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Simoni M, Menegazzi C, Fracassi C, Biffi CC, Genova F, Tenace NP, Lucianò R, Raimondi A, Tacchetti C, Brugarolas J, Mazza D, Bernardi R. PML restrains p53 activity and cellular senescence in clear cell renal cell carcinoma. EMBO Mol Med 2024; 16:1324-1351. [PMID: 38730056 PMCID: PMC11178789 DOI: 10.1038/s44321-024-00077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
Clear-cell renal cell carcinoma (ccRCC), the major subtype of RCC, is frequently diagnosed at late/metastatic stage with 13% 5-year disease-free survival. Functional inactivation of the wild-type p53 protein is implicated in ccRCC therapy resistance, but the detailed mechanisms of p53 malfunction are still poorly characterized. Thus, a better understanding of the mechanisms of disease progression and therapy resistance is required. Here, we report a novel ccRCC dependence on the promyelocytic leukemia (PML) protein. We show that PML is overexpressed in ccRCC and that PML depletion inhibits cell proliferation and relieves pathologic features of anaplastic disease in vivo. Mechanistically, PML loss unleashed p53-dependent cellular senescence thus depicting a novel regulatory axis to limit p53 activity and senescence in ccRCC. Treatment with the FDA-approved PML inhibitor arsenic trioxide induced PML degradation and p53 accumulation and inhibited ccRCC expansion in vitro and in vivo. Therefore, by defining non-oncogene addiction to the PML gene, our work uncovers a novel ccRCC vulnerability and lays the foundation for repurposing an available pharmacological intervention to restore p53 function and chemosensitivity.
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Affiliation(s)
- Matilde Simoni
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Menegazzi
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristina Fracassi
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Claudia C Biffi
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Medical Advisor, Sanofi, Milan, Italy
| | - Francesca Genova
- Center for Omics Sciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Nazario Pio Tenace
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberta Lucianò
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Raimondi
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Carlo Tacchetti
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Universita' Vita-Salute San Raffaele, Milan, Italy
| | - James Brugarolas
- Kidney Cancer Program, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Internal Medicine, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Davide Mazza
- Experimental Imaging Center, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Rosa Bernardi
- Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
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de Figueiredo-Pontes LL, Catto LFB, Chauffaille MDLLF, Pagnano KBB, Madeira MIA, Nunes EC, Hamerschlak N, de Andrade Silva MC, Carneiro TX, Bortolheiro TC, de Freitas TT, Bittencourt RI, Maranhão Fagundes E, Magalhães Rego E. Diagnosis and management of acute promyelocytic leukemia: Brazilian consensus guidelines 2024 on behalf of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy. Hematol Transfus Cell Ther 2024:S2531-1379(24)00253-0. [PMID: 38890097 DOI: 10.1016/j.htct.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 06/20/2024] Open
Abstract
Improvements in clinical assessment have occurred since the last published recommendations on the diagnosis and treatment of acute promyelocytic leukemia in 2013. Here, a committee of specialists of the Brazilian Association of Hematology, Hemotherapy and Cellular Therapy presents a comprehensive review on the current knowledge, focusing on the advances in diagnosis, risk assessment, and frontline and salvage therapy. The concept of urgent diagnosis is explored as well as the management of critical situations such as coagulopathy and differentiation syndrome. Recent adjustments in risk stratification based on white blood cell counts only are presented together with the incorporation of chemo-free regimens for non-high-risk patients. Special conditions such as acute promyelocytic leukemia in children, the elderly and pregnant women are discussed. Finally, acute promyelocytic leukemia is presented as a highly curable disease because of the real possibility of targeted therapy towards differentiation, and, paradoxically, as a serious and urgent condition that deserves prompt recognition and management to avoid early mortality.
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Affiliation(s)
| | - Luiz Fernando Bazzo Catto
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil; Translational Stem Cell Biology Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | | | | | - Maria Isabel Ayrosa Madeira
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Elenaide Coutinho Nunes
- Unidade de Hematologia e Oncologia do Hospital das Clínicas da Universidade Federal do Paraná, Curitiba, PR, Brazil and Instituto Pasquini de Hematologia e Transplante, Hospital Nossa Senhora das Graças, Curitiba, PR, Brazil
| | | | | | | | - Teresa Cristina Bortolheiro
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Irmandade da Santa Casa de São Paulo da Santa Casa de São Paulo, São Paulo, SP, Brazil
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Droc G, Stancioaica MC, Soare CG, Stefan MG, Ingustu D, Martac C, Coriu D, Isac S, Suciu N, Andrei S. Acute Promyelocytic Leukemia and Severe Differentiation Syndrome in Pregnancy-A Management Challenge. Life (Basel) 2023; 13:life13051141. [PMID: 37240786 DOI: 10.3390/life13051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Acute promyelocytic leukemia (APL) is generated by the PML-RARA fusion gene. In patients suffering from APL, the early diagnosis and treatment are essential in the successful management. We reported a case of a 27-year-old 17th-week pregnant patient diagnosed with APL. After an extensive hematological diagnostic panel, the acute promyelocytic leukemia was confirmed, and the patient received all-trans retinoic acid (ATRA), idarubicin (IDA), and dexamethasone, following national guidelines. Due to ATRA-related differentiation syndrome, the therapy was adjusted, and hydroxycarbamide was added with a good outcome. The patient was admitted to the ICU secondary to hypoxemic respiratory failure on the 2nd day after hospital admission. Our patient received an individualized drug combination, adjusted by the clinical response. Furthermore, the drugs used in APL treatment are all teratogenic. Despite various major complications, including severe acute respiratory distress syndrome (ARDS), which needed mechanical ventilation; ICU-acquired myopathy; and spontaneous abortion, the patient had a good outcome and was transferred from the ICU after a total stay of 40 days. APL during pregnancy is a rare entity of intermediate-risk APL. Our study emphasized the need for individualized therapy in a rare case of a pregnant woman diagnosed with a potentially fatal hematologic disease.
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Affiliation(s)
- Gabriela Droc
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
- Department of Anesthesiology and Intensive Care I, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | | | - Corina Gabriela Soare
- Department of Anaesthesiology, Cork University Hospital, College Rd. Wilton, T12 DC4A Cork, Ireland
| | - Mihai-Gabriel Stefan
- Department of Anaesthesiology and Intensive Care Medicine II, "Prof CC Iliescu" Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Daiana Ingustu
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Cristina Martac
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Daniel Coriu
- Department of Haematology, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
- Department of Haematology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Sebastian Isac
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
- Department of Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Nicolae Suciu
- Department of Obstetrics and Gynecology, National Institute Mothers and Children Health "Alessandrescu-Rusescu", 011061 Bucharest, Romania
| | - Stefan Andrei
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
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Li G, Wu J, Li R, Pan Y, Ma W, Xu J, Nan M, Hou L. Improvement of Early Death in Acute Promyelocytic Leukemia: A Population-Based Analysis. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2023; 23:e78-e84. [PMID: 36567214 DOI: 10.1016/j.clml.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early death is a major factor of treatment failure in acute promyelocytic leukemia (APL), however, the recent trends in the incidence of early death based on the population-level are not clear. Hence, this study is aimed at describing the incidence, recent trends, causes and characteristics of early death in APL based on the real world. MATERIALS AND METHODS APL patients diagnosed from 1986 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) dataset were enrolled, and categorized based on gender, age, year of diagnosis, race, marital status, resident county and socioeconomic status (SES). The risk factors for all-cause and acute myelocytic leukemia (AML) specific early death were determined by univariate and multivariate logistic regression analyses, and stratified analysis was conducted by age. RESULTS Overall, 3212 APL patients were included in analysis between 1986 and 2015, of which a total of 683 (21.3%) patients were noted for early death. Significant differences were recognized for patient distribution by age, year of diagnosis, marital status, and SES. The early death rate of APL patients diagnosed during 2006-2015 was significantly lower than that of the early stage, but this trend was not evident in juvenile patients. At the same time, older age, and lower SES score were independent risk factors for early death in the multivariate analysis. CONCLUSION We established that the early death trend in APL has decreased over the past few years, but the early death rate remains high, especially in older patients and those with lower SES.
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Affiliation(s)
- Guangda Li
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Jieya Wu
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Ruibai Li
- Department of Hematology, Xiyuan Hospital, China Academy of Chinese Medicine Sciences, Beijing, China
| | - Yiming Pan
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Wei Ma
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Xu
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Mengdie Nan
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; Beijing University of Chinese Medicine, Beijing, China
| | - Li Hou
- Department of Hematology and Oncology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
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Lei Y, Wang K, Yang JY, Lin XH, Liu AL. Sequence-specific amperometric detection based on a double-probe mode and enzyme-mediated multiple signal electrocatalysis for the double-stranded DNA of PML/RARα-related fusion gene. Anal Chim Acta 2022; 1231:340436. [DOI: 10.1016/j.aca.2022.340436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/22/2022] [Accepted: 09/21/2022] [Indexed: 11/16/2022]
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Treatment for relapsed acute promyelocytic leukemia. Ann Hematol 2022; 101:2575-2582. [PMID: 35972562 DOI: 10.1007/s00277-022-04954-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/11/2022] [Indexed: 11/01/2022]
Abstract
The advent of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) has significantly improved the outcomes of acute promyelocytic leukemia (APL); nevertheless, a small fraction of patients still experience relapse. Due to the infrequency of APL relapse coupled with the rapid change in the therapeutic landscape, there are limited available data regarding the treatment of relapsed APL. In this situation, however, ATO-based therapy has been shown to result in high rates of hematological and molecular complete remission (CR). Autologous hematopoietic cell transplantation (HCT) is considered the postremission therapy of choice when patients achieve molecular CR, whereas recent studies have suggested that molecular CR is not prerequisite for the success of autologous HCT. Allogeneic HCT can be reserved for selected patients, i.e., those who cannot achieve CR and those who relapse after autologous HCT, because of high toxicities and the expectation of highly favorable outcomes with autologous HCT during CR. For patients who are ineligible for HCT, prolonged administration of ATRA + ATO would be a viable option. To further refine the therapy for patients with relapsed APL, it is imperative to aggregate clinical data of patients who relapse after the ATRA + ATO frontline therapy within the framework of national and international collaboration.
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Min GJ, Cho BS, Park SS, Park S, Jeon YW, Yahng SA, Shin SH, Yoon JH, Lee SE, Eom KS, Kim YJ, Lee S, Min CK, Cho SG, Lee JW, Kim HJ. Treatment for relapsed acute promyelocytic leukemia: what is the best post-remission treatment? Blood Res 2022; 57:197-206. [PMID: 35880495 PMCID: PMC9492525 DOI: 10.5045/br.2022.2022060] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/03/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Arsenic trioxide (ATO) is the standard treatment for relapsed acute promyelocytic leukemia (APL). However, consensus on post-remission therapies is still lacking. Methods We evaluated 52 patients who experienced relapse following initial treatment of APL between 2000 and 2019 at Catholic Hematology Hospital. Among them, 41 patients received reinduction treatment, 30 with ATO-based regimen, whereas 11 with conventional intensive chemotherapy (IC). Results The ATO reinduction group showed a significantly higher second molecular complete remission (mCR2) rate, superior neutrophil and platelet recovery, and a lower infection rate than the IC reinduction group. No significant differences were observed in survival outcomes after post-remission treatment among the ATO-based (N=19), autologous (N=12), and allogeneic (N=6) hematopoietic stem cell transplantation (HSCT) groups. In the ATO-based and autologous HSCT groups, among patients with mCR2 after ATO reinduction, nine and five patients experienced a second relapse, respectively (50.7% vs. 41.7%, P=0.878). Among these patients, seven received salvage allogeneic HSCT; six remained alive. The other seven patients received ATO without HSCT. Five died from disease progression, and two survived and have been in mCR2 since. Conclusion Post-remission treatment outcomes of patients with relapsed APL were not significantly different, regardless of the treatment option, suggesting the feasibility of ATO-based treatment without HSCT in mCR2. Allogeneic HSCT may be an effective salvage treatment modality for patients with a second relapse. Owing to a few cases of relapsed APL, multicenter prospective studies may help elucidate the efficacy of each post-remission treatment.
