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Basquiera AL, Seiwald MC, Best Aguilera CR, Enciso L, Fernandez I, Jansen AM, Nunes E, Sanchez del Villar M, Urbalejo Ceniceros VI, Rocha V. Expert Recommendations for the Diagnosis, Treatment, and Management of Adult B-Cell Acute Lymphoblastic Leukemia in Latin America. JCO Glob Oncol 2023; 9:e2200292. [PMID: 37167576 PMCID: PMC10497277 DOI: 10.1200/go.22.00292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/19/2023] [Accepted: 03/13/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE Despite strong induction chemotherapy response rates, only 30%-40% of patients with adult B-cell acute lymphoblastic leukemia (ALL) attain long-term remission. This study analyzes ALL in Latin America (LA) and recommends diagnosis, treatment, and management protocols. METHODS The Americas Health Foundation organized a panel of hematologists from Argentina, Brazil, Chile, Colombia, and Mexico to examine ALL diagnosis and therapy and produce recommendations. RESULTS Lack of regional data, unequal access to diagnosis and therapy, inadequate treatment response, and uneven health care distribution complicate adult ALL management. The panel recommended diagnosis, first-line and refractory treatment, and post-transplantation maintenance. Targeted treatments, including rituximab, blinatumomab, and inotuzumab ozogamicin, are becoming available in LA and must be equitably accessed. CONCLUSION This review adapts global information on treating ALL to LA. Governments, the medical community, society, academia, industry, and patient advocates must work together to improve policies.
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Affiliation(s)
- Ana Lisa Basquiera
- Hematology and Oncology Service, Bone Marrow Transplant Program, Hospital Privado Universitario de Cordoba, Instituto Universitario de Ciencias Biomédicas de Cordoba (IUCBC), Cordoba, Argentina
| | - Maria Cristina Seiwald
- Department of Clinical Medicine, Hematology and Hemotherapy, University of Sao Paulo (FMUSP), Sao Paulo, Brazil
| | - Carlos Roberto Best Aguilera
- Conacyt National Quality Postgraduate Program, University of Guadalajara & Western General Hospital, Guadalajara, Mexico
| | | | | | | | - Elenaide Nunes
- Hospital de Clínicas—Federal University of Parana, Parana, Brazil
| | - Matias Sanchez del Villar
- Chief Bone Marrow Transplant Service, Department of Hematology, Clinica Alemana de Santiago, Santiago, Chile
| | | | - Vanderson Rocha
- Department of Clinical Medicine, Hematology and Hemotherapy, University of Sao Paulo (FMUSP), Sao Paulo, Brazil
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2
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Thair Tahir N, Thamer NA, Mahmood NA.. Role of Vitamin D in the diagnosis of acute Myeloid Leukemia. BIONATURA 2023. [DOI: 10.21931/rb/2023.08.01.50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
A range of hematological and biochemical markers have been investigated in Acute Myeloid Leukemia (AML) patients to determine the relationship between cancer growth and metabolic problems. This study aimed to determine the effects of vitamin D deficiency in Iraqi patients with acute myeloid leukemia who had recently been diagnosed. There was a significant inverse correlation between the total serum cholesterol (TC) level of acute myeloid leukemia (AML) patients group [(148.77±12.2) for males, (165.29±9.64) for females] and the control group [(164.50±7.26) for males, (180.05±7.31) for females], also an inverse correlation between high-density lipoprotein (HDL) level of acute myeloid leukemia (AML) patients group [(46.00±2.04) for males, (46.18±1.08) for females] and control group [(54.25±1.86) for males,(51.94±1.37) for females]. A significant difference was between the serum triglyceride (TG) level of acute myeloid leukemia (AML) patients group [(128.71±13.07) for males, (152.48±10.6) for females] and control group [85.12±11.30) for male, (90.50±10.90) for females], also between vitamin D level of acute myeloid leukemia (AML) patients group [(17.23±1.18) for males, (12.96±0.74) for females] and control group [(42.62±1.43) for males, (40.76±0.82) for females]. A statistically significant difference was between the serum calcium levels of individuals with acute myeloid leukemia [(8.99±0.32) for males, (8.91±0.23) for females] and the control group [(13.13±1.16) for males, (10.73±0.28) for females]. AML patients can benefit from vitamin D treatment, according to a pairwise analysis of receiver operating characteristic (ROC) curves. The above results are related to concluding that Vitamin D can be utilized as a diagnostic test for AML patients.
