1
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Bouchla A, Thomopoulos TP, Papageorgiou SG, Apostolopoulou C, Loucari C, Mpazani E, Pappa V. Predicting outcome in higher-risk myelodysplastic syndrome patients treated with azacitidine. Epigenomics 2021; 13:1129-1143. [PMID: 34291653 DOI: 10.2217/epi-2021-0124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
5-Azacitidine (5-AZA) is widely used for the treatment of higher-risk myelodysplastic syndromes. However, response and survival rates vary considerably, while indicated treatment duration remains undefined. For these reasons, factors determining response and survival are of major importance. Clinical, morphological, flow cytometry, cytogenetic and molecular factors are discussed in this review. Biomarkers predictive of response and prognosis, as well as their link to the mode of action of 5-AZA are also addressed, shifting the focus from clinical practice to investigational research. Their use could further improve prognostic classification of 5-AZA treated higher-risk myelodysplastic syndromes in the near future.
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Affiliation(s)
- Anthi Bouchla
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
| | - Thomas P Thomopoulos
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
| | - Christina Apostolopoulou
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
| | - Constantinos Loucari
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
| | - Efthimia Mpazani
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
| | - Vasiliki Pappa
- Second Department of Internal Medicine & Research Unit Hematology Unit, University General Hospital Attikon, Rimini, 12462 Chaidari, Athens, Greece
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2
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Diamantopoulos PT, Viniou NA. Factors affecting response to 5-azacytidine and prognosis of myelodysplastic syndrome. Is long-term survival a realistic goal? Leuk Res 2021; 103:106543. [PMID: 33640709 DOI: 10.1016/j.leukres.2021.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/15/2021] [Accepted: 02/18/2021] [Indexed: 12/14/2022]
Abstract
The introduction of hypomethylating agents (HMAs) 5-azacytidine and decitabine has altered the prognosis of patients with myelodysplastic syndrome (MDS). Over the past few years, the International Prognostic Scoring System (IPSS) and the revised IPSS (IPSS-R) have been used both to define the prognosis of patients with MDS and to select patients to be treated with HMAs. Nevertheless, the prognosis of individual patients with MDS can differ considerably from the one calculated with the use of the above-mentioned prognostic systems. Thus, some patients may achieve long-term survival irrespective of their initial prognostic score. Several factors besides those used to define the IPSS/IPSS-R are analyzed in this review article; these include age and gender, the baseline hematologic characteristics, the comorbidities, the cytogenetic and molecular profile of the patients, as well as their response to treatment with 5-azacytidine. Thus, insight into a more personalized way of managing patients with MDS is given and long-term survival is set as a more realistic goal of treatment with 5-azacytidine.
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Affiliation(s)
- Panagiotis T Diamantopoulos
- First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
| | - Nora-Athina Viniou
- First Department of Internal Medicine, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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3
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Dahn ML, Cruickshank BM, Jackson AJ, Dean C, Holloway RW, Hall SR, Coyle KM, Maillet H, Waisman DM, Goralski KB, Giacomantonio CA, Weaver ICG, Marcato P. Decitabine Response in Breast Cancer Requires Efficient Drug Processing and Is Not Limited by Multidrug Resistance. Mol Cancer Ther 2020; 19:1110-1122. [PMID: 32156786 DOI: 10.1158/1535-7163.mct-19-0745] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/30/2020] [Accepted: 03/05/2020] [Indexed: 11/16/2022]
Abstract
Dysregulation of DNA methylation is an established feature of breast cancers. DNA demethylating therapies like decitabine are proposed for the treatment of triple-negative breast cancers (TNBC) and indicators of response need to be identified. For this purpose, we characterized the effects of decitabine in a panel of 10 breast cancer cell lines and observed a range of sensitivity to decitabine that was not subtype specific. Knockdown of potential key effectors demonstrated the requirement of deoxycytidine kinase (DCK) for decitabine response in breast cancer cells. In treatment-naïve breast tumors, DCK was higher in TNBCs, and DCK levels were sustained or increased post chemotherapy treatment. This suggests that limited DCK levels will not be a barrier to response in patients with TNBC treated with decitabine as a second-line treatment or in a clinical trial. Methylome analysis revealed that genome-wide, region-specific, tumor suppressor gene-specific methylation, and decitabine-induced demethylation did not predict response to decitabine. Gene set enrichment analysis of transcriptome data demonstrated that decitabine induced genes within apoptosis, cell cycle, stress, and immune pathways. Induced genes included those characterized by the viral mimicry response; however, knockdown of key effectors of the pathway did not affect decitabine sensitivity suggesting that breast cancer growth suppression by decitabine is independent of viral mimicry. Finally, taxol-resistant breast cancer cells expressing high levels of multidrug resistance transporter ABCB1 remained sensitive to decitabine, suggesting that the drug could be used as second-line treatment for chemoresistant patients.
