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Xu S, Jiao S, Guo H, Chen W, Yao S. IMPeTUs parameters correlate with clinical features in newly diagnosed multiple myeloma. Eur J Radiol Open 2024; 13:100598. [PMID: 39296251 PMCID: PMC11408006 DOI: 10.1016/j.ejro.2024.100598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 08/21/2024] [Accepted: 08/27/2024] [Indexed: 09/21/2024] Open
Abstract
Objectives To investigate the correlations between IMPeTUs-based 18 F-FDG PET/CT parameters and clinical features in patients with newly diagnosed multiple myeloma (MM). Materials and methods PET/CT were analysed according to the IMPeTUs criteria. We correlated these PET/CT parameters with known clinically relevant features, bone marrow plasma cell (BMPC) infiltration rate and the presence of cytogenetic abnormalities. Results A total of 149 patients (86 males, 63 females; mean age, 59.9 ± 9.7 years) were included. Bone marrow metabolic state correlated with the most clinical features including hemoglobin (rho=-0.23, p=0.004), FLC ratio (rho=0.24, p=0.005), β2 M (rho=0.28, p=0.001), CRP (rho=0.25, p=0.003), serum calcium (rho=0.22, p=0.02), serum creatinine (rho=0.24, p=0.004) and BMPC (rho=0.21, p=0.003). Besides, the level of hemoglobin was significant lower (0.043), and the levels of FLC ratio (0.037), β2 M (p=0.024), CRP (p=0.05), and BMPC (p=0.043) were significant higher in patients having hypermetabolism in limbs and ribs. Hottest bone lesion Deauville criteria had a moderate correlation with CRP (rho=0.27, p=0.001) and serum calcium (rho=0.25, p=0.01). Conclusion Several IMPeTUs-based PET/CT parameters showed significant correlations with clinical features reflecting disease burden and biology, suggesting that these new criteria can be used in the risk stratification in MM patients.
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Affiliation(s)
- Shuaishuai Xu
- Department of Nuclear Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Shengxiu Jiao
- Department of Nuclear Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Huimin Guo
- Department of Nuclear Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Wenkun Chen
- Department of Nuclear Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
| | - Shuzhan Yao
- Department of Nuclear Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, China
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Chen X, Varma G, Davies F, Morgan G. Approach to High-Risk Multiple Myeloma. Hematol Oncol Clin North Am 2024; 38:497-510. [PMID: 38195306 DOI: 10.1016/j.hoc.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Improving the outcome of high-risk myeloma (HRMM) is a key therapeutic aim for the next decade. To achieve this aim, it is necessary to understand in detail the genetic drivers underlying this clinical behavior and to target its biology therapeutically. Advances have already been made, with a focus on consensus guidance and the application of novel immunotherapeutic approaches. Cases of HRMM are likely to have impaired prognosis even with novel strategies. However, if disease eradication and minimal disease states are achieved, then cure may be possible.
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Affiliation(s)
- Xiaoyi Chen
- Center Blood Cancer, Perlmutter Cancer Center, New York University, NYCLangone, Room# 496, Medical Science Building 4th Floor, 540 1st Avenue, New York, NY 10016, USA
| | - Gaurav Varma
- Center Blood Cancer, Perlmutter Cancer Center, New York University, NYCLangone, Room# 496, Medical Science Building 4th Floor, 540 1st Avenue, New York, NY 10016, USA
| | - Faith Davies
- Center Blood Cancer, Perlmutter Cancer Center, New York University, NYCLangone, Room# 496, Medical Science Building 4th Floor, 540 1st Avenue, New York, NY 10016, USA
| | - Gareth Morgan
- Center Blood Cancer, Perlmutter Cancer Center, New York University, NYCLangone, Room# 496, Medical Science Building 4th Floor, 540 1st Avenue, New York, NY 10016, USA.
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Gradel KO. Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review. J Clin Med 2023; 12:6132. [PMID: 37834777 PMCID: PMC10573484 DOI: 10.3390/jcm12196132] [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: 07/07/2023] [Revised: 09/18/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
This review assesses how publications interpret factors that influence the serum or plasma albumin (PA) level in prognostic indices, focusing on inflammation and nutrition. On PubMed, a search for "albumin AND prognosis" yielded 23,919 results. From these records, prognostic indices were retrieved, and their names were used as search strings on PubMed. Indices found in 10 or more original research articles were included. The same search strings, restricted to "Review" or "Systematic review", retrieved yielded on the indices. The data comprised the 10 latest original research articles and up to 10 of the latest reviews. Thirty indices had 294 original research articles (6 covering two indices) and 131 reviews, most of which were from recent years. A total of 106 articles related the PA level to inflammation, and 136 related the PA level to nutrition. For the reviews, the equivalent numbers were 54 and 65. In conclusion, more publications mention the PA level as a marker of nutrition rather than inflammation. This is in contrast to several general reviews on albumin and nutritional guidelines, which state that the PA level is a marker of inflammation but not nutrition. Hypoalbuminemia should prompt clinicians to focus on the inflammatory aspects in their patients.
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Affiliation(s)
- Kim Oren Gradel
- Center for Clinical Epidemiology, Odense University Hospital, 5000 Odense, Denmark; ; Tel.: +45-21-15-80-85
- Research Unit of Clinical Epidemiology, Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
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Andreozzi F, Dragani M, Quivoron C, Le Bras F, Assi T, Danu A, Belhadj K, Lazarovici J, Cotteret S, Bernard OA, Ribrag V, Michot JM. Precision Medicine Approach Based on Molecular Alterations for Patients with Relapsed or Refractory Multiple Myeloma: Results from the MM-EP1 Study. Cancers (Basel) 2023; 15:cancers15051508. [PMID: 36900299 PMCID: PMC10001403 DOI: 10.3390/cancers15051508] [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: 12/03/2022] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Despite that cytogenetic and molecular analysis of tumor cells can rapidly identify recurring molecular abnormalities, no personalized therapy is currently available in the setting of relapsed/refractory multiple myeloma (r/r MM). METHODS MM-EP1 is a retrospective study aimed at comparing a personalized molecular-oriented (MO) versus a non-molecular-oriented (no-MO) approach in r/r MM. Actionable molecular targets and their associated therapies were the BRAF V600E mutation and BRAF inhibitors; t(11;14)(q13;q32) and BCL2 inhibitors; and t(4;14)(p16;q32) with FGFR3 fusion/rearrangements and FGFR3 inhibitors. RESULTS One hundred three highly pretreated r/r MM patients with a median age of 67 years (range 44-85) were included. Seventeen (17%) patients were treated using an MO approach with BRAF inhibitors (vemurafenib or dabrafenib, n = 6), BCL2 inhibitor (venetoclax, n = 9), or FGFR3 inhibitor (erdafitinib, n = 2). Eighty-six (86%) patients received non-MO therapies. Overall response rate was 65% in MO patients versus 58% in the non-MO group (p = 0.053). Median PFS and OS were 9 and 6 months (HR = 0.96; CI95 = 0.51-1.78; p = 0.88) and 26 and 28 months (HR = 0.98; CI95 = 0.46-2.12; p = 0.98), respectively, in MO and no-MO patients. CONCLUSION Despite the low number of patients treated with an MO approach, this study highlights the strengths and weakness of a molecular-targeted approach for the treatment of multiple myeloma. Widespread biomolecular techniques and improvement of precision medicine treatment algorithms could improve selection for precision medicine in myeloma.