Keywords; acute myeloid leukemia (AML), Hypereosinophilia, ROC curve, hypocholesterolemia, vitamin D.
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Affiliation(s)
| | - N. A Thamer
- Medical Technical College, Al-Farahidi University, Al-Jadiriyah Bridge, Baghdad, Iraq
| | - Noah A . Mahmood
- Iraqi Center for Cancer and Medical Genetics Research -Muatansiriyah University Baghdad, Iraq
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3
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Colunga-Pedraza PR, Colunga-Pedraza JE, Peña-Lozano SP, Gómez-De León A, Ruiz-Delgado GJ, Ribeiro RC. Diagnosis and treatment of acute lymphoblastic leukemia in Latin America. HEMATOLOGY (AMSTERDAM, NETHERLANDS) 2022; 27:971-976. [PMID: 36040187 DOI: 10.1080/16078454.2022.2117119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE to discuss the status and challenges associated with the management of acute lymphoblastic leukemia (ALL) in Latin America. METHODS This review summarizes various insights gained from information regarding diagnostic approaches and treatment strategies in adult patients with ALL in Latin American Countries. RESULTS Information regarding ALL in Latin America is scarce; however, many efforts have been made to overcomes these barriers. Nevertheless, major obstacles to successful treatment in Latin America and LMIC remain poor adherence, abandonment of treatment, and lack of supportive therapy and new therapeutic agents. CONCLUSION Further improvements in survival should be pursued by developing more Latin American registries, forming cooperative groups, developing educational models to facilitate earlier diagnosis and prevention of complications, better support therapy and management of infections, and adapting treatment strategies.
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Affiliation(s)
- Perla R Colunga-Pedraza
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Hematología, Hospital Universitario "Dr. José E. González", Monterrey, Mexico
| | - Julia E Colunga-Pedraza
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Hematología, Hospital Universitario "Dr. José E. González", Monterrey, Mexico
| | - Samantha P Peña-Lozano
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Hematología, Hospital Universitario "Dr. José E. González", Monterrey, Mexico
| | - Andrés Gómez-De León
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Servicio de Hematología, Hospital Universitario "Dr. José E. González", Monterrey, Mexico
| | - Guillermo J Ruiz-Delgado
- Centro de Hematología y Medicina Interna, Clínica RUIZ, Puebla, Mexico.,Universidad Popular Autónoma del Estado de Puebla, Puebla, México
| | - Raul C Ribeiro
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
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4
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Rivera-Luna R, Perez-Vera P, Galvan-Diaz C, Velasco-Hidalgo L, Olaya-Vargas A, Cardenas-Cardos R, Aguilar-Ortiz M, Ponce-Cruz J. Triple-hit explanation for the worse prognosis of pediatric acute lymphoblastic leukemia among Mexican and Hispanic children. Front Oncol 2022; 12:1072811. [PMID: 36531028 PMCID: PMC9747921 DOI: 10.3389/fonc.2022.1072811] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 10/31/2022] [Indexed: 04/06/2024] Open
Abstract
Acute lymphoblastic leukemia (ALL) is the most common malignancy among Mexican and Hispanic children and the first cause of death by disease in Mexico. We propose a "triple-hit" explanation for the survival gap affecting this population. The first hit can be attributed to epidemiology and social, cultural, and economic burdens. The second hit refers to cancer biology, with a high incidence of unfavorable genetic characteristics associated with an unfavorable response to treatment and, subsequently, poor survival. Finally, the third hit relates to sub-optimal treatment and support. Society and culture, leukemia biology, and treatment approach limitations are key factors that should not be seen apart and must be considered comprehensively in any strategy to improve the prognosis of Mexican and Hispanic children with ALL.
