1
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Algrin C, Pérol L, Chapiro E, Baseggio L, Maloum K, Settegrana C, Lesesve JF, Siavellis J, Delmer A, Michallet AS, Ferrant E, Feugier P, Tomowiak C, Brion A, Ghez D, Fornecker LM, Ivanoff S, Struski S, Sutton L, Radford-Weiss I, Eclache V, Lefebvre C, Leblond V, Nguyen-Khac F, Roos-Weil D. Retrospective analysis of a cohort of 41 de novo B-cell prolymphocytic leukemia patients: impact of genetics and targeted therapies (a FILO study). Haematologica 2023; 108:1691-1696. [PMID: 36546425 PMCID: PMC10230425 DOI: 10.3324/haematol.2022.282162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/14/2022] [Indexed: 11/15/2023] Open
Affiliation(s)
- Caroline Algrin
- Groupe Hospitalier Mutualiste de Grenoble, Service d'Onco-Hématologie, Grenoble.
| | - Louis Pérol
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Paris
| | - Elise Chapiro
- Sorbonne Université, Unité de Cytogénétique Hématologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France; Centre de Recherche des Cordeliers, INSERM, Drug resistance in hematological malignancies (DRIHM) Team, Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, F-75006 Paris
| | - Lucile Baseggio
- Hôpital Lyon Sud, Laboratoire d'Hématologie, Hospices Civils de Lyon, Pierre-Bénite
| | - Karim Maloum
- Sorbonne Université, Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP, Paris
| | | | | | | | - Alain Delmer
- CHU Reims, Service d'Hématologie Clinique, Reims
| | | | - Emmanuelle Ferrant
- Hôpital Lyon Sud, Service d'Hématologie Clinique, Hospices Civils de Lyon, Pierre-Bénite
| | - Pierre Feugier
- CHU Nancy, Service d'Hématologie Clinique, Vandoeuvre-lès-Nancy
| | | | - Annie Brion
- CHU J Minjoz, Service d'Hématologie Clinique, Besançon
| | - David Ghez
- Institut Gustave Roussy, Service d'Hématologie Clinique, Villejuif
| | - Luc-Matthieu Fornecker
- Service d'Hématologie, Institut de Cancérologie Strasbourg Europe (ICANS), 17 rue Albert Calmette, Strasbourg
| | - Sarah Ivanoff
- Hôpital Avicenne, Service d'Hématologie Clinique, AP-HP, Bobigny
| | - Stéphanie Struski
- IUCT Oncopole - Toulouse, Laboratoire d'hématologie/Plateau Technique Hématologie-Oncologie, Toulouse
| | | | | | - Virginie Eclache
- Hôpital Avicenne, Service d'Hématologie Biologique, AP-HP, Bobigny
| | - Christine Lefebvre
- CHU Grenoble Alpes, Laboratoire de Cytogénétique des Hémopathies, Grenoble
| | - Véronique Leblond
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Paris
| | - Florence Nguyen-Khac
- Sorbonne Université, Unité de Cytogénétique Hématologique, Hôpital Pitié-Salpêtrière, APHP, Paris, France; Centre de Recherche des Cordeliers, INSERM, Drug resistance in hematological malignancies (DRIHM) Team, Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, F-75006 Paris
| | - Damien Roos-Weil
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France; Centre de Recherche des Cordeliers, INSERM, Drug resistance in hematological malignancies (DRIHM) Team, Sorbonne Université, Université Sorbonne Paris Cité, Université Paris Descartes, Université Paris Diderot, F-75006 Paris.