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Affiliation(s)
- Fabio Andreozzi
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, 94805 Villejuif, France
- Hematology Department, Institute Jules Bordet, 1070 Bruxelles, Belgium
- Correspondence:
| | - Matteo Dragani
- Hematology Department, Gustave Roussy, 94805 Villejuif, France
| | - Cyril Quivoron
- Translational Research Hematological Laboratory, Gustave Roussy, 94805 Villejuif, France
- INSERM U1170, Université Paris-Saclay, Gustave Roussy, 94805 Villejuif, France
| | - Fabien Le Bras
- Hematology Department, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, 94000 Créteil, France
| | - Tarek Assi
- Hematology Department, Gustave Roussy, 94805 Villejuif, France
| | - Alina Danu
- Hematology Department, Gustave Roussy, 94805 Villejuif, France
| | - Karim Belhadj
- Hematology Department, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, 94000 Créteil, France
| | | | - Sophie Cotteret
- Department of Medical Biology and Pathology, Gustave Roussy, 94805 Villejuif, France
| | - Olivier A. Bernard
- INSERM U1170, Université Paris-Saclay, Gustave Roussy, 94805 Villejuif, France
| | - Vincent Ribrag
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, 94805 Villejuif, France
- Hematology Department, Gustave Roussy, 94805 Villejuif, France
- Translational Research Hematological Laboratory, Gustave Roussy, 94805 Villejuif, France
- INSERM U1170, Université Paris-Saclay, Gustave Roussy, 94805 Villejuif, France
| | - Jean-Marie Michot
- Département d’Innovation Thérapeutique et d’Essais Précoces, Gustave Roussy, 94805 Villejuif, France
- Hematology Department, Gustave Roussy, 94805 Villejuif, France
- INSERM U1170, Université Paris-Saclay, Gustave Roussy, 94805 Villejuif, France
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Kaur G, Jena L, Gupta R, Farswan A, Gupta A, Sriram K. Correlation of changes in subclonal architecture with progression in the MMRF CoMMpass study. Transl Oncol 2022; 23:101472. [PMID: 35777247 PMCID: PMC9253848 DOI: 10.1016/j.tranon.2022.101472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 06/03/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Multiple myeloma (MM) is a heterogeneous plasma cell proliferative disorder that arises from its premalignant precursor stages through a complex cascade of interactions between clonal mutations and co-evolving microenvironment. The temporo-spatial evolutionary trajectories of MM are established early during myelomatogenesis in precursor stages and retained in MM. Such molecular events impact subsequent disease progression and clinical outcomes. Identification of clonal sweeps of actionable gene targets in MM could reveal potential vulnerabilities that may exist in early stages and thus potentiate prognostication and customization of early therapeutic interventions. We have evaluated clonal evolution at multiple time points in 76 MM patients enrolled in the MMRF CoMMpass study. The major findings of this study are (a) MM progresses predominantly through branching evolution, (b) there is a heterogeneous spectrum of mutational landscapes that include unique actionable gene targets at diagnosis compared to progression, (c) unique clonal gains/ losses of mutant driver genes can be identified in patients with different cytogenetic aberrations, (d) there is a significant correlation between co-occurring oncogenic mutations/ co-occurring subclones e.g., with mutated TP53+SYNE1, NRAS+MAGI3, and anticorrelative dependencies between FAT3+FCGBP gene pairs. Such co-trajectories may synchronize molecular events of drug response, myelomatogenesis and warrant future studies to explore their potential for early prognostication and development of risk stratified personalized therapies in MM.
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Affiliation(s)
- Gurvinder Kaur
- Laboratory Oncology Unit, Dr. B. R.A. IRCH, AIIMS, New Delhi
| | - Lingaraja Jena
- Laboratory Oncology Unit, Dr. B. R.A. IRCH, AIIMS, New Delhi
| | - Ritu Gupta
- Laboratory Oncology Unit, Dr. B. R.A. IRCH, AIIMS, New Delhi.
| | - Akanksha Farswan
- SBILab, Department of Electronics and Communication Engineering, IIIT, Delhi
| | - Anubha Gupta
- SBILab, Department of Electronics and Communication Engineering, IIIT, Delhi.
| | - K Sriram
- Department of Computational Biology & Centre for Computational Biology, IIIT, Delhi
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Viol Ferreira Lopes MA, Higashi F, Crusoe EDQ, Peres ALM, Cury P, Hungria VTDM. Impact of the lactate dehydrogenase in association with the International Staging System prognostic score in multiple myeloma patients treated in real life. Hematol Transfus Cell Ther 2022:S2531-1379(22)00112-2. [DOI: 10.1016/j.htct.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/03/2022] [Accepted: 07/13/2022] [Indexed: 10/15/2022] Open
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Zheng L, Zhang A, Liu J, Liu M, Zhang Y. HDAC1 promotes the migration of human myeloma cells via regulation of the lncRNA/Slug axis. Int J Mol Med 2022; 49:3. [PMID: 34738621 PMCID: PMC8589458 DOI: 10.3892/ijmm.2021.5058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 09/21/2021] [Indexed: 12/13/2022] Open
Abstract
Understanding the mechanisms underlying malignancy in myeloma cells is important for targeted treatment and drug development. Histone deacetylases (HDACs) can regulate the progression of various cancer types; however, their roles in myeloma are not well known. In the present study, the expression of class I HDACs in myeloma cells and tissues was evaluated. Furthermore, the effects of HDAC1 on the migration of myeloma cells and the associated mechanisms were investigated. Among the class I HDACs evaluated, HDAC1 was upregulated in both myeloma cells and tissues. Targeted inhibition of HDAC1 suppressed the migration of myeloma cells. Of the assessed transcription factors, small interfering (si)‑HDAC1 decreased the expression of Slug. Overexpression of Slug reversed the si‑HDAC1‑mediated suppressed migration of myeloma cells. Mechanistically, the results revealed that HDAC1 regulated the mRNA stability of Slug, while it had no effect on its transcription or nuclear export. Furthermore, HDAC1 negatively regulated the expression of long non‑coding RNA (lncRNA) NONHSAT113026, which could bind with the 3'‑untranslated region of Slug mRNA to facilitate its degradation. The present study demonstrated that HDAC1 promoted the migration of human myeloma cells via regulation of lncRNA/Slug signaling.
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Affiliation(s)
- Lisha Zheng
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, P.R. China
| | - Ang Zhang
- Department of Hematology, PLA Strategic Support Force Characteristic Medical Center, Beijing 100101, P.R. China
| | - Jishan Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, P.R. China
| | - Min Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing 100191, P.R. China
| | - Yikun Zhang
- Department of Hematology, PLA Strategic Support Force Characteristic Medical Center, Beijing 100101, P.R. China
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8
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Farswan A, Jena L, Kaur G, Gupta A, Gupta R, Rani L, Sharma A, Kumar L. Branching clonal evolution patterns predominate mutational landscape in multiple myeloma. Am J Cancer Res 2021; 11:5659-5679. [PMID: 34873486 PMCID: PMC8640818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023] Open
Abstract
Multiple Myeloma (MM) arises from malignant transformation and deregulated proliferation of clonal plasma cells (PCs) harbouring heterogeneous molecular anomalies. The effect of evolving mutations on clone fitness and their cellular prevalence shapes the progressing myeloma genome and impacts clinical outcomes. Although clonal heterogeneity in MM is well established, which subclonal mutations emerge/persist/perish with progression in MM and which of these can be targeted therapeutically remains an open question. In line with this, we have sequenced pairwise whole exomes of 62 MM patients collected at two time points, i.e., at diagnosis and on progression. Somatic variants were called using a novel ensemble approach where a consensus was deduced from four variant callers (Illumina's Dragen, Strelka2, SomaticSniper and SpeedSeq) and actionable/druggable gene targets were identified. A marked intraclonal heterogeneity was observed. Branching evolution was observed among 72.58% patients, of whom 64.51% had low TMBs (<10) and 61.29% had 2 or more founder clones. The hypermutator patients (with high TMB levels ≥10 to ≤100) showed a significant decrease in their TMBs from diagnosis (median TMB 77.11) to progression (median TMB 31.22). A distinct temporal fall in subclonal driver mutations was identified recurrently across diagnosis to progression e.g., in PABPC1, BRAF, KRAS, CR1, DIS3 and ATM genes in 3 or more patients suggesting such patients could be treated early with target specific drugs like Vemurafenib/Cobimetinib. An analogous rise in driver mutations was observed in KMT2C, FOXD4L1, SP140, NRAS and other genes. A few drivers such as FAT4, IGLL5 and CDKN1A retained consistent distribution patterns at two time points. These findings are clinically relevant and point at consideration of evaluating multi time point subclonal mutational landscapes for designing better risk stratification strategies and tailoring time to time risk adapted combination therapies in future.
