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Muradashvili T, Liu Y, VanOudenhove J, Gu SX, Krause DS, Montanari F, Carlino MJ, Mancuso R, Stempel JM, Halene S, Zeidan AM, Podoltsev NA, Neparidze N. Aplastic anemia in association with multiple myeloma: clinical and pathophysiological insights. Leuk Lymphoma 2024:1-8. [PMID: 39225418 DOI: 10.1080/10428194.2024.2393260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 07/31/2024] [Accepted: 08/12/2024] [Indexed: 09/04/2024]
Abstract
We investigated immune cytopenia in multiple myeloma (MM) patients with concurrent acquired aplastic anemia (AA), focusing on three clinical cases treated with plasma cell-directed therapy. All three patients achieved partial response in MM and one patient experienced complete resolution of AA. Two patients had partial improvement in transfusion requirement but continued to suffer from severe AA, leading to immunosuppressive therapy (IST) with improvement of transfusion requirement in both patients. In vitro serum testing of these patients demonstrated platelet mitochondrial dysfunction and platelet apoptosis but did not show sera-specific inhibition of erythroid colony formation in progenitor cells. The levels of IL8 and IL15 were elevated in MM patients with AA, implicating their potential roles in this co-occurrence. Response to IST points to the possibility of myeloma-dysregulated immune system leading to autoreactive T-cell destruction of hematopoietic stem and progenitor cells, offering insights for developing new treatment for cytopenia in MM.
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Affiliation(s)
| | - Yuxin Liu
- Section of Hematology, Department of Internal Medicine, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jennifer VanOudenhove
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Sean X Gu
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Diane S Krause
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Pathology, Yale School of Medicine, New Haven, USA
- Yale Stem Cell Center, New Haven, CT, USA
| | - Francesca Montanari
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Maximillian J Carlino
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
- Yale Stem Cell Center, New Haven, CT, USA
| | - Rubia Mancuso
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
- Yale Stem Cell Center, New Haven, CT, USA
| | - Jessica M Stempel
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Stephanie Halene
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Nikolai A Podoltsev
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Natalia Neparidze
- Section of Hematology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Tachita T, Ri M, Aoki S, Asano A, Kanamori T, Totani H, Kinoshita S, Asao Y, Narita T, Masaki A, Ito A, Kusumoto S, Komatsu H, Iida S. Comprehensive analysis of serum cytokines in patients with multiple myeloma before and after lenalidomide and dexamethasone. Cancer Med 2024; 13:e70019. [PMID: 39031503 PMCID: PMC11259000 DOI: 10.1002/cam4.70019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/19/2024] [Accepted: 07/05/2024] [Indexed: 07/22/2024] Open
Abstract
Multiple myeloma (MM) is an incurable B-cell malignancy often accompanied by profound immunodeficiency. Lenalidomide (Len) is an immunomodulatory drug that exerts promising therapeutic effects on MM through the immune system. However, predictive markers related to the effects of Len treatment are not fully understood. This study aimed to identify candidate biomarkers for predicting the clinical efficacy of Len and dexamethasone (Ld) therapy through a comprehensive analysis of serum cytokines. The levels of 48 cytokines in the serum of patients with MM just before Ld therapy (n = 77), at the time of best response (n = 56), and at disease progression (n = 49) were measured and evaluated. Patients with high IL-18 and M-CSF levels showed significantly shorter progression-free survival and overall survival (OS). In contrast, patients with high PDGF-BB levels had longer survival. Moreover, low levels of G-CSF, IL-7, IL-8, and SDF-1α were associated with shorter OS after Ld therapy. During Ld therapy, pro-inflammatory cytokines such as IL-2Rα, IL-18, and TNF-α were decreased, while IFN-γ was increased. IL-4 and IL-6 levels increased during disease progression. In conclusion, this study provides a better understanding of the association between cytokines and the efficacy of Ld therapy as well as the unique changes in cytokines related to inflammatory and immune responses during Ld therapy.
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Affiliation(s)
- Takuto Tachita
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
- Department of Gastroenterology and HematologyHirosaki University Graduate School of MedicineHirosakiJapan
| | - Masaki Ri
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Sho Aoki
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Arisa Asano
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Takashi Kanamori
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Haruhito Totani
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Shiori Kinoshita
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yu Asao
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Tomoko Narita
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Ayako Masaki
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Asahi Ito
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Shigeru Kusumoto
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Hirokazu Komatsu
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Shinsuke Iida
- Department of Hematology and OncologyNagoya City University Graduate School of Medical SciencesNagoyaJapan
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Cytokine-Mediated Dysregulation of Signaling Pathways in the Pathogenesis of Multiple Myeloma. Int J Mol Sci 2020; 21:ijms21145002. [PMID: 32679860 PMCID: PMC7403981 DOI: 10.3390/ijms21145002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 12/15/2022] Open
Abstract
Multiple myeloma (MM) is a hematologic disorder of B lymphocytes characterized by the accumulation of malignant plasma cells (PCs) in the bone marrow. The altered plasma cells overproduce abnormal monoclonal immunoglobulins and also stimulate osteoclasts. The host’s immune system and microenvironment are of paramount importance in the growth of PCs and, thus, in the pathogenesis of the disease. The interaction of MM cells with the bone marrow (BM) microenvironment through soluble factors and cell adhesion molecules causes pathogenesis of the disease through activation of multiple signaling pathways, including NF-κβ, PI3K/AKT and JAK/STAT. These activated pathways play a critical role in the inhibition of apoptosis, sustained proliferation, survival and migration of MM cells. Besides, these pathways also participate in developing resistance against the chemotherapeutic drugs in MM. The imbalance between inflammatory and anti-inflammatory cytokines in MM leads to an increased level of pro-inflammatory cytokines, which in turn play a significant role in dysregulation of signaling pathways and proliferation of MM cells; however, the association appears to be inadequate and needs more research. In this review, we are highlighting the recent findings on the roles of various cytokines and growth factors in the pathogenesis of MM and the potential therapeutic utility of aberrantly activated signaling pathways to manage the MM disease.