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Affiliation(s)
- Gi-June Min
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Sik Cho
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Soo Park
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Silvia Park
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Woo Jeon
- Department of Hematology, Yeouido St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Ah Yahng
- Department of Hematology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Seung-Hawn Shin
- Department of Hematology, Eunpyeong St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae-Ho Yoon
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung-Eun Lee
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ki-Seong Eom
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo-Jin Kim
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok Lee
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chang-Ki Min
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seok-Goo Cho
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong Wook Lee
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hee-Je Kim
- Department of Hematology, Seoul St. Mary's Hematology Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Successful allogeneic bone marrow transplantation in a case of variant acute promyelocytic leukemia with ZBTB16-RARA. Ann Hematol 2022; 101:1129-1132. [DOI: 10.1007/s00277-022-04825-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
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9
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Baysal M, Gürsoy V, Hunutlu FC, Erkan B, Demirci U, Bas V, Gulsaran SK, Pinar IE, Ersal T, Kirkizlar TA, Atli EI, Kirkizlar HO, Ümit EG, Gürkan H, Ozkocaman V, Ozkalemkas F, Demir AM, Ali R. The evaluation of risk factors leading to early deaths in patients with acute promyelocytic leukemia: a retrospective study. Ann Hematol 2022; 101:1049-1057. [PMID: 35190843 DOI: 10.1007/s00277-022-04798-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/14/2022] [Indexed: 11/28/2022]
Abstract
Acute promyelocytic leukemia (APL) differs from other forms of acute myeloid leukemia (AML), including coagulopathy, hemorrhage, disseminated intravascular coagulation (DIC), and treatment success with all-trans retinoic acid (ATRA). Despite ATRA, early deaths (ED) are still common in APL. Here, we evaluated factors associated with ED and applicability of scoring systems used to diagnose DIC. Ninety-one APL patients (55 females, 36 males, and median age 40 years) were included. ED was defined as deaths attributable to any cause between day of diagnosis and following 30th day. DIC was assessed based on DIC scoring system released by the International Society of Thrombosis and Hemostasis (ISTH) and Chinese Diagnostic Scoring System (CDSS). Patients' median follow-up time was 49.2 months, and ED developed in 14 (15.4% of) cases. Patients succumbing to ED had higher levels of the Eastern Cooperative Oncology Group Performance Status (ECOG PS), lactate dehydrogenase (LDH), and ISTH DIC, and lower fibrinogen levels (p <0.05). In multivariate Cox regression analysis, age >55 and ECOG PS ≥2 rates were revealed to be associated with ED. Based on ISTH and CDSS scores, DIC was reported in 47.3 and 58.2% of the patients, respectively. Despite advances in APL, ED is still a major obstacle. Besides the prompt recognition and correction of coagulopathy, those at high ED risk are recommended to be detected rapidly. Implementation of local treatment plans and creating awareness should be achieved in hematological centers. Common utilization of ATRA and arsenic trioxide (ATO) may be beneficial to overcome ED and coagulopathy in APL patients.
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Affiliation(s)
- Mehmet Baysal
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey.
| | - Vildan Gürsoy
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Fazil Cagri Hunutlu
- Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Buket Erkan
- Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Ufuk Demirci
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Volkan Bas
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Sedanur Karaman Gulsaran
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Ibrahim Ethem Pinar
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Tuba Ersal
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Tugcan Alp Kirkizlar
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Emine Ikbal Atli
- Department of Medical Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Hakki Onur Kirkizlar
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Elif G Ümit
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Hakan Gürkan
- Department of Medical Genetics, Trakya University School of Medicine, Edirne, Turkey
| | - Vildan Ozkocaman
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Fahir Ozkalemkas
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
| | - Ahmet Muzaffer Demir
- Division of Hematology Edirne, Department of Internal Medicine, Trakya University School of Medicine, Balkan Campus, 22030, Edirne, Turkey
| | - Ridvan Ali
- Division of Hematology, Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey
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Breccia M. Autologous stem cell transplantation finds a place in acute promyelocytic leukaemia. Br J Haematol 2020; 192:237-238. [PMID: 33216973 DOI: 10.1111/bjh.17219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Massimo Breccia
- Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University, Rome, Italy
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11
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All-Trans Retinoic Acid Prevented Vein Grafts Stenosis by Inhibiting Rb-E2F Mediated Cell Cycle Progression and KLF5-RARα Interaction in Human Vein Smooth Muscle Cells. Cardiovasc Drugs Ther 2020; 35:103-111. [PMID: 33044585 DOI: 10.1007/s10557-020-07089-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE Vein graft failure (VGF) is an important limitation for coronary artery bypass graft (CABG) surgery. Inhibition of the excessive proliferation and migration of venous smooth muscle cells (SMCs) is an effective strategy to alleviate VGF during the CABG perioperative period. In the present study, we aimed to explore the role and potential mechanism of all-trans retinoic acid (ATRA) on preventing vein grafts stenosis. METHODS The autogenous vein grafts model was established in the right jugular artery of rabbits. Immunohistochemistry staining and western blot assays were used to detected the protein expression, while real-time PCR assay was applied for mRNAs expression detection. The interaction between proteins was identified by co-immunoprecipitation assay. The Cell Counting Kit-8 and wound-healing assays were used to investigate the role of ATRA on human umbilical vein smooth muscle cells (HUVSMCs) function. Cell cycle progression was identified by flow cytometry assay. RESULTS Vein graft stenosis and SMCs hyperproliferation were confirmed in vein grafts by histological and Ki-67 immunohistochemistry assays. Treatment of ATRA (10 mg/kg/day) significantly mitigated the stenosis extent of vein grafts, demonstrated by the decreased thickness of intima-media, and decreased Ki-67 expression. ATRA could repress the PDGF-bb-induced excessive proliferation and migration of HUVSMCs, which was mediated by Rb-E2F dependent cell cycle inhibition. Meanwhile, ATRA could reduce the interaction between KLF5 and RARα, thereby inhibiting the function of cis-elements of KLF5. KLF5-induced inducible nitric oxide synthase (iNOS) expression activation could be significantly inhibited by ATRA. CONCLUSIONS These results suggested that ATRA treatment may represent an effective prevention and therapy avenue for VGF.
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12
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Kohan R, Collin A, Guizzardi S, Tolosa de Talamoni N, Picotto G. Reactive oxygen species in cancer: a paradox between pro- and anti-tumour activities. Cancer Chemother Pharmacol 2020; 86:1-13. [PMID: 32572519 DOI: 10.1007/s00280-020-04103-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 06/10/2020] [Indexed: 12/13/2022]
Abstract
Cancer constitutes a group of heterogeneous diseases that share common features. They involve the existence of altered cellular pathways which result in uncontrolled cell proliferation. Deregulation of production and/or elimination of reactive oxygen species (ROS) appear to be a relevant issue in most of them. ROS have a dual role in cell metabolism: they are compromised in normal cellular homeostasis, but their overproduction has been reported to promote oxidative stress (OS), a process that may induce the damage of cell structures. ROS accumulation is implicated in the activation of signaling pathways that promote cell proliferation and metabolic adaptations to tumour growth. One characteristic of cancer cells is the sensitivity to OS, which often results from the combination of high anabolic needs and hypoxic growth conditions. However, there is still no clear evidence about the levels of oxidant species that promote cellular transformation or, otherwise, if OS induction could be adequate as an antitumour therapeutic tool. There is a need for novel therapeutic strategies based on the new knowledge of cancer biology. Targeting oncogenic molecular mechanisms with non-classical agents and/or natural compounds would be beneficial as chemoprevention or new adjuvant therapies. In addition, epigenetics and environment, and particularly dietary factors may influence the development and prevention of cancer. This article will present a revision of the current research about molecular aspects proposed to be involved in the anticancer features of oxidant and antioxidant-based therapies targeting cancer cells, and their participation in the balance of oxidative species and cancer cell death.
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Affiliation(s)
- Romina Kohan
- Cátedra de Bioquímica y Biología Molecular, Facultad de Ciencias Médicas, UNC, INICSA (CONICET-UNC), Pabellón Argentina, 2do Piso, Ciudad Universitaria, 5000, Córdoba, Argentina.,Cátedra de Biología Celular A, Facultad de Odontología, UNC, Córdoba, Argentina
| | - Alejandro Collin
- Cátedra de Bioquímica y Biología Molecular, Facultad de Ciencias Médicas, UNC, INICSA (CONICET-UNC), Pabellón Argentina, 2do Piso, Ciudad Universitaria, 5000, Córdoba, Argentina
| | - Solange Guizzardi
- Cátedra de Bioquímica y Biología Molecular, Facultad de Ciencias Médicas, UNC, INICSA (CONICET-UNC), Pabellón Argentina, 2do Piso, Ciudad Universitaria, 5000, Córdoba, Argentina
| | - Nori Tolosa de Talamoni
- Cátedra de Bioquímica y Biología Molecular, Facultad de Ciencias Médicas, UNC, INICSA (CONICET-UNC), Pabellón Argentina, 2do Piso, Ciudad Universitaria, 5000, Córdoba, Argentina
| | - Gabriela Picotto
- Cátedra de Bioquímica y Biología Molecular, Facultad de Ciencias Médicas, UNC, INICSA (CONICET-UNC), Pabellón Argentina, 2do Piso, Ciudad Universitaria, 5000, Córdoba, Argentina.
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13
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Yang S, Ma R, Yuan X, Jiang L, Shi J, Yang J, Lei P, Zang Y, Chen X, Zhang Y, Liu Z, Guo J, Zhang L, Zhu X, Zhu Z. Improved Outcomes of All-trans-retinoic Acid and Arsenic Trioxide Plus Idarubicin as a Frontline Treatment in Adult Patients With Acute Promyelocytic Leukemia. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:e382-e391. [PMID: 32336675 DOI: 10.1016/j.clml.2019.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 09/29/2019] [Accepted: 10/03/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The purpose of this study was to explore the outcomes of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) plus idarubicin (IDA) as a frontline treatment in adult patients with acute promyelocytic leukemia (APL). PATIENTS AND METHODS We analyzed the outcomes of ATRA and intravenous ATO plus IDA as a frontline induction therapy in 118 patients with APL with high-risk (HR) and standard-risk (SR) disease from January 2008 to December 2017. The medical records of 118 patients with APL (HR, n = 45; SR, n = 73) who received the frontline triple combination regimen at Henan Provincial People's Hospital and Tongji Hospital were retrospectively reviewed. Consolidation therapy comprised 6 cycles of ATO and ATRA plus IDA, and IDA was administered in 1 to 4 cycles of consolidation therapy based on the comparable clinical efficacy compared with 6 cycles and fewer side effects to myocardium without subsequent maintenance therapy. RESULTS Of 118 patients, there were 3 (2.5%) early deaths and 115 (97.5%) hematologic complete remissions; 102 (88.7%) of 115 patients achieved molecular complete remission following induction therapy, and all patients were polymerase chain reaction-negative for promyelocytic leukemia-retinoic acid receptor alpha after the first cycle of consolidation therapy. The 5-year overall survival (OS) and event-free survival (EFS) were 93.0% ± 2.9% and 92.4% ± 3.0%, respectively. Early death, hematologic complete remissions, molecular complete remissions, and toxicities were comparable between the HR and SR groups. The cumulative incidence of relapse in the HR group was 4.7% (n = 2), and the cumulative incidence of relapse in the SR group was 0. The OS and EFS of the SR and HR groups were comparable (92.3% ± 4.5% vs. 92.8% ± 4.0%; X2 = 0.263; P = .608; 92.3% ± 4.5% vs. 91.1% ± 4.2%, X2 = 0.917; P = .338). The total dosage of IDA was approximately 181 to 258 mg, and no patient experienced cardiotoxicity. OS and EFS were not influenced by fms-related tyrosine kinase 3 internal tandem duplication mutation status (P = .405 and P = .528, respectively). CONCLUSION The triple combination of ATRA and ATO plus IDA as both an induction and consolidation therapy for the HR and SR groups attained excellent outcomes, and this regimen was effective, safe, and easy, without maintenance therapy. The triple combination treatment might be a preferred frontline therapy for patients with APL, especially for those with HR or the APL fms-related tyrosine kinase 3 internal tandem duplication mutation.
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Affiliation(s)
- Shiwei Yang
- Henan Provincial People's Hospital, Institute of Hematology of Henan Provincial People's Hospital, Zhengzhou, Henan, PR China; Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China; Henan Provincial People's Hospital, Henan Key Laboratory of Stem Cell Differentiation and Modification, Zhengzhou, Henan, PR China
| | - Rongjun Ma
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoli Yuan
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Li Jiang
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jie Shi
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jing Yang
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Pingchong Lei
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yuzhu Zang
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiangli Chen
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yin Zhang
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhongwen Liu
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Jianmin Guo
- Department of Hematology, People's Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Lin Zhang
- Henan Provincial People's Hospital, Institute of Hematology of Henan Provincial People's Hospital, Zhengzhou, Henan, PR China; Henan Provincial People's Hospital, Henan Key Laboratory of Stem Cell Differentiation and Modification, Zhengzhou, Henan, PR China
| | - Xiaojian Zhu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Zunmin Zhu
- Henan Provincial People's Hospital, Institute of Hematology of Henan Provincial People's Hospital, Zhengzhou, Henan, PR China; Henan Provincial People's Hospital, Henan Key Laboratory of Stem Cell Differentiation and Modification, Zhengzhou, Henan, PR China.