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Affiliation(s)
- Akanksha Farswan
- SBILab, Department of Electronics and Communication Engineering, Indraprastha Institute of Information Technology-Delhi (IIIT-D)Delhi 110020, India
| | - Lingaraja Jena
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS)New Delhi 110029, India
| | - Gurvinder Kaur
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS)New Delhi 110029, India
| | - Anubha Gupta
- SBILab, Department of Electronics and Communication Engineering, Indraprastha Institute of Information Technology-Delhi (IIIT-D)Delhi 110020, India
| | - Ritu Gupta
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS)New Delhi 110029, India
| | - Lata Rani
- Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS)New Delhi 110029, India
| | - Atul Sharma
- Department of Medical Oncology, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS)New Delhi 110029, India
| | - Lalit Kumar
- Department of Medical Oncology, Dr. B.R.A. IRCH, All India Institute of Medical Sciences (AIIMS)New Delhi 110029, India
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9
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Paschali A, Panagiotidis E, Triantafyllou T, Palaska V, Tsirou K, Verrou E, Υiannaki E, Markala D, Papanikolaou A, Pouli A, Konstantinidou P, Chatzipavlidou V, Terpos E, Katodritou E. A proposed index of diffuse bone marrow [18F]-FDG uptake and PET skeletal patterns correlate with myeloma prognostic markers, plasma cell morphology, and response to therapy. Eur J Nucl Med Mol Imaging 2020; 48:1487-1497. [PMID: 33099659 DOI: 10.1007/s00259-020-05078-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The investigation of a semi-quantitative index in the pelvis to assess for diffuse bone marrow (BM) [18F]-FDG uptake and the investigation of PET skeletal patterns in multiple myeloma (MM) patients, in accordance with prognostic markers, clonal plasma cell (cPC) morphology, and response to therapy. METHODS We prospectively analyzed [18F]-FDG PET/CT in 90 MM patients (newly diagnosed, 60; relapsed/refractory, 30). Among other PET/CT parameters, we calculated the ratio SUVmax pelvis/liver and examined for correlations with known MM prognostic parameters, cPC morphology (good vs. low/intermediate differentiation), and response to therapy. RESULTS SUVmax pelvis/liver ratio was significantly lower for the group of good differentiation vs. intermediate/low differentiation cPCs (p < 0.001) and showed a positive correlation with BM infiltration rate, β2 microglobulin, serum ferritin, international staging system (ISS), and revised ISS; no significant correlation was found with hemoglobin. A cutoff value of 1.1 showed an excellent specificity (99%) and high sensitivity (76%) for diffuse BM involvement (AUC 0.94; p < 0.001). Mixed pattern and appendicular involvement correlated with poor prognostic features while normal pattern, found in 30% of patients, correlated with good prognostic features. Presence of ≥ 10 focal lesions negatively predicted for overall response (p < 0.05; OR 4.8). The CT component improved the diagnostic performance of PET. CONCLUSION This study showed, for the first time, that cPC morphology and markers related with MM biology, correlate with SUVmax pelvis/liver index, which could be used as a surrogate marker for BM assessment and disease prognosis; PET patterns correlate with MM prognostic features and response rates.
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Affiliation(s)
- A Paschali
- Department of Nuclear Medicine, Theagenion Cancer Hospital, Thessaloniki, Greece.
| | - E Panagiotidis
- Department of Nuclear Medicine, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - T Triantafyllou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - V Palaska
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - K Tsirou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - E Verrou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - E Υiannaki
- Hematology/Flow cytometry Lab, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - D Markala
- Hematology/Flow cytometry Lab, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - A Papanikolaou
- Hematopathology Department, Evangelismos General Hospital, Athens, Greece
| | - A Pouli
- Hematology Department, "St Savvas" Oncology Hospital, Athens, Greece
| | - P Konstantinidou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - V Chatzipavlidou
- Department of Nuclear Medicine, Theagenion Cancer Hospital, Thessaloniki, Greece
| | - E Terpos
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - E Katodritou
- Department of Hematology, Theagenion Cancer Hospital, Thessaloniki, Greece
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10
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Steiner N, Jöhrer K, Plewan S, Brunner-Véber A, Göbel G, Nachbaur D, Wolf D, Gunsilius E, Untergasser G. The FMS like Tyrosine Kinase 3 (FLT3) Is Overexpressed in a Subgroup of Multiple Myeloma Patients with Inferior Prognosis. Cancers (Basel) 2020; 12:cancers12092341. [PMID: 32825035 PMCID: PMC7565188 DOI: 10.3390/cancers12092341] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/05/2020] [Accepted: 08/16/2020] [Indexed: 11/16/2022] Open
Abstract
Therapy resistance remains a major challenge in the management of multiple myeloma (MM). We evaluated the expression of FLT3 tyrosine kinase receptor (FLT3, CD135) in myeloma cells as a possible clonal driver. FLT3 expression was analyzed in bone marrow biopsies of patients with monoclonal gammopathy of undetermined significance or smoldering myeloma (MGUS, SMM), newly diagnosed MM (NDMM), and relapsed/refractory MM (RRMM) by immunohistochemistry (IHC). FLT3 gene expression was analyzed by RNA sequencing (RNAseq) and real-time PCR (rt-PCR). Anti-myeloma activity of FLT3 inhibitors (midostaurin, gilteritinib) was tested in vitro on MM cell lines and primary MM cells by 3H-tymidine incorporation assays or flow cytometry. Semi-quantitative expression analysis applying a staining score (FLT3 expression IHC-score, FES, range 1-6) revealed that a high FES (>3) was associated with a significantly shorter progression-free survival (PFS) in NDMM and RRMM patients (p = 0.04). RNAseq and real-time PCR confirmed the expression of FLT3 in CD138-purified MM samples. The functional relevance of FLT3 expression was corroborated by demonstrating the in vitro anti-myeloma activity of FLT3 inhibitors on FLT3-positive MM cell lines and primary MM cells. FLT3 inhibitors might offer a new targeted therapy approach in a subgroup of MM patients displaying aberrant FLT3 signaling.
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Affiliation(s)
- Normann Steiner
- Department of Internal Medicine V (Hematology and Medical Oncology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; (S.P.); (D.N.); (D.W.); (E.G.); (G.U.)
- Correspondence: ; Tel.: +43-(0)-512-504-82926
| | - Karin Jöhrer
- Tyrolean Cancer Research Institute, Innrain 66, A-6020 Innsbruck, Austria;
| | - Selina Plewan
- Department of Internal Medicine V (Hematology and Medical Oncology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; (S.P.); (D.N.); (D.W.); (E.G.); (G.U.)
| | - Andrea Brunner-Véber
- Department of Pathology, Neuropathology and Molecular Pathology, Medical University of Innsbruck, Müllerstraße 44, A-6020 Innsbruck, Austria;
| | - Georg Göbel
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Schöpfstraße 41/1, A-6020 Innsbruck, Austria;
| | - David Nachbaur
- Department of Internal Medicine V (Hematology and Medical Oncology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; (S.P.); (D.N.); (D.W.); (E.G.); (G.U.)
| | - Dominik Wolf
- Department of Internal Medicine V (Hematology and Medical Oncology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; (S.P.); (D.N.); (D.W.); (E.G.); (G.U.)
| | - Eberhard Gunsilius
- Department of Internal Medicine V (Hematology and Medical Oncology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; (S.P.); (D.N.); (D.W.); (E.G.); (G.U.)
| | - Gerold Untergasser
- Department of Internal Medicine V (Hematology and Medical Oncology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria; (S.P.); (D.N.); (D.W.); (E.G.); (G.U.)
