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Ogana HA, Hurwitz S, Wei N, Lee E, Morris K, Parikh K, Kim YM. Targeting integrins in drug-resistant acute myeloid leukaemia. Br J Pharmacol 2024; 181:295-316. [PMID: 37258706 DOI: 10.1111/bph.16149] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/14/2023] [Accepted: 05/10/2023] [Indexed: 06/02/2023] Open
Abstract
Acute myeloid leukaemia (AML) continues to have a poor prognosis, warranting new therapeutic strategies. The bone marrow (BM) microenvironment consists of niches that interact with not only normal haematopoietic stem cells (HSC) but also leukaemia cells like AML. There are many adhesion molecules in the BM microenvironment; therein, integrins have been of central interest. AML cells express integrins that bind to ligands in the microenvironment, enabling adhesion of leukaemia cells in the microenvironment, thereby initiating intracellular signalling pathways that are associated with cell migration, cell proliferation, survival, and drug resistance that has been described to mediate cell adhesion-mediated drug resistance (CAM-DR). Identifying and targeting integrins in AML to interrupt interactions with the microenvironment have been pursued as a strategy to overcome CAM-DR. Here, we focus on the BM microenvironment and review the role of integrins in CAM-DR of AML and discuss integrin-targeting strategies. LINKED ARTICLES: This article is part of a themed issue on Cancer Microenvironment and Pharmacological Interventions. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v181.2/issuetoc.
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Affiliation(s)
- Heather A Ogana
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Samantha Hurwitz
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Nathan Wei
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Eliana Lee
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kayla Morris
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Karina Parikh
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Yong-Mi Kim
- Children's Hospital Los Angeles, Department of Pediatrics, Division of Hematology and Oncology, Cancer and Blood Disease Institute, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
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Lee S, Kang S, Eun Y, Kim H, Lee J, Koh EM, Cha HS. Increased risk of malignancy in patients with Takayasu's arteritis: a population-based cohort study in Korea. Sci Rep 2022; 12:22047. [PMID: 36543807 PMCID: PMC9772336 DOI: 10.1038/s41598-022-24324-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022] Open
Abstract
This study aimed to evaluate the relative risk of malignancy in patients with Takayasu's arteritis compared to that in the general population. This retrospective nationwide cohort study used data from the Korean Health Insurance Review and Assessment Service database. All newly diagnosed patients with Takayasu's arteritis were identified between January 2009 and December 2019. They were observed until the diagnosis of malignancy, death, or end of the observational period, December 2020. The standardized incidence ratios (SIRs) of the overall and site-specific malignancies were estimated and compared with the incidence of cancer in the general population retrieved from the National Cancer Registry. We identified 1449 newly diagnosed patients with Takayasu's arteritis during the observational period (9196 person-years). A total of 74, 66, and 8 patients had overall, solid, and hematologic malignancies, respectively. The risks of overall [SIR, 1.62; 95% confidence interval (CI) 1.27-2.03], solid (SIR, 1.51; 95% CI 1.17-1.92), and hematologic (SIR, 4.05; 95% CI 1.75-7.98) malignancies were increased compared to those in the general population. In solid malignancies, breast (SIR, 2.07; 95% CI 1.16-3.42) and ovarian (SIR, 4.45; 95% CI 1.21-11.39) cancers had an increased risk. In hematologic malignancies, the risk of myelodysplasia increased (SIR, 18.02; 95% CI 3.72-52.66). Immunosuppressive agent use was not associated with malignancy. There was no specific period when cancer more frequently occurred. An increased risk of malignancy was observed in patients with Takayasu's arteritis compared to that in the general population in this large-scale nationwide population study of Korean health insurance data.
