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Huang H, Liu Y, Zeng M, Chen X, Yin Y, Guo H, Yan Z, Lin J. Clinical analysis of hairy cell leukemia: the rare indolent hematological malignancy. Am J Transl Res 2024; 16:466-476. [PMID: 38463575 PMCID: PMC10918128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To analyze the clinical features, diagnosis and treatment and prognosis of the rare hairy cell leukemia (HCL), in order to provide new references for the clinical and basic research of HCL. METHODS The clinical data of 17 patients with HCL admitted to Fujian Medical University Union Hospital, the Affiliated Hospital of Putian University and the First Affiliated Hospital of Gannan Medical University from January 1, 2016 to July 1, 2023 were collected and retrospectively studied, and the clinical features, diagnosis and treatment effects and prognosis of patients with HCL were analyzed. The Kaplan-Meier method was used for survival analysis. Meanwhile, the latest literature from PubMed was retrieved to systematically discuss the research progress in the diagnosis and treatment of HCL. RESULTS In this study, there were 11 males and 6 females, the median age at diagnosis was 59.5 (30-81) years old, and the median time from the onset of clinical symptoms or signs to diagnosis was 4.5 (0.5-28.5) months. There were 9 cases (52.94%) with lymphoma B symptoms (fever, night sweating, and weight loss), 15 cases (88.24%) were accompanied by splenomegaly (3 cases of mild splenomegaly, 4 cases of moderate splenomegaly, and 8 cases of megasplenomegaly), the positive rate of BRAFV600E mutation is 76.47% (13/17). All patients in this study were treated, of which 11 were treated with Cladribine, 3 with Interferon, 2 with FC regimen, and 1 with R-CVP regimen + Cladribine. The median follow-up time was 39 (range, 2-83) months, 3 patients died, all due to failure of chemotherapy due to disease progression. The prognosis of HCL-v patients was significantly worse than that of cHCL patients (P=0.01), and there was no significant difference in the impact of different treatment regiments on the OS of HCL patients (P=0.328). CONCLUSION HCL is a rare clinically indolent hematological tumor, which is sensitive to Cladribine, with the emergence of precision treatments such as the novel molecular-targeted drugs and immunotherapy also plays an indispensable role in clinical practice of HCL.
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Affiliation(s)
- He Huang
- Department of Cardiovascular Medicine (Cardiology), The First Affiliated Hospital of Gannan Medical UniversityGanzhou 341000, Jiangxi, China
| | - Yanquan Liu
- Department of Hematology, The First Dongguan Affiliated Hospital of Guangdong Medical UniversityDongguan 523808, Guangdong, China
| | - Minjuan Zeng
- Department of Hematology, The First Dongguan Affiliated Hospital of Guangdong Medical UniversityDongguan 523808, Guangdong, China
| | - Xiaojun Chen
- Department of Hematology, The Affiliated Hospital of Putian UniversityPutian 351100, Fujian, China
| | - Yue Yin
- Fujian Institute of Hematology, Fujian Medical University Union HospitalFuzhou 350001, Fujian, China
| | - Huidong Guo
- Department of Pathology, The First Affiliated Hospital of Gannan Medical UniversityGanzhou 341000, Jiangxi, China
| | - Zhimin Yan
- Department of Hematology, The First Affiliated Hospital of Gannan Medical UniversityGanzhou 341000, Jiangxi, China
| | - Jie Lin
- Department of Intensive Medicine (Comprehensive ICU), The First Affiliated Hospital of Gannan Medical UniversityGanzhou 341000, Jiangxi, China
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Pentostatin Biosynthesis Pathway Elucidation and Its Application. FERMENTATION 2022. [DOI: 10.3390/fermentation8090459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Pentostatin (PNT), a nucleoside antibiotic with a 1,3-diazo ring structure, is distributed in several actinomycetes and fungi species. Its special structure makes PNT possess a wide spectrum of biological and pharmacological properties, such as antibacterial, antitrypanosomal, anticancer, antiviral, herbicidal, insecticidal, and immunomodulatory effects. Because of the promising adenosine deaminase inhibitory activity of PNT, its extensive application in the clinical treatment of malignant tumors has been extensively studied. However, the fermentation level of microbial-derived PNT is low and cannot meet medical needs. Because the biosynthesis pathway of PNT is obscure, only high-yield mutant screening and optimization of medium components and fermentation processes have been conducted for enhancing its production. Recently, the biosynthesis pathways of PNT in actinomycetes and fungi hosts have been revealed successively, and the large-scale production of PNT by systematic metabolic engineering will become an inevitable trend. Therefore, this review covers all aspects of PNT research, in which major advances in understanding the resource microorganisms, mechanism of action, and biosynthesis pathway of PNT were achieved and diverse clinical applications of PNT were emphasized, and it will lay the foundation for commercial transformation and industrial technology of PNT based on systematic metabolic engineering.