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Affiliation(s)
- Margaret L Dahn
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Ainsleigh J Jackson
- Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Cheryl Dean
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ryan W Holloway
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Steven R Hall
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Krysta M Coyle
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hillary Maillet
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David M Waisman
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Biochemistry and Molecular Biology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kerry B Goralski
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.,College of Pharmacy, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Carman A Giacomantonio
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ian C G Weaver
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.,Brain Repair Centre, Halifax, Nova Scotia, Canada
| | - Paola Marcato
- Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada. .,Department of Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia, Canada
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4
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Stomper J, Lübbert M. Can we predict responsiveness to hypomethylating agents in AML? Semin Hematol 2019; 56:118-124. [PMID: 30926087 DOI: 10.1053/j.seminhematol.2019.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 02/18/2019] [Accepted: 02/22/2019] [Indexed: 11/11/2022]
Abstract
DNA-hypomethylating agents (HMAs) were developed as nonintensive treatment alternatives to standard chemotherapy in older, unfit patients with acute myeloid leukemia and myelodysplastic syndrome. Given their distinct effects on the methylome and transcriptome of malignant cells compared to cytarabine (Ara-C) and other cytotoxic drugs not inhibiting DNA methyltransferases, it is of great interest to define their specific clinical ``signature.'' Here, we present and discuss clinical, genetic, and epigenetic predictors of responsiveness to HMAs. Indeed, mounting evidence supports the notion that HMAs are not "just another kind of low-dose Ara-C." Not only patient factors (age, performance status, comorbidities, etc.), blast counts, and early platelet response, but also adverse genetics (monosomal karyotype and/or a TP53 mutation) have predictive potential. Given the surprising-and initially counterintuitive-responses observed in patients with the latter features, these are subject to mechanistic studies to elucidate their as yet unresolved interaction with HMAs. Finally, other potential biomarkers for HMA response such as elevated fetal hemoglobin might also contribute to overcome the present challenges in predicting responsiveness to HMAs.
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Affiliation(s)
- Julia Stomper
- Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany
| | - Michael Lübbert
- Department of Hematology, Oncology, and Stem Cell Transplantation, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany; German Cancer Research Consortium (DKTK), Freiburg, Germany.
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5
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Vidal V, Robert G, Goursaud L, Durand L, Ginet C, Karsenti JM, Luciano F, Gastaud L, Garnier G, Braun T, Hirsch P, Raffoux E, Nloga AM, Padua RA, Dombret H, Rohrlich P, Ades L, Chomienne C, Auberger P, Fenaux P, Cluzeau T. BCL2L10 positive cells in bone marrow are an independent prognostic factor of azacitidine outcome in myelodysplastic syndrome and acute myeloid leukemia. Oncotarget 2018; 8:47103-47109. [PMID: 28514758 PMCID: PMC5564547 DOI: 10.18632/oncotarget.17482] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/14/2017] [Indexed: 12/12/2022] Open
Abstract
Azacitidine (AZA), the reference treatment for most higher-risk myelodysplastic (MDS) patients can also improve overall survival (OS) in elderly acute myeloid leukemia (AML) patients ineligible for intensive chemotherapy, but reliable biological markers predicting response and OS in patients treated with AZA are lacking. In a preliminary study, we found that an increase of the percentage of BCL2L10, an anti-apoptotic member of the bcl-2 family, was correlated with AZA resistance. In this study, we assessed prospectively by flow cytometry the prognostic value of BCL2L10 positive bone marrow mononuclear cells in 70 patients (42 MDS and 28 AML), prior to AZA treatment. In patients with baseline marrow blasts below 30%, the baseline percentage of bone marrow BCL2L10 positive cells inversely correlated with response to AZA and OS independently of the International Prognostic Scoring System (IPSS) and IPSS-revised (IPSS-R). Specifically, OS was significantly lower in patients with more than 10% BCL2L10 positive cells (median 8.3 vs 22.9 months in patients with less than 10% positivity, p = 0,001). In summary, marrow BCL2L10 positive cells may be a biomarker for azacitidine response and OS, with a potential impact in clinical practice.