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Bai J, Wang J, Yang Y, Zhang W, Wang F, Zhang L, Chen H, Wang X, Feng Y, Shen Y, Huang L, He A. Serum platelet factor 4 is a promising predictor in newly diagnosed patients with multiple myeloma treated with thalidomide and VAD regimens. ACTA ACUST UNITED AC 2019; 24:387-391. [PMID: 30890040 DOI: 10.1080/16078454.2019.1592826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Frequent loss of expression of platelet factor 4 (PF4) in multiple myeloma (MM) was revealed in several previous researches. The predictive analysis of serum PF4 level in newly diagnosed MM has not been well elucidated. This study is to assess if serum PF4 could be a prognostic factor in predicting treatment response and survival of MM treated with thalidomide and VAD regimens. METHODS Sera of 122 MM were gained pre- and post-treatment of chemotherapy and oral thalidomide. Serological PF4 measurements were performed by ELISA. Kaplan-Meier method was employed for survival analysis. Log rank test was used significance analysis. Multivariate analysis of overall survival used Cox-regression. RESULTS Our data showed that the median serum PF4 concentration was negatively associated with MM response and a significant correlation between serum PF4 level and unfavorable clinical features (β2-microglobulin, ISS stage, del17p and creatinine). MM with lower serum PF4 concentration at diagnosis were prone to gain complete remission and very good partial remission after two courses of chemotherapy. Besides del17p, β2-microglobulin, treatment response, the low serum PF4 concentration was an independent variable associated with a poor overall survival by univariate analysis and multivariate analysis. CONCLUSIONS We speculate serum PF4 is a promising response and prognostic factor in newly diagnosed MM treated with thalidomide and VAD regimens.
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Affiliation(s)
- Ju Bai
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Jianli Wang
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Yun Yang
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Wanggang Zhang
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Fangxia Wang
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Lei Zhang
- b Department of Clinical Lab , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Hongli Chen
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Xiaman Wang
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Yuandong Feng
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Ying Shen
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Lingjuan Huang
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
| | - Aili He
- a Department of Hematology , Second Affiliated Hospital, Xi'an Jiaotong University , Xi'an , People's Republic of China
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Yang L, Wu Q, Xu L, Zhang W, Zhu Y, Liu H, Xu J, Gu J. Increased expression of colony stimulating factor-1 is a predictor of poor prognosis in patients with clear-cell renal cell carcinoma. BMC Cancer 2015; 15:67. [PMID: 25886010 PMCID: PMC4339479 DOI: 10.1186/s12885-015-1076-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/10/2015] [Indexed: 01/03/2023] Open
Abstract
Background This study aims to evaluate the impact of colony stimulating factor-1 (CSF-1) expression on recurrence and survival of patients with clear-cell renal cell carcinoma (ccRCC) following surgery. Methods We retrospectively enrolled 267 patients (195 in the training cohort and 72 in the validation cohort) with ccRCC undergoing nephrectomy at a single institution. Clinicopathologic features, cancer-specific survival (CSS) and recurrence-free survival (RFS) were recorded. CSF-1 levels were assessed by immunohistochemistry in tumor tissues. Kaplan-Meier method was applied to compare survival curves. Cox regression models were used to analyze the impact of prognostic factors on CSS and RFS. Concordance index (C-index) was calculated to assess predictive accuracy. Results In both cohorts, CSF-1 expression positively correlated with advanced Fuhrman grade and necrosis. High CSF-1 expression indicated poor survival and early recurrence of ccRCC patients after surgery, especially those with advanced TNM stage disease. Multivariate Cox regression analysis showed CSF-1 expression was an independent unfavorable prognostic factor for recurrence and survival. The predictive accuracy of the University of California Los Angeles Integrated Staging System (UISS) was significantly improved when CSF-1 expression was incorporated. Conclusions High CSF-1 expression is a potential adverse prognostic biomarker for recurrence and survival of ccRCC patients after nephrectomy.