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Affiliation(s)
- Roberto Rivera-Luna
- Department of Oncology, National Institute of Pediatrics, Mexico City, Mexico
- Progenitor and Hematopoietic Cell Transplant Unit, National Institute of Pediatrics, Mexico City, Mexico
| | - Patricia Perez-Vera
- Laboratory of Genetics and Cancer, National Institute of Pediatrics, Mexico City, Mexico
| | - Cesar Galvan-Diaz
- Department of Oncology, National Institute of Pediatrics, Mexico City, Mexico
| | | | - Alberto Olaya-Vargas
- Progenitor and Hematopoietic Cell Transplant Unit, National Institute of Pediatrics, Mexico City, Mexico
| | | | - Marco Aguilar-Ortiz
- Department of Oncology, National Institute of Pediatrics, Mexico City, Mexico
| | - Jesus Ponce-Cruz
- Pediatric Oncology Unit, ABC Medical Center, Mexico City, Mexico
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5
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Bradley T, Kwon D, Monge J, Sekeres M, Chandhok N, Thomassen A, Swords R, Padron E, Lancet J, Talati C, Watts J. Molecular characteristics and outcomes in Hispanic and non-Hispanic patients with acute myeloid leukemia. EJHAEM 2022; 3:1231-1240. [PMID: 36467830 PMCID: PMC9713060 DOI: 10.1002/jha2.589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/17/2022] [Indexed: 06/17/2023]
Abstract
Hispanic patients have been reported to have an increased incidence of AML and possibly inferior outcomes compared to non-Hispanics. We conducted a retrospective study of 225 AML patients (58 Hispanic and 167 non-Hispanic) at two academic medical centers in Florida. Disease characteristics, cytogenetics, mutation profiles, and clinical outcomes were assessed. Hispanic patients were younger at presentation than non-Hispanics (p = 0.0013). We found associations between single gene mutations and ethnicity, with IDH1 mutations being more common in non-Hispanics (95.2% vs. 4.8%, p = 0.0182) and WT1 mutations more common in Hispanics (62.5% vs. 37.5%, p = 0.0455). We also found an emerging trend towards adverse risk cytogenetics in Hispanic patients (p = 0.1796), as well as high risk fusions such as MLL-r (70% vs. 30%, p = 0.004). There was no difference in overall survival (OS) between Hispanic and non-Hispanics patients. When examining only newly diagnosed patients (n = 105), there was improved OS in Hispanics (median 44.7 months vs. 14 months, p = 0.026) by univariate analysis and equivalent OS by multivariate analysis (hazard ratio = 1.52 [95% CI = 0.74-3.15]). Hispanics with a driver mutation not class-defining had improved survival compared to non-Hispanics. Our study demonstrates significant genetic differences between Floridian Hispanics and non-Hispanics, but no difference in OS in patients treated at an academic medical center.
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Affiliation(s)
- Terrence Bradley
- Division of Hematology, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
| | - Deukwoo Kwon
- Division of Biostatistics, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
| | - Jorge Monge
- Division of Hematology and Medical OncologyWeill Cornell Medical CollegeNew YorkNew YorkUSA
| | - Mikkael Sekeres
- Division of Hematology, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
| | - Namrata Chandhok
- Division of Hematology, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
| | - Amber Thomassen
- Division of Hematology, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
| | - Ronan Swords
- Division of Hematology and Medical OncologyOregon Health Sciences UniversityPortlandOregonUSA
| | - Eric Padron
- Department of Malignant HematologyMoffitt Cancer CenterTampaFloridaUSA
| | - Jeff Lancet
- Department of Malignant HematologyMoffitt Cancer CenterTampaFloridaUSA
| | - Chetasi Talati
- Department of Malignant HematologyMoffitt Cancer CenterTampaFloridaUSA
| | - Justin Watts
- Division of Hematology, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiFloridaUSA
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6
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Ayala-Marin YM, Grant AH, Rodriguez G, Kirken RA. Quadruple and Truncated MEK3 Mutants Identified from Acute Lymphoblastic Leukemia Promote Degradation and Enhance Proliferation. Int J Mol Sci 2021; 22:12210. [PMID: 34830095 PMCID: PMC8618549 DOI: 10.3390/ijms222212210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 11/17/2022] Open
Abstract
Compared to other ethnicities, Hispanic children incur the highest rates of leukemia, and most cases are diagnosed as Acute Lymphoblastic Leukemia (ALL). Despite improved treatment and survival for ALL, disproportionate health outcomes in Hispanics persist. Thus, it is essential to identify oncogenic mutations within this demographic to aid in the development of new strategies to diagnose and treat ALL. Using whole-exome sequencing, five single nucleotide polymorphisms within mitogen-activated protein kinase 3 (MAP2K3) were identified in an ALL cancer patient library from the U.S./Mexico border. MAP2K3 R26T and P11T are located near the substrate-binding site, while R65L and R67W localized to the kinase domain. Truncated-MAP2K3 mutant Q73* was also identified. Transfection in HEK293 cells showed that the quadruple-MEK3 mutant (4M-MEK3) impacted protein stability, inducing degradation and reducing expression. The expression of 4M-MEK3 could be rescued by cysteine/serine protease inhibition, and proteasomal degradation of truncated-MEK3 occurred in a ubiquitin-independent manner. MEK3 mutants displayed reduced auto-phosphorylation and enzymatic activity, as seen by decreases in p38 phosphorylation. Furthermore, uncoupling of the MEK3/p38 signaling pathway resulted in less suppressive activity on HEK293 cell viability. Thus, disruption of MEK3 activation may promote proliferative signals in ALL. These findings suggest that MEK3 represents a potential therapeutic target for treating ALL.
