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Gajendra S, Gore AR, Jha B, Sood N, Bhargava M. Therapy-related acute myeloid leukemia in a patient with B-cell acute lymphoblastic leukemia. Blood Res 2021; 56:339-342. [PMID: 34776413 PMCID: PMC8721456 DOI: 10.5045/br.2021.2021093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/22/2021] [Accepted: 08/25/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Smeeta Gajendra
- Laboratory Oncology Unit, Dr Brairch, All India Institute of Medical Sciences, New Delhi, India
| | - Akshay Ramesh Gore
- Department of Hematopathology, Medanta - The Medicity Hospital, Gurgaon, India
| | - Bhawna Jha
- Department of Hematopathology, Medanta - The Medicity Hospital, Gurgaon, India
| | - Nitin Sood
- Department of Medical Oncology & Hematology, Medanta - The Medicity Hospital, Gurgaon, India
| | - Manorama Bhargava
- Department of Hematopathology, Medanta - The Medicity Hospital, Gurgaon, India
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2
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Siegel SE, Advani A, Seibel N, Muffly L, Stock W, Luger S, Shah B, DeAngelo DJ, Freyer DR, Douer D, Johnson RH, Hayes-Lattin B, Lewis M, Jaboin JJ, Coccia PF, Bleyer A. Treatment of young adults with Philadelphia-negative acute lymphoblastic leukemia and lymphoblastic lymphoma: Hyper-CVAD vs. pediatric-inspired regimens. Am J Hematol 2018; 93:1254-1266. [PMID: 30058716 DOI: 10.1002/ajh.25229] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 06/29/2018] [Accepted: 07/16/2018] [Indexed: 01/19/2023]
Abstract
For young adults with acute lymphoblastic leukemia, pediatric-based regimens are likely to provide the following when compared to hyper-CVAD regimens: better disease control, less hospitalization time, diminished acute toxicities, decreased financial cost, more quality-adjusted life years, and fewer adverse late effects, such as infertility, myelodysplasia, and second malignant neoplasms. There are also reasons to expect less cardiac and cognitive dysfunction after pediatric regimens. The improved quality and quantity of life associated with pediatric regimens renders them preferable to hyper-CVAD regimens for the treatment of Philadelphia-negative B-precursor or T-cell acute lymphoblastic leukemia and lymphoblastic lymphoma in young adults.
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Affiliation(s)
- Stuart E. Siegel
- Critical Mass Young Adult Cancer Alliance; Washington District of Columbia
| | | | - Nita Seibel
- Cancer Therapy Evaluation Program, National Cancer Institute; Bethesda Maryland and Children's Oncology Group
| | - Lori Muffly
- Department of Medicine; Blood and Marrow Transplantation, Stanford University; Palo Alto California and SWOG
| | - Wendy Stock
- University of Chicago; Chicago Illinois and The Alliance
| | - Selina Luger
- University of Pennsylvania; Philadelphia Pennsylvania and ECOG-ACRIN
| | - Bijal Shah
- Moffitt Cancer Center; Tampa Florida and SWOG
| | - Daniel J. DeAngelo
- Department of Medical Oncology, Dana Farber Cancer Institute ALL Consortium; Dana Farber Cancer Institute; Boston Massachusetts
| | - David R. Freyer
- University of Southern California, Norris Comprehensive Cancer Center; Los Angeles California and Children's Oncology Group
| | - Dan Douer
- Department of Medicine; University of Southern California; Los Angeles California and ECOG-ACRIN
| | - Rebecca H. Johnson
- Mary Bridge Children's Hospital and Health Center, National Clinical Oncology Research Program and Tacoma General Hospital; Tacoma Washington and SWOG, Children's Oncology Group
| | | | - Mark Lewis
- Department of Hematology/Oncology; Intermountain Healthcare; Salt Lake City Utah and SWOG
| | - Jerry J. Jaboin
- Department of Radiation Oncology; Oregon Health and Science University; Portland Oregon and NRG Oncology Group
| | - Peter F. Coccia
- Department of Pediatrics; University of Nebraska Medical Center; Omaha Nebraska and Children's Oncology Group
| | - Archie Bleyer
- Department of Radiation Oncology; Oregon Health and Science University; Portland Oregon and Children's Oncology Group
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3
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Abaza Y, M Kantarjian H, Faderl S, Jabbour E, Jain N, Thomas D, Kadia T, Borthakur G, D Khoury J, Burger J, Wierda W, O'Brien S, Konopleva M, Ferrajoli A, Kebriaei P, Dabaja B, Kornblau S, Alvarado Y, Daver N, Pemmaraju N, Bose P, Thompson P, Al Azzawi H, Kelly M, Garris R, Jain P, Garcia-Manero G, Cortes J, Ravandi F. Hyper-CVAD plus nelarabine in newly diagnosed adult T-cell acute lymphoblastic leukemia and T-lymphoblastic lymphoma. Am J Hematol 2018; 93:91-99. [PMID: 29047158 DOI: 10.1002/ajh.24947] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 10/08/2017] [Accepted: 10/14/2017] [Indexed: 02/03/2023]