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2
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Johansson P, Dierichs L, Klein-Hitpass L, Bergmann AK, Möllmann M, Menninger S, Habenberger P, Klebl B, Siveke JT, Dührsen U, Choidas A, Dürig J. Anti-leukemic effect of CDK9 inhibition in T-cell prolymphocytic leukemia. Ther Adv Hematol 2020; 11:2040620720933761. [PMID: 33117517 PMCID: PMC7570784 DOI: 10.1177/2040620720933761] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 05/19/2020] [Indexed: 12/22/2022] Open
Abstract
T-cell prolymphocytic leukemia (T-PLL) is an aggressive malignancy characterized by chemotherapy resistance and a median survival of less than 2 years. Here, we investigated the pharmacological effects of the novel highly specific cyclin-dependent kinase 9 (CDK9) inhibitor LDC526 and its clinically used derivate atuveciclib employing primary T-PLL cells in an ex vivo drug sensitivity testing platform. Importantly, all T-PLL samples were sensitive to CDK9 inhibition at submicromolar concentrations, while conventional cytotoxic drugs were found to be largely ineffective. At the cellular level LDC526 inhibited the phosphorylation at serine 2 of the RNA polymerase II C-terminal domain resulting in decreased de novo RNA transcription. LDC526 induced apoptotic leukemic cell death through down-regulating MYC and MCL1 both at the mRNA and protein level. Microarray-based transcriptomic profiling revealed that genes down-modulated in response to CDK9 inhibition were enriched for MYC and JAK-STAT targets. By contrast, CDK9 inhibition increased the expression of the tumor suppressor FBXW7, which may contribute to decreased MYC and MCL1 protein levels. Finally, the combination of atuvecliclib and the BCL2 inhibitor venetoclax exhibited synergistic anti-leukemic activity, providing the rationale for a novel targeted-agent-based treatment of T-PLL.
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Affiliation(s)
| | - Laura Dierichs
- Institute for Developmental Cancer Therapeutics, West German Cancer Center, University Hospital Essen, Essen, Germany
- Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK, partner site Essen) and German Cancer Research Center, DKFZ, Heidelberg, Germany
| | - Ludger Klein-Hitpass
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anke K. Bergmann
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Michael Möllmann
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | | | - Bert Klebl
- Lead Discovery Center GmbH, Dortmund, Germany
| | - Jens T. Siveke
- Institute for Developmental Cancer Therapeutics, West German Cancer Center, University Hospital Essen, Essen, Germany
- Division of Solid Tumor Translational Oncology, German Cancer Consortium (DKTK, partner site Essen) and German Cancer Research Center, DKFZ, Heidelberg, Germany
| | - Ulrich Dührsen
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | - Jan Dürig
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
- German Cancer Consortium (DKTK, partner site Essen) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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3
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Intrathecal alemtuzumab: a potential treatment of refractory leptomeningeal T-cell prolymphocytic leukemia. Blood Adv 2020; 3:3333-3336. [PMID: 31698446 DOI: 10.1182/bloodadvances.2019000289] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/27/2019] [Indexed: 11/20/2022] Open
Abstract
Key Points
This is the first report of successful treatment of therapy-resistant leptomeningeal T-PLL with intrathecal alemtuzumab. Intrathecal alemtuzumab is a potentially safe and efficacious therapeutic alternative for treatment of leptomeningeal T-PLL.
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4
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Mulvey E, Ruan J. Biomarker-driven management strategies for peripheral T cell lymphoma. J Hematol Oncol 2020; 13:59. [PMID: 32448357 PMCID: PMC7245625 DOI: 10.1186/s13045-020-00889-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 05/01/2020] [Indexed: 01/08/2023] Open
Abstract
Peripheral T cell lymphomas are heterogeneous diseases which remain treatment challenges. Recent advances in molecular and genomic profiling have provided unprecedented insight into disease pathogenesis driven by distinct cells of origins and molecular pathways. The discovery and clinical application of molecular biomarkers in PTCL subtypes has the potential to transform personalized care for patients with PTCL in diagnosis, prognosis, and therapy. Targeting CD30+ PTCL with the antibody-drug conjugate brentuximab vedotin in the relapsed setting and in combination with chemotherapy in the frontline setting has improved patient survivals. Epigenetic modifying agents, including HDAC inhibitors and hypomethylating agents, have demonstrated broad clinical efficacy and durability and are in clinical development for combination strategies for both relapsed and frontline settings. Wide-ranging novel agents targeting critical intracellular pathways and tumor microenvironment are in active exploration to define clinical activities. This review summarizes PTCL-specific biomarkers which are increasingly incorporated in clinical practice to guide precision diagnosis and personalized treatment.
