1
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Circular RNA Expression Signatures Provide Promising Diagnostic and Therapeutic Biomarkers for Chronic Lymphocytic Leukemia. Cancers (Basel) 2023; 15:cancers15051554. [PMID: 36900344 PMCID: PMC10000909 DOI: 10.3390/cancers15051554] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a known hematologic malignancy associated with a growing incidence and post-treatment relapse. Hence, finding a reliable diagnostic biomarker for CLL is crucial. Circular RNAs (circRNAs) represent a new class of RNA involved in many biological processes and diseases. This study aimed to define a circRNA-based panel for the early diagnosis of CLL. To this point, the list of the most deregulated circRNAs in CLL cell models was retrieved using bioinformatic algorithms and applied to the verified CLL patients' online datasets as the training cohort (n = 100). The diagnostic performance of potential biomarkers represented in individual and discriminating panels, was then analyzed between CLL Binet stages and validated in individual sample sets I (n = 220) and II (n = 251). We also estimated the 5-year overall survival (OS), introduced the cancer-related signaling pathways regulated by the announced circRNAs, and provided a list of possible therapeutic compounds to control the CLL. These findings show that the detected circRNA biomarkers exhibit better predictive performance compared to current validated clinical risk scales, and are applicable for the early detection and treatment of CLL.
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2
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Yu T, Qiao C, Lv M, Tang L. Novel anti-CD38 humanized mAb SG003 possessed enhanced cytotoxicity in lymphoma than Daratumumab via antibody-dependent cell-mediated cytotoxicity. BMC Biotechnol 2019; 19:28. [PMID: 31118070 PMCID: PMC6530185 DOI: 10.1186/s12896-019-0524-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/07/2019] [Indexed: 12/02/2022] Open
Abstract
Background In vivo use of monoclonal antibodies has become routine clinical practice in the treatment of human cancer. CD38 is an attractive target, because it has double roles, as a receptor and an ectoenzyme. Daratumumab, an anti-CD38 antibody, is currently in the clinical trials for multiple myeloma. Results Here we obtained a humanized anti-CD38 antibody, SG003, using SDR-grafting method. SG003 possessed stronger antigen binding activity than Daratumumab, and its epitope was far from that of Daratumumab, an anti-CD38 antibody currently in the clinical trials for multiple myeloma; besides, SG003 showed enhanced antibody-dependent cell-mediated cytotoxicity function and in vivo inhibitory efficacy of tumor growth in xenograft mice model. Conclusion SG003 seemed to be a good option to improve the curative effect of CD38-related cancers.
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Affiliation(s)
- Tao Yu
- Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Chunxia Qiao
- State key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing, 100850, China
| | - Ming Lv
- Sumgen Biotech co., Ltd., Hangzhou, 310000, China
| | - Luqun Tang
- Department of Radiation Oncology, the Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, China.
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3
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Cavallari M, Cavazzini F, Bardi A, Volta E, Melandri A, Tammiso E, Saccenti E, Lista E, Quaglia FM, Urso A, Laudisi M, Menotti E, Formigaro L, Dabusti M, Ciccone M, Tomasi P, Negrini M, Cuneo A, Rigolin GM. Biological significance and prognostic/predictive impact of complex karyotype in chronic lymphocytic leukemia. Oncotarget 2018; 9:34398-34412. [PMID: 30344950 PMCID: PMC6188145 DOI: 10.18632/oncotarget.26146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 09/01/2018] [Indexed: 12/21/2022] Open
Abstract
The complex karyotype (CK) is an established negative prognostic marker in a number of haematological malignancies. After the introduction of effective mitogens, a growing body of evidence has suggested that the presence of 3 or more aberrations by conventional banding analysis (CBA) is associated with an unfavorable outcome in chronic lymphocytic leukemia (CLL). Thus, the importance of CBA was recognized by the 2018 guidelines of the International Workshop on CLL, which proposed the introduction of CBA in clinical trials to validate the value of karyotype aberrations. Indeed, a number of observational studies showed that cytogenetic aberrations and, particularly, the CK may have a negative independent impact on objective outcome measures (i.e. time to first treatment, progression free survival, time to chemorefractoriness and overall survival) both in patients treated with chemoimmunotherapy and, possibly, in patients receiving novel mechanism-based treatment. Here, we set out to present the scientific evidence supporting the significance of CK as a prognostic marker in CLL and to discuss the biological basis showing that the CK is a consequence of genomic instability.
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Affiliation(s)
- Maurizio Cavallari
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Francesco Cavazzini
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Antonella Bardi
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Eleonora Volta
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Aurora Melandri
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Elisa Tammiso
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Elena Saccenti
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Enrico Lista
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Francesca Maria Quaglia
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Antonio Urso
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Michele Laudisi
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Elisa Menotti
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Luca Formigaro
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Melissa Dabusti
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Maria Ciccone
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Paolo Tomasi
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Massimo Negrini
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Antonio Cuneo
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
| | - Gian Matteo Rigolin
- Hematology Section, Department of Medical Sciences, Azienda Ospedaliero-Universitaria, Arcispedale S. Anna, University of Ferrara, Ferrara, Italy
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4
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Morabito F, Shanafelt TD, Gentile M, Reda G, Mauro FR, Rossi D, Di Renzo N, Molica S, Angrilli F, Chiarenza A, Cutrona G, Chaffee KG, Parikh SA, Tripepi G, D'Arrigo G, Vigna E, Recchia AG, Cortelezzi A, Gaidano G, Di Raimondo F, Fais F, Foà R, Neri A, Ferrarini M. Immunoglobulin heavy chain variable region gene and prediction of time to first treatment in patients with chronic lymphocytic leukemia: Mutational load or mutational status? Analysis of 1003 cases. Am J Hematol 2018; 93:E216-E219. [PMID: 29984867 DOI: 10.1002/ajh.25206] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 06/28/2018] [Indexed: 01/04/2023]
Affiliation(s)
- Fortunato Morabito
- Biotechnology Research Unit, Azienda Sanitaria Provinciale di Cosenza Aprigliano (CS) Italy
| | - Tait D Shanafelt
- Department of Medicine, Division of Hematology Stanford University California
| | - Massimo Gentile
- Hematology Unit, Department of Onco‐hematology A.O. of Cosenza Cosenza Italy
| | - Gianluigi Reda
- Hematology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan Italy
| | - Francesca Romana Mauro
- Hematology, Department of Cellular Biotechnologies and Hematology ‘Sapienza’ University Rome Italy
| | - Davide Rossi
- Oncology Institute of Southern Switzerland and Institute of Oncology Research Bellinzona Switzerland
| | | | - Stefano Molica
- Department of Oncology and Haematology Pugliese‐Ciaccio Hospital Catanzaro Italy
| | | | - Annalisa Chiarenza
- Division of Hematology AOU Policlinico‐OVE, University of Catania Catania Italy
| | - Giovanna Cutrona
- UO Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa Italy
| | - Kari G. Chaffee
- Division of Biomedical Statistics and Informatics Mayo Clinic Rochester Minnesota
| | - Sameer A. Parikh
- Department of Internal Medicine, Division of Hematology Mayo Clinic Rochester Minnesota
| | - Giovanni Tripepi
- Consiglio Nazionale delle Ricerche, Istituto di Biomedicina ed Immunologia Molecolare Reggio Calabria Italy
| | - Graziella D'Arrigo
- Consiglio Nazionale delle Ricerche, Istituto di Biomedicina ed Immunologia Molecolare Reggio Calabria Italy
| | - Ernesto Vigna
- Hematology Unit, Department of Onco‐hematology A.O. of Cosenza Cosenza Italy
| | - Anna Grazia Recchia
- Biotechnology Research Unit, Azienda Sanitaria Provinciale di Cosenza Aprigliano (CS) Italy
| | - Agostino Cortelezzi
- Hematology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan Italy
| | - Gianluca Gaidano
- Division of Haematology, Department of Translational Medicine Università del Piemonte Orientale Novara Italy
| | | | - Franco Fais
- UO Molecular Pathology, IRCCS Ospedale Policlinico San Martino, Genoa Italy
- Department of Experimental Medicine University of Genova Genoa Italy
| | - Robin Foà
- Hematology, Department of Cellular Biotechnologies and Hematology ‘Sapienza’ University Rome Italy
| | - Antonino Neri
- Hematology Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milan Italy
| | - Manlio Ferrarini
- Department of Experimental Medicine University of Genova Genoa Italy
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5
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Mele S, Devereux S, Pepper AG, Infante E, Ridley AJ. Calcium-RasGRP2-Rap1 signaling mediates CD38-induced migration of chronic lymphocytic leukemia cells. Blood Adv 2018; 2:1551-1561. [PMID: 29970392 PMCID: PMC6039665 DOI: 10.1182/bloodadvances.2017014506] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/24/2018] [Indexed: 01/08/2023] Open
Abstract
CD38 is a transmembrane exoenzyme that is associated with poor prognosis in chronic lymphocytic leukemia (CLL). High CD38 levels in CLL cells are linked to increased cell migration, but the molecular basis is unknown. CD38 produces nicotinic acid adenine dinucleotide phosphate and adenosine 5'-diphosphate-ribose, both of which can act to increase intracellular Ca2+ levels. Here we show that CD38 expression increases basal intracellular Ca2+ levels and stimulates CLL cell migration both with and without chemokine stimulation. We find that CD38 acts via intracellular Ca2+ to increase the activity of the Ras family GTPase Rap1, which is in turn regulated by the Ca2+-sensitive Rap1 guanine-nucleotide exchange factor RasGRP2. Both Rap1 and RasGRP2 are required for CLL cell migration, and RasGRP2 is polarized in primary CLL cells with high CD38 levels. These results indicate that CD38 promotes RasGRP2/Rap1-mediated CLL cell adhesion and migration by increasing intracellular Ca2+ levels.
