or confounding and whether any associations found between smoking and NHL represent cause-and-effect. Reports of the association between smoking and NHL were identified from Medline. Confidence intervals on relative risks and odds ratios, use of multiple comparisons, and information on source, direction, actual existence and size of potential biases and confounding and features of any associations were abstracted. Four out of five cohort studies found no association between current smoking and NHL but three may have been biased against doing so. One found an association with follicular lymphoma but without a convincing exposure-risk gradient. The fifth found a strong association and an exposure-response gradient with ever smoking but excluded living cases from the end-point. Only one study found an association with past smoking which lacked features of causality. Eight out of 14 case-control studies found no association between current and/or past smoking and NHL but five may have been biased against doing so. Of six positive studies, three involved multiple comparisons, the association of one became non-significant after eliminating bias, four did not explore features of causality and one found an association only in heavy smokers, particularly under 45 years old. There are no grounds to reject the null hypothesis but associations should continue to be sought particularly in subgroups of smokers and with NHL subtypes.
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Affiliation(s)
- H G Peach
- The University of Melbourne, Ballarat Health Services Base Hospital, Ballarat, Australia
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Mauritzson N, Johansson B, Rylander L, Albin M, Strömberg U, Billström R, Ahlgren T, Mikoczy Z, Mitelman F, Hagmar L, Nilsson PG. The prognostic impact of karyotypic subgroups in myelodysplastic syndromes is strongly modified by sex. Br J Haematol 2001; 113:347-56. [PMID: 11380398 DOI: 10.1046/j.1365-2141.2001.02750.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The prognostic impact of karyotypic patterns in a consecutive series of 389 adult myelodysplastic syndromes (MDS) was investigated. Time period did not significantly influence the survival times. In the analyses, the MDS cases were subdivided into the cytogenetic subgroups used in the International Prognostic Scoring System, i.e. favourable [-Y, del(5q) or del(20q) as single aberrations or normal karyotype, n = 241], poor [-7, del(7q), der(1;7) or complex karyotypes, i.e. > or = three abnormalities, n = 89] and intermediate (other aberrations, n = 59). The survival times correlated well with the prognostic subgroups, confirming that the cytogenetic classification was valid. Expressed as hazard ratios (HRs), with the favourable subgroup as the reference, the intermediate and poor subgroup HRs increased to 1.5 (95% confidence interval, 1.1-2.1) and 3.2 (2.4-4.1) respectively. Sex, age, morphological subtype and smoking habits significantly modified this prognostic impact. Shorter survival was detected for men in the favourable and the intermediate subgroups, but not in the poor prognosis subgroup. Using women in the favourable subgroup as the reference and adjusting for age, the HR for men was 1.6 (1.2-2.1) in the favourable subgroup. Adjusting for smoking habits as well decreased the HR to 1.4 (1.1-2.0) and, when also excluding cases with del(5q) as the sole anomaly, no significant difference could be discerned [HR 1.2 (0.9-1.6], suggesting that the better outcome for women in the favourable subgroup was mainly as a result of the '5q-syndrome' and to smoking habits. In the intermediate subgroup, the corresponding HRs were 3.0 (1.5-6.0) when adjusted for age and 2.7 (1.3-5.5) when also adjusted for smoking habits. Different survival times between men and women have never previously been reported for this MDS group. Although it remains to be elucidated whether environmental and/or constitutional factors cause the observed sex-related difference, these observations have obvious clinical ramifications, not least in designing and evaluating therapy protocols.
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Affiliation(s)
- N Mauritzson
- Department of Internal Medicine, Division of Haematology, Lund University Hospital, Sweden.
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Affiliation(s)
- Harry W. Daniell
- Department of Family Practice, University of California Medical School at Davis, Redding, California
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Affiliation(s)
- F E Alexander
- Department of Public Health Services, University of Edinburgh, Medical School, UK
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Daniell HW, Tam E, Filice A. Larger axillary metastases in obese women and smokers with breast cancer--an influence by host factors on early tumor behavior. Breast Cancer Res Treat 1993; 25:193-201. [PMID: 8369520 DOI: 10.1007/bf00689833] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
To better define the influence by host factors on very early breast cancer behavior, we retrospectively analyzed nodal status, diameter of the largest axillary metastasis (M), diameter of the primary tumor (P), the M/P ratio, tumor estrogen receptor status, age, obesity, and smoking habits in 176 women with node-positive breast cancer. Both M/P ratios and M were larger in the 72 obese women and in the 40 nonobese smokers than in the 64 nonobese nonsmokers after control for other factors. Step-wise regression analysis demonstrated independent associations between M/P ratios and obesity (p = 0.0002), larger primary tumors (p < 0.0001), more positive nodes (p < 0.0001), and smoking (p = 0.0268), as well as between M and obesity (p = 0.0201), larger primary tumors (p = 0.0093), and more positive nodes (p = 0.0001). Among the 104 nonobese women, smoking was associated both with larger M (p = 0.0257) and larger M/P (p = 0.0055). Our observations suggest more rapid growth by metastases in obese women and smokers with breast cancer, as well as earlier metastasis from their primary tumors.
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Affiliation(s)
- H W Daniell
- Department of Family Practice, University of California Medical School, Davis
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Abstract
In recent years many subtypes of CLL and some CML variants have been recognized throughout the world by means of careful clinical, epidemiological, immunological, molecular biological and viral studies. Most striking has been the establishment of a close association between certain immunophenotypical subtypes of CLL and infection with HTLV-I and possibly HTLV-II. CLL has consistently been shown to have a strong genetic component and a low incidence among Asians, but a growing body of evidence also links this major leukaemia type with environmental factors including solvents, unidentified farming and other occupational exposures. In contrast, CML is characterized by few genetic associations, relatively homogenous world-wide distribution, greater frequency in Blacks than in Whites, little evidence of viral aetiology, and evidence that exposures to ionizing radiation, benzene and possibly other chemical agents are important aetiological factors. Most studies suggest that acquired rather than genetic factors are of greater importance in the aetiology of CML, but this conclusion is somewhat difficult to reconcile with the relatively small variation in incidence rates internationally. Common to both disorders in most populations are an increasing incidence with age, male predominance, and stability of incidence, survival and mortality over the years, exclusive of improved survival of CML following allogeneic bone marrow transplantation.
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Brown LM, Everett GD, Gibson R, Burmeister LF, Schuman LM, Blair A. Smoking and risk of non-Hodgkin's lymphoma and multiple myeloma. Cancer Causes Control 1992; 3:49-55. [PMID: 1536913 DOI: 10.1007/bf00051912] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Population-based case-control interview studies of 622 White men with non-Hodgkin's lymphoma and 820 controls from Iowa and Minnesota (United States) and 173 White men with multiple myeloma and 452 controls from Iowa offered the opportunity to investigate the relationship of these cancers with smoking. Risks were significantly elevated for all lymphoma (odds ratio [OR] = 1.4), high-grade lymphoma (OR = 2.3), and unclassified lymphoma (OR = 2.8) for cigarette smokers. Dose-response gradients were not seen with intensity of cigarette use, but risks for these subtypes were greatest for cigarette smokers of longest duration. Similar elevations in risks were seen for tobacco users. The risk of multiple myeloma was not significantly elevated for either tobacco users or cigarette smokers. The findings from this study confirm the lack of an association between smoking and multiple myeloma and provide some support for an association between tobacco use and certain subtypes of non-Hodgkin's lymphoma.
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Affiliation(s)
- L M Brown
- Epidemiology and Biostatistics Program, National Cancer Institute, Bethesda, MD 20892
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