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MESH Headings
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Antineoplastic Agents, Immunological/therapeutic use
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor/antagonists & inhibitors
- Consolidation Chemotherapy
- Disease Management
- Enzyme Inhibitors/therapeutic use
- Epigenesis, Genetic/drug effects
- Forecasting
- Humans
- Immunoconjugates/pharmacology
- Immunoconjugates/therapeutic use
- Leukemia-Lymphoma, Adult T-Cell/drug therapy
- Lymphoma, Extranodal NK-T-Cell/drug therapy
- Lymphoma, Large-Cell, Anaplastic/drug therapy
- Lymphoma, T-Cell, Peripheral/drug therapy
- Maintenance Chemotherapy
- Molecular Targeted Therapy/methods
- Neoplasm Proteins/antagonists & inhibitors
- Precision Medicine/methods
- Precision Medicine/trends
- Signal Transduction/drug effects
- Therapies, Investigational/methods
- Tumor Microenvironment/drug effects
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Affiliation(s)
- Erin Mulvey
- Meyer Cancer Center, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA
| | - Jia Ruan
- Meyer Cancer Center, Weill Cornell Medicine, 1305 York Avenue, 7th Floor, New York, NY, 10021, USA.
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5
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Staber PB, Herling M, Bellido M, Jacobsen ED, Davids MS, Kadia TM, Shustov A, Tournilhac O, Bachy E, Zaja F, Porkka K, Hoermann G, Simonitsch-Klupp I, Haferlach C, Kubicek S, Mayerhoefer ME, Hopfinger G, Jaeger U, Dearden C. Consensus criteria for diagnosis, staging, and treatment response assessment of T-cell prolymphocytic leukemia. Blood 2019; 134:1132-1143. [PMID: 31292114 PMCID: PMC7042666 DOI: 10.1182/blood.2019000402] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 06/26/2019] [Indexed: 12/18/2022] Open
Abstract
T-cell prolymphocytic leukemia (T-PLL) is a rare, mature T-cell neoplasm with a heterogeneous clinical course. With the advent of novel treatment options that will potentially change the management of patients with T-PLL, it has become necessary to produce consensus guidelines for the design and conduct of clinical trials. The T-PLL International Study group (TPLL-ISG) set out to define standardized criteria for diagnosis, treatment indication, and evaluation of response. These criteria will facilitate comparison of results from clinical trials in T-PLL, and will thus support clinical decision making, as well as the approval of new therapeutics by healthcare authorities.
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Affiliation(s)
- Philipp B Staber
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Marco Herling
- Department of Internal Medicine, Center for Integrated Oncology Aachen-Bonn-Cologne-Duesseldorf, and
- Excellence Cluster for Cellular Stress Response and Aging-Associated Diseases, University of Cologne, Cologne, Germany
- Center for Molecular Medicine, University of Cologne, Cologne, Germany
| | - Mar Bellido
- Hematology Department, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Eric D Jacobsen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Matthew S Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Tapan Mahendra Kadia
- Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston, TX
| | - Andrei Shustov
- Seattle Cancer Care Alliance, University of Washington, Seattle, WA
| | | | - Emmanuel Bachy
- Department of Hematology, Hospices Civils de Lyon, Lyon, France
| | - Francesco Zaja
- S.C. Ematologia Azienda Sanitaria Universitaria Integrata, Trieste, Italy
| | - Kimmo Porkka
- Department of Hematology, Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | - Gregor Hoermann
- Central Institute of Medical and Chemical Laboratory Diagnostics, University Hospital Innsbruck, Innsbruck, Austria
- Department of Laboratory Medicine and
| | | | | | - Stefan Kubicek
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
- Christian Doppler Laboratory for Chemical Epigenetics and Anti-Infectives, CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Marius E Mayerhoefer