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Affiliation(s)
- Seulkee Lee
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Seonyoung Kang
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Yeonghee Eun
- grid.264381.a0000 0001 2181 989XDivision of Rheumatology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyungjin Kim
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Jaejoon Lee
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Eun-Mi Koh
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
| | - Hoon-Suk Cha
- grid.264381.a0000 0001 2181 989XDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351 Republic of Korea
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Baakhlagh S, Kashani B, Zandi Z, Bashash D, Moradkhani M, Nasrollahzadeh A, Yaghmaei M, Mousavi SA, Ghaffari SH. Toll-like receptor 4 signaling pathway is correlated with pathophysiological characteristics of AML patients and its inhibition using TAK-242 suppresses AML cell proliferation. Int Immunopharmacol 2020; 90:107202. [PMID: 33278749 DOI: 10.1016/j.intimp.2020.107202] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Acute myeloid leukemia (AML) is one of the most severe blood cancers. Many studies have revealed that inflammation has an essential role in the progression of hematopoietic malignancies. Since the toll-like receptor 4 (TLR4) pathway, an important pathway involved in inflammation induction, has previously been associated with solid tumors, we hypothesized that it would be correlated with the pathophysiological characteristics of AML patients and could be considered as an anticancer target. METHOD We evaluated the mRNA expression of TLR4, MyD88, RelB, and NF-кB using qRT-PCR in bone-marrow samples of 40 AML patients categorized into four groups according to prognosis, cell type, age, and drug response. Next, we explored the expression of these genes in three AML cell lines (NB4, U937, and KG-1) and used TAK-242, a specific inhibitor of TLR4, to investigate whether this inhibition could suppress AML cell proliferation using cell-cycle analysis. The effect of TAK-242 on arsenic trioxide (ATO) cytotoxicity was also assessed. RESULT The results of qRT-PCR showed that most genes had higher expression in patients with poor prognosis or drug-resistant statues. They were also overexpressed in patients with less-differentiated cells. Moreover, TAK-242 inhibited cell proliferation of all the cell lines and altered their cell cycle distribution. It could also intensify the cytotoxicity of ATO in combination therapy. CONCLUSION In sum, the TLR4 pathway was related to pathophysiological characteristics of AML and its inhibition using TAK-242 could be considered as a promising treatment strategy in the TLR4 expressing AML cells, individually or in combination with ATO.
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Affiliation(s)
- Sedigheh Baakhlagh
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Kashani
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Zandi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Department of Medical Genetics, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Bashash
- Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Malihe Moradkhani
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Nasrollahzadeh
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Marjan Yaghmaei
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed A Mousavi
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed H Ghaffari
- Hematology, Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Cancer Incidence Among Air Transportation Industry Workers Using the National Cohort Study of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162906. [PMID: 31416127 PMCID: PMC6727080 DOI: 10.3390/ijerph16162906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/27/2022]
Abstract
Background: There are increasing concerns regarding increased cancer risks in professional flight attendants due to their exposure to occupational hazards that are known or suspected to be carcinogenic. In this study, we aimed to analyze various cancer risks among a cohort of Korean air transportation industry workers. Methods: We used data from the Korean National Health Insurance Service (NHIS) database from 2002 to 2015. The age-standardized incidence ratios (SIRs) for all types of cancers in the aircraft transport industry workers compared to government employees and the entire employee population were calculated with adjustment for five-year age ranges via the indirect standardized method with gender stratification. Results: Leukemia (ICD-10; C91–C95) showed significantly higher SIRs (95% confidence interval (CI)) compared to the government employee group (1.86, 1.15–2.84) and the whole employee group (1.77, 1.10–2.70). Conclusion: Air transportation industry workers have an increased risk of leukemia compared to other occupational groups.
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Ueda N, Fujita K, Okuno Y, Nakatani K, Mio T. Therapy-related acute myeloid leukemia after chemotherapy in extensive disease-small cell lung cancer. Clin Case Rep 2019; 7:100-103. [PMID: 30656018 PMCID: PMC6332741 DOI: 10.1002/ccr3.1931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 10/09/2018] [Accepted: 10/31/2018] [Indexed: 11/07/2022] Open
Abstract
We experienced therapy-related acute myeloid leukemia (t-AML) in a patient with extensive disease-small cell lung cancer (ED-SCLC). This case is rare and has educational message because ED-SCLC has a poor prognosis and often cannot survive until developing therapy related hematological malignancy. Furthermore this case had unique chromosomal abnormalities. With recent advances in chemotherapy and radiotherapy, the prognosis of lung cancer has improved, while t-AML has been increasing in frequency.