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Affiliation(s)
- Valérie Vidal
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France
| | - Guillaume Robert
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, Nice, France
| | - Laure Goursaud
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France
| | - Laetitia Durand
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France
| | - Clemence Ginet
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, Nice, France
| | - Jean Michel Karsenti
- Cote d'azur University, Nice Sophia Antipolis University, CHU of Nice, Nice, France
| | - Frederic Luciano
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, Nice, France
| | - Lauris Gastaud
- Centre Antoine Lacassagne, Service d'oncologie, Nice, France
| | - Georges Garnier
- CH Princesse Grace, Service de Médecine Interne, Monaco, Monaco
| | - Thorsten Braun
- Hôpital Avicenne, Paris 13 University, APHP, Bobigny, France
| | - Pierre Hirsch
- Hôpital Saint Antoine, Service d'Hématologie Clinique et de Thérapie Cellulaire, Paris, France.,Sorbonne Universités, UPMC Univ Paris 6, UMRS 938, CDR Saint-Antoine, Paris, France
| | - Emmanuel Raffoux
- Hôpital Saint Louis, Paris 7 University, Service d'Hématologie Adulte, APHP, Paris, France
| | - Anne Marie Nloga
- Hôpital Saint Louis, Paris 7 University, Service d'Hématologie Sénior, APHP, Paris, France
| | - Rose Ann Padua
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France
| | - Hervé Dombret
- Hôpital Saint Louis, Paris 7 University, Service d'Hématologie Adulte, APHP, Paris, France
| | - Pierre Rohrlich
- Cote d'azur University, Nice Sophia Antipolis University, CHU of Nice, Nice, France
| | - Lionel Ades
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France.,Hôpital Saint Louis, Paris 7 University, Service d'Hématologie Sénior, APHP, Paris, France
| | | | - Patrick Auberger
- INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, Nice, France.,Cote d'azur University, Nice Sophia Antipolis University, CHU of Nice, Nice, France
| | - Pierre Fenaux
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France.,Hôpital Saint Louis, Paris 7 University, Service d'Hématologie Sénior, APHP, Paris, France
| | - Thomas Cluzeau
- INSERM U1131, Institut Universitaire d'hématologie, Paris, France.,INSERM U1065, Centre Méditerranéen de Médecine Moléculaire, Nice, France.,Cote d'azur University, Nice Sophia Antipolis University, CHU of Nice, Nice, France
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6
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Mutations in the DNA methylation pathway and number of driver mutations predict response to azacitidine in myelodysplastic syndromes. Oncotarget 2017; 8:106948-106961. [PMID: 29291002 PMCID: PMC5739787 DOI: 10.18632/oncotarget.22157] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 10/03/2017] [Indexed: 11/25/2022] Open
Abstract
We evaluated the association of mutations in 34 candidate genes and response to azacitidine in 84 patients with myelodysplastic syndrome (MDS), with 217 somatic mutations identified by next-generation sequencing. Most patients (93%) had ≥1 mutation (mean=2.6/patient). The overall response rate to azacitidine was 42%. No clinical characteristic was associated with response to azacitidine. However, total number of mutations/patient was negatively associated with overall drug response (odds ratio [OR]: 0.56, 95% confidence interval [CI]: 0.33–0.94; p=0.028), and a positive association was found for having ≥1 mutation in a DNA methylation-related gene: TET2, DNMT3A, IDH1 and/or IDH2 (OR: 4.76, 95%CI: 1.31–17.27; p=0.017). Mutations in TP53 (hazard ratio [HR]: 3.88; 95%CI: 1.94–7.75) and EZH2 (HR: 2.50; 95%CI: 1.23–5.09) were associated with shorter overall survival. Meta-analysis of 6 studies plus present data (n=815 patients) allowed assessment of the association of drug response with mutations in 9 candidate genes: ASXL1, CBL, EZH2, SF3B1, SRSF2, TET2, DNMT3A, IDH1/2 and TP53. TET2 mutations predicted a more favorable drug response compared with ‘wild-type’ peers (pooled OR: 1.67, 95%CI: 1.14–2.44; p=0.01). In conclusion, mutations in the DNA methylation pathway, especially TET2 mutations, and low number of total mutations are associated with a better response to azacitidine.
