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Bidet A, Dulucq S, Smol T, Marceau-Renaut A, Morisset S, Coiteux V, Noël-Walter MP, Nicolini FE, Tigaud I, Luquet I, Struski S, Gaillard B, Penther D, Tondeur S, Nadal N, Hermet E, Véronèse L, Réa D, Gervais C, Theisen O, Terré C, Cony-Makhoul P, Lefebvre C, Gaillard JB, Radford I, Vervaeke AL, Barin C, Chapiro E, Nguyen-Khac F, Etienne G, Preudhomme C, Mahon FX, Roche-Lestienne C. Poor prognosis of chromosome 7 clonal aberrations in Philadelphia-negative metaphases and relevance of potential underlying myelodysplastic features in chronic myeloid leukemia. Haematologica 2018; 104:1150-1155. [PMID: 30573507 PMCID: PMC6545846 DOI: 10.3324/haematol.2018.208801] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/18/2018] [Indexed: 11/30/2022] Open
Abstract
Clonal chromosome abnormalities in Philadelphia-negative cells could concern chronic myeloid leukemia patients treated by tyrosine kinase inhibitors. The European LeukemiaNet distinguishes -7/del(7q) abnormalities as a “warning”. However, the impact of clonal chromosome abnormalities, and specifically those of -7/del(7q), in Philadelphia-negative cells on clinical outcomes is unclear and based on case-reports showing morphological dysplasia and increased risk of acute myeloid leukemia, suggesting the coexistence of chronic myeloid leukemia and high-risk myelodysplastic syndrome. The aim of this study was to determine whether the impact of -7/del(7q) clonal chromosome abnormalities in Philadelphia-negative cells on the clinical outcome is different from that of other types of abnormalities, and we argue for an underlying associated high-risk myelodysplastic syndrome. Among 102 chronic myeloid leukemia patients with clonal chromosome abnormalities in Philadelphia-negative cells with more than a median of 6 years of follow up, patients with -7/del(7q) more frequently had signs of dysplasia, a lower cumulative incidence of deep molecular response and often needed further treatment lines, with the consequent impact on event-free and progression-free survival. Morphological features of dysplasia are associated with myelodysplastic syndrome/acute myeloid leukemia mutations and compromise the optimal response to tyrosine kinase inhibitors, irrespectively of the type of clonal chromosome abnormalities in Philadelphia-negative cells. However, mutation patterns determined by next-generation sequencing could not clearly explain the underlying high-risk disease. We hereby confirm the pejorative prognostic value of -7/del(7q) clonal chromosome abnormalities in Philadelphia-negative cells and suggest that myelodysplastic features constitute a warning signal that response to tyrosine kinase inhibitors may be less than optimal.
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Affiliation(s)
| | | | - Thomas Smol
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille.,Centre de Recherche Jean-Pierre Aubert, UMR-S 1172, Université de Lille
| | - Alice Marceau-Renaut
- Institut d'Hématologie, Centre de Biologie Pathologie Génétique, CHU Lille.,Inserm, UMR-S 1172, Lille
| | | | - Valérie Coiteux
- Service des Maladies du Sang, Hôpital Claude Huriez, CHU Lille
| | | | - Franck-Emmanuel Nicolini
- Département d'Hématologie, Centre Léon Bérard, Lyon.,Inserm U1052, Centre de Recherche en Cancérologie, Centre Léon Bérard, Lyon
| | - Isabelle Tigaud
- Laboratoire de Cytogénétique et de Biologie Moléculaire, Service d'Hématologie Biologique - CBPAS, GHS - Hospices Civils de Lyon, Pierre-Bénite Cedex, France
| | - Isabelle Luquet
- Laboratoire d'Hématologie, Plateau Technique Hématologie-Oncologie, Institut Universitaire du Cancer de Tolouse Oncopole
| | - Stéphanie Struski
- Laboratoire d'Hématologie, Plateau Technique Hématologie-Oncologie, Institut Universitaire du Cancer de Tolouse Oncopole
| | | | - Dominique Penther
- Laboratoire de Génétique Oncologique, Centre de Lutte Contre le Cancer Henri Becquerel, Rouen
| | - Sylvie Tondeur
- Laboratoire d'Hématologie-Cytogénétique, CHU Saint-Etienne, Hôpital Nord, Saint-Etienne Cedex 2
| | - Nathalie Nadal
- Laboratoire de Génétique Chromosomique et Moléculaire, Plateau Technique de Biologie, CHU de Dijon
| | - Eric Hermet
- Service d'Hématologie Clinique, CHU Estaing, Clermont-Ferrand
| | | | - Delphine Réa
- Service Clinique des Maladies du Sang, Hôpital St Louis, Paris
| | - Carine Gervais
- Laboratoire Régional de Cytogénétique Hématologique d'Alsace, CHU de Haute Pierre, Strasbourg Cedex
| | - Olivier Theisen
- Laboratoire de Cytogénétique Hématologique, Plateau Technique Hôtel Dieu, Nantes
| | - Christine Terré
- Laboratoire de Cytogénétique du Centre Hospitalier Valence, Le Chesnay
| | | | - Christine Lefebvre
- Unité de Génétique des Hémopathies, Institut de Biologie et Pathologie, CHU Grenoble Alpes, Grenoble Cedex 9
| | | | - Isabelle Radford
- Laboratoire de Cytogénétique, Hôpital Necker - Enfants Malades, Paris
| | | | - Carole Barin
- Laboratoire de Cytogénétique Onco-Hématologie, Hôpital Bretonneau, Tours
| | - Elise Chapiro