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14
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Banerjee M, Ferragut Cardoso AP, Lykoudi A, Wilkey DW, Pan J, Watson WH, Garbett NC, Rai SN, Merchant ML, States JC. Arsenite Exposure Displaces Zinc from ZRANB2 Leading to Altered Splicing. Chem Res Toxicol 2020; 33:1403-1417. [PMID: 32274925 DOI: 10.1021/acs.chemrestox.9b00515] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Exposure to arsenic, a class I carcinogen, affects 200 million people globally. Skin is the major target organ, but the molecular etiology of arsenic-induced skin carcinogenesis remains unclear. Arsenite (As3+)-induced disruption of alternative splicing could be involved, but the mechanism is unknown. Zinc finger proteins play key roles in alternative splicing. As3+ can displace zinc (Zn2+) from C3H1 and C4 zinc finger motifs (zfm's), affecting protein function. ZRANB2, an alternative splicing regulator with two C4 zfm's integral to its structure and splicing function, was chosen as a candidate for this study. We hypothesized that As3+ could displace Zn2+ from ZRANB2, altering its structure, expression, and splicing function. As3+/Zn2+ binding and mutual displacement experiments were performed with synthetic apo-peptides corresponding to each ZRANB2 zfm, employing a combination of intrinsic fluorescence, ultraviolet spectrophotometry, zinc colorimetric assay, and liquid chromatography-tandem mass spectrometry. ZRANB2 expression in HaCaT cells acutely exposed to As3+ (0 or 5 μM, 0-72 h; or 0-5 μM, 6 h) was examined by RT-qPCR and immunoblotting. ZRANB2-dependent splicing of TRA2B mRNA, a known ZRANB2 target, was monitored by reverse transcription-polymerase chain reaction. As3+ bound to, as well as displaced Zn2+ from, each zfm. Also, Zn2+ displaced As3+ from As3+-bound zfm's acutely, albeit transiently. As3+ exposure induced ZRANB2 protein expression between 3 and 24 h and at all exposures tested but not ZRANB2 mRNA expression. ZRANB2-directed TRA2B splicing was impaired between 3 and 24 h post-exposure. Furthermore, ZRANB2 splicing function was also compromised at all As3+ exposures, starting at 100 nm. We conclude that As3+ exposure displaces Zn2+ from ZRANB2 zfm's, changing its structure and compromising splicing of its targets, and increases ZRANB2 protein expression as a homeostatic response both at environmental/toxicological exposures and therapeutically relevant doses.
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Affiliation(s)
- Mayukh Banerjee
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40202, United States
| | - Ana P Ferragut Cardoso
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40202, United States
| | - Angeliki Lykoudi
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40202, United States
| | - Daniel W Wilkey
- Division of Nephrology & Hypertension, Department of Medicine, University of Louisville, Louisville, Kentucky 40202, United States
| | - Jianmin Pan
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky 40202, United States
| | - Walter H Watson
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40202, United States.,Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, University of Louisville, Louisville, Kentucky 40202, United States
| | - Nichola C Garbett
- Division of Medical Oncology and Hematology, Department of Medicine, University of Louisville, Louisville, Kentucky 40202, United States.,James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky 40202, United States
| | - Shesh N Rai
- Biostatistics and Bioinformatics Facility, James Graham Brown Cancer Center, University of Louisville, Louisville, Kentucky 40202, United States.,Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky 40202, United States
| | - Michael L Merchant
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40202, United States.,Division of Nephrology & Hypertension, Department of Medicine, University of Louisville, Louisville, Kentucky 40202, United States
| | - J Christopher States
- Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky 40202, United States
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15
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Mitrovic M, Kostic T, Virijevic M, Karan‐Djurasevic T, Suvajdzic Vukovic N, Pavlovic S, Tosic N. The influence of Wilms' tumor 1 gene expression level on prognosis and risk stratification of acute promyelocytic leukemia patients. Int J Lab Hematol 2019; 42:82-87. [DOI: 10.1111/ijlh.13144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/05/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Mirjana Mitrovic
- Clinic of Hematology Clinical Center of Serbia Belgrade Serbia
- School of Medicine University of Belgrade Belgrade Serbia
| | - Tatjana Kostic
- Institute for Molecular Genetics and Genetic Engineering University of Belgrade Belgrade Serbia
| | - Marijana Virijevic
- Clinic of Hematology Clinical Center of Serbia Belgrade Serbia
- School of Medicine University of Belgrade Belgrade Serbia
| | | | - Nada Suvajdzic Vukovic
- Clinic of Hematology Clinical Center of Serbia Belgrade Serbia
- School of Medicine University of Belgrade Belgrade Serbia
| | - Sonja Pavlovic
- Institute for Molecular Genetics and Genetic Engineering University of Belgrade Belgrade Serbia
| | - Natasa Tosic
- Institute for Molecular Genetics and Genetic Engineering University of Belgrade Belgrade Serbia
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16
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Shah G, Mikhail FM, Bachiasvili K, Vachhani P, Erba HP, Papadantonakis N. Outcomes of high-risk acute promyelocytic leukemia patients treated with arsenic trioxide (ATO)/all trans retinoic acid (ATRA) based induction and consolidation without maintenance phase: A case Series. Hematol Oncol Stem Cell Ther 2019; 13:143-146. [PMID: 31629725 DOI: 10.1016/j.hemonc.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/30/2019] [Indexed: 10/25/2022] Open
Abstract
Patients with high-risk acute promyelocytic leukemia (APL) have inferior outcomes compared with patients with low-risk APL, predominantly due to higher risk of early mortality related to hemorrhage. The majority of regimens contain prolonged maintenance, but the impact of this phase is not clear in the era of all trans retinoic acid (ATRA) and arsenic trioxide (ATO). We present a retrospective analysis of 10 patients that were treated for high risk APL based on the consolidation treatment phase of APL 0406 study without subsequent maintenance. With a median follow up of 38 months, all patients remain in remission.
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Affiliation(s)
- Gaurav Shah
- Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fady M Mikhail
- Department of Genetics, University of Alabama at Birmingham, Birmingham,AL, USA
| | - Kimo Bachiasvili
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pankit Vachhani
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Harry P Erba
- Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Nikolaos Papadantonakis
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
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17
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Miller KP, Venkataraman G, Gocke CD, Batista DA, Borowitz MJ, Burns KH, Pratz K, Duffield AS. Bone Marrow Findings in Patients With Acute Promyelocytic Leukemia Treated With Arsenic Trioxide. Am J Clin Pathol 2019; 152:675-685. [PMID: 31305869 DOI: 10.1093/ajcp/aqz087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Increasingly, acute promyelocytic leukemia (APL) is treated with a combination of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). This study characterizes bone marrow findings after ATRA/ATO therapy. METHODS Bone marrow biopsies from 16 patients treated with ATRA/ATO and seven patients treated with ATRA/chemotherapy (CTX) for APL were evaluated. RESULTS In ATRA/ATO cases, the marrow was likely to be hypercellular (79%) with a decreased myeloid:erythroid (M:E) ratio (88%), megaloblastoid maturation of erythroid precursors (100%), erythroid atypia (75%), and increased (88%) and atypical (75%) megakaryocytes. Significant myeloid atypia was only seen in extensive residual disease. The ATRA/CTX cases were less likely to be hypercellular (38%), have a M:E ratio of 1:1 or less (0%), exhibit significant erythroid atypia (0%), or have increased (0%) or atypical (38%) megakaryocytes. CONCLUSIONS Bone marrow biopsies from patients treated with ATO have unusual but characteristic features. Despite variability in marrow findings, clinical outcomes were uniformly favorable.
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Affiliation(s)
- Karin P Miller
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Christopher D Gocke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Denise A Batista
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael J Borowitz
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kathleen H Burns
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Keith Pratz
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Amy S Duffield
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD
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18
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Zhou L, Zhang T, Zhu Q, Zhang P, Yu L, Shen B, Yi W, Qiu M, Zhu C. Mina53 regulates the differentiation and proliferation of leukemia cells. Hematol Oncol 2019; 37:513-515. [DOI: 10.1002/hon.2621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Lixiao Zhou
- College of Life Sciences Zhejiang University Hangzhou China
- Key Laboratory of Organ Development and Regeneration of Zhejiang Province, Institute of Life Sciences Hangzhou Normal University Hangzhou China
| | - Ting Zhang
- College of Medical Technology Zhejiang Chinese Medical University Hangzhou China
| | - Qiang Zhu
- College of Life Sciences Zhejiang University Hangzhou China
| | | | - Liyang Yu
- College of Life Sciences Zhejiang University Hangzhou China
| | - Binghui Shen
- Department of Cancer Genetics and Epigenetics Beckman Research Institute, City of Hope Duarte California
| | - Wen Yi
- College of Life Sciences Zhejiang University Hangzhou China
| | - Mengsheng Qiu
- College of Life Sciences Zhejiang University Hangzhou China
- Key Laboratory of Organ Development and Regeneration of Zhejiang Province, Institute of Life Sciences Hangzhou Normal University Hangzhou China
| | - Chenggang Zhu
- College of Life Sciences Zhejiang University Hangzhou China
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19
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Pötsch I, Baier D, Keppler BK, Berger W. Challenges and Chances in the Preclinical to Clinical Translation of Anticancer Metallodrugs. METAL-BASED ANTICANCER AGENTS 2019. [DOI: 10.1039/9781788016452-00308] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Despite being “sentenced to death” for quite some time, anticancer platinum compounds are still the most frequently prescribed cancer therapies in the oncological routine and recent exciting news from late-stage clinical studies on combinations of metallodrugs with immunotherapies suggest that this situation will not change soon. It is perhaps surprising that relatively simple molecules like cisplatin, discovered over 50 years ago, are still widely used clinically, while none of the highly sophisticated metal compounds developed over the last decade, including complexes with targeting ligands and multifunctional (nano)formulations, have managed to obtain clinical approval. In this book chapter, we summarize the current status of ongoing clinical trials for anticancer metal compounds and discuss the reasons for previous failures, as well as new opportunities for the clinical translation of metal complexes.
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Affiliation(s)
- Isabella Pötsch
- University of Vienna, Department of Inorganic Chemistry Währingerstrasse Vienna 1090 Austria
- Medical University of Vienna, Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I Borschkegasse 8a 1090 Vienna Austria
| | - Dina Baier
- University of Vienna, Department of Inorganic Chemistry Währingerstrasse Vienna 1090 Austria
- Medical University of Vienna, Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I Borschkegasse 8a 1090 Vienna Austria
| | - Bernhard K. Keppler
- University of Vienna, Department of Inorganic Chemistry Währingerstrasse Vienna 1090 Austria
| | - Walter Berger
- Medical University of Vienna, Institute of Cancer Research and Comprehensive Cancer Center, Department of Medicine I Borschkegasse 8a 1090 Vienna Austria
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20
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Nachliely M, Trachtenberg A, Khalfin B, Nalbandyan K, Cohen-Lahav M, Yasuda K, Sakaki T, Kutner A, Danilenko M. Dimethyl fumarate and vitamin D derivatives cooperatively enhance VDR and Nrf2 signaling in differentiating AML cells in vitro and inhibit leukemia progression in a xenograft mouse model. J Steroid Biochem Mol Biol 2019; 188:8-16. [PMID: 30508646 DOI: 10.1016/j.jsbmb.2018.11.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/12/2018] [Accepted: 11/29/2018] [Indexed: 12/11/2022]
Abstract
Acute myeloid leukemia (AML) is one of the deadliest hematological malignancies without effective treatment for most patients. Vitamin D derivatives (VDDs) - active metabolites 1α,25-dihydroxyvitamin D2 (1,25D2) and 1α,25-dihydroxyvitamin D3 (1,25D3) and their analogs - are differentiation-inducing agents which have potential for the therapy of AML. However, calcemic toxicity of VDDs limits their clinical use at doses effective against cancer cells in vivo. Here, we demonstrate that in AML cell cultures, moderate pro-differentiation effects of low concentrations of VDDs can be synergistically enhanced by structurally distinct compounds known to activate the transcription factor Nuclear Factor (Erythroid-derived 2)-Like 2 (NFE2L2 or Nrf2). Particularly, dimethyl fumarate (DMF), which is clinically approved for the treatment of multiple sclerosis and psoriasis, strongly cooperated with 1,25D3, PRI-5100 (19-nor-1,25D2; paricalcitol) and PRI-5202 (a double-point modified 19-nor analog of 1,25D2). The pro-differentiation synergy between VDDs (1,25D3 or PRI-5202) and Nrf2 activators (DMF, tert-butylhydroquinone or carnosic acid) was associated with a cooperative upregulation of the protein levels of the vitamin D receptor (VDR) and Nrf2 as well as increased mRNA expression of their respective target genes. These data support the notion that VDDs and Nrf2 activators synergize in inducing myeloid cell differentiation through the cooperative activation of the VDR and Nrf2/antioxidant response element signaling pathways. We have previously reported that PRI-5202 is more potent by approximately two orders of magnitude than 1,25D3 as a differentiation inducer in AML cell lines. In this study, we found that PRI-5202 was also at least 5-fold less calcemic in healthy mice compared to both its direct precursor PRI-1907 and 1,25D3. In addition, PRI-5202 was remarkably more resistant against degradation by the human 25-hydroxyvitamin D3-24-hydroxylase than both 1,25D2 and 1,25D3. Importantly, using a xenograft mouse model we demonstrated that co-administration of PRI-5202 and DMF resulted in a marked cooperative inhibition of human AML tumor growth without inducing treatment toxicity. Collectively, our findings provide a rationale for clinical testing of low-toxic VDD/DMF combinations as a novel approach for differentiation therapy of AML.
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Affiliation(s)
- Matan Nachliely
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Beer Sheva, Israel
| | - Aviram Trachtenberg
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Beer Sheva, Israel
| | - Boris Khalfin
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Beer Sheva, Israel
| | - Karen Nalbandyan
- Department of Pathology, Soroka University Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Beer-Sheva, Israel
| | - Merav Cohen-Lahav
- Laboratory of Biochemistry, Soroka University Medical Center, 84101 Beer Sheva, Beer Sheva, Israel
| | - Kaori Yasuda
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 939-0398 Imizu, Toyama, Japan
| | - Toshiyuki Sakaki
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 939-0398 Imizu, Toyama, Japan
| | - Andrzej Kutner
- Department of Pharmacology, Pharmaceutical Research Institute, 01-793 Warsaw, Poland
| | - Michael Danilenko
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, 84105 Beer Sheva, Israel.