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Affiliation(s)
- Naoko Ueda
- Division of Respiratory Medicine, Center for Respiratory DiseasesNational Hospital Organization Kyoto Medical CenterKyotoJapan
- Department of NephrologyNational Hospital Organization Kyoto Medical CenterKyotoJapan
| | - Kohei Fujita
- Division of Respiratory Medicine, Center for Respiratory DiseasesNational Hospital Organization Kyoto Medical CenterKyotoJapan
| | - Yoshiaki Okuno
- Department of HaematologyNational Hospital Organization Kyoto Medical CenterKyotoJapan
| | - Koichi Nakatani
- Division of Respiratory Medicine, Center for Respiratory DiseasesNational Hospital Organization Kyoto Medical CenterKyotoJapan
| | - Tadashi Mio
- Division of Respiratory Medicine, Center for Respiratory DiseasesNational Hospital Organization Kyoto Medical CenterKyotoJapan
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Koeffler HP, Leong G. Preleukemia: one name, many meanings. Leukemia 2016; 31:534-542. [PMID: 27899806 PMCID: PMC5339433 DOI: 10.1038/leu.2016.364] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/11/2016] [Accepted: 11/14/2016] [Indexed: 12/15/2022]
Abstract
Definition of preleukemia has evolved. It was first used to describe the myelodysplastic syndrome (MDS) with a propensity to progress to acute myeloid leukemia (AML). Individuals with germline mutations of either RUNX1, CEBPA, or GATA2 can also be called as preleukemic because they have a markedly increased incidence of evolution into AML. Also, alkylating chemotherapy or radiation can cause MDS/preleukemia, which nearly always progress to AML. More recently, investigators noted that AML patients who achieved complete morphological remission after chemotherapy often have clonal hematopoiesis predominantly marked by either DNMT3A, TET2 or IDH1/2 mutations, which were also present at diagnosis of AML. This preleukemic clone represents involvement of an early hematopoietic stem cells, which is resistant to standard therapy. The same clonal hematopoietic mutations have been identified in older ‘normal' individuals who have a modest increased risk of developing frank AML. These individuals have occasionally been said, probably inappropriately, to have a preleukemia clone. Our evolving understanding of the term preleukemia has occurred by advancing technology including studies of X chromosome inactivation, cytogenetics and more recently deep nucleotide sequencing.
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Affiliation(s)
- H P Koeffler
- Department of Hematology and Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.,Cancer Science Institute of Singapore, National University of Singapore, Singapore.,National University Cancer Institute of Singapore, National University Hospital, Singapore
| | - G Leong
- Cancer Science Institute of Singapore, National University of Singapore, Singapore
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7
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Matsuo M, Iwanaga M, Kondo H, Soda M, Jo T, Horio K, Takasaki Y, Kawaguchi Y, Tsushima H, Imaizumi Y, Imanishi D, Taguchi J, Sawayama Y, Hata T, Miyazaki Y. Clinical features and prognosis of patients with myelodysplastic syndromes who were exposed to atomic bomb radiation in Nagasaki. Cancer Sci 2016; 107:1484-1491. [PMID: 27487572 PMCID: PMC5084675 DOI: 10.1111/cas.13025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 07/19/2016] [Accepted: 07/27/2016] [Indexed: 01/19/2023] Open
Abstract
There is evidence that radiation exposure is a causative factor of myelodysplastic syndromes (MDS). However, little is known about whether radiation exposure is also a prognostic factor of MDS. We investigated the impact of radiation exposure on the prognosis of MDS in Nagasaki atomic bomb survivors using the International Prognostic Scoring System (IPSS) and the revised version (IPSS‐R). Subjects were 140 patients with primary MDS diagnosed between 1985 and 2011 and evaluable for IPSS, IPSS‐R, and exposure distance. Of those, 31 were exposed at <1.5 km, 35 at 1.5–2.99 km, and 74 at ≥3.0 km. By the end of March 2014, 47 patients (34%) progressed to overt leukemia and 106 (75.7%) died. By comparing with patients exposed at ≥3.0 km, those exposed at <1.5 km had significantly higher frequencies of abnormal chromosome (P = 0.02), intermediate/poor IPSS, and intermediate/poor/very poor IPSS‐R cytogenetic category (P = 0.0001, and P < 0.0001, respectively). As with de novo MDS, multivariate Cox regression analyses revealed that cytogenetic abnormalities, IPSS karyotype, and IPSS‐R cytogenetics were significantly associated with poor survival, and cumulative incidence of leukemic transformation in MDS among atomic bomb survivors, but exposure distance was not associated with any poor outcomes. These suggest that exposure to the greater dose of atomic bomb radiation is associated with developing poor cytogenetic abnormalities in MDS, which might consequently lead to overt leukemia among atomic bomb survivors.