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Georg Hopfinger
- Division of Blood and Marrow Transplantation, Department of Medicine I, Medical University of Vienna, Vienna, Austria; and
| | - Ulrich Jaeger
- Division of Hematology and Hemostaseology, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Claire Dearden
- The Royal Marsden Hospital, NHS Foundation Trust, London, United Kingdom
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6
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Schlichte MJ, Sheu JC, Cohen DN, Rosen T. Indurated erythema of the neck and upper back. Int J Dermatol 2019; 58:1255-1257. [PMID: 31148147 DOI: 10.1111/ijd.14491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 04/01/2019] [Accepted: 04/24/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Megan J Schlichte
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA
| | | | - Daniel N Cohen
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Theodore Rosen
- Department of Dermatology, Baylor College of Medicine, Houston, TX, USA.,Michael E. DeBakey VA Medical Center, Houston, TX, USA
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7
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EBMT prospective observational study on allogeneic hematopoietic stem cell transplantation in T-prolymphocytic leukemia (T-PLL). Bone Marrow Transplant 2019; 54:1391-1398. [PMID: 30664723 DOI: 10.1038/s41409-019-0448-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/27/2018] [Accepted: 01/04/2019] [Indexed: 12/11/2022]
Abstract
Preliminary data suggest that allogeneic stem cell transplantation (allo-SCT) may be effective in T-prolymphocytic leukemia (T-PLL). The purpose of the present observational study was to assess the outcome of allo-SCT in patients aged 65 years or younger with a centrally confirmed diagnosis of T-PLL. Patients were consecutively registered with the EBMT at the time of transplantation and followed by routine EBMT monitoring but with an extended dataset. Between 2007 and 2012, 37 evaluable patients (median age 56 years) were accrued. Pre-treatment contained alemtuzumab in 95% of patients. Sixty-two percent were in complete remission (CR) at the time of allo-SCT. Conditioning contained total body irradiation with 6 Gy or more (TBI6) in 30% of patients. With a median follow-up of 50 months, the 4-year non-relapse mortality, relapse incidence, progression-free (PFS) and overall survival were 32, 38, 30 and 42%, respectively. By univariate analysis, TBI6 in the conditioning was the only significant predictor for a low relapse risk, and an interval between diagnosis and allo-SCT of more than 12 months was associated with a lower NRM. This study confirms for the first time prospectively that allo-SCT can provide long-term disease control in a sizable albeit limited proportion of patients with T-PLL.
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8
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Hew J, Pham D, Matthews Hew T, Minocha V. A Novel Treatment With Obinutuzumab-Chlorambucil in a Patient With B-Cell Prolymphocytic Leukemia: A Case Report and Review of the Literature. J Investig Med High Impact Case Rep 2018; 6:2324709618788674. [PMID: 30038912 PMCID: PMC6050796 DOI: 10.1177/2324709618788674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 06/20/2018] [Accepted: 06/23/2018] [Indexed: 12/25/2022] Open
Abstract
We report the case of a patient with B-cell prolymphocytic leukemia who was
successfully treated with the novel humanized monoclonal antibody obinutuzumab.
This patient was previously treated with the combination of rituximab and
bendamustine and had recurrent infusion reactions. Her treatment with rituximab
and bendamustine was discontinued when she developed disease progression after 3
cycles of therapy. She was then treated with obinutuzumab 1000 mg on day 1 of
every cycle and chlorambucil 0.5 mg/kg on days 1 and 15 every 28 days to which
she had greater tolerability. After 4 cycles of treatment, she had resolution of
her clinical symptoms, massive splenomegaly, and normalization of her white
blood cell count.