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21
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Zheng JC, Chang KJ, Jin YX, Zhao XW, Li B, Yang MH. Arsenic Trioxide Inhibits the Metastasis of Small Cell Lung Cancer by Blocking Calcineurin-Nuclear Factor of Activated T Cells (NFAT) Signaling. Med Sci Monit 2019; 25:2228-2237. [PMID: 30913205 PMCID: PMC6446656 DOI: 10.12659/msm.913091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/11/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The inhibitory effect of arsenic trioxide (As₂O₃) on lung cancer has been reported in some preclinical studies. However, its effect on small cell lung cancer (SCLC) has been poorly explored. Calcineurin and its substrate, nuclear factor of activated T cells (NFAT), mediate the downstream signaling of VEGF, and is critical in the process endothelium activation and tumor metastasis. In this study, we aimed to evaluate whether As₂O₃ had inhibitory effects on endothelial cells activation and the metastasis of SCLC, and to explore the possible mechanisms. MATERIAL AND METHODS In vitro, human umbilical vein endothelial cells (HUVECs) were used. Cell Counting Kit-8 assay and cell migration assay were performed to determine the effect of As₂O₃ on HUVECs proliferation and migration. The level of calcineurin, NFAT, downstream factors for Down syndrome candidate region 1 (DSCR1), and the endogenous inhibitor of calcineurin, were evaluated by quantitative PCR and western blotting. In vivo, SCLC metastasis models were established by injecting NCI-H446 cells into tail veins of nude mice. Tumor-bearing mice were treated with As₂O₃ or calcineurin inhibitor for 10 days, after which tumor metastasis in target organs was evaluated. RESULTS As₂O₃ significantly inhibited the proliferation and migration of endothelial cells. Also, As₂O₃ inhibited the expression levels of calcineurin, NFAT, and the downstream target genes CXCR7 and RND1, while it upregulated the level of DSCR1. Both As₂O₃ and calcineurin inhibitor exhibited notable inhibitory effect on the metastasis of SCLC, without obvious side effects. CONCLUSIONS These findings suggested that As₂O₃ had remarkable inhibitory effects on the endothelial cell activation and SCLC metastasis, and the mechanism might be related to the blocking of calcineurin-NFAT signaling by upregulating DSCR1.
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Affiliation(s)
- Jin-Cheng Zheng
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China
| | - Ke-Jie Chang
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China
| | - Yu-Xiang Jin
- Department of Thoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China
| | - Xue-Wei Zhao
- Department of Thoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China
| | - Bing Li
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China
| | - Meng-Hang Yang
- Department of Respiratory and Critical Care Medicine, Changzheng Hospital, Second Military Medical University, Shanghai, P.R. China
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22
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Yang MH, Wan WQ, Luo JS, Zheng MC, Huang K, Yang LH, Mai HR, Li J, Chen HQ, Sun XF, Liu RY, Chen GH, Feng X, Ke ZY, Li B, Tang YL, Huang LB, Luo XQ. Multicenter randomized trial of arsenic trioxide and Realgar-Indigo naturalis formula in pediatric patients with acute promyelocytic leukemia: Interim results of the SCCLG-APL clinical study. Am J Hematol 2018; 93:1467-1473. [PMID: 30160789 PMCID: PMC6282847 DOI: 10.1002/ajh.25271] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 08/23/2018] [Accepted: 08/26/2018] [Indexed: 12/12/2022]
Abstract
Intravenous arsenic trioxide (ATO) has been adopted as the first‐line treatment for acute promyelocytic leukemia (APL). Another arsenic compound named the Realgar‐Indigo naturalis formula (RIF), an oral traditional Chinese medicine containing As4S4, has been shown to be highly effective in treating adult APL. In the treatment of pediatric APL, the safety and efficacy of RIF remains to be confirmed. This randomized, multicenter, and noninferiority trial was conducted to determine whether intravenous ATO can be substituted by oral RIF in the treatment of pediatric APL. From September 2011 to January 2017, among 92 patients who were 16 years old or younger with newly diagnosed PML‐RARa positive APL, 82 met eligible criteria and were randomly assigned to ATO (n = 42) or RIF (n = 40) group. The remaining 10 patients did not fulfilled eligible criteria because five did not accept randomization, four died and one had hemiplegia prior to arsenic randomization due to intracranial hemorrhage or cerebral thrombosis. Induction and consolidation treatment contained ATO or RIF, all‐trans‐retinoic acid and low intensity chemotherapy. End points included event‐free survival (EFS), adverse events and hospital days. After a median 3‐year follow‐up, the estimated 5‐year EFS was 100% in both groups, and adverse events were mild. However, patients in the RIF group had significantly less hospital stay than those in the ATO group. This interim analysis shows that oral RIF is as effective and safe as intravenous ATO for the treatment of pediatric APL, with the advantage of reducing hospital stay. Final trial analysis will reveal mature outcome data.
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Affiliation(s)
- Ming-Hua Yang
- Department of Pediatrics; Xiangya Hospital, Central South University; Changsha Hunan China
| | - Wu-Qing Wan
- Department of Pediatrics; Second Xiangya Hospital, Central South University; Hunan China
| | - Jie-Si Luo
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Min-Cui Zheng
- Department of Hematology; Hunan Childdren's Hospital; Changsha Hunan China
| | - Ke Huang
- Department of Pediatrics; Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University; Guangzhou China
| | - Li-Hua Yang
- Department of Pediatrics; Zhujiang Hospital, Southern Medical University; Guangzhou China
| | - Hui-Rong Mai
- Department of Hematology and Oncology; Shenzhen Children's Hospital; Shenzhen China
| | - Jian Li
- Department of Pediatric Hematology; Fujian Medical University Union Hospital; Fuzhou Fujian China
| | - Hui-Qin Chen
- Department of Pediatrics; Third Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Xiao-Fei Sun
- Department of Pediatrics; Sun Yat-Sen University Cancer Center; Guanzhou China
| | - Ri-Yang Liu
- Department of Pediatrics; Huizhou Municipal Central Hospital; Huizhou Guangdong China
| | - Guo-Hua Chen
- Department of Pediatrics; First People's Hospital of Huizhou; Huizhou Guangdong China
| | - Xiaoqin Feng
- Department of Pediatrics; Nanfang Hospital, Southern Medical University; Guangzhou China
| | - Zhi-Yong Ke
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Bin Li
- Clinical Trials Unit, First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Yan-Lai Tang
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Li-Bin Huang
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
| | - Xue-Qun Luo
- Department of Pediatrics; First Affiliated Hospital, Sun Yat-Sen University; Guangzhou China
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23
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Al-Qassab Y, Grassilli S, Brugnoli F, Vezzali F, Capitani S, Bertagnolo V. Protective role of all-trans retinoic acid (ATRA) against hypoxia-induced malignant potential of non-invasive breast tumor derived cells. BMC Cancer 2018; 18:1194. [PMID: 30497437 PMCID: PMC6267073 DOI: 10.1186/s12885-018-5038-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 11/04/2018] [Indexed: 12/14/2022] Open
Abstract
Background The presence of hypoxic areas is common in all breast lesions but no data clearly correlate low oxygenation with the acquisition of malignant features by non-invasive cells, particularly by cells from ductal carcinoma in situ (DCIS), the most frequently diagnosed tumor in women. Methods By using a DCIS-derived cell line, we evaluated the effects of low oxygen availability on malignant features of non-invasive breast tumor cells and the possible role of all-trans retinoic acid (ATRA), a well-known anti-leukemic drug, in counteracting the effects of hypoxia. The involvement of the β2 isoform of PI-PLC (PLC-β2), an ATRA target in myeloid leukemia cells, was also investigated by specific modulation of the protein expression. Results We demonstrated that moderate hypoxia is sufficient to induce, in DCIS-derived cells, motility, epithelial-to-mesenchymal transition (EMT) and expression of the stem cell marker CD133, indicative of their increased malignant potential. Administration of ATRA supports the epithelial-like phenotype of DCIS-derived cells cultured under hypoxia and keeps down the number of CD133 positive cells, abrogating almost completely the effects of poor oxygenation. We also found that the mechanisms triggered by ATRA in non-invasive breast tumor cells cultured under hypoxia is in part mediated by PLC-β2, responsible to counteract the effects of low oxygen availability on CD133 levels. Conclusions Overall, we assigned to hypoxia a role in increasing the malignant potential of DCIS-derived cells and we identified in ATRA, currently used in treatment of acute promyelocytic leukemia (APL), an agonist potentially useful in preventing malignant progression of non-invasive breast lesions showing hypoxic areas.
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Affiliation(s)
- Yasamin Al-Qassab
- Signal Transduction Unit, Section of Anatomy and Histology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44121, Ferrara, Italy.,College of Medicine, Department of Anatomy, University of Baghdad, Baghdad, Iraq
| | - Silvia Grassilli
- Signal Transduction Unit, Section of Anatomy and Histology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44121, Ferrara, Italy
| | - Federica Brugnoli
- Signal Transduction Unit, Section of Anatomy and Histology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44121, Ferrara, Italy
| | - Federica Vezzali
- Signal Transduction Unit, Section of Anatomy and Histology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44121, Ferrara, Italy
| | - Silvano Capitani
- Signal Transduction Unit, Section of Anatomy and Histology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44121, Ferrara, Italy.,LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Valeria Bertagnolo
- Signal Transduction Unit, Section of Anatomy and Histology, Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Via Fossato di Mortara, 70, 44121, Ferrara, Italy.
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24
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Spinello I, Saulle E, Quaranta MT, Pasquini L, Pelosi E, Castelli G, Ottone T, Voso MT, Testa U, Labbaye C. The small-molecule compound AC-73 targeting CD147 inhibits leukemic cell proliferation, induces autophagy and increases the chemotherapeutic sensitivity of acute myeloid leukemia cells. Haematologica 2018; 104:973-985. [PMID: 30467201 PMCID: PMC6518905 DOI: 10.3324/haematol.2018.199661] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022] Open
Abstract
CD147 is a transmembrane glycoprotein with multiple functions in human healthy tissues and diseases, in particular in cancer. Overexpression of CD147 correlates with biological functions that promote tumor progression and confers resistance to chemotherapeutic drugs. In contrast to solid tumors, the role of CD147 has not been extensively studied in leukemia. Understanding whether CD147 represents a new hematologic target and whether its inhibitor AC-73 may be used in leukemia therapy may reveal an alternative treatment strategy in patients with acute myeloid leukemia (AML). We analyzed CD147 expression and function in hematopoietic progenitor cells from normal cord blood, in several leukemic cell lines and in primary leukemic blasts obtained from patients with AML. We investigated the effects of AC-73, used alone or in combination with arabinosylcytosine (Ara-C) and arsenic trioxide (ATO), on leukemic cell proliferation. We demonstrated that CD147 overexpression promotes leukemic cell proliferation. We showed that AC-73 exhibits a potent growth inhibitory activity in leukemic cells, by inhibiting the ERK/STAT3 activation pathway and activating autophagy. We demonstrated that AC-73 exerts an anti-proliferative effect additive to chemotherapy by enhancing leukemic cell sensitivity to Ara-C-induced cytotoxicity or to ATO-induced autophagy. We also reported CD147 expression in the fraction of leukemic blasts expressing CD371, a marker of leukemic stem cells. Altogether, our study indicates CD147 as a novel potential target in the treatment of AML and AC-73 as an anti-proliferative drug and an inducer of autophagy in leukemic cells to use in combination with chemotherapeutic agents.
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Affiliation(s)
- Isabella Spinello
- National Center for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome
| | - Ernestina Saulle
- National Center for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome
| | - Maria Teresa Quaranta
- National Center for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome
| | | | - Elvira Pelosi
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità
| | - Germana Castelli
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità
| | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Ugo Testa
- Department of Oncology and Molecular Medicine, Istituto Superiore di Sanità
| | - Catherine Labbaye
- National Center for Drug Research and Evaluation, Istituto Superiore di Sanità, Rome
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25
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Chaiswing L, St. Clair WH, St. Clair DK. Redox Paradox: A Novel Approach to Therapeutics-Resistant Cancer. Antioxid Redox Signal 2018; 29:1237-1272. [PMID: 29325444 PMCID: PMC6157438 DOI: 10.1089/ars.2017.7485] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/05/2018] [Indexed: 02/06/2023]
Abstract
SIGNIFICANCE Cancer cells that are resistant to radiation and chemotherapy are a major problem limiting the success of cancer therapy. Aggressive cancer cells depend on elevated intracellular levels of reactive oxygen species (ROS) to proliferate, self-renew, and metastasize. As a result, these aggressive cancers maintain high basal levels of ROS compared with normal cells. The prominence of the redox state in cancer cells led us to consider whether increasing the redox state to the condition of oxidative stress could be used as a successful adjuvant therapy for aggressive cancers. Recent Advances: Past attempts using antioxidant compounds to inhibit ROS levels in cancers as redox-based therapy have met with very limited success. However, recent clinical trials using pro-oxidant compounds reveal noteworthy results, which could have a significant impact on the development of strategies for redox-based therapies. CRITICAL ISSUES The major objective of this review is to discuss the role of the redox state in aggressive cancers and how to utilize the shift in redox state to improve cancer therapy. We also discuss the paradox of redox state parameters; that is, hydrogen peroxide (H2O2) as the driver molecule for cancer progression as well as a target for cancer treatment. FUTURE DIRECTIONS Based on the biological significance of the redox state, we postulate that this system could potentially be used to create a new avenue for targeted therapy, including the potential to incorporate personalized redox therapy for cancer treatment.