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Affiliation(s)
- Silvia Mele
- Randall Centre for Cell and Molecular Biophysics, and
- School of Cancer Sciences, King's College London, London, United Kingdom
| | - Stephen Devereux
- School of Cancer Sciences, King's College London, London, United Kingdom
| | - Andrea G Pepper
- School of Cancer Sciences, King's College London, London, United Kingdom
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom; and
| | | | - Anne J Ridley
- Randall Centre for Cell and Molecular Biophysics, and
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, United Kingdom
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6
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Jain P, Nogueras González GM, Kanagal-Shamanna R, Rozovski U, Sarwari N, Tam C, Wierda WG, A. Thompson P, Jain N, Luthra R, Quesada A, Sanchez-Petitto G, Ferrajoli A, Burger J, Kantarjian H, Cortes J, O’Brien S, Keating MJ, Estrov Z. The absolute percent deviation of IGHV mutation rather than a 98% cut-off predicts survival of chronic lymphocytic leukaemia patients treated with fludarabine, cyclophosphamide and rituximab. Br J Haematol 2018; 180:33-40. [PMID: 29164608 PMCID: PMC5745295 DOI: 10.1111/bjh.15018] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 09/19/2017] [Indexed: 01/03/2023]
Abstract
The degree of somatic hypermutation, determined as percent deviation of immunoglobulin heavy chain gene variable region sequence from the germline (IGHV%), is an important prognostic factor in chronic lymphocytic leukaemia (CLL). Currently, a cut-off of 2% deviation or 98% sequence identity to germline in IGHV sequence is routinely used to dichotomize CLL patients into mutated and unmutated groups. Because dissimilar IGHV% cut-offs of 1-5% were identified in different studies, we wondered whether no cut-off should be applied and IGHV% treated as a continuous variable. We analysed the significance of IGHV% in 203 CLL patients enrolled on the original frontline fludarabine, cyclophosphamide and rituximab (FCR) trial with a median of 10 years follow-up. Using the Cox Proportional Hazard model, IGHV% was identified as a continuous variable that is significantly associated with progression-free (PFS) and overall survival (OS) (P < 0·001). Furthermore, we validated this finding in 323 patients treated with FCR off-protocol and in the total cohort (n = 535). Multivariate analysis revealed a continuous trend. Higher IGHV% levels were incrementally associated with favorable PFS and OS in both FCR-treated cohorts (P < 0·001, both cohorts). Taken together, our data suggest that IGHV% is a continuous variable in CLL patients treated with FCR.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers
- Cyclophosphamide/administration & dosage
- Female
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Male
- Middle Aged
- Mutation
- Neoplasm Staging
- Prognosis
- Proportional Hazards Models
- Rituximab/administration & dosage
- Treatment Outcome
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
- Young Adult
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Affiliation(s)
- Preetesh Jain
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Rashmi Kanagal-Shamanna
- Department of Hematopathology, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Uri Rozovski
- Davidoff Cancer Center, Beilinson Campus, Tel-Aviv University, Tel-Aviv, Israel
| | - Nawid Sarwari
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - William G. Wierda
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Philip A. Thompson
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Nitin Jain
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Rajyalakshmi Luthra
- Department of Hematopathology, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Andres Quesada
- Department of Hematopathology, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gabriela Sanchez-Petitto
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alessandra Ferrajoli
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jan Burger
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hagop Kantarjian
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jorge Cortes
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Susan O’Brien
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Chao Family Comprehensive Cancer Center, University of Irvine, Irvine, California, USA
| | - Michael J. Keating
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Zeev Estrov
- Department of Leukemia, and, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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7
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Stauder R, Eichhorst B, Hamaker ME, Kaplanov K, Morrison VA, Österborg A, Poddubnaya I, Woyach JA, Shanafelt T, Smolej L, Ysebaert L, Goede V. Management of chronic lymphocytic leukemia (CLL) in the elderly: a position paper from an international Society of Geriatric Oncology (SIOG) Task Force. Ann Oncol 2017; 28:218-227. [PMID: 27803007 DOI: 10.1093/annonc/mdw547] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is > 70 years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living and social support. Comorbidity scoring and geriatric assessment tools are helpful in achieving such multidimensional evaluation in a systematic manner. The introduction of new drugs including novel monoclonal antibodies and kinase inhibitors offers enhanced opportunities for the treatment of elderly patients with CLL. This position paper of a Task Force of the International Society of Geriatric Oncology (SIOG) reviews currently available evidence relevant to such patients. All types of elderly patient (i.e. chronological age > 65-70 years) are considered, from robust (fit) to vulnerable (unfit) to the terminally ill. Among the topics covered are the following: (i) the relationship between chronological age, prognosis and survival, (ii) assessment of biological aging, (iii) biological age as a determinant of treatment feasibility and tolerance and (iv) tailoring of both first and further-line treatment to the circumstances of the individual patient.
