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Zavras PD, Sinanidis I, Tsakiroglou P, Karantanos T. Understanding the Continuum between High-Risk Myelodysplastic Syndrome and Acute Myeloid Leukemia. Int J Mol Sci 2023; 24:ijms24055018. [PMID: 36902450 PMCID: PMC10002503 DOI: 10.3390/ijms24055018] [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: 01/31/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Myelodysplastic syndrome (MDS) is a clonal hematopoietic neoplasm characterized by bone marrow dysplasia, failure of hematopoiesis and variable risk of progression to acute myeloid leukemia (AML). Recent large-scale studies have demonstrated that distinct molecular abnormalities detected at earlier stages of MDS alter disease biology and predict progression to AML. Consistently, various studies analyzing these diseases at the single-cell level have identified specific patterns of progression strongly associated with genomic alterations. These pre-clinical results have solidified the conclusion that high-risk MDS and AML arising from MDS or AML with MDS-related changes (AML-MRC) represent a continuum of the same disease. AML-MRC is distinguished from de novo AML by the presence of certain chromosomal abnormalities, such as deletion of 5q, 7/7q, 20q and complex karyotype and somatic mutations, which are also present in MDS and carry crucial prognostic implications. Recent changes in the classification and prognostication of MDS and AML by the International Consensus Classification (ICC) and the World Health Organization (WHO) reflect these advances. Finally, a better understanding of the biology of high-risk MDS and the mechanisms of disease progression have led to the introduction of novel therapeutic approaches, such as the addition of venetoclax to hypomethylating agents and, more recently, triplet therapies and agents targeting specific mutations, including FLT3 and IDH1/2. In this review, we analyze the pre-clinical data supporting that high-risk MDS and AML-MRC share the same genetic abnormalities and represent a continuum, describe the recent changes in the classification of these neoplasms and summarize the advances in the management of patients with these neoplasms.
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Dey D, Hasan MM, Biswas P, Papadakos SP, Rayan RA, Tasnim S, Bilal M, Islam MJ, Arshe FA, Arshad EM, Farzana M, Rahaman TI, Baral SK, Paul P, Bibi S, Rahman MA, Kim B. Investigating the Anticancer Potential of Salvicine as a Modulator of Topoisomerase II and ROS Signaling Cascade. Front Oncol 2022; 12:899009. [PMID: 35719997 PMCID: PMC9198638 DOI: 10.3389/fonc.2022.899009] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/02/2022] [Indexed: 12/14/2022] Open
Abstract
Salvicine is a new diterpenoid quinone substance from a natural source, specifically in a Chinese herb. It has powerful growth-controlling abilities against a broad range of human cancer cells in both in vitro and in vivo environments. A significant inhibitory effect of salvicine on multidrug-resistant (MDR) cells has also been discovered. Several research studies have examined the activities of salvicine on topoisomerase II (Topo II) by inducing reactive oxygen species (ROS) signaling. As opposed to the well-known Topo II toxin etoposide, salvicine mostly decreases the catalytic activity with a negligible DNA breakage effect, as revealed by several enzymatic experiments. Interestingly, salvicine dramatically reduces lung metastatic formation in the MDA-MB-435 orthotopic lung cancer cell line. Recent investigations have established that salvicine is a new non-intercalative Topo II toxin by interacting with the ATPase domains, increasing DNA-Topo II interaction, and suppressing DNA relegation and ATP hydrolysis. In addition, investigations have revealed that salvicine-induced ROS play a critical role in the anticancer-mediated signaling pathway, involving Topo II suppression, DNA damage, overcoming multidrug resistance, and tumor cell adhesion suppression, among other things. In the current study, we demonstrate the role of salvicine in regulating the ROS signaling pathway and the DNA damage response (DDR) in suppressing the progression of cancer cells. We depict the mechanism of action of salvicine in suppressing the DNA-Topo II complex through ROS induction along with a brief discussion of the anticancer perspective of salvicine.
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Affiliation(s)
- Dipta Dey
- Biochemistry and Molecular Biology department, Life Science Faculty, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalgonj, Bangladesh
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Partha Biswas
- Department of Genetic Engineering and Biotechnology, Faculty of Biological Science and Technology, Jashore University of Science and Technology (JUST), Jashore, Bangladesh
- ABEx Bio-Research Center, East Azampur, Dhaka, Bangladesh
| | - Stavros P. Papadakos
- First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Rehab A. Rayan
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Sabiha Tasnim
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka, Bangladesh
| | - Muhammad Bilal
- College of Pharmacy, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Mohammod Johirul Islam
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Farzana Alam Arshe
- Department of Biochemistry and Microbiology, North South University, Dhaka, Bangladesh
| | - Efat Muhammad Arshad
- Department of Biochemistry and Microbiology, North South University, Dhaka, Bangladesh
| | - Maisha Farzana
- College of Medical, Veterinary and Life Sciences, University of Glasgow, University Avenue, Glasgow, United Kingdom
| | - Tanjim Ishraq Rahaman
- Department of Biotechnology and Genetic Engineering, Faculty of Life Science, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj, Bangladesh
| | | | - Priyanka Paul
- Biochemistry and Molecular Biology department, Life Science Faculty, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalgonj, Bangladesh
| | - Shabana Bibi
- Yunnan Herbal Laboratory, College of Ecology and Environmental Sciences, Yunnan University, Kunming, China
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Md. Ataur Rahman
- Global Biotechnology & Biomedical Research Network (GBBRN), Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Islamic University, Kushtia, Bangladesh
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Korean Medicine-Based Drug Repositioning Cancer Research Center, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
- *Correspondence: Md. Ataur Rahman, ; Bonglee Kim,
| | - Bonglee Kim
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Korean Medicine-Based Drug Repositioning Cancer Research Center, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
- *Correspondence: Md. Ataur Rahman, ; Bonglee Kim,
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Ball S, Komrokji RS, Sallman DA. Prognostic scoring systems and risk stratification in myelodysplastic syndrome: focus on integration of molecular profile. Leuk Lymphoma 2021; 63:1281-1291. [PMID: 34933652 DOI: 10.1080/10428194.2021.2018579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Myelodysplastic syndromes (MDS) form a clinically and molecularly heterogeneous disease group. Precise risk stratification remains crucial for choosing optimal management strategies. Several conventional prognostic scoring systems have been developed and validated in the MDS population. These risk models divide patients into prognostic subgroups based on clinical and cytogenetic characteristics. Lack of dynamicity, variable risk estimate across models, and heterogeneity within intermediate-risk group are the limitations of traditional models like IPSS-R, with questionable relevance of these scoring systems in treated MDS patients. Recent progress in next-generation sequencing techniques has improved understanding of the distribution and prognostic importance of recurrent genetic mutations in MDS. Early studies have suggested that incorporating mutations in risk stratification could supplement IPSS-R in further refining the model's performance in predicting overall survival and risk of transformation to acute myeloid leukemia and should translate into a molecularly driven prognostication approach in the near future.
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Affiliation(s)
- Somedeb Ball
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Rami S Komrokji
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - David A Sallman
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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Gorombei P, Guidez F, Ganesan S, Chiquet M, Pellagatti A, Goursaud L, Tekin N, Beurlet S, Patel S, Guerenne L, Le Pogam C, Setterblad N, de la Grange P, LeBoeuf C, Janin A, Noguera ME, Sarda-Mantel L, Merlet P, Boultwood J, Konopleva M, Andreeff M, West R, Pla M, Adès L, Fenaux P, Krief P, Chomienne C, Omidvar N, Padua RA. BCL-2 Inhibitor ABT-737 Effectively Targets Leukemia-Initiating Cells with Differential Regulation of Relevant Genes Leading to Extended Survival in a NRAS/BCL-2 Mouse Model of High Risk-Myelodysplastic Syndrome. Int J Mol Sci 2021; 22:ijms221910658. [PMID: 34638998 PMCID: PMC8508829 DOI: 10.3390/ijms221910658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022] Open
Abstract
During transformation, myelodysplastic syndromes (MDS) are characterized by reducing apoptosis of bone marrow (BM) precursors. Mouse models of high risk (HR)-MDS and acute myelogenous leukemia (AML) post-MDS using mutant NRAS and overexpression of human BCL-2, known to be poor prognostic indicators of the human diseases, were created. We have reported the efficacy of the BCL-2 inhibitor, ABT-737, on the AML post-MDS model; here, we report that this BCL-2 inhibitor also significantly extended survival of the HR-MDS mouse model, with reductions of BM blasts and lineage negative/Sca1+/KIT+ (LSK) cells. Secondary transplants showed increased survival in treated compared to untreated mice. Unlike the AML model, BCL-2 expression and RAS activity decreased following treatment and the RAS:BCL-2 complex remained in the plasma membrane. Exon-specific gene expression profiling (GEP) of HR-MDS mice showed 1952 differentially regulated genes upon treatment, including genes important for the regulation of stem cells, differentiation, proliferation, oxidative phosphorylation, mitochondrial function, and apoptosis; relevant in human disease. Spliceosome genes, found to be abnormal in MDS patients and downregulated in our HR-MDS model, such as Rsrc1 and Wbp4, were upregulated by the treatment, as were genes involved in epigenetic regulation, such as DNMT3A and B, upregulated upon disease progression and downregulated upon treatment.
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Affiliation(s)
- Petra Gorombei
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Fabien Guidez
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Saravanan Ganesan
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Mathieu Chiquet
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Andrea Pellagatti
- Blood Cancer UK Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, and BRC Haematology Theme, Oxford OX3 9DU, UK; (A.P.); (J.B.)
| | - Laure Goursaud
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Nilgun Tekin
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Stephanie Beurlet
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Satyananda Patel
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Laura Guerenne
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Carole Le Pogam
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Niclas Setterblad
- Imagerie Département, Université de Paris, Institut de la Recherche Saint-Louis, 75010 Paris, France;
| | - Pierre de la Grange
- GenoSplice Technology, Paris Biotech Santé, 29 Rue du Faubourg Saint-Jacques, 75014 Paris, France;
| | - Christophe LeBoeuf
- INSERM UMR-S942, Université de Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, 75010 Paris, France; (C.L.); (A.J.)
| | - Anne Janin
- INSERM UMR-S942, Université de Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, 75010 Paris, France; (C.L.); (A.J.)
| | - Maria-Elena Noguera
- Department of Cytology, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, 75010 Paris, France;
| | - Laure Sarda-Mantel
- Radiopharmacie AP-HP, Hôpital Saint-Louis, Service Medicine Nuclear, AP-HP Lariboisiere, 75010 Paris, France;
| | - Pascale Merlet
- Nuclear Medicine, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, 75010 Paris, France;
| | - Jacqueline Boultwood
- Blood Cancer UK Molecular Haematology Unit, Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, and BRC Haematology Theme, Oxford OX3 9DU, UK; (A.P.); (J.B.)
| | - Marina Konopleva
- M. D. Anderson Cancer Center, The University of Texas, Houston, TX 77030, USA; (M.K.); (M.A.)
| | - Michael Andreeff
- M. D. Anderson Cancer Center, The University of Texas, Houston, TX 77030, USA; (M.K.); (M.A.)
| | - Robert West
- Department of Public Health, Cardiff University School of Medicine, Cardiff CF14 4XN, UK;
| | - Marika Pla
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Lionel Adès
- INSERM UMR-S944, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, 75010 Paris, France; (L.A.); (P.F.)
| | - Pierre Fenaux
- INSERM UMR-S944, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, 75010 Paris, France; (L.A.); (P.F.)
| | - Patricia Krief
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Christine Chomienne
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
| | - Nader Omidvar
- Department of Haematology, Cardiff University School of Medicine, Cardiff CF14 4XN, UK;
| | - Rose Ann Padua
- INSERM UMR-S1131, Université de Paris, Institut de la Recherche Saint-Louis, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis Hôpital, 75010 Paris, France; (P.G.); (F.G.); (S.G.); (M.C.); (L.G.); (N.T.); (S.B.); (S.P.); (L.G.); (C.L.P.); (M.P.); (P.K.); (C.C.)