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Affiliation(s)
- Luksana Chaiswing
- Department of Toxicology and Cancer Biology, University of Kentucky-Lexington, Lexington, Kentucky
| | - William H. St. Clair
- Department of Radiation Medicine, University of Kentucky-Lexington, Lexington, Kentucky
| | - Daret K. St. Clair
- Department of Toxicology and Cancer Biology, University of Kentucky-Lexington, Lexington, Kentucky
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26
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Gilleece MH, Labopin M, Yakoub-Agha I, Volin L, Socié G, Ljungman P, Huynh A, Deconinck E, Wu D, Bourhis JH, Cahn JY, Polge E, Mohty M, Savani BN, Nagler A. Measurable residual disease, conditioning regimen intensity, and age predict outcome of allogeneic hematopoietic cell transplantation for acute myeloid leukemia in first remission: A registry analysis of 2292 patients by the Acute Leukemia Working Party European Society of Blood and Marrow Transplantation. Am J Hematol 2018; 93:1142-1152. [PMID: 29981272 DOI: 10.1002/ajh.25211] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/13/2018] [Accepted: 06/18/2018] [Indexed: 12/26/2022]
Abstract
Patients with acute myeloid leukemia (AML) in morphological first complete remission (CR1) pre-allogeneic hematopoietic cell transplantation (HCT) may have measurable residual disease (MRD) by molecular and immunophenotyping criteria. We assessed interactions of MRD status with HCT conditioning regimen intensity in patients aged <50 years (y) or ≥50y. This was a retrospective study by the European Society for Blood and Marrow Transplantation registry. Patients were >18y with AML CR1 MRD NEG/POS and recipients of HCT in 2000-2015. Conditioning regimens were myeloablative (MAC), reduced intensity (RIC) or non-myeloablative (NMA). Outcomes included leukemia free survival (LFS), overall survival (OS), relapse incidence (RI), non-relapse mortality (NRM), chronic graft-vs-host (cGVHD), and GVHD-free and relapse-free survival (GRFS). The 2292 eligible patients were categorized into four paired groups: <50y MRD POS MAC (N = 240) vs RIC/NMA (N = 58); <50y MRD NEG MAC (N = 665) vs RIC/NMA (N = 195); ≥50y MRD POS MAC (N = 126) vs RIC/NMA (N = 230), and ≥50y MRD NEG MAC (N = 223) vs RIC/NMA (N = 555). In multivariate analysis RIC/NMA was only inferior to MAC for patients in the <50y MRD POS group, with worse RI (HR 1.71) and LFS (HR 1.554). Patients <50Y MRD NEG had less cGVHD after RIC/NMA HCT (HR 0.714). GRFS was not significantly affected by conditioning intensity in any group. Patients aged <50y with AML CR1 MRD POS status should preferentially be offered MAC allo-HCT. Prospective studies are needed to address whether patients with AML CR1 MRD NEG may be spared the toxicity of MAC regimens. New approaches are needed for ≥50y AML CR1 MRD POS.
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Affiliation(s)
- Maria H. Gilleece
- Department of Haematology; Leeds Teaching Hospitals Trust, University of Leeds; Leeds United Kingdom
| | | | | | - Liisa Volin
- Comprehensive Cancer Center, Stem Cell Transplantation Unit; Helsinki University Hospital; Helsinki Finland
| | - Gerard Socié
- Service d'Hématologie Greffe; Hôpital Saint-Louis, Assistance Publique Hôpitaux de Paris; Paris France
| | - Per Ljungman
- Center for Allogeneic Stem Cell Transplantation, Karolinska University Hospital; Stockholm Sweden
| | - Anne Huynh
- Service d'Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole; Toulouse France
| | - Eric Deconinck
- Hematology Department; CHRU Besancon, INSERM UMR1098, Universite de Franche-Comte; Besancon France
| | - Depei Wu
- Department of Hematology; First Affiliated Hospital of Soochow University; Suzhou Jiangsu China
| | | | - Jean Yves Cahn
- Department of Haematology, Centre Hospital; Universitaire Grenoble Alpes; Grenoble France
| | - Emmanuelle Polge
- Acute Leukemia Working Party; European Society for Blood and Marrow Transplantation Paris Study Office/European Center for Biostatistical and Epidemiological Evaluation in Hematopoietic Cell Therapy (CEREST-TC); Paris France
| | - Mohamad Mohty
- Hopital Saint-Antoine, Université Pierre and Marie Curie, Institut National de la Santé et de la Recherche Médicale Unite Mixte de Recherche U938; Paris France
| | - Bipin N. Savani
- Division of Hematology/Oncology, Department of Internal Medicine; Vanderbilt University Medical Center; Nashville Tennessee
| | - Arnon Nagler
- Chaim Sheba Medical Center; Tel Aviv University; Tel-Hashomer Israel
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27
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Lou Y, Lu Y, Zhu Z, Ma Y, Suo S, Wang Y, Chen D, Tong H, Qian W, Meng H, Mai W, Yu W, Xu W, Wang L, Mao L, Pei R, Jin J. Improved long-term survival in all Sanz risk patients of newly diagnosed acute promyelocytic leukemia treated with a combination of retinoic acid and arsenic trioxide-based front-line therapy. Hematol Oncol 2018; 36:584-590. [PMID: 29862538 DOI: 10.1002/hon.2519] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 04/26/2018] [Accepted: 04/29/2018] [Indexed: 12/30/2022]
Abstract
Limited data was available for long-term follow-up in newly diagnosed acute promyelocytic leukemia (APL) patients treated with all-trans-retinoic acid (ATRA) plus intravenously arsenic trioxide (ATO)-based front-line therapy. The aim of this work was to retrospectively analyze the long-term survival rate and frequency of therapy-related myeloid neoplasia (t-MN) occurring in a large cohort of APL patients. A total of 760 newly diagnosed patients with APL between January 1999 and May 2016 were evaluated. The early death rate was 9.2% (70/760). Of the remaining 690 patients with complete remission, patients were grouped according to front-line regimens: ATRA plus ATO with or without chemotherapy (ATO group) and ATRA with chemotherapy (non-ATO group). The median duration of follow-up was 7.5 years (1.0-18.3 years). ATO group showed significant superior 10-year estimated relapse-free survival (RFS) up to 90.3% comparing with 65.5% in the non-ATO group (P < 0.0001). In addition, the 10-year estimated overall survival (OS) was 93.9% for patients in the ATO group and 89.1% for those in the non-ATO group (P = 0.03). In the subgroup analysis, the RFS rate was also higher in ATO group comparing with non-ATO group in both low-to-intermediate-risk (94.2% vs 64.6%, P < 0.0001) and high-risk subgroup (89.6% vs 74.7%, P = 0.04). Notably, the 3-year RFS and OS rates in the chemotherapy-free subgroup of the low-to-intermediate-risk patients (n = 88) were 100% and 100%, respectively. In the entire cohort, a total of 10 patients developed secondary malignant neoplasms, including 7 patients with therapy-related myeloid neoplasms (t-MN). The estimated 5-year cumulative incidence risk of t-MN in the ATO and non-ATO groups was 1.0% and 0.4%, respectively (P = 0.34). Thus, our data revealed that the long-term outcome of patients treated with ATRA plus ATO-based regimens was associated with continuing high efficacy in all Sanz risk patients with newly diagnosed APL.
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Affiliation(s)
- Yinjun Lou
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Ying Lu
- Department of Hematology, the Ningbo Yinzhou People's Hospital, Zhejiang, People's Republic of China
| | - Zhijuan Zhu
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
- Fujian Provincial Key Laboratory of Hematology, Fujian Institute of Hematology, Fujian Medical University Union Hospital, Fuzhou, Fujian, People's Republic of China
| | - Yafang Ma
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Shanshan Suo
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Yungui Wang
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Dong Chen
- Department of Hematology, the Ningbo Yinzhou People's Hospital, Zhejiang, People's Republic of China
| | - Hongyan Tong
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Wenbin Qian
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Haitao Meng
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Wenyuan Mai
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Wenjun Yu
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Weilai Xu
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Lei Wang
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Liping Mao
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
| | - Renzhi Pei
- Department of Hematology, the Ningbo Yinzhou People's Hospital, Zhejiang, People's Republic of China
| | - Jie Jin
- Department of Hematology, Leukemia center, The First Affiliated Hospital of Zhejiang University, College of Medicine; Key Laboratory of Hematopoietic Malignancies in Zhejiang Province, Hangzhou, Zhejiang, People's Republic of China
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28
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Li J. Downregulation of ROS1 enhances the therapeutic efficacy of arsenic trioxide in acute myeloid leukemia cell lines. Oncol Lett 2018; 15:9392-9396. [PMID: 29805662 DOI: 10.3892/ol.2018.8458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 08/01/2017] [Indexed: 11/06/2022] Open
Abstract
The present study investigated the function of ROS proto-oncogene 1 receptor tyrosine kinase (ROS1) in regulating the migration and proliferation of acute myeloid leukemia (AML) cells through Wnt/β-catenin signaling, and in arsenic trioxide (ATO) treatment. The migration and proliferation of multiple ROS1-silenced leukemic cell lines was assessed, and the expression levels of proteins associated with Wnt/β-catenin signaling were determined using western blot analysis. Compared with the AML control cells, ROS1-knockdown cells exhibited increased migration and proliferation, and the significant downregulation of β-catenin expression. Additionally, ROS1 knockdown sensitized AML cells to the effects of chemotherapeutic ATO. The results of the present study demonstrated that, in leukemic cell lines, ROS1 counteracted the effects of ATO on migration and proliferation, suggesting that ROS1 may be a potential therapeutic target in patients with AML undergoing ATO treatment. The results of the present study provided novel insight into the function of ATO and ROS1 in regulating AML progression.
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Affiliation(s)
- Jun Li
- Department of Hematology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, P.R. China
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29
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Renneville A, Attias P, Thomas X, Bally C, Hayette S, Farhat H, Eclache V, Marceau-Renaut A, Cassinat B, Feuillard J, Terré C, Delabesse E, Park S, Lejeune J, Chevret S, Adès L, Preudhomme C, Fenaux P. Genetic analysis of therapy-related myeloid neoplasms occurring after intensive treatment for acute promyelocytic leukemia. Leukemia 2018; 32:2066-2069. [PMID: 29740159 DOI: 10.1038/s41375-018-0137-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/18/2018] [Accepted: 04/04/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Aline Renneville
- Hematology Laboratory, Biology and Pathology Center, Lille, France
| | - Philippe Attias
- Service d'Hématologie Seniors, Saint-Louis Hospital, AP-HP, Paris, France
| | - Xavier Thomas
- Hematology Department, Lyon Sud Hospital, Pierre Bénite, France
| | - Cécile Bally
- Service d'Hématologie Seniors, Saint-Louis Hospital, AP-HP, Paris, France
| | | | - Hassan Farhat
- Hematology Department, André Mignot Hospital, Le Chesnay, France
| | - Virginie Eclache
- Hematology Laboratory, Avicenne Hospital, AP-HP, Bobigny, France
| | | | - Bruno Cassinat
- Service de Biologie Cellulaire, Saint-Louis Hospital, AP-HP, Paris, France
| | | | - Christine Terré
- Hematology Laboratory, Andre Mignot Hospital, Le Chesnay, France
| | - Eric Delabesse
- Institut Universitaire de Cancérologie de Toulouse, CHU de Toulouse, Toulouse, France
| | - Sophie Park
- Hematology Department, CHU Grenoble Alpes, Grenoble, France
| | - Julie Lejeune
- Biostatistic Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - Sylvie Chevret
- Biostatistic Department, Saint-Louis Hospital, AP-HP, Paris, France
| | - Lionel Adès
- Service d'Hématologie Seniors, Saint-Louis Hospital, AP-HP, Paris, France
| | | | - Pierre Fenaux
- Service d'Hématologie Seniors, Saint-Louis Hospital, AP-HP, Paris, France. .,Groupe Français des myélodysplasies (GFM), Paris, France.
