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Fatima N, Shen Y, Crassini K, Burling O, Thurgood L, Iwanowicz EJ, Lang H, Karanewsky DS, Christopherson RI, Mulligan SP, Best OG. The CIpP activator, TR-57, is highly effective as a single agent and in combination with venetoclax against CLL cells in vitro. Leuk Lymphoma 2024; 65:585-597. [PMID: 38227293 DOI: 10.1080/10428194.2023.2300055] [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: 10/24/2022] [Accepted: 12/11/2023] [Indexed: 01/17/2024]
Abstract
Despite advances in treatment, a significant proportion of patients with chronic lymphocytic leukemia (CLL) will relapse with drug-resistant disease. The imipridones, ONC-201 and ONC-212, are effective against a range of different cancers, including acute myeloid leukemia (AML) and tumors of the brain, breast, and prostate. These drugs induce cell death through activation of the mitochondrial protease, caseinolytic protease (CIpP), and the unfolded protein response (UPR). Here we demonstrate that the novel imipridone analog, TR-57, has efficacy as a single agent and synergises with venetoclax against CLL cells under in vitro conditions that mimic the tumor microenvironment. Changes in protein expression suggest TR-57 activates the UPR, inhibits the AKT and ERK1/2 pathways and induces pro-apoptotic changes in the expression of proteins of the BCL-2 family. The study suggests that TR-57, as a single agent and in combination with venetoclax, may represent an effective treatment option for CLL.
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MESH Headings
- Humans
- Sulfonamides/pharmacology
- Bridged Bicyclo Compounds, Heterocyclic/pharmacology
- Bridged Bicyclo Compounds, Heterocyclic/therapeutic use
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Apoptosis/drug effects
- Drug Synergism
- Cell Line, Tumor
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Unfolded Protein Response/drug effects
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Proto-Oncogene Proteins c-bcl-2/metabolism
- Proto-Oncogene Proteins c-bcl-2/genetics
- Signal Transduction/drug effects
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Affiliation(s)
- Narjis Fatima
- Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Camperdown, Australia
- School of Life and Environmental Sciences, University of Sydney, Camperdown, Australia
| | - Yandong Shen
- Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Camperdown, Australia
- School of Life and Environmental Sciences, University of Sydney, Camperdown, Australia
| | - Kyle Crassini
- Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Camperdown, Australia
| | - Olivia Burling
- Flinders Health and Medical Research Institute, Department of Genetics and Molecular Medicine, College of Medicine and Public Health, Flinders University, Camperdown, Australia
| | - Lauren Thurgood
- Flinders Health and Medical Research Institute, Department of Genetics and Molecular Medicine, College of Medicine and Public Health, Flinders University, Camperdown, Australia
| | | | - Henk Lang
- Madera Therapeutics, LLC, Cary, North Carolina, USA
| | | | | | - Stephen P Mulligan
- Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Camperdown, Australia
- School of Life and Environmental Sciences, University of Sydney, Camperdown, Australia
| | - O Giles Best
- Kolling Institute of Medical Research, Royal North Shore Hospital, University of Sydney, Camperdown, Australia
- School of Life and Environmental Sciences, University of Sydney, Camperdown, Australia
- Flinders Health and Medical Research Institute, Department of Genetics and Molecular Medicine, College of Medicine and Public Health, Flinders University, Camperdown, Australia
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2
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Ghergus D, Martin M, Knapp AM, Delmotte F, Joublin-Delavat A, Jung S, Schickel JN, Mendel I, Dupuis A, Drénou B, Ghesquières H, Salles G, Baseggio L, Herbrecht R, Korganow AS, Vallat L, Soulas-Sprauel P, Meffre E, Martin T. Normal B cells express ZAP70 in chronic lymphocytic leukemia: A link between autoimmunity and lymphoproliferation? Am J Hematol 2024; 99:48-56. [PMID: 37853951 DOI: 10.1002/ajh.27137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023]
Abstract
ZAP70 has a prognostic value in chronic lymphocytic leukemia (CLL), through altered B-cell receptor signaling, which is important in CLL pathogenesis. A good correlation between ZAP70 expression in CLL cells and the occurrence of autoimmune phenomena has been reported. Yet, the great majority of CLL-associated autoimmune cytopenia is due to polyclonal immunoglobulin (Ig) G synthesized by nonmalignant B cells, and this phenomenon is poorly understood. Here, we show, using flow cytometry, that a substantial percentage of CD5- nonmalignant B cells from CLL patients expresses ZAP70 compared with CD5- B cells from healthy subjects. This ZAP70 expression in normal B cells from CLL patients was also evidenced by the detection of ZAP70 mRNA at single-cell level with polyclonal Ig heavy- and light-chain gene transcripts. ZAP70+ normal B cells belong to various B-cell subsets and their presence in the naïve B-cell subset suggests that ZAP70 expression may occur during early B-cell development in CLL patients and potentially before malignant transformation. The presence of ZAP70+ normal B cells is associated with autoimmune cytopenia in CLL patients in our cohort of patients, and recombinant antibodies produced from these ZAP70+ nonmalignant B cells were frequently autoreactive including anti-platelet reactivity. These results provide a better understanding of the implication of ZAP70 in CLL leukemogenesis and the mechanisms of autoimmune complications of CLL.
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Affiliation(s)
- Dana Ghergus
- Strasbourg University, Strasbourg, France
- Department of Clinical Hematology, Hospices Civils de Lyon, Lyon, France
| | - Mickaël Martin
- Strasbourg University, Strasbourg, France
- Department of Clinical Immunology and Internal Medicine, Tertiary Center for Primary Immunodeficiency, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France
- Department of Internal Medicine, Poitiers University Hospital, Poitiers, France
| | | | - Fabien Delmotte
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Sophie Jung
- Strasbourg University, Strasbourg, France
- Faculty of Dentistry, Strasbourg University, Strasbourg, France
| | - Jean-Nicolas Schickel
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Arnaud Dupuis
- French Blood Institute of Strasbourg, Strasbourg, France
| | - Bernard Drénou
- Department of Hematology, Groupe Hospitalier de la Région Mulhouse Sud Alsace, Mulhouse, France
| | - Hervé Ghesquières
- Department of Clinical Hematology, Hospices Civils de Lyon, Lyon, France
| | - Gilles Salles
- Department of Clinical Hematology, Hospices Civils de Lyon, Lyon, France
| | - Lucile Baseggio
- Laboratory of Hematology, Hospices Civils de Lyon, Lyon, France
| | - Raoul Herbrecht
- Department of Hematology, Institut de Cancérologie Strasbourg Europe (ICANS), Strasbourg, France
- Strasbourg University, IINSERM UMR-S1113/IRFAC, Strasbourg, France
| | - Anne-Sophie Korganow
- Strasbourg University, Strasbourg, France
- Department of Clinical Immunology and Internal Medicine, Tertiary Center for Primary Immunodeficiency, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France
| | - Laurent Vallat
- Department of Molecular Genetics of Cancer, Strasbourg University Hospital and INSERM UMR-S1113, Strasbourg, France
| | - Pauline Soulas-Sprauel
- Strasbourg University, Strasbourg, France
- Faculty of Pharmacy, Strasbourg University, Strasbourg, France
| | - Eric Meffre
- Department of Immunobiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Thierry Martin
- Strasbourg University, Strasbourg, France
- Department of Clinical Immunology and Internal Medicine, Tertiary Center for Primary Immunodeficiency, National Reference Center for Systemic Autoimmune Diseases (CNR RESO), Strasbourg University Hospital, Strasbourg, France
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3
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Kislenko E, İncel A, Gawlitza K, Sellergren B, Rurack K. Towards molecularly imprinted polymers that respond to and capture phosphorylated tyrosine epitopes using fluorescent bis-urea and bis-imidazolium receptors. J Mater Chem B 2023; 11:10873-10882. [PMID: 37877301 DOI: 10.1039/d3tb01474f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Abstract
Early detection of cancer is essential for successful treatment and improvement in patient prognosis. Deregulation of post-translational modifications (PTMs) of proteins, especially phosphorylation, is present in many types of cancer. Therefore, the development of materials for the rapid sensing of low abundant phosphorylated peptides in biological samples can be of great therapeutic value. In this work, we have synthesised fluorescent molecularly imprinted polymers (fMIPs) for the detection of the phosphorylated tyrosine epitope of ZAP70, a cancer biomarker. The polymers were grafted as nanometer-thin shells from functionalised submicron-sized silica particles using a reversible addition-fragmentation chain-transfer (RAFT) polymerisation. Employing the combination of fluorescent urea and intrinsically cationic bis-imidazolium receptor cross-linkers, we have developed fluorescent sensory particles, showing an imprinting factor (IF) of 5.0. The imprinted polymer can successfully distinguish between phosphorylated and non-phosphorylated tripeptides, reaching lower micromolar sensitivity in organic solvents and specifically capture unprotected peptide complements in a neutral buffer. Additionally, we have shown the importance of assessing the influence of counterions present in the MIP system on the imprinting process and final material performance. The potential drawbacks of using epitopes with protective groups, which can co-imprint with targeted functionality, are also discussed.
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Affiliation(s)
- Evgeniia Kislenko
- Chemical and Optical Sensing Division, Bundesanstalt für Materialforschung und -prüfung (BAM), Richard-Willstätter-Str. 11, D-12489 Berlin, Germany.
| | - Anıl İncel
- Department of Biomedical Sciences, Faculty of Health and Society, Malmö University, SE-20506 Malmö, Sweden
| | - Kornelia Gawlitza
- Chemical and Optical Sensing Division, Bundesanstalt für Materialforschung und -prüfung (BAM), Richard-Willstätter-Str. 11, D-12489 Berlin, Germany.
| | - Börje Sellergren
- Department of Biomedical Sciences, Faculty of Health and Society, Malmö University, SE-20506 Malmö, Sweden
| | - Knut Rurack
- Chemical and Optical Sensing Division, Bundesanstalt für Materialforschung und -prüfung (BAM), Richard-Willstätter-Str. 11, D-12489 Berlin, Germany.
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4
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Abstract
PURPOSE OF REVIEW There have been significant advances in the treatment of relapsed/refractory chronic lymphocytic leukemia (CLL) over the past two decades. However, the intention of treatment remains control of the disease and delay of progression rather than a cure which remains largely elusive. Considering that CLL is mostly seen in older patients, there are multiple factors that play a role in the selection of CLL beyond the frontline treatment. Here, we review the concept of relapsed CLL, factors that predispose to relapse, and therapeutic options available to this patient population. We also review investigational therapies and provide a framework for selection of therapies in this setting. RECENT FINDINGS Targeted therapies with continuous BTK inhibitors (BTKi) or fixed duration venetoclax plus anti-CD20 monoclonal antibody therapy have established superiority over chemoimmunotherapy in relapsed CLL and have become the preferred standard of care treatment. The second-generation more selective BTK inhibitors (acalabrutinib and zanubrutinib) have shown improved safety profile compared to ibrutinib. However, resistance to the covalent BTK inhibitors may emerge and is commonly associated with mutations in BTK or other downstream enzymes. The novel non-covalent BTK inhibitors such as pirtobrutinib (Loxo-305) and nemtabrutinib (ARQ 531) are showing promising activities for relapsed CLL refractory to prior covalent BTKi. Other novel therapies such as chimeric antigen receptor (CAR) T cell therapy have also shown significant activities for relapsed and refractory CLL. Measurable residual disease (MRD) assessment has a growing importance in venetoclax-based limited-duration therapy and there is mounting evidence that MRD negativity improves outcomes. However, it remains to be seen if this will become an established clinically significant endpoint. Further, the optimal sequence of various treatment options remains to be determined. Patients with relapsed CLL now have more options for the treatment of the disease. The choice of therapy is best individualized especially in the absence of direct comparisons of targeted therapies, and the coming years will bring more data on the best sequence of use of the therapeutic agents.
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Affiliation(s)
- Oluwatobi Odetola
- Robert H. Lurie Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 805, Chicago, IL, 60611, USA.
| | - Shuo Ma
- Robert H. Lurie Comprehensive Cancer Center, Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 805, Chicago, IL, 60611, USA
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5
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Yu TY, Jhou HJ, Chen PH, Lee CH. Effect of Lenalidomide Maintenance in Chronic Lymphocytic Leukemia: A Meta-Analysis and Trial-Sequential Analysis. Curr Oncol 2022; 29:4245-4259. [PMID: 35735448 PMCID: PMC9222174 DOI: 10.3390/curroncol29060339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 12/02/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is the most common lymphoproliferative disease in adults. Despite durable responses and sustained remission rates to frontline therapy, CLL is still incurable within standard therapy and eventually relapses. Maintenance therapies aim to achieve deep remission. However, the efficacy and safety of lenalidomide maintenance are still debated. Randomized controlled trials published before March 2022 were retrieved from databases. Primary outcomes were progression-free survival (PFS) and overall survival (OS). Trial sequential analysis examined analytical power in primary outcomes. Secondary outcomes were Grade 3–4 neutropenia, treatment discontinuation (TD), serious adverse events (SAE), and fatal adverse events (FAE). Hazard (HR) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Four articles (733 patients) met the selection criteria. Lenalidomide maintenance was associated with a statistically significant effect in prolonging PFS (HR, 0.43; 95% CI, 0.28–0.68; I2 = 57%) and higher proportion of SAE (OR 4.64; 95% CI 2.96–7.26; I2 = 0%) and exhibited no difference in OS (HR, 0.62; 95% CI, 0.29–1.30; I2 = 52%) observation/placebo. It showed no significant difference compared with observation/placebo regarding Grade 3–4 neutropenia (OR 2.30; 95% CI 0.84–6.28; I2 = 81%), TD (OR 0.76; 95% CI 0.29–1.99; I2 = 84%), and FAE (OR 0.86; 95% CI 0.28–2.63; I2 = 0%). Lenalidomide maintenance can prolong PFS in CLL. Further studies should verify its effect on OS.