- Service d'Hématologie Biologique, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris et Sorbonne Université, Paris
| | - Florence Nguyen-Khac
- Service d'Hématologie Biologique, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris et Sorbonne Université, Paris
| | - Gabriel Etienne
- Département d'Hématologie, Institut Bergonié, Bordeaux, France
| | - Claude Preudhomme
- Centre de Recherche Jean-Pierre Aubert, UMR-S 1172, Université de Lille.,Institut d'Hématologie, Centre de Biologie Pathologie Génétique, CHU Lille.,Inserm, UMR-S 1172, Lille
| | | | - Catherine Roche-Lestienne
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille .,Centre de Recherche Jean-Pierre Aubert, UMR-S 1172, Université de Lille.,Inserm, UMR-S 1172, Lille
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Jawad MD, Shi M, Oliveira JL, Hoyer JD, Christopher Hook C, Go RS. Clinical course of patients with incidental finding of 20q- in the bone marrow without a morphologic evidence of myeloid neoplasm. Am J Hematol 2016; 91:556-9. [PMID: 26928533 DOI: 10.1002/ajh.24347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 02/19/2016] [Accepted: 02/23/2016] [Indexed: 01/17/2023]
Abstract
Deletion of the long arm of chromosome 20 (20q-) is a frequent finding in bone marrow karyotypes, mainly associated with myeloid neoplasms (MNs). Its clinical significance in the setting of normal bone marrow morphology is unclear. We described the clinical characteristics, cytogenetic findings, and outcome of 102 such patients seen at our institution from 2000-2014. Their median age was 66 years. The indication for bone marrow biopsy was either unexplained cytopenias (48%) or hematologic cancer staging/reevaluation (52%). In 88 (86%) patients, 20q- was an isolated finding. Thirty-nine (38%) patients previously received chemotherapy and 88 (86%) had cytopenias at the time of 20q- finding. After a median of 35 months, 12 (13%) patients developed MNs: 10 myelodysplastic syndromes, one acute myeloid leukemia and one myeloproliferative neoplasm. None of 14 patients with normal blood counts, but 7 of 35 (20%) with mild cytopenias, and 5 of 53 (9%) with moderate/severe cytopenias developed MNs. We did not find an association between the number of metaphases with 20q- and the development of MN. The incidental finding of 20q- in the bone marrow generally does not portend an early stage MN. Particularly, those without cytopenias at the time of diagnosis may have a good prognosis. Am. J. Hematol. 91:556-559, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Majd D. Jawad
- Division of Hematology; Mayo Clinic; Rochester Minnesota
| | - Min Shi
- Division of Hematopathology; Mayo Clinic; Rochester Minnesota
| | | | - James D. Hoyer
- Division of Hematopathology; Mayo Clinic; Rochester Minnesota
| | | | - Ronald S. Go
- Division of Hematology; Mayo Clinic; Rochester Minnesota
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Gniot M, Lewandowski K, Ratajczak B, Lewandowska M, Lehmann-Kopydłowska A, Jarmuż-Szymczak M, Komarnicki M. Transient presence of clonal chromosomal aberrations in Ph-negative cells in patients with chronic myeloid leukemia remaining in deep molecular response on tyrosine kinase inhibitor treatment. Cancer Genet 2014; 207:503-10. [PMID: 25496750 DOI: 10.1016/j.cancergen.2014.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 10/06/2014] [Accepted: 10/07/2014] [Indexed: 11/18/2022]
Abstract
Advancements in treatment of chronic myeloid leukemia (CML) turned this formerly fatal neoplasm into a manageable chronic condition. Therapy with tyrosine kinase inhibitors (TKIs) often leads to significant reduction of disease burden, known as the deep molecular response (DMR). Herein, we decided to analyze the cohort of CML patients treated in our center with TKIs, who obtain and retain DMR for a period longer than 24 months. The aim of the study was to evaluate the frequency of clonal cytogenetic aberrations in Philadelphia-negative (Ph-) cells in patients with DMR during TKI treatment. The analyzed data was obtained during routine molecular and cytogenetic treatment monitoring, using G-banded trypsin and Giemsa stain (GTG) karyotyping and reverse transcription quantitative PCR. We noticed that approximately 50% of patients (28 of 55) in DMR had, at some follow-up point, transient changes in the karyotype of their Ph- bone marrow cells. In 9.1% of cases (5 of 55), the presence of the same aberrations was observed at different time points. The most frequently appearing aberrations were monosomies of chromosomes 19, 20, 21, and Y. Statistical analysis suggests that the occurrence of such abnormalities in CML patients correlates with the TKI treatment time.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Chromosome Aberrations
- Cytogenetic Analysis
- Female
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative
- Male
- Middle Aged
- Philadelphia Chromosome
- Protein Kinase Inhibitors/therapeutic use
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Affiliation(s)
- Michał Gniot
- Department of Hematology, University of Medical Sciences, Szamarzewskiego, Poznan, Poland.