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Affiliation(s)
- R Stauder
- Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, Innsbruck, Austria
| | - B Eichhorst
- Department I of Internal Medicine, University Hospital Cologne, Center of Integrated Oncology (CIO) Cologne-Bonn, Cologne, Germany
| | - M E Hamaker
- Department of Geriatric Medicine, Diakonessenhuis, Utrecht, The Netherlands
| | - K Kaplanov
- Department of Hematology, Volgograd Regional Clinical Oncology Center, Volgograd, Russian Federation
| | - V A Morrison
- University of Minnesota, Hennepin County Medical Center, Minneapolis, USA
| | - A Österborg
- Karolinska University Hospital and Institute, Stockholm, Sweden
| | - I Poddubnaya
- Russian Medical Academy for Postgraduate Education, Moscow, Russian Federation
| | - J A Woyach
- Department of Internal Medicine, Ohio State University, Ohio, USA
| | - T Shanafelt
- Department of Hematology and Oncology, Mayo Clinic, Rochester, USA
| | - L Smolej
- 4th Department of Internal Medicine-Hematology, University Hospital and Charles University Faculty of Medicine, Hradec Králové, Czech Republic
| | - L Ysebaert
- Hematology Department, IUC Toulouse-Oncopole, Toulouse, France
| | - V Goede
- Department I of Internal Medicine, University Hospital Cologne, Center of Integrated Oncology (CIO) Cologne-Bonn, Cologne, Germany
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8
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Murphy EJ, Neuberg DS, Rassenti LZ, Hayes G, Redd R, Emson C, Li K, Brown JR, Wierda WG, Turner S, Greaves AW, Zent CS, Byrd JC, McConnel C, Barrientos J, Kay N, Hellerstein MK, Chiorazzi N, Kipps TJ, Rai KR. Leukemia-cell proliferation and disease progression in patients with early stage chronic lymphocytic leukemia. Leukemia 2017; 31:1348-1354. [PMID: 28115735 PMCID: PMC5462857 DOI: 10.1038/leu.2017.34] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/23/2016] [Accepted: 01/11/2017] [Indexed: 01/23/2023]
Abstract
The clinical course of patients with recently diagnosed early stage chronic lymphocytic leukemia (CLL) is highly variable. We examined the relationship between CLL-cell birth rate and treatment-free survival (TFS) in 97 patients with recently diagnosed, Rai stage 0-II CLL in a blinded, prospective study, using in vivo 2H2O labeling. Birth rates ranged from 0.07 to 1.31% new cells per day. With median follow-up of 4.0 years, 33 subjects (34%) required treatment by NCI criteria. High-birth rate was observed in 44% of subjects and was significantly associated with shorter TFS, unmutated IGHV status and expression of ZAP70 and of CD38. In multivariable modeling considering age, gender, Rai stage, expression of ZAP70 or CD38, IGHV mutation status and FISH cytogenetics, only CLL-cell birth rate and IGHV mutation status met criteria for inclusion. Hazard ratios were 3.51 (P=0.002) for high-birth rate and 4.93 (P<0.001) for unmutated IGHV. The association between elevated birth rate and shorter TFS was observed in subjects with either mutated or unmutated IGHVs, and the use of both markers was a better predictor of TFS than either parameter alone. Thus, an increased CLL birth rate in early stage disease is a strong predictor of disease progression and earlier treatment.
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Affiliation(s)
- E J Murphy
- Department of Medicine, University of California, San Francisco, CA, USA
- KineMed Inc., Emeryville, CA, USA
| | - D S Neuberg
- Dana Farber Cancer Institute, Boston, MA, USA
- CLL Research Consortium, San Diego, CA, USA
| | - L Z Rassenti
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Moores Cancer Center, University of California, San Diego, CA, USA
| | - G Hayes
- KineMed Inc., Emeryville, CA, USA
| | - R Redd
- Dana Farber Cancer Institute, Boston, MA, USA
| | - C Emson
- KineMed Inc., Emeryville, CA, USA
| | - K Li
- KineMed Inc., Emeryville, CA, USA
| | - J R Brown
- Dana Farber Cancer Institute, Boston, MA, USA
- CLL Research Consortium, San Diego, CA, USA
| | - W G Wierda
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, M. D. Anderson Cancer Center, Houston, TX, USA
| | - S Turner
- KineMed Inc., Emeryville, CA, USA
| | - A W Greaves
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Moores Cancer Center, University of California, San Diego, CA, USA
| | - C S Zent
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - J C Byrd
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Ohio State University, Columbus, OH, USA
| | | | - J Barrientos
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA
| | - N Kay
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - M K Hellerstein
- KineMed Inc., Emeryville, CA, USA
- Department of Nutritional Science and Toxicology, University of California, Berkeley, CA, USA
| | - N Chiorazzi
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - T J Kipps
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Moores Cancer Center, University of California, San Diego, CA, USA
| | - K R Rai
- CLL Research Consortium, San Diego, CA, USA
- Department of Medicine, Hofstra Northwell School of Medicine, Manhasset, NY, USA
- Feinstein Institute for Medical Research, Manhasset, NY, USA
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9
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Wagner B, da Silva Nardi F, Schramm S, Kraemer T, Celik AA, Dürig J, Horn PA, Dührsen U, Nückel H, Rebmann V. HLA-E allelic genotype correlates with HLA-E plasma levels and predicts early progression in chronic lymphocytic leukemia. Cancer 2017; 123:814-823. [PMID: 27859015 DOI: 10.1002/cncr.30427] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/05/2016] [Accepted: 10/03/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Human leukocyte antigen-E (HLA-E) is a nonclassical major histocompatibility complex class I molecule that recently came into sharper focus as a putative marker of advanced tumor stages and disease progression. In solid tumors, increased HLA-E expression as well as elevated soluble HLA-E (sHLA-E) plasma levels are associated with a poor prognosis; however, a role for HLA-E in hematologic malignancies remains to be established. METHODS The authors analyzed HLA-E alleles and sHLA-E levels in a cohort of 110 individuals with chronic lymphocytic leukemia (CLL). RESULTS In patients with CLL, levels of sHLA-E increased with advanced disease stage (P = .01) and decreased after therapy (P = .01). Longitudinal follow-up revealed that both HLA-E*01:03 alleles and high levels of sHLA-E were significantly associated with a requirement for early treatment in patients with CLL (P = .027 and P = .023, respectively). In vitro, sHLA-E inhibited degranulation and interferon-γ production by natural killer (NK) cells when cocultivated with tumor cells. Moreover, sHLA-E loaded onto microspheres induced transforming growth factor-β release by NK cells. Multivariate analysis revealed that the presence of at least 1 HLA-E*01:03 allele was an independent predictor of a requirement for early treatment. CONCLUSIONS HLA-E alleles and sHLA-E levels may represent novel biomarkers for early disease progression in patients with CLL. Cancer 2017;123:814-23. © 2016 American Cancer Society.
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MESH Headings
- Aged
- Alleles
- Biomarkers, Tumor/blood
- Disease Progression
- Female
- Genotype
- Histocompatibility Antigens Class I/blood
- Histocompatibility Antigens Class I/genetics
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Leukocytes/pathology
- Male
- Middle Aged
- Prognosis
- HLA-E Antigens
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Affiliation(s)
- Bettina Wagner
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Fabiola da Silva Nardi
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
- Coordinaton for the Improvement of Higher Education Personnel (CAPES) Foundation, Ministry of Education of Brazil, Brasilia, Brazil
| | - Sabine Schramm
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Thomas Kraemer
- Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - Alexander A Celik
- Institute for Transfusion Medicine, Hannover Medical School, Hannover, Germany
| | - Jan Dürig
- Department of Hematology, University Hospital Essen, Essen, Germany
| | - Peter A Horn
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
| | - Ulrich Dührsen
- Department of Hematology, University Hospital Essen, Essen, Germany
| | - Holger Nückel
- Department of Hematology, University Hospital Essen, Essen, Germany
| | - Vera Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, Essen, Germany
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10
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Direct in vivo evidence for increased proliferation of CLL cells in lymph nodes compared to bone marrow and peripheral blood. Leukemia 2017; 31:1340-1347. [PMID: 28074063 PMCID: PMC5462849 DOI: 10.1038/leu.2017.11] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/28/2016] [Accepted: 12/13/2016] [Indexed: 12/15/2022]
Abstract
Chronic Lymphocytic Leukemia (CLL) is a progressive malignancy of mature B-cells that involves the peripheral blood (PB), lymph nodes (LNs) and bone marrow (BM). While the majority of CLL cells are in a resting state, small populations of proliferating cells exist; however, the anatomical site of active cell proliferation remains to be definitively determined. Based on findings that CLL cells in LNs have increased expression of B-cell activation genes, we tested the hypothesis that the fraction of “newly born” cells would be highest in the LNs. Using a deuterium oxide (2H) in vivo labeling method in which patients consumed deuterated (heavy) water (2H2O), we determined CLL cell kinetics in concurrently obtained samples from LN, PB, and BM. The LN was identified as the anatomical site harboring the largest fraction of newly born cells, compared to PB and BM. In fact, the calculated birth rate in the LN reached as high a 3.3% of the clone per day. Subdivision of the bulk CLL population by flow cytometry identified the subpopulation with the CXCR4dimCD5bright phenotype as containing the highest proportion of newly born cells within each compartment, including the LN, identifying this subclonal population as an important target for novel treatment approaches.