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Affiliation(s)
- Tsung-Ying Yu
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Hong-Jie Jhou
- Department of Neurology, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Po-Huang Chen
- Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: (P.-H.C.); (C.-H.L.); Tel.: +886-2-87923311 (P.-H.C. & C.-H.L.)
| | - Cho-Hao Lee
- Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- Correspondence: (P.-H.C.); (C.-H.L.); Tel.: +886-2-87923311 (P.-H.C. & C.-H.L.)
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6
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Greiner SM, Märklin M, Holzmayer S, Kaban K, Meyer S, Hinterleitner C, Tandler C, Hagelstein I, Jung G, Salih HR, Heitmann JS, Kauer J. Identification of CD105 (endoglin) as novel risk marker in CLL. Ann Hematol 2022; 101:773-780. [PMID: 35044512 PMCID: PMC8913466 DOI: 10.1007/s00277-022-04756-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 01/03/2022] [Indexed: 12/21/2022]
Abstract
Several genetic and clinical markers are established as prognostic factors in chronic lymphocytic leukemia (CLL). However, additional markers are needed for risk stratification. Flow cytometric analysis is a mainstay of CLL diagnostics, thus identification of novel prognostic surface markers can improve risk assessment without increasing burden for patients and physicians. Furthermore, surface molecules preferentially expressed in high-risk cases could serve as therapeutic targets for immunotherapy. CD105 (endoglin) is a TGF-beta coreceptor and activates endothelial cells in healthy tissues and cancer. In addition, it is expressed on healthy hematopoietic precursors as well as lymphoid and myeloid leukemias. In acute myeloid leukemia (AML), a CD105 antibody is successfully applied in clinical studies. In CLL, mRNA expression of the CD105 gene ENG reportedly correlates with other risk factors but failed to show significant correlation with overall survival. However, CD105 protein expression in CLL has never been studied. We here analyzed CD105 surface expression on CLL cells from 71 patients by flow cytometry and report for the first time that substantial levels of CD105 are detectable on CLL cells in 70.4% of patients. Using receiver operating characteristics, we established a cutoff of 5.99% positive cells to distinguish between low and high CD105 levels, the latter correlating with decreased time to first treatment and overall survival. High CD105 expression further correlates with CD38 expression. Our study identified membrane expression of CD105 as a potential risk marker and therapeutic target in high-risk CLL. However, multivariant analyses of large cohorts should be performed in confirmatory studies.
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Affiliation(s)
- Sarah M Greiner
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Melanie Märklin
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Samuel Holzmayer
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Kübra Kaban
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Sophie Meyer
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Clemens Hinterleitner
- Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany.,Department of Medical Oncology & Pneumology, University Hospital Tübingen, Tübingen, Germany
| | - Claudia Tandler
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Ilona Hagelstein
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Gundram Jung
- Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany.,Interfaculty Institute for Cell Biology, Department of Immunology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, University of Tübingen, Tübingen, Germany
| | - Helmut R Salih
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany
| | - Jonas S Heitmann
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany. .,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany.
| | - Joseph Kauer
- Clinical Collaboration Unit Translational Immunology, German Cancer Consortium (DKTK), Department of Internal Medicine, University Hospital Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", Eberhard Karls University, Tübingen, Germany.,Interfaculty Institute for Cell Biology, Department of Immunology, German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Partner Site Tübingen, University of Tübingen, Tübingen, Germany.,Department of Internal Medicine V. Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
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7
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Zhao J, He H, Guo Z, Liu Z. Molecularly Imprinted and Cladded Nanoparticles Provide Better Phosphorylation Recognition. Anal Chem 2021; 93:16194-16202. [PMID: 34839654 DOI: 10.1021/acs.analchem.1c04070] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Phosphorylation is one of the most frequently occurring post-translation modifications in mammals. Because abnormal protein phosphorylation is related to many diseases, phosphorylation analysis is essential for a sound understanding of protein phosphorylation and its relationship with diseases. Among several types of reagents for phosphorylation recognition, molecularly imprinted polymers (MIPs), as synthetic mimics of antibodies, have exhibited unique strengths that can overcome the drawbacks of biological reagents. However, the performance of current MIPs has remained unideal. Meanwhile, while the currently existing imprinting methods have permitted the production of several material formats, such as crushed particles and mesoporous nanoparticles, a general method allowing for the preparation of monodispersed molecularly imprinted nanoparticles has not been developed yet. Herein, we report a new approach called reverse microemulsion template docking surface imprinting and cladding (RMTD-SIC) for facile preparation of monodispersed imprinted nanoparticles for better phosphorylation recognition. Through rational design and controllable engineering, monodisperse imprinted and cladded nanoparticles specific to general phosphorylation and tyrosine phosphorylation were synthesized, which yield the highest imprinting factors as compared with published studies. The prepared nanomaterials exhibited excellent specificity and affinity, allowing for specific enrichment and improved mass spectrometric identification of target phosphorylated peptides from complex samples containing 100-fold more abundant interfering peptides. Therefore, the RMTD-SIC approach holds great potential for phosphorylation analysis and phosphorylation recognition-based applications.
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Affiliation(s)
- Jialing Zhao
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Hui He
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Zhanchen Guo
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Zhen Liu
- State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Nanjing University, Nanjing 210023, China
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8
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The future of laboratory testing in chronic lymphocytic leukaemia. Pathology 2021; 53:377-384. [PMID: 33678426 DOI: 10.1016/j.pathol.2021.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/31/2021] [Accepted: 01/31/2021] [Indexed: 01/24/2023]
Abstract
Chronic lymphocytic leukaemia (CLL) is a malignant lymphoproliferative disorder characterised by the accumulation of dysfunctional B-lymphocytes in the blood and lymphoid tissues. It is a clonally complex disease with a high degree of both intra-tumoural and inter-patient heterogeneity. This variability leads to a wide range of clinical outcomes and highlights the critical need for accurate prognostic tests in CLL. With the advent of a range of new targeted agents for CLL in recent years, there is also a clinical need for improved predictive tests to therapy. This review of laboratory testing in CLL focuses on emerging technologies for prognostication including single nucleotide polymorphism microarray for karyotypic analysis, targeted next generation sequencing analysis of the immunoglobulin heavy chain variable region gene as well as genes recurrently mutated in the disease such as TP53, and detection of minimal residual disease.
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9
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Fatima N, Shen Y, Crassini K, Iwanowicz EJ, Lang H, Karanewsky DS, Christopherson RI, Mulligan SP, Best OG. The ClpP activator ONC-212 (TR-31) inhibits BCL2 and B-cell receptor signaling in CLL. EJHAEM 2021; 2:81-93. [PMID: 35846080 PMCID: PMC9175891 DOI: 10.1002/jha2.160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 02/05/2023]
Abstract
Despite advances in therapy, a significant proportion of patients with chronic lymphocytic leukemia (CLL) relapse with drug resistant disease. Novel treatment approaches are required, particularly for high risk disease. The imipridones represent a new class of cancer therapy that has been investigated in pre-clinical and clinical trials against a range of different cancers. We investigated the effects of the imipridone, ONC-212, against CLL cells cultured under conditions that mimic aspects of the tumour microenvironment and a TP53ko CLL cell line (OSU-CLL-TP53ko). ONC-212 induced dose-dependent apoptosis, cell cycle arrest and reduced the migration of CLL cells in vitro, including cells from patients with TP53 lesions and OSU-CLL-TP53ko cells. The effects of ONC-212 were associated with protein changes consistent with activation of the mitochondrial protease, CIpP, and the integrated stress response. We also observed inhibition of pathways downstream of the B-cell receptor (BCR) (AKT and MAPK-ERK1/2) and a pro-apoptotic shift in the balance of proteins of the BCL2 family of proteins (BCL2, MCL1, BCLxL, BAX and NOXA). In conclusion, the study suggests ONC-212 may represent an effective treatment for high risk CLL disease by inhibiting multiple facets of the BCR signaling pathway and the pro-survival effects of the BCL2-family proteins.
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Affiliation(s)
- Narjis Fatima
- Kolling Institute of Medical ResearchRoyal North Shore HospitalUniversity of SydneySydneyAustralia
- School of Life and Environmental SciencesUniversity of SydneySydneyAustralia
| | - Yandong Shen
- Kolling Institute of Medical ResearchRoyal North Shore HospitalUniversity of SydneySydneyAustralia
- School of Life and Environmental SciencesUniversity of SydneySydneyAustralia
| | - Kyle Crassini
- Kolling Institute of Medical ResearchRoyal North Shore HospitalUniversity of SydneySydneyAustralia
| | | | - Henk Lang
- Madera TherapeuticsLLCCaryNorth Carolina
| | | | | | - Stephen P. Mulligan
- Kolling Institute of Medical ResearchRoyal North Shore HospitalUniversity of SydneySydneyAustralia
- School of Life and Environmental SciencesUniversity of SydneySydneyAustralia
| | - Oliver G. Best
- Kolling Institute of Medical ResearchRoyal North Shore HospitalUniversity of SydneySydneyAustralia
- School of Life and Environmental SciencesUniversity of SydneySydneyAustralia
- Department of Molecular Medicine and GeneticsFlinders Health and Medical Research Institute (FHMRI)College of Medicine and Public HealthFlinders UniversityAdelaideAustralia
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10
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Hampel PJ, Parikh SA, Call TG. Incorporating molecular biomarkers into the continuum of care in chronic lymphocytic leukemia. Leuk Lymphoma 2021; 62:1289-1301. [PMID: 33410372 DOI: 10.1080/10428194.2020.1869966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Chronic lymphocytic leukemia (CLL) is a mature B-cell malignancy characterized by marked heterogeneity. Discoveries in disease biology over the past two decades have helped explain clinical variability and heralded the arrival of the targeted therapy era. In this article, we review improvements in risk stratification which have coincided with this progress, including individual biomarkers and their incorporation into prognostic models. Amidst an ever-expanding list of biomarkers, we seek to bring focus to the essential tests to improve patient care and counseling at particular times in the disease course, beginning with prognosis at diagnosis. The majority of patients do not require treatment at the time of diagnosis, making time-to-first-treatment a key initial prognostic concern. Prognostic and predictive biomarkers are then considered at subsequent major junctures, including at the time of treatment initiation, while on therapy, and at the time of relapse on novel agents.
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Affiliation(s)
- Paul J Hampel
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sameer A Parikh
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Call
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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11
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Cruz-Mora A, Murrieta-Alvarez I, Olivares-Gazca JC, León-Peña A, Cantero-Fortiz Y, García-Navarrete YI, Sánchez-Valledor LF, Khalaf D, Ruiz-Delgado GJ, Ruiz-Argüelles GJ. Up to half of patients diagnosed with chronic lymphocytic leukemia in México may not require treatment. ACTA ACUST UNITED AC 2020; 25:156-159. [PMID: 32268849 DOI: 10.1080/16078454.2020.1749473] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Introduction: Although therapeutic choices for patients with chronic lymphocytic leukemia (CLL) were once limited, treatment of this disease has vastly improved in the last decades.Patients and methods: Consecutive CLL patients diagnosed in a single institution were analyzed. Treatment was withheld in persons with CLL Rai stage 0 or 1, until progression and in persons with stages 2-4, with a negative expression of ZAP-70 until progression. Between 1983 and 1991, patients were give chlorambucil and prednisone (CP); after 1991 fludarabine and cyclophosphamide (FC) and after 1998, rituximab and FC (FCR).Results: 98 patients with CLL were identified; 49 were followed for >3 months. 21 persons (43%) did not require treatment nor progressed; 14 received CP, 6 FC, 7 FCR and one rituximab. Median overall survival (OS) has not been reached, being above 247 months; median OS for patients given CP was 115 months, for FC above 132 months and for FCR above 136 months (p > 0.5).Conclusion: CLL seems to be less aggressive in Mexican mestizos than in Caucasians; 43% of patients do not need treatment at all.