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Affiliation(s)
- Masatoshi Matsuo
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masako Iwanaga
- Department of Frontier Life Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Hisayoshi Kondo
- Division of Scientific Data Registry, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Midori Soda
- Nagasaki Prefectural Cancer Registry, Nagasaki, Japan.,Department of Epidemiology, Radiation Effects Research Foundation, Nagasaki, Japan
| | - Tatsuro Jo
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kensuke Horio
- Department of Hematology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Yumi Takasaki
- Department of Internal Medicine, St. Francis Hospital, Nagasaki, Japan
| | - Yasuhisa Kawaguchi
- Department of Internal Medicine, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan
| | - Hideki Tsushima
- Department of Internal Medicine, Nagasaki Harbor Medical Center City Hospital, Nagasaki, Japan
| | | | - Daisuke Imanishi
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Jun Taguchi
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Sawayama
- Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomoko Hata
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan
| | - Yasushi Miyazaki
- Department of Hematology, Atomic Bomb Disease and Hibakusya Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan. .,Department of Hematology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. .,Department of Hematology, Nagasaki University Hospital, Nagasaki, Japan.
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8
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Lymphohematopoietic cancers induced by chemicals and other agents and their implications for risk evaluation: An overview. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2014; 761:40-64. [PMID: 24731989 DOI: 10.1016/j.mrrev.2014.04.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 04/02/2014] [Accepted: 04/03/2014] [Indexed: 12/13/2022]
Abstract
Lymphohematopoietic neoplasia are one of the most common types of cancer induced by therapeutic and environmental agents. Of the more than 100 human carcinogens identified by the International Agency for Research on Cancer, approximately 25% induce leukemias or lymphomas. The objective of this review is to provide an introduction into the origins and mechanisms underlying lymphohematopoietic cancers induced by xenobiotics in humans with an emphasis on acute myeloid leukemia, and discuss the implications of this information for risk assessment. Among the agents causing lymphohematopoietic cancers, a number of patterns were observed. Most physical and chemical leukemia-inducing agents such as the therapeutic alkylating agents, topoisomerase II inhibitors, and ionizing radiation induce mainly acute myeloid leukemia through DNA-damaging mechanisms that result in either gene or chromosomal mutations. In contrast, biological agents and a few immunosuppressive chemicals induce primarily lymphoid neoplasms through mechanisms that involve alterations in immune response. Among the environmental agents examined, benzene was clearly associated with acute myeloid leukemia in humans, with increasing but still limited evidence for an association with lymphoid neoplasms. Ethylene oxide and 1,3-butadiene were linked primarily to lymphoid cancers. Although the association between formaldehyde and leukemia remains controversial, several recent evaluations have indicated a potential link between formaldehyde and acute myeloid leukemia. The four environmental agents examined in detail were all genotoxic, inducing gene mutations, chromosomal alterations, and/or micronuclei in vivo. Although it is clear that rapid progress has been made in recent years in our understanding of leukemogenesis, many questions remain for future research regarding chemically induced leukemias and lymphomas, including the mechanisms by which the environmental agents reviewed here induce these diseases and the risks associated with exposures to such agents.