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7
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Ramos F, Robledo C, Pereira A, Pedro C, Benito R, de Paz R, del Rey M, Insunza A, Tormo M, Díez-Campelo M, Xicoy B, Salido E, Sánchez-del-Real J, Arenillas L, Florensa L, Luño E, del Cañizo C, Sanz GF, María Hernández-Rivas J. Multidimensional assessment of patient condition and mutational analysis in peripheral blood, as tools to improve outcome prediction in myelodysplastic syndromes: A prospective study of the Spanish MDS group. Am J Hematol 2017; 92:E534-E541. [PMID: 28612357 DOI: 10.1002/ajh.24813] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 06/04/2017] [Accepted: 06/05/2017] [Indexed: 12/13/2022]
Abstract
The International Prognostic Scoring System and its revised form (IPSS-R) are the most widely used indices for prognostic assessment of patients with myelodysplastic syndromes (MDS), but can only partially account for the observed variation in patient outcomes. This study aimed to evaluate the relative contribution of patient condition and mutational status in peripheral blood when added to the IPSS-R, for estimating overall survival and the risk of leukemic transformation in patients with MDS. A prospective cohort (2006-2015) of 200 consecutive patients with MDS were included in the study series and categorized according to the IPSS-R. Patients were further stratified according to patient condition (assessed using the multidimensional Lee index for older adults) and genetic mutations (peripheral blood samples screened using next-generation sequencing). The change in likelihood-ratio was tested in Cox models after adding individual covariates. The addition of the Lee index to the IPSS-R significantly improved prediction of overall survival [hazard ratio (HR) 3.02, 95% confidence interval (CI) 1.96-4.66, P < 0.001), and mutational analysis significantly improved prediction of leukemic evolution (HR 2.64, 1.56-4.46, P < 0.001). Non-leukemic death was strongly linked to patient condition (HR 2.71, 1.72-4.25, P < 0.001), but not to IPSS-R score (P = 0.35) or mutational status (P = 0.75). Adjustment for exposure to disease-modifying therapy, evaluated as a time-dependent covariate, had no effect on the proposed model's predictive ability. In conclusion, patient condition, assessed by the multidimensional Lee index and patient mutational status can improve the prediction of clinical outcomes of patients with MDS already stratified by IPSS-R.