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Affiliation(s)
- Antonio Cruz-Mora
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - Iván Murrieta-Alvarez
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - Juan Carlos Olivares-Gazca
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - Andrés León-Peña
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - Yahveth Cantero-Fortiz
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad de las Américas Puebla, Puebla, México
| | - Yarely Itzayana García-Navarrete
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - Luisa Fernanda Sánchez-Valledor
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad de las Américas Puebla, Puebla, México
| | - Dina Khalaf
- Medical School, Mc Master University, Hamilton, Canada
| | - Guillermo José Ruiz-Delgado
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad Popular Autónoma del Estado de Puebla, Puebla, México.,Laboratorios Ruiz, Puebla, México
| | - Guillermo José Ruiz-Argüelles
- Centro de Hematología y Medicina Interna de Puebla, Puebla, México.,Medical School, Universidad Popular Autónoma del Estado de Puebla, Puebla, México.,Laboratorios Ruiz, Puebla, México
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12
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Chen J, Moore A, Ringshausen I. ZAP-70 Shapes the Immune Microenvironment in B Cell Malignancies. Front Oncol 2020; 10:595832. [PMID: 33194762 PMCID: PMC7653097 DOI: 10.3389/fonc.2020.595832] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
Zeta-chain-associated protein kinase-70 (ZAP-70) is a tyrosine kinase mainly expressed in T cells, NK cells and a subset of B cells. Primarily it functions in T cell receptor (TCR) activation through its tyrosine kinase activity. Aberrant expression of ZAP-70 has been evidenced in different B cell malignancies, with high expression of ZAP-70 in a subset of patients with Chronic Lymphocytic Leukemia (CLL), associating with unfavorable disease outcomes. Previous studies to understand the mechanisms underlying this correlation have been focused on tumor intrinsic mechanisms, including the activation of B cell receptor (BCR) signaling. Recent evidence also suggests that ZAP-70, intrinsically expressed in tumor cells, can modulate the cross-talk between malignant B cells and the immune environment, implying a more complex role of ZAP-70 in the pathogenesis of B cell malignancies. Meanwhile, the indispensible roles of ZAP-70 in T cell and NK cell activation also demonstrate that the autologous expression of ZAP-70 in the immune environment can be a central target in modulation of tumor immunity. Here we review the evidences of the link between ZAP-70 and tumor immunology in the microenvironment in B cell malignancies. Considering an emerging role of immunotherapies in treating these conditions, understanding the distinct molecular functions of ZAP-70 in a broader cellular context could ultimately benefit patient care.
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Affiliation(s)
| | | | - Ingo Ringshausen
- Department of Haematology, Jeffrey Cheah Biomedical Centre, Wellcome Trust/MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
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13
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IBL-202 is synergistic with venetoclax in CLL under in vitro conditions that mimic the tumor microenvironment. Blood Adv 2020; 4:5093-5106. [PMID: 33085757 DOI: 10.1182/bloodadvances.2019001369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 09/06/2020] [Indexed: 10/23/2022] Open
Abstract
The B-cell receptor signaling pathway and dysregulation of the Bcl-2 family of proteins play crucial roles in the pathogenesis of chronic lymphocytic leukemia (CLL). Despite significant advances in the treatment of the disease, relapse and drug resistance are not uncommon. In the current study, we investigated the dual PI3/PIM kinase inhibitor IBL-202 in combination with venetoclax as a treatment option for CLL using both primary CLL cells and TP53-deficient OSU-CLL cells generated using the CRISPR-Cas9 system. IBL-202 and venetoclax were highly synergistic against primary CLL cells cocultured with CD40L fibroblasts (combination index [CI], 0.4, at a fractional effect of 0.9) and TP53-knockout (KO) OSU-CLL cells (CI, 0.5, at a fractional effect of 0.9). Synergy between the drugs was consistent, with a significant (P < .05) reduction in the 50% inhibitory concentration for both drugs. IBL-202 and venetoclax in combination induced cell-cycle arrest and slowed the proliferation of both wild-type and TP53-KO cell lines. The drug combination inhibited AKT phosphorylation, reduced expression of Bcl-xL and NF-κB, and increased the Noxa/Mcl-1 ratio. Downregulation of CXCR4 was consistent with inhibition of the SDF-1α-induced migratory capacity of CLL cells. Synergy between IBL-202 and venetoclax against primary CLL cells cultured under conditions that mimic the tumor microenvironment suggests this drug combination may be effective against CLL cells within the lymph nodes and bone marrow. Furthermore, the efficacy of the combination against the TP53-KO OSU-CLL cell line suggests the combination may be a highly effective treatment strategy for high-risk CLL.
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14
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Roy Chowdhury S, Bouchard EDJ, Saleh R, Nugent Z, Peltier C, Mejia E, Hou S, McFall C, Squires M, Hewitt D, Davidson L, Shen GX, Johnston JB, Doucette C, Hatch GM, Fernyhough P, Marshall A, Gibson SB, Dawe DE, Banerji V. Mitochondrial Respiration Correlates with Prognostic Markers in Chronic Lymphocytic Leukemia and Is Normalized by Ibrutinib Treatment. Cancers (Basel) 2020; 12:cancers12030650. [PMID: 32168755 PMCID: PMC7139649 DOI: 10.3390/cancers12030650] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 12/20/2022] Open
Abstract
Mitochondrial bioenergetics profiling, a measure of oxygen consumption rates, correlates with prognostic markers and can be used to assess response to therapy in chronic lymphocytic leukemia (CLL) cells. In this study, we measured mitochondrial respiration rates in primary CLL cells using respirometry to evaluate mitochondrial function. We found significant increases in mitochondrial respiration rates in CLL versus control B lymphocytes. We also observed amongst CLL patients that advanced age, female sex, zeta-chain-associated protein of 70 kD (ZAP-70+), cluster of differentiation 38 (CD38+), and elevated β2-microglobulin (β2-M) predicted increased maximal respiration rates. ZAP-70+ CLL cells exhibited significantly higher bioenergetics than B lymphocytes or ZAP-70− CLL cells and were more sensitive to the uncoupler, carbonyl cyanide-p-trifluoro-methoxyphenylhydrazone (FCCP). Univariable and multivariable linear regression analysis demonstrated that ZAP-70+ predicted increased maximal respiration. ZAP-70+ is a surrogate for B cell receptor (BCR) activation and can be targeted by ibrutinib, which is a clinically approved Bruton’s tyrosine kinase (BTK) inhibitor. Therefore, we evaluated the oxygen consumption rates (OCR) of CLL cells and plasma chemokine (C-C motif) ligands 3 and 4 (CCL3/CCL4) levels from ibrutinib-treated patients and demonstrated decreased OCR similar to control B lymphocytes, suggesting that ibrutinib treatment resets the mitochondrial bioenergetics, while diminished CCL3/CCL4 levels indicate the down regulation of the BCR signaling pathway in CLL. Our data support evaluation of mitochondrial respiration as a preclinical tool for the response assessment of CLL cells.
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Affiliation(s)
- Subir Roy Chowdhury
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Eric D. J. Bouchard
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Ryan Saleh
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Zoann Nugent
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Cheryl Peltier
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Edgard Mejia
- Departments of Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada; (E.M.); (S.H.); (A.M.)
| | - Sen Hou
- Departments of Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada; (E.M.); (S.H.); (A.M.)
| | - Carly McFall
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Mandy Squires
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Donna Hewitt
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Linda Davidson
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
| | - Garry X. Shen
- Departments of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada; (C.D.); (G.M.H.)
| | - James B. Johnston
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
- Departments of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Christine Doucette
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada; (C.D.); (G.M.H.)
- Departments of Physiology & Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Grant M. Hatch
- Children’s Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada; (C.D.); (G.M.H.)
- St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada
| | - Paul Fernyhough
- Departments of Pharmacology and Therapeutics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Departments of Biochemistry and Medical Genetics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3N4, Canada
| | - Aaron Marshall
- Departments of Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada; (E.M.); (S.H.); (A.M.)
- Departments of Pharmacology and Therapeutics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
| | - Spencer B. Gibson
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
- Departments of Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0T5, Canada; (E.M.); (S.H.); (A.M.)
- Departments of Pharmacology and Therapeutics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
| | - David E. Dawe
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
- Departments of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada
| | - Versha Banerji
- Research Institute in Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3V 0V9, Canada; (S.R.C.); (E.D.J.B.); (R.S.); (Z.N.); (C.P.); (C.M.); (M.S.); (D.H.); (L.D.); (J.B.J.); (S.B.G.); (D.E.D.)
- Departments of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada
- Departments of Pharmacology and Therapeutics, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P4, Canada;
- Correspondence: ; Tel.: +1-204-7871-884; Fax: +1-204-7870-196
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15
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Javandoost E, Firoozi-Majd E, Rostamian H, Khakpoor-Koosheh M, Mirzaei HR. Role of microRNAs in Chronic Lymphocytic Leukemia Pathogenesis. Curr Med Chem 2020; 27:282-297. [PMID: 31544709 DOI: 10.2174/0929867326666190911114842] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/20/2019] [Accepted: 08/27/2019] [Indexed: 12/13/2022]
Abstract
MicroRNAs (miRNAs) are a group of small endogenous non-coding RNAs involved in many cancers and various cellular processes such as cellular growth, DNA methylation, apoptosis, and differentiation. 13q14.3 chromosomal region contains miR-15 and miR-16 and deletion of this region is a commonly reported aberration in Chronic Lymphoblastic Leukemia (CLL), suggesting miRNAs involvement in CLL pathogenesis. MicroRNAs are known as oncogenes and tumor suppressors in CLL which may also serve as markers of onset and progression of the disease. The most prevalent form of leukemia diagnosed in adults in the western world, chronic lymphocytic leukemia, accounts for one-third of all leukemias. CLL is characterized by the presence of B Cell Malignant Clones in secondary lymphoid tissues, peripheral blood and bone marrow. The precise etiology of CLL is remained to be known, however, a number of Chromosomal Abnormalities such as deletions of 13q14.3, 11q and 17p and trisomy 12 have been detected. In this review, we offer our prospect on how miRNAs are involved in the CLL pathogenesis and disease progression. Further understanding of the underlying mechanisms and regulation of CLL pathogenesis has underscored the need for further research regarding their role in this disease.
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Affiliation(s)
- Ehsan Javandoost
- Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ehsan Firoozi-Majd
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hosein Rostamian
- Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Khakpoor-Koosheh
- Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Mirzaei
- Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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16
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Basabaeen AA, Abdelgader EA, BaHashwan OS, Babekir EA, Abdelateif NM, Bamusa SA, Abdelrahim SO, Altayeb OA, Fadul EA, Ibrahim IK. Combined analysis of ZAP-70 and CD38 expression in sudanese patients with B-cell chronic lymphocytic leukemia. BMC Res Notes 2019; 12:282. [PMID: 31122288 PMCID: PMC6533771 DOI: 10.1186/s13104-019-4319-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/18/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the ZAP-70 and CD38 expressions and their combined expressions in Sudanese B-CLL patients and their relationships with clinical and hematological characteristics as well as the disease staging at presentation. RESULTS In the present cross-sectional descriptive study, analysis of ZAP-70 expression showed that 36/110 (32.7%) patients positively expressed ZAP-70 and insignificant higher presentation in intermediate and at advanced stages as well as no correlation was seen with hematological parameters and clinical features compared with negatively ZAP-70, on the other hand, 41/110 (37.3%) were CD38+ and no significant correlation was shown with the stage at presentation, clinical characteristics (except Splenomegaly, P = 0.02) and hematological parameters. However, in combined expressions of both ZAP-70 and CD38 together, 20/110 (18.2%) were concordantly ZAP-70+/CD38+, 53/110 (48.2%) concordantly ZAP-70-/CD38- and 37/110 (33.6%) either ZAP-70+ or CD38+, and these three groups showed insignificant correlation with clinical (except Splenomegaly, P = 0.03) and hematological parameters, and the stage at presentation. Our data showed the combined analysis of these two markers, lead to classify our patients into three subgroups (either concordant positive, negative or discordant expressions) with statistically insignificant correlation with clinical presentation (except Splenomegaly), hematological parameters and stage at presentation of B-CLL patients.
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MESH Headings
- ADP-ribosyl Cyclase 1/blood
- ADP-ribosyl Cyclase 1/genetics
- ADP-ribosyl Cyclase 1/immunology
- Adult
- Aged
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Cross-Sectional Studies
- Female
- Gene Expression
- Humans
- Immunophenotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Membrane Glycoproteins/blood
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/immunology
- Middle Aged
- Neoplasm Staging
- Prospective Studies
- Splenomegaly/diagnosis
- Splenomegaly/genetics
- Splenomegaly/immunology
- Splenomegaly/pathology
- Sudan
- ZAP-70 Protein-Tyrosine Kinase/blood
- ZAP-70 Protein-Tyrosine Kinase/genetics
- ZAP-70 Protein-Tyrosine Kinase/immunology
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Affiliation(s)
- Ameen Abdulaziz Basabaeen
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
- Ministry of Health & Population, Hadhramout, Yemen
| | | | - Othman Saeed BaHashwan
- Department of Family Medicine, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
| | - Ebtihal Ahmed Babekir
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | - Nour Mahmoud Abdelateif
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | | | - Saadia Osman Abdelrahim
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | - Osama Ali Altayeb
- Flow Cytometry Laboratory for Leukemia & Lymphoma Diagnosis, Khartoum, Sudan
| | - Eman Abbass Fadul
- Flow Cytometry Laboratory for Leukemia & Lymphoma Diagnosis, Khartoum, Sudan
| | - Ibrahim Khider Ibrahim
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
- Department of Hematology, School of Medical Sciences, University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
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17
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Schieber M, Ma S. The expanding role of venetoclax in chronic lymphocytic leukemia and small lymphocytic lymphoma. Blood Lymphat Cancer 2019; 9:9-17. [PMID: 32009829 PMCID: PMC6859801 DOI: 10.2147/blctt.s177009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/01/2019] [Indexed: 12/19/2022]
Abstract
The BCL-2 protein family members inhibit cellular apoptosis, and their overexpression represents a common survival adaption in cancer. Recently, a selective BCL-2 inhibitor ABT-199, venetoclax, has demonstrated remarkable activity in relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), both as a single agent and in combination with anti-CD20 immunotherapies, such as rituximab. In this article, we review the development and latest clinical data that have led to the expanded approval of venetoclax with rituximab in relapsed/refractory CLL/SLL. We also discuss ongoing and future clinical trials designed to evaluate the efficacy of venetoclax in previously untreated patients and to investigate venetoclax combinations with inhibitors of B-cell receptor signaling pathway. These studies hope to offer an expanded list of chemotherapy-free regimens for patients with CLL/SLL.