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Affiliation(s)
| | | | | | - Robert A. Kirken
- Border Biomedical Research Center, Department of Biological Sciences, The University of Texas at El Paso, El Paso, TX 79968, USA; (Y.M.A.-M.); (A.H.G.); (G.R.)
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7
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Bencomo-Alvarez AE, Rubio AJ, Gonzalez MA, Eiring AM. Blood cancer health disparities in the United States Hispanic population. Cold Spring Harb Mol Case Stud 2021; 7:a005967. [PMID: 33593728 PMCID: PMC8040735 DOI: 10.1101/mcs.a005967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Cancer is a challenging, multifaceted disease that involves a combination of biological and nonbiological factors. Aside from COVID-19, cancer is the second leading cause of death in the United States and the first among Hispanic Americans. The Hispanic population is the largest minority group in the United States, which is rapidly growing in size. Unfortunately, U.S. Hispanics and other minority groups experience many different health disparities, resulting in poor survival outcomes and a reduced quality of life. Factors such as genomic mutations, lower socioeconomic status, lack of education, reduced access to health care, comorbidities, and environmental factors all contribute to these health-care inequalities. In the context of blood cancer health disparities, Hispanic patients are often diagnosed at a younger age and have worse outcomes compared with non-Hispanic individuals. In this commentary, we highlight the existing knowledge about cancer health disparities in the Hispanic population, with a focus on chronic and acute leukemia. In our experience at the U.S./Mexican border, analysis of several different blood cancers demonstrated that younger Hispanic patients with acute lymphoid or myeloid leukemia have higher incidence rates and worse prognoses. A combined approach, involving improved health-care access and better knowledge of the underlying factors, will allow for more timely diagnoses and the development of intervention strategies aimed at reducing or eliminating the disparities.
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Affiliation(s)
- Alfonso E Bencomo-Alvarez
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas 79905, USA
| | - Andres J Rubio
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas 79905, USA
| | - Mayra A Gonzalez
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas 79905, USA
| | - Anna M Eiring
- Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas 79905, USA
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8
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Diversity of genetic alterations of primary central nervous system lymphoma in Hispanic versus non-Hispanic patients. Cancer Treat Res Commun 2021; 27:100310. [PMID: 33581493 DOI: 10.1016/j.ctarc.2021.100310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 01/02/2021] [Accepted: 01/08/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE Primary central nervous system lymphoma (PCNSL) is a rare type of non-Hodgkin lymphoma. Previous studies have identified MYD88, CD79b and PIM1 as the most common genetic mutations in PCNSL. The extent to which mutations vary by ethnicity is unknown. The purpose of this study was to describe differences in genetic mutations and survival by Hispanic ethnicity in PCNSL. METHODS 30 patients with PCNSL were examined for mutations in 275 genes by DNA analysis and 1408 genes by RNA analysis utilizing next generation sequencing. RESULTS 60% of patients were Hispanic. 125 different mutated genes were detected. The most commonly affected genes were: MYD88 (44%), CARD11 (21%), CD79b (17%), PIM1 (17%) and KMT2D (17%) . MYD88 mutation was less frequent in Hispanic patients (27% vs 66%, P=.02). More Hispanic patients had >3 mutated genes (89% vs 55 %. P=.03). Two-year progression-free survival (PFS) and overall survival (OS) in Hispanic vs. non-Hispanic patients (PFS 60% vs 27%, P=.09), (OS 60% vs 36%, P=.23). MYD88, CARD11, PIM1, and KMT2D were not associated with significant differences in OS or PFS. CD79b mutation correlated with superior 2-yr PFS (P=.04). CONCLUSIONS We identified highly recurrent genetic alterations in PCNSL. Our data suggest that heterogeneity in some mutations may be related to ethnicity. There was no statistically significant difference in 2-yr PFS and OS in our Hispanic patients. Studies on larger population may further help to describe differences in tumor biology, and outcomes in Hispanic patients.