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Jiang H, Qin X, Wang Q, Xu Q, Wang J, Wu Y, Chen W, Wang C, Zhang T, Xing D, Zhang R. Application of carbohydrates in approved small molecule drugs: A review. Eur J Med Chem 2021; 223:113633. [PMID: 34171659 DOI: 10.1016/j.ejmech.2021.113633] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/04/2021] [Accepted: 06/06/2021] [Indexed: 12/24/2022]
Abstract
Carbohydrates are an important energy source and play numerous key roles in all living organisms. Carbohydrates chemistry involved in diagnosis and treatment of diseases has been attracting increasing attention. Carbohydrates could be one of the major focuses of new drug discovery. Currently, however, carbohydrate-containing drugs account for only a small percentage of all drugs in clinical use, which does not match the important roles of carbohydrates in the organism. In other words, carbohydrates are a relatively untapped source of new drugs and therefore may offer exciting novel therapeutic opportunities. Here, we presented an overview of the application of carbohydrates in approved small molecule drugs and emphasized and evaluated the roles of carbohydrates in those drugs. The potential development direction of carbohydrate-containing drugs was presented after summarizing the advantages and challenges of carbohydrates in the development of new drugs.
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Affiliation(s)
- Hongfei Jiang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, China; Cancer Institute, Qingdao University, Qingdao, 266071, China
| | - Xiaofei Qin
- Department of Bioengineering, Zhuhai Campus of Zunyi Medical University, Zhuhai, 519041, China
| | - Qi Wang
- Department of Critical Medicine, Hainan Maternal and Children's Medical Center, Haikou, 570312, China
| | - Qi Xu
- Laboratory of Immunology for Environment and Health, Shandong Analysis and Test Center, Qilu University of Technology Shandong Academy of Sciences, Jinan, China
| | - Jie Wang
- Cancer Institute, Qingdao University, Qingdao, 266071, China
| | - Yudong Wu
- Cancer Institute, Qingdao University, Qingdao, 266071, China
| | - Wujun Chen
- Cancer Institute, Qingdao University, Qingdao, 266071, China
| | - Chao Wang
- Cancer Institute, Qingdao University, Qingdao, 266071, China
| | - Tingting Zhang
- Cancer Institute, Qingdao University, Qingdao, 266071, China
| | - Dongming Xing
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, China; Cancer Institute, Qingdao University, Qingdao, 266071, China; School of Life Sciences, Tsinghua University, Beijing, 100084, China
| | - Renshuai Zhang
- The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, 266071, China; Cancer Institute, Qingdao University, Qingdao, 266071, China.
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Fancher KM, Lally-Montgomery ZC. Moxetumomab pasudotox: A first-in-class treatment for hairy cell leukemia. J Oncol Pharm Pract 2019; 25:1467-1472. [PMID: 30917739 DOI: 10.1177/1078155219838041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hairy cell leukemia is a rare indolent B-cell lymphoid malignancy. Durable remission can be obtained with purine analogues, but relapse is inevitable, and effective treatment options may be limited. Moxetumomab pasudotox is a recombinant CD22-targeting immunotoxin that has recently been approved by the United States Food and Drug Administration for the treatment of relapsed or refractory hairy cell leukemia. Approval was based on a pivotal phase III study in this unique patient population. Rationale for use, clinical trial data, and current treatment recommendations are detailed. Common adverse effects are reviewed, and management strategies for select adverse effects are suggested. Implications for contemporary practitioners are also provided, as use of this novel agent is likely to increase as follow-up studies are reported.