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Affiliation(s)
- Michael Schieber
- Department of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Shuo Ma
- Department of Medicine, Division of Hematology/Oncology, Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
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18
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Ectopic Lck expression in CLL demarcates intratumoral subpopulations with aberrant B-cell receptor signaling. Blood Adv 2019; 2:877-882. [PMID: 29669754 DOI: 10.1182/bloodadvances.2017015321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/26/2018] [Indexed: 11/20/2022] Open
Abstract
Key Points
Ectopic Lck expression signifies interpatient and intratumoral heterogeneity in CLL. Lck expression identifies CLL subpopulations with aberrant BCR signaling.
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19
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Shen Y, Crassini K, Sandhu S, Fatima N, Christopherson RI, Mulligan SP, Best OG. Dual inhibition of MEK1/2 and AKT by binimetinib and MK2206 induces apoptosis of chronic lymphocytic leukemia cells under conditions that mimic the tumor microenvironment. Leuk Lymphoma 2019; 60:1632-1643. [PMID: 30648436 DOI: 10.1080/10428194.2018.1542148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Several key pathways mediate signaling via the B-cell receptor, including the mitogen-activated protein kinase-ERK1/2 pathway. However, inhibition of MEK1/2, a key component of the MAPK-ERK1/2 signaling cascade, results in paradoxical activation of AKT in chronic lymphocytic leukemia (CLL) cells. In the current study we demonstrate synergy between the MEK1/2 inhibitor binimetinib and the AKT inhibitor MK2206, which combined induce apoptosis of primary CLL cells and restrict the cell cycle progression and proliferation of the OSU-CLL cell line. The mechanisms of action of the drug combination involve dual inhibition of MAPK-ERK1/2 and AKT signaling and down-regulation of Mcl-1 expression. Collectively, these data suggest that dual inhibition of MEK1/2 and AKT may represent a therapeutic option for CLL, capable of overcoming the pro-survival effects of the lymph node and bone marrow microenvironments.
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Affiliation(s)
- Yandong Shen
- a Northern Blood Research Centre, Kolling Institute , Royal North Shore Hospital , St Leonards , NSW , Australia.,b School of Life and Environmental Sciences (SOLES) , University of Sydney , Sydney , NSW , Australia
| | - Kyle Crassini
- a Northern Blood Research Centre, Kolling Institute , Royal North Shore Hospital , St Leonards , NSW , Australia
| | - Suneet Sandhu
- a Northern Blood Research Centre, Kolling Institute , Royal North Shore Hospital , St Leonards , NSW , Australia
| | - Narjis Fatima
- a Northern Blood Research Centre, Kolling Institute , Royal North Shore Hospital , St Leonards , NSW , Australia
| | - Richard I Christopherson
- b School of Life and Environmental Sciences (SOLES) , University of Sydney , Sydney , NSW , Australia
| | - Stephen P Mulligan
- a Northern Blood Research Centre, Kolling Institute , Royal North Shore Hospital , St Leonards , NSW , Australia.,b School of Life and Environmental Sciences (SOLES) , University of Sydney , Sydney , NSW , Australia
| | - O Giles Best
- a Northern Blood Research Centre, Kolling Institute , Royal North Shore Hospital , St Leonards , NSW , Australia.,b School of Life and Environmental Sciences (SOLES) , University of Sydney , Sydney , NSW , Australia
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20
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Gao C, Zhou C, Zhuang J, Liu L, Wei J, Liu C, Li H, Sun C. Identification of key candidate genes and miRNA‑mRNA target pairs in chronic lymphocytic leukemia by integrated bioinformatics analysis. Mol Med Rep 2018; 19:362-374. [PMID: 30431072 PMCID: PMC6297738 DOI: 10.3892/mmr.2018.9636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a malignant clonal proliferative disorder of B cells. Inhibition of cell apoptosis and cell cycle arrest are the main pathological causes of this disease, but its molecular mechanism requires further investigation. The purpose of the present study was to identify biomarkers for the early diagnosis and treatment of CLL, and to explore the molecular mechanisms of CLL progression. A total of 488 differentially expressed genes (DEGs) and 32 differentially expressed microRNAs (miRNAs; DEMs) for CLL were identified by analyzing the gene chips GSE22529, GSE39411 and GSE62137. Functional and pathway enrichment analyses of DEGs demonstrated that DEGs were mainly involved in transcriptional dysregulation and multiple signaling pathways, such as the nuclear factor‑κB and mitogen‑activated protein kinase signaling pathways. In addition, Cytoscape software was used to visualize the protein‑protein interactions of these DEGs in order to identify hub genes, which could be used as biomarkers for the early diagnosis and treatment of CLL. Cytoscape software was also used to analyze the association between the predicted target mRNAs of DEMs and DEGs and increase knowledge about the miRNA‑mRNA regulatory network associated with the progression of CLL. Taken together, the present study provided a bioinformatics basis for advancing our understanding of the pathogenesis of CLL by identifying differentially expressed hub genes, miRNA‑mRNA target pairs and molecular pathways. In addition, hub genes may be used as novel biomarkers for the diagnosis of CLL and to guide the selection of CLL drug combinations.
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Affiliation(s)
- Chundi Gao
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, P.R. China
| | - Chao Zhou
- Cancer Center, Weifang Traditional Chinese Hospital, Weifang, Shandong 261000, P.R. China
| | - Jing Zhuang
- Cancer Center, Weifang Traditional Chinese Hospital, Weifang, Shandong 261000, P.R. China
| | - Lijuan Liu
- Cancer Center, Weifang Traditional Chinese Hospital, Weifang, Shandong 261000, P.R. China
| | - Junyu Wei
- Cancer Center, Weifang Traditional Chinese Hospital, Weifang, Shandong 261000, P.R. China
| | - Cun Liu
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, P.R. China
| | - Huayao Li
- College of First Clinical Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, P.R. China
| | - Changgang Sun
- Cancer Center, Weifang Traditional Chinese Hospital, Weifang, Shandong 261000, P.R. China
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21
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Byrd JC, Ruppert AS, Heerema NA, Halvorson AE, Hoke E, Smith MR, Godwin JE, Couban S, Fehniger TA, Thirman MJ, Tallman MS, Appelbaum FR, Stone RM, Robinson S, Chang JE, Mandrekar SJ, Larson RA. Lenalidomide consolidation benefits patients with CLL receiving chemoimmunotherapy: results for CALGB 10404 (Alliance). Blood Adv 2018; 2:1705-1718. [PMID: 30030269 PMCID: PMC6058242 DOI: 10.1182/bloodadvances.2017015396] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 03/28/2018] [Indexed: 02/07/2023] Open
Abstract
Prior to novel targeted agents for chronic lymphocytic leukemia (CLL), the best chemoimmunotherapy regimen in patients with non-del(11q) disease was unclear. The role of lenalidomide was also not defined. This phase 2 study randomized 342 untreated patients with non-del(11q) CLL requiring therapy to fludarabine plus rituximab (FR; n = 123), FR plus lenalidomide consolidation (FR+L; n = 109), or FR plus cyclophosphamide (FCR; n = 110) and compared 2-year progression-free survival (PFS) rates of each to the historical control rate with FC (60%). Patients with del(11q) in at least 20% of pretreatment cells continued with FCR (n = 27) or were reassigned to FCR+L (n = 31) and excluded from the primary analysis. Among non-del(11q) patients, 2-year PFS rates were 64% (90% confidence interval [CI], 57-71; FR), 72% (90% CI, 65-79; FR+L), and 74% (90% CI, 66-80; FCR); FR+L and FCR had rates significantly greater than historical control. Median PFS was significantly shorter with FR compared with FR+L (P = .04) and FCR (P < .001): 43 (95% CI, 33-50), 61 (95% CI, 45-71), and 97 (95% CI, 61 to not reached) months, respectively. Median follow-up was 73 months and median overall survival (OS) was only reached with FCR (101 months; 95% CI, 96 to not reached). With FR+L, the risk of death decreased over time and was lower than with FR at later time points (P = .01), but not significantly different from FCR (P = .21). Future studies incorporating short courses of lenalidomide into other novel treatment regimens are justified.
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Affiliation(s)
| | - Amy S Ruppert
- Division of Hematology
- Alliance Statistics and Data Center, and
| | - Nyla A Heerema
- Department of Pathology, The Ohio State University, Columbus, OH
| | | | - Eva Hoke
- Alliance Statistics and Data Center, Duke University, Durham, NC
| | - Mitchell R Smith
- Department of Medical Oncology and Hematology, George Washington University Cancer Center, Washington, DC
| | | | | | - Todd A Fehniger
- Division of Oncology, Washington University School of Medicine, St. Louis, MO
| | - Michael J Thirman
- Department of Medicine, University of Chicago Comprehensive Cancer Center, Chicago, IL
| | | | | | - Richard M Stone
- Dana-Farber/Partners CancerCare, Harvard Cancer Center, Boston, MA; and
| | - Sue Robinson
- QEII Health Sciences Centre, Halifax, NS, Canada
| | - Julie E Chang
- Department of Medicine, University of Wisconsin, Madison, WI
| | | | - Richard A Larson
- Department of Medicine, University of Chicago Comprehensive Cancer Center, Chicago, IL
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22
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Crassini K, Shen Y, O'Dwyer M, O'Neill M, Christopherson R, Mulligan S, Best OG. The dual inhibitor of the phosphoinositol-3 and PIM kinases, IBL-202, is effective against chronic lymphocytic leukaemia cells under conditions that mimic the hypoxic tumour microenvironment. Br J Haematol 2018; 182:654-669. [PMID: 29978459 DOI: 10.1111/bjh.15447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 05/14/2018] [Indexed: 12/15/2022]
Abstract
Despite significant advances in treatment, chronic lymphocytic leukaemia (CLL) remains an incurable disease. Ibrutinib and idelalisib, which inhibit Bruton Tyrosine kinase (BTK) and phosphoinositol-3 (PI3) kinase-δ respectively, have become important treatment options for the disease and demonstrate the potential of targeting components of the B-cell receptor-signalling pathway. IBL-202 is a dual inhibitor of the PIM and PI3 kinases. Synergy between the pan-PIM inhibitor, pPIMi, and idelalisib against a range of haematological cell lines and primary CLL cells supports the rationale for preclinical studies of IBL-202 in CLL. Importantly, IBL-202, but not idelalisib, was cytotoxic against CLL cells under in vitro conditions that mimic the hypoxic tumour microenvironment. The significant effects of IBL-202 on CD49d and CXCR4 expression and migration, cycle and proliferation of CLL cells suggest the drug may also interfere with the migratory and proliferative capacity of the leukaemic cells. Collectively, these data demonstrate that dual inhibition of the PIM and PI3 kinases by IBL-202 may be an effective strategy for targeting CLL cells, particularly within the environmental niches known to confer drug-resistance.
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Affiliation(s)
- Kyle Crassini
- Northern Blood Research Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Sydney, Australia
| | - Yandong Shen
- Northern Blood Research Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Sydney, Australia.,School of Molecular Biosciences, University of Sydney, Sydney, Australia
| | | | | | | | - Stephen Mulligan
- Northern Blood Research Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Sydney, Australia.,School of Molecular Biosciences, University of Sydney, Sydney, Australia
| | - O Giles Best
- Northern Blood Research Centre, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Sydney, Australia.,School of Molecular Biosciences, University of Sydney, Sydney, Australia
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23
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Papageorgiou SG, Diamantopoulos MA, Kontos CK, Bouchla A, Vasilatou D, Bazani E, Scorilas A, Pappa V. MicroRNA-92a-3p overexpression in peripheral blood mononuclear cells is an independent predictor of prolonged overall survival of patients with chronic lymphocytic leukemia. Leuk Lymphoma 2018; 60:658-667. [PMID: 29911923 DOI: 10.1080/10428194.2018.1461861] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
MicroRNA-92a-3p (miR-92a-3p) derives from the oncogenic miR-17/92 cluster and its highly homologous miR-106a/363 cluster. miR-92a-3p regulates the expression of key transcription factors such as HIF1 and inhibits SOCS1 to enhance the anti-apoptotic STAT3/IL6 signaling pathway. In this study, we assessed the putative usefulness of miR-92a-3p as a prognostic and/or diagnostic biomarker in chronic lymphocytic leukemia (CLL). For this purpose, total RNA was extracted from mononuclear cells isolated from the peripheral blood of 88 CLL patients and 36 non-leukemic blood donors, was polyadenylated and reversely transcribed. miR-92a-3p expression was quantified using an accurate qPCR method. miR-92a-3p levels were significantly lower in peripheral blood mononuclear cells of CLL patients. Overall survival (OS) analysis revealed that high miR-92a-3p expression predicts significantly prolonged OS of CLL patients. Interestingly, miR-92a-3p overexpression remains a significant prognosticator in subgroups of CLL patients with distinct prognosis. In conclusion, miR-92a-3p overexpression is a potential surrogate biomarker of favorable outcome of CLL patients.