- Tyrolean Cancer Research Institute, Innrain 66, A-6020 Innsbruck, Austria;
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11
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Zhang XY, Rajagopalan D, Chung TH, Hooi L, Toh TB, Tian JS, Rashid MBMA, Sahib NRBM, Gu M, Lim JJ, Wang W, Chng WJ, Jha S, Chow EKH. Frequent upregulation of G9a promotes RelB-dependent proliferation and survival in multiple myeloma. Exp Hematol Oncol 2020; 9:8. [PMID: 32477831 PMCID: PMC7243326 DOI: 10.1186/s40164-020-00164-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 05/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background Multiple myeloma is an incurable hematological malignancy characterized by a heterogeneous genetic and epigenetic landscape. Although a number of genetic aberrations associated with myeloma pathogenesis, progression and prognosis have been well characterized, the role of many epigenetic aberrations in multiple myeloma remain elusive. G9a, a histone methyltransferase, has been found to promote disease progression, proliferation and metastasis via diverse mechanisms in several cancers. A role for G9a in multiple myeloma, however, has not been previously explored. Methods Expression levels of G9a/EHMT2 of multiple myeloma cell lines and control cells Peripheral Blood Mononuclear Cells (PBMCs) were analyzed. Correlation of G9a expression and overall survival of multiple myeloma patients were analyzed using patient sample database. To further study the function of G9a in multiple myeloma, G9a depleted multiple myeloma cells were built by lentiviral transduction, of which proliferation, colony formation assays as well as tumorigenesis were measured. RNA-seq of G9a depleted multiple myeloma with controls were performed to explore the downstream mechanism of G9a regulation in multiple myeloma. Results G9a is upregulated in a range of multiple myeloma cell lines. G9a expression portends poorer survival outcomes in a cohort of multiple myeloma patients. Depletion of G9a inhibited proliferation and tumorigenesis in multiple myeloma. RelB was significantly downregulated by G9a depletion or small molecule inhibition of G9a/GLP inhibitor UNC0642, inducing transcription of proapoptotic genes Bim and BMF. Rescuing RelB eliminated the inhibition in proliferation and tumorigenesis by G9a depletion. Conclusions In this study, we demonstrated that G9a is upregulated in most multiple myeloma cell lines. Furthermore, G9a loss-of-function analysis provided evidence that G9a contributes to multiple myeloma cell survival and proliferation. This study found that G9a interacts with NF-κB pathway as a key regulator of RelB in multiple myeloma and regulates RelB-dependent multiple myeloma survival. G9a therefore is a promising therapeutic target for multiple myeloma.
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Affiliation(s)
- Xi Yun Zhang
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore.,2Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore
| | - Deepa Rajagopalan
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore
| | - Tae-Hoon Chung
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore
| | - Lissa Hooi
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore
| | - Tan Boon Toh
- 3The N.1 Institute for Health (N.1), National University of Singapore, Center for Life Sciences, 28 Medical Drive, Singapore, 117456 Singapore
| | - Johann Shane Tian
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore
| | | | - Noor Rashidha Bte Meera Sahib
- 5Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597 Singapore
| | - Mengjie Gu
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore.,5Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597 Singapore
| | - Jhin Jieh Lim
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore
| | - Wilson Wang
- 6Department of Orthopaedic Surgery, National University of Singapore, Kent Ridge, Singapore, 119074 Singapore
| | - Wee Joo Chng
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore.,2Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228 Singapore.,7National University Cancer Institute, National University Health System, Singapore, 119228 Singapore
| | - Sudhakar Jha
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore.,8Department of Biochemistry, National University of Singapore, Singapore, Singapore
| | - Edward Kai-Hua Chow
- 1Cancer Science Institute of Singapore, Centre for Translational Medicine, National University of Singapore, (MD6) #13-01G, 14 Medical Drive, Singapore, 117599 Singapore.,5Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597 Singapore
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12
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Gao M, Li C, Xiao H, Dong H, Jiang S, Fu Y, Gong L. hsa_circ_0007841: A Novel Potential Biomarker and Drug Resistance for Multiple Myeloma. Front Oncol 2019; 9:1261. [PMID: 31803627 PMCID: PMC6877741 DOI: 10.3389/fonc.2019.01261] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022] Open
Abstract
Purpose: Circular RNA (circRNA) is a key regulatory factor in the development and progression of human tumors. However, the working mechanism and clinical significance of most circRNAs remain unknown in human cancers, including multiple myeloma (MM). Patients and Methods: This study employs high-throughput circRNA microarray with bioinformatics to identify differentially expressed circRNAs in patients with MM. The hsa_circ_0007841 expressions were observed in the MM tissues of 86 patients. Drug-resistant cell lines and pathological features were also detected. In addition, the relationship between hsa_circ_0007841 expressions in the MM tissues and the pathological features of patients with MM were evaluated and role of hsa_circ_0007841 as a potential biomarker and therapeutic target was assessed. Results: The results show that in the MM cell lines and drug-resistant cell lines, hsa_circ_0007841 expression was significantly upregulated, which was closely associated with disease prognosis. Specifically, hsa_circ_0007841 upregulation was correlated with chromosomal aberrations such as gain 1q21, t (4:14) and mutations in ATR and IRF4 genes. This finding was corroborated in large samples. Finally, bioinformatics analysis showed that eight differentially expressed miRNAs and 10 candidate mRNAs interacted with hsa_circ_0007841, shedding some new light on the basic functional research. Conclusion: This study may be the first to report that hsa_circ_0007841 is significantly upregulated in MM. It also suggests that hsa_circ_0007841 may be a novel biomarker for MM and its involvement in the progression of MM.
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Affiliation(s)
- Meng Gao
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Chengyuan Li
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Han Xiao
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Hang Dong
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Siyi Jiang
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Yunfeng Fu
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Liying Gong
- The Third Xiangya Hospital of Central South University, Changsha, China
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13
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Saltarella I, Morabito F, Giuliani N, Terragna C, Omedè P, Palumbo A, Bringhen S, De Paoli L, Martino E, Larocca A, Offidani M, Patriarca F, Nozzoli C, Guglielmelli T, Benevolo G, Callea V, Baldini L, Grasso M, Leonardi G, Rizzo M, Falcone AP, Gottardi D, Montefusco V, Musto P, Petrucci MT, Dammacco F, Boccadoro M, Vacca A, Ria R. Prognostic or predictive value of circulating cytokines and angiogenic factors for initial treatment of multiple myeloma in the GIMEMA MM0305 randomized controlled trial. J Hematol Oncol 2019; 12:4. [PMID: 30626425 PMCID: PMC6327520 DOI: 10.1186/s13045-018-0691-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/25/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Several new drugs are approved for treatment of patients with multiple myeloma (MM), but no validated biomarkers are available for the prediction of a clinical outcome. We aimed to establish whether pretreatment blood and bone marrow plasma concentrations of major cytokines and angiogenic factors (CAFs) of patients from a phase 3 trial of a MM treatment could have a prognostic and predictive value in terms of response to therapy and progression-free and overall survival and whether these patients could be stratified for their prognosis. METHODS Blood and bone marrow plasma levels of Ang-2, FGF-2, HGF, VEGF, PDGF-β, IL-8, TNF-α, TIMP-1, and TIMP-2 were determined at diagnosis in MM patients enrolled in the GIMEMA MM0305 randomized controlled trial by an enzyme-linked immunosorbent assay (ELISA). These levels were correlated both reciprocally and with the type of therapy and patients' characteristics and with a group of non-MM patients as controls. RESULTS No significant differences were detected between the blood and bone marrow plasma levels of angiogenic cytokines. A cutoff for each CAF was established. The therapeutic response of patients with blood plasma levels of CAFs lower than the cutoff was better than the response of those with higher levels in terms of percentage of responding patients and quality of response. CONCLUSION FGF-2, HGF, VEGF, and PDGF-β plasma levels at diagnosis have predictive significance for response to treatment. The stratification of patients based on the levels of CAFs at diagnosis and their variations after therapy is useful to characterize different risk groups concerning outcome and response to therapy. TRIAL REGISTRATION Clinical trial information can be found at the following link: NCT01063179.
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Affiliation(s)
- Ilaria Saltarella
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Fortunato Morabito
- Biothecnology Research Unit, Aprigliano, Cosenza, Italy.,Hemato-oncology Department Augusta Victoria Hospital, Jerusalem, Israel
| | - Nicola Giuliani
- Department of Clinical and Experimental Medicine, Myeloma Unit, University of Parma, Parma, Italy
| | - Carolina Terragna
- "Seràgnoli" Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Bologna University School of Medicine, Bologna, Italy
| | - Paola Omedè
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Antonio Palumbo
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Sara Bringhen
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Enrica Martino
- Division of Hematology, AOU "Policlinico-Vittorio Emanuele", Catania, Italy
| | - Alessandra Larocca
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | | | | | - Chiara Nozzoli
- Cellular Therapies and Transfusion Medicine Unit, AOU Careggi, Florence, Italy
| | | | - Giulia Benevolo
- SC Hematology AO Città della Salute e della Scienza, Turin, Italy
| | - Vincenzo Callea
- Divisione di Ematologia, Ospedali Riuniti, Reggio di Calabria, Italy
| | - Luca Baldini
- Hematology Unit, Fondazione IRCCS, Cà Granda, OM Policlinico, DIPO, University of Milan, Milan, Italy
| | | | - Giovanna Leonardi
- Department of Oncology and Hematology AOU, Hematology Unit, Modena, Italy
| | | | | | - Daniela Gottardi
- A.O.U. S. Giovanni Battista A.O. Mauriziano-Umberto I, Turin, Italy
| | | | - Pellegrino Musto
- IRCCS Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Maria Teresa Petrucci
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Rome, Italy
| | - Franco Dammacco
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Mario Boccadoro
- Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Turin, Italy
| | - Angelo Vacca
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy
| | - Roberto Ria
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro" Medical School, Bari, Italy. .,Internal Medicine "G. Baccelli", Myeloma Unit, University of Bari "Aldo Moro" Medical School, Azienda Ospedaliero-Universitaria Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy.