- Correspondence: ; Tel.: +33-1-57-27-90-22; Fax: +33-1-57-27-90-13
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Li W, Li M, Yang X, Zhang W, Cao L, Gao R. Summary of animal models of myelodysplastic syndrome. Animal Model Exp Med 2021; 4:71-76. [PMID: 33738439 PMCID: PMC7954832 DOI: 10.1002/ame2.12144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/01/2020] [Indexed: 01/26/2023] Open
Abstract
Myelodysplastic syndrome (MDS) is a malignant tumor of the hematological system characterized by long-term, progressive refractory hemocytopenia. In addition, the risk of leukemia is high, and once it develops, the course of acute leukemia is short with poor curative effect. Animal models are powerful tools for studying human diseases and are highly effective preclinical platforms. Animal models of MDS can accurately show genetic aberrations and hematopoietic clone phenotypes with similar cellular features (such as impaired differentiation and increased apoptosis), and symptoms can be used to assess existing treatments. Animal models are also helpful for understanding the pathogenesis of MDS and its relationship with acute leukemia, which helps with the identification of candidate genes related to the MDS phenotype. This review summarizes the current status of animal models used to research myelodysplastic syndrome (MDS).
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Affiliation(s)
- Weisha Li
- NHC Key Laboratory of Human Disease Comparative MedicineBeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
- Institute of Laboratory Animal SciencesChinese Academy of Medical Sciences (CAMS)BeijingChina
- Comparative Medicine CenterPeking Union Medical College (PUMC)BeijingChina
| | - Mengyuan Li
- NHC Key Laboratory of Human Disease Comparative MedicineBeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
- Institute of Laboratory Animal SciencesChinese Academy of Medical Sciences (CAMS)BeijingChina
- Comparative Medicine CenterPeking Union Medical College (PUMC)BeijingChina
| | - Xingjiu Yang
- NHC Key Laboratory of Human Disease Comparative MedicineBeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
- Institute of Laboratory Animal SciencesChinese Academy of Medical Sciences (CAMS)BeijingChina
- Comparative Medicine CenterPeking Union Medical College (PUMC)BeijingChina
| | - Wenlong Zhang
- NHC Key Laboratory of Human Disease Comparative MedicineBeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
- Institute of Laboratory Animal SciencesChinese Academy of Medical Sciences (CAMS)BeijingChina
- Comparative Medicine CenterPeking Union Medical College (PUMC)BeijingChina
| | - Lin Cao
- Beijing Tongren Hospital Affiliated to Capital Medical UniversityBeijingChina
| | - Ran Gao
- NHC Key Laboratory of Human Disease Comparative MedicineBeijingChina
- Beijing Engineering Research Center for Experimental Animal Models of Human Critical DiseasesBeijingChina
- Institute of Laboratory Animal SciencesChinese Academy of Medical Sciences (CAMS)BeijingChina
- Comparative Medicine CenterPeking Union Medical College (PUMC)BeijingChina
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Huang HJ, Li B, Qin TJ, Xu ZF, Hu NB, Pan LJ, Qu SQ, Liu D, Zhang YD, Xiao ZJ. [Molecular features and prognostic value of RAS mutations in patients with myelodysplastic syndromes]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2020; 41:723-730. [PMID: 33113603 PMCID: PMC7595862 DOI: 10.3760/cma.j.issn.0253-2727.2020.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 11/05/2022]
Abstract
Objective: To explore the molecular features and prognostic value of RAS mutations in patients with myelodysplastic syndromes (MDS) . Methods: 112-gene targeted sequencing was conducted to detect RAS mutations in 776 patients with newly diagnosed primary MDS from December 2011 to December 2018. The mutual exclusivity and co-occurrence in gene mutations and clonal architecture were explored. Moreover, the prognostic significance of RAS mutations in MDS was analyzed. Results: RAS gene mutations were found in 52 (6.7% ) cases, 38 (4.9% ) of whom harbored NRAS mutation, 18 (2.3% ) KRAS mutation, and 4 (0.5% ) both NRAS and KRAS mutations. All the NRAS mutations and 65% of the KRAS mutations were located in codons 12, 13, and 61. PTPN11, FLT3, U2AF1, RUNX1, WT1, ETV6, and NPM1 mutations were enriched in patients with RAS mutations (Q<0.05) . Around 80% of RAS mutations represented subclonal lesions in patients who harbored at least two different mutations. Patients with RAS mutations were more frequently diagnosed with MDS with excess blast (MDS-EB) (82.7% vs. 35.2% , P<0.001) and had higher levels of white blood cell count (4.33×10(9)/L vs. 2.71×10(9)/L, P<0.001) , neutrophil absolute count (2.13×10(9)/L vs. 1.12×10(9)/L, P<0.001) , and bone marrow blast percentage (7% vs. 2% , P<0.001) but lower levels of platelet count (48×10(9)/L vs. 62×10(9)/L, P=0.048) . RAS mutations were correlated with higher-risk categories in the Revised International Prognostic Scoring System (IPSS-R) (71.1% vs. 37.9% , P<0.001) . The median overall survival of patients with NRAS mutations was shorter than the others (P=0.011) , while the significance was lost in the multivariable model. Conclusion: RAS gene mutations always occurred in the late-stage MDS and co-occurred with other signal transduction- and transcription factor-related gene mutations. PTPN11, a RAS pathway-related gene, is an independent poor prognostic factor in MDS patients.
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Affiliation(s)
- H J Huang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - B Li
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - T J Qin
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Z F Xu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - N B Hu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - L J Pan
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - S Q Qu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - D Liu
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Y D Zhang
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Z J Xiao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
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Oka S, Ono K, Nohgawa M. Relationship between p53 expression and prognosis of myelodysplastic syndrome treated with azacitidine. J Hematop 2020. [DOI: 10.1007/s12308-020-00412-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Skayneh H, Jishi B, Hleihel R, Hamieh M, Darwiche N, Bazarbachi A, El Sabban M, El Hajj H. A Critical Review of Animal Models Used in Acute Myeloid Leukemia Pathophysiology. Genes (Basel) 2019; 10:E614. [PMID: 31412687 PMCID: PMC6722578 DOI: 10.3390/genes10080614] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 07/30/2019] [Accepted: 08/01/2019] [Indexed: 12/24/2022] Open
Abstract
Acute myeloid leukemia (AML) is one of the most frequent, complex, and heterogeneous hematological malignancies. AML prognosis largely depends on acquired cytogenetic, epigenetic, and molecular abnormalities. Despite the improvement in understanding the biology of AML, survival rates remain quite low. Animal models offer a valuable tool to recapitulate different AML subtypes, and to assess the potential role of novel and known mutations in disease progression. This review provides a comprehensive and critical overview of select available AML animal models. These include the non-mammalian Zebrafish and Drosophila models as well as the mammalian rodent systems, comprising rats and mice. The suitability of each animal model, its contribution to the advancement of knowledge in AML pathophysiology and treatment, as well as its advantages and limitations are discussed. Despite some limitations, animal models represent a powerful approach to assess toxicity, and permit the design of new therapeutic strategies.
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Affiliation(s)
- Hala Skayneh
- Department of Experimental Pathology, Microbiology and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Batoul Jishi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Rita Hleihel
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Maguy Hamieh
- Department of Experimental Pathology, Microbiology and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Nadine Darwiche
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Ali Bazarbachi
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Marwan El Sabban
- Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.
| | - Hiba El Hajj
- Department of Experimental Pathology, Microbiology and Immunology, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.
- Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 1107 2020, Lebanon.
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10
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Valent P, Orazi A, Savona MR, Patnaik MM, Onida F, van de Loosdrecht AA, Haase D, Haferlach T, Elena C, Pleyer L, Kern W, Pemovska T, Vladimer GI, Schanz J, Keller A, Lübbert M, Lion T, Sotlar K, Reiter A, De Witte T, Pfeilstöcker M, Geissler K, Padron E, Deininger M, Orfao A, Horny HP, Greenberg PL, Arber DA, Malcovati L, Bennett JM. Proposed diagnostic criteria for classical chronic myelomonocytic leukemia (CMML), CMML variants and pre-CMML conditions. Haematologica 2019; 104:1935-1949. [PMID: 31048353 PMCID: PMC6886439 DOI: 10.3324/haematol.2019.222059] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 04/29/2019] [Indexed: 12/15/2022] Open
Abstract
Chronic myelomonocytic leukemia (CMML) is a myeloid neoplasm characterized by dysplasia, abnormal production and accumulation of monocytic cells and an elevated risk of transforming into acute leukemia. Over the past two decades, our knowledge about the pathogenesis and molecular mechanisms in CMML has increased substantially. In parallel, better diagnostic criteria and therapeutic strategies have been developed. However, many questions remain regarding prognostication and optimal therapy. In addition, there is a need to define potential pre-phases of CMML and special CMML variants, and to separate these entities from each other and from conditions mimicking CMML. To address these unmet needs, an international consensus group met in a Working Conference in August 2018 and discussed open questions and issues around CMML, its variants, and pre-CMML conditions. The outcomes of this meeting are summarized herein and include diag nostic criteria and a proposed classification of pre-CMML conditions as well as refined minimal diagnostic criteria for classical CMML and special CMML variants, including oligomonocytic CMML and CMML associated with systemic mastocytosis. Moreover, we propose diagnostic standards and tools to distinguish between 'normal', pre-CMML and CMML entities. These criteria and standards should facilitate diagnostic and prognostic evaluations in daily practice and clinical studies in applied hematology.