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Affiliation(s)
- Sotirios G Papageorgiou
- a Second Department of Internal Medicine and Research Unit , University General Hospital "Attikon" , Athens , Greece
| | - Marios A Diamantopoulos
- b Department of Biochemistry and Molecular Biology , National and Kapodistrian University of Athens , Athens , Greece
| | - Christos K Kontos
- b Department of Biochemistry and Molecular Biology , National and Kapodistrian University of Athens , Athens , Greece
| | - Anthi Bouchla
- a Second Department of Internal Medicine and Research Unit , University General Hospital "Attikon" , Athens , Greece
| | - Diamantina Vasilatou
- a Second Department of Internal Medicine and Research Unit , University General Hospital "Attikon" , Athens , Greece
| | - Efthymia Bazani
- a Second Department of Internal Medicine and Research Unit , University General Hospital "Attikon" , Athens , Greece
| | - Andreas Scorilas
- b Department of Biochemistry and Molecular Biology , National and Kapodistrian University of Athens , Athens , Greece
| | - Vasiliki Pappa
- a Second Department of Internal Medicine and Research Unit , University General Hospital "Attikon" , Athens , Greece
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24
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Alves-Silva JC, de Carvalho JL, Rabello DA, Serejo TRT, Rego EM, Neves FAR, Lucena-Araujo AR, Pittella-Silva F, Saldanha-Araujo F. GLP overexpression is associated with poor prognosis in Chronic Lymphocytic Leukemia and its inhibition induces leukemic cell death. Invest New Drugs 2018; 36:955-960. [PMID: 29855824 DOI: 10.1007/s10637-018-0613-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 05/24/2018] [Indexed: 12/21/2022]
Abstract
Background Heterodimeric methyltransferases GLP (EHMT1/KMT1D) and G9a (EHMT2/KMT1C) are two closely related enzymes that promote the monomethylation and dimethylation of histone H3 lysine 9. Dysregulation of their activity has been implicated in several types of human cancer. Patients and methods Here, in order to investigate whether GLP/G9a exerts any impact on Chronic Lymphocytic Leukemia (CLL), GLP/G9a expression levels were assessed in a cohort of 50 patients and the effects of their inhibition were verified for the viability of CLL cells. Also, qRT-PCR was used to investigate the transcriptional levels of GLP/G9a in CLL patients. In addition, patient samples were classified according to ZAP-70 protein expression by flow cytometry and according to karyotype integrity by cytogenetics analysis. Finally, a selective small molecule inhibitor for GLP/G9a was used to ascertain whether these methyltransferases influenced the viability of MEC-1 CLL cell lineage. Results mRNA analysis revealed that CLL samples had higher levels of GLP, but not G9a, when compared to non-leukemic controls. Interestingly, patients with unfavorable cytogenetics showed higher expression levels of GLP compared to patients with favorable karyotypes. More importantly, GLP/G9a inhibition markedly induced cell death in CLL cells. Conclusion Taken together, these results indicate that GLP is associated with a worse prognosis in CLL, and that the inhibition of GLP/G9a influences CLL cell viability. Altogether, the present data demonstrate that these methyltransferases can be potential markers for disease progression, as well as a promising epigenetic target for CLL treatment and the prevention of disease evolution.
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Affiliation(s)
- Juliana Carvalho Alves-Silva
- Laboratório de Patologia Molecular do Câncer, Universidade de Brasília, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil
- Laboratório de Farmacologia Molecular, Universidade de Brasília, Campus Darcy Ribeiro, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil
| | - Juliana Lott de Carvalho
- Laboratório de Biotecnologia, Universidade Católica de Brasília, SGAN 916 Módulo B, Brasília, DF, 70790-160, Brazil
| | - Doralina Amaral Rabello
- Laboratório de Patologia Molecular do Câncer, Universidade de Brasília, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil
| | - Teresa Raquel Tavares Serejo
- Laboratório de Farmacologia Molecular, Universidade de Brasília, Campus Darcy Ribeiro, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil
| | - Eduardo Magalhaes Rego
- Laboratório de Hematologia, Universidade de São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, SP, 14.048-900, Brazil
| | - Francisco Assis Rocha Neves
- Laboratório de Farmacologia Molecular, Universidade de Brasília, Campus Darcy Ribeiro, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil
| | - Antonio Roberto Lucena-Araujo
- Laboratório de Hematologia, Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, Recife, PE, 50670-901, Brazil
| | - Fábio Pittella-Silva
- Laboratório de Patologia Molecular do Câncer, Universidade de Brasília, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil
| | - Felipe Saldanha-Araujo
- Laboratório de Farmacologia Molecular, Universidade de Brasília, Campus Darcy Ribeiro, Av. L2 Norte, Brasília, DF, 70.910-900, Brazil.
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25
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Alayed K, Schweitzer K, Awadallah A, Shetty S, Turakhia S, Meyerson H. A multicolour flow cytometric assay for c-MYC protein in B-cell lymphoma. J Clin Pathol 2018; 71:906-915. [PMID: 29769234 DOI: 10.1136/jclinpath-2018-205075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 04/20/2018] [Accepted: 04/30/2018] [Indexed: 11/03/2022]
Abstract
AIM Develop an objective assay to detect c-MYC protein expression using multiparametric flow cytometry (FCM) as an alternative to immunohistochemistry (IHC). METHODS 57 patient samples and 11 cell line samples were evaluated. Cell suspensions were obtained and c-MYC staining was performed in combination with CD45 and CD19 and, in some samples, CD10. The percentage of c-MYC+ cells by FCM was correlated with the percentage determined by IHC. The relationship between c-MYC protein expression and the presence of a c-MYC gene rearrangement in aggressive and high-grade lymphomas was also assessed. RESULTS c-MYC expression by FCM and IHC demonstrated a high degree of correlation in a training set of 33 patient cases, r=0.92, 11 cell line samples, r=0.81 and in a validation set of 24 aggressive and high-grade B-cell lymphomas, r=0.85. c-MYC gene was rearranged by fluorescence in situ hybridisation in 6/9 samples with high c-MYC expression (>40%) by FCM and 6/14 by IHC. CONCLUSIONS We have developed a reliable multicolour FCM assay to detect c-MYC expression suitable for clinical laboratories that should be helpful to accurately quantify c-MYC expression in B-cell lymphomas.
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Affiliation(s)
- Khaled Alayed
- Department of Pathology, University Hospitals Cleveland Medical Center and Seidman Comprehensive Cancer Center, Cleveland, Ohio, USA.,Department of Pathology, King Saud University, Riyadh, Saudi Arabia
| | - Karen Schweitzer
- Department of Pathology, University Hospitals Cleveland Medical Center and Seidman Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Amad Awadallah
- Department of Pathology, University Hospitals Cleveland Medical Center and Seidman Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Shashirekha Shetty
- Department of Pathology, University Hospitals Cleveland Medical Center and Seidman Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Samir Turakhia
- Department of Pathology, University Hospitals Cleveland Medical Center and Seidman Comprehensive Cancer Center, Cleveland, Ohio, USA
| | - Howard Meyerson
- Department of Pathology, University Hospitals Cleveland Medical Center and Seidman Comprehensive Cancer Center, Cleveland, Ohio, USA
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Liu Y, Wang Y, Yang J, Bi Y, Wang H. ZAP-70 in chronic lymphocytic leukemia: A meta-analysis. Clin Chim Acta 2018; 483:82-88. [PMID: 29680229 DOI: 10.1016/j.cca.2018.04.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 04/14/2018] [Accepted: 04/16/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Recent studies have reported that zeta-chain-associated protein kinase 70 (ZAP-70) expression plays a prognostic role in chronic lymphocytic leukemia (CLL). However, these results remain controversial. Thus, we performed a meta-analysis to clarify the prognostic value of ZAP-70 expression in CLL. MATERIALS AND METHODS Relevant studies were searched in PubMed, Embase, Cochrane library, and Web of Science up to January 2018. Clinicopathological features and prognostic data were extracted from the studies. We pooled estimates and 95% confidence intervals (CIs) and estimated the heterogeneity of studies using Mantel-Haenszel or DerSimonian and Laird method. RESULTS Twelve studies that included 1956 patients with CLL were eligible for inclusion. The pooled results revealed that increased ZAP-70 expression was significantly associated with poor overall survival (hazard ratio [HR] = 2.48, 95% CI: 1.72-3.59, P = 0.019, I2 = 53.0%) and event-free survival (HR = 4.17, 95% CI: 2.17-8.01, P = 0.014, I2 = 68.2%) in a random-effects model with significant heterogeneity. Clinicopathological analysis demonstrated that ZAP-70 expression was significantly associated with unmutated immunoglobulin heavy-chain genes, CD38 expression, serum β-2 microglobulin, and lymphocyte doubling time. CONCLUSIONS Our findings indicated that ZAP-70 was a strong prognostic biomarker for patients with CLL.
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Affiliation(s)
- Yini Liu
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan 430071, China
| | - Yangfeng Wang
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan 430071, China
| | - Jule Yang
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan 430071, China
| | - Yongyi Bi
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan 430071, China
| | - Hong Wang
- Department of Occupational and Environmental Health, School of Health Sciences, Wuhan University, Donghu Road 115, Wuhan 430071, China.
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27
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iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood 2018. [PMID: 29540348 DOI: 10.1182/blood-2017-09-806398] [Citation(s) in RCA: 987] [Impact Index Per Article: 164.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The previous edition of the consensus guidelines of the International Workshop on Chronic Lymphocytic Leukemia (iwCLL), published in 2008, has found broad acceptance by physicians and investigators caring for patients with CLL. Recent advances including the discovery of the genomic landscape of the disease, the development of genetic tests with prognostic relevance, and the detection of minimal residual disease (MRD), coupled with the increased availability of novel targeted agents with impressive efficacy, prompted an international panel to provide updated evidence- and expert opinion-based recommendations. These recommendations include a revised version of the iwCLL response criteria, an update on the use of MRD status for clinical evaluation, and recommendations regarding the assessment and prophylaxis of viral diseases during management of CLL.
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28
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Fernández-Martínez JL, deAndrés-Galiana EJ, Sonis ST. Genomic data integration in chronic lymphocytic leukemia. J Gene Med 2018; 19. [PMID: 27928896 DOI: 10.1002/jgm.2936] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/04/2016] [Accepted: 11/26/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND B-cell chronic lymphocytic leukemia (CLL) is a heterogeneous disease and the most common adult leukemia in western countries. IgVH mutational status distinguishes two major types of CLL, each associated with a different prognosis and survival. Sequencing identified NOTCH1 and SF3B1 as the two main recurrent mutations. We described a novel method to clarify how these mutations affect gene expression by finding small-scale signatures that predict the IgVH, NOTCH1 and SF3B1 mutations. We subsequently defined the biological pathways and correlation networks involved in disease development, with the potential goal of identifying new drugable targets. METHODS We modeled a microarray dataset consisting of 48807 probes derived from 163 samples. The use of Fisher's ratio and fold change combined with feature elimination allowed us to identify the minimum number of genes with the highest predictive mutation power and, subsequently, we applied network and pathway analyses of these genes to identify their biological roles. RESULTS The mutational status of the patients was accurately predicted (94-99%) using small-scale gene signatures: 13 genes for IgVH, 60 for NOTCH1 and 22 for SF3B1. LPL plays an important role in the case of the IgVH mutation, whereas MSI2, LTK, TFEC and CNTAP2 are involved in the NOTCH1 mutation, and RPL32 and PLAGL1 are involved in the SF3B1 mutation. Four high discriminatory genes (IGHG1, MYBL1, NRIP1 and RGS1) are common to these three mutations. The IL-4-mediated signaling events pathway appears to be involved as a common mechanism and suggests an important role of the immune response mechanisms and antigen presentation. CONCLUSIONS This retrospective analysis served to provide a deeper understanding of the effects of the different mutations in CLL disease progression, with the expectation that these findings will be clinically applied in the near future to the development of new drugs.