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14
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Zhang H, Li L, Chen Q, Li M, Feng J, Sun Y, Zhao R, Zhu Y, Lv Y, Zhu Z, Huang X, Xie W, Xiang W, Yao P. PGC1β regulates multiple myeloma tumor growth through LDHA-mediated glycolytic metabolism. Mol Oncol 2018; 12:1579-1595. [PMID: 30051603 PMCID: PMC6120252 DOI: 10.1002/1878-0261.12363] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/16/2018] [Accepted: 07/03/2018] [Indexed: 12/13/2022] Open
Abstract
Multiple myeloma (MM) is an incurable hematologic malignancy due to inevitable relapse and chemoresistance development. Our preliminary data show that MM cells express high levels of PGC1β and LDHA. In this study, we investigated the mechanism behind PGC1β‐mediated LDHA expression and its contribution to tumorigenesis, to aid in the development of novel therapeutic approaches for MM. Real‐time PCR and western blotting were first used to evaluate gene expression of PGC1β and LDHA in different MM cells, and then, luciferase reporter assay, chromatin immunoprecipitation, LDHA deletion report vectors, and siRNA techniques were used to investigate the mechanism underlying PGC1β‐induced LDHA expression. Furthermore, knockdown cell lines and lines stably overexpressing PGC1β or LDHA lentivirus were established to evaluate in vitro glycolysis metabolism, mitochondrial function, reactive oxygen species (ROS) formation, and cell proliferation. In addition, in vivo xenograft tumor development studies were performed to investigate the effect of PGC1β or LDHA expression on tumor growth and mouse survival. We found that PGC1β and LDHA are highly expressed in different MM cells and LDHA is upregulated by PGC1β through the PGC1β/RXRβ axis acting on the LDHA promoter. Overexpression of PGC1β or LDHA significantly potentiated glycolysis metabolism with increased cell proliferation and tumor growth. On the other hand, knockdown of PGC1β or LDHA largely suppressed glycolysis metabolism with increased ROS formation and apoptosis rate, in addition to suppressing tumor growth and enhancing mouse survival. This is the first time the mechanism underlying PGC1β‐mediated LDHA expression in multiple myeloma has been identified. We conclude that PGC1β regulates multiple myeloma tumor growth through LDHA‐mediated glycolytic metabolism. Targeting the PGC1β/LDHA pathway may be a novel therapeutic strategy for multiple myeloma treatment.
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Affiliation(s)
- Hongyu Zhang
- Department of Hematology, Peking University Shenzhen Hospital, China
| | - Ling Li
- Department of Pediatrics, Hainan Maternal and Child Health Hospital, Haikou, China
| | - Qi Chen
- Department of Hematology, Peking University Shenzhen Hospital, China
| | - Min Li
- Institute of Rehabilitation Center, Tongren Hospital of Wuhan University, China
| | - Jia Feng
- Department of Hematology, Peking University Shenzhen Hospital, China
| | - Ying Sun
- Department of Pediatrics, Hainan Maternal and Child Health Hospital, Haikou, China
| | - Rong Zhao
- Institute of Rehabilitation Center, Tongren Hospital of Wuhan University, China
| | - Yin Zhu
- Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, China
| | - Yang Lv
- Department of Pediatrics, Hainan Maternal and Child Health Hospital, Haikou, China
| | - Zhigang Zhu
- Department of Geriatrics, National Key Clinical Specialty, Guangzhou First People's Hospital, Guangzhou Medical University, China
| | - Xiaodong Huang
- Institute of Rehabilitation Center, Tongren Hospital of Wuhan University, China
| | - Weiguo Xie
- Institute of Rehabilitation Center, Tongren Hospital of Wuhan University, China
| | - Wei Xiang
- Department of Pediatrics, Hainan Maternal and Child Health Hospital, Haikou, China
| | - Paul Yao
- Department of Hematology, Peking University Shenzhen Hospital, China.,Department of Pediatrics, Hainan Maternal and Child Health Hospital, Haikou, China.,Institute of Rehabilitation Center, Tongren Hospital of Wuhan University, China
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15
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Soekojo CY, de Mel S, Ooi M, Yan B, Chng WJ. Potential Clinical Application of Genomics in Multiple Myeloma. Int J Mol Sci 2018; 19:ijms19061721. [PMID: 29890777 PMCID: PMC6032230 DOI: 10.3390/ijms19061721] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/02/2018] [Accepted: 06/07/2018] [Indexed: 12/19/2022] Open
Abstract
Multiple myeloma is a heterogeneous disease with different characteristics, and genetic aberrations play important roles in this heterogeneity. Studies have shown that these genetic aberrations are crucial in prognostication and response assessment; recent efforts have focused on their possible therapeutic implications. Despite many emerging studies being published, the best way to incorporate these results into clinical practice remains unclear. In this review paper we describe the different genomic techniques available, including the latest advancements, and discuss the potential clinical application of genomics in multiple myeloma.
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Affiliation(s)
- Cinnie Yentia Soekojo
- Department of Hematology-Oncology, National University Cancer Institute, Singapore, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Sanjay de Mel
- Department of Hematology-Oncology, National University Cancer Institute, Singapore, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Melissa Ooi
- Department of Hematology-Oncology, National University Cancer Institute, Singapore, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore.
| | - Benedict Yan
- Department of Laboratory Medicine, National University Hospital, National University Health System, 5 Lower Kent Ridge Road, Singapore 119074, Singapore.
| | - Wee Joo Chng
- Department of Hematology-Oncology, National University Cancer Institute, Singapore, National University Health System, 1E Kent Ridge Road, Singapore 119228, Singapore.
- Cancer Science Institute of Singapore, National University of Singapore,14 Medical Drive, Singapore 117599, Singapore.
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16
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Endothelial progenitor cells in multiple myeloma neovascularization: a brick to the wall. Angiogenesis 2017; 20:443-462. [PMID: 28840415 DOI: 10.1007/s10456-017-9571-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 07/31/2017] [Indexed: 12/12/2022]
Abstract
Multiple myeloma (MM) is characterized by the clonal expansion of plasma cells in the bone marrow that leads to events such as bone destruction, anaemia and renal failure. Despite the several therapeutic options available, there is still no effective cure, and the standard survival is up to 4 years. The evolution from the asymptomatic stage of monoclonal gammopathy of undetermined significance to MM and the progression of the disease itself are related to cellular and molecular alterations in the bone marrow microenvironment, including the development of the vasculature. Post-natal vasculogenesis is characterized by the recruitment to the tumour vasculature of bone marrow progenitors, known as endothelial progenitor cells (EPCs), which incorporate newly forming blood vessels and differentiate into endothelial cells. Several processes related to EPCs, such as recruitment, mobilization, adhesion and differentiation, are tightly controlled by cells and molecules in the bone marrow microenvironment. In this review, the bone marrow microenvironment and the mechanisms associated to the development of the neovasculature promoted by EPCs are discussed in detail in both a non-pathological scenario and in MM. The latest developments in therapy targeting the vasculature and EPCs in MM are also highlighted. The identification and characterization of the pathways relevant to the complex setting of MM are of utter importance to identify not only biomarkers for an early diagnosis and disease progression monitoring, but also to reveal intervention targets for more effective therapy directed to cancer cells and the endothelial mediators relevant to neovasculature development.