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9
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Dinmohamed AG, Visser O. Incidence of acute promyelocytic leukemia across Europe: results of RARECAREnet-a population-based study. Stem Cell Investig 2019; 6:37. [PMID: 31853453 DOI: 10.21037/sci.2019.10.03] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/08/2019] [Indexed: 11/06/2022]
Abstract
The scarcity of studies performed over the past decades in Central and South America provided clues that the prevalence of acute promyelocytic leukemia (APL)-a rare and distinct subtype of acute myeloid leukemia-might be higher among descendants of Spaniards, as compared to other ethnic groups. Currently, a comprehensive apprehension on APL incidence across Europe has yet been established. Therefore, we conducted a population-based study to assess the incidence of APL across Europe. We selected all patients diagnosed with APL in Europe from the RARECAREnet database that holds data from 94 cancer registries across 27 European countries on rare malignancies diagnosed during 2000-2007. Age-standardized incidence rates (ASRs) with 95% confidence intervals (CIs) were calculated for the European pool per 100,000 person-years. Also, crude incidence rates with 95% CIs were calculated per 100,000 person-years by country. Overall, 1,876 patients with APL (48% male and 24% aged ≥65 years) were included in our analytic cohort. The overall ASR of APL was 0.112 (95% CI, 0.107-0.117) in Europe. The incidence of APL varied considerably across Europe, with the highest incidence in Spain (0.257; 95% CI, 0.205-0.317), as compared to the European average. Altogether, these finding adds additional support to the hypothesis that APL might be more prevalent among individuals with Spanish ancestry. Future research is warranted to specifically explore etiologic factors of APL across different genetic and environmental backgrounds.
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Affiliation(s)
- Avinash G Dinmohamed
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands.,Amsterdam UMC, University of Amsterdam, Department of Hematology, Cancer Center Amsterdam, Amsterdam, The Netherlands
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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10
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Mata-Rocha M, Rangel-López A, Jiménez-Hernández E, Morales-Castillo BA, González-Torres C, Gaytan-Cervantes J, Álvarez-Olmos E, Núñez-Enríquez JC, Fajardo-Gutiérrez A, Martín-Trejo JA, Solís-Labastida KA, Medina-Sansón A, Flores-Lujano J, Sepúlveda-Robles OA, Peñaloza-González JG, Espinoza-Hernández LE, Núñez-Villegas NN, Espinosa-Elizondo RM, Cortés-Herrera B, Torres-Nava JR, Flores-Villegas LV, Merino-Pasaye LE, Bekker-Méndez VC, Velázquez-Aviña MM, Pérez-Saldívar ML, Bautista-Martínez BA, Amador-Sánchez R, González-Avila AI, Jiménez-Morales S, Duarte-Rodríguez DA, Santillán-Juárez JD, García-Velázquez AJ, Rosas-Vargas H, Mejía-Aranguré JM. Identification and Characterization of Novel Fusion Genes with Potential Clinical Applications in Mexican Children with Acute Lymphoblastic Leukemia. Int J Mol Sci 2019; 20:E2394. [PMID: 31096545 PMCID: PMC6566803 DOI: 10.3390/ijms20102394] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 11/27/2018] [Accepted: 11/30/2018] [Indexed: 11/16/2022] Open
Abstract
Acute lymphoblastic leukemia is the most common type of childhood cancer worldwide. Mexico City has one of the highest incidences and mortality rates of this cancer. It has previously been recognized that chromosomal translocations are important in cancer etiology. Specific fusion genes have been considered as important treatment targets in childhood acute lymphoblastic leukemia (ALL). The present research aimed at the identification and characterization of novel fusion genes with potential clinical implications in Mexican children with acute lymphoblastic leukemia. The RNA-sequencing approach was used. Four fusion genes not previously reported were identified: CREBBP-SRGAP2B, DNAH14-IKZF1, ETV6-SNUPN, ETV6-NUFIP1. Although a fusion gene is not sufficient to cause leukemia, it could be involved in the pathogenesis of the disease. Notably, these new translocations were found in genes encoding for hematopoietic transcription factors which are known to play an important role in leukemogenesis and disease prognosis such as IKZF1, CREBBP, and ETV6. In addition, they may have an impact on the prognosis of Mexican pediatric patients with ALL, with the potential to be included in the current risk stratification schemes or used as therapeutic targets.