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Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria .,Ludwig Boltzmann Institute for Hematology & Oncology, Vienna, Austria
| | - Attilio Orazi
- Department of Pathology, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Michael R Savona
- Department of Medicine, Vanderbilt University School of Medicine, Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Mrinal M Patnaik
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Francesco Onida
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Arjan A van de Loosdrecht
- Department of Hematology, Amsterdam UMC, location VU University Medical Center, Cancer Center Amsterdam, the Netherlands
| | - Detlef Haase
- Clinic of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | | | - Chiara Elena
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Lisa Pleyer
- 3 Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria
| | | | - Tea Pemovska
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Gregory I Vladimer
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Julie Schanz
- Clinic of Hematology and Medical Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Keller
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Michael Lübbert
- Department of Medicine I, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lion
- Children's Cancer Research Institute and Department of Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Karl Sotlar
- Institute of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - Andreas Reiter
- Department of Hematology and Oncology, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
| | - Theo De Witte
- Department of Tumor Immunology-Nijmegen Center for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Michael Pfeilstöcker
- Ludwig Boltzmann Institute for Hematology & Oncology, Vienna, Austria.,3 Medical Department, Hanusch Hospital, Vienna, Vienna, Austria
| | | | - Eric Padron
- Malignant Hematology Department, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Michael Deininger
- Huntsman Cancer Institute & Division of Hematology and Hematologic Malignancies, University of Utah, Salt Lake City, UT, USA
| | - Alberto Orfao
- Servicio Central de Citometría, Centro de Investigación del Cáncer (IBMCC, CSIC-USAL), CIBERONC and IBSAL, Universidad de Salamanca, Salamanca, Spain
| | - Hans-Peter Horny
- Institute of Pathology, Ludwig-Maximilians University, Munich, Germany
| | | | - Daniel A Arber
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Luca Malcovati
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - John M Bennett
- Department of Pathology, Hematopathology Unit and James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
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11
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Clonal Hematopoiesis with Oncogenic Potential (CHOP): Separation from CHIP and Roads to AML. Int J Mol Sci 2019; 20:ijms20030789. [PMID: 30759825 PMCID: PMC6387423 DOI: 10.3390/ijms20030789] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/10/2019] [Accepted: 02/11/2019] [Indexed: 12/21/2022] Open
Abstract
The development of leukemia is a step-wise process that is associated with molecular diversification and clonal selection of neoplastic stem cells. Depending on the number and combinations of lesions, one or more sub-clones expand/s after a variable latency period. Initial stages may develop early in life or later in adulthood and include premalignant (indolent) stages and the malignant phase, defined by an acute leukemia. We recently proposed a cancer model in which the earliest somatic lesions are often age-related early mutations detectable in apparently healthy individuals and where additional oncogenic mutations will lead to the development of an overt neoplasm that is usually a preleukemic condition such as a myelodysplastic syndrome. These neoplasms may or may not transform to overt acute leukemia over time. Thus, depending on the type and number of somatic mutations, clonal hematopoiesis (CH) can be divided into CH with indeterminate potential (CHIP) and CH with oncogenic potential (CHOP). Whereas CHIP mutations per se usually create the molecular background of a neoplastic process, CHOP mutations are disease-related or even disease-specific lesions that trigger differentiation and/or proliferation of neoplastic cells. Over time, the acquisition of additional oncogenic events converts preleukemic neoplasms into secondary acute myeloid leukemia (sAML). In the present article, recent developments in the field are discussed with a focus on CHOP mutations that lead to distinct myeloid neoplasms, their role in disease evolution, and the impact of additional lesions that can drive a preleukemic neoplasm into sAML.
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12
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Antigenic Targets for the Immunotherapy of Acute Myeloid Leukaemia. J Clin Med 2019; 8:jcm8020134. [PMID: 30678059 PMCID: PMC6406328 DOI: 10.3390/jcm8020134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 01/10/2019] [Accepted: 01/20/2019] [Indexed: 12/18/2022] Open
Abstract
One of the most promising approaches to preventing relapse is the stimulation of the body’s own immune system to kill residual cancer cells after conventional therapy has destroyed the bulk of the tumour. In acute myeloid leukaemia (AML), the high frequency with which patients achieve first remission, and the diffuse nature of the disease throughout the periphery, makes immunotherapy particularly appealing following induction and consolidation therapy, using chemotherapy, and where possible stem cell transplantation. Immunotherapy could be used to remove residual disease, including leukaemic stem cells from the farthest recesses of the body, reducing, if not eliminating, the prospect of relapse. The identification of novel antigens that exist at disease presentation and can act as targets for immunotherapy have also proved useful in helping us to gain a better understand of the biology that belies AML. It appears that there is an additional function of leukaemia associated antigens as biomarkers of disease state and survival. Here, we discuss these findings.
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13
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Kontic M, Stevic R, Stojsic J, Jekic B, Bunjevacki V. Synchronous primary lung cancers: A multidisciplinary approach in diagnosis. TUMORI JOURNAL 2018; 97:e16-9. [DOI: 10.1177/030089161109700424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background For patients with two or more primary cancers a correct diagnosis is critically important because prognosis and treatment vary considerably between multiple primary cancers and metastatic disease. Case report Two bilateral synchronous primary lung malignancies of different histological types were diagnosed and immunohistochemically confirmed in a 60-year-old woman. In biopsy specimens of the right lung pure squamous cell carcinoma was detected (stage IIIa). The tumor expressed AE1/AE3, cytokeratin 5 and 34βE12. In biopsy specimens of the left lung small cell carcinoma was detected (stage IIIa). The small cells expressed synaptophysin, chromogranin A and CD56. DNA was extracted from paraffin-embedded tissue of both tumors. Exons 5–9 of the TP53 gene were examined for genetic mutations by polymerase chain reaction and DNA sequencing analysis. Direct sequencing of DNA isolated from the small cell carcinoma revealed a TGC to TTC mutation at codon 404 of TP53 exon 5. In DNA isolated from the squamous cell carcinoma no TP53 mutation was found. The tumors' different response to chemotherapy also suggested that they belonged to different histological types. The patient lived 24 months after the diagnosis, which is more typical for stage III than for stage IV lung carcinoma. Conclusion Discrimination of synchronous primary lung cancers from intrapulmonary metastases based only on clinical findings can be very difficult. Multidisciplinary diagnostic evaluation is therefore very helpful in cases like this, because a correct diagnosis will determine the best treatment for the patient and consequently a better prognosis.
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Affiliation(s)
- Milica Kontic
- Department of Oncology, Institute for
Lung Diseases and TB, Clinical Center of Serbia, Medical Faculty, University of
Belgrade
| | - Ruza Stevic
- Department of Radiology, Institute for
Lung Diseases and TB, Clinical Center of Serbia, Medical Faculty, University of
Belgrade
| | - Jelena Stojsic
- Department of Pathology, Institute for
Lung Diseases and TB, Clinical Center of Serbia, Medical Faculty, University of
Belgrade
| | - Biljana Jekic
- Department of Oncogenetics, Institute
for Human Genetics, Medical Faculty, University of Belgrade, Serbia
| | - Vera Bunjevacki
- Department of Oncogenetics, Institute
for Human Genetics, Medical Faculty, University of Belgrade, Serbia
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14
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p53-/- synergizes with enhanced NrasG12D signaling to transform megakaryocyte-erythroid progenitors in acute myeloid leukemia. Blood 2016; 129:358-370. [PMID: 27815262 DOI: 10.1182/blood-2016-06-719237] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 11/01/2016] [Indexed: 12/11/2022] Open
Abstract
Somatic mutations in TP53 and NRAS are associated with transformation of human chronic myeloid diseases to acute myeloid leukemia (AML). Here, we report that concurrent RAS pathway and TP53 mutations are identified in a subset of AML patients and confer an inferior overall survival. To further investigate the genetic interaction between p53 loss and endogenous NrasG12D/+ in AML, we generated conditional NrasG12D/+p53-/- mice. Consistent with the clinical data, recipient mice transplanted with NrasG12D/+p53-/- bone marrow cells rapidly develop a highly penetrant AML. We find that p53-/- cooperates with NrasG12D/+ to promote increased quiescence in megakaryocyte-erythroid progenitors (MEPs). NrasG12D/+p53-/- MEPs are transformed to self-renewing AML-initiating cells and are capable of inducing AML in serially transplanted recipients. RNA sequencing analysis revealed that transformed MEPs gain a partial hematopoietic stem cell signature and largely retain an MEP signature. Their distinct transcriptomes suggests a potential regulation by p53 loss. In addition, we show that during AML development, transformed MEPs acquire overexpression of oncogenic Nras, leading to hyperactivation of ERK1/2 signaling. Our results demonstrate that p53-/- synergizes with enhanced oncogenic Nras signaling to transform MEPs and drive AML development. This model may serve as a platform to test candidate therapeutics in this aggressive subset of AML.
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15
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The genomic landscape of myeloid neoplasms with myelodysplasia and its clinical implications. Curr Opin Oncol 2016; 27:551-9. [PMID: 26352542 DOI: 10.1097/cco.0000000000000229] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE OF REVIEW This article will review the most recent advances in the understanding of the genetic basis of myeloid neoplasms with myelodysplasia and will discuss its clinical implications. RECENT FINDINGS Recurrent somatic mutations have been identified in about 90% of patients with myeloid neoplasms with myelodysplasia, involving genes of RNA splicing, DNA methylation, histone modification, transcription regulation, DNA repair, signal transduction, and cohesin complex. Somatic mutations are acquired in a linear manner in a multipotent hematopoietic stem cell, resulting in a growth advantage at the stem cell level and in defective differentiation and maturation of hematopoietic precursors. Recently, evidence has been provided of age-related hematopoietic clones, driven by mutations of genes recurrently mutated in myeloid neoplasms. These hematopoietic clones may represent either premalignant clones with the potential to progress to myeloid neoplasm or small malignant clones at a preclinical stage. SUMMARY The available evidence clearly indicates that greater understanding of the molecular basis of myeloid neoplasms with myelodysplasia has relevant implications in the classification of these disorders, as well as in predicting disease risk and response to specific treatment modalities, and may open avenues of research leading to novel therapeutic options and personalized treatment in the individual patient.
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16
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Prevalence, clonal dynamics and clinical impact of TP53 mutations in patients with myelodysplastic syndrome with isolated deletion (5q) treated with lenalidomide: results from a prospective multicenter study of the german MDS study group (GMDS). Leukemia 2016; 30:1956-9. [PMID: 27133825 DOI: 10.1038/leu.2016.111] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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17
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Guerenne L, Beurlet S, Said M, Gorombei P, Le Pogam C, Guidez F, de la Grange P, Omidvar N, Vanneaux V, Mills K, Mufti GJ, Sarda-Mantel L, Noguera ME, Pla M, Fenaux P, Padua RA, Chomienne C, Krief P. GEP analysis validates high risk MDS and acute myeloid leukemia post MDS mice models and highlights novel dysregulated pathways. J Hematol Oncol 2016; 9:5. [PMID: 26817437 PMCID: PMC4728810 DOI: 10.1186/s13045-016-0235-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 01/19/2016] [Indexed: 12/13/2022] Open
Abstract
Background In spite of the recent discovery of genetic mutations in most myelodysplasic (MDS) patients, the pathophysiology of these disorders still remains poorly understood, and only few in vivo models are available to help unravel the disease. Methods We performed global specific gene expression profiling and functional pathway analysis in purified Sca1+ cells of two MDS transgenic mouse models that mimic human high-risk MDS (HR-MDS) and acute myeloid leukemia (AML) post MDS, with NRASD12 and BCL2 transgenes under the control of different promoters MRP8NRASD12/tethBCL-2 or MRP8[NRASD12/hBCL-2], respectively. Results Analysis of dysregulated genes that were unique to the diseased HR-MDS and AML post MDS mice and not their founder mice pointed first to pathways that had previously been reported in MDS patients, including DNA replication/damage/repair, cell cycle, apoptosis, immune responses, and canonical Wnt pathways, further validating these models at the gene expression level. Interestingly, pathways not previously reported in MDS were discovered. These included dysregulated genes of noncanonical Wnt pathways and energy and lipid metabolisms. These dysregulated genes were not only confirmed in a different independent set of BM and spleen Sca1+ cells from the MDS mice but also in MDS CD34+ BM patient samples. Conclusions These two MDS models may thus provide useful preclinical models to target pathways previously identified in MDS patients and to unravel novel pathways highlighted by this study. Electronic supplementary material The online version of this article (doi:10.1186/s13045-016-0235-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura Guerenne
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France.
| | - Stéphanie Beurlet
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France.
| | - Mohamed Said
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK.