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17
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Abstract
OBJECTIVES This integrative review describes the genomic variants that have been found to be associated with poor prognosis in patients diagnosed with multiple myeloma (MM). Second, it identifies MM genetic and genomic changes using next-generation sequencing, specifically whole-genome sequencing or exome sequencing. DATA SOURCE A search for peer-reviewed articles through PubMed, EBSCOhost, and DePaul WorldCat Libraries Worldwide yielded 33 articles that were included in the final analysis. CONCLUSION The most commonly reported genetic changes were KRAS, NRAS, TP53, FAM46C, BRAF, DIS3, ATM, and CCND1. These genetic changes play a role in the pathogenesis of MM, prognostication, and therapeutic targets for novel therapies. IMPLICATIONS FOR NURSING PRACTICE MM genetics and genomics are expanding rapidly; oncology nurse clinicians must have basic competencies in genetics and genomics to help patients understand the complexities of genetic and genomic alterations and be able to refer patients to appropriate genomic professionals if needed.
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18
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Clinicopathological significance of the p16 hypermethylation in multiple myeloma, a systematic review and meta-analysis. Oncotarget 2017; 8:83270-83279. [PMID: 29137341 PMCID: PMC5669967 DOI: 10.18632/oncotarget.18742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 04/25/2017] [Indexed: 01/15/2023] Open
Abstract
It is well known that the loss of function of the p16INK4A gene is mainly caused by the hypermethylation of the p16 gene; however, whether or not the inactivation is associated with the clinical significance of multiple myeloma (MM) remains elusive. A meta-analysis was conducted to quantitatively determine the role of the p16 hypermethylation in the clinical significance of MM. We demonstrated that MM patients show much higher hypermethylation rates on the p16 gene in bone marrow compared to normal individuals, as well as monoclonal gammopathy of undetermined significance (MGUS). The difference of aberrant p16 hypermethylation between MM patients in advanced stage and MM patients in early stage is not statistically significant. Interestingly, the survival rate of MM patients with the p16 hypermethylation is much shorter compared to those without the p16 hypermethylation. Our results demonstrate that hypermethylation status of the p16 gene may play a role in the progression of MGUS to MM, as well as worse survival in MM. The p16 hypermethylation, which induces the loss of function of the p16 gene that plays a critical role in the early tumorigenesis of MM.
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19
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Lanzel EA, Paula Gomez Hernandez M, Bates AM, Treinen CN, Starman EE, Fischer CL, Parashar D, Guthmiller JM, Johnson GK, Abbasi T, Vali S, Brogden KA. Predicting PD-L1 expression on human cancer cells using next-generation sequencing information in computational simulation models. Cancer Immunol Immunother 2016; 65:1511-1522. [PMID: 27688163 DOI: 10.1007/s00262-016-1907-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 09/23/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Interaction of the programmed death-1 (PD-1) co-receptor on T cells with the programmed death-ligand 1 (PD-L1) on tumor cells can lead to immunosuppression, a key event in the pathogenesis of many tumors. Thus, determining the amount of PD-L1 in tumors by immunohistochemistry (IHC) is important as both a diagnostic aid and a clinical predictor of immunotherapy treatment success. Because IHC reactivity can vary, we developed computational simulation models to accurately predict PD-L1 expression as a complementary assay to affirm IHC reactivity. METHODS Multiple myeloma (MM) and oral squamous cell carcinoma (SCC) cell lines were modeled as examples of our approach. Non-transformed cell models were first simulated to establish non-tumorigenic control baselines. Cell line genomic aberration profiles, from next-generation sequencing (NGS) information for MM.1S, U266B1, SCC4, SCC15, and SCC25 cell lines, were introduced into the workflow to create cancer cell line-specific simulation models. Percentage changes of PD-L1 expression with respect to control baselines were determined and verified against observed PD-L1 expression by ELISA, IHC, and flow cytometry on the same cells grown in culture. RESULT The observed PD-L1 expression matched the predicted PD-L1 expression for MM.1S, U266B1, SCC4, SCC15, and SCC25 cell lines and clearly demonstrated that cell genomics play an integral role by influencing cell signaling and downstream effects on PD-L1 expression. CONCLUSION This concept can easily be extended to cancer patient cells where an accurate method to predict PD-L1 expression would affirm IHC results and improve its potential as a biomarker and a clinical predictor of treatment success.
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Affiliation(s)
- Emily A Lanzel
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - M Paula Gomez Hernandez
- Iowa Institute for Oral Health Research, N423 DSB, College of Dentistry, The University of Iowa, 801 Newton Road, Iowa City, IA, 52242, USA
| | - Amber M Bates
- Iowa Institute for Oral Health Research, N423 DSB, College of Dentistry, The University of Iowa, 801 Newton Road, Iowa City, IA, 52242, USA
| | - Christopher N Treinen
- Iowa Institute for Oral Health Research, N423 DSB, College of Dentistry, The University of Iowa, 801 Newton Road, Iowa City, IA, 52242, USA
| | - Emily E Starman
- Iowa Institute for Oral Health Research, N423 DSB, College of Dentistry, The University of Iowa, 801 Newton Road, Iowa City, IA, 52242, USA
| | - Carol L Fischer
- Iowa Institute for Oral Health Research, N423 DSB, College of Dentistry, The University of Iowa, 801 Newton Road, Iowa City, IA, 52242, USA
| | | | - Janet M Guthmiller
- College of Dentistry, University of Nebraska Medical Center, 40th and Holdrege, Lincoln, NE, USA
| | - Georgia K Johnson
- Department of Periodontics, College of Dentistry, The University of Iowa, Iowa City, IA, USA
| | - Taher Abbasi
- Cellworks Research India Ltd, Whitefield, Bangalore, India
- Cellworks Group Inc, 2033 Gateway Place Suite 500, San Jose, CA, USA
| | - Shireen Vali
- Cellworks Research India Ltd, Whitefield, Bangalore, India
- Cellworks Group Inc, 2033 Gateway Place Suite 500, San Jose, CA, USA
| | - Kim A Brogden
- Iowa Institute for Oral Health Research, N423 DSB, College of Dentistry, The University of Iowa, 801 Newton Road, Iowa City, IA, 52242, USA.
- Department of Periodontics, College of Dentistry, The University of Iowa, Iowa City, IA, USA.
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20
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Gagliardi A, Carbone C, Russo A, Cuccurullo R, Lucania A, Cioppa PD, Misso G, Caraglia M, Tommasino C, Mastrullo L. Combined use of free light chain and heavy/light chain ratios allow diagnosis and monitoring of patients with monoclonal gammopathies: Experience of a single institute, with three exemplar case reports. Oncol Lett 2016; 12:2363-2370. [PMID: 27698801 PMCID: PMC5038391 DOI: 10.3892/ol.2016.4965] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/02/2016] [Indexed: 01/06/2023] Open
Abstract
Monoclonal gammopathies are characterized by serum monoclonal component (MC) plus an intact immunoglobulin and a free light chain (FLC), or a combination of both. The measurement of FLC with Freelite® is the standard practice recommended by International Myeloma Working Group guidelines. Recently, Hevylite® heavy/light chains (HLC) assays were introduced to specifically target junctional epitopes between the heavy and light chains of intact immunoglobulins, allowing the independent quantification of the involved (MC) and uninvolved (polyclonal immunoglobulin background) HLC isotype. Between January 2012 and March 2014, 90 patients were examined: 49 multiple myeloma (MM), 6 smoldering MM (SMM) and 35 monoclonal gammopathy of undetermined significance (MGUS). Of these 90 patients, 300 samples were collected at different times. The diagnostic and monitoring contribution of Hevylite A and G assays was assessed in all 90 patients examined. Additionally, 3 representative cases were selected. The Hevylite absolute values and ratio demonstrated high sensitivity and specificity with respect to serum protein electrophoresis and serum immunofixation. The combined use of Hevylite A and G with Freelite was particularly useful in dubious cases with more than one MC or with co-migrating components, as well as in the course of monitoring to assess the independent change of FLC and HLC, possibly reflecting the presence of clonal heterogeneity in the cohort. From this study, it can be concluded that FLC and HLC are independent, useful markers to monitor the MC and to assess with greater specificity and sensitivity the effect of therapy, thereby providing clinical support. Further studies are required to assess the prognostic potential of Hevylite in MGUS and SMM.