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Affiliation(s)
- Karen M Fancher
- 1 Department of Pharmacy Practice, Duquesne University School of Pharmacy, Pittsburgh, Pennsylvania.,2 University of Pittsburgh Medical Center Passavant, Pittsburgh, Pennsylvania
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Davis G, Perks A, Liyanage P, Staines K. Oral hairy leukoplakia arising in a patient with hairy cell leukaemia: the first reported case. BMJ Case Rep 2017; 2017:bcr-2016-218663. [PMID: 28385698 DOI: 10.1136/bcr-2016-218663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Oral hairy leukoplakia (OHL) is an oral mucosal lesion that is associated with Epstein-Barr virus infection. It commonly presents as an asymptomatic, non-removable white patch on the lateral borders of the tongue in individuals who are immunocompromised. Historically, OHL was thought to be pathognomonic of HIV infection; however, it is now an established phenomenon in a range of conditions affecting immune competence. Hairy cell leukaemia (HCL) is a rare chronic B cell lymphoproliferative disease named after the distinctive cytology of the atypical cells. We report the first case of OHL arising in an individual with HCL that resolved following remission of the haematological malignancy.
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Affiliation(s)
- Gemma Davis
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
| | - Alexandra Perks
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
| | - Pemith Liyanage
- Oral and Maxillofacial Pathology, University of Bristol Dental Hospital, Bristol, UK
| | - Konrad Staines
- Oral Medicine, University of Bristol Dental Hospital, Bristol, UK
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Ledderose C, Woehrle T, Ledderose S, Strasser K, Seist R, Bao Y, Zhang J, Junger WG. Cutting off the power: inhibition of leukemia cell growth by pausing basal ATP release and P2X receptor signaling? Purinergic Signal 2016; 12:439-51. [PMID: 27020575 DOI: 10.1007/s11302-016-9510-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/16/2016] [Indexed: 01/12/2023] Open
Abstract
T cells respond to antigen stimulation with the rapid release of cellular ATP, which stimulates an autocrine feedback mechanism that regulates calcium influx through P2X receptors. This autocrine purinergic feedback mechanism plays an essential role in the activation of T cells resulting in cell proliferation and clonal expansion. We recently reported that increases in mitochondrial ATP production drive this stimulation-induced purinergic signaling mechanism but that low-level mitochondrial ATP production fuels basal T cell functions required to maintain vigilance of unstimulated T cells. Here we studied whether defects in these purinergic signaling mechanisms are involved in the unwanted proliferation of leukemia T cells. We found that acute leukemia T cells (Jurkat) possess a larger number and more active mitochondria than their healthy counterparts. Jurkat cells have higher intracellular ATP concentrations and generat more extracellular ATP than unstimulated T cells from healthy donors. As a result, increased purinergic signaling through P2X1 and P2X7 receptors elevates baseline levels of cytosolic Ca(2+) in Jurkat cells. We found that pharmacological inhibition of this basal purinergic signaling mechanism decreases mitochondrial activity, Ca(2+) signaling, and cell proliferation. Similar results were seen in the leukemic cell lines THP-1, U-937, and HL-60. Combined treatment with inhibitors of P2X1 or P2X7 receptors and the chemotherapeutic agent 6-mercaptopurine completely blocked Jurkat cell proliferation. Our results demonstrate that increased mitochondrial metabolism promotes autocrine purinergic signaling and uncontrolled proliferation of leukemia cells. These findings suggest that deranged purinergic signaling can result in T cell malignancy and that therapeutic targeting aimed at purinergic signaling is a potential strategy to combat T cell leukemia.
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Affiliation(s)
- Carola Ledderose
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Tobias Woehrle
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Stephan Ledderose
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Katharina Strasser
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Richard Seist
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Yi Bao
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Jingping Zhang
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Wolfgang G Junger
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
- Ludwig Boltzmann Institute for Traumatology, 1200, Vienna, Austria.
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