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Pukkala E, Helminen M, Haldorsen T, Hammar N, Kojo K, Linnersjö A, Rafnsson V, Tulinius H, Tveten U, Auvinen A. Cancer incidence among Nordic airline cabin crew. Int J Cancer 2012; 131:2886-97. [PMID: 22447246 DOI: 10.1002/ijc.27551] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Accepted: 03/05/2012] [Indexed: 11/11/2022]
Abstract
Airline cabin crew are occupationally exposed to cosmic radiation and jet lag with potential disruption of circadian rhythms. This study assesses the influence of work-related factors in cancer incidence of cabin crew members. A cohort of 8,507 female and 1,559 male airline cabin attendants from Finland, Iceland, Norway and Sweden was followed for cancer incidence for a mean follow-up time of 23.6 years through the national cancer registries. Standardized incidence ratios (SIRs) were defined as ratios of observed and expected numbers of cases. A case-control study nested in the cohort (excluding Norway) was conducted to assess the relation between the estimated cumulative cosmic radiation dose and cumulative number of flights crossing six time zones (indicator of circadian disruption) and cancer risk. Analysis of breast cancer was adjusted for parity and age at first live birth. Among female cabin crew, a significantly increased incidence was observed for breast cancer [SIR 1.50, 95% confidence interval (95% CI) 1.32-1.69], leukemia (1.89, 95% CI 1.03-3.17) and skin melanoma (1.85, 95% CI 1.41-2.38). Among men, significant excesses in skin melanoma (3.00, 95% CI 1.78-4.74), nonmelanoma skin cancer (2.47, 95% CI 1.18-4.53), Kaposi sarcoma (86.0, 95% CI 41.2-158) and alcohol-related cancers (combined SIR 3.12, 95% CI 1.95-4.72) were found. This large study with complete follow-up and comprehensive cancer incidence data shows an increased incidence of several cancers, but according to the case-control analysis, excesses appear not to be related to the cosmic radiation or circadian disruptions from crossing multiple time zones.
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Affiliation(s)
- Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
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Yonal I, Hindilerden F, Ozcan E, Palanduz S, Aktan M. The co-presence of deletion 7q, 20q and inversion 16 in therapy-related acute myeloid leukemia developed secondary to treatment of breast cancer with cyclophosphamide, doxorubicin, and radiotherapy: a case report. J Med Case Rep 2012; 6:67. [PMID: 22339850 PMCID: PMC3327634 DOI: 10.1186/1752-1947-6-67] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 02/16/2012] [Indexed: 11/20/2022] Open
Abstract
Introduction Therapy-related acute myeloid leukemia occurs as a complication of treatment with chemotherapy, radiotherapy, immunosuppressive agents or exposure to environmental carcinogens. Case presentation We report a case of therapy-related acute myeloid leukemia in a 37-year-old Turkish woman in complete remission from breast cancer. Our patient presented to our facility with fatigue, fever, sore throat, peripheral lymphadenopathy, and moderate hepatosplenomegaly. On peripheral blood and bone marrow aspirate smears, monoblasts were present. Immunophenotypic analysis of the bone marrow showed expression of CD11b, CD13, CD14, CD15, CD33, CD34, CD45 and human leukocyte antigen-DR, findings compatible with the diagnosis of acute monoblastic leukemia (French-American-British classification M5a). Therapy-related acute myeloid leukemia developed three years after adjuvant chemotherapy consisting of an alkylating agent, cyclophosphamide and DNA topoisomerase II inhibitor, doxorubicin and adjuvant radiotherapy. Cytogenetic analysis revealed a 46, XX, deletion 7 (q22q34), deletion 20 (q11.2q13.1) karyotype in five out of 20 metaphases and inversion 16 was detected by fluorescence in situhybridization. There was no response to chemotherapy (cytarabine and idarubicin, FLAG-IDA protocol, azacitidine) and our patient died in the 11th month after diagnosis. Conclusions The median survival in therapy-related acute myeloid leukemia is shorter compared to de novoacute myeloid leukemia. Also, the response to therapy is poor. In therapy-related acute myeloid leukemia, complex karyotypes have been associated with abnormalities of chromosome 5, rather than 7. To the best of our knowledge, this is the first case of therapy-related acute myeloid leukemia showing the co-presence of deletion 7q, 20q and the inversion 16 signal.
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Affiliation(s)
- Ipek Yonal
- Istanbul University Istanbul Medical Faculty, Department of Internal Medicine, Division of Hematology, Istanbul, Turkey.
