Successful treatment of fanconi anemia and T-cell acute lymphoblastic leukemia

A Systematic Review to Assess the Relationship between Disseminated Cerebral Aspergillosis, Leukemias and Lymphomas, and Their Respective Therapeutics

Disseminated disease following invasive pulmonary aspergillosis (IPA) remains a significant contributor to mortality amongst patients with hematologic malignancies (HMs). At the highest risk of mortality are those with disseminated disease to the central nervous system, known as cerebral aspergillosis (CA). However, little is known about the risk factors contributing to disease amongst HM patients. A systematic review using PRISMA guidelines was undertaken to define HM patient subgroups, preventative measures, therapeutic interventions, and outcomes of patients with disseminated CA following IPA. The review resulted in the identification of 761 records, of which 596 articles were screened, with the final inclusion of 47 studies and 76 total patients. From included articles, the proportion of CA was assessed amongst HM patient subgroups. Further, pre-and post-infection characteristics, fungal species, and mortality were evaluated for the total population included and HM patient subgroups. Patients with acute myeloid leukemia and acute lymphoid lymphoma, patients receiving corticosteroids as a part of their HM therapeutic regimen, and anti-fungal prophylaxis constitute the top identified patient populations at risk for disseminated CA. Overall, information presented here indicates that measures for the prevention of IPA should be taken in higher-risk HM patient subgroups. Specifically, the type of anti-fungal therapy used should be carefully considered for those patients with IPA and increased risk for cerebral dissemination. Additional reports detailing patient characteristics are needed to define further the risk of developing disseminated CA from IPA in patients with HMs.

Leukemia growth is inhibited by benzoxime without causing any harmful effect in rats bearing RBL-1 ×enotransplants

The present study aimed to investigate the effect of benzoxime on leukemia RBL-1 cell proliferation and a leukemic Sprague-Dawley rat model. Proliferation of RBL-1 cells was determined using an MTT assay. Sprague-Dawley rats were assigned randomly into three groups of 10 animals each, where the positive control group was administered an intravenous injection of normal saline, the negative control group was administered 1×10⁶ RBL-1 cells and the treatment group was administered with 1×10⁶ RBL-1 cells and then benzoxime (50 mg/kg/day) for 1 week. Increased dosage of benzoxime reduced RBL-1 cell viability from 92 at 2 µM to ٢١٪ at ١٢ µM after ٢٤ h. Benzoxime treatment prevented the loss of body weight in the rats with leukemia. Compared with the negative control rats, the body weight was determined to be significantly reduced (P<0.05) in the positive control rats. The weight of the spleen and liver was determined to be significantly increased (P<0.02) in the positive control rats and the benzoxime-treated rats compared with that in the negative control group on day 35 of RBL-1 cell implantation. Analysis of leukocytes in rats on day 35 demonstrated a significant reduction (P<0.05) in the cluster of differentiation (CD)11b and CD45 level in the positive control group compared with that in the negative control group. The level of CD11b and CD45 was determined to be similar in the rats in the benzoxime treatment and negative control groups. Analysis of the level of serum glutamic pyruvic transaminase, serum glutamic oxaloacetic transaminase and blood urea nitrogen indicated that all three components exhibited no significant changes in the rats following treatment with benzoxime compared with the component levels in the negative control group. The levels of these three components were in the normal range in rats treated with benzoxime on day 35 of cell implantation. These data demonstrated that the liver and kidneys are not influenced by benzoxime in rats with leukemia. In summary, the present study demonstrated that benzoxime efficiently prevents leukemia growth without inducing any harmful effects in rat models through targeting CD11b and CD45 level; thus, benzoxime should be evaluated further regarding its use in the treatment of leukemia.