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30
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Cui W, Wang J, Nie RM, Zhao LL, Gao MQ, Zhu HM, Chen L, Hu J, Li JM, Shen ZX, Wang ZY, Chen SJ, Chen Z, Wang KK, Xi XD, Mi JQ. Arsenic trioxide at conventional dosage does not aggravate hemorrhage in the first-line treatment of adult acute promyelocytic leukemia. Eur J Haematol 2018; 100:344-350. [DOI: 10.1111/ejh.13018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Wen Cui
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
- Department of Clinical Laboratory; Shanghai Municipal Hospital of Traditional Chinese Medicine; Shanghai University of Traditional Chinese Medicine; Shanghai China
| | - Jin Wang
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Rui-Min Nie
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Ling-Ling Zhao
- Department of Clinical Laboratory; Shanghai Xuhui Central Hospital; Shanghai China
| | - Meng-Qing Gao
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Hong-Ming Zhu
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Li Chen
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Jiong Hu
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Jun-Min Li
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Zhi-Xiang Shen
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Zhen-Yi Wang
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Sai-Juan Chen
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Zhu Chen
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Kan-Kan Wang
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Xiao-Dong Xi
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
- Collaborative Innovation Center of Hematology; Shanghai China
| | - Jian-Qing Mi
- Shanghai Institute of Hematology; State Key Laboratory for Medical Genomics and Department of Hematology; Collaborative Innovation Center of Systems Biomedicine; Pôle Sino-Français des Sciences du Vivant et Genomique; Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine; Shanghai China
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Su J, Liu G, Lian Y, Kamal Z, Que X, Qiu Y, Qiu M. Preparation and characterization of erythrocyte membrane cloaked PLGA/arsenic trioxide nanoparticles and evaluation of their in vitro anti-tumor effect. RSC Adv 2018; 8:20068-20076. [PMID: 35541656 PMCID: PMC9080777 DOI: 10.1039/c8ra01417e] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/01/2018] [Indexed: 12/30/2022] Open
Abstract
Arsenic trioxide (ATO) is used for acute promyelocytic leukemia (APL) that is resistant to all-trans-retinoic acid, but its direct intravenous injection sometimes induces severe toxic side effects. Here, we developed a delivery system of red blood cell membrane (RBCM) cloaked poly (lactic-co-glycolic) acid (PLGA)-ATO nanoparticles (RPANs) to reduce the toxicity. PLGA was used to entrap the ATO, and the PLGA-ATO nanoparticles (PANs) were prepared by the emulsification method. Then RBCMs were employed to cloak the PANs using ultrasonication, to develop the RPANs delivery system. The prepared RPANs had a uniform size of around 233.6 nm with an obvious core–shell structure, as observed by TEM. The completeness of the membrane proteins was confirmed by SDS-PAGE and an in vitro release time of 65 h was determined for the RPANs. The RPANs also exhibited low cytotoxicity against the 293k kidney cell line (84.6% cell viability rate), which suggested that the ATO toxicity was reduced by RBCM cloaking. Moreover, the anti-tumor effects of the RPANs against the HL60 cell line were comparable to those of ATO solution. Our study demonstrated that the RPANs system has anti-tumor potential and could be developed into a safe and sustained release delivery system for ATO. Arsenic trioxide (ATO) is used for acute promyelocytic leukemia (APL) that is resistant to all-trans-retinoic acid, but its direct intravenous injection sometimes induces severe toxic side effects.![]()
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Affiliation(s)
- Jing Su
- School of Pharmacy
- Shanghai Jiao Tong University
- Shanghai 200240
- China
| | - Geyi Liu
- School of Pharmacy
- Shanghai Jiao Tong University
- Shanghai 200240
- China
| | - Yumei Lian
- School of Pharmacy
- Shanghai Jiao Tong University
- Shanghai 200240
- China
| | - Zul Kamal
- School of Pharmacy
- Shanghai Jiao Tong University
- Shanghai 200240
- China
- Department of Pharmacy
| | - Xiao Que
- School of Pharmacy
- Shanghai Jiao Tong University
- Shanghai 200240
- China
| | | | - Mingfeng Qiu
- School of Pharmacy
- Shanghai Jiao Tong University
- Shanghai 200240
- China
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32
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Lengfelder E, Görlich D, Nowak D, Spiekermann K, Haferlach C, Krug U, Kreuzer KA, Braess J, Schliemann C, Lindemann HW, Horst HA, Schiel X, Flasshove M, Hecht A, Schnittger S, Schneider S, Wörmann B, Hofmann WK, Berdel WE, Bormann E, Sauerland C, Büchner T, Hiddemann W. Frontline therapy of acute promyelocytic leukemia: Randomized comparison of ATRA and intensified chemotherapy versus ATRA and anthracyclines. Eur J Haematol 2017; 100:154-162. [DOI: 10.1111/ejh.12994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Eva Lengfelder
- Department of Hematology and Oncology; University Hospital Mannheim; Mannheim Germany
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research; University of Muenster; Muenster Germany
| | - Daniel Nowak
- Department of Hematology and Oncology; University Hospital Mannheim; Mannheim Germany
| | - Karsten Spiekermann
- Internal Medicine III; University Hospital Grosshadern; Ludwig-Maximilian-University Munich; Munich Germany
| | | | - Utz Krug
- Department of Medicine A; Hematology-Oncology; University of Muenster; Muenster Germany
| | - Karl-Anton Kreuzer
- Department I of Internal Medicine; University at Cologne; Cologne Germany
| | - Jan Braess
- Community Hospital Barmherzige Brüder; Regensburg Germany
| | - Christoph Schliemann
- Department of Medicine A; Hematology-Oncology; University of Muenster; Muenster Germany
| | | | | | - Xaver Schiel
- Community Hospital München-Harlaching; Munich Germany
| | | | - Anna Hecht
- Department of Hematology and Oncology; University Hospital Mannheim; Mannheim Germany
| | | | - Stephanie Schneider
- Internal Medicine III; University Hospital Grosshadern; Ludwig-Maximilian-University Munich; Munich Germany
| | - Bernhard Wörmann
- Department of Hematology and Oncology; Charité University Medicine Berlin; Berlin Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology; University Hospital Mannheim; Mannheim Germany
| | - Wolfgang E. Berdel
- Department of Medicine A; Hematology-Oncology; University of Muenster; Muenster Germany
| | - Eike Bormann
- Institute of Biostatistics and Clinical Research; University of Muenster; Muenster Germany
| | - Cristina Sauerland
- Institute of Biostatistics and Clinical Research; University of Muenster; Muenster Germany
| | - Thomas Büchner
- Department of Medicine A; Hematology-Oncology; University of Muenster; Muenster Germany
| | - Wolfgang Hiddemann
- Internal Medicine III; University Hospital Grosshadern; Ludwig-Maximilian-University Munich; Munich Germany
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33
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Acute Myeloid Leukaemia: New Targets and Therapies. Int J Mol Sci 2017; 18:ijms18122577. [PMID: 29189736 PMCID: PMC5751180 DOI: 10.3390/ijms18122577] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/22/2017] [Accepted: 11/29/2017] [Indexed: 12/13/2022] Open
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de Thé H, Pandolfi PP, Chen Z. Acute Promyelocytic Leukemia: A Paradigm for Oncoprotein-Targeted Cure. Cancer Cell 2017; 32:552-560. [PMID: 29136503 DOI: 10.1016/j.ccell.2017.10.002] [Citation(s) in RCA: 192] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/01/2017] [Accepted: 09/29/2017] [Indexed: 12/14/2022]
Abstract
Recent clinical trials have demonstrated that the immense majority of acute promyelocytic leukemia (APL) patients can be definitively cured by the combination of two targeted therapies: retinoic acid (RA) and arsenic. Mouse models have provided unexpected insights into the mechanisms involved. Restoration of PML nuclear bodies upon RA- and/or arsenic-initiated PML/RARA degradation is essential, while RA-triggered transcriptional activation is dispensable for APL eradication. Mutations of the arsenic-binding site of PML/RARA, but also PML, have been detected in therapy-resistant patients, demonstrating the key role of PML in APL cure. PML nuclear bodies are druggable and could be harnessed in other conditions.
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Affiliation(s)
- Hugues de Thé
- Collège de France, PSL Research University, Chaire d'Oncologie Cellulaire et Moléculaire, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, INSERM UMR 944, CNRS UMR 7212, Hôpital St. Louis, Paris, France.
| | - Pier Paolo Pandolfi
- Cancer Research Institute, Beth Israel Deaconess Cancer Center, Department of Medicine and Pathology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Zhu Chen
- Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 200025 Shanghai, China
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35
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Affiliation(s)
- Hawi Debelo
- Department of Nutrition Science, Purdue University, West Lafayette, IN
| | - Janet A Novotny
- Beltsville Human Nutrition Research Center, Agricultural Research Service, USDA, Beltsville, MD
| | - Mario G Ferruzzi
- Plants for Human Health Institute, North Carolina State University, Kannapolis, NC
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36
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Glorieux C, Calderon PB. Catalase, a remarkable enzyme: targeting the oldest antioxidant enzyme to find a new cancer treatment approach. Biol Chem 2017; 398:1095-1108. [PMID: 28384098 DOI: 10.1515/hsz-2017-0131] [Citation(s) in RCA: 331] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 04/04/2017] [Indexed: 12/18/2022]
Abstract
This review is centered on the antioxidant enzyme catalase and will present different aspects of this particular protein. Among them: historical discovery, biological functions, types of catalases and recent data with regard to molecular mechanisms regulating its expression. The main goal is to understand the biological consequences of chronic exposure of cells to hydrogen peroxide leading to cellular adaptation. Such issues are of the utmost importance with potential therapeutic extrapolation for various pathologies. Catalase is a key enzyme in the metabolism of H2O2 and reactive nitrogen species, and its expression and localization is markedly altered in tumors. The molecular mechanisms regulating the expression of catalase, the oldest known and first discovered antioxidant enzyme, are not completely elucidated. As cancer cells are characterized by an increased production of reactive oxygen species (ROS) and a rather altered expression of antioxidant enzymes, these characteristics represent an advantage in terms of cell proliferation. Meanwhile, they render cancer cells particularly sensitive to an oxidant insult. In this context, targeting the redox status of cancer cells by modulating catalase expression is emerging as a novel approach to potentiate chemotherapy.
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37
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Lou Y, Ma Y, Sun J, Suo S, Tong H, Qian W, Mai W, Meng H, Jin J. Effectivity of a modified Sanz risk model for early death prediction in patients with newly diagnosed acute promyelocytic leukemia. Ann Hematol 2017; 96:1793-1800. [PMID: 28823055 DOI: 10.1007/s00277-017-3096-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/07/2017] [Indexed: 12/18/2022]
Abstract
Early death is the main obstacle for the cure of patients with acute promyelocytic leukemia (APL). We have analyzed risk factors of early death from 526 consecutive newly diagnosed APL patients between 2004 and 2016. The overall incidence of early death was 7.2% (38/526). The peak hazard of early death occurred in the first 0-3 days. Multivariate logistic analysis demonstrated white blood cell (WBC) counts [odds ratio (OR) = 1.039; 95% confidence interval (CI): 1.024-1.055; P < 0.001], age (OR = 1.061; 95% CI: 1.025-1.099; P = 0.001) and platelet counts (OR = 0.971; 95% CI: 0.944-0.999; P = 0.038) were independent risk factors for early death. Furthermore, receiver-operator characteristic (ROC) curve analyses revealed a simple WBC/platelet ratio was significantly more accurate in predicting early death [areas under the ROC curve (AUC) = 0.842, 95% CI: 0.807-0.872) than WBC counts (AUC = 0.793; 95% CI: 0.756-0.827) or Sanz score (AUC = 0.746; 95% CI: 0.706-0.783). We stratified APL patients into four risk subgroups: low risk (WBC ≤ 10 × 109/L, platelet >40 × 109/L), intermediate risk (WBC/platelet <0.2 and age ≤ 60, not in low risk), high risk (WBC/platelet ≥0.2 or age > 60, not in low and ultra-high risk) and ultra-high risk (WBC > 50 × 109/L), the early death rates were 0, 0.6, 12.8, and 41.2%, respectively. In conclusion, we proposed a modified Sanz risk model as a useful predictor of early death risk in patients with APL.
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Affiliation(s)
- Yinjun Lou
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Yafang Ma
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Jianai Sun
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Sansan Suo
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Hongyan Tong
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Wenbin Qian
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Wenyuan Mai
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Haitao Meng
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China
| | - Jie Jin
- Department of Hematology, the First Affiliated Hospital, College of Medicine, Zhejiang University, 79# Qingchun Road, Hangzhou, 310003, China. .,Key Laboratory of Hematopoietic Malignancies, Hangzhou, Zhejiang Province, People's Republic of China.
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38
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Masciarelli S, Capuano E, Ottone T, Divona M, De Panfilis S, Banella C, Noguera NI, Picardi A, Fontemaggi G, Blandino G, Lo-Coco F, Fazi F. Retinoic acid and arsenic trioxide sensitize acute promyelocytic leukemia cells to ER stress. Leukemia 2017; 32:285-294. [PMID: 28776567 PMCID: PMC5808088 DOI: 10.1038/leu.2017.231] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/10/2017] [Accepted: 06/20/2017] [Indexed: 01/03/2023]
Abstract
Retinoic acid (RA) in association with chemotherapy or with arsenic trioxide (ATO) results in high cure rates of acute promyelocytic leukemia (APL). We show that RA-induced differentiation of human leukemic cell lines and primary blasts dramatically increases their sensitivity to endoplasmic reticulum (ER) stress-inducing drugs at doses that are not toxic in the absence of RA. In addition, we demonstrate that the PERK pathway, triggered in response to ER stress, has a major protective role. Moreover, low amounts of pharmacologically induced ER stress are sufficient to strongly increase ATO toxicity. Indeed, in the presence of ER stress, ATO efficiently induced apoptosis in RA-sensitive and RA-resistant APL cell lines, at doses ineffective in the absence of ER stress. Our findings identify the ER stress-related pathways as potential targets in the search for novel therapeutic strategies in AML.