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Affiliation(s)
- Minerva Mata-Rocha
- CONACyT-Unidad de Investigacion Medica en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Siglo XXI, IMSS, 06720 Mexico City, Mexico.
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Angelica Rangel-López
- Coordinacion de Investigacion en Salud, Unidad Habilitada de Apoyo al Predictamen, Centro Medico Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Elva Jiménez-Hernández
- Servicio de Hematologia Pediatrica, Hospital General "Gaudencio González Garza", Centro Medico Nacional (CMN) "La Raza", IMSS, 02990 Mexico City, Mexico.
- Servicio de Oncología, Hospital Pediatrico de Moctezuma, Secretaria de Salud de la Ciudad de Mexico, Ciudad de Mexico, 15530 Mexico City, Mexico.
| | - Blanca Angélica Morales-Castillo
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Carolina González-Torres
- Laboratorio de Secuenciación, Division de Desarrollo de la Investigacion, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Javier Gaytan-Cervantes
- Laboratorio de Secuenciación, Division de Desarrollo de la Investigacion, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Enrique Álvarez-Olmos
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Juan Carlos Núñez-Enríquez
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Arturo Fajardo-Gutiérrez
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Jorge Alfonso Martín-Trejo
- Servicio de Hematologia, UMAE Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | | | - Aurora Medina-Sansón
- Servicio de Oncología, Hospital Infantil de Mexico Federico Gómez, Secretaria de Salud, 06720 Mexico City, Mexico.
| | - Janet Flores-Lujano
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Omar Alejandro Sepúlveda-Robles
- CONACyT-Unidad de Investigacion Medica en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Siglo XXI, IMSS, 06720 Mexico City, Mexico.
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | | | - Laura Eugenia Espinoza-Hernández
- Servicio de Hematologia Pediatrica, Hospital General "Gaudencio González Garza", Centro Medico Nacional (CMN) "La Raza", IMSS, 02990 Mexico City, Mexico.
| | - Nora Nancy Núñez-Villegas
- Servicio de Hematologia Pediatrica, Hospital General "Gaudencio González Garza", Centro Medico Nacional (CMN) "La Raza", IMSS, 02990 Mexico City, Mexico.
| | | | - Beatriz Cortés-Herrera
- Servicio de Hematologia Pediatrica, Hospital General de Mexico, Secretaria de Salud, 06726 Mexico City, Mexico.
| | - José Refugio Torres-Nava
- Servicio de Oncología, Hospital Pediatrico de Moctezuma, Secretaria de Salud de la Ciudad de Mexico, Ciudad de Mexico, 15530 Mexico City, Mexico.
| | - Luz Victoria Flores-Villegas
- Servicio de Hematologia Pediatrica, Centro Medico Nacional "20 de Noviembre", ISSSTE, 03229 Mexico City, Mexico.
| | | | - Vilma Carolina Bekker-Méndez
- Unidad de Investigacion Medico en Inmunologia e Infectologia, Hospital de Infectologia "Dr. Daniel Méndez Hernández", "La Raza", IMSS, 02990 Mexico City, Mexico.