A systems biology approach for elucidating the interaction of curcumin with Fanconi anemia FANC G protein and the key disease targets of leukemia

Fanconi anemia (FA) is an autosomal recessive disorder with a high risk of malignancies including acute myeloid leukemia and squamous cell carcinoma. There is a constant search out of new potential therapeutic molecule to combat this disorder. In most cases, patients with FA develop haematological malignancies with acute myeloid leukemia and acute lymphoblastic leukemia. Identifying drugs which can efficiently block the pathways of both these disorders can be an ideal and novel strategy to treat FA. The curcumin, a natural compound obtained from turmeric is an interesting therapeutic molecule as it has been reported in the literature to combat both FA as well as leukemia. However, its complete mechanism is not elucidated. Herein, a systems biology approach for elucidating the therapeutic potential of curcumin against FA and leukemia is investigated by analyzing the computational molecular interactions of curcumin ligand with FANC G of FA and seven other key disease targets of leukemia. The proteins namely DOT1L, farnesyl transferase (FDPS), histone decetylase (EP3000), Polo-like kinase (PLK-2), aurora-like kinase (AUKRB), tyrosine kinase (ABL1), and retinoic acid receptor alpha (RARA) were chosen as disease targets for leukemia and modeled structure of FANC G protein as the disease target for FA. The docking investigations showed that curcumin had a very high binding affinity of -8.1 kcal/mol with FANC G protein. The key disease targets of leukemia namely tyrosine kinase (ABL1), aurora-like kinase (AUKRB), and polo-like kinase (PLK-2) showed that they had the comparable binding affinities of -9.7 k cal/mol, -8.7 k cal/mol, and -8.6 k cal/mol, respectively with curcumin. Further, the percentage similarity scores obtained from PAM50 using EMBOSS MATCHER was shown to provide a clue to understand the structural relationships to an extent and to predict the binding affinity. This investigation shows that curcumin effectively interacts with the disease targets of both FA and leukemia.

Haematopoietic cell transplantation for acute leukaemia and advanced myelodysplastic syndrome in Fanconi anaemia

Acute leukaemia or advanced myelodysplastic syndrome (MDS ≥ 5% blasts) in Fanconi anaemia (FA) patients is associated with a poor prognosis. We report 21 FA patients with acute leukaemia or advanced MDS who underwent haematopoietic cell transplantation (HCT) at the University of Minnesota between 1988 and 2011. Six patients had biallelic BRCA2 mutations. Eight patients received pre-transplant cytoreduction, with 3 achieving complete remission. HCT donor source included human leucocyte antigen-matched sibling (n = 2) or alternative donors (n = 19). Neutrophil engraftment was 95% for the entire cohort, and the incidence of acute graft-versus-host disease was 19%. 5-year overall survival (OS) was 33%, with a relapse rate of 24%, with similar OS in patients with biallelic BRCA2 mutations. Our study supports the use of HCT in the treatment of FA patients with acute leukaemia or advanced MDS, however, the role of chemotherapy prior to HCT remains unclear for this population. FA patients with biallelic BRCA2 are unique and may benefit from higher dose chemotherapy relative to other complementation groups.

In vivo evaluation of the synthesized novel 2-benzyloxybenzaldehyde analog CCY-1a-E2 for the treatment of leukemia in the BALB/c mouse WEHI-3 allograft model

Our previous study demonstrated that the 2-benzyloxybenzaldehyde analog CCY-1a-E2 is a potent compound against HL-60 human leukemia cell lines. To investigate the potential therapeutic application of CCY-1a-E2 for leukemia, we analyzed the antileukemic effects and safety of CCY-1a-E2 in the BALB/c mouse WEHI-3 allograft model. Our results showed that CCY-1a-E2 decreased the percentage of viable cells in a concentration-dependent manner. The IC(50) of CCY-1a-E2 was 5 μM for the 24-h treatment of WEHI-3 cells. We examined the antileukemic activity of CCY-1a-E2 in the BALB/c mouse WEHI-3 allograft model. The CCY-1a-E2 (100 mg/kg) group was not found to have significantly decreased body weight compared with the control group, while the leukemia group was found to have significantly decreased body weight compared with the control mice. The CCY-1a-E2 (100 mg/kg) group showed no difference in spleen and liver weight, but significantly decreased levels of CD11b and CD45 compared with the leukemia group. In safety evaluation analysis, CCY-1a-E2 had no adverse effects on renal, hepatic and hematological parameters. Based on these observations, CCY-1a-E2 has efficacious antileukemic activity in the BALB/c mouse WEHI-3 allograft model.