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11
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Iwanaga M, Hsu WL, Soda M, Takasaki Y, Tawara M, Joh T, Amenomori T, Yamamura M, Yoshida Y, Koba T, Miyazaki Y, Matsuo T, Preston DL, Suyama A, Kodama K, Tomonaga M. Risk of Myelodysplastic Syndromes in People Exposed to Ionizing Radiation: A Retrospective Cohort Study of Nagasaki Atomic Bomb Survivors. J Clin Oncol 2011; 29:428-34. [PMID: 21149671 DOI: 10.1200/jco.2010.31.3080] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose The risk of myelodysplastic syndromes (MDS) has not been fully investigated among people exposed to ionizing radiation. We investigate MDS risk and radiation dose-response in Japanese atomic bomb survivors. Patients and Methods We conducted a retrospective cohort study by using two databases of Nagasaki atomic bomb survivors: 64,026 people with known exposure distance in the database of Nagasaki University Atomic-Bomb Disease Institute (ABDI) and 22,245 people with estimated radiation dose in the Radiation Effects Research Foundation Life Span Study (LSS). Patients with MDS diagnosed from 1985 to 2004 were identified by record linkage between the cohorts and the Nagasaki Prefecture Cancer Registry. Cox and Poisson regression models were used to estimate relationships between exposure distance or dose and MDS risk. Results There were 151 patients with MDS in the ABDI cohort and 47 patients with MDS in the LSS cohort. MDS rate increased inversely with exposure distance, with an excess relative risk (ERR) decay per km of 1.2 (95% CI, 0.4 to 3.0; P < .001) for ABDI. MDS risk also showed a significant linear response to exposure dose level (P < .001) with an ERR per Gy of 4.3 (95% CI, 1.6 to 9.5; P < .001). After adjustment for sex, attained age, and birth year, the MDS risk was significantly greater in those exposed when young. Conclusion A significant linear radiation dose-response for MDS exists in atomic bomb survivors 40 to 60 years after radiation exposure. Clinicians should perform careful long-term follow-up of irradiated people to detect MDS as early as possible.
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Affiliation(s)
- Masako Iwanaga
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Wan-Ling Hsu
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Midori Soda
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Yumi Takasaki
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Masayuki Tawara
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Tatsuro Joh
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Tatsuhiko Amenomori
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Masaomi Yamamura
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Yoshiharu Yoshida
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Takashi Koba
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Yasushi Miyazaki
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Tatsuki Matsuo
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Dale L. Preston
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Akihiko Suyama
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Kazunori Kodama
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
| | - Masao Tomonaga
- From the Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Science; Kwassui Women's College; Radiation Effects Research Foundation; Japanese Red Cross Nagasaki Genbaku Hospital; St. Francis Hospital; Nagasaki Municipal Hospital; Nagasaki Atomic Bomb Casualty Council Health Management Center; and Nagasaki Municipal Medical Center, Nagasaki; Radiation Effects Research Foundation, Hiroshima, Japan; and Hirosoft International, Seattle, WA
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12
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Liu SV, Zneimer S, Tahbaz A, Douer D. Therapy-related acute myeloid leukemia following treatment with trabectedin for Ewing's sarcoma. Acta Haematol 2011; 126:76-8. [PMID: 21502754 DOI: 10.1159/000324936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 02/08/2011] [Indexed: 12/28/2022]
Affiliation(s)
- Stephen V Liu
- Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA 90033, USA
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13
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Abstract
The treatment and survival outcome of acute leukemia in women is generally similar to that of men. However, acute leukemia in women poses additional challenges in clinical practice. In addition to important precautions during therapy, such as prevention of abnormal uterine bleeding in premenopausal women and therapy during pregnancy, women who are survivors of acute leukemia face unique and potentially long-term health-related problems. In this review, we address the aforementioned issues, as well as the various health and psychosocial challenges faced by women who survive childhood leukemia during their path to adulthood. Finally, we address the issue of therapy-related acute leukemia in the category of women who are survivors of breast and ovarian cancer.
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14
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Abstract
The treatment of acute leukemia is usually similar in women and men. The outcome is also generally the same. However, diagnosis in women poses additional challenges in clinical practice such as leukemia following breast or ovarian cancers, prevention of abnormal uterine bleeding in premenopausal females, treatment during pregnancy related-problems in long-term survivors. All these special issues are addressed in this review of the literature.