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Affiliation(s)
- Fernando Ramos
- Department of Hematology; Hospital Universitario de León; León Spain
- Institute of Biomedicine (IBIOMED, León); León Spain
| | - Cristina Robledo
- Unidad de Diagnóstico Molecular y Celular del Cáncer, IBSAL, IBMCC-Centro de Investigación del Cáncer (USAL-CSIC); Salamanca Spain
| | - Arturo Pereira
- Department of Blood Transfusion; Hospital Clínic i Provincial; Barcelona Spain
| | - Carmen Pedro
- Department of Hematology; Hospital del Mar; Barcelona Spain
| | - Rocío Benito
- Unidad de Diagnóstico Molecular y Celular del Cáncer, IBSAL, IBMCC-Centro de Investigación del Cáncer (USAL-CSIC); Salamanca Spain
| | - Raquel de Paz
- Department of Hematology; Hospital Universitario La Paz; Madrid Spain
| | - Mónica del Rey
- Unidad de Diagnóstico Molecular y Celular del Cáncer, IBSAL, IBMCC-Centro de Investigación del Cáncer (USAL-CSIC); Salamanca Spain
| | - Andrés Insunza
- Department of Hematology; Hospital Universitario Marqués de Valdecilla; Santander Spain
| | - Mar Tormo
- Department of Hematology and Oncology; Hospital Clínico de Valencia; Valencia Spain
| | - María Díez-Campelo
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - Blanca Xicoy
- Department of Hematology, Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol, Badalona, Josep Carreras Leukemia Research Institute; Badalona Spain
| | - Eduardo Salido
- Department of Hematology; Hospital Universitario La Arrixaca; Murcia Spain
| | | | | | | | - Elisa Luño
- Department of Hematology; Hospital Universitario Central de Asturias; Oviedo Spain
| | - Consuelo del Cañizo
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
| | - Guillermo F. Sanz
- Department of Hematology Hospital Universitari i Politècnic La Fe; Valencia Spain
| | - Jesús María Hernández-Rivas
- Unidad de Diagnóstico Molecular y Celular del Cáncer, IBSAL, IBMCC-Centro de Investigación del Cáncer (USAL-CSIC); Salamanca Spain
- Department of Hematology; Hospital Universitario de Salamanca; Salamanca Spain
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8
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Kostroma II, Gritsaev SV, Sidorova ZY, Tiranova SA, Svitina SP, Drizhun YS, Chubukina ZV, Martynkevich IS, Kapustin SI, Bessmeltsev SS. [Aberrant methylation of the promoter regions of the SOX7 and p15INK4b genes and Wnt signaling pathway antagonists in patients with acute myeloid leukemias]. TERAPEVT ARKH 2017; 88:31-36. [PMID: 27459612 DOI: 10.17116/terarkh201688731-36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM to investigate the methylation status of the SOX7 and p15NK4b genes and Wnt signaling pathway antagonists in patients with acute myeloid leukemia (AML) in order to assess the association of the rate of aberrant methylation (AM) with the morphological variant and pattern of chromosomal aberrations, as well as the impact of the methylation status on survival. SUBJECTS AND METHODS The data of 57 AML patients aged 20 to 79 years were analyzed. The methylation status of the genes was studied by methylation-specific polymerase chain reaction. RESULTS The signs of the AM of ≥1 gene were detected in 52 (91.2%) of the 57 patients. The most common finding was AM of simultaneously 2 or 3 genes: in 29.8 and 21.1% of the patients, respectively. Concurrent methylation of 3-5 genes proved to be a more frequent finding in AML patients with myelodysplasia: in 7 (70%) of 10 patients. The proportion of patients with methylation of 5 genes was considerably higher in a group of patients with a complex karyotype: 50% versus 8.3% among other patients (odds ratio: 11.0; 95% confidence interval 2.0 to 61.6; p=0.01). There were no differences in the median overall and relapse-free survival rates in patients with a normal karyotype and without FLT3 and NPM mutations, who received induction therapy, in relation to the number of genes with AM. CONCLUSION AM of the p15NK4b and SOX7 genes and Wnt signaling pathway antagonists is detected in the majority of patients with AML, which allows hypomethylating agents to be recommended for the treatment of patients who cannot use intensive cytostatic therapy for different reasons. The detection of a large number of genes with the aberrant methylation status in most AML patients with myelodysplasia or a complex karyotype serves as the basis for initiating trials to evaluate the efficiency of a combination of 5-azacytidine and cytostatics.