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Affiliation(s)
- Jason Hew
- University of Florida, Jacksonville, FL, USA
| | - Dat Pham
- University of Florida, Jacksonville, FL, USA
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9
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Jain P, Aoki E, Keating M, Wierda WG, O'Brien S, Gonzalez GN, Ferrajoli A, Jain N, Thompson PA, Jabbour E, Kanagal-Shamanna R, Pierce S, Alousi A, Hosing C, Khouri I, Estrov Z, Cortes J, Kantarjian H, Ravandi F, Kadia TM. Characteristics, outcomes, prognostic factors and treatment of patients with T-cell prolymphocytic leukemia (T-PLL). Ann Oncol 2018; 28:1554-1559. [PMID: 28379307 DOI: 10.1093/annonc/mdx163] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Indexed: 11/13/2022] Open
Abstract
Background T-cell prolymphocytic leukemia (T-PLL) is a rare and aggressive disease. In this study, we report our experience from 119 patients with T-PLL. Patients and methods We reviewed the clinico-pathologic records of 119 consecutive patients with T-PLL, who presented to our institution between 1990 and 2016. Results One hundred and nineteen patients with T-PLL were analysed. Complex karyotype and aberrations in chromosome 14 were seen in 65% and 52% patients, respectively. Seventy-five patients (63%) were previously untreated and 43 (37%) were initially treated outside our institution. Sixty-three previously untreated patients (84%) received frontline therapies. Overall, 95 patients (80%) have died. Median overall survival (OS) from diagnosis was 19 months [95% confidence interval (CI) 16-26 months]. Using recursive partitioning (RP), we found that patients with hemoglobin < 9.3 g/dl, lactate dehydrogenase (LDH) ≥ 1668 IU/l, white blood cell ≥ 208 K/l and β2M ≥ 8 mg/l had significantly inferior OS and patients with hemoglobin < 9.3 g/dl had inferior progression-free survival (PFS). In multivariate analysis, we identified that presence of pleural effusion [hazard ratio (HR) 2.08 (95% CI 1.11-3.9); P = 0.02], high LDH (≥ 1668 IU/l) [HR 2.5 (95% CI 1.20-4.24); P < 0.001)], and low hemoglobin (< 9.3 g/dl) [HR 0.33 (95% CI 0.14-0.75); P = 0.008] were associated with shorter OS. Fifty-five previously untreated patients received treatment with an alemtuzumab-based regimen (42 monotherapy and 13 combination with pentostatin). Overall response rate, complete remission rate (CR) for single-agent alemtuzumab and alemtuzumab combined with pentostatin were 83%, 66% and 82%, 73% respectively. In patients who achieved initial CR, stem cell transplantation was not associated with longer PFS and OS. Conclusion Outcomes in T-PLL remain poor. Multicenter collaborative effort is required to conduct prospective studies.
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Affiliation(s)
- P Jain
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - E Aoki
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - M Keating
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - W G Wierda
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - S O'Brien
- Division of Hematology/Oncology, Chao Family Comprehensive Cancer Center, UC Irvine, Irvine
| | | | - A Ferrajoli
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - N Jain
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - P A Thompson
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - E Jabbour
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | | | - S Pierce
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - A Alousi
- Stem Cell Transplantation, The MD Anderson Cancer Center, Houston, USA
| | - C Hosing
- Stem Cell Transplantation, The MD Anderson Cancer Center, Houston, USA
| | - I Khouri
- Stem Cell Transplantation, The MD Anderson Cancer Center, Houston, USA
| | - Z Estrov
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - J Cortes
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - H Kantarjian
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - F Ravandi
- Department of Leukemia, The MD Anderson Cancer Center, Houston
| | - T M Kadia
- Department of Leukemia, The MD Anderson Cancer Center, Houston
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10
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Johansson P, Klein-Hitpass L, Choidas A, Habenberger P, Mahboubi B, Kim B, Bergmann A, Scholtysik R, Brauser M, Lollies A, Siebert R, Zenz T, Dührsen U, Küppers R, Dürig J. SAMHD1 is recurrently mutated in T-cell prolymphocytic leukemia. Blood Cancer J 2018; 8:11. [PMID: 29352181 PMCID: PMC5802577 DOI: 10.1038/s41408-017-0036-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/05/2017] [Accepted: 10/12/2017] [Indexed: 01/19/2023] Open
Abstract
