Abivertinib inhibits megakaryocyte differentiation and platelet biogenesis

Critical shifts in lipid metabolism promote megakaryocyte differentiation and proplatelet formation

During megakaryopoiesis, megakaryocytes (MK) undergo cellular morphological changes with strong modification of membrane composition and lipid signaling. Here we adopt a lipid-centric multiomics approach to create a quantitative map of the MK lipidome during maturation and proplatelet formation. Data reveal that MK differentiation is driven by an increased fatty acyl import and de novo lipid synthesis, resulting in an anionic membrane phenotype. Pharmacological perturbation of fatty acid import and phospholipid synthesis blocked membrane remodeling and directly reduced MK polyploidization and proplatelet formation resulting in thrombocytopenia. The anionic lipid shift during megakaryopoiesis was paralleled by lipid-dependent relocalization of the scaffold protein CKIP-1 and recruitment of the kinase CK2α to the plasma membrane, which seems to be essential for sufficient platelet biogenesis. Overall, this study provides a framework to understand how the MK lipidome is altered during maturation and the impact of MK membrane lipid remodeling on MK kinase signaling involved in thrombopoiesis.

Developing therapeutic approaches for chronic myeloid leukemia: a review

Modern clinical therapy of chronic myeloid leukemia (CML) with TKIs is highly efficacious in most CML patients, while it is not remedial and generally confined due to intolerance or resistance. CML is currently considered a severe disease. Interestingly, stem cell transplantation in the past decade was an attractive clinical therapeutic option in CML patients, but it is not successful due to independently more death rates in older patients. So, the targeting of BCR::ABL oncoprotein is extensively used to enhance the reduction in a higher percentage of CML patients by tyrosine kinase inhibitors (TKIs). However, resistance or intolerance responses to these inhibitors are responsible for future deterioration and further development of disease. At this point, the clinical treatment of CML is a major challenge, and the lack of molecular responses to TKIs are not succeeded with chemotherapy alone. So, the considerable efficacious clinical necessities remain unmet. Therefore, continuous efforts are needed to explore new potential treatment strategies with an increasing understanding of CML biology. Therefore, this review deals with the investigation of TKI treatment with interferon, chemotherapy (Hydroxyurea, Homoharringtonine, Omacetaxine, Cytarabine), and several other new TKIs under beneficial clinical trials. Additionally, the approaches towards TKIs-resistant or intolerant CML cells where the respective signaling pathway gets up-regulated are also targeted with its inhibitor. This review presents evidence that new TKIs under clinical and pre-clinical trials may improve the chemotherapy of CML.

CT guided autologous blood localization of pulmonary ground glass nodules for video assisted thoracoscopic surgery compared to micro-coil localization

OBJECTIVES

To investigate feasibility and safety of autologous blood in preoperative computed tomography (CT)-guided localization of pulmonary ground-glass nodules (GGNs) by comparing to mico-coil prior to video-assisted thoracoscopic surgery.

METHODS

Clinical data of patients with GGNs who underwent video-assisted thoracoscopic surgery followed by preoperative CT-guided autologous blood or micro-coil localization was retrospectively reviewed in our department between September 2019 and November 2021. The localization duration, localization success rate, localization-related complication, localization cost, operation time, and conversion rate were compared between the 2 localization groups.

RESULTS

Totally 65 patients with 65 GGNs were included in our study, with 34 patients in autologous blood group (group B) and 31 patients in micro-coil group (group M). There is no conversion to thoracotomy. The age, sex, nodule location, diameter of nodule and distance from the pleura between the 2 groups were statistically comparable. Compared with group M, group B had similar localization success rate (94.1% vs 83.9%, P = 0.183) but shorter localization time (14.50 ± 2.61 min vs 16.35 ± 2.30 min, P = 0.004), lower cost ($92.4 ± 3.2 vs $475.6 ± 8.5, P = 0.001), and lower incidence of puncture complications (3.0% vs 19.3%, P = 0.042).

CONCLUSIONS

The autologous blood localization is an effective and more economical method for preoperative GGNs localization, and is associated with fewer complications compared to micro-coil localization.

IRF4 expression is low in Philadelphia negative myeloproliferative neoplasms and is associated with a worse prognosis

Interferon regulatory factor 4 (IRF4) is involved in the pathogenesis of various hematologic malignancies. Its expression has been related to the negative regulation of myeloid-derived suppressor cells (MDSCs) and the polarization of anti-inflammatory M2 macrophages, thereby altering immunosurveillance and inflammatory mechanisms. An abnormal inflammatory status in the bone marrow microenvironment of myeloproliferative neoplasms (MPNs) has recently been demonstrated; moreover, in chronic myeloid leukemia a downregulated expression of IRF4 has been found. In this context, we evaluated the IRF4 expression in 119 newly diagnosed consecutive Philadelphia negative MPNs (Ph- MPNs), showing a low expression among the MPNs phenotypes with a more significant decrease in primary myelofibrosis patients. Lower IRF4 levels were associated with JAK2 + and triple negatives cases carrying the worst prognosis. Furthermore, the IRF4 levels were related to leukemic transformation and a shorter leukemia-free survival; moreover, the risk of myelofibrosis transformation in polycythemia vera and essential thrombocythemia patients was more frequent in cases with lower IRF4 levels. Overall, our study demonstrates an IRF4 dysregulated expression in MPNs patients and its association with a worse prognosis. Further studies could validate these data, to improve our knowledge of the MPNs pathogenesis and confirm the IRF4 role as a new prognostic factor.