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Affiliation(s)
- I I Kostroma
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - S V Gritsaev
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - Zh Yu Sidorova
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - S A Tiranova
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - S P Svitina
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - Yu S Drizhun
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - Zh V Chubukina
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - I S Martynkevich
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - S I Kapustin
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
| | - S S Bessmeltsev
- Russian Research Institute of Hematology and Transfusiology, Federal Biomedical Agency of Russia, Moscow, Russia
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9
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Scott LJ. Azacitidine: A Review in Myelodysplastic Syndromes and Acute Myeloid Leukaemia. Drugs 2016; 76:889-900. [DOI: 10.1007/s40265-016-0585-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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10
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Guo Y, Bosompem A, Mohan S, Erdogan B, Ye F, Vickers KC, Sheng Q, Zhao S, Li CI, Su PF, Jagasia M, Strickland SA, Griffiths EA, Kim AS. Transfer RNA detection by small RNA deep sequencing and disease association with myelodysplastic syndromes. BMC Genomics 2015; 16:727. [PMID: 26400237 PMCID: PMC4581457 DOI: 10.1186/s12864-015-1929-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/16/2015] [Indexed: 11/10/2022] Open
Abstract
Background Although advances in sequencing technologies have popularized the use of microRNA (miRNA) sequencing (miRNA-seq) for the quantification of miRNA expression, questions remain concerning the optimal methodologies for analysis and utilization of the data. The construction of a miRNA sequencing library selects RNA by length rather than type. However, as we have previously described, miRNAs represent only a subset of the species obtained by size selection. Consequently, the libraries obtained for miRNA sequencing also contain a variety of additional species of small RNAs. This study looks at the prevalence of these other species obtained from bone marrow aspirate specimens and explores the predictive value of these small RNAs in the determination of response to therapy in myelodysplastic syndromes (MDS). Methods Paired pre and post treatment bone marrow aspirate specimens were obtained from patients with MDS who were treated with either azacytidine or decitabine (24 pre-treatment specimens, 23 post-treatment specimens) with 22 additional non-MDS control specimens. Total RNA was extracted from these specimens and submitted for next generation sequencing after an additional size exclusion step to enrich for small RNAs. The species of small RNAs were enumerated, single nucleotide variants (SNVs) identified, and finally the differential expression of tRNA-derived species (tDRs) in the specimens correlated with diseasestatus and response to therapy. Results Using miRNA sequencing data generated from bone marrow aspirate samples of patients with known MDS (N = 47) and controls (N = 23), we demonstrated that transfer RNA (tRNA) fragments (specifically tRNA halves, tRHs) are one of the most common species of small RNA isolated from size selection. Using tRNA expression values extracted from miRNA sequencing data, we identified six tRNA fragments that are differentially expressed between MDS and normal samples. Using the elastic net method, we identified four tRNAs-derived small RNAs (tDRs) that together can explain 67 % of the variation in treatment response for MDS patients. Similar analysis of specifically mitochondrial tDRs (mt-tDRs) identified 13 mt-tDRs which distinguished disease status in the samples and a single mt-tDR which predited response. Finally, 14 SNVs within the tDRs were found in at least 20 % of the MDS samples and were not observed in any of the control specimens. Discussion This study highlights the prevalence of tDRs in RNA-seq studies focused on small RNAs. The potential etiologies of these species, both technical and biologic, are discussed as well as important challenges in the interpretation of tDR data. Conclusions Our analysis results suggest that tRNA fragments can be accurately detected through miRNA sequencing data and that the expression of these species may be useful in the diagnosis of MDS and the prediction of response to therapy. Electronic supplementary material The online version of this article (doi:10.1186/s12864-015-1929-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yan Guo
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Amma Bosompem
- Department of Pathology, Immunology, and Microbiology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Sanjay Mohan
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Begum Erdogan
- Department of Pathology, Immunology, and Microbiology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Fei Ye
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA.
| | - Kasey C Vickers
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Quanhu Sheng
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Shilin Zhao
- Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Chung-I Li
- Department of Applied Mathematics, National Chiayi University, Chiayi City, Taiwan.
| | - Pei-Fang Su
- Department of Statistics, National Cheng Kung University, Tainan City, Taiwan.
| | - Madan Jagasia
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | - Stephen A Strickland
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
| | | | - Annette S Kim
- Department of Pathology, Immunology, and Microbiology, Vanderbilt University Medical Center, Nashville, TN, USA. .,Present address: Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115, USA.