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Affiliation(s)
- Juan Luis Fernández-Martínez
- Group of Inverse Problems, Optimization and Machine Learning, Department of Mathematics, University of Oviedo, Oviedo, Asturias, Spain
| | - Enrique J deAndrés-Galiana
- Group of Inverse Problems, Optimization and Machine Learning, Department of Mathematics, University of Oviedo, Oviedo, Asturias, Spain.,Artificial Intelligence Center, University of Oviedo, Oviedo, Asturias, Spain
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29
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30
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Vangapandu HV, Havranek O, Ayres ML, Kaipparettu BA, Balakrishnan K, Wierda WG, Keating MJ, Davis RE, Stellrecht CM, Gandhi V. B-cell Receptor Signaling Regulates Metabolism in Chronic Lymphocytic Leukemia. Mol Cancer Res 2017; 15:1692-1703. [PMID: 28835371 PMCID: PMC5714317 DOI: 10.1158/1541-7786.mcr-17-0026] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 06/16/2017] [Accepted: 08/15/2017] [Indexed: 11/16/2022]
Abstract
Peripheral blood chronic lymphocytic leukemia (CLL) cells are quiescent but have active transcription and translation processes, suggesting that these lymphocytes are metabolically active. Based on this premise, the metabolic phenotype of CLL lymphocytes was investigated by evaluating the two intracellular ATP-generating pathways. Metabolic flux was assessed by measuring glycolysis as extracellular acidification rate (ECAR) and mitochondrial oxidative phosphorylation as oxygen consumption rate (OCR) and then correlated with prognostic factors. Further, the impact of B-cell receptor signaling (BCR) on metabolism was determined by genetic ablation and pharmacological inhibitors. Compared with proliferative B-cell lines, metabolic fluxes of oxygen and lactate were low in CLL cells. ECAR was consistently low, but OCR varied considerably in human patient samples (n = 45). Higher OCR was associated with poor prognostic factors such as ZAP 70 positivity, unmutated IGHV, high β2M levels, and higher Rai stage. Consistent with the association of ZAP 70 and IGHV unmutated status with active BCR signaling, genetic ablation of BCR mitigated OCR in malignant B cells. Similarly, knocking out PI3Kδ, a critical component of the BCR pathway, decreased OCR and ECAR. In concert, PI3K pathway inhibitors dramatically reduced OCR and ECAR. In harmony with a decline in metabolic activity, the ribonucleotide pools in CLL cells were reduced with duvelisib treatment. Collectively, these data demonstrate that CLL metabolism, especially OCR, is linked to prognostic factors and is curbed by BCR and PI3K pathway inhibition.Implications: This study identifies a relationship between oxidative phosphorylation in CLL and prognostic factors providing a rationale to therapeutically target these processes. Mol Cancer Res; 15(12); 1692-703. ©2017 AACR.
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MESH Headings
- Adenosine Triphosphate/genetics
- Adenosine Triphosphate/metabolism
- Apoptosis/genetics
- Cell Line, Tumor
- Cell Proliferation/genetics
- Class I Phosphatidylinositol 3-Kinases/genetics
- Glycolysis/genetics
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Metabolic Networks and Pathways/genetics
- Oxidative Phosphorylation
- Oxygen Consumption/genetics
- Prognosis
- Receptors, Antigen, B-Cell/genetics
- ZAP-70 Protein-Tyrosine Kinase/genetics
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Affiliation(s)
- Hima V Vangapandu
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
- MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, Texas
| | - Ondrej Havranek
- MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, Texas
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mary L Ayres
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Kumudha Balakrishnan
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
- MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, Texas
| | - William G Wierda
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael J Keating
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - R Eric Davis
- MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, Texas
- Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christine M Stellrecht
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas
- MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, Texas
| | - Varsha Gandhi
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
- MD Anderson Cancer Center UT Health Graduate School of Biomedical Sciences, Houston, Texas
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
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31
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Mina A, Sandoval Sus J, Sleiman E, Pinilla-Ibarz J, Awan FT, Kharfan-Dabaja MA. Using prognostic models in CLL to personalize approach to clinical care: Are we there yet? Blood Rev 2017; 32:159-166. [PMID: 29122300 DOI: 10.1016/j.blre.2017.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/14/2017] [Accepted: 10/27/2017] [Indexed: 01/14/2023]
Abstract
Four decades ago, two staging systems were developed to help stratify CLL into different prognostic categories. These systems, the Rai and the Binet staging, depended entirely on abnormal exam findings and evidence of anemia and thrombocytopenia. Better understanding of biologic, genetic, and molecular characteristics of CLL have contributed to better appreciating its clinical heterogeneity. New prognostic models, the GCLLSG prognostic index and the CLL-IPI, emerged. They incorporate biologic and genetic information related to CLL and are capable of predicting survival outcomes and cases anticipated to need therapy earlier in the disease course. Accordingly, these newer models are helping develop better informed surveillance strategies and ultimately tailor treatment intensity according to presence (or lack thereof) of certain prognostic markers. This represents a step towards personalizing care of CLL patients. We anticipate that as more prognostic factors continue to be identified, the GCLLSG prognostic index and CLL-IPI models will undergo further revisions.
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Affiliation(s)
- Alain Mina
- Dept. of Internal Medicine, Kansas University Medical Ctr, Kansas City, KS, USA
| | | | - Elsa Sleiman
- Faculty of Medicine, American Univ. of Beirut, Beirut, Lebanon
| | - Javier Pinilla-Ibarz
- Dept. of Malignant Hematology, Moffitt Cancer Ctr, Tampa, FL, USA; Department of Oncologic Sciences, Moffitt Cancer Ctr, Univ. of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Farrukh T Awan
- Div. of Hematology, Dept. of Internal Medicine, The Ohio State Univ. Comprehensive Cancer Ctr, Columbus, OH, USA
| | - Mohamed A Kharfan-Dabaja
- Department of Oncologic Sciences, Moffitt Cancer Ctr, Univ. of South Florida Morsani College of Medicine, Tampa, FL, USA; Dept. of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Ctr, Tampa, FL, USA.
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32
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Abstract
More than six decades ago Watson and Crick published the chemical structure of DNA. This discovery revolutionized our approach to medical science and opened new perspectives for the diagnosis and treatment of many diseases including cancer. Since then, progress in molecular biology, together with the rapid advance of technologies, allowed to clone hundreds of protein-coding genes that were found mutated in all types of cancer. Normal and aberrant gene functions, interactions, and mechanisms of mutations were studied to identify the intricate network of pathways leading to cancer. With the acknowledgment of the genetic nature of cancer, new diagnostic, prognostic, and therapeutic strategies have been attempted and developed, but very few have found their way in the clinical field. In an effort to identify new translational targets, another great discovery has changed our way to look at genes and their functions. MicroRNAs have been the first noncoding genes involved in cancer. This review is a brief chronological history of microRNAs and cancer. Through the work of few of the greatest scientists of our times, this chapter describes the discovery of microRNAs from C. elegans to their debut in cancer and in the medical field, the concurrent development of technologies, and their future translational applications. The purpose was to share the exciting path that lead to one of the most important discoveries in cancer genetics in the past 20 years.
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Affiliation(s)
- Alessandra Drusco
- Wexner Medical Center, The Ohio State University, Columbus, OH, United States
| | - Carlo M Croce
- Wexner Medical Center, The Ohio State University, Columbus, OH, United States.
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Lachowiez C, Deodhar A, Kozin E, Spurgeon S. Obinutuzumab is Effective in Chronic Lymphocytic Leukemia and Rheumatoid Arthritis After Rituximab Failure: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:516-519. [PMID: 28487504 PMCID: PMC5434858 DOI: 10.12659/ajcr.903747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL) is the most common leukemia affecting older adults. As such, many of these patients suffer from co-existing disease states, and the provider must take these comorbidities into account when determining a treatment regimen. The widespread use of monoclonal antibodies (mAbs) has drastically changed the treatment landscape of multiple diseases, ranging from leukemia to autoimmune conditions such as rheumatoid arthritis. CASE REPORT We present the case of a patient who had progression of his CLL and rheumatoid symptoms on rituximab therapy, and was subsequently treated with the second-generation anti-CD20 antibody obinutuzumab. Obinutuzumab therapy was associated with simultaneous sustained remission of both disease states, allowing for discontinuation of all other disease-modifying anti-rheumatic drugs (DMARDs), and prolonged remission of his CLL. CONCLUSIONS While anti-CD20 antibodies have a clear role in the treatment of leukemia and inflammatory conditions, the success of obinutuzumab in RA has not been fully evaluated. We present this case as further evidence of the strong role of anti-CD 20 therapy in multiple conditions, and the unique opportunity for control of simultaneous disease states through targeted inhibition of shared common pathways.
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Affiliation(s)
- Curtis Lachowiez
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Atul Deodhar
- Department of Medicine, Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR, USA
| | - Eliana Kozin
- Department of Hematology and Medical Oncology, Oregon Health and Science University, Knight Cancer Institute, Portland, OR, USA
| | - Stephen Spurgeon
- Department of Hematology and Medical Oncology, Oregon Health and Science University, Knight Cancer Institute, Portland, OR, USA
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Vangapandu HV, Jain N, Gandhi V. Duvelisib: a phosphoinositide-3 kinase δ/γ inhibitor for chronic lymphocytic leukemia. Expert Opin Investig Drugs 2017; 26:625-632. [PMID: 28388280 PMCID: PMC5584596 DOI: 10.1080/13543784.2017.1312338] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 03/24/2017] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Frontline chemotherapy is successful against chronic lymphocytic leukemia (CLL), but results in untoward toxicity. Further, prognostic factors, cytogenetic anomalies, and compensatory cellular signaling lead to therapy resistance or disease relapse. Therefore, for the past few years, development of targeted therapies is on the rise. PI3K is a major player in the B-cell receptor (BCR) signaling axis, which is critical for the survival and maintenance of B cells. Duvelisib, a PI3K δ/γ dual isoform specific inhibitor that induces apoptosis and reduces cytokine and chemokine levels in vitro, holds promise for CLL. Areas covered: Herein, we review PI3K isoforms and their inhibitors in general, and duvelisib in particular; examine literature on preclinical investigations, pharmacokinetics and clinical studies of duvelisib either as single agent or in combination, for patients with CLL and other lymphoid malignancies. Expert opinion: Duvelisib targets the PI3K δ isoform, which is necessary for cell proliferation and survival, and γ isoform, which is critical for cytokine signaling and pro-inflammatory responses from the microenvironment. In phase I clinical trials, duvelisib as a single agent showed promise for CLL and other lymphoid malignancies. Phase II and III trials of duvelisib alone or in combination with other agents are ongoing.
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Affiliation(s)
- Hima V. Vangapandu
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77054
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030
| | - Varsha Gandhi
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, 77054
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35
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Abbassy HA, Aboelwafa RA, Ghallab OM. Evaluation of Interleukin-9 Expression as a Potential Therapeutic Target in Chronic Lymphocytic Leukemia in a Cohort of Egyptian Patients. Indian J Hematol Blood Transfus 2017; 33:477-482. [PMID: 29075057 DOI: 10.1007/s12288-017-0804-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 03/14/2017] [Indexed: 01/07/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a common lymphoid malignancy that has a highly variable clinical course. Genomic features as zeta-chain-associated protein kinase 70 (ZAP70) expression and CD38 expression provide further differentiation of disease prognosis. Extensive studies have confirmed the oncogenic activities of IL-9 in lymphoma. The aim of the current study was to investigate the contribution of IL-9 expression to the pathogenesis of CLL and its correlation to other prognostic parameters. This study was conducted on 80 patients at diagnosis with CLL and 80 healthy controls. Using real time polymerase chain reaction and enzyme linked immunosorbant assay, IL-9 mRNA expression and its serum level were compared between patients and controls. They were both correlated with other prognostic factors. RESULTS There was an overexpression of IL-9 in CLL patients that correlated with modified Rai staging, ZAP70, CD38 and all hallmarks of an active and aggressive disease. The correlation between IL-9 upregulation and patient characteristics provided direct clinical evidence for its contribution to the pathogenesis of CLL. In conclusion, significantly higher expression of IL-9 measured at both the mRNA and the protein levels in patients with CLL that correlates with more complex course of the disease and worse prognosis may allow one to speculate its importance in the pathogenesis of the disease and its possible impact on prognosis.
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Affiliation(s)
- Hadeer A Abbassy
- Clinical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Reham A Aboelwafa
- Clinical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Omar M Ghallab
- Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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36
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Wakim J, Arman E, Becker-Herman S, Kramer MP, Bakos E, Shachar I, Elson A. The PTPROt tyrosine phosphatase functions as an obligate haploinsufficient tumor suppressor in vivo in B-cell chronic lymphocytic leukemia. Oncogene 2017; 36:3686-3694. [PMID: 28166196 DOI: 10.1038/onc.2016.523] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 12/02/2016] [Accepted: 12/22/2016] [Indexed: 01/30/2023]
Abstract
The tyrosine phosphatase PTPROt is a suggested tumor suppressor (TS) in B-cell chronic lymphocytic leukemia (CLL), and its expression is reduced in this disease. In order to examine how reduced PTPROt expression affects CLL in vivo we induced CLL in PTPROt-targeted mice. Unexpectedly, loss of both Ptprot alleles delayed disease detection and progression and lengthened survival relative to mice carrying two intact alleles, indicating that PTPROt fulfills a novel tumor-promoting role in CLL. Tumor cells from mice lacking PTPROt exhibited reduced B-cell receptor (BCR)-induced signaling, as well as increased apoptosis and autophagy. Inhibition of BCR/Src signaling in CLL cells induced their apoptosis, indicating that these findings are linked causally. These results suggest a cell-autonomous mechanism for the weakened CLL phenotype of PTPROt-deficient mice and uncover non-redundant roles for PTPROt in support of BCR signaling and survival of CLL cells. In contrast, loss of only one Ptprot allele induced earlier detection and progression of CLL and reduced survival, consistent with a tumor-suppressing role for PTPROt. Tumor cells from mice lacking one or both Ptprot allele exhibited increased interleukin-10 (IL-10) expression and signaling, factors known to support CLL; cells lacking one Ptprot alleles exhibited normal BCR signaling and cell death rates. We conclude that loss of one Ptprot allele promotes CLL, most likely by activating IL-10 signaling. Loss of both Ptprot alleles also reduces BCR signaling and increases cell death rates, offsetting the IL-10 effects and reducing the severity of the disease. PTPROt thus functions as an obligate haploinsufficient TS in CLL, where its expression levels determine its role as a promoter or inhibitor of the tumorigenic process in mice. Partial loss of PTPROt generates the strongest disease phenotype, suggesting that its intermediate expression levels in CLL are selected for.