| | - Petra Gorombei
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France.
| | - Carole Le Pogam
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France.
| | - Fabien Guidez
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France.
| | - Pierre de la Grange
- GenoSplice technology, iPEPS-ICM, Hôpital de la Pitié Salpêtrière, Paris, France.
| | - Nader Omidvar
- Haematology Department, Cardiff University School of Medicine, Cardiff, UK.
| | - Valérie Vanneaux
- Assistance Publique-Hôpitaux de Paris (AP-HP), Unité de Thérapie Cellulaire, Hôpital Saint Louis, Paris, France.
| | - Ken Mills
- Centre for Cancer Research and Cell Biology, Queen's University Belfast, Belfast, UK.
| | - Ghulam J Mufti
- Department of Haematological Medicine, King's College London and Kings College Hospital, London, UK.
| | - Laure Sarda-Mantel
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie Hôpital Saint Louis, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Médecine Nucléaire, Hôpital Lariboisière, Paris, France.
| | - Maria Elena Noguera
- Assistance Publique-Hôpitaux de Paris (AP-HP), Laboratoire d'Hématologie, Hôpital Saint Louis, Paris, France.
| | - Marika Pla
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France. .,Université Paris-Diderot, Sorbonne Paris Cité, Département d'Expérimentation Animale, Institut Universitaire d'Hématologie, Paris, France.
| | - Pierre Fenaux
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Laboratoire d'Hématologie, Hôpital Saint Louis, Paris, France.
| | - Rose Ann Padua
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Laboratoire d'Hématologie, Hôpital Saint Louis, Paris, France.
| | - Christine Chomienne
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France. .,Assistance Publique-Hôpitaux de Paris (AP-HP), Laboratoire d'Hématologie, Hôpital Saint Louis, Paris, France.
| | - Patricia Krief
- Université Paris-Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, Unité Mixte de Recherche (UMR-S) 1131, Paris, France. .,Institut National de la Santé et de la Recherche Médicale (INSERM) Unité (U) 1131, Paris, France.
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Zhang X, Lancet JE, Zhang L. Molecular pathology of myelodysplastic syndromes: new developments and implications for diagnosis and treatment. Leuk Lymphoma 2015; 56:3022-30. [DOI: 10.3109/10428194.2015.1037756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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19
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Increased expression of interferon signaling genes in the bone marrow microenvironment of myelodysplastic syndromes. PLoS One 2015; 10:e0120602. [PMID: 25803272 PMCID: PMC4372597 DOI: 10.1371/journal.pone.0120602] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 01/24/2015] [Indexed: 11/19/2022] Open
Abstract
Introduction The bone marrow (BM) microenvironment plays an important role in the pathogenesis of myelodysplastic syndromes (MDS) through a reciprocal interaction with resident BM hematopoietic cells. We investigated the differences between BM mesenchymal stromal cells (MSCs) in MDS and normal individuals and identified genes involved in such differences. Materials and Methods BM-derived MSCs from 7 MDS patients (3 RCMD, 3 RAEB-1, and 1 RAEB-2) and 7 controls were cultured. Global gene expression was analyzed using a microarray. Result We found 314 differentially expressed genes (DEGs) in RCMD vs. control, 68 in RAEB vs. control, and 51 in RAEB vs. RCMD. All comparisons were clearly separated from one another by hierarchical clustering. The overall similarity between differential expression signatures from the RCMD vs. control comparison and the RAEB vs. control comparison was highly significant (p = 0), which indicates a common transcriptomic response in these two MDS subtypes. RCMD and RAEB simultaneously showed an up-regulation of interferon alpha/beta signaling and the ISG15 antiviral mechanism, and a significant fraction of the RAEB vs. control DEGs were also putative targets of transcription factors IRF and ICSBP. Pathways that involved RNA polymerases I and III and mitochondrial transcription were down-regulated in RAEB compared to RCMD. Conclusion Gene expression in the MDS BM microenvironment was different from that in normal BM and exhibited altered expression according to disease progression. The present study provides genetic evidence that inflammation and immune dysregulation responses that involve the interferon signaling pathway in the BM microenvironment are associated with MDS pathogenesis, which suggests BM MSCs as a possible therapeutic target in MDS.
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Pellagatti A, Boultwood J. The molecular pathogenesis of the myelodysplastic syndromes. Eur J Haematol 2015; 95:3-15. [DOI: 10.1111/ejh.12515] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Andrea Pellagatti
- Leukaemia & Lymphoma Research Molecular Haematology Unit; Nuffield Division of Clinical Laboratory Sciences; Radcliffe Department of Medicine; University of Oxford; Oxford UK
| | - Jacqueline Boultwood
- Leukaemia & Lymphoma Research Molecular Haematology Unit; Nuffield Division of Clinical Laboratory Sciences; Radcliffe Department of Medicine; University of Oxford; Oxford UK
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21
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Badar T, Cortes JE, Ravandi F, O'Brien S, Verstovsek S, Garcia-Manero G, Kantarjian H, Borthakur G. Phase I study of S-trans, trans-farnesylthiosalicylic acid (salirasib), a novel oral RAS inhibitor in patients with refractory hematologic malignancies. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:433-438.e2. [PMID: 25795639 DOI: 10.1016/j.clml.2015.02.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Revised: 02/09/2015] [Accepted: 02/12/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Rat sarcoma (RAS)/rapidly accelerated fibrosarcoma (RAF)/mitogen-activated protein kinase activation (mutational or nonmutational) is a key pathway for survival and proliferative advantage of leukemic cells. Salirasib (Concordia Pharmaceuticals) is an oral RAS inhibitor that causes dislocation of RAS by competing directly with farnesylated RAS in binding to its putative membrane-binding proteins. Salirasib does not inhibit farnesyl transferase enzyme. PATIENTS AND METHODS We report on a phase I study of Salirasib in patients with relapsed/refractory hematologic malignancies. Salirasib was administered orally twice daily on days 1 to 21 of a 28-day cycle in a "3+3" dose escalation design. RESULTS Seventeen patients with relapsed/refractory leukemia were treated for a median of 4 cycles (range, 1-29). Three patients each were enrolled at a dose level of 100, 200, 400, 600, and 800 mg twice daily and 2 patients at a dose level of 900 mg twice daily. No dose-limiting toxicities were encountered. Grade 1/2 diarrhea was the only frequent nonhematologic toxicity observed in 14 of 17 (82%) patients and was resolved with oral antidiarrheal agents. Eight (47%) patients (4 with myelodysplastic syndrome, 2 with acute myeloid leukemia, 1 with chronic myelomonocytic leukemia, and 1 with chronic myeloid leukemia) had hematological improvement; 1 in 3 lineages, 1 in 2 lineages, and 6 in 1 lineage. None of the patients achieved complete remission. The responses lasted for a median of 10 weeks (range, 5-115). The study was discontinued because of financial constraints. CONCLUSION Salirasib was well tolerated and showed modest activity in relapsed/refractory hematological malignancies. The safety profile of Salirasib and its hematological malignancy relevant target makes it a potential drug to be used in combination therapy.
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Affiliation(s)
- Talha Badar
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX
| | - Jorge E Cortes
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX
| | - Farhad Ravandi
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX
| | - Susan O'Brien
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX
| | - Srdan Verstovsek
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX
| | | | - Hagop Kantarjian
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX
| | - Gautam Borthakur
- Department of Leukemia, M.D. Anderson Cancer Center, Houston, TX.
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22
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Zeichner SB, Alghamdi S, Elhammady G, Poppiti RJ. Prognostic significance of TP53 mutations and single nucleotide polymorphisms in acute myeloid leukemia: a case series and literature review. Asian Pac J Cancer Prev 2014; 15:1603-9. [PMID: 24641375 DOI: 10.7314/apjcp.2014.15.4.1603] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The response to treatment and overall survival (OS) of patients with acute myeloid leukemia (AML) is variable, with a median ranging from 6 months to 11.5 years. TP53 is associated with old age, chemotherapy resistance, and worse OS. Using genetic sequencing, we set out to look at our own experience with AML, and hypothesized that both TP53 mutations and SNPs at codon 72 would mimic the literature by occurring in a minority of patients, and conferring a worse OS. MATERIALS AND METHODS We performed a pilot study of randomly selected, newly diagnosed AML patients at Mount Sinai Medical Center, diagnosed from 2005-2008 (n=10). TP53 PCR sequencing was performed using DNA from bone marrow smears. Analysis was accomplished using Mutation Surveyor software with confirmation of the variants using the COSMIC and dbSNP databases. RESULTS Fewer than half of the patients harbored TP53 mutations (40%). There was no significant difference in OS based on gender, AML history, risk-stratified karyotype, or TP53 mutation. There were possible trends toward improved survival among patients less than 60 (11 vs 4 months, p=0.09), Hispanics (8 vs 1 months, p=0.11), and those not harboring SNP P72R (8 vs 2 months, p=0.10). There was a significant improvement in survival among patients with better performance status (28 vs 4 months, p=0.01) and those who did not have a complex karyotype (8 vs 1 months, p=0.03). The most commonly observed TP53 mutation was a missense N310K (40%) and the most commonly observed SNP was P72R (100.0%). CONCLUSIONS Our study confirms previous reports that poor PS and the presence of a complex karyotype are associated with a decreased OS. In our cohort, TP53 mutations were relatively common, occurring more frequently in male patients with an adverse karyotype. Although there was no significant difference in survival between TP53 mutated and un-mutated patients, there was a possible trend toward worse OS among patients with SNP P72R. Larger studies are needed to validate these findings.
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Affiliation(s)
- Simon Blechman Zeichner
- Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, Florida, USA E-mail :
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23
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Zoi K, Cross NCP. Molecular pathogenesis of atypical CML, CMML and MDS/MPN-unclassifiable. Int J Hematol 2014; 101:229-42. [PMID: 25212680 DOI: 10.1007/s12185-014-1670-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 09/02/2014] [Accepted: 09/02/2014] [Indexed: 12/21/2022]
Abstract
According to the 2008 WHO classification, the category of myelodysplastic/myeloproliferative neoplasms (MDS/MPN) includes atypical chronic myeloid leukaemia (aCML), chronic myelomonocytic leukaemia (CMML), MDS/MPN-unclassifiable (MDS/MPN-U), juvenile myelomonocytic leukaemia (JMML) and a "provisional" entity, refractory anaemia with ring sideroblasts and thrombocytosis (RARS-T). The remarkable progress in our understanding of the somatic pathogenesis of MDS/MPN has made it clear that there is considerable overlap among these diseases at the molecular level, as well as layers of unexpected complexity. Deregulation of signalling plays an important role in many cases, and is clearly linked to more highly proliferative disease. Other mutations affect a range of other essential, interrelated cellular mechanisms, including epigenetic regulation, RNA splicing, transcription, and DNA damage response. The various combinations of mutations indicate a multi-step pathogenesis, which likely contributes to the marked clinical heterogeneity of these disorders. The delineation of complex clonal architectures may serve as the cornerstone for the identification of novel therapeutic targets and lead to better patient outcomes. This review summarizes some of the current knowledge of molecular pathogenetic lesions in the MDS/MPN subtypes that are seen in adults: atypical CML, CMML and MDS/MPN-U.