Abstract
Nelarabine, a water soluble prodrug of 9-β-D-arabinofuranosylguanine (ara-G), is a T-cell specific purine nucleoside analogue. Given its activity in relapsed and refractory T acute lymphoblastic leukemia (T-ALL) and T lymphoblastic lymphoma (T-LBL), we sought to define its role in the frontline treatment of adult patients. Therefore, we conducted a single arm phase 2 study to determine the safety and efficacy of nelarabine in combination with hyper-CVAD in newly diagnosed patients. For induction/consolidation, patients received eight cycles of hyper-CVAD alternating with high-dose methotrexate and cytarabine plus two cycles of nelarabine given at a dose of 650 mg/m2 intravenously daily for 5 days. This was followed by thirty months of POMP maintenance chemotherapy with two additional cycles of nelarabine given instead of cycles 6 and 7 of POMP maintenance. Sixty-seven patients, including 40 with T-ALL and 26 with T-LBL, were enrolled. Complete response rates in both T-ALL and T-LBL were 87% and 100% respectively. Grade 3 to 4 neurotoxic adverse events were reported in 5 patients. There were 21 relapses (31%) including 2 after allogeneic stem cell transplantation. Median duration of follow-up was 42.5 months. The 3-year complete remission duration (CRD) and overall survival (OS) rates were 66% and 65%, respectively. Compared to our historic hyper-CVAD data, there was no survival benefit with the addition of nelarabine. In conclusion, hyper-CVAD plus nelarabine was well tolerated and active in the frontline treatment of adult T-ALL/LBL patients.
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Affiliation(s)
- Yasmin Abaza
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hagop M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stefan Faderl
- Department of Hematology/Oncology, Hackensack University Medical Center, Hackensack, New Jersey
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Deborah Thomas
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tapan Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gautam Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jan Burger
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - William Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Susan O'Brien
- Department of Hematology/Oncology, University of California, Irvine, California
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alessandra Ferrajoli
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Bouthaina Dabaja
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Steven Kornblau
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Yesid Alvarado
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Prithviraj Bose
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Philip Thompson
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hind Al Azzawi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mary Kelly
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rebecca Garris
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Preetesh Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Jorge Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Birkenmeier G, Hemdan NYA, Kurz S, Bigl M, Pieroh P, Debebe T, Buchold M, Thieme R, Wichmann G, Dehghani F. Ethyl Pyruvate Combats Human Leukemia Cells but Spares Normal Blood Cells. PLoS One 2016; 11:e0161571. [PMID: 27579985 PMCID: PMC5006986 DOI: 10.1371/journal.pone.0161571] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 08/08/2016] [Indexed: 01/17/2023] Open
Abstract
Ethyl pyruvate, a known ROS scavenger and anti-inflammatory drug was found to combat leukemia cells. Tumor cell killing was achieved by concerted action of necrosis/apoptosis induction, ATP depletion, and inhibition of glycolytic and para-glycolytic enzymes. Ethyl lactate was less harmful to leukemia cells but was found to arrest cell cycle in the G0/G1 phase. Both, ethyl pyruvate and ethyl lactate were identified as new inhibitors of GSK-3β. Despite the strong effect of ethyl pyruvate on leukemia cells, human cognate blood cells were only marginally affected. The data were compiled by immune blotting, flow cytometry, enzyme activity assay and gene array analysis. Our results inform new mechanisms of ethyl pyruvate-induced cell death, offering thereby a new treatment regime with a high therapeutic window for leukemic tumors.