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Affiliation(s)
- J Wakim
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
| | - E Arman
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
| | - S Becker-Herman
- Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel
| | - M P Kramer
- Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel
| | - E Bakos
- Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel
| | - I Shachar
- Department of Immunology, The Weizmann Institute of Science, Rehovot, Israel
| | - A Elson
- Department of Molecular Genetics, The Weizmann Institute of Science, Rehovot, Israel
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37
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Kipps TJ, Stevenson FK, Wu CJ, Croce CM, Packham G, Wierda WG, O'Brien S, Gribben J, Rai K. Chronic lymphocytic leukaemia. Nat Rev Dis Primers 2017; 3:16096. [PMID: 28102226 PMCID: PMC5336551 DOI: 10.1038/nrdp.2016.96] [Citation(s) in RCA: 293] [Impact Index Per Article: 41.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chronic lymphocytic leukaemia (CLL) is a malignancy of CD5+ B cells that is characterized by the accumulation of small, mature-appearing lymphocytes in the blood, marrow and lymphoid tissues. Signalling via surface immunoglobulin, which constitutes the major part of the B cell receptor, and several genetic alterations play a part in CLL pathogenesis, in addition to interactions between CLL cells and other cell types, such as stromal cells, T cells and nurse-like cells in the lymph nodes. The clinical progression of CLL is heterogeneous and ranges from patients who require treatment soon after diagnosis to others who do not require therapy for many years, if at all. Several factors, including the immunoglobulin heavy-chain variable region gene (IGHV) mutational status, genomic changes, patient age and the presence of comorbidities, should be considered when defining the optimal management strategies, which include chemotherapy, chemoimmunotherapy and/or drugs targeting B cell receptor signalling or inhibitors of apoptosis, such as BCL-2. Research on the biology of CLL has profoundly enhanced our ability to identify patients who are at higher risk for disease progression and our capacity to treat patients with drugs that selectively target distinctive phenotypic or physiological features of CLL. How these and other advances have shaped our current understanding and treatment of patients with CLL is the subject of this Primer.
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Affiliation(s)
- Thomas J Kipps
- Division of Hematology-Oncology, Department of Medicine, Moores Cancer Centre, University of California, San Diego, 3855 Health Sciences Drive M/C 0820, La Jolla, California 92093, USA
| | - Freda K Stevenson
- Southampton Cancer Research UK Centre, Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Catherine J Wu
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Carlo M Croce
- Department of Molecular Virology, Immunology and Medical Genetics, Ohio State University, Columbus, Ohio, USA
| | - Graham Packham
- Southampton Cancer Research UK Centre, Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - William G Wierda
- Department of Hematology, MD Anderson Cancer Centre, Houston, Texas, USA
| | - Susan O'Brien
- Division of Hematology, Department of Medicine, University of California, Irvine, California, USA
| | - John Gribben
- Department of Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Kanti Rai
- CLL Research and Treatment Program, Feinstein Institute for Medical Research, Northwell Health, New Hyde Park, New York, USA
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38
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Filip AA, Grenda A, Popek S, Koczkodaj D, Michalak-Wojnowska M, Budzyński M, Wąsik-Szczepanek E, Zmorzyński S, Karczmarczyk A, Giannopoulos K. Expression of circulating miRNAs associated with lymphocyte differentiation and activation in CLL-another piece in the puzzle. Ann Hematol 2017; 96:33-50. [PMID: 27730344 PMCID: PMC5203831 DOI: 10.1007/s00277-016-2840-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 09/25/2016] [Indexed: 11/28/2022]
Abstract
Expression of microRNAs is altered in cancer. Circulating miRNA level assessed in body fluids commonly reflects their expression in tumor cells. In leukemias, however, both leukemic and nonleukemic cells compose circulating miRNA expression profile of peripheral blood. The latter contribution to extracellular miRNA pool may result in specific microenvironmental signaling, which promotes proliferation and survival. In our study, we used qT-PCR to assay peripheral blood serum of 22 chronic lymphocytic leukemia (CLL) patients for the expression of 84 miRNAs associated with activation and differentiation of B and T lymphocytes. Results were analyzed regarding the most important prognostic factors. We have found that the general expression of examined miRNAs in CLL patients was lower as compared to healthy volunteers. Only miR-34a-5p, miR31-5p, miR-155-5p, miR-150-5p, miR-15a-3p, and miR-29a-3p were expressed on a higher level. Alterations of expression observed in CLL patients involved miRNAs associated both with B and T lymphocyte differentiation and activation. The most important discriminating factors for all functional miRNA groups were trisomy 12, CD38 expression, B2M level, WBC, and NOTCH1 gene mutation. Correlation of expression of miRNAs related to T lymphocytes with prognostic factors proves their supportive function in a leukemic microenvironment. Further studies utilizing a larger test group of patients may warrant the identification of circulating miRNAs that are key players in intercellular interactions and should be considered in the design of microenvironment-targeted therapies.
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MESH Headings
- Aged
- Aged, 80 and over
- B-Lymphocytes/physiology
- Base Sequence
- Cell Differentiation/physiology
- Cells, Cultured
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Male
- MicroRNAs/biosynthesis
- MicroRNAs/blood
- MicroRNAs/genetics
- Middle Aged
- T-Lymphocytes/physiology
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Affiliation(s)
- Agata A Filip
- Department of Cancer Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080, Lublin, Poland.
| | - Anna Grenda
- Department of Cancer Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080, Lublin, Poland
| | - Sylwia Popek
- Department of Cancer Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080, Lublin, Poland
| | - Dorota Koczkodaj
- Department of Cancer Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080, Lublin, Poland
| | | | - Michał Budzyński
- Department of Cancer Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080, Lublin, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Szymon Zmorzyński
- Department of Cancer Genetics, Medical University of Lublin, Radziwiłłowska 11, 20-080, Lublin, Poland
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Crassini K, Shen Y, Mulligan S, Giles Best O. Modeling the chronic lymphocytic leukemia microenvironment in vitro. Leuk Lymphoma 2016; 58:266-279. [PMID: 27756161 DOI: 10.1080/10428194.2016.1204654] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Microenvironments within the lymph node and bone marrow promote proliferation and drug resistance in chronic lymphocytic leukemia (CLL). Successful treatment of CLL must therefore target the leukemic cells within these compartments. A better understanding of the interaction between CLL cells and the tumor microenvironment has led to the development of in vitro models that mimic the mechanisms that support leukemic cell survival and proliferation in vivo. Employing these models as part of the pre-clinical evaluation of novel therapeutic agents enables a better approximation of their potential clinical efficacy. In this review we summarize the current literature describing how different aspects of the tumor microenvironment have been modeled in vitro and detail how these models have been employed to study the biology of the disease and potential efficacy of novel therapeutic agents.
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Affiliation(s)
- Kyle Crassini
- a Northern Blood Research Centre , Kolling Institute of Medical Research, Royal North Shore Hospital , Sydney , Australia
| | - Yandong Shen
- a Northern Blood Research Centre , Kolling Institute of Medical Research, Royal North Shore Hospital , Sydney , Australia
| | - Stephen Mulligan
- a Northern Blood Research Centre , Kolling Institute of Medical Research, Royal North Shore Hospital , Sydney , Australia.,b Chronic Lymphocytic Leukemia Research Consortium (CLLARC) , Australia
| | - O Giles Best
- a Northern Blood Research Centre , Kolling Institute of Medical Research, Royal North Shore Hospital , Sydney , Australia.,b Chronic Lymphocytic Leukemia Research Consortium (CLLARC) , Australia
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40
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Wiestner A. The role of B-cell receptor inhibitors in the treatment of patients with chronic lymphocytic leukemia. Haematologica 2016; 100:1495-507. [PMID: 26628631 DOI: 10.3324/haematol.2014.119123] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Chronic lymphocytic leukemia is a malignancy of mature auto-reactive B cells. Genetic and functional studies implicate B-cell receptor signaling as a pivotal pathway in its pathogenesis. Full B-cell receptor activation requires tumor-microenvironment interactions in lymphoid tissues. Spleen tyrosine kinase, Bruton's tyrosine kinase, and the phosphatidylinositol 3-kinase (PI3K) δ isoform are essential for B-cell receptor signal transduction but also mediate the effect of other pathways engaged in chronic lymphocytic leukemia cells in the tissue-microenvironment. Orally bioavailable inhibitors of spleen tyrosine kinase, Bruton's tyrosine kinase, or PI3Kδ, induce high rates of durable responses. Ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, and idelalisib, a selective inhibitor of PI3Kδ, have obtained regulatory approval in chronic lymphocytic leukemia. Ibrutinib and idelalisib are active in patients with high-risk features, achieving superior disease control in difficult-to-treat patients than prior best therapy, making them the preferred agents for chronic lymphocytic leukemia with TP53 aberrations and for patients resistant to chemoimmunotherapy. In randomized trials, both ibrutinib, versus ofatumumab, and idelalisib in combination with rituximab, versus placebo with rituximab improved survival in relapsed/refractory chronic lymphocytic leukemia. Responses to B-cell receptor inhibitors are mostly partial, and within clinical trials treatment is continued until progression or occurrence of intolerable side effects. Ibrutinib and idelalisib are, overall, well tolerated; notable adverse events include increased bruising and incidence of atrial fibrillation on ibrutinib and colitis, pneumonitis and transaminase elevations on idelalisib. Randomized trials investigate the role of B-cell receptor inhibitors in first-line therapy and the benefit of combinations. This review discusses the biological basis for targeted therapy of chronic lymphocytic leukemia with B-cell receptor inhibitors, and summarizes the clinical experience with these agents.
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Affiliation(s)
- Adrian Wiestner
- Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
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41
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Işıksaçan N, Çınar S, Aktaş Çetin E, Aktan M, Deniz G. Cytokine Contents in Chronic Lymphocytic Leukemia: Association with ZAP70 Expression. Turk J Haematol 2016; 33:202-8. [PMID: 26376785 PMCID: PMC5111465 DOI: 10.4274/tjh.2014.0469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 04/20/2015] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Chronic lymphocytic leukemia (CLL) is a disease that shows varying clinical progression, and expression of the protein tyrosine kinase ZAP70 has been described as a very valuable prognostic factor. Patients with ZAP70 positivity are characterized by worse clinical course and significantly shorter progression-free and overall survival. In this study, intracytoplasmic interferon gamma (IFN-γ) and interleukin-4 (IL-4) content of T, B, and CLL cells in CLL patients and their correlations with Rai staging and ZAP70 positivity were investigated. MATERIALS AND METHODS CLL patients newly diagnosed or in follow-up at the İstanbul University İstanbul Medical Faculty Hematology Department were included in this study. These patients were classified according to Rai staging and ZAP70 expression. IL-4, IFN-γ, and ZAP70 expressions in peripheral blood T, B, and CLL cells were measured by four-color flow cytometry. RESULTS There was a statistically significant correlation between advanced disease and ZAP70 positivity. IL-4-secreting T cells were significantly increased; however, IFN-γ secretion was significantly decreased in CLL patients compared to healthy individuals, whereas IL-4-secreting B cells were significantly diminished in contrast to T cells. CONCLUSION These findings suggest damage in the cellular immunity and that IL-4 might lead to many complications and may be important in disease progression.
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Affiliation(s)
| | | | | | | | - Günnur Deniz
- İstanbul University Institute of Experimental Medicine, Department of Immunology, İstanbul, Turkey, Phone : +90 212 414 20 00 (pbx) 33306 E-mail:
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Cozzolino I, Rocco M, Villani G, Picardi M. Lymph Node Fine-Needle Cytology of Non-Hodgkin Lymphoma: Diagnosis and Classification by Flow Cytometry. Acta Cytol 2016; 60:302-314. [PMID: 27554776 DOI: 10.1159/000448389] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 07/11/2016] [Indexed: 12/31/2022]
Abstract
In the last decades, lymph node fine-needle cytology (FNC), coupled with flow cytometry (FC), has gained a role in the diagnosis and classification of non-Hodgkin lymphoma (NHL). The combination of FNC/FC allows the diagnosis and classification of NHL in lymph node samples with a high sensitivity and specificity by combining cytological features and specific phenotypic profiles. The present review provides a brief technical description of FC and a detailed analysis of the current markers and their combinations (diagnostic algorithm) for the diagnosis and classification of NHL. The basic principles of clonality assessment, as well as the diagnostic strengths and weaknesses of the procedure, are reported. The current diagnostic algorithms for NHL classification are critically reviewed with a focus on specific problems related to single entities. Moreover, this review provides a detailed analysis of the different clinical contexts in which FNC/FC is performed and related implications. Future and further applications of FNC/FC for NHL are also discussed.