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Affiliation(s)
- S Masciarelli
- Section of Histology and Medical Embryology, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - E Capuano
- Section of Histology and Medical Embryology, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - T Ottone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - M Divona
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - S De Panfilis
- Centre for Life Nano Science, Istituto Italiano di Tecnologia, Rome, Italy
| | - C Banella
- Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - N I Noguera
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - A Picardi
- Stem Cell Transplant Unit, Rome Transplant Network, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - G Fontemaggi
- Oncogenomic and Epigenetic Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - G Blandino
- Oncogenomic and Epigenetic Unit, Regina Elena National Cancer Institute, Rome, Italy
| | - F Lo-Coco
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.,Laboratory of Neuro-Oncohematology Unit, Santa Lucia Foundation, Rome, Italy
| | - F Fazi
- Section of Histology and Medical Embryology, Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
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39
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Thiosemicarbazone derivatives, thiazolyl hydrazones, effectively inhibit leukemic tumor cell growth: Down-regulation of ribonucleotide reductase activity and synergism with arabinofuranosylcytosine. Food Chem Toxicol 2017; 108:53-62. [PMID: 28716444 DOI: 10.1016/j.fct.2017.07.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 07/06/2017] [Accepted: 07/13/2017] [Indexed: 02/03/2023]
Abstract
Cellular growth inhibition exerted by thiosemicarbazones is mainly attributed to down-regulation of ribonucleotide reductase (RNR) activity, with RNR being responsible for the rate-limiting step of de novo DNA synthesis. In this study, we investigated the antineoplastic effects of three newly synthesized thiosemicarbazone derivatives, thiazolyl hydrazones, in human HL-60 promyelocytic leukemia cells. The cytotoxicity of compounds alone and in combination with arabinofuranosylcytosine (AraC) was determined by growth inhibition assays. Effects on deoxyribonucleoside triphosphate (dNTP) concentrations were quantified by HPLC, and the incorporation of radio-labeled 14C-cytidine into nascent DNA was measured using a beta counter. Cell cycle distribution was analyzed by FACS, and protein levels of RNR subunits and checkpoint kinases were evaluated by Western blotting. VG12, VG19, and VG22 dose-dependently decreased intracellular dNTP concentrations, impaired cell cycle progression and, consequently, inhibited the growth of HL-60 cells. VG19 also lowered the protein levels of RNR subunits R1 and R2 and significantly diminished the incorporation of radio-labeled 14C-cytidine, being equivalent to an inhibition of DNA synthesis. Combination of thiazolyl hydrazones with AraC synergistically potentiated the antiproliferative effects seen with each drug alone and might therefore improve conventional chemotherapeutic regimens for the treatment of human malignancies such as acute promyelocytic or chronic myelogenous leukemia.
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40
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Piersma AH, Hessel EV, Staal YC. Retinoic acid in developmental toxicology: Teratogen, morphogen and biomarker. Reprod Toxicol 2017; 72:53-61. [PMID: 28591664 DOI: 10.1016/j.reprotox.2017.05.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/08/2017] [Accepted: 05/30/2017] [Indexed: 12/11/2022]
Abstract
This review explores the usefulness retinoic acid (RA) related physiological factors as possible biomarkers of embryotoxicity. RA is involved in the morphogenesis of the early embryo as well as in the development and maturation of a wide variety of organ anlagen. The region-specific homeostasis of RA in the embryo is in many ways the driving force determining developmental cell proliferation versus differentiation. As a consequence, RA concentrations are carefully controlled in time and space in the developing embryo. RA deficiency and overdosing both result in characteristic patterns of malformations that may involve many different organ systems. The central role of RA in embryo development provides us with a set of sensitive biomarkers that may be employed in developmental toxicity testing. This includes the synthesizing and metabolizing enzymes of RA, but also a myriad of related morphogenetic factors and their genes, of which the expression may be affected by changes in RA balance. Several examples of embryotoxicants interfering with the homeostasis of RA and related parameters have been described. A preliminary adverse outcome pathway framework for RA mediated malformations has been published. Expansion of this framework and its application in developmental toxicity testing may allow the detection of a large variety of embryotoxicants with diverse modes of action. RA homeostasis therefore provides a promising set of molecular tools that may be employed in the advancement of mode of action driven animal-free developmental toxicity testing.
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Affiliation(s)
- Aldert H Piersma
- Center for Health Protection, National Institute for Public Health and the Environment RIVM, Antonie van Leeuwenhoeklaan 9, P.O. Box 1, 3720 BA Bilthoven, The Netherlands.
| | - Ellen V Hessel
- Center for Health Protection, National Institute for Public Health and the Environment RIVM, Antonie van Leeuwenhoeklaan 9, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
| | - Yvonne C Staal
- Center for Health Protection, National Institute for Public Health and the Environment RIVM, Antonie van Leeuwenhoeklaan 9, P.O. Box 1, 3720 BA Bilthoven, The Netherlands
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41
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Mo XD, Lv M, Huang XJ. Preventing relapse after haematopoietic stem cell transplantation for acute leukaemia: the role of post-transplantation minimal residual disease (MRD) monitoring and MRD-directed intervention. Br J Haematol 2017; 179:184-197. [PMID: 28542711 DOI: 10.1111/bjh.14778] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Xiao-Dong Mo
- Peking University People's Hospital; Peking University Institute of Haematology; Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation; Beijing China
| | - Meng Lv
- Peking University People's Hospital; Peking University Institute of Haematology; Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation; Beijing China
| | - Xiao-Jun Huang
- Peking University People's Hospital; Peking University Institute of Haematology; Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation; Beijing China
- Peking-Tsinghua Centre for Life Sciences; Beijing China
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42
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Rao CV, Pal S, Mohammed A, Farooqui M, Doescher MP, Asch AS, Yamada HY. Biological effects and epidemiological consequences of arsenic exposure, and reagents that can ameliorate arsenic damage in vivo. Oncotarget 2017; 8:57605-57621. [PMID: 28915699 PMCID: PMC5593671 DOI: 10.18632/oncotarget.17745] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 04/27/2017] [Indexed: 01/18/2023] Open
Abstract
Through contaminated diet, water, and other forms of environmental exposure, arsenic affects human health. There are many U.S. and worldwide "hot spots" where the arsenic level in public water exceeds the maximum exposure limit. The biological effects of chronic arsenic exposure include generation of reactive oxygen species (ROS), leading to oxidative stress and DNA damage, epigenetic DNA modification, induction of genomic instability, and inflammation and immunomodulation, all of which can initiate carcinogenesis. High arsenic exposure is epidemiologically associated with skin, lung, bladder, liver, kidney and pancreatic cancer, and cardiovascular, neuronal, and other diseases. This review briefly summarizes the biological effects of arsenic exposure and epidemiological cancer studies worldwide, and provides an overview for emerging rodent-based studies of reagents that can ameliorate the effects of arsenic exposure in vivo. These reagents may be translated to human populations for disease prevention. We propose the importance of developing a biomarker-based precision prevention approach for the health issues associated with arsenic exposure that affects millions of people worldwide.
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Affiliation(s)
- Chinthalapally V Rao
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Sanya Pal
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Altaf Mohammed
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Mudassir Farooqui
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Mark P Doescher
- Stephenson Cancer Center and Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Adam S Asch
- Stephenson Cancer Center, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
| | - Hiroshi Y Yamada
- Center for Cancer Prevention and Drug Development, Department of Medicine, Hematology/Oncology Section, University of Oklahoma Health Sciences Center (OUHSC), Oklahoma City, OK, USA
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Cîrstea M, Coliță A, Ionescu B, Ghiaur A, Vasilescu D, Dobrea C, Jardan C, Dragomir M, Gheorghe A, Várady Z, Lupu AR. Therapy-related myelodysplastic syndrome after successful treatment of acute promyelocytic leukemia: case report and literature review. REV ROMANA MED LAB 2017. [DOI: 10.1515/rrlm-2017-0013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Abstract
In the 2016 revision of the World Health Organization classification the term therapy-related myeloid neoplasia (t-MN) defines a subgroup of acute myeloid leukemia (AML) comprising patients who develop myelodysplastic syndrome (MDS-t) or acute myeloid leukemia (AML-t) after treatment with cytotoxic and/or radiation therapy for various malignancies or autoimmune disorders. We report the case of a 36 year old patient with t-MN (t-MDS) after achieving complete remission (CR) of a PML-RARA positive acute promyelocytic leukemia (APL) at 32 months after diagnosis. Initially classified as low risk APL and treated according to the AIDA protocol - induction and 3 consolidation cycles - the patient achieved a complete molecular response in September 2013 and started maintenance therapy. On follow-up PML-RARA transcript remained negative. In January 2016 leukopenia and thrombocytopenia developed and a peripheral blood smear revealed hypogranular and agranular neutrophils. Immunophenotyping in the bone marrow aspirate identified undifferentiated blast cells that did not express cytoplasmic myeloperoxidase. The cytogenetic study showed normal karyotype. The molecular biology tests not identified PMLRARA transcript. A diagnosis of t-MDS (AREB-2 - WHO 2008) was established. Treatment of AML was started with 2 “3+7” regimens and 1 MEC cycle. Two months from diagnosis, while in CR, an allogeneic HSCT from an unrelated HLA compatible donor was performed after myeloablative regimen. An unfavorable clinical evolution was followed by death on day 9 after transplantation. The occurrence of t-MNs during CR of APL represents a particular problem in terms of follow-up and differential diagnosis of relapse and constitutes a dramatic complication for a disease with a favorable prognosis.
This work was supported by the grants PN 41-087 /PN2-099 from the Romanian Ministry of Research and Technology
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Affiliation(s)
- Mihaela Cîrstea
- Department of Onco-hematology, Fundeni Clinical Institute , Bucharest , Romania
| | - Adriana Coliță
- Fundeni Clinical Institute Romania , Bucharest , Romania
| | - Bogdan Ionescu
- Fundeni Clinical Institute Romania , Bucharest , Romania
| | | | | | - Camelia Dobrea
- Fundeni Clinical Institute Romania , Bucharest , Romania
| | | | | | - Anca Gheorghe
- Fundeni Clinical Institute Romania , Bucharest , Romania
| | - Zsofia Várady
- Fundeni Clinical Institute Romania , Bucharest , Romania
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Hackl H, Astanina K, Wieser R. Molecular and genetic alterations associated with therapy resistance and relapse of acute myeloid leukemia. J Hematol Oncol 2017; 10:51. [PMID: 28219393 PMCID: PMC5322789 DOI: 10.1186/s13045-017-0416-0] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/04/2017] [Indexed: 12/31/2022] Open
Abstract
Background The majority of individuals with acute myeloid leukemia (AML) respond to initial chemotherapy and achieve a complete remission, yet only a minority experience long-term survival because a large proportion of patients eventually relapse with therapy-resistant disease. Relapse therefore represents a central problem in the treatment of AML. Despite this, and in contrast to the extensive knowledge about the molecular events underlying the process of leukemogenesis, information about the mechanisms leading to therapy resistance and relapse is still limited. Purpose and content of review Recently, a number of studies have aimed to fill this gap and provided valuable information about the clonal composition and evolution of leukemic cell populations during the course of disease, and about genetic, epigenetic, and gene expression changes associated with relapse. In this review, these studies are summarized and discussed, and the data reported in them are compiled in order to provide a resource for the identification of molecular aberrations recurrently acquired at, and thus potentially contributing to, disease recurrence and the associated therapy resistance. This survey indeed uncovered genetic aberrations with known associations with therapy resistance that were newly gained at relapse in a subset of patients. Furthermore, the expression of a number of protein coding and microRNA genes was reported to change between diagnosis and relapse in a statistically significant manner. Conclusions Together, these findings foster the expectation that future studies on larger and more homogeneous patient cohorts will uncover pathways that are robustly associated with relapse, thus representing potential targets for rationally designed therapies that may improve the treatment of patients with relapsed AML, or even facilitate the prevention of relapse in the first place. Electronic supplementary material The online version of this article (doi:10.1186/s13045-017-0416-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hubert Hackl
- Division of Bioinformatics, Biocenter, Medical University of Innsbruck, Innrain 80, 6020, Innsbruck, Austria
| | - Ksenia Astanina
- Department of Medicine I and Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Austria
| | - Rotraud Wieser
- Department of Medicine I and Comprehensive Cancer Center, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Wien, Austria.