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Affiliation(s)
- Katerina Zoi
- Haematology Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
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24
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Yao DC, de Lima M. Utility of the p53 mutant protein in patients with low-risk myelodysplastic syndrome. Rev Bras Hematol Hemoter 2014; 36:173-4. [PMID: 25031053 PMCID: PMC4109744 DOI: 10.1016/j.bjhh.2014.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 03/14/2014] [Indexed: 11/20/2022] Open
Affiliation(s)
- David C Yao
- University Hospitals Case Medical Center, Cleveland, United States; Seidman Cancer Center and Case Western Reserve University, Cleveland, United States
| | - Marcos de Lima
- University Hospitals Case Medical Center, Cleveland, United States; Seidman Cancer Center and Case Western Reserve University, Cleveland, United States.
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25
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Velloso EDRP. Scientific comment on tumor suppressor p53 protein expression: prognostic significance in patients with low-risk myelodysplastic syndrome. Rev Bras Hematol Hemoter 2014; 36:175-7. [PMID: 25031054 PMCID: PMC4109737 DOI: 10.1016/j.bjhh.2014.03.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 02/18/2014] [Indexed: 11/15/2022] Open
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26
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Saft L, Karimi M, Ghaderi M, Matolcsy A, Mufti GJ, Kulasekararaj A, Göhring G, Giagounidis A, Selleslag D, Muus P, Sanz G, Mittelman M, Bowen D, Porwit A, Fu T, Backstrom J, Fenaux P, MacBeth KJ, Hellström-Lindberg E. p53 protein expression independently predicts outcome in patients with lower-risk myelodysplastic syndromes with del(5q). Haematologica 2014; 99:1041-9. [PMID: 24682512 DOI: 10.3324/haematol.2013.098103] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Del(5q) myelodysplastic syndromes defined by the International Prognostic Scoring System as low- or intermediate-1-risk (lower-risk) are considered to have an indolent course; however, recent data have identified a subgroup of these patients with more aggressive disease and poorer outcomes. Using deep sequencing technology, we previously demonstrated that 18% of patients with lower-risk del(5q) myelodysplastic syndromes carry TP53 mutated subclones rendering them at higher risk of progression. In this study, bone marrow biopsies from 85 patients treated with lenalidomide in the MDS-004 clinical trial were retrospectively assessed for p53 expression by immunohistochemistry in association with outcome. Strong p53 expression in ≥ 1% of bone marrow progenitor cells, observed in 35% (30 of 85) of patients, was significantly associated with higher acute myeloid leukemia risk (P=0.0006), shorter overall survival (P=0.0175), and a lower cytogenetic response rate (P=0.009), but not with achievement or duration of 26-week transfusion independence response. In a multivariate analysis, p53-positive immunohistochemistry was the strongest independent predictor of transformation to acute myeloid leukemia (P=0.0035). Pyrosequencing analysis of laser-microdissected cells with strong p53 expression confirmed the TP53 mutation, whereas cells with moderate expression predominantly had wild-type p53. This study validates p53 immunohistochemistry as a strong and clinically useful predictive tool in patients with lower-risk del(5q) myelodysplastic syndromes. This study was based on data from the MDS 004 trial (clinicaltrials.gov identifier: NCT00179621).
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Affiliation(s)
- Leonie Saft
- Department of Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Sweden Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
| | - Mohsen Karimi
- Department of Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Sweden
| | - Mehran Ghaderi
- Department of Oncology and Pathology, Karolinska Institute, Stockholm, Sweden
| | - András Matolcsy
- Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | | | | | - Gudrun Göhring
- Institute for Cell and Molecular Pathology, Medical University Hannover, Germany
| | | | | | - Petra Muus
- Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | | | - Moshe Mittelman
- Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv, Israel
| | | | - Anna Porwit
- Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Ontario, Canada
| | - Tommy Fu
- Celgene Corporation, Summit, NJ, USA
| | | | - Pierre Fenaux
- Service d'Hématologie Séniors, Hôpital St Louis, Université Paris 7, France
| | | | - Eva Hellström-Lindberg
- Department of Medicine, Karolinska Institute, Karolinska University Hospital Huddinge, Sweden
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27
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Nuclear Nox4-derived reactive oxygen species in myelodysplastic syndromes. BIOMED RESEARCH INTERNATIONAL 2014; 2014:456937. [PMID: 24719867 PMCID: PMC3955662 DOI: 10.1155/2014/456937] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 01/21/2014] [Indexed: 12/25/2022]
Abstract
A role for intracellular ROS production has been recently implicated in the pathogenesis and progression of a wide variety of neoplasias. ROS sources, such as NAD(P)H oxidase (Nox) complexes, are frequently activated in AML (acute myeloid leukemia) blasts and strongly contribute to their proliferation, survival, and drug resistance. Myelodysplastic syndromes (MDS) comprise a heterogeneous group of disorders characterized by ineffective hematopoiesis, with an increased propensity to develop AML. The molecular basis for MDS progression is unknown, but a key element in MDS disease progression is the genomic instability. NADPH oxidases are now recognized to have specific subcellular localizations, this targeting to specific compartments for localized ROS production. Local Nox-dependent ROS production in the nucleus may contribute to the regulation of redox-dependent cell growth, differentiation, senescence, DNA damage, and apoptosis. We observed that Nox1, 2, and 4 isoforms and p22phox and Rac1 subunits are expressed in MDS/AML cell lines and MDS samples, also in the nuclear fractions. Interestingly, Nox4 interacts with ERK and Akt1 within nuclear speckle domain, suggesting that Nox4 could be involved in regulating gene expression and splicing factor activity. These data contribute to the elucidation of the molecular mechanisms used by nuclear ROS to drive MDS evolution to AML.
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28
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Schittenhelm MM, Illing B, Ahmut F, Rasp KH, Blumenstock G, Döhner K, Lopez CD, Kampa-Schittenhelm KM. Attenuated expression of apoptosis stimulating protein of p53-2 (ASPP2) in human acute leukemia is associated with therapy failure. PLoS One 2013; 8:e80193. [PMID: 24312201 PMCID: PMC3842400 DOI: 10.1371/journal.pone.0080193] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 09/10/2013] [Indexed: 12/31/2022] Open
Abstract
Inactivation of the p53 pathway is a universal event in human cancers and promotes tumorigenesis and resistance to chemotherapy. Inactivating p53 mutations are uncommon in non-complex karyotype leukemias, thus the p53-pathway must be inactivated by other mechanisms. The Apoptosis Stimulating Protein of p53-2 (ASPP2) is a damage-inducible p53-binding protein that enhances apoptosis at least in part through a p53-mediated pathway. We have previously shown, that ASPP2 is an independent haploinsufficient tumor suppressor in vivo. Now, we reveal that ASPP2 expression is significantly attenuated in acute myeloid and lymphoid leukemia – especially in patients with an unfavorable prognostic risk profile and patients who fail induction chemotherapy. In line, knock down of ASPP2 in expressing leukemia cell lines and native leukemic blasts attenuates damage-induced apoptosis. Furthermore, cultured blasts derived from high-risk leukemias fail to induce ASPP2 expression upon anthracycline treatment. The mechanisms of ASPP2 dysregulation are unknown. We provide evidence that attenuation of ASPP2 is caused by hypermethylation of the promoter and 5′UTR regions in native leukemia blasts. Together, our results suggest that ASPP2 contributes to the biology of leukemia and expression should be further explored as a potential prognostic and/or predictive biomarker to monitor therapy responses in acute leukemia.
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MESH Headings
- Adult
- Aged
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Apoptosis/drug effects
- Apoptosis/genetics
- Apoptosis Regulatory Proteins/genetics
- Apoptosis Regulatory Proteins/metabolism
- Cell Line, Tumor
- Female
- Gene Expression Regulation, Leukemic
- Gene Knockdown Techniques
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Middle Aged
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Treatment Failure
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Marcus M. Schittenhelm
- University Hospital Tübingen, Department of Hematology, Oncology, Rheumatology, Immunology and Pulmology, Tübingen, Germany
| | - Barbara Illing
- University Hospital Tübingen, Department of Hematology, Oncology, Rheumatology, Immunology and Pulmology, Tübingen, Germany
| | - Figen Ahmut
- University Hospital Tübingen, Department of Hematology, Oncology, Rheumatology, Immunology and Pulmology, Tübingen, Germany
| | - Katharina Henriette Rasp
- University Hospital Tübingen, Department of Hematology, Oncology, Rheumatology, Immunology and Pulmology, Tübingen, Germany
| | - Gunnar Blumenstock
- Department of Clinical Epidemiology and Applied Biometry, Eberhard Karls University Tübingen, Germany
| | - Konstanze Döhner
- University Hospital Ulm, Department of Internal Medicine III, Ulm, Germany
| | - Charles D. Lopez
- Department of Medicine, Division of Hematology and Medical Oncology, Oregon Health & Science University and The OHSU Knight Cancer Institute, Portland, Oregon, United States of America
| | - Kerstin M. Kampa-Schittenhelm
- University Hospital Tübingen, Department of Hematology, Oncology, Rheumatology, Immunology and Pulmology, Tübingen, Germany
- * E-mail:
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29
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Itzykson R, Fenaux P, Solary E. Chronic myelomonocytic leukemia: myelodysplastic or myeloproliferative? Best Pract Res Clin Haematol 2013; 26:387-400. [PMID: 24507815 DOI: 10.1016/j.beha.2013.09.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Chronic myelomonocytic leukemia (CMML) is a clonal disease of the hematopoietic stem cell that provokes a stable increase in peripheral blood monocyte count. The World Health Organisation classification appropriately underlines that the disease combines dysplastic and proliferative features. The percentage of blast cells in the blood and bone marrow distinguishes CMML-1 from CMML-2. The disease is usually diagnosed after the age of 50, with a strong male predominance. Inconstant and non-specific cytogenetic aberrations have a negative prognostic impact. Recurrent gene mutations affect mainly the TET2, SRSF2, and ASXL1 genes. Median survival is 3 years, with patients dying from progression to AML (20-30%) or from cytopenias. ASXL1 is the only gene whose mutation predicts outcome and can be included within a prognostic score. Allogeneic stem cell transplantation is possibly curative but rarely feasible. Hydroxyurea, which is the conventional cytoreductive agent, is used in myeloproliferative forms, and demethylating agents could be efficient in the most aggressive forms of the disease.
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Affiliation(s)
| | - Pierre Fenaux
- Hôpital Avicenne, Service d'hématologie clinique, Paris 13 university, 125 rue de Stalingrad, 93009 Bobigny, France.
| | - Eric Solary
- Inserm UMR 1009, Institut Gustave Roussy, 14 rue Edouard Vaillant, 94805 Villejuif cedex, France.
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30
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Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet. Blood 2013; 122:2943-64. [PMID: 23980065 DOI: 10.1182/blood-2013-03-492884] [Citation(s) in RCA: 478] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients with a poor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment because of advanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended.