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Rodrigues CA, Gonçalves MV, Ikoma MRV, Lorand-Metze I, Pereira AD, Farias DLCD, Chauffaille MDLLF, Schaffel R, Ribeiro EFO, Rocha TSD, Buccheri V, Vasconcelos Y, Figueiredo VLDP, Chiattone CS, Yamamoto M. Diagnosis and treatment of chronic lymphocytic leukemia: recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia. Rev Bras Hematol Hemoter 2016; 38:346-357. [PMID: 27863764 PMCID: PMC5119662 DOI: 10.1016/j.bjhh.2016.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 07/19/2016] [Indexed: 02/06/2023] Open
Abstract
Chronic lymphocytic leukemia is characterized by clonal proliferation and progressive accumulation of B-cell lymphocytes that typically express CD19+, CD5+ and CD23+. The lymphocytes usually infiltrate the bone marrow, peripheral blood, lymph nodes, and spleen. The diagnosis is established by immunophenotyping circulating B-lymphocytes, and prognosis is defined by two staging systems (Rai and Binet) established by physical examination and blood counts, as well as by several biological and genetic markers. In this update, we present the recommendations from the Brazilian Group of Chronic Lymphocytic Leukemia for the diagnosis and treatment of chronic lymphocytic leukemia. The following recommendations are based on an extensive literature review with the aim of contributing to more uniform patient care in Brazil and possibly in other countries with a similar social–economic profile.
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Affiliation(s)
- Celso Arrais Rodrigues
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Hospital Sírio Libanês, São Paulo, SP, Brazil.
| | - Matheus Vescovi Gonçalves
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil; Fleury Medicina e Saúde, São Paulo, SP, Brazil
| | | | | | | | | | | | - Rony Schaffel
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | | | - Talita Silveira da Rocha
- A.C Camargo Cancer Center, São Paulo, SP, Brazil; Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil
| | - Valeria Buccheri
- Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil
| | - Yuri Vasconcelos
- Instituto Goiano de Oncologia e Hematologia (INGOH), Goiânia, GO, Brazil
| | | | - Carlos Sérgio Chiattone
- Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brazil; Hospital Samaritano, São Paulo, SP, Brazil
| | - Mihoko Yamamoto
- Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
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Dezorella N, Katz BZ, Shapiro M, Polliack A, Perry C, Herishanu Y. SLP76 integrates into the B-cell receptor signaling cascade in chronic lymphocytic leukemia cells and is associated with an aggressive disease course. Haematologica 2016; 101:1553-1562. [PMID: 27443285 DOI: 10.3324/haematol.2015.139154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 07/12/2016] [Indexed: 01/07/2023] Open
Abstract
I In the last decade, the B-cell receptor has emerged as a pivotal stimulus in the pathogenesis of chronic lymphocytic leukemia, and a very feasible therapeutic target in this disease. B-cell receptor responsiveness in chronic lymphocytic leukemia cells is heterogeneous among patients and correlates with aggressiveness of the disease. Here we show, for the first time, that SLP76, a key scaffold protein in T-cell receptor signaling, is ectopically expressed in chronic lymphocytic leukemia cells, with variable levels among patients, and correlates positively with unmutated immunoglobulin heavy chain variable gene status and ZAP-70 expression. We found that SLP76 was functionally active in chronic lymphocytic leukemia cells. A SYK-dependent basal level of phosphorylated SLP76 exists in the cells, and upon B-cell receptor engagement, SLP76 tyrosine phosphorylation is significantly enhanced concomitantly with increased physical association with BTK. B-cell receptor-induced SLP76 phosphorylation is mediated by upstream signaling events involving LCK and SYK. Knockdown of SLP76 in the cells resulted in decreased induction of BTK, PLCγ2 and IκB phosphorylation, as well as cell viability after B-cell receptor activation with anti-IgM. Consistent with our biochemical findings, high total SLP76 expression in chronic lymphocytic leukemia cells correlated with a more aggressive disease course. IN CONCLUSION SLP76 is ectopically expressed in chronic lymphocytic leukemia cells where it plays a role in B-cell receptor signaling.
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Affiliation(s)
- Nili Dezorella
- Department of Hematology, Tel-Aviv Sourasky Medical Center, Jerusalem, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Jerusalem, Israel
| | - Ben-Zion Katz
- Department of Hematology, Tel-Aviv Sourasky Medical Center, Jerusalem, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Jerusalem, Israel
| | - Mika Shapiro
- Department of Hematology, Tel-Aviv Sourasky Medical Center, Jerusalem, Israel
| | - Aaron Polliack
- Department of Hematology, Hadassah University Hospital and Hebrew University Medical School, Jerusalem, Israel
| | - Chava Perry
- Department of Hematology, Tel-Aviv Sourasky Medical Center, Jerusalem, Israel
| | - Yair Herishanu
- Department of Hematology, Tel-Aviv Sourasky Medical Center, Jerusalem, Israel .,Sackler Faculty of Medicine, Tel-Aviv University, Jerusalem, Israel
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Pinilla-Ibarz J, Emole J. Chronic Lymphocytic Leukemia in the Elderly, Which Investigations Are Necessary: A Map for the Practicing Oncologist. Cancer Control 2016; 22:7-16. [PMID: 26618341 DOI: 10.1177/107327481502204s03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Chronic lymphocytic leukemia (CLL), the most prevalent leukemia in the Western world, is predominantly a disease of older individuals who also have other comorbidities as well as declining organ and bone marrow reserve. Although chemoimmunotherapy is the frontline therapy for fit CLL patients who can tolerate the therapy, many elderly patients cannot tolerate such intense therapy. METHODS The authors first reviewed the most recent findings concerning CLL cytogenetics, molecular biology, and prognostic models. They then surveyed recent and ongoing trials of novel CLL agents and strategies, with a focus on those most relevant to elderly patients. RESULTS Novel therapies, revised staging procedures, and careful assessment of individual patients' frailty and functional status will allow clinicians to provide optimal care management for older CLL patients. CONCLUSION Therapy for the elderly CLL population must be tailored to each patient's fitness level and comorbid conditions, with special consideration for the potential quality-of-life impacts of various treatment recommendations.
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Affiliation(s)
- Javier Pinilla-Ibarz
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL 33612, USA.
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Matuszak M, Lewandowski K, Czyż A, Kiernicka-Parulska J, Przybyłowicz-Chalecka A, Jarmuż-Szymczak M, Lewandowska M, Komarnicki M. The prognostic significance of surface dipeptidylpeptidase IV (CD26) expression in B-cell chronic lymphocytic leukemia. Leuk Res 2016; 47:166-71. [PMID: 27376546 DOI: 10.1016/j.leukres.2016.06.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 04/03/2016] [Accepted: 06/13/2016] [Indexed: 12/12/2022]
Abstract
A number of factors related to B-cell chronic lymphocytic leukemia (B-CLL) patients' prognosis have been identified. However, still some factors better reflecting disease activity in individual cases are explored. The study aimed to evaluate prognostic significance of dipeptidylpeptidase IV/CD26 expression on B-CLL cells and its relationship with other well established prognostic factors. The study included 94 patients with newly diagnosed B-CLL and involved analysis of clinical, laboratory, flow-cytometry and cytogenetic data. Detailed analysis showed that CD26 expression on B-CLL cells correlates with Rai's clinical stage of the disease at diagnosis (p=0.034), β2-microglobulin concentration (p=0.012), lactic acid dehydrogenase activity (p=0.045) and absolute lymphocytes' count (p=0.027) in the blood. The multivariate analysis revealed that time to treatment (TTT) was significantly influenced by Rai clinical stage, LDH activity in blood and CD26 expression on B-CLL cell's. Moreover, in the multivariate analysis restricted to the group of patients with documented cytogenetic risk (n=36) CD26 expression, Rai clinical stage and cytogenetic profile remained their independent impact on TTT. The results of our study indicate that the CD26 expression should be incorporated in B-CLL patients risk assessment along with well known prognostic factors, since it seems to have a relationship with the tumor mass and influences TTT.
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Affiliation(s)
- Magdalena Matuszak
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Krzysztof Lewandowski
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland.
| | - Anna Czyż
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Jolanta Kiernicka-Parulska
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Przybyłowicz-Chalecka
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Jarmuż-Szymczak
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland; Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Maria Lewandowska
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Mieczysław Komarnicki
- Department of Haematology and Stem Cell Transplantation, Poznan University of Medical Sciences, Poznan, Poland
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Bachow SH, Lamanna N. Evolving Strategies for the Treatment of Chronic Lymphocytic Leukemia in the Upfront Setting. Curr Hematol Malig Rep 2016; 11:61-70. [PMID: 26951237 DOI: 10.1007/s11899-016-0298-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Chronic lymphocytic leukemia (CLL) is a disease of marked clinical heterogeneity, and while some patients have a normal life expectancy, others develop rapidly progressive disease shortly after diagnosis. The current standard for upfront treatment of CLL is chemoimmunotherapy for younger fit patients, FCR (fludarabine, cyclophosphamide, and rituximab) being the prototype. For older patients, BR (bendamustine and rituximab) exhibits excellent activity with decreased toxicity. For the frailest patients, CD20 monoclonal antibodies with or without chlorambucil have proven to be efficacious. The novel oral kinase inhibitors ibrutinib and idelalisib are FDA-approved in the relapsed/refractory setting, and ibrutinib is approved upfront for those with del(17p). These drugs have produced long-term durable responses in the relapsed/refractory setting, and studies are underway using these as single agent upfront or in combination with both chemotherapy and monoclonal antibodies. Here, we review standard upfront therapies and new agents and combinations that are on the horizon for CLL.
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Affiliation(s)
- Spencer H Bachow
- Leukemia Service, Division of Hematology and Oncology, Department of Medicine, Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Nicole Lamanna
- Leukemia Service, Division of Hematology and Oncology, Department of Medicine, Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA. .,College of Physicians and Surgeons, Columbia University Medical Center, 161 Fort Washington Avenue, 9th Floor, New York, NY, USA.
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Abstract
B-cell chronic lymphocytic leukemia (CLL) is the most common adult human leukemia. Although, the molecular alterations leading to CLL onset and progression are still under investigation (specifically, the interplay and exact role of oncogenes and tumor suppressors in CLL pathogenesis). MicroRNAs are small non-coding RNAs that regulate gene expression and are expressed in a tissue specific manner. Deregulation of microRNAs can alter expression levels of genes involved in the development and/or progression of tumors. In CLL, microRNAs can function as oncogenes or tumor suppressors. Here, we review the most recent findings on the role of microRNAs in the onset/progression of CLL, and how this knowledge can be used to identify new biomarkers and targets to treat this leukemia.
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Affiliation(s)
- Veronica Balatti
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Mario Acunzo
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Yuri Pekarky
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
| | - Carlo M Croce
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, Wexner Medical Center, The Ohio State University, Columbus, OH, USA
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Amaya-Chanaga CI, Rassenti LZ. Biomarkers in chronic lymphocytic leukemia: Clinical applications and prognostic markers. Best Pract Res Clin Haematol 2016; 29:79-89. [DOI: 10.1016/j.beha.2016.08.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 07/07/2016] [Accepted: 08/04/2016] [Indexed: 02/01/2023]
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Davis Z, Forconi F, Parker A, Gardiner A, Thomas P, Catovsky D, Rose-Zerilli M, Strefford JC, Oscier D. The outcome of Chronic lymphocytic leukaemia patients with 97% IGHV gene identity to germline is distinct from cases with <97% identity and similar to those with 98% identity. Br J Haematol 2016; 173:127-36. [PMID: 26846718 DOI: 10.1111/bjh.13940] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/18/2015] [Indexed: 12/25/2022]
Abstract
IGHV gene mutational status has prognostic significance in chronic lymphocytic leukaemia (CLL) but the percentage of mutations that correlates best with clinical outcome remains controversial. We initially studied 558 patients from diagnosis and found significant differences in median time to first treatment (TTFT) among Stage A patients and in overall survival (OS) for the whole cohort, between cases with <97% and 97-98·99% identity and between cases with 97-98·99% and ≥99% identity, when cases from the IGHV3-21 Stereotype Subset #2 were excluded. A significant difference in progression-free survival (PFS) and OS between those with <97% and 97-98·99% identity, but not between those with 97-98·99% and ≥99% identity was also observed in a validation cohort comprising 460 patients in the UK CLL4 trial. Cox Regression analyses in the Stage A cohort revealed that a model which incorporated <97%, 97-98·99% and ≥99% identity as subgroups, was a better predictor of TTFT in CLL than using the 98% cut-off. Multivariate analysis selected the three mutational subgroups as independent predictors of TTFT in Stage A patients, and of OS in the diagnostic cohort. This study highlights that cases with 97% identity should not be considered to have the same prognosis as other cases with mutated IGHV genes defined as <98% identity to germline.
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Affiliation(s)
- Zadie Davis
- Department of Molecular Pathology, Royal Bournemouth Hospital, Sutton, UK
| | | | - Anton Parker
- Department of Molecular Pathology, Royal Bournemouth Hospital, Sutton, UK
| | - Anne Gardiner
- Department of Molecular Pathology, Royal Bournemouth Hospital, Sutton, UK
| | - Peter Thomas
- Clinical Research Unit, Bournemouth University, Sutton, UK
| | - Daniel Catovsky
- Department of Haemato-oncology, Institute for Cancer Research, Sutton, UK
| | | | | | - David Oscier
- Department of Molecular Pathology, Royal Bournemouth Hospital, Sutton, UK
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