T-cell prolymphocytic leukemia (T-PLL) is an aggressive malignancy with a median survival of the patients of less than two years. Besides characteristic chromosomal translocations, frequent mutations affect the ATM gene, JAK/STAT pathway members, and epigenetic regulators. We here performed a targeted mutation analysis for 40 genes selected from a RNA sequencing of 10 T-PLL in a collection of 28 T-PLL, and an exome analysis of five further cases. Nonsynonymous mutations were identified in 30 of the 40 genes, 18 being recurrently mutated. We identified recurrently mutated genes previously unknown to be mutated in T-PLL, which are SAMHD1, HERC1, HERC2, PRDM2, PARP10, PTPRC, and FOXP1. SAMHD1 regulates cellular deoxynucleotide levels and acts as a potential tumor suppressor in other leukemias. We observed destructive mutations in 18% of cases as well as deletions in two further cases. Taken together, we identified additional genes involved in JAK/STAT signaling (PTPRC), epigenetic regulation (PRDM2), or DNA damage repair (SAMHD1, PARP10, HERC1, and HERC2) as being recurrently mutated in T-PLL. Thus, our study considerably extends the picture of pathways involved in molecular pathogenesis of T-PLL and identifies the tumor suppressor gene SAMHD1 with ~20% of T-PLL affected by destructive lesions likely as major player in T-PLL pathogenesis.
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Affiliation(s)
- Patricia Johansson
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany. .,Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Ludger Klein-Hitpass
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | | | | | - Bijan Mahboubi
- Center for Drug Discovery, Department of Pediatrics, Emory Center for AIDS Research, Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Baek Kim
- Center for Drug Discovery, Department of Pediatrics, Emory Center for AIDS Research, Emory University, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Anke Bergmann
- Institute for Human Genetics, Christian-Albrechts-University Kiel and University Hospital Schleswig Holstein, Kiel, Germany
| | - René Scholtysik
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martina Brauser
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anna Lollies
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Reiner Siebert
- Institute for Human Genetics, Christian-Albrechts-University Kiel and University Hospital Schleswig Holstein, Kiel, Germany.,Institute of Human Genetics, University of Ulm and University Hospital of Ulm, Ulm, Germany
| | - Thorsten Zenz
- Department of Molecular Therapy in Haematology and Oncology, National Center for Tumor Diseases and German Cancer Research Center, Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Ulrich Dührsen
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ralf Küppers
- Institute of Cell Biology (Cancer Research), University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Jan Dürig
- Department of Hematology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
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11
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T-cell prolymphocytic leukemia in an adolescent with ataxia-telangiectasia: novel approach with a JAK3 inhibitor (tofacitinib). Blood Adv 2017; 1:2724-2728. [PMID: 29296924 DOI: 10.1182/bloodadvances.2017010470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 11/13/2017] [Indexed: 02/02/2023] Open
Abstract
A 19-year-old ataxia-telangiectasia patient with T-cell prolymphocytic leukemia harbored 2 JAK3-activating hotspot mutations.The patient suffered toxicities with chemotherapy, but demonstrated a clinical response to novel use of a JAK3 inhibitor (tofacitinib).
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12
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Abstract
PURPOSE OF REVIEW We aimed to produce a comprehensive update on clinical and biological data regarding two rare lymphoid neoplasms, B and T prolymphocytic leukemias, and assess therapeutic management in the light of new molecular insights and the advent of targeted therapies. RECENT FINDINGS B cell prolymphocytic leukemia (B-PLL) diagnosis remains challenging in the absence of clear immunophenotypic or cytogenetic signature and overlap with mantle cell lymphoma. New molecular defects have been identified in T cell prolymphocytic leukemia (T-PLL), especially in the JAK STAT pathway. Like in chronic lymphocytic leukemia (CLL), B-PLL treatment depends on the presence of TP53 dysfunction. In T-PLL, alemtuzumab still remains the standard of care. Allogeneic transplantation is the only curable option. Thanks to reduced intensity conditioning regimens, it has become accessible to a larger number of patients. PLL prognosis remains poor with conventional therapies. However, great advances in the understanding of both T- and B-PLL pathogenesis lead to promising new therapeutic agents.