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11
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Mátrai Z, Andrikovics H, Szilvási A, Bors A, Kozma A, Ádám E, Halm G, Karászi É, Tordai A, Masszi T. Lipoprotein Lipase as a Prognostic Marker in Chronic Lymphocytic Leukemia. Pathol Oncol Res 2016; 23:165-171. [PMID: 27757836 DOI: 10.1007/s12253-016-0132-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 10/12/2016] [Indexed: 12/29/2022]
Abstract
The marked clinical heterogeneity of CLL makes early prognosis assessment important. Lipoprotein lipase (LPL) has been shown to confer adverse prognosis in CLL, recent data indicating it might also contribute to CLL cell survival and metabolism. We determined LPL mRNA expression in unselected peripheral blood of 84 CLL patients by RT PCR. Results were correlated with other prognostic markers and outcome. 30/84 (40 %) of cases were LPL positive based on the cutoff established by ROC analysis. In LPL positive patients significantly shorter median survival (136 vs 258 months, p < 0.0001) and time to first treatment intervals (36 vs 144 months, p < 0.002) were documented. LPL values correlated with male gender, higher stages, more treatment requirement, CD38 positivity and unmutated IgVH genes. Among cases with 13q deletion, LPL positivity identified a subcohort with poor outcome (median survival 108 months vs NR, p < 0.0001). In multivariate analysis, cytogenetic aberrations and LPL had significant impact on survival. Our results confirm that LPL is a strong predictor of outcome in CLL, able to improve prognostic accuracy in good risk cytogenetic subgroups. The relationship between its prognostic and functional role in CLL needs to be explored further.
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Affiliation(s)
- Zoltán Mátrai
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary.
| | - Hajnalka Andrikovics
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - Anikó Szilvási
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - András Bors
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - András Kozma
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Emma Ádám
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Gabriella Halm
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Éva Karászi
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary
| | - Attila Tordai
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - Tamás Masszi
- Department of Haematology and Stem Cell Transplantation, St. István and St László Hospital, Budapest, Hungary.,Third Department of Internal Medicine, Semmelweis University, Budapest, Hungary
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12
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Scarfò L, Ferreri AJM, Ghia P. Chronic lymphocytic leukaemia. Crit Rev Oncol Hematol 2016; 104:169-82. [PMID: 27370174 DOI: 10.1016/j.critrevonc.2016.06.003] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 05/01/2016] [Accepted: 06/14/2016] [Indexed: 01/11/2023] Open
Abstract
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia among the adults in the Western World. CLL (and the corresponding nodal entity small lymphocytic lymphoma, SLL) is classified as a lymphoproliferative disorder characterised by the relentless accumulation of mature B-lymphocytes showing a peculiar immunophenotype in the peripheral blood, bone marrow, lymph nodes and spleen. CLL clinical course is very heterogeneous: the majority of patients follow an indolent clinical course with no or delayed treatment need and with a prolonged survival, while others experience aggressive disease requiring early treatment followed by frequent relapses. In the last decade, the improved understanding of CLL pathogenesis shed light on premalignant conditions (i.e., monoclonal B-cell lymphocytosis, MBL), defined new prognostic and predictive markers, improving patient stratification, but also broadened the therapeutic armamentarium with novel agents, targeting fundamental signaling pathways.
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Affiliation(s)
- Lydia Scarfò
- Department of Onco-Haematology, Division of Experimental Oncology, IRCCS San Raffaele Hospital, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrés J M Ferreri
- Department of Onco-Haematology, Division of Experimental Oncology, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Paolo Ghia
- Department of Onco-Haematology, Division of Experimental Oncology, IRCCS San Raffaele Hospital, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
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13
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Duncavage E, Advani RH, Agosti S, Foulis P, Gibson C, Kang L, Khoury JD, Medeiros LJ, Ohgami RS, O'Malley DP, Patel KP, Rosenbaum JN, Wilson C. Template for Reporting Results of Biomarker Testing of Specimens From Patients With Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma. Arch Pathol Lab Med 2016; 140:1228-1230. [PMID: 27081879 DOI: 10.5858/arpa.2016-0045-cp] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Eric Duncavage
- From the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri (Drs Duncavage and Rosenbaum); the Departments of Medicine, Oncology Division (Dr Advani), and Pathology (Dr Ohgami), Stanford University Medical Center, Stanford, California; the Pathology & Laboratory Medicine Service, James A. Haley Veterans Affairs Medical Center, Tampa, Florida (Drs Agosti, Foulis, and Kang); Blood and Marrow Transplantation, the Moffitt Cancer Center, Tampa, Florida (Ms Gibson); the Department of Hematopathology, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston (Drs Khoury, Medeiros, and Patel); the Department of Pathology, Clarient Pathology Services, Aliso Viejo, California (Dr O'Malley); and the Department of Hematopathology, University of New Mexico Health Sciences Center, Albuquerque (Dr Wilson)
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14
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Abstract
B cells provide immunity to extracellular pathogens by secreting a diverse repertoire of antibodies with high affinity and specificity for exposed antigens. The B cell receptor (BCR) is a transmembrane antibody, which facilitates the clonal selection of B cells producing secreted antibodies of the same specificity. The diverse antibody repertoire is generated by V(D)J recombination of heavy and light chain genes, whereas affinity maturation is mediated by activation-induced cytidine deaminase (AID)-mediated mutagenesis. These processes, which are essential for the generation of adaptive humoral immunity, also render B cells susceptible to chromosomal rearrangements and point mutations that in some cases lead to cancer. In this chapter, we will review the central role of PI3K s in mediating signals from the B cell receptor that not only facilitate the development of functional B cell repertoire, but also support the growth and survival of neoplastic B cells, focusing on chronic lymphocytic leukemia (CLL) B cells. Perhaps because of the central role played by PI3K in BCR signaling, B cell leukemia and lymphomas are the first diseases for which a PI3K inhibitor has been approved for clinical use.
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MESH Headings
- Animals
- B-Lymphocytes/cytology
- B-Lymphocytes/enzymology
- Cell Survival
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/enzymology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/physiopathology
- Phosphatidylinositol 3-Kinases/genetics
- Phosphatidylinositol 3-Kinases/metabolism
- Receptors, Antigen, B-Cell/genetics
- Receptors, Antigen, B-Cell/metabolism
- Signal Transduction
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Affiliation(s)
- Klaus Okkenhaug
- Laboratory of Lymphocyte Signaling and Development, The Babraham Institute, Cambridge, CB22 3AT, UK.