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15
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Kushner BH, Kramer K, Modak S, Qin LX, Yataghena K, Jhanwar SC, Cheung NKV. Reduced risk of secondary leukemia with fewer cycles of dose-intensive induction chemotherapy in patients with neuroblastoma. Pediatr Blood Cancer 2009; 53:17-22. [PMID: 19148951 PMCID: PMC4079040 DOI: 10.1002/pbc.21931] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND We report a prospective study of secondary leukemia (SL)/myelodysplastic syndrome (MDS) in neuroblastoma (NB) patients treated with > or =5 cycles of dose-intensive chemotherapy. PROCEDURE NB patients received induction with high-dose cyclophosphamide (4,200 mg/m(2))-doxorubicin (75 mg/m(2))-vincristine (cycles 1, 2, 4, 6, 8), and high-dose cisplatin (200 mg/m(2))-etoposide (600 mg/m(2)) (cycles 3, 5, 7). Bone marrow was examined every 1-3 months for > or =36 months, with inclusion of extensive chromosomal studies 1-3 months post-induction and 1-2x/year thereafter. RESULTS One hundred eight four patients received 5 (n = 76), 6 (n = 45), 7 (n = 59), or 8 (n = 4) cycles. Eight patients developed SL/MDS (only one each in the 5- and 6-cycle groups), at 12-50 months, including two cases detected in surveillance studies. Among 108 patients who received > or =6 cycles, the 5-year cumulative incidence was 7.1% (95% CI: 2%, 12.2%), versus 0% among 54 patients who received 5 cycles without maintenance oral etoposide. Five-year cumulative incidences were 1.46%, 2.28%, and 8.47% among patients in the 5-, 6-, and 7-cycle groups, with fewer cycles having a significantly lower risk (P = 0.048). There was no significant association of risk with potentially leukemogenic consolidative treatments (targeted radiotherapy, myeloablative therapy, and oral etoposide). CONCLUSIONS Reducing the number of dose-intensive cycles significantly decreases the risk of SL/MDS, yielding 5-year rates matching the low range (0.4-2.2%) reported for moderate-dose combination chemotherapy regimens used against other pediatric solid tumors.
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Affiliation(s)
- Brian H. Kushner
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Tel: 212-639-6793. Fax: 212-717-3239.
| | - Kim Kramer
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Tel: 212-639-6410. Fax: 212-717-3239.
| | - Shakeel Modak
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Tel: 212-639-7623. Fax: 212-717-3695.
| | - Li-Xuan Qin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, E. 63 Street, New York, NY 10065, Tel: 646-735-8116; Fax: 646-735-0010;
| | - Karima Yataghena
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Tel: 212-639-6140. Fax: 212-717-3492.
| | - Suresh C. Jhanwar
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Tel: 212-639-8895. Fax: 212-794-5830.
| | - Nai-Kong V. Cheung
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065. Tel: 646-888-2313. Fax: 212-744-2245.
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16
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Rajcan-Separovic E, Maguire J, Loukianova T, Nisha M, Kalousek D. Loss of 1p and 7p in radiation-induced meningiomas identified by comparative genomic hybridization. CANCER GENETICS AND CYTOGENETICS 2003; 144:6-11. [PMID: 12810249 DOI: 10.1016/s0165-4608(02)00864-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cytogenetic and molecular studies of radiation-induced meningiomas (RIM) are rare and controversial. While comparative genomic hybridization (CGH) analysis identified monosomy 22 as the predominant change in RIM, occurring in frequencies comparable to those found in spontaneous meningioma (SM), molecular genetic analysis shows infrequent loss of chromosome 22 DNA markers. We have performed CGH analysis of six additional cases of RIM and detected an unbalanced genome in five of 6 cases. Loss of 1p and 7p was identified in the majority of RIM with an abnormal karyotype (4/5 cases), whereas loss of 6q occurred in three of five cases. Only one of five RIM had monosomy for chromosome 22. Loss of 7p is not frequently reported in SM and yet it was detected in four of 5 RIM with an abnormal karyotype in our study. Molecular and cytogenetic studies of chromosome 7 copy number should be attempted on a larger number of RIM to further investigate the role of 7p loss in RIM.
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Affiliation(s)
- Evica Rajcan-Separovic
- Cytogenetics Laboratory, Department of Pathology, University of British Columbia, BC Children's Hospital, Vancouver, BC, Canada.