| | - Krzysztof Lewandowski
- Department of Hematology, University of Medical Sciences, Szamarzewskiego, Poznan, Poland
| | - Błażej Ratajczak
- Department of Hematology, University of Medical Sciences, Szamarzewskiego, Poznan, Poland
| | - Maria Lewandowska
- Department of Hematology, University of Medical Sciences, Szamarzewskiego, Poznan, Poland
| | | | - Małgorzata Jarmuż-Szymczak
- Department of Hematology, University of Medical Sciences, Szamarzewskiego, Poznan, Poland; Institute of Human Genetics, Polish Academy of Sciences, Strzeszynska, Poznan, Poland
| | - Mieczysław Komarnicki
- Department of Hematology, University of Medical Sciences, Szamarzewskiego, Poznan, Poland
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Lobetti-Bodoni C, Ferrero D, Genuardi E, Passera R, Bernocco E, Sia D, Grignani G, Crisà E, Monitillo L, Rocci A, Drandi D, Giai V, Zanni M, Boi M, Isaia G, Barbero D, Lunghi M, Abruzzese E, Radaelli F, Pini M, Pregno P, Carlo-Stella C, Gaidano G, Boccadoro M, Ladetto M. Telomere loss in Philadelphia-negative hematopoiesis after successful treatment of chronic myeloid leukemia: evidence for premature aging of the myeloid compartment. Mech Ageing Dev 2012; 133:479-88. [PMID: 22687638 DOI: 10.1016/j.mad.2012.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 04/11/2012] [Accepted: 05/29/2012] [Indexed: 01/08/2023]
Abstract
Telomere shortening, a well-known marker of aging and cellular stress, occurs under several conditions in the hematopoietic compartment, including aplastic anemia and following iatrogenic noxae. We decided to verify whether pathological telomere erosion also arises in restored Philadelphia-negative (Ph-negative) hematopoiesis following successful treatment of chronic myeloid leukemia (CML). Eighty-one CML patients in complete cytogenetic remission were compared to 76 age-matched healthy subjects. Myeloid cells of CML patients had shorter telomeres than controls (6521 bp vs 7233 bp, p<0.001). This difference was specific for the myeloid compartment, since it was not observed in lymphoid cells (6774 bp vs 6909 bp, p=0.620). Acquired Ph-negative cytogenetic abnormalities (p=0.010), lack of complete molecular remission (p=0.016) and age (p=0.013) were independent predictors of telomere shortening. Telomere dynamics were assessed over a median follow-up period of 22 months. We documented accelerated non-physiological ongoing telomere shortening in 17/59 CML patients (28%). Patients experiencing grade 2-4 hematological toxicity, during CML remission possessed significantly shorter telomeres compared to those lacking toxicity (p=0.005 for any toxicity, p=0.007 for anemia). CML patients suffer from significant and often ongoing telomere stress resulting in premature and selective aging of the myeloid compartment which might have long-term consequences on function and integrity of Ph-negative hematopoiesis.
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Affiliation(s)
- Chiara Lobetti-Bodoni
- Division of Hematology, University of Turin, A.O.U. San Giovanni Battista, Turin, Italy
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Georgiou G, Efthymiou A, Vardounioti I, Boutsikas G, Angelopoulou MK, Vassilakopoulos TP, Kyrtsonis MC, Plata E, Tofas P, Bitsani A, Bartzi V, Pessach I, Dimou M, Panayiotidis P. Development of acute myeloid leukemia with NPM1 mutation, in Ph-negative clone, during treatment of CML with imatinib. Leukemia 2011; 26:824-6. [PMID: 21986839 DOI: 10.1038/leu.2011.280] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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