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Affiliation(s)
- Gerd Birkenmeier
- Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
- * E-mail:
| | - Nasr Y. A. Hemdan
- Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Susanne Kurz
- Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Marina Bigl
- Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Philipp Pieroh
- Department of Orthopedics, Trauma and Plastic Surgery, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
- Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06097 Halle (Saale), Germany
| | - Tewodros Debebe
- Institute of Medical Microbiology, Medical Faculty, University of Leipzig, Liebigstr. 21, 04103 Leipzig, Germany
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Martin Buchold
- Institute of Biochemistry, Medical Faculty, University of Leipzig, Johannisallee 30, 04103 Leipzig, Germany
| | - Rene Thieme
- University Medical Center, Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University of Leipzig, Liebigstr. 19, 04103 Leipzig, Germany
| | - Gunnar Wichmann
- ENT-Research Lab, Department of Otolaryngology, Head and Neck Surgery, University Hospital Leipzig, Medical Faculty, University of Leipzig, Liebigstr. 21, 04103 Leipzig, Germany
| | - Faramarz Dehghani
- Department of Anatomy and Cell Biology, Martin Luther University Halle-Wittenberg, Grosse Steinstrasse 52, 06097 Halle (Saale), Germany
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Establishment of a Therapeutic Anti-Pan HLA-Class II Monoclonal Antibody That Directly Induces Lymphoma Cell Death via Large Pore Formation. PLoS One 2016; 11:e0150496. [PMID: 27028595 PMCID: PMC4814124 DOI: 10.1371/journal.pone.0150496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 02/15/2016] [Indexed: 02/04/2023] Open
Abstract
To develop a new therapeutic monoclonal Antibody (mAb) for Hodgkin lymphoma (HL), we immunized a BALB/c mouse with live HL cell lines, alternating between two HL cell lines. After hybridization, we screened the hybridoma clones by assessing direct cytotoxicity against a HL cell line not used for immunization. We developed this strategy for establishing mAb to reduce the risk of obtaining clonotypic mAb specific for single HL cell line. A newly established mouse anti-human mAb (4713) triggered cytoskeleton-dependent, but complement- and caspase-independent, cell death in HL cell lines, Burkitt lymphoma cell lines, and advanced adult T-cell leukemia cell lines. Intravenous injection of mAb 4713 in tumor-bearing SCID mice improved survival significantly. mAb 4713 was revealed to be a mouse anti-human pan-HLA class II mAb. Treatment with this mAb induced the formation of large pores on the surface of target lymphoma cells within 30 min. This finding suggests that the cell death process induced by this anti-pan HLA-class II mAb may involve the same death signals stimulated by a cytolytic anti-pan MHC class I mAb that also induces large pore formation. This multifaceted study supports the therapeutic potential of mAb 4713 for various forms of lymphoma.