| | - Jan A Burger
- Department of Leukemia, MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
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15
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Zutter MM, Bloom KJ, Cheng L, Hagemann IS, Kaufman JH, Krasinskas AM, Lazar AJ, Leonard DGB, Lindeman NI, Moyer AM, Nikiforova MN, Nowak JA, Pfeifer JD, Sepulveda AR, Willis JE, Yohe SL. The Cancer Genomics Resource List 2014. Arch Pathol Lab Med 2015; 139:989-1008. [PMID: 25436904 DOI: 10.5858/arpa.2014-0330-cp] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
CONTEXT Genomic sequencing for cancer is offered by commercial for-profit laboratories, independent laboratory networks, and laboratories in academic medical centers and integrated health networks. The variability among the tests has created a complex, confusing environment. OBJECTIVE To address the complexity, the Personalized Health Care (PHC) Committee of the College of American Pathologists proposed the development of a cancer genomics resource list (CGRL). The goal of this resource was to assist the laboratory pathology and clinical oncology communities. DESIGN The PHC Committee established a working group in 2012 to address this goal. The group consisted of site-specific experts in cancer genetic sequencing. The group identified current next-generation sequencing (NGS)-based cancer tests and compiled them into a usable resource. The genes were annotated by the working group. The annotation process drew on published knowledge, including public databases and the medical literature. RESULTS The compiled list includes NGS panels offered by 19 laboratories or vendors, accompanied by annotations. The list has 611 different genes for which NGS-based mutation testing is offered. Surprisingly, of these 611 genes, 0 genes were listed in every panel, 43 genes were listed in 4 panels, and 54 genes were listed in 3 panels. In addition, tests for 393 genes were offered by only 1 or 2 institutions. Table 1 provides an example of gene mutations offered for breast cancer genomic testing with the annotation as it appears in the CGRL 2014. CONCLUSIONS The final product, referred to as the Cancer Genomics Resource List 2014, is available as supplemental digital content.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sophia L Yohe
- From the Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee (Dr Zutter); the Department of Pathology, Clarient Diagnostic Services, Aliso Viejo, California (Dr Bloom); the Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis (Dr Cheng); the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri (Drs Hagemann and Pfeifer); Surveys, College of American Pathologists, Northfield, Illinois (Dr Kaufman); the Department of Pathology, Emory University, Atlanta, Georgia (Dr Krasinskas); the Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston (Dr Lazar); the Department of Pathology and Laboratory Medicine, Fletcher Allen Health Care, Burlington, Vermont (Dr Leonard); the Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts (Dr Lindeman); the Department of Pathology, Mayo Clinic, Rochester, Minnesota (Dr Moyer); Molecular and Genomic Pathology Laboratory, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Dr Nikiforova); the Department of Pathology, NorthShore University Health System, Evanston, Illinois (Dr Nowak); the Department of Pathology and Cell Biology, Columbia University Medical Center, New York, New York (Dr Sepulveda); the Department of Pathology, Case Medical Center/Case Western Reserve University, Cleveland, Ohio (Dr Willis); and the Department of Molecular Pathology and Hematopathology, University of Minnesota, Minneapolis (Dr Yohe)
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16
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Cornet E, Debliquis A, Rimelen V, Civic N, Docquier M, Troussard X, Drénou B, Matthes T. Developing Molecular Signatures for Chronic Lymphocytic Leukemia. PLoS One 2015; 10:e0128990. [PMID: 26046539 PMCID: PMC4457530 DOI: 10.1371/journal.pone.0128990] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2015] [Accepted: 05/04/2015] [Indexed: 01/01/2023] Open
Abstract
Chronic lymphocytic leukemia (CLL) is a clonal malignancy of mature B cells that displays a great clinical heterogeneity, with many patients having an indolent disease that will not require intervention for many years, while others present an aggressive and symptomatic leukemia requiring immediate treatment. Although there is no cure for CLL, the disease is treatable and current standard chemotherapy regimens have been shown to prolong survival. Recent advances in our understanding of the biology of CLL have led to the identification of numerous cellular and molecular markers with potential diagnostic, prognostic and therapeutic significance. We have used the recently developed digital multiplexed gene-expression technique (DMGE) to analyze a cohort of 30 CLL patients for the presence of specific genes with known diagnostic and prognostic potential. Starting from a set of 290 genes we were able to develop a molecular signature, based on the analysis of 13 genes, which allows distinguishing CLL from normal peripheral blood and from normal B cells, and a second signature based on 24 genes, which distinguishes mutated from unmutated cases (LymphCLL Mut). A third classifier (LymphCLL Diag), based on a 44-gene signature, distinguished CLL cases from a series of other B-cell chronic lymphoproliferative disorders (n = 51). While the methodology presented here has the potential to provide a "ready to use" classification tool in routine diagnostics and clinical trials, application to larger sample numbers are still needed and should provide further insights about its robustness and utility in clinical practice.
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MESH Headings
- Antigens, CD/genetics
- Antigens, CD/immunology
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Cohort Studies
- Gene Expression
- Humans
- Immunoglobulin Heavy Chains/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Mutation
- Neoplasm Proteins/genetics
- Neoplasm Proteins/immunology
- Prognosis
- RNA, Messenger/genetics
- RNA, Messenger/immunology
- Transcriptome
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Affiliation(s)
- Edouard Cornet
- CHU Caen, Laboratory of Hematology, 14000, Caen, France
- University of Caen, Medical School, 14000, Caen, France
| | - Agathe Debliquis
- Département d’Hématologie, Hôpital de Mulhouse, 68051, Mulhouse, France
| | - Valérie Rimelen
- Département d’Hématologie, Hôpital de Mulhouse, 68051, Mulhouse, France
| | - Natacha Civic
- Genomics Platform iGE3, University Medical Center, 1211, Geneva, Switzerland
| | - Mylène Docquier
- Genomics Platform iGE3, University Medical Center, 1211, Geneva, Switzerland
| | - Xavier Troussard
- CHU Caen, Laboratory of Hematology, 14000, Caen, France
- University of Caen, Medical School, 14000, Caen, France
| | - Bernard Drénou
- Département d’Hématologie, Hôpital de Mulhouse, 68051, Mulhouse, France
| | - Thomas Matthes
- Hematology Service, University Hospital Geneva, 1211, Geneva, Switzerland
- Clinical Pathology Service, University Hospital Geneva, 1211, Geneva, Switzerland
- * E-mail:
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17
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Telomere shortening associated with increased genomic complexity in chronic lymphocytic leukemia. Tumour Biol 2015; 36:8317-24. [DOI: 10.1007/s13277-015-3556-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/11/2015] [Indexed: 01/08/2023] Open
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18
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Ruiz-Lafuente N, Alcaraz-García MJ, Sebastián-Ruiz S, García-Serna AM, Gómez-Espuch J, Moraleda JM, Minguela A, García-Alonso AM, Parrado A. IL-4 Up-Regulates MiR-21 and the MiRNAs Hosted in the CLCN5 Gene in Chronic Lymphocytic Leukemia. PLoS One 2015; 10:e0124936. [PMID: 25909590 PMCID: PMC4409305 DOI: 10.1371/journal.pone.0124936] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/08/2015] [Indexed: 12/22/2022] Open
Abstract
Interleukin 4 (IL-4) induces B-cell differentiation and survival of chronic lymphocytic leukemia (CLL) cells. MicroRNAs (miRNAs) regulate mRNA and protein expression, and several miRNAs, deregulated in CLL, might play roles as oncogenes or tumor suppressors. We have studied the miRNA profile of CLL, and its response to IL-4, by oligonucleotide microarrays, resulting in the detection of a set of 129 mature miRNAs consistently expressed in CLL, which included 41 differentially expressed compared to normal B cells (NBC), and 6 significantly underexpressed in ZAP-70 positive patients. IL-4 stimulation brought about up-regulation of the 5p and 3p mature variants of the miR-21 gene, which maps immediately downstream to the VMP1 gene, and of the mature forms generated from the miR-362 (3p and 5p), miR-500a (3p), miR-502 (3p), and miR-532 (3p and 5p) genes, which map within the third intron of the CLCN5 gene. Both genes are in turn regulated by IL-4, suggesting that these miRNAs were regulated by IL-4 as passengers from their carrier genes. Their levels of up-regulation by IL-4 significantly correlated with cytoprotection. MiR-21 has been reported to be leukemogenic, associated to bad prognosis in CLL, and the miRNA more frequently overexpressed in human cancer. Up-regulation by IL-4 of miR-21 and the miRNAs hosted in the CLCN5 locus may contribute to evasion of apoptosis of CLL cells. These findings indicate that the IL-4 pathway and the miRNAs induced by IL-4 are promising targets for the development of novel therapies in CLL.