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Affiliation(s)
- Liu Yang
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Qian Wu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Le Xu
- Department of Urology, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
| | - Weijuan Zhang
- Department of Immunology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, 200032, China.
| | - Yu Zhu
- Department of Urology, Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200011, China.
| | - Haiou Liu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Jiejie Xu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
| | - Jianxin Gu
- Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Mailbox 103, 138 Yixueyuan Road, Shanghai, 200032, China.
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Zhou R, Zhou Y, Chen Z. Exploration of macrophage colony-stimulating factor as a new type of tumor marker. Biomed Rep 2013; 1:845-849. [PMID: 24649040 DOI: 10.3892/br.2013.170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 09/18/2013] [Indexed: 11/06/2022] Open
Abstract
Gastric cancer is a common type of malignancy with a high incidence of mortality. Therefore, tumor markers should be identified to screen for various types of cancer. Elevated serum concentrations of macrophage colony-stimulating factor (M-CSF) have been found in a variety of malignant diseases. The aim of the present study was to investigate the possibility of serum M-CSF as a new type of tumor marker and to determine its effectiveness when combinedd with other tumor markers. Serum was collected from 32 gastric cancer patients, who were initially diagnosed by gastroscopy, at the Department of General Surgery of Huashan Hospital betwee July, 2010 and December, 2011, and 8 controls. The serum level of M-CSF was measured by enzyme-linked immunosorbent assay kits (ELISA). Clinical and pathological testing was conducted to analyze the differences in the serum level of M-CSF, as comparing to traditional tumor markers. Carcinoembryonic antigen (CEA) and M-CSF levels were found to be significantly higher in the gastric cancer group as compared to the non-gastric cancer group (P<0.05). CEA levels were significantly elevated when the gastric cancer lesions infiltrated the serosa (P=0.046). Additionally, the increased levels of M-CSF were of statistical significance when there was lymph node involvement in gastric cancer. For distant metastasis, the levels of M-CSF were decreased (P=0.026), however, the ratio of CEA to M-CSF values increased significantly (P=0.048). Furthermore, the M-CSF level was positively correlated with TNM stage in gastric cancer patients without distant organ metastasis, in contrast to gastric cancer patients with distant organ metastasis. In conclusion, M-CSF may be considered as a new type of tumor marker that can be combined with traditional tumor markers in order to determine whether the cancer migrated to distant organs.
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Affiliation(s)
- Ru Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Yiming Zhou
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Zongyou Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
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Zheng MM, Zhang Z, Bemis K, Belch AR, Pilarski LM, Shively JE, Kirshner J. The systemic cytokine environment is permanently altered in multiple myeloma. PLoS One 2013; 8:e58504. [PMID: 23544044 PMCID: PMC3609759 DOI: 10.1371/journal.pone.0058504] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/05/2013] [Indexed: 02/03/2023] Open
Abstract
Multiple myeloma (MM) is an incurable bone marrow malignancy of the B cell lineage. Utilizing multiplex Luminex technology we measured levels of 25 cytokines in the plasma of normal donors (n = 177), those with monoclonal gammopathy of undetermined significance (n = 8), and MM patients (n = 55) with either active disease, on treatment, or in remission. The cytokine levels were compared between normal donors and MM patients as well as between various phases of MM, and discriminant analysis was used to create a predictive classification model based on the differentially expressed cytokines. Evaluating age- and gender-dependence of cytokine expression, we determined that with age there is a shift toward a pro-inflammatory environment. Moreover, we observed a strong gender bias in cytokine expression. However, the profile of differentially expressed cytokines was heavily skewed toward an anti-inflammatory, pro-tumorigenic response in patients with MM. Significantly, our predictive model placed all patients in remission in the same category as those with active disease. Thus, our study demonstrates that the homeostasis of systemic cytokines is not restored when MM patients enter remission, suggesting that once an individual has cancer, the microenvironment is permanently altered and the system is primed for a relapse.
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Affiliation(s)
- Mary M. Zheng
- Department of Biological Sciences, Purdue University, West Lafayette, Indiana, United States of America
| | - Zhifang Zhang
- Division of Immunology, Beckman Research Institute of the City of Hope National Medical Center, Duarte, California, United States of America
| | - Kyle Bemis
- Department of Statistics, Purdue University, West Lafayette, Indiana, United States of America
| | - Andrew R. Belch
- Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Linda M. Pilarski
- Department of Medical Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Alberta, Canada
| | - John E. Shively
- Division of Immunology, Beckman Research Institute of the City of Hope National Medical Center, Duarte, California, United States of America
| | - Julia Kirshner
- Department of Biological Sciences, Purdue University, West Lafayette, Indiana, United States of America
- * E-mail:
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Kowalska M, Druzd-Sitek A, Fuksiewicz M, Kotowicz B, Chechlinska M, Syczewska M, Walewski J, Kaminska J. Procollagen I amino-terminal propeptide as a potential marker for multiple myeloma. Clin Biochem 2010; 43:604-8. [DOI: 10.1016/j.clinbiochem.2009.12.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2009] [Revised: 12/16/2009] [Accepted: 12/17/2009] [Indexed: 10/20/2022]
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