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17
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Relling MV, Boyett JM, Blanco JG, Raimondi S, Behm FG, Sandlund JT, Rivera GK, Kun LE, Evans WE, Pui CH. Granulocyte colony-stimulating factor and the risk of secondary myeloid malignancy after etoposide treatment. Blood 2003; 101:3862-7. [PMID: 12531808 DOI: 10.1182/blood-2002-08-2405] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Event-free survival for children with acute lymphoblastic leukemia (ALL) now exceeds 80% in the most effective trials. Failures are due to relapse, toxicity, and second cancers such as therapy-related myeloid leukemia or myelodysplasia (t-ML). Topoisomerase II inhibitors and alkylators can induce t-ML; additional risk factors for t-ML remain poorly defined. The occurrence of t-ML among children who had received granulocyte colony-stimulating factor (G-CSF) following ALL remission induction therapy prompted us to examine this and other putative risk factors for t-ML in 412 children treated on 2 consecutive ALL protocols from 1991 to 1998. All children received etoposide and anthracyclines, 99 of whom received G-CSF; 284 also received cyclophosphamide, 58 of whom also received cranial irradiation. There were 20 children who developed t-ML at a median of 2.3 years (range, 1.0-6.0 years), including 16 cases of acute myeloid leukemia, 3 myelodysplasia, and 1 chronic myeloid leukemia. Stratifying by protocol, the cumulative incidence functions differed (P =.017) according to the use of G-CSF and irradiation: 6-year cumulative incidence (standard error) of t-ML of 12.3% (5.3%) among the 44 children who received irradiation without G-CSF, 11.0% (3.5%) among the 85 children who received G-CSF but no irradiation, 7.1% (7.2%) among the 14 children who received irradiation plus G-CSF, and 2.7% (1.3%) among the 269 children who received neither irradiation nor G-CSF. Even when children receiving irradiation were excluded, the incidence was still higher in those receiving G-CSF (P =.019). In the setting of intensive antileukemic therapy, short-term use of G-CSF may increase the risk of t-ML.
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Affiliation(s)
- Mary V Relling
- Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA.
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18
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Pedersen-Bjergaard J, Christiansen DH, Andersen MK, Skovby F. Causality of myelodysplasia and acute myeloid leukemia and their genetic abnormalities. Leukemia 2002; 16:2177-84. [PMID: 12399959 DOI: 10.1038/sj.leu.2402764] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2002] [Accepted: 07/26/2002] [Indexed: 11/09/2022]
Abstract
New insights into causative factors for the development of myelodysplasia (MDS) and acute myeloid leukemia (AML), with associations to specific cytogenetic and genetic abnormalities have been obtained primarily from studies of patients with the therapy-related subsets of the two diseases. Current knowledge now makes it possible to distinguish between at least seven major genetic subgroups of MDS and AML, and has directed research towards more specific causative factors also for de novo MDS and AML.
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Affiliation(s)
- J Pedersen-Bjergaard
- Cytogenetic Laboratory, Section of Hematology/Oncology, Department of Clinical Genetics, Juliane Marie Center, University Hospital, Rigshospitalet, Copenhagen, Denmark
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19
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Affiliation(s)
- E Lynge
- University of Copenhagen, Institute of Public Health, Blegdamsvej 3,DK-2000, Copenhagen, Denmark.
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20
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Abstract
Cytogenetic abnormalities are seen in approximately 50% of cases of myelodysplastic syndrome (MDS) and 80% of cases of secondary MDS (following chemotherapy or radiotherapy). These abnormalities generally consist of partial or complete chromosome deletion or addition (del5q, -7, +8, -Y, del20q), whereas balanced or unbalanced translocations are rarely found in MDS. Fluorescence hybridization techniques (fluorescence in situ hybridization [FISH], multiplex FISH, and spectral karyotyping) are useful in detecting chromosomal anomalies in cases in which few mitoses are obtained or rearrangements are complex. Ras mutations are the molecular abnormalities most frequently found in MDS, followed by p15 gene hypermethylation, FLT3 duplications, and p53 mutations, but none of these abnormalities are specific for MDS. The rare cases of balanced translocations in MDS have allowed the identification of genes whose rearrangements appear to play a role in the pathogenesis of some cases of MDS. These genes include MDS1-EVI1 in t(3;3) or t(3;21) translocations, TEL in t(5;12), HIP1 in t(5;7), MLF1 in t(3;5), and MEL1 in t(1;3). Genes more frequently implicated in the pathogenesis of MDS cases, such as those involving del5q, remain unknown, although some candidate genes are currently being studied. Cytogenetic and known molecular abnormalities generally carry a poor prognosis in MDS and can be incorporated into prognostic scoring systems such as the International Prognostic Scoring System.
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