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BCL-2 inhibition with ABT-737 prolongs survival in an NRAS/BCL-2 mouse model of AML by targeting primitive LSK and progenitor cells. Blood 2013; 122:2864-76. [PMID: 23943652 DOI: 10.1182/blood-2012-07-445635] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Myelodysplastic syndrome (MDS) transforms into an acute myelogenous leukemia (AML) with associated increased bone marrow (BM) blast infiltration. Using a transgenic mouse model, MRP8[NRASD12/hBCL-2], in which the NRAS:BCL-2 complex at the mitochondria induces MDS progressing to AML with dysplastic features, we studied the therapeutic potential of a BCL-2 homology domain 3 mimetic inhibitor, ABT-737. Treatment significantly extended lifespan, increased survival of lethally irradiated secondary recipients transplanted with cells from treated mice compared with cells from untreated mice, with a reduction of BM blasts, Lin-/Sca-1(+)/c-Kit(+), and progenitor populations by increased apoptosis of infiltrating blasts of diseased mice assessed in vivo by technicium-labeled annexin V single photon emission computed tomography and ex vivo by annexin V/7-amino actinomycin D flow cytometry, terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling, caspase 3 cleavage, and re-localization of the NRAS:BCL-2 complex from mitochondria to plasma membrane. Phosphoprotein analysis showed restoration of wild-type (WT) AKT or protein kinase B, extracellular signal-regulated kinase 1/2 and mitogen-activated protein kinase patterns in spleen cells after treatment, which showed reduced mitochondrial membrane potential. Exon specific gene expression profiling corroborates the reduction of leukemic cells, with an increase in expression of genes coding for stem cell development and maintenance, myeloid differentiation, and apoptosis. Myelodysplastic features persist underscoring targeting of BCL-2-mediated effects on MDS-AML transformation and survival of leukemic cells.
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32
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Kim MS, Kim GM, Choi YJ, Kim HJ, Kim YJ, Jin W. TrkC promotes survival and growth of leukemia cells through Akt-mTOR-dependent up-regulation of PLK-1 and Twist-1. Mol Cells 2013; 36:177-84. [PMID: 23832765 PMCID: PMC3887946 DOI: 10.1007/s10059-013-0061-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/21/2013] [Accepted: 06/10/2013] [Indexed: 11/30/2022] Open
Abstract
It has been suggested that activation of receptor PTKs is important for leukemogenesis and leukemia cell response to targeted therapy in hematological malignancies including leukemia. PTKs induce activation of the PI3K/Akt/mTOR pathway, which can result in prevention of apoptosis. Here, we describe an important role of the TrkC-associated molecular network in the process of leukemogenesis. TrkC was found to be frequently overexpressed in human leukemia cells and leukemia subtypes. In U937 human leukemia cells, blockade of TrkC using small hairpin RNA (shRNA) specific to TrkC or K562a, a specific inhibitor of TrkC, resulted in a significant decrease in growth and survival of the cells, which was closely associated with reduced mTOR level and Akt activity. In addition, TrkC enhances the survival and proliferation of leukemia, which is correlated with activation of the PI3K/Akt pathway. Moreover, TrkC significantly inhibits apoptosis via induction of the expression of PLK-1 and Twist-1 through activation of AKT/mTor pathway; therefore, it plays a key role in leukemogenesis. These findings reveal an unexpected physiological role for TrkC in the pathogenesis of leukemia and have important implications for understanding various hematological malignancies.
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Affiliation(s)
- Min Soo Kim
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon 406-840,
Korea
| | - Gyoung Mi Kim
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon 406-840,
Korea
| | - Yun-Jeong Choi
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon 406-840,
Korea
| | - Hye Joung Kim
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701,
Korea
| | - Yoo-Jin Kim
- Department of Hematology, Catholic Blood and Marrow Transplantation Center, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 137-701,
Korea
| | - Wook Jin
- Department of Molecular Medicine, School of Medicine, Gachon University, Incheon 406-840,
Korea
- Gachon Medical Research Institute, Gil Medical Center, Incheon 405-760,
Korea
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33
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Itzykson R, Kosmider O, Renneville A, Gelsi-Boyer V, Meggendorfer M, Morabito M, Berthon C, Adès L, Fenaux P, Beyne-Rauzy O, Vey N, Braun T, Haferlach T, Dreyfus F, Cross NC, Preudhomme C, Bernard OA, Fontenay M, Vainchenker W, Schnittger S, Birnbaum D, Droin N, Solary E. Prognostic Score Including Gene Mutations in Chronic Myelomonocytic Leukemia. J Clin Oncol 2013; 31:2428-36. [DOI: 10.1200/jco.2012.47.3314] [Citation(s) in RCA: 406] [Impact Index Per Article: 36.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Several prognostic scoring systems have been proposed for chronic myelomonocytic leukemia (CMML), a disease in which some gene mutations—including ASXL1—have been associated with poor prognosis in univariable analyses. We developed and validated a prognostic score for overall survival (OS) based on mutational status and standard clinical variables. Patients and Methods We genotyped ASXL1 and up to 18 other genes including epigenetic (TET2, EZH2, IDH1, IDH2, DNMT3A), splicing (SF3B1, SRSF2, ZRSF2, U2AF1), transcription (RUNX1, NPM1, TP53), and signaling (NRAS, KRAS, CBL, JAK2, FLT3) regulators in 312 patients with CMML. Genotypes and clinical variables were included in a multivariable Cox model of OS validated by bootstrapping. A scoring system was developed using regression coefficients from this model. Results ASXL1 mutations (P < .0001) and, to a lesser extent, SRSF2 (P = .03), CBL (P = .003), and IDH2 (P = .03) mutations predicted inferior OS in univariable analysis. The retained independent prognostic factors included ASXL1 mutations, age older than 65 years, WBC count greater than 15 ×109/L, platelet count less than 100 ×109/L, and anemia (hemoglobin < 10 g/dL in female patients, < 11g/dL in male patients). The resulting five-parameter prognostic score delineated three groups of patients with median OS not reached, 38.5 months, and 14.4 months, respectively (P < .0001), and was validated in an independent cohort of 165 patients (P < .0001). Conclusion A new prognostic score including ASXL1 status, age, hemoglobin, WBC, and platelet counts defines three groups of CMML patients with distinct outcomes. Based on concordance analysis, this score appears more discriminative than those based solely on clinical parameters.
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Affiliation(s)
- Raphaël Itzykson
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Olivier Kosmider
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Aline Renneville
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Véronique Gelsi-Boyer
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Manja Meggendorfer
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Margot Morabito
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Céline Berthon
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Lionel Adès
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Pierre Fenaux
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Odile Beyne-Rauzy
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Norbert Vey
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Thorsten Braun
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Torsten Haferlach
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - François Dreyfus
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Nicholas C.P. Cross
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Claude Preudhomme
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Olivier A. Bernard
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Michaela Fontenay
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - William Vainchenker
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Susanne Schnittger
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Daniel Birnbaum
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Nathalie Droin
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
| | - Eric Solary
- Raphaël Itzykson, Margot Morabito, Olivier A. Bernard, William Vainchenker, Nathalie Droin, Eric Solary, Institut Gustave Roussy, Villejuif; Raphaël Itzykson, Margot Morabito, William Vainchenker, Nathalie Droin, Eric Solary, Université Paris-Sud, Le Kremlin-Bicêtre, Orsay; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Assistance Publique–Hôpitaux de Paris, Hôpital Cochin; Olivier Kosmider, François Dreyfus, Michaela Fontenay, Université Paris Descartes; Olivier Kosmider, Michaela Fontenay,
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Al-Kali A, Quintás-Cardama A, Luthra R, Bueso-Ramos C, Pierce S, Kadia T, Borthakur G, Estrov Z, Jabbour E, Faderl S, Ravandi F, Cortes J, Tefferi A, Kantarjian H, Garcia-Manero G. Prognostic impact of RAS mutations in patients with myelodysplastic syndrome. Am J Hematol 2013; 88:365-9. [PMID: 23512829 DOI: 10.1002/ajh.23410] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 01/28/2013] [Accepted: 01/31/2013] [Indexed: 01/22/2023]
Abstract
RAS is an oncogene frequently mutated in human cancer. RAS mutations have been reported in 10-15% of cases of acute myeloid leukemia (AML) but they appear to be less frequent among patients with myelodysplastic syndrome (MDS). The impact of RAS mutations in patients with MDS is unclear. We conducted a retrospective study in 1,067 patients with newly diagnosed MDS for whom RAS mutational analysis was available. Overall, 4% of patients carried mutant RAS alleles. Notably, FLT3 mutations, which were found in 2% of patients, were mutually exclusive with RAS mutations. Patients with RAS mutations had a higher white blood cell count as well as bone marrow blasts compared with patients carrying wild-type RAS. However, no differences were observed between both groups regarding the risk of AML transformation (9% vs. 7%) and overall survival (395 days vs. 500 days, P = 0.057). In summary, RAS mutations are infrequent in patients with MDS and do not appear to negatively impact their outcome.
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Affiliation(s)
| | | | - Raja Luthra
- Department of Hematopathology; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Carlos Bueso-Ramos
- Department of Hematopathology; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Sherry Pierce
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Tapan Kadia
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Gautam Borthakur
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Zeev Estrov
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Elias Jabbour
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Stefan Faderl
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Farhad Ravandi
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Jorges Cortes
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
| | - Ayalew Tefferi
- Department of Hematology; Mayo Clinic; Rochester; Minnesota
| | - Hagop Kantarjian
- Department of Leukemia; The University of Texas MD Anderson Cancer Center; Houston; Texas
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Patnaik MM, Lasho TL, Finke CM, Hanson CA, Hodnefield JM, Knudson RA, Ketterling RP, Pardanani A, Tefferi A. Spliceosome mutations involving SRSF2, SF3B1, and U2AF35 in chronic myelomonocytic leukemia: prevalence, clinical correlates, and prognostic relevance. Am J Hematol 2013; 88:201-6. [PMID: 23335386 DOI: 10.1002/ajh.23373] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 11/22/2012] [Accepted: 11/26/2012] [Indexed: 01/19/2023]
Abstract
SRSF2, SF3B1, and U2AF35 (U2AF1) are the three most frequent genes involved with spliceosome mutations in myeloid malignancies. SF3B1 mutations are most frequent (~80%) in myelodysplastic syndromes (MDS) with ring sideroblasts (RS) but lack prognostic relevance. SRSF2 mutations are associated with shortened overall (OS) and leukemia-free survival (LFS) in both MDS and myelofibrosis. In this study of 226 patients with chronic myelomonocytic leukemia (CMML), mutational frequencies were 40% for SRSF2 (all affecting P95), 6% for SF3B1 (primarily K700E) and 9% for U2AF35 (mostly S34F and Q157P/R). These mutations were mutually exclusive and 54% of the patients displayed at least one mutation. The three mutation groups were phenotypically similar, with the exception of higher RS% (P < 0.0001) in patients with SF3B1 mutations. At a median follow-up of 15 months, 176 (78%) deaths and 32 (14%) leukemic transformations were documented. OS (median survivals of 17, 16, 17, and 20 months; P = 0.48) and LFS (leukemic transformation rates of 17, 13, 15, and 5%; P = 0.63) were similar among patients with none of the three mutations, SRSF2, SF3B1, or U2AF35 mutations, respectively. We conclude that SRSF2 is the most frequently mutated spliceosome gene in CMML but neither it nor SF3B1 or U2AF35 mutations are prognostically relevant.