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Hu Z, Medeiros LJ, Fang L, Sun Y, Tang Z, Tang G, Sun T, Quesada AE, Hu S, Wang SA, Pei L, Lu X. Prognostic significance of cytogenetic abnormalities in T-cell prolymphocytic leukemia. Am J Hematol 2017; 92:441-447. [PMID: 28194886 DOI: 10.1002/ajh.24679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/30/2017] [Accepted: 02/08/2017] [Indexed: 01/04/2023]
Abstract
T-cell prolymphocytic leukemia (T-PLL) is an aggressive mature T-cell neoplasm. The most common cytogenetic abnormality associated with T-PLL is inv(14)(q11.2q32) involving TCL1, but other abnormalities also have been reported. In this study, we correlated cytogenetic abnormalities with clinical outcome in 97 T-PLL patients, including 66 men and 31 women with a median age of 63 years (range, 34-81). Twenty-seven patients had a normal karyotype (NK), one had two chromosomal aberrations, and 69 had a complex karyotype (CK). Patients with a CK had poorer overall survival (OS) than patients with a NK (P = .0016). In the CK group, the most common aberrations involved 14q (n = 45) and 8q (n = 38). Additional deletions of chromosomes 17p, 11q, 6q, 12p, 13q were observed frequently. No individual cytogenetic abnormality impacted OS. Patients with ≥5 aberrations had an OS of 11 months versus 22 months in patients with <5 aberrations (P = 0.0132). Fluorescence in situ hybridization for TCL1 successfully performed in 27 cases showed rearrangement in 8/10 (80%) NK versus 16/17 (94%) CK cases. OS of patients with TCL1 rearrangement and/or 14q aberrations was not significantly different from patients without TCL1 rearrangement and 14q aberrations (P = .3467). Patients with refractory disease showed worse OS in both the NK and CK groups (P = .0014 and P < .0001, respectively), compared with patients who achieved remission but then relapsed. Stem cell transplantation did not appear to improve OS regardless of karyotype complexity. In conclusion, patients with T-PLL often have a CK which is a poor prognostic factor, particularly in patients with ≥5 cytogenetic aberrations.
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Affiliation(s)
- Zhihong Hu
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - L. Jeffrey Medeiros
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Lianghua Fang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
- Department of OncologyJiangsu Province Hospital of Traditional Chinese MedicineNanjing Jiangsu China
| | - Yi Sun
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Zhenya Tang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Guilin Tang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Tsieh Sun
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Andres E. Quesada
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Shimin Hu
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Sa A. Wang
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Lin Pei
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
| | - Xinyan Lu
- Department of HematopathologyThe University of Texas MD Anderson Cancer CenterHouston Texas USA
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Senchak J, Pickens P. Brentuximab Vedotin Therapy for Cutaneous Lesions in T-Prolymphocytic Leukemia: A Case Report. Hematol Rep 2016; 8:6593. [PMID: 27757215 PMCID: PMC5062622 DOI: 10.4081/hr.2016.6593] [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: 05/10/2016] [Accepted: 08/30/2016] [Indexed: 11/23/2022] Open
Abstract
We present an 88-year-old male with simultaneous T-cell prolymphocytic leukemia and stable smoldering myeloma with excellent initial response to three months of alemtuzumab. The patient relapsed at twelve months with severe cutaneous disease. Biopsy of a representative plaque demonstrated CD30 positivity in rare malignant lymphocytes. The patient demonstrated no response to reintroduction with a full course of alemtuzumab. He was therefore treated with brentuximab vedotin, resulting in partial remission of skin involvement that persisted for three months.
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Affiliation(s)
- Jordan Senchak
- Drexel University College of Medicine, Philadelphia , Abington, PA, USA
| | - Peter Pickens
- Department of Hematology/Oncology, Abington Memorial Hospital , Abington, PA, USA
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