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S100A9 induces differentiation of acute myeloid leukemia cells through TLR4. Blood 2017; 129:1980-1990. [PMID: 28137827 DOI: 10.1182/blood-2016-09-738005] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/20/2017] [Indexed: 12/22/2022] Open
Abstract
S100A8 and S100A9 are calcium-binding proteins predominantly expressed by neutrophils and monocytes and play key roles in both normal and pathological inflammation. Recently, both proteins were found to promote tumor progression through the establishment of premetastatic niches and inhibit antitumor immune responses. Although S100A8 and S100A9 have been studied in solid cancers, their functions in hematological malignancies remain poorly understood. However, S100A8 and S100A9 are highly expressed in acute myeloid leukemia (AML), and S100A8 expression has been linked to poor prognosis in AML. We identified a small subpopulation of cells expressing S100A8 and S100A9 in AML mouse models and primary human AML samples. In vitro and in vivo analyses revealed that S100A9 induces AML cell differentiation, whereas S100A8 prevents differentiation induced by S100A9 activity and maintains AML immature phenotype. Treatment with recombinant S100A9 proteins increased AML cell maturation, induced growth arrest, and prolonged survival in an AML mouse model. Interestingly, anti-S100A8 antibody treatment had effects similar to those of S100A9 therapy in vivo, suggesting that high ratios of S100A9 over S100A8 are required to induce differentiation. Our in vitro studies on the mechanisms/pathways involved in leukemic cell differentiation revealed that binding of S100A9 to Toll-like receptor 4 (TLR4) promotes activation of p38 mitogen-activated protein kinase, extracellular signal-regulated kinases 1 and 2, and Jun N-terminal kinase signaling pathways, leading to myelomonocytic and monocytic AML cell differentiation. These findings indicate that S100A8 and S100A9 are regulators of myeloid differentiation in leukemia and have therapeutic potential in myelomonocytic and monocytic AMLs.
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46
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Roggenbeck BA, Banerjee M, Leslie EM. Cellular arsenic transport pathways in mammals. J Environ Sci (China) 2016; 49:38-58. [PMID: 28007179 DOI: 10.1016/j.jes.2016.10.001] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 10/07/2016] [Accepted: 10/08/2016] [Indexed: 06/06/2023]
Abstract
Natural contamination of drinking water with arsenic results in the exposure of millions of people world-wide to unacceptable levels of this metalloid. This is a serious global health problem because arsenic is a Group 1 (proven) human carcinogen and chronic exposure is known to cause skin, lung, and bladder tumors. Furthermore, arsenic exposure can result in a myriad of other adverse health effects including diseases of the cardiovascular, respiratory, neurological, reproductive, and endocrine systems. In addition to chronic environmental exposure to arsenic, arsenic trioxide is approved for the clinical treatment of acute promyelocytic leukemia, and is in clinical trials for other hematological malignancies as well as solid tumors. Considerable inter-individual variability in susceptibility to arsenic-induced disease and toxicity exists, and the reasons for such differences are incompletely understood. Transport pathways that influence the cellular uptake and export of arsenic contribute to regulating its cellular, tissue, and ultimately body levels. In the current review, membrane proteins (including phosphate transporters, aquaglyceroporin channels, solute carrier proteins, and ATP-binding cassette transporters) shown experimentally to contribute to the passage of inorganic, methylated, and/or glutathionylated arsenic species across cellular membranes are discussed. Furthermore, what is known about arsenic transporters in organs involved in absorption, distribution, and metabolism and how transport pathways contribute to arsenic elimination are described.
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Affiliation(s)
- Barbara A Roggenbeck
- Department of Physiology and Membrane Protein Disease Research Group, University of Alberta, Edmonton, AB, T6G 2H7, Canada.
| | - Mayukh Banerjee
- Department of Physiology and Membrane Protein Disease Research Group, University of Alberta, Edmonton, AB, T6G 2H7, Canada
| | - Elaine M Leslie
- Department of Physiology and Membrane Protein Disease Research Group, University of Alberta, Edmonton, AB, T6G 2H7, Canada; Division of Analytical and Environmental Toxicology, Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada.
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Chen J, Cheng J, Yi J, Xie B, Lin L, Liu Z, Zhao H, Wang B, Ai Z, Yang Y, Wei H. Differential expression and response to arsenic stress of MRPs and ASAN1 determine sensitivity of classical multidrug-resistant leukemia cells to arsenic trioxide. Leuk Res 2016; 50:116-122. [PMID: 27736728 DOI: 10.1016/j.leukres.2016.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/30/2016] [Accepted: 10/01/2016] [Indexed: 11/29/2022]
Abstract
There is no cross-resistance between arsenic trioxide and conventional chemotherapeutics. Classical multi-drug resistant (MDR) cells remain sensitive to arsenic trioxide, which may even reverse the drug resistance. Arsenic trioxide is also effective in leukemias/tumors that persist despite conventional cytotoxic or targeted drugs. We obtained a highly arsenic-resistant MDR leukemic cell line, HL-60/RS, by exposing leukemic HL-60 cells to adriamycin selection. We compared the arsenic sensitivity, and the expression and responses to arsenic of the arsenic-related transporters, MRP1, MRP2, and ASNA1, in paired parent/arsenic-resistant HL-60/RS/HL-60 and arsenic-sensitive/parental K562/ADM/K562 cells. Expression levels of MRP1, MRP2, and ASNA1 were negatively correlated with cell sensitivities to arsenic trioxide, and ASNA1 expression notably was highest in HL-60/RS cells and lowest in K562/ADM cells. Expression levels of MRP1, MRP2, and ASNA1 were significantly enhanced in HL-60/RS cells and inhibited in K562/ADM cells by arsenic trioxide treatment, compared with their parental sensitive cells, in accord with the high-resistance of HL-60/RS cells and high-sensitivity of K562/ADM cells. In conclusion, the cross-resistance of conventional chemotherapeutics-resistant leukemic cells to arsenic trioxide is determined by both levels of MRP1, MRP2, and ASNA1, and also by the responses of these transporters to arsenic stress.
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Affiliation(s)
- Jing Chen
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Jie Cheng
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Juan Yi
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Bei Xie
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Li Lin
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Zhuan Liu
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Huaishun Zhao
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Bei Wang
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Ziying Ai
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Yue Yang
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Hulai Wei
- Key Laboratory of Preclinical Study for New Drugs of Gansu Province, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
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Bochtler T, Fröhling S, Weichert W, Endris V, Thiede C, Hutter B, Hundemer M, Ho AD, Krämer A. Evolution of a FLT3-TKD mutated subclone at meningeal relapse in acute promyelocytic leukemia. Cold Spring Harb Mol Case Stud 2016; 2:a001123. [PMID: 27626069 PMCID: PMC5002926 DOI: 10.1101/mcs.a001123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Here, we report the case of an acute promyelocytic leukemia (APL) patient who—although negative for FLT3 mutations at diagnosis—developed isolated FLT3 tyrosine kinase II domain (FLT3-TKD)-positive meningeal relapse, which, in retrospect, could be traced back to a minute bone marrow subclone present at first diagnosis. Initially, the 48-yr-old female diagnosed with high-risk APL had achieved complete molecular remission after standard treatment with all-trans retinoic acid (ATRA) and chemotherapy according to the AIDA (ATRA plus idarubicin) protocol. Thirteen months after the start of ATRA maintenance, the patient suffered clinically overt meningeal relapse along with minute molecular traces of PML/RARA (promyelocytic leukemia/retinoic acid receptor alpha) in the bone marrow. Following treatment with arsenic trioxide and ATRA in combination with intrathecal cytarabine and methotrexate, the patient achieved a complete molecular remission in both cerebrospinal fluid (CSF) and bone marrow, which currently lasts for 2 yr after completion of therapy. Whole-exome sequencing and subsequent ultradeep targeted resequencing revealed a heterozygous FLT3-TKD mutation in CSF leukemic cells (p.D835Y, c.2503G>T, 1000/1961 reads [51%]), which was undetectable in the concurrent bone marrow sample. Interestingly, the FLT3-TKD mutated meningeal clone originated from a small bone marrow subclone present in a variant allele frequency of 0.4% (6/1553 reads) at initial diagnosis. This case highlights the concept of clonal evolution with a subclone harboring an additional mutation being selected as the “fittest” and leading to meningeal relapse. It also further supports earlier suggestions that FLT3 mutations may play a role for migration and clonal expansion in the CSF sanctuary site.
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Affiliation(s)
- Tilmann Bochtler
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany;; Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
| | - Stefan Fröhling
- Department of Translational Oncology, National Center for Tumor Diseases and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany;; Section for Personalized Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany;; DKFZ-Heidelberg Center for Personalized Oncology (HIPO), 69120 Heidelberg, Germany
| | - Wilko Weichert
- Institute of Pathology, Technical University of Munich, 81675 Munich, Germany;; Institute of Pathology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Volker Endris
- Institute of Pathology, University of Heidelberg, 69120 Heidelberg, Germany
| | - Christian Thiede
- Department of Internal Medicine I, University of Dresden, 01307 Dresden, Germany
| | - Barbara Hutter
- Division of Applied Bioinformatics, National Center for Tumor Diseases and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Michael Hundemer
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
| | - Anthony D Ho
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
| | - Alwin Krämer
- Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany;; Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, 69120 Heidelberg, Germany
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Long AH, Highfill SL, Cui Y, Smith JP, Walker AJ, Ramakrishna S, El-Etriby R, Galli S, Tsokos MG, Orentas RJ, Mackall CL. Reduction of MDSCs with All-trans Retinoic Acid Improves CAR Therapy Efficacy for Sarcomas. Cancer Immunol Res 2016; 4:869-880. [PMID: 27549124 DOI: 10.1158/2326-6066.cir-15-0230] [Citation(s) in RCA: 232] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 07/29/2016] [Indexed: 01/04/2023]
Abstract
Genetically engineered T cells expressing CD19-specific chimeric antigen receptors (CAR) have shown impressive activity against B-cell malignancies, and preliminary results suggest that T cells expressing a first-generation disialoganglioside (GD2)-specific CAR can also provide clinical benefit in patients with neuroblastoma. We sought to assess the potential of GD2-CAR therapies to treat pediatric sarcomas. We observed that 18 of 18 (100%) of osteosarcomas, 2 of 15 (13%) of rhabdomyosarcomas, and 7 of 35 (20%) of Ewing sarcomas expressed GD2. T cells engineered to express a third-generation GD2-CAR incorporating the 14g2a-scFv with the CD28, OX40, and CD3ζ signaling domains (14g2a.CD28.OX40.ζ) mediated efficient and comparable lysis of both GD2+ sarcoma and neuroblastoma cell lines in vitro However, in xenograft models, GD2-CAR T cells had no antitumor effect against GD2+ sarcoma, despite effectively controlling GD2+ neuroblastoma. We observed that pediatric sarcoma xenografts, but not neuroblastoma xenografts, induced large populations of monocytic and granulocytic murine myeloid-derived suppressor cells (MDSC) that inhibited human CAR T-cell responses in vitro Treatment of sarcoma-bearing mice with all-trans retinoic acid (ATRA) largely eradicated monocytic MDSCs and diminished the suppressive capacity of granulocytic MDSCs. Combined therapy using GD2-CAR T cells plus ATRA significantly improved antitumor efficacy against sarcoma xenografts. We conclude that retinoids provide a clinically accessible class of agents capable of diminishing the suppressive effects of MDSCs, and that co-administration of retinoids may enhance the efficacy of CAR therapies targeting solid tumors. Cancer Immunol Res; 4(10); 869-80. ©2016 AACR.
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Affiliation(s)
- Adrienne H Long
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland. Department of Microbiology and Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Steven L Highfill
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Yongzhi Cui
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Jillian P Smith
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Alec J Walker
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Sneha Ramakrishna
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Rana El-Etriby
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland
| | - Susana Galli
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland
| | - Maria G Tsokos
- Laboratory of Pathology, CCR, NCI, NIH, Bethesda, Maryland
| | - Rimas J Orentas
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland
| | - Crystal L Mackall
- Pediatric Oncology Branch, Center for Cancer Research, NCI, NIH, Bethesda, Maryland. Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
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Marchwicka A, Cunningham A, Marcinkowska E, Brown G. Therapeutic use of selective synthetic ligands for retinoic acid receptors: a patent review. Expert Opin Ther Pat 2016; 26:957-71. [PMID: 27336223 DOI: 10.1080/13543776.2016.1205586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Differentiation therapy using all-trans retinoic acid (ATRA) revolutionised the treatment of acute promyelocytic leukaemia to such an extent that it is now one of the most curable types of leukaemia, with ATRA and anthracycline-based chemotherapy providing cure rates above 80%. Isotretinoin is used to treat chronic acne. Here, we examine the information described in recent patents and the extent to which new findings are influencing extending retinoid-based differentiation therapy to other cancers, as well as the development of new therapies for other disorders. AREAS COVERED A search has been performed on the literature and worldwide patents filed during 2014 to the present time, focusing on synthetic agonists and antagonists of retinoic acid receptors and novel compositions for the delivery of these agents. EXPERT OPINION New potential therapeutic applications have been described, including lung, breast and head and neck cancers, T cell lymphoma and neurodegenerative, metabolic, ophthalmic, muscle, and inflammatory disorders. Recent patents have described the means to maximise retinoid activity. Two decades of efforts to extend retinoid-based therapies have been disappointing and new synthetic retinoids, target diseases and modes of delivery may well resolve this long standing issue.
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Affiliation(s)
- Aleksandra Marchwicka
- a Laboratory of Protein Biochemistry, Faculty of Biotechnology , University of Wroclaw , Wroclaw , Poland
| | - Alan Cunningham
- b Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences , University of Birmingham , Birmingham , UK
| | - Ewa Marcinkowska
- a Laboratory of Protein Biochemistry, Faculty of Biotechnology , University of Wroclaw , Wroclaw , Poland
| | - Geoffrey Brown
- c Institute of Clinical Sciences, College of Medical and Dental Sciences , University of Birmingham , Birmingham , UK
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