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Affiliation(s)
- Mrinal M Patnaik
- Division of Hematology, Mayo Clinic, Rochester, Minnesota 55905, USA
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36
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Kulasekararaj AG, Smith AE, Mian SA, Mohamedali AM, Krishnamurthy P, Lea NC, Gäken J, Pennaneach C, Ireland R, Czepulkowski B, Pomplun S, Marsh JC, Mufti GJ. TP53 mutations in myelodysplastic syndrome are strongly correlated with aberrations of chromosome 5, and correlate with adverse prognosis. Br J Haematol 2013; 160:660-72. [PMID: 23297687 DOI: 10.1111/bjh.12203] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 10/26/2012] [Indexed: 12/31/2022]
Abstract
This study aimed to determine the incidence/prognostic impact of TP53 mutation in 318 myelodysplastic syndrome (MDS) patients, and to correlate the changes to cytogenetics, single nucleotide polymorphism array karyotyping and clinical outcome. The median age was 65 years (17-89 years) and median follow-up was 45 months [95% confidence interval (CI) 27-62 months]. TP53 mutations occurred in 30 (9.4%) patients, exclusively in isolated del5q (19%) and complex karyotype (CK) with -5/5q-(72%), correlated with International Prognostic Scoring System intermediate-2/high, TP53 protein expression, higher blast count and leukaemic progression. Patients with mutant TP53 had a paucity of mutations in other genes implicated in myeloid malignancies. Median overall survival of patients with TP53 mutation was shorter than wild-type (9 versus 66 months, P < 0.001) and it retained significance in multivariable model (Hazard Ratio 3.8, 95%CI 2.3-6.3,P < 0.001). None of the sequentially analysed samples showed a disappearance of the mutant clone or emergence of new clones, suggesting an early occurrence of TP53 mutations. A reduction in mutant clone correlated with response to 5-azacitidine, however clones increased in non-responders and persisted at relapse. The adverse impact of TP53 persists after adjustment for cytogenetic risk and is of practical importance in evaluating prognosis. The relatively common occurrence of these mutations in two different prognostic spectrums of MDS, i.e. isolated 5q- and CK with -5/5q-, possibly implies two different mechanistic roles for TP53 protein.
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Affiliation(s)
- Austin G Kulasekararaj
- Department of Haematological Medicine, King's College London, School of Medicine, London, UK
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Itzykson R, Droin N, Solary E. Current insights in the cellular and molecular biology of chronic myelomonocytic leukemia. Int J Hematol Oncol 2012. [DOI: 10.2217/ijh.12.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SUMMARY Chronic myelomonocytic leukemia is a rare clonal myeloid disorder most often seen in the elderly that remains a virtually incurable disease. Chronic myelomonocytic leukemia has long been considered as a myelodysplastic syndrome by diagnostic classifications, but recent insights in the cellular and molecular biology of the disease has refined its identity. The malignant clone was shown to generate myeloid-derived suppressive cells that may contribute to disease expansion, whereas the role of progenitor hypersensitivity to granulomonocyte colony-stimulating factor probably defines two distinct subgroups. At least one gene mutation can now be identified in almost all the patients. The most frequently mutated genes are TET2, SRSF2 and ASXL1, with a frequent combination of mutations in the first two genes, whereas ASXL1 mutations define a poor prognostic subgroup of patients. A number of additional mutations have been identified that confer to the disease its phenotype specificity; for example, mutations in RUNX1 induce thrombocytopenia, those in SF3B1 can be associated with anemia, and those in signaling molecules including NRAS, KRAS, CBL, JAK2 and FLT3, characterize the proliferative forms of the disease. Based on these recent observations, new working models on disease pathogenesis are proposed and may serve as a basis for the search for alternative and more efficient therapeutic approaches.
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Affiliation(s)
- Raphaël Itzykson
- Inserm UMR 1009, Institut Gustave Roussy 114, Rue Edouard Vaillant, 94805 Villejuif, France
- IFR54 (IRCIV), Institut Gustave Roussy, Villejuif, France
- Faculty of Medicine, University Paris-Sud, Le Kremlin-Bicêtre, France
| | - Nathalie Droin
- Inserm UMR 1009, Institut Gustave Roussy 114, Rue Edouard Vaillant, 94805 Villejuif, France
- IFR54 (IRCIV), Institut Gustave Roussy, Villejuif, France
- Faculty of Medicine, University Paris-Sud, Le Kremlin-Bicêtre, France
| | - Eric Solary
- Inserm UMR 1009, Institut Gustave Roussy 114, Rue Edouard Vaillant, 94805 Villejuif, France
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Tyner JW, Yang WF, Bankhead A, Fan G, Fletcher LB, Bryant J, Glover JM, Chang BH, Spurgeon SE, Fleming WH, Kovacsovics T, Gotlib JR, Oh ST, Deininger MW, Zwaan CM, Den Boer ML, van den Heuvel-Eibrink MM, O'Hare T, Druker BJ, Loriaux MM. Kinase pathway dependence in primary human leukemias determined by rapid inhibitor screening. Cancer Res 2012; 73:285-96. [PMID: 23087056 DOI: 10.1158/0008-5472.can-12-1906] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Kinases are dysregulated in most cancers, but the frequency of specific kinase mutations is low, indicating a complex etiology in kinase dysregulation. Here, we report a strategy to rapidly identify functionally important kinase targets, irrespective of the etiology of kinase pathway dysregulation, ultimately enabling a correlation of patient genetic profiles to clinically effective kinase inhibitors. Our methodology assessed the sensitivity of primary leukemia patient samples to a panel of 66 small-molecule kinase inhibitors over 3 days. Screening of 151 leukemia patient samples revealed a wide diversity of drug sensitivities, with 70% of the clinical specimens exhibiting hypersensitivity to one or more drugs. From this data set, we developed an algorithm to predict kinase pathway dependence based on analysis of inhibitor sensitivity patterns. Applying this algorithm correctly identified pathway dependence in proof-of-principle specimens with known oncogenes, including a rare FLT3 mutation outside regions covered by standard molecular diagnostic tests. Interrogation of all 151 patient specimens with this algorithm identified a diversity of kinase targets and signaling pathways that could aid prioritization of deep sequencing data sets, permitting a cumulative analysis to understand kinase pathway dependence within leukemia subsets. In a proof-of-principle case, we showed that in vitro drug sensitivity could predict both a clinical response and the development of drug resistance. Taken together, our results suggested that drug target scores derived from a comprehensive kinase inhibitor panel could predict pathway dependence in cancer cells while simultaneously identifying potential therapeutic options.
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Affiliation(s)
- Jeffrey W Tyner
- Department of Cell and Developmental Biology, Oregon Health & Science University, Portland, OR 97239, USA
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Beurlet S, Chomienne C, Padua RA. Engineering mouse models with myelodysplastic syndrome human candidate genes; how relevant are they? Haematologica 2012; 98:10-22. [PMID: 23065517 DOI: 10.3324/haematol.2012.069385] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Myelodysplastic syndromes represent particularly challenging hematologic malignancies that arise from a large spectrum of genetic events resulting in a disease characterized by a range of different presentations and outcomes. Despite efforts to classify and identify the key genetic events, little improvement has been made in therapies that will increase patient survival. Animal models represent powerful tools to model and study human diseases and are useful pre-clinical platforms. In addition to enforced expression of candidate oncogenes, gene inactivation has allowed the consequences of the genetic effects of human myelodysplastic syndrome to be studied in mice. This review aims to examine the animal models expressing myelodysplastic syndrome-associated genes that are currently available and to highlight the most appropriate model to phenocopy myelodysplastic syndrome disease and its risk of transformation to acute myelogenous leukemia.
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40
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Kadia TM, Kantarjian H, Kornblau S, Borthakur G, Faderl S, Freireich EJ, Luthra R, Garcia-Manero G, Pierce S, Cortes J, Ravandi F. Clinical and proteomic characterization of acute myeloid leukemia with mutated RAS. Cancer 2012; 118:5550-9. [PMID: 22569880 DOI: 10.1002/cncr.27596] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 02/16/2012] [Accepted: 02/21/2012] [Indexed: 11/11/2022]
Abstract
BACKGROUND Activating mutations in RAS are frequently present in patients with acute myeloid leukemia (AML), but their overall prognostic impact is not clear. METHODS A retrospective analysis was performed to establish the clinical characteristics of patients with RAS-mutated (RAS(mut) ) AML, to analyze their outcome by therapy, and to describe the proteomic profile of RAS(mut) compared with wild-type RAS (RAS(WT) ) AML. RESULTS Of 609 patients with newly diagnosed AML, 11% had RAS(mut) . Compared with RAS(WT) , patients with RAS(mut) AML were younger (median age, 54 years vs 63 years; P = .001), had a higher white blood cell count (16K mm(-3) vs 4K mm(-3) ; P < 0.001) and bone marrow blast percentage (56% vs 42%; P = .01) at diagnosis, and were less likely to have an antecedent hematologic disorder (36% vs 50%; P = .03). The inv(16) karyotype was overrepresented in patients with RAS(mut) and the -5 and/or -7 karyotype was underrepresented. RAS mutations were found to have no prognostic impact on overall survival or disease-free survival overall or within cytogenetic subgroups. There was a suggestion that patients with RAS(mut) benefited from cytarabine (AraC)-based therapy. Proteomic analysis revealed simultaneous upregulation of the RAS-Raf-MAP kinase and phosphoinositide 3-kinase (PI3K) signaling pathways in patients with RAS(mut) . CONCLUSIONS RAS mutations in AML may delineate a subset of patients who benefit from AraC-based therapy and who may be amenable to treatment with inhibitors of RAS and PI3K signaling pathways.
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Affiliation(s)
- Tapan M Kadia
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
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Abstract
Multifactorial pathogenetic features underlying myelodysplastic syndromes (MDS) relate to inherent abnormalities within the hematopoietic precursor cell population. The predominant final common pathogenetic pathway causing ineffective hematopoiesis in MDS has been the varying degrees of apoptosis of the hematopoietic precursors and their progeny. A variety of molecular abnormalities have been demonstrated in MDS. These lesions are attributable to nonrandom cytogenetic and oncogenic mutations, indicative of chromosomal and genetic instability, transcriptional RNA splicing abnormalities, and epigenetic changes. Evolutionary cytogenetic changes may occur during the course of the disorder, which are associated with disease progression. These genetic derangements reflect a multistep process believed to underlie the transformation of MDS to acute myeloid leukemia. Recent findings provide molecular insights into specific gene mutations playing major roles for the development and clinical outcome of MDS and their propensity to progress to a more aggressive stage. Use of more comprehensive and sensitive methods for molecular profiling using 'next-generation' sequencing techniques for MDS marrow cells will likely further define critical biologic lesions underlying this spectrum of diseases.
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Affiliation(s)
- P L Greenberg
- Hematology Division, Stanford University Cancer Center, Stanford, CA, USA.
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Asai T, Liu Y, Bae N, Nimer SD. The p53 tumor suppressor protein regulates hematopoietic stem cell fate. J Cell Physiol 2011; 226:2215-21. [PMID: 21660944 DOI: 10.1002/jcp.22561] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The p53 tumor suppressor protein is a key transcription factor that regulates several signaling pathways involved in the cell's response to stress. Through stress-induced activation, p53 accumulates and triggers the expression of target genes that protect the genetic integrity of all cells including hematopoietic stem cells (HSCs). These protective mechanisms include cell-cycle arrest, DNA repair, induction of apoptosis, or initiation of senescence. In addition to its function under stress conditions, p53 has important functions during steady-state hematopoiesis, regulating HSC quiescence and self-renewal. In addition, it appears that p53 levels affect HSC competition for the hematopoietic niche, with the less p53 activated HSCs preferentially surviving. The specific genes and precise mechanisms underlying p53's effects on normal HSCs are slowly being clarified. p53 also plays an important role in leukemia stem cell (LSC) behavior, with p53 loss affecting drug resistance and disease progression. Pharmacologic activation of p53 function could overcome the adverse impact of p53 inactivation in LSCs. Thus, understanding the p53 regulatory mechanisms active in HSCs and LSCs may promote the development of new therapeutic strategies that could eliminate the population of largely quiescent LSCs.