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Nguyen JC, Kubik MJ, Broome HE, Curtin PT, Dell'Aquila ML, Wang HY. Successful treatment of both double minute of C-MYC and BCL-2 rearrangement containing large B-cell lymphoma with subsequent unfortunate development of therapy-related acute myeloid leukemia with t(3;3)(q26.2;q21). Pathol Res Pract 2015; 211:883-91. [PMID: 26300063 DOI: 10.1016/j.prp.2015.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 06/25/2015] [Accepted: 07/13/2015] [Indexed: 11/16/2022]
Abstract
Double minute chromosomes (DMs), although relatively frequently encountered in solid tumors, are rare in hematologic neoplasms such as acute myeloid leukemia (AML), and even rarer in lymphoid neoplasms. t(3;3)(q26.2;q21) is a very rare genetic alteration observed in myeloid neoplasm. Herein we report an interesting and unique case of concomitant C-MYC DMs and t(14;18)-containing large B-cell lymphoma, which was successfully treated with R-hyper-CVAD; unfortunately, the patient has developed a therapy-related AML (t-AML) 2 years since the start of his lymphoma treatment. His t-AML contains both t(3;3)(q26.2;q21) and monosomy 7, and the patient died of AML 10 months after the initial diagnosis of t-AML despite clinical remission. To the best of our knowledge, this is the first reported case of C-MYC DM-containing de novo large B-cell lymphoma, which was successfully treated with complete remission, but unfortunately died of t-AML harboring t(3;3)(q21;q26).
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Chromosomes, Human, Pair 3
- Fatal Outcome
- Flow Cytometry
- Genes, bcl-2
- Genes, myc
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/chemically induced
- Leukemia, Myeloid, Acute/genetics
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Male
- Middle Aged
- Mutation
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/genetics
- Translocation, Genetic
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Affiliation(s)
- John C Nguyen
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Melanie J Kubik
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - H Elizabeth Broome
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Peter T Curtin
- Division of Hematology, Department of Medicine, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Marie L Dell'Aquila
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Huan-You Wang
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
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Quintás-Cardama A, Daver N, Kim H, Dinardo C, Jabbour E, Kadia T, Borthakur G, Pierce S, Shan J, Cardenas-Turanzas M, Cortes J, Ravandi F, Wierda W, Estrov Z, Faderl S, Wei Y, Kantarjian H, Garcia-Manero G. A prognostic model of therapy-related myelodysplastic syndrome for predicting survival and transformation to acute myeloid leukemia. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2014; 14:401-10. [PMID: 24875590 DOI: 10.1016/j.clml.2014.03.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 02/25/2014] [Accepted: 03/17/2014] [Indexed: 02/04/2023]
Abstract
INTRODUCTION/BACKGROUND We evaluated the characteristics of a cohort of patients with myelodysplastic syndrome (MDS) related to therapy (t-MDS) to create a prognostic model. PATIENTS AND METHODS We identified 281 patients with MDS who had received previous chemotherapy and/or radiotherapy for previous malignancy. Potential prognostic factors were determined using univariate and multivariate analyses. RESULTS Multivariate Cox regression analysis identified 7 factors that independently predicted short survival in t-MDS: age ≥ 65 years (hazard ratio [HR], 1.63), Eastern Cooperative Oncology Group performance status 2-4 (HR, 1.86), poor cytogenetics (-7 and/or complex; HR, 2.47), World Health Organization MDS subtype (RARs or RAEB-1/2; HR, 1.92), hemoglobin (< 11 g/dL; HR, 2.24), platelets (< 50 × 10(9)/dL; HR, 2.01), and transfusion dependency (HR, 1.59). These risk factors were used to create a prognostic model that segregated patients into 3 groups with distinct median overall survival: good (0-2 risk factors; 34 months), intermediate (3-4 risk factors; 12 months), and poor (5-7 risk factors; 5 months) (P < .001) and 1-year leukemia-free survival (96%, 84%, and 72%, respectively, P = .003). This model also identified distinct survival groups according to t-MDS therapy. CONCLUSION In summary, we devised a prognostic model specifically for patients with t-MDS that predicted overall survival and leukemia-free survival. This model might facilitate the development of risk-adapted therapeutic strategies.