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Affiliation(s)
- Natalia Ruiz-Lafuente
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - María-José Alcaraz-García
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Silvia Sebastián-Ruiz
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Azahara-María García-Serna
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Joaquín Gómez-Espuch
- Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - José-María Moraleda
- Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Alfredo Minguela
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Ana-María García-Alonso
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Antonio Parrado
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
- * E-mail:
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19
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Adamopoulos PG, Kontos CK, Papageorgiou SG, Pappa V, Scorilas A. KLKB1 mRNA overexpression: A novel molecular biomarker for the diagnosis of chronic lymphocytic leukemia. Clin Biochem 2015; 48:849-54. [PMID: 25891023 DOI: 10.1016/j.clinbiochem.2015.04.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Revised: 04/06/2015] [Accepted: 04/07/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Plasma kallikrein, also known as Fletcher factor or kallikrein B1 (KLKB1), is a serine endopeptidase, like its homologs tissue kallikrein and kallikrein-related peptidases (KLKs). Its physiological role is to catalyze the release of kinins and other vasoactive peptides. Several KLKs have been proposed as putative tumor biomarkers with significant diagnostic and/or prognostic value in human malignancies arising from solid tumors; the most prominent example is the worldwide use of KLK3 (prostate-specific antigen, PSA) in prostate cancer diagnostics. The aim of this study was to analyze KLKB1 mRNA expression in B-cell chronic lymphocytic leukemia (CLL) patients and to examine its diagnostic value as a novel molecular biomarker in CLL. DESIGN AND METHODS Total RNA was isolated from peripheral blood mononuclear cells of sixty-nine patients previously diagnosed with CLL and thirty-one healthy blood donors. After cDNA preparation, a sensitive and cost-effective quantitative real-time PCR (qRT-PCR) methodology was developed and applied for KLKB1 mRNA quantification. Last, we carried out a biostatistical analysis to assess the clinical significance of KLKB1 mRNA expression. RESULTS According to our findings, KLKB1 mRNA expression is significantly higher in CLL patients than in healthy blood donors. Furthermore, KLKB1 mRNA levels are negatively correlated with CD38 expression, an established prognostic biomarker in CLL. Most importantly, KLKB1 mRNA expression possesses important diagnostic value, distinguishing very efficiently CLL patients from non-leukemic population. CONCLUSIONS KLKB1 mRNA expression is a putative molecular biomarker in CLL, meriting investigation in large cohorts of CLL patients and non-leukemic controls.
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Affiliation(s)
| | - Christos K Kontos
- Department of Biochemistry and Molecular Biology, University of Athens, Athens GR-15701, Greece
| | - Sotirios G Papageorgiou
- Second Department of Internal Medicine, Propaedeutic, University of Athens, University General Hospital "Attikon", Athens GR-12462, Greece
| | - Vassiliki Pappa
- Second Department of Internal Medicine, Propaedeutic, University of Athens, University General Hospital "Attikon", Athens GR-12462, Greece
| | - Andreas Scorilas
- Department of Biochemistry and Molecular Biology, University of Athens, Athens GR-15701, Greece.
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20
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Rogalińska M, Błoński JZ, Góralski P, Wawrzyniak E, Hartman M, Rogalska A, Robak P, Koceva-Chyła A, Piekarski H, Robak T, Kiliańska ZM. Relationship between in vitro drug sensitivity and clinical response of patients to treatment in chronic lymphocytic leukemia. Int J Oncol 2015; 46:1259-67. [PMID: 25572009 DOI: 10.3892/ijo.2015.2823] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/04/2014] [Indexed: 11/05/2022] Open
Abstract
To improve the efficacy of therapeutic options in chronic lymphocytic leukemia (CLL) an in vitro system to determine the response of mononuclear blood cells from blood of patients was elaborated. The study combines four approaches, i.e., cell viability, apoptosis rate, differential scanning calorimetry (DSC), and immunoblotting to develop personalized therapy protocols based on the cell sensitivity to drug exposure of individual CLL patients. The complementary analyses were performed on 28 peripheral blood samples from previously untreated CLL patients before therapy. The induction and progress of apoptosis in CLL cells exposed in vitro to purine analogs combined with mafosfamide, i.e., cladribine + mafosfamide (CM) and fludarabine + mafosfamide (FM) were assessed using the above approaches. The changes in thermal profiles (decrease/loss of transition at 95±5˚C) coincided with an accumulation of apoptotic cells, a decrease in the number of viable cells, and differences in the expression of the apoptosis‑related protein PARP‑1. No significant changes were observed in the thermal profiles of nuclei isolated from CLL cells resistant to the treatment. The complementary assays revealed a strong relationship between both the in vitro sensitivity of leukemia cells to drugs and the clinical response of the patients, determined usually after the sixth course of treatment (after ~6 months of therapy). As a summary of studies followed by complementary tests, our findings demonstrate the value of in vitro exposure of CLL cell samples to drugs intended to treat CLL patients, before their administration in order to recommend the most suitable and effective therapy for individual patients.
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Affiliation(s)
- Małgorzata Rogalińska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Jerzy Z Błoński
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Paweł Góralski
- Department of Physical Chemistry, Faculty of Chemistry, University of Lodz, Lodz, Poland
| | - Ewa Wawrzyniak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Mariusz Hartman
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Aneta Rogalska
- Department of Thermobiology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Paweł Robak
- Department of Experimental Hematology, Medical University of Lodz, Lodz, Poland
| | - Aneta Koceva-Chyła
- Department of Thermobiology, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
| | - Henryk Piekarski
- Department of Physical Chemistry, Faculty of Chemistry, University of Lodz, Lodz, Poland
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Zofia M Kiliańska
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland
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21
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Ruiz-Lafuente N, Alcaraz-García MJ, Sebastián-Ruiz S, Gómez-Espuch J, Funes C, Moraleda JM, García-Garay MC, Montes-Barqueros N, Minguela A, Álvarez-López MR, Parrado A. The gene expression response of chronic lymphocytic leukemia cells to IL-4 is specific, depends on ZAP-70 status and is differentially affected by an NFκB inhibitor. PLoS One 2014; 9:e109533. [PMID: 25280001 PMCID: PMC4184842 DOI: 10.1371/journal.pone.0109533] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Accepted: 09/01/2014] [Indexed: 01/01/2023] Open
Abstract
Interleukin 4 (IL-4), an essential mediator of B cell development, plays a role in survival of chronic lymphocytic leukemia (CLL) cells. To obtain new insights into the function of the IL-4 pathway in CLL, we analyzed the gene expression response to IL-4 in CLL and in normal B cells (NBC) by oligonucleotide microarrays, resulting in the identification of 232 non-redundant entities in CLL and 146 in NBC (95 common, 283 altogether), of which 189 were well-defined genes in CLL and 123 in NBC (83 common, 229 altogether) (p<0.05, 2-fold cut-off). To the best of our knowledge, most of them were novel IL-4 targets for CLL (98%), B cells of any source (83%), or any cell type (70%). Responses were significantly higher for 54 and 11 genes in CLL and NBC compared to each other, respectively. In CLL, ZAP-70 status had an impact on IL-4 response, since different sets of IL-4 targets correlated positively or negatively with baseline expression of ZAP-70. In addition, the NFκB inhibitor 6-Amino-4-(4-phenoxyphenethylamino)quinazoline, which reversed the anti-apoptotic effect of IL-4, preferentially blocked the response of genes positively correlated with ZAP-70 (e.g. CCR2, SUSD2), but enhanced the response of genes negatively correlated with ZAP-70 (e.g. AUH, BCL6, LY75, NFIL3). Dissection of the gene expression response to IL-4 in CLL and NBC contributes to the understanding of the anti-apoptotic response. Initial evidence of a connection between ZAP-70 and NFκB supports further exploration of targeting NFκB in the context of the assessment of inhibition of the IL-4 pathway as a therapeutic strategy in CLL, especially in patients expressing bad prognostic markers.