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Affiliation(s)
- Alfredo Gagliardi
- Complex Operative Unit of Hematology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Claudio Carbone
- Complex Operative Unit of Clinical Pathology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Angela Russo
- Complex Operative Unit of Clinical Pathology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Rosanna Cuccurullo
- Complex Operative Unit of Hematology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Anna Lucania
- Complex Operative Unit of Hematology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Paola Della Cioppa
- Complex Operative Unit of Hematology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Gabriella Misso
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, I-80138 Naples, Italy
| | - Michele Caraglia
- Department of Biochemistry, Biophysics and General Pathology, Second University of Naples, I-80138 Naples, Italy
| | - Catello Tommasino
- Complex Operative Unit of Clinical Pathology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
| | - Lucia Mastrullo
- Complex Operative Unit of Hematology, San Gennaro Hospital, Naples 1 Local Health Center, I-80135 Naples, Italy
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21
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Tomasiuk R, Gawroński K, Rzepecki P, Rabijewski M, Cacko M. The evaluation of NT-proCNP, C-reactive protein and serum amyloid A protein concentration in patients with multiple myeloma undergoing stem cell transplantation. Leuk Res 2016; 47:123-7. [PMID: 27322507 DOI: 10.1016/j.leukres.2016.05.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/21/2016] [Accepted: 05/23/2016] [Indexed: 11/27/2022]
Abstract
The importance of proinflamatory cytokines and acute phase proteins in pathogenesis and progression of MM is well known. However, there are any studies evaluating the role of NT-proCN in management and treatment of MM. The aim of our study was to evaluate the concentration of NT-proCNP and acute phase proteins in patients with MM before and after stem cell transplantation. We involved 40 newly diagnosed MM patients in stage III according to the Durie-Salmon classification and treated with high dose of melphalan (200mg/m2) prior to ASCT. Concentration of NT-proCNP, hs-CRP and SAA were measured before conditioning treatment and every 4days until the 24th day after stem cell infusion. We observed low NT-proCNP levels before conditioning treatment (0.121±0.04pmol/l), the higher in day on ASCT (0.28±0.14pmol/l). Further we showed significant gradual increase concentration of NT-proCNP up to 12days after stem cells infusion (1.07±0.72pmol/l). The kinetics of hs-CRP and SAA levels were similar to NT-proCNP. We showed positive correlation between NT-proCNP levels and absolute neutrophil and platelets count in patients after ASCT. NT-proCNP can be useful parameter to assess effectiveness of treatment and monitoring of hematopoetic recovery time in patients with MM after stem cell transplantations.
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Affiliation(s)
- Ryszard Tomasiuk
- Department of Laboratory Diagnostics, Mazovian Bródno Hospital in Warsaw, Poland
| | - Krzysztof Gawroński
- Department of Internal Diseases and Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Piotr Rzepecki
- Department of Internal Diseases and Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Michał Rabijewski
- Department of Internal Medicine, Diabetology and Endocrinology, Medical University of Warsaw, Poland
| | - Marek Cacko
- Department of Nuclear Medicine, Mazovian Bródno Hospital in Warsaw, Poland.
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22
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Faiman B, Valent J. Assessment and monitoring of patients receiving chemotherapy for multiple myeloma: strategies to improve outcomes. Blood Lymphat Cancer 2016; 6:21-35. [PMID: 31360078 PMCID: PMC6467334 DOI: 10.2147/blctt.s90764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Improved understanding as to the biology of multiple myeloma (MM) and the bone marrow microenvironment has led to the development of new drugs to treat MM. This explosion of new and highly effective drugs has led to dramatic advances in the management of MM and underscores the need for supportive care. Impressive and deep response rates to chemotherapy, monoclonal antibodies, and small molecule drugs provide hope of a cure or prolonged remission for the majority of individuals. For most patients, long-term, continuous therapy is often required to suppress the malignant plasma cell clone, thus requiring clinicians to become more astute in assessment, monitoring, and intervention of side effects as well as monitoring response to therapy. Appropriate diagnosis and monitoring strategies are essential to ensure that patients receive the appropriate chemotherapy and supportive therapy at relapse, and that side effects are appropriately managed to allow for continued therapy and adherence to the regimen. Multiple drugs with complex regimens are currently available with varying side effect profiles. Knowledge of the drugs used to treat MM and the common adverse events will allow for preventative strategies to mitigate adverse events and prompt intervention. The purpose of this paper is to review updates in the diagnosis and management of MM, and to provide strategies for assessment and monitoring of patients receiving chemotherapy for MM.
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Affiliation(s)
- Beth Faiman
- Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA,
| | - Jason Valent
- Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA,
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23
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Bhutani M, Landgren O, Usmani SZ. Multiple myeloma: is it time for biomarker-driven therapy? Am Soc Clin Oncol Educ Book 2016:e493-503. [PMID: 25993214 DOI: 10.14694/edbook_am.2015.35.e493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Remarkable strides have been made in understanding the molecular mechanisms by which multiple myeloma develops, leading to more sophisticated classification that incorporates not only the traditional diagnostic criteria, but also immunophenotype, genetic, and molecular features. However, even with this added information, considerable heterogeneity in clinical outcomes exists within the identified subtypes. The present paradigm for myeloma treatment is built on the basic step of defining transplant eligibility versus noneligibility, as determined by age, performance status, and cumulative burden of comorbidities. An incredibly complex heterogeneous disease is, therefore, treated in a generalized way with the result that large interpatient variability exists in the outcome. As antimyeloma therapeutics continue to expand it is becoming even more crucial to personalize treatment approaches that provide the most value to a specific patient. Development of biomarkers, either individually or as larger sets or patterns and ranging from analysis of blood or bone marrow to biomedical imaging, is a major focus in the field. Biomarkers such as involved serum free light chain ratio and MRI focal lesions have been implemented in the new definition of multiple myeloma and guide clinicians to initiate treatment in otherwise asymptomatic individuals. Currently, however, there is not enough evidence to support intensifying the treatment for high-risk disease or reducing the treatment for low-risk disease. Minimal residual disease-negative status is an important biomarker that holds promise for monitoring the effectiveness of response-adapted strategies. This article sheds light on the forward landscape and rear-mirror view of biomarkers in myeloma.
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Affiliation(s)
- Manisha Bhutani
- From the Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Carolinas Healthcare System, Charlotte, NC; Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ola Landgren
- From the Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Carolinas Healthcare System, Charlotte, NC; Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Saad Z Usmani
- From the Department of Hematologic Oncology & Blood Disorders, Levine Cancer Institute/Carolinas Healthcare System, Charlotte, NC; Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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24
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Noll JE, Vandyke K, Hewett DR, Mrozik KM, Bala RJ, Williams SA, Kok CH, Zannettino AC. PTTG1 expression is associated with hyperproliferative disease and poor prognosis in multiple myeloma. J Hematol Oncol 2015; 8:106. [PMID: 26445238 PMCID: PMC4595141 DOI: 10.1186/s13045-015-0209-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 09/28/2015] [Indexed: 01/08/2023] Open
Abstract
Background Multiple myeloma (MM) is an incurable haematological malignancy characterised by the clonal proliferation of malignant plasma cells within the bone marrow. We have previously identified pituitary tumour transforming gene 1 (Pttg1) as a gene that is significantly upregulated in the haematopoietic compartment of the myeloma-susceptible C57BL/KaLwRij mouse strain, when compared with the myeloma-resistant C57BL/6 mouse. Over-expression of PTTG1 has previously been associated with malignant progression and an enhanced proliferative capacity in solid tumours. Methods In this study, we investigated PTTG1 gene and protein expression in MM plasma cells from newly diagnosed MM patients. Gene expression profiling was used to identify gene signatures associated with high PTTG1 expression in MM patients. Additionally, we investigated the effect of short hairpin ribonucleic acid (shRNA)-mediated PTTG1 knockdown on the proliferation of the murine myeloma plasma cell line 5TGM1 in vitro and in vivo. Results PTTG1 was found to be over-expressed in 36–70 % of MM patients, relative to normal controls, with high PTTG1 expression being associated with poor patient outcomes (hazard ratio 2.49; 95 % CI 1.28 to 4.86; p = 0.0075; log-rank test). In addition, patients with high PTTG1 expression exhibited increased expression of cell proliferation-associated genes including CCNB1, CCNB2, CDK1, AURKA, BIRC5 and DEPDC1. Knockdown of Pttg1 in 5TGM1 cells decreased cellular proliferation, without affecting cell cycle distribution or viability, and decreased expression of Ccnb1, Birc5 and Depdc1 in vitro. Notably, Pttg1 knockdown significantly reduced MM tumour development in vivo, with an 83.2 % reduction in tumour burden at 4 weeks (p < 0.0001, two-way ANOVA). Conclusions This study supports a role for increased PTTG1 expression in augmenting tumour development in a subset of MM patients. Electronic supplementary material The online version of this article (doi:10.1186/s13045-015-0209-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jacqueline E Noll
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
| | - Kate Vandyke
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia. .,SA Pathology, Adelaide, Australia.