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Affiliation(s)
| | - Naval Daver
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Hawk Kim
- Division of Hematology-Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Courtney Dinardo
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Elias Jabbour
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Tapan Kadia
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Gautam Borthakur
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Sherry Pierce
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Jianqin Shan
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | | | - Jorge Cortes
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - William Wierda
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Zeev Estrov
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Stefan Faderl
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Yue Wei
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX
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Luskin MR, Roy DB, Wasik MA, Loren AW. Development of lymphomas containing Epstein-Barr virus after therapy with hyper-CVAD regimen. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2013; 14:e55-8. [PMID: 24393621 DOI: 10.1016/j.clml.2013.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/05/2013] [Accepted: 11/17/2013] [Indexed: 01/27/2023]
Affiliation(s)
- Marlise R Luskin
- Abramson Cancer Center, Division of Hematology and Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
| | - Darshan B Roy
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Mariusz A Wasik
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Alison W Loren
- Abramson Cancer Center, Division of Hematology and Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
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Adams M, Jenney M, Lazarou L, White R, Birdsall S, Staab T, Schindler D, Meyer S. Acute myeloid leukaemia after treatment for acute lymphoblastic leukaemia in girl with Bloom syndrome. ACTA ACUST UNITED AC 2013; 4. [PMID: 24932421 DOI: 10.4172/2157-7412.1000177] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Bloom syndrome (BS) is an inherited genomic instability disorder caused by disruption of the BLM helicase and confers an extreme cancer predisposition. Here we report on a girl with BS who developed acute lymphoblastic leukaemia (ALL) at age nine, and treatment-related acute myeloid leukaemia (t-AML) aged 12. She was compound heterozygous for the novel BLM frameshift deletion c.1624delG and the previously described c.3415C>T nonsense mutation. Two haematological malignancies in a child with BS imply a fundamental role for BLM for normal haematopoiesis, in particular in the presence of genotoxic stress.
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Affiliation(s)
- Madeleine Adams
- Department of Paediatric Oncology, Children's Hospital for Wales, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Laz Lazarou
- Department of Medical Genetics, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Rhian White
- Department of Medical Genetics, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Sanda Birdsall
- Tumour Cytogenetics, University Hospital, Cardiff CF14 4XW, United Kingdom
| | - Timo Staab
- Department of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Detlev Schindler
- Department of Human Genetics, University of Würzburg, Würzburg, Germany
| | - Stefan Meyer
- Stem Cell and Leukaemia Proteomics Laboratory; School of Cancer and Imaging Sciences, The University of Manchester, Manchester Academic Health Science Centre ; Department of Paediatric Onclogy, Royal Manchester Children's Hospital ; Paediatric and Adolescent Oncology, The Christie NHS Foundation Trust, Manchester, UK
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10
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Yonal I, Hindilerden F, Ozcan E, Palanduz S, Aktan M. The co-presence of deletion 7q, 20q and inversion 16 in therapy-related acute myeloid leukemia developed secondary to treatment of breast cancer with cyclophosphamide, doxorubicin, and radiotherapy: a case report. J Med Case Rep 2012; 6:67. [PMID: 22339850 PMCID: PMC3327634 DOI: 10.1186/1752-1947-6-67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 02/16/2012] [Indexed: 11/20/2022] Open
Abstract