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MESH Headings
- Apoptosis
- Biomarkers, Tumor/genetics
- Blotting, Western
- Case-Control Studies
- Cell Proliferation
- Cells, Cultured
- Gene Expression Profiling
- Humans
- I-kappa B Proteins/genetics
- Interleukin-4/pharmacology
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphocytes/cytology
- Lymphocytes/metabolism
- NF-kappa B/antagonists & inhibitors
- NF-kappa B/genetics
- Oligonucleotide Array Sequence Analysis
- RNA, Messenger/genetics
- Real-Time Polymerase Chain Reaction
- Reverse Transcriptase Polymerase Chain Reaction
- ZAP-70 Protein-Tyrosine Kinase/genetics
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Affiliation(s)
- Natalia Ruiz-Lafuente
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - María-José Alcaraz-García
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Silvia Sebastián-Ruiz
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Joaquín Gómez-Espuch
- Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Consuelo Funes
- Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - José-María Moraleda
- Servicio de Hematología y Hemoterapia, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | | | - Natividad Montes-Barqueros
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Alfredo Minguela
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - María-Rocío Álvarez-López
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Centro de Investigación Biomédica en Red de enfermedades hepáticas y digestivas, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
| | - Antonio Parrado
- Servicio de Inmunología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria Virgen de la Arrixaca (IMIB-Arrixaca), Murcia, Spain
- * E-mail:
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22
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Chastain EC, Duncavage EJ. Clinical Prognostic Biomarkers in Chronic Lymphocytic Leukemia and Diffuse Large B-Cell Lymphoma. Arch Pathol Lab Med 2014; 139:602-7. [DOI: 10.5858/arpa.2014-0086-ra] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context
Diffuse large B-cell lymphoma and chronic lymphocytic leukemia are 2 of the most common B-cell lymphomas in adults. Both diffuse large B-cell lymphoma and chronic lymphocytic leukemia share heterogeneous outcomes, and the use of prognostic biomarkers to better stratify risk in these patients has now become commonplace.
Objective
To review chronic lymphocytic leukemia and diffuse large B-cell lymphoma biomarkers commonly used in the clinical laboratory, which can be divided into the following 3 main groups by testing methodology: chromosomal based (including fluorescence in situ hybridization and cytogenetics), expression based (including immunohistochemistry and flow cytometry), and DNA based (including gene sequencing for somatic mutations and IGVH mutational status).
Data Sources
Review of recent literature.
Conclusions
In chronic lymphocytic leukemia, important biomarkers include expression of CD38 and ZAP-70, IGVH mutational status, somatic mutations in TP53 and NOTCH1, and abnormalities in chromosomes 11, 12, 13q, and 17. In diffuse large B-cell lymphoma, important biomarkers include chromosomal rearrangement of BCL2, BCL6, and MYC and expression of CD5, BCL2, and CD43, as well as somatic mutations in TP53 and BCL6.
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Affiliation(s)
- Elizabeth C. Chastain
- From the Department of Pathology and Immunology, Washington University, St Louis, Missouri
| | - Eric J. Duncavage
- From the Department of Pathology and Immunology, Washington University, St Louis, Missouri
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24
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Gentile M, Mauro FR, Rossi D, Vincelli I, Tripepi G, Recchia AG, De Stefano L, Campanelli M, Giannarelli D, Bossio S, Morabito L, Vigna E, Gaidano G, Foà R, Morabito F. Italian external and multicentric validation of the MD Anderson Cancer Center nomogram and prognostic index for chronic lymphocytic leukaemia patients: analysis of 1502 cases. Br J Haematol 2014; 167:224-32. [PMID: 25041609 DOI: 10.1111/bjh.13032] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/10/2014] [Indexed: 11/29/2022]
Abstract
We performed an external and multicentric validation of the nomogram and prognostic index (PI) proposed by the MD Anderson Cancer Center to prognostically stratify chronic lymphocytic leukaemia (CLL) patients in 1502 CLL cases. All six parameters involved in the nomogram and PI (age, sex, absolute lymphocyte count, number of lymph node groups, Rai stage and β2-microglobulin) were independently associated with survival. The nomogram was accurate in predicting survival (c-index = 0·82). According to the PI, 38·7% of patients were at low-risk, 58·3% at intermediate-risk and 3% at high-risk. The estimated median survival times were: not reached for low-risk, 13·4 years for intermediate-risk and 3·4 years for high-risk. The estimated median and 5-year survival by PI were similar to those originally reported. The PI remained a predictor of survival when analysis was limited to 847 Rai stage 0 (P < 0·0001) and 151 clinical monoclonal B-cell lymphocytosis (cMBL) cases (P = 0·033). Finally, the PI allowed prediction of time to therapy in all patients (P < 0·0001), in Rai 0 (P < 0·0001) and in cMBL cases (P = 0·044). Our results confirm the ability of the PI to predict prognosis, even in early stage disease cases. The study also extended the utility of the PI to cMBL cases.
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25
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Barth MJ, Czuczman MS. Ofatumumab: a novel, fully human anti-CD20 monoclonal antibody for the treatment of chronic lymphocytic leukemia. Future Oncol 2014; 9:1829-39. [PMID: 24295413 DOI: 10.2217/fon.13.219] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Ofatumumab is a fully human, IgG anti-CD20 monoclonal antibody codeveloped by GlaxoSmithKline (Brentford, UK) and Genmab (Copenhagen, Denmark). In preclinical studies, ofatumumab exhibited more potent in vitro activity than rituximab against B-cell malignancies and prolonged survival in in vivo animal models compared with rituximab. Ofatumumab is clinically well tolerated with initial infusion reactions being the predominant associated toxicity. Ofatumumab has demonstrated efficacy in relapsed/refractory chronic lymphocytic leukemia (CLL) and has received regulatory approval in both Europe and the USA for treatment of fludarabine and alemtuzumab refractory disease. Single-agent ofatumumab has resulted in overall response rates of 42-51% in relapsed/refractory CLL and up to 80% when combined with chemotherapy. In de novo CLL, overall response rates of 77-78% have been achieved.
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Affiliation(s)
- Matthew J Barth
- Department of Pediatrics, Roswell Park Cancer Institute, University at Buffalo, Buffalo, NY, USA
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26
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Gentile M, Cutrona G, Mosca L, Matis S, Fabris S, Lionetti M, Ilariucci F, Zupo S, Musolino C, Levato L, Molica S, Di Raimondo F, Vincelli I, Di Rienzo N, Pesce EA, Angrilli F, Federico M, Neri A, Ferrarini M, Morabito F. Prospective validation of a risk score based on biological markers for predicting progression free survival in Binet stage A chronic lymphocytic leukemia patients: results of the multicenter O-CLL1-GISL study. Am J Hematol 2014; 89:743-50. [PMID: 24711230 DOI: 10.1002/ajh.23729] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 04/02/2014] [Indexed: 01/09/2023]
Abstract
A risk score based on three biological features (CD38, ZAP-70, and IGHV mutational status) was previously developed to predict progression-free survival (PFS) in untreated Binet A CLL patients. Here we perform a score validation analysis in a prospective and independent cohort of patients. Biological markers (CD38, ZAP-70, and IGHV mutational status) and gene expression profiles (GEP) of leukemic cells from CLL patients included in a prospective multicenter observational study (O-CLL1-GISL protocol, clinicaltrial.gov ID:NCT00917549) were used to assess the value and reproducibility of this score. To date, 468 Binet A patients were classified as low- (0 positive marker), intermediate- (1 positive marker), or high-risk (2 or 3 positive markers) using the progression risk score. The 3-year PFS probability was 91.7%, 82.9%, and 57.4% for low-, intermediate-, and high-risk (P < 0.0001) cases, respectively. These values were similar to those found in the original cohort. At Cox multivariate analysis, Rai stage, absolute lymphocyte count, progression risk score, and β-2 microglobulin maintained an independent prognostic impact on PFS. This score remained a predictor of progression when analysis was limited to 371 Rai 0 cases (P < 0.0001). Finally, the cells from the different CLL risk groups showed differences in their gene expression patterns. These results confirm the ability of this progression risk score to predict PFS among Binet A patients. The utility of the score was also extended by demonstrating that it retains prognostic value when applied exclusively to Rai 0 patients. Specific transcriptional patterns were significantly associated with risk groups.
