1
|
Liu YJ, Li XH, Song YL, Zhou YC, Cai RZ, Chi PD. Evaluation of diagnostic efficacy of NRP-1/CD304 in hematological diseases. Cancer Med 2023. [PMID: 36965095 DOI: 10.1002/cam4.5838] [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: 11/20/2022] [Revised: 02/27/2023] [Accepted: 03/12/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Previous studies had explored the diagnostic or prognostic value of NRP-1/CD304 in blastic plasmacytoid dendritic cell neoplasm (BPDCN), acute myeloid leukemia (AML), and B-cell acute lymphoblastic leukemia (B-ALL), whereas the expression and application value of NRP-1/CD304 in other common hematological diseases have not been reported. METHODS Bone marrow samples from 297 newly diagnosed patients with various hematological diseases were collected to detect the expression of NRP-1/CD304 by flow cytometry (FCM). The diagnostic efficacy of NRP-1/ CD304-positive diseases was analyzed by receiver operating characteristic (ROC) curve, and the area under the ROC curve (AUC) was compared. RESULTS In the research cohort, the total positive rate of NRP-1/CD304 was 14.81% (44/297), mainly distributed in BPDCN (100%, 6/6), B-ALL (48.61%, 35/72), and AML (4.48%, 3/67), with statistically significant differences (p < 0.01). Other diseases, such as T-cell acute lymphoblastic leukemia (T-ALL), B-cell non-Hodgkin lymphoma (B-NHL), T/NK-cell lymphoma and plasma cell neoplasms, did not express NRP-1/CD304. The AUC of NRP-1/CD304 was 0.936 (95% CI 0.898-0.973), 0.723 (95% CI 0.646-0.801), and 0.435 (95% CI 0.435) in BPDCN, B-ALL and AML, respectively. Besides, CD304 was commonly expressed in B-ALL with BCR-ABL1 gene rearrangement (p = 0.000), and CD304 expression was positively correlated with CD34 co-expression (p = 0.009) and CD10 co-expression (p = 0.007). CONCLUSIONS NRP-1/CD304 is only expressed in BPDCN, B-ALL and AML, but not in other common hematological diseases. This indicates that NRP-1/CD304 has no obvious diagnostic and follow-up study value in hematological diseases other than BPDCN, B-ALL, and AML.
Collapse
Affiliation(s)
- Yi-Jun Liu
- Sun Yat-sen University Cancer Center, Guangzhou, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangzhou, 510060, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangzhou, 510060, People's Republic of China
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Xiao-Hui Li
- Sun Yat-sen University Cancer Center, Guangzhou, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangzhou, 510060, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangzhou, 510060, People's Republic of China
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Yi-Ling Song
- Sun Yat-sen University Cancer Center, Guangzhou, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangzhou, 510060, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangzhou, 510060, People's Republic of China
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Yi-Chen Zhou
- Sun Yat-sen University Cancer Center, Guangzhou, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangzhou, 510060, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangzhou, 510060, People's Republic of China
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Rong-Zeng Cai
- Sun Yat-sen University Cancer Center, Guangzhou, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangzhou, 510060, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangzhou, 510060, People's Republic of China
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| | - Pei-Dong Chi
- Sun Yat-sen University Cancer Center, Guangzhou, Guangzhou, 510060, People's Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou, Guangzhou, 510060, People's Republic of China
- Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangzhou, 510060, People's Republic of China
- Department of Clinical Laboratory, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, 510060, People's Republic of China
| |
Collapse
|
2
|
Nisar I, Shahid S, Yousuf F, Lakhani LS, Ashraf S, Imam U, Zaheer J, Belgaumi A, Fadoo Z. Treatment outcomes and prognostic factors of childhood acute lymphoblastic leukemia in a low-middle income population: A multi-institutional report from Pakistan. Pediatr Blood Cancer 2023; 70:e29889. [PMID: 35920528 DOI: 10.1002/pbc.29889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 06/27/2022] [Accepted: 06/27/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Imran Nisar
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Shahira Shahid
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Fatimah Yousuf
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Laila Saleem Lakhani
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Uzma Imam
- Pediatric Oncology Department, National Institute of Child Health, Karachi, Pakistan
| | - Junaid Zaheer
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.,Department of Oncology, Aga Khan University, Karachi, Pakistan
| | - Asim Belgaumi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.,Department of Oncology, Aga Khan University, Karachi, Pakistan
| | - Zehra Fadoo
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan.,Department of Oncology, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
3
|
Xu Q, Xue L, An F, Xu H, Wang L, Geng L, Zhang X, Song K, Yao W, Wan X, Tong J, Liu H, Liu X, Zhu X, Zhai Z, Sun Z, Wang X. Impact of Consolidative Unrelated Cord Blood Transplantation on Clinical Outcomes of Patients With Relapsed/Refractory Acute B Lymphoblastic Leukemia Entering Remission Following CD19 Chimeric Antigen Receptor T Cells. Front Immunol 2022; 13:879030. [PMID: 35558072 PMCID: PMC9086894 DOI: 10.3389/fimmu.2022.879030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Background While chimeric antigen receptor (CAR)-T cell therapy is becoming widely used in hematological malignancies with remarkable remission rate, their high recurrence remains an obstacle to overcome. The role of consolidative transplantation following CAR-T cell-mediated remission remains controversial. We conducted a retrospective study to explore whether bridging to unrelated cord blood transplantation (UCBT) could improve the prognosis of patients entering remission after CAR-T therapy with different characteristics through subgroup analyses. Methods We reviewed 53 patients with relapsed/refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) successfully infused with CD19 CAR-T cells and achieved complete remission (CR). In this study, 25 patients received consolidative UCBT (UCBT group) and 28 patients did not accept any intervention until relapse (non-UCBT group). Subgroup analysis on prognosis was then performed according to gender, age, number of previous relapses, tumor burden, presence of poor prognostic markers, and structure of CAR. Results Compared with the