Introduction Therapy-related acute myeloid leukemia occurs as a complication of treatment with chemotherapy, radiotherapy, immunosuppressive agents or exposure to environmental carcinogens. Case presentation We report a case of therapy-related acute myeloid leukemia in a 37-year-old Turkish woman in complete remission from breast cancer. Our patient presented to our facility with fatigue, fever, sore throat, peripheral lymphadenopathy, and moderate hepatosplenomegaly. On peripheral blood and bone marrow aspirate smears, monoblasts were present. Immunophenotypic analysis of the bone marrow showed expression of CD11b, CD13, CD14, CD15, CD33, CD34, CD45 and human leukocyte antigen-DR, findings compatible with the diagnosis of acute monoblastic leukemia (French-American-British classification M5a). Therapy-related acute myeloid leukemia developed three years after adjuvant chemotherapy consisting of an alkylating agent, cyclophosphamide and DNA topoisomerase II inhibitor, doxorubicin and adjuvant radiotherapy. Cytogenetic analysis revealed a 46, XX, deletion 7 (q22q34), deletion 20 (q11.2q13.1) karyotype in five out of 20 metaphases and inversion 16 was detected by fluorescence in situhybridization. There was no response to chemotherapy (cytarabine and idarubicin, FLAG-IDA protocol, azacitidine) and our patient died in the 11th month after diagnosis. Conclusions The median survival in therapy-related acute myeloid leukemia is shorter compared to de novoacute myeloid leukemia. Also, the response to therapy is poor. In therapy-related acute myeloid leukemia, complex karyotypes have been associated with abnormalities of chromosome 5, rather than 7. To the best of our knowledge, this is the first case of therapy-related acute myeloid leukemia showing the co-presence of deletion 7q, 20q and the inversion 16 signal.
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Affiliation(s)
- Ipek Yonal
- Istanbul University Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey.
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11
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Zhou Y, Tang G, Medeiros LJ, McDonnell TJ, Keating MJ, Wierda WG, Wang SA. Therapy-related myeloid neoplasms following fludarabine, cyclophosphamide, and rituximab (FCR) treatment in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma. Mod Pathol 2012; 25:237-45. [PMID: 22080061 DOI: 10.1038/modpathol.2011.158] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This study is focused on therapy-related myeloid neoplasms after the most promising frontline FCR (fludarabine, cyclophosphamide, and rituximab) therapy in previously untreated chronic lymphocytic leukemia patients. A total of 28 therapy-related myeloid neoplasm patients were identified, including 19 patients from 3 well-controlled FCR frontline trials (n=426 patients), giving an estimated frequency of 4.5% (1.9-8.3%) in a follow-up period of 44 months (range 5-122 months). Clinically, therapy-related myeloid neoplasms could emerge directly from 'prolonged myelosuppression' after FCR (10 patients), or after achieving complete hematological recovery (n=18). The overall latency was 35 months (range 3-118 months), with the former group of 23 months and the latter 42 months (P<0.001). In all, 10 cases presented as therapy-related acute myeloid leukemia and 18 as therapy-related myelodysplastic syndromes. Abnormal cytogenetics was present in 26 of 27 (96%) patients, with frequent chromosomes 5 and 7 abnormalities. The median survival was 7 months after therapy-related myeloid neoplasms. Our results indicate that the risk of therapy-related myeloid neoplasms secondary to frontline FCR therapy may not be as high as previously reported after removing the confounding factor of previous cytotoxic exposure, but this risk increased with older age and likely growth factor co-administration. Therapy-related myeloid neoplasms after FCR therapy shares clinicopathological features with therapy-related myeloid neoplasms secondary to other alkylating agents, but has a shorter latency interval indicating possible synergetic effects of the nucleotide analog fludarabine. The fact that therapy-related myeloid neoplasms can directly emerge from 'prolonged myelosuppression' warrants a bone marrow examination to rule out therapy-related myeloid neoplasms in this clinical setting.
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Affiliation(s)
- Yi Zhou
- Department of Hematopathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
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LI XIN, DU WEN, LIU WEI, LI XIAOQING, LI HONGRUI, HUANG SHIANG. Comprehensive flow cytometry phenotype in acute leukemia at diagnosis and at relapse. APMIS 2010; 118:353-9. [DOI: 10.1111/j.1600-0463.2010.02603.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2009. [DOI: 10.1002/pds.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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