| | | | - María Luisa Pérez-Saldívar
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | | | - Raquel Amador-Sánchez
- Servicio de Hematologia Pediatrica, Hospital General Regional "Carlos McGregor Sanchez Navarro", IMSS, 03100 Mexico City, Mexico.
| | - Ana Itamar González-Avila
- Servicio de Hematologia Pediatrica, Hospital General Regional "Carlos McGregor Sanchez Navarro", IMSS, 03100 Mexico City, Mexico.
| | - Silvia Jiménez-Morales
- Laboratorio de Genomica del Cancer del Instituto Nacional de Medicina Genomica (INMEGEN), 14610 Mexico City, Mexico.
| | - David Aldebarán Duarte-Rodríguez
- Unidad de Investigacion Medico en Epidemiologia Clinica, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | | | | | - Haydeé Rosas-Vargas
- Unidad de Investigacion Medica en Genética Humana, Hospital de Pediatria, Centro Medico Nacional Siglo XXI, IMSS, 06720 Mexico City, Mexico.
| | - Juan Manuel Mejía-Aranguré
- Coordinación de Investigacion en Salud, IMSS, Torre Academia Nacional de Medicina, 06720 Mexico City, Mexico.
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11
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Shallis RM, Wang R, Davidoff A, Ma X, Zeidan AM. Epidemiology of acute myeloid leukemia: Recent progress and enduring challenges. Blood Rev 2019; 36:70-87. [PMID: 31101526 DOI: 10.1016/j.blre.2019.04.005] [Citation(s) in RCA: 404] [Impact Index Per Article: 80.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/06/2019] [Accepted: 04/26/2019] [Indexed: 01/08/2023]
Abstract
Acute myeloid leukemia (AML) is a malignant disorder of the bone marrow which is characterized by the clonal expansion and differentiation arrest of myeloid progenitor cells. The age-adjusted incidence of AML is 4.3 per 100,000 annually in the United States (US). Incidence increases with age with a median age at diagnosis of 68 years in the US. The etiology of AML is heterogeneous. In some patients, prior exposure to therapeutic, occupational or environmental DNA-damaging agents is implicated, but most cases of AML remain without a clear etiology. AML is the most common form of acute leukemia in adults and has the shortest survival (5-year survival = 24%). Curative therapies, including intensive chemotherapy and allogeneic stem cell transplantation, are generally applicable to a minority of patients who are younger and fit, while most older individuals exhibit poor prognosis and survival. Differences in patient outcomes are influenced by disease characteristics, access to care including active therapies and supportive care, and other factors. After many years without therapeutic advances, several new therapies have been approved and are expected to impact patient outcomes, especially for older patients and those with refractory disease.
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Affiliation(s)
- Rory M Shallis
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, USA
| | - Rong Wang
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, USA; Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, USA
| | - Amy Davidoff
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, USA; Department of Health Policy and Management, School of Public Health, Yale University, New Haven, USA
| | - Xiaomei Ma
- Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, USA; Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, USA
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine, New Haven, USA; Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Yale University, New Haven, USA.
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Fernandes da Silva Junior W, Medina AB, Yamakawa PE, Buccheri V, Velloso ED, Rocha V. Treating Adult Acute Lymphoblastic Leukemia in Brazil—Increased Early Mortality Using a German Multicenter Acute Lymphoblastic Leukemia-based regimen. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2018; 18:e255-e259. [DOI: 10.1016/j.clml.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 02/27/2018] [Accepted: 03/08/2018] [Indexed: 10/17/2022]
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13
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Hispanic ethnicity is associated with younger age at presentation but worse survival in acute myeloid leukemia. Blood Adv 2017; 1:2120-2123. [PMID: 29296859 DOI: 10.1182/bloodadvances.2017007013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 09/04/2017] [Indexed: 11/20/2022] Open
Abstract
SEER data and a Bronx validation cohort demonstrate that Hispanics present with AML at younger age but have shorter survival than whites.Increased frequency of high-risk mutations in Hispanics provides a potential biologic explanation for poorer outcomes in Hispanics.
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