non-UCBT group, patients who underwent consolidative UCBT had better median event-free survival (EFS; 12.3 months vs. 6.2 months; P = 0.035) and relapse-free survival (RFS; 22.3 months vs. 7.2 months; P = 0.046), while no significant difference was found in overall survival (OS; 30.8 months vs. 15.3 months; P = 0.118). Subsequent multivariate analysis revealed that bridging to UCBT was a protective factor for RFS (P = 0.048) but had no significant effect on EFS (P = 0.205) or OS (P = 0.541). In the subgroup analysis, UCBT has an added benefit in patients with specific characteristics. Patients who experienced ≥2 relapses or with sustained non-remission (NR) showed better RFS (P = 0.025) after UCBT. Better EFS was seen in patients with poor prognostic markers (P = 0.027). In the subgroup with pre-infusion minimal residual disease (MRD) ≥5% or with extramedullary disease (EMD), UCBT significantly prolonged EFS (P = 0.009), RFS (P = 0.017), and OS (P = 0.026). Patients with occurrence of acute graft-versus-host disease (aGVHD) appeared to have a longer duration of remission (P = 0.007). Conclusion Consolidative UCBT can, to some extent, improve clinical outcomes of patients with R/R B-ALL entering remission following CD19 CAR-T therapy, especially in patients with more recurrences before treatment, patients with poor prognostic markers, and patients with a higher tumor burden. The occurrence of aGVHD after UCBT was associated with better RFS.
Collapse
Affiliation(s)
- Qianwen Xu
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Lei Xue
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Furun An
- Hematology Department, The Second Hospital of Anhui Medical University (SHAMU), Hefei, China
| | - Hui Xu
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Li Wang
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Liangquan Geng
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xuhan Zhang
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Kaidi Song
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Wen Yao
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiang Wan
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Juan Tong
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Huilan Liu
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xin Liu
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiaoyu Zhu
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Zhimin Zhai
- Hematology Department, The Second Hospital of Anhui Medical University (SHAMU), Hefei, China
| | - Zimin Sun
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xingbing Wang
- Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China (USCT) (Anhui Provincial Hospital), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| |
Collapse
|
4
|
Jiang H, Li C, Yin P, Guo T, Liu L, Xia L, Wu Y, Zhou F, Ai L, Shi W, Lu X, Wang H, Tang L, Wei Q, Deng J, Jin R, Xiong W, Dong J, Mei H, Hu Y. Anti-CD19 chimeric antigen receptor-modified T-cell therapy bridging to allogeneic hematopoietic stem cell transplantation for relapsed/refractory B-cell acute lymphoblastic leukemia: An open-label pragmatic clinical trial. Am J Hematol 2019; 94:1113-1122. [PMID: 31321805 DOI: 10.1002/ajh.25582] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/12/2019] [Accepted: 07/13/2019] [Indexed: 12/24/2022]
Abstract
Chimeric antigen receptor-modified T-cell (CAR-T) therapy is effective and safe for patients with relapsed/refractory B-cell acute lymphoblastic leukemia (r/r B-ALL), but its value has been limited in terms of long-term leukemia-free survival. New strategies that can help CAR-T therapy achieve lasting effect are urgently warranted. This non-randomized interventional pragmatic clinical trial had a particular aim. It explored whether consolidative allogeneic hematopoietic stem cell transplantation (allo-HSCT) could improve the long-term prognosis of the minimal residual disease-negative complete remission (MRD- CR) patients after CAR-T therapy. In the first stage, 58 r/r B-ALL patients received split doses of CAR-T cells after lymphodepleting chemotherapy, and 51 (87.9%) achieved CR. In the second stage, 21/47 MRD- CR patients without previous allo-HSCT and contraindications or other restrictions, on their own accord, received consolidative allo-HSCT within three months after CAR-T therapy. There was no difference in overall survival (OS) between the MRD- CR patients who received allo-HSCT and those who did not. However, event-free survival (EFS) and relapse-free survival (RFS) were significantly prolonged by allo-HSCT in the subgroups. This was with either high (≥5%) pre-infusion bone marrow MRD assessed by flow cytometry (BM-FCM-MRD) or poor prognostic markers (P < .05). However, no difference was found in EFS and RFS for patients with pre-infusion BM-FCM-MRD <5% and without poor prognostic markers (P > .05). To conclude, CAR-T therapy bridging to allo-HSCT is a safe and effective therapeutic strategy for r/r B-ALL patients, and may prolong their EFS and RFS, especially when they have high pre-infusion BM-FCM-MRD or poor prognostic markers.
Collapse
Affiliation(s)
- Huiwen Jiang
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Chenggong Li
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Ping Yin
- Department of Epidemiology and BiostatisticsSchool of Public Health, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430030 China
| | - Tao Guo
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Lin Liu
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Linghui Xia
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Yaohui Wu
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Fen Zhou
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Department of PediatricsUnion Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430022 China
| | - Lisha Ai
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Wei Shi
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Xuan Lu
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Huafang Wang
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Lu Tang
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Qiuzhe Wei
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
| | - Jun Deng
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Runming Jin
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Department of PediatricsUnion Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan 430022 China
| | - Wei Xiong
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Jian Dong
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Heng Mei
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical CollegeHuazhong University of Science and Technology Wuhan 430022 China
- Hubei Clinical Medical Center of Cell Therapy for Neoplastic Disease Wuhan 430022 China
| |
Collapse
|