| | - Duncan R Hewett
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
| | - Krzysztof M Mrozik
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
| | - Rachel J Bala
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
| | - Sharon A Williams
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia.
| | - Chung H Kok
- Leukaemia Research Group, Cancer Theme, SAHMRI, Adelaide, Australia.
| | - Andrew Cw Zannettino
- Myeloma Research Laboratory, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide and Cancer Theme, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia. .,Discipline of Physiology, School of Medicine, Faculty of Health Sciences, University of Adelaide, Cancer Theme, Level 5 South, SAHMRI, PO Box 11060, Adelaide, SA, 5001, Australia.
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25
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Fall DJ, Stessman H, Patel SS, Sachs Z, Van Ness BG, Baughn LB, Linden MA. Utilization of translational bioinformatics to identify novel biomarkers of bortezomib resistance in multiple myeloma. J Cancer 2014; 5:720-7. [PMID: 25368671 PMCID: PMC4216795 DOI: 10.7150/jca.9864] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 08/20/2014] [Indexed: 11/07/2022] Open
Abstract
Multiple myeloma (MM) is an incurable malignant neoplasm hallmarked by a clonal expansion of plasma cells, the presence of a monoclonal protein in the serum and/or urine (M-spike), lytic bone lesions, and end organ damage. Clinical outcomes for patients with MM have improved greatly over the last decade as a result of the re-purposing of compounds such as thalidomide derivatives, as well as the development of novel chemotherapeutic agents including first and second generation proteasome inhibitors, bortezomib (Bz) and carfilzomib. Unfortunately, despite these improvements, the majority of patients relapse following treatment. While Bz, one of the most commonly used proteasome inhibitors, has been successfully incorporated into clinical practice, some MM patients have de novo resistance to Bz, and the majority of the remainder subsequently develop drug resistance following treatment. A significant gap in clinical care is the lack of a reliable clinical test that would predict which MM patients have or will subsequently develop Bz resistance. Thus, as Bz resistance remains a significant challenge, research efforts are needed to identify novel biomarkers of early Bz resistance, particularly when an early therapeutic intervention can be initiated. Recent advances in MM research indicate that genomic data can be extracted to identify novel biomarkers that can be utilized to select more effective, personalized treatment protocols for individual patients. Computationally integrating large patient databases with data from whole transcriptome profiling and laboratory-based models can potentially revolutionize our understanding of MM disease mechanisms. This systems-wide approach can provide rational therapeutic targets and novel biomarkers of risk and treatment response. In this review, we discuss the use of high-content datasets (predominantly gene expression profiling) to identify novel biomarkers of treatment response and resistance to Bz in MM.
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Affiliation(s)
- Deanna J Fall
- 1. Gillette Children's Specialty Healthcare, St. Paul, MN
| | - Holly Stessman
- 2. Department of Genomic Sciences, University of Washington, Seattle, WA
| | - Sagar S Patel
- 3. Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Zohar Sachs
- 3. Department of Medicine, University of Minnesota, Minneapolis, MN; ; 4. Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN
| | - Brian G Van Ness
- 5. Department of Genetics, Cell Biology, University of Minnesota, Minneapolis, MN
| | - Linda B Baughn
- 5. Department of Genetics, Cell Biology, University of Minnesota, Minneapolis, MN; ; 6. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Michael A Linden
- 6. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
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26
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João C, Costa C, Coelho I, Vergueiro MJ, Ferreira M, da Silva MG. Long-term survival in multiple myeloma. Clin Case Rep 2014; 2:173-9. [PMID: 25614805 PMCID: PMC4302619 DOI: 10.1002/ccr3.76] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Revised: 03/17/2014] [Accepted: 04/15/2014] [Indexed: 11/24/2022] Open
Abstract
Key Clinical Message The survival of multiple myeloma patients has improved very significantly over the last decade. Still median overall survival is inferior to 5 years. A small proportion of patients survive longer than 10 years. In this paper we discuss four cases illustrating the nonhomogeneous clinical presentation and evolution of this subset of patients. Surprisingly, these long survivors do not always have deep responses and some require frequent treatments, which include autologous stem cell transplantation and novel drugs. The authors discuss several aspects of these clinical histories, including treatment options, raising hypothesis on their relation with long survivorship which may be important to have in consideration when studying this subject.
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Affiliation(s)
- Cristina João
- Department of Hematology, IPOFG Lisboa, Portugal ; Clinical Research Unit, IPOFG Lisboa, Portugal
| | - Carlos Costa
- Department of Hematology, IPOFG Lisboa, Portugal
| | - Inês Coelho
- Department of Hematology, IPOFG Lisboa, Portugal
| | | | | | - Maria Gomes da Silva
- Department of Hematology, IPOFG Lisboa, Portugal ; Clinical Research Unit, IPOFG Lisboa, Portugal
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27
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Hope C, Ollar SJ, Heninger E, Hebron E, Jensen JL, Kim J, Maroulakou I, Miyamoto S, Leith C, Yang DT, Callander N, Hematti P, Chesi M, Bergsagel PL, Asimakopoulos F. TPL2 kinase regulates the inflammatory milieu of the myeloma niche. Blood 2014; 123:3305-15. [PMID: 24723682 PMCID: PMC4046426 DOI: 10.1182/blood-2014-02-554071] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/07/2014] [Indexed: 02/06/2023] Open
Abstract
Targeted modulation of microenvironmental regulatory pathways may be essential to control myeloma and other genetically/clonally heterogeneous cancers. Here we report that human myeloma-associated monocytes/macrophages (MAM), but not myeloma plasma cells, constitute the predominant source of interleukin-1β (IL-1β), IL-10, and tumor necrosis factor-α at diagnosis, whereas IL-6 originates from stromal cells and macrophages. To dissect MAM activation/cytokine pathways, we analyzed Toll-like receptor (TLR) expression in human myeloma CD14(+) cells. We observed coregulation of TLR2 and TLR6 expression correlating with local processing of versican, a proteoglycan TLR2/6 agonist linked to carcinoma progression. Versican has not been mechanistically implicated in myeloma pathogenesis. We hypothesized that the most readily accessible target in the versican-TLR2/6 pathway would be the mitogen-activated protein 3 (MAP3) kinase, TPL2 (Cot/MAP3K8). Ablation of Tpl2 in the genetically engineered in vivo myeloma model, Vκ*MYC, led to prolonged disease latency associated with plasma cell growth defect. Tpl2 loss abrogated the "inflammatory switch" in MAM within nascent myeloma lesions and licensed macrophage repolarization in established tumors. MYC activation/expression in plasma cells was independent of Tpl2 activity. Pharmacologic TPL2 inhibition in human monocytes led to dose-dependent attenuation of IL-1β induction/secretion in response to TLR2 stimulation. Our results highlight a TLR2/6-dependent TPL2 pathway as novel therapeutic target acting nonautonomously through macrophages to control myeloma progression.
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Affiliation(s)
- Chelsea Hope
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Samuel J Ollar
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Erika Heninger
- University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Ellen Hebron
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Jeffrey L Jensen
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Jaehyup Kim
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Ioanna Maroulakou
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Shigeki Miyamoto
- University of Wisconsin Carbone Cancer Center, Madison, WI; Department of Oncology, University of Wisconsin-Madison, Madison, WI
| | - Catherine Leith
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; and
| | - David T Yang
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; and
| | - Natalie Callander
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | - Peiman Hematti
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
| | | | | | - Fotis Asimakopoulos
- Department of Medicine, Division of Hematology/Oncology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI; University of Wisconsin Carbone Cancer Center, Madison, WI
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