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Affiliation(s)
- Massimo Gentile
- Hematology Unit; Department of Onco-hematology; A.O. of Cosenza; Cosenza Italy
| | | | - Laura Mosca
- Department of Clinical Sciences and Community Health; University of Milano and Hematology CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Serena Matis
- Direzione Scientifica IRCCS; San Martino IST; Genova Italy
| | - Sonia Fabris
- Department of Clinical Sciences and Community Health; University of Milano and Hematology CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | - Marta Lionetti
- Department of Clinical Sciences and Community Health; University of Milano and Hematology CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | | | - Simona Zupo
- SS Molecular Diagnostics IRCCS S; Martino-IST; Genova Italy
| | | | - Luciano Levato
- Department of Oncology and Haematology; Pugliese-Ciaccio Hospital; Catanzaro Italy
| | - Stefano Molica
- Department of Oncology and Haematology; Pugliese-Ciaccio Hospital; Catanzaro Italy
| | - Francesco Di Raimondo
- Department of Biomedical Sciences; Division of Haematology; University of Catania and Ferrarotto Hospital; Catania Italy
| | | | | | | | | | - Massimo Federico
- Department of Onco-hematology; Università di Modena Centro Oncologico Modenese; Policlinico Modena Italy
| | - Antonino Neri
- Department of Clinical Sciences and Community Health; University of Milano and Hematology CTMO, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico; Milano Italy
| | | | - Fortunato Morabito
- Hematology Unit; Department of Onco-hematology; A.O. of Cosenza; Cosenza Italy
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27
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Glibert P, Vossaert L, Van Steendam K, Lambrecht S, Van Nieuwerburgh F, Offner F, Kipps T, Dhaenens M, Deforce D. Quantitative proteomics to characterize specific histone H2A proteolysis in chronic lymphocytic leukemia and the myeloid THP-1 cell line. Int J Mol Sci 2014; 15:9407-21. [PMID: 24871368 PMCID: PMC4100102 DOI: 10.3390/ijms15069407] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/30/2014] [Accepted: 05/21/2014] [Indexed: 01/01/2023] Open
Abstract
Proteome studies on hematological malignancies contribute to the understanding of the disease mechanism and to the identification of new biomarker candidates. With the isobaric tag for relative and absolute quantitation (iTRAQ) method we analyzed the protein expression between B-cells of healthy people and chronic lymphocytic leukemia (CLL) B-cells. CLL is the most common lymphoid cancer of the blood and is characterized by a variable clinical course. By comparing samples of patients with an aggressive vs. indolent disease, we identified a limited list of differentially regulated proteins. The enhanced sensitivity attributed to the iTRAQ labels led to the discovery of a previously reported but still not clarified proteolytic product of histone H2A (cH2A) which we further investigated in light of the suggested functional properties of this modification. In the exploratory proteome study the Histone H2A peptide was up-regulated in CLL samples but a more specific and sensitive screening of a larger patient cohort indicated that cH2A is of myeloid origin. Our subsequent quantitative analysis led to a more profound characterization of the clipping in acute monocytic leukemia THP-1 cells subjected to induced differentiation.
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MESH Headings
- Amino Acid Sequence
- B-Lymphocytes/metabolism
- B-Lymphocytes/pathology
- Gene Expression Regulation, Leukemic
- Histones/analysis
- Histones/genetics
- Histones/metabolism
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Middle Aged
- Molecular Sequence Data
- Proteolysis
- Proteomics/methods
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Affiliation(s)
- Pieter Glibert
- Laboratory of Pharmaceutical Biotechnology, Ghent University, 72 Harelbekestraat, B-9000 Ghent, Belgium.
| | - Liesbeth Vossaert
- Laboratory of Pharmaceutical Biotechnology, Ghent University, 72 Harelbekestraat, B-9000 Ghent, Belgium.
| | - Katleen Van Steendam
- Laboratory of Pharmaceutical Biotechnology, Ghent University, 72 Harelbekestraat, B-9000 Ghent, Belgium.
| | - Stijn Lambrecht
- Department of Rheumatology, Ghent University Hospital, 185 1P7 De Pintelaan, B-9000 Ghent, Belgium.
| | - Filip Van Nieuwerburgh
- Laboratory of Pharmaceutical Biotechnology, Ghent University, 72 Harelbekestraat, B-9000 Ghent, Belgium.
| | - Fritz Offner
- Department of Hematology, Ghent University Hospital, 185 1P7 De Pintelaan, B-9000 Ghent, Belgium.
| | - Thomas Kipps
- Department of Medicine, Moores Cancer Center, University of California at San Diego (UCSD), 3855 Health Sciences Drive, La Jolla, CA 92093, USA.
| | - Maarten Dhaenens
- Laboratory of Pharmaceutical Biotechnology, Ghent University, 72 Harelbekestraat, B-9000 Ghent, Belgium.
| | - Dieter Deforce
- Laboratory of Pharmaceutical Biotechnology, Ghent University, 72 Harelbekestraat, B-9000 Ghent, Belgium.
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28
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Molica S, Brugiatelli M, Morabito F, Ferrara F, Iannitto E, Di Renzo N, Capalbo S, Musto P, Di Raimondo F. Treatment of elderly patients with chronic lymphocytic leukemia: an unmet cinical need. Expert Rev Hematol 2014; 6:441-9. [PMID: 23991930 DOI: 10.1586/17474086.2013.814845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In chronic lymphocytic leukemia (CLL), the most prevalent lymphoid malignancy in western countries, patients have a median age at diagnosis of 72 years. In the last few years, there has been remarkable progress in understanding the biology of CLL, the detection of molecular prognostic factors and the development of more effective therapies. However, many of the milestone studies were conducted in populations that were considerably younger than the average age of the CLL population. Today, the challenge is to improve management of elderly patients. In this population, outcome of treatment with newer highly effective therapies is often compromised by comorbidities and poor performance status. Decision on how elderly patients should be treated is thus a complex issue. The management of these patients should rely on the development of risk-stratified treatment strategies based on the assessment of individual functional status and the biologic characteristics of CLL. New single agents with reduced toxic effects (i.e., inhibitors of BCR signalling) that have achieved promising results in Phase I/II studies when available should modify the paradigm of the treatment of elderly patients with CLL.
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Affiliation(s)
- Stefano Molica
- Dipartimento Onco-Ematologico Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy.
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29
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González-Gascón y Marín I, Hernández JA, Martín A, Alcoceba M, Sarasquete ME, Rodríguez-Vicente A, Heras C, de las Heras N, Fisac R, García de Coca A, de la Fuente I, Hernández-Sánchez M, Recio I, Galende J, Martín-Núñez G, Alonso JM, Hernández-Rivas JM, González M. Mutation status and immunoglobulin gene rearrangements in patients from northwest and central region of Spain with chronic lymphocytic leukemia. BIOMED RESEARCH INTERNATIONAL 2014; 2014:257517. [PMID: 24790994 PMCID: PMC3985179 DOI: 10.1155/2014/257517] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/07/2014] [Accepted: 02/24/2014] [Indexed: 01/09/2023]
Abstract
The aim of this study was to investigate the frequency and mutation status of the immunoglobulin heavy variable chain (IGHV) in a cohort of 224 patients from northwest and central region of Spain diagnosed with chronic lymphocytic leukemia (CLL), and to correlate it with cytogenetic abnormalities, overall survival (OS) and time to first treatment (TTFT). 125 patients had mutated IGHV, while 99 had unmutated IGHV. The most frequently used IGHV family was IGHV3, followed by IGHV1 and IGHV4. The regions IGHV3-30, IGHV1-69, IGHV3-23, and IGHV4-34 were the most commonly used. Only 3.1% of the patients belonged to the subfamily IGHV3-21 and we failed to demonstrate a worse clinical outcome in this subgroup. The IGHV4 family appeared more frequently with mutated pattern, similar to IGHV3-23 and IGHV3-74. By contrast, IGHV1-69 was expressed at a higher frequency in unmutated CLL patients. All the cases from IGHV3-11 and almost all from IGHV5-51 subfamily belonged to the group of unmutated CLL.
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Affiliation(s)
- I. González-Gascón y Marín
- Servicio de Hematología, Departamento de Medicina, Hospital Universitario Infanta Leonor, Calle Gran