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11
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Lucijanic M, Lasan-Trcic R, Kusec R, Pejsa V, Stoos-Veic T, Jaksic O. Loss of response to azacitidine is associated with deletion 12p13 in a patient with myelodysplastic syndrome with unique translocation t(13;17)(q12;q25) after prior breast cancer and acute promyelocytic leukemia. Ann Hematol 2015; 94:1617-9. [PMID: 26088813 DOI: 10.1007/s00277-015-2428-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/09/2015] [Indexed: 11/26/2022]
MESH Headings
- Antimetabolites, Antineoplastic/administration & dosage
- Antimetabolites, Antineoplastic/adverse effects
- Azacitidine/administration & dosage
- Azacitidine/adverse effects
- Breast Neoplasms/drug therapy
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Chromosome Deletion
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 13/genetics
- Drug Resistance, Neoplasm/drug effects
- Drug Resistance, Neoplasm/genetics
- Female
- Humans
- Leukemia, Promyelocytic, Acute/chemically induced
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- Middle Aged
- Myelodysplastic Syndromes/chemically induced
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/pathology
- Neoplasms, Second Primary/drug therapy
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Translocation, Genetic
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Affiliation(s)
- Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Avenija Gojka Suska 6, 10000, Zagreb, Croatia
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12
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Jonas BA, Greenberg PL. MDS prognostic scoring systems – past, present, and future. Best Pract Res Clin Haematol 2014; 28:3-13. [PMID: 25659725 DOI: 10.1016/j.beha.2014.11.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 11/04/2014] [Indexed: 11/30/2022]
Abstract
The myelodysplastic syndromes (MDS) are a heterogeneous group of clonal myeloid haemopathies characterized by defective differentiation of haematopoietic cells and expansion of the abnormal clone. This leads to bone marrow failure with the resulting peripheral blood cytopenias and evolution to or toward acute myeloid leukaemia that characterize MDS clinically. The clinical heterogeneity of MDS has led several groups to analyze patient and clinical characteristics to develop prognostic scoring systems yielding estimates of overall and leukaemia-free survival to guide clinical decision-making. These models have evolved over time as our understanding of the pathogenesis, natural history, and treatment of MDS has improved. Rapid advances in flow cytometric analysis, adjuncts to standard metaphase cytogenetics, and gene mutation analysis are revolutionizing our understanding of MDS pathogenesis and prognosis. Despite the existence of multiple well-validated prognostic scoring systems, further refinements of current models with these new sources of prognostic data are needed and are described herein.
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Affiliation(s)
- Brian A Jonas
- Department of Internal Medicine, Division of Hematology and Oncology, University of California Davis School of Medicine, UC Davis Comprehensive Cancer Center, 4501 X Street, Suite 3016, Sacramento, CA 95817, United States.
| | - Peter L Greenberg
- Department of Internal Medicine, Division of Hematology, Stanford University School of Medicine, Stanford Comprehensive Cancer Center, 875 Blake Wilbur Drive, Stanford, CA 94305, United States.
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13
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Treppendahl MB, Kristensen LS, Grønbæk K. Predicting response to epigenetic therapy. J Clin Invest 2014; 124:47-55. [PMID: 24382389 DOI: 10.1172/jci69737] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Drugs targeting the epigenome are new promising cancer treatment modalities; however, not all patients receive the same benefit from these drugs. In contrast to conventional chemotherapy, responses may take several months after the initiation of treatment to occur. Accordingly, identification of good pretreatment predictors of response is of great value. Many clinical parameters and molecular targets have been tested in preclinical and clinical studies with varying results, leaving room for optimization. Here we provide an overview of markers that may predict the efficacy of FDA- and EMA-approved epigenetic drugs.
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