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Affiliation(s)
- Takashi Asai
- Sloan-Kettering Institute, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA
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Bejar R, Stevenson K, Abdel-Wahab O, Galili N, Nilsson B, Garcia-Manero G, Kantarjian H, Raza A, Levine RL, Neuberg D, Ebert BL. Clinical effect of point mutations in myelodysplastic syndromes. N Engl J Med 2011; 364:2496-506. [PMID: 21714648 PMCID: PMC3159042 DOI: 10.1056/nejmoa1013343] [Citation(s) in RCA: 1238] [Impact Index Per Article: 95.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Myelodysplastic syndromes are clinically heterogeneous disorders characterized by clonal hematopoiesis, impaired differentiation, peripheral-blood cytopenias, and a risk of progression to acute myeloid leukemia. Somatic mutations may influence the clinical phenotype but are not included in current prognostic scoring systems. METHODS We used a combination of genomic approaches, including next-generation sequencing and mass spectrometry-based genotyping, to identify mutations in samples of bone marrow aspirate from 439 patients with myelodysplastic syndromes. We then examined whether the mutation status for each gene was associated with clinical variables, including specific cytopenias, the proportion of blasts, and overall survival. RESULTS We identified somatic mutations in 18 genes, including two, ETV6 and GNAS, that have not been reported to be mutated in patients with myelodysplastic syndromes. A total of 51% of all patients had at least one point mutation, including 52% of the patients with normal cytogenetics. Mutations in RUNX1, TP53, and NRAS were most strongly associated with severe thrombocytopenia (P<0.001 for all comparisons) and an increased proportion of bone marrow blasts (P<0.006 for all comparisons). In a multivariable Cox regression model, the presence of mutations in five genes retained independent prognostic significance: TP53 (hazard ratio for death from any cause, 2.48; 95% confidence interval [CI], 1.60 to 3.84), EZH2 (hazard ratio, 2.13; 95% CI, 1.36 to 3.33), ETV6 (hazard ratio, 2.04; 95% CI, 1.08 to 3.86), RUNX1 (hazard ratio, 1.47; 95% CI, 1.01 to 2.15), and ASXL1 (hazard ratio, 1.38; 95% CI, 1.00 to 1.89). CONCLUSIONS Somatic point mutations are common in myelodysplastic syndromes and are associated with specific clinical features. Mutations in TP53, EZH2, ETV6, RUNX1, and ASXL1 are predictors of poor overall survival in patients with myelodysplastic syndromes, independently of established risk factors. (Funded by the National Institutes of Health and others.).
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Affiliation(s)
- Rafael Bejar
- Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA 02115, USA
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Jädersten M, Saft L, Smith A, Kulasekararaj A, Pomplun S, Göhring G, Hedlund A, Hast R, Schlegelberger B, Porwit A, Hellström-Lindberg E, Mufti GJ. TP53 mutations in low-risk myelodysplastic syndromes with del(5q) predict disease progression. J Clin Oncol 2011; 29:1971-9. [PMID: 21519010 DOI: 10.1200/jco.2010.31.8576] [Citation(s) in RCA: 362] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To determine the frequency of TP53 mutations and the level of p53 protein expression by immunohistochemistry (IHC) in low-risk myelodysplastic syndromes (MDS) with del(5q) and to assess their impact on disease progression. PATIENTS AND METHODS Pre- and postprogression bone marrow (BM) samples from 55 consecutive patients with International Prognostic Scoring System low risk (n = 32) or intermediate-1 risk (n = 23) were studied by next-generation sequencing of TP53. IHC for p53 was performed on 148 sequential BM samples. RESULTS TP53 mutations with a median clone size of 11% (range, 1% to 54%) were detected in 10 patients (18%) already at an early phase of the disease. Mutations were equally common in low-risk and intermediate-1-risk patients and were associated with evolution to acute myeloid leukemia (5 of 10 v 7 of 45; P = .045). Nine of 10 patients carrying mutations showed more than 2% BM progenitors with strong p53 staining. The probability of a complete cytogenetic response to lenalidomide was lower in mutated patients (0 of 7 v 12 of 24; P = .024). CONCLUSION By using sensitive deep-sequencing technology, we demonstrated that TP53 mutated populations may occur at an early disease stage in almost a fifth of low-risk MDS patients with del(5q). Importantly, mutations were present years before disease progression and were associated with an increased risk of leukemic evolution. TP53 mutations could not be predicted by common clinical features but were associated with p53 overexpression. Our findings indicate a previously unrecognized heterogeneity of the disease which may significantly affect clinical decision making.
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Affiliation(s)
- Martin Jädersten
- Center for Experimental Hematology M54, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Sweden.
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Sardina JL, López-Ruano G, Sánchez-Sánchez B, Llanillo M, Hernández-Hernández A. Reactive oxygen species: are they important for haematopoiesis? Crit Rev Oncol Hematol 2011; 81:257-74. [PMID: 21507675 DOI: 10.1016/j.critrevonc.2011.03.005] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 03/15/2011] [Accepted: 03/22/2011] [Indexed: 02/07/2023] Open
Abstract
The production of reactive oxygen species (ROS) has traditionally been related to deleterious effects for cells. However, it is now widely accepted that ROS can play an important role in regulating cellular signalling and gene expression. NADPH oxidase ROS production seems to be especially important in this regard. Some lines of evidence suggest that ROS may be important modulators of cell differentiation, including haematopoietic differentiation, in both physiologic and pathologic conditions. Here we shall review how ROS can regulate cell signalling and gene expression. We shall also focus on the importance of ROS for haematopoietic stem cell (HSC) biology and for haematopoietic differentiation. We shall review the involvement of ROS and NADPH oxidases in cancer, and in particular what is known about the relationship between ROS and haematological malignancies. Finally, we shall discuss the use of ROS as cancer therapeutic targets.
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Affiliation(s)
- José L Sardina
- Department of Biochemistry and Molecular Biology, University of Salamanca, Salamanca, Spain
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Mewawalla P, Dasanu CA. Immune alterations in untreated and treated myelodysplastic syndrome. Expert Opin Drug Saf 2011; 10:351-61. [PMID: 21417834 DOI: 10.1517/14740338.2011.534456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Current literature suggests a variety of immune abnormalities are present in myelodysplastic syndrome (MDS) patients. However, they have not been comprehensively characterized or systematized to date. As a result, their clinical implications remain largely unknown. In addition, an increased incidence of various autoimmune conditions has been documented in MDS patients. AREAS COVERED The authors offer a comprehensive review of the existing literature on immune mechanisms involved in the pathogenesis of MDS, various immune abnormalities documented in its course, their link with the clonal evolution of MDS as well as immune alterations induced by the existing MDS therapies. EXPERT OPINION The course of MDS is accompanied by complex immune alterations, including T-cell and NK-cell defects, decreased functional abilities of neutrophils and antigen-presenting cells, altered antibody and cytokine production. While contemporary MDS therapies are shown to possess some immunomodulatory properties, authentic autoimmune conditions have also been documented with lenalidomide and recombinant erythropoietin. Caution should be exerted with the use of these agents in MDS patients with evidence of autoimmune disorders, as exacerbation of autoimmune phenomena can be anticipated. While the heterogeneity of MDS represents an inherent limitation, integration of emerging information from molecular biology, genetics, immunology research and clinical practice could translate into improved outcomes of this disease spectrum.
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Affiliation(s)
- Prerna Mewawalla
- University of Connecticut, Department of Medicine, 24 Park Pl, Apt 20A, Hartford, Farmington, CT-06106, USA.
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Neukirchen J, Haas R, Germing U. Prognostic molecular markers in myelodysplastic syndromes. Expert Rev Hematol 2010; 2:563-75. [PMID: 21083021 DOI: 10.1586/ehm.09.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cytogenetic findings in myelodysplastic syndromes play an important role in diagnosis, prognostication and clinical decision making. Therefore, they became an important aspect in scoring systems such as the International Prognostic Scoring System (IPSS) and the WHO-adapted Prognostic Scoring System (WPSS). Ongoing efforts to refine the categorization of karyotypes with regard to prognosis and therapeutic options will change scoring systems in the near future. In order to learn more about the pathophysiology of myelodysplastic syndromes, various molecular genetic aberrations are identified and their impact on prognosis discussed. New screening methods such as gene expression or single nucleotide polymorphism analysis are good candidates to find entrance in clinical practice in the future as they are useful tools in further elucidation of the underlying defects in myelodysplastic syndromes and the development of more specific classifications of the disease concerning risk assessment.
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Affiliation(s)
- Judith Neukirchen
- Department of Hematology, Oncology and Clinical Immunology, Heinrich-Heine-University of Duesseldorf, Moorenstraße 5, Düesseldorf, Germany.
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Pérez B, Kosmider O, Cassinat B, Renneville A, Lachenaud J, Kaltenbach S, Bertrand Y, Baruchel A, Chomienne C, Fontenay M, Preudhomme C, Cavé H. Genetic typing of CBL, ASXL1, RUNX1, TET2 and JAK2 in juvenile myelomonocytic leukaemia reveals a genetic profile distinct from chronic myelomonocytic leukaemia. Br J Haematol 2010; 151:460-8. [DOI: 10.1111/j.1365-2141.2010.08393.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gelsi-Boyer V, Trouplin V, Roquain J, Adélaïde J, Carbuccia N, Esterni B, Finetti P, Murati A, Arnoulet C, Zerazhi H, Fezoui H, Tadrist Z, Nezri M, Chaffanet M, Mozziconacci MJ, Vey N, Birnbaum D. ASXL1 mutation is associated with poor prognosis and acute transformation in chronic myelomonocytic leukaemia. Br J Haematol 2010; 151:365-75. [PMID: 20880116 DOI: 10.1111/j.1365-2141.2010.08381.x] [Citation(s) in RCA: 178] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Chronic myelomonocytic leukaemia (CMML) is a haematological disease currently classified in the category of myelodysplastic syndromes/myeloproliferative neoplasm (MDS/MPN) because of its dual clinical and biological presentation. The molecular biology of CMML is poorly characterized. We studied a series of 53 CMML samples including 31 cases of myeloproliferative form (MP-CMML) and 22 cases of myelodysplastic forms (MD-CMML) using array-comparative genomic hybridisation (aCGH) and sequencing of 13 candidate genes including ASXL1, CBL, FLT3, IDH1, IDH2, JAK2, KRAS, NPM1, NRAS, PTPN11, RUNX1, TET2 and WT1. Mutations in ASXL1 and in the genes associated with proliferation (CBL, FLT3, PTPN11, NRAS) were mainly found in MP-CMML cases. Mutations of ASXL1 correlated with an evolution toward an acutely transformed state: all CMMLs that progressed to acute phase were mutated and none of the unmutated patients had evolved to acute leukaemia. The overall survival of ASXL1 mutated patients was lower than that of unmutated patients.
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Affiliation(s)
- Véronique Gelsi-Boyer
- Laboratoire d'Oncologie Moléculaire, Centre de Recherche en Cancérologie de Marseille, UMR891 Inserm, Institut Paoli-Calmettes, Université de la Méditerranée Aix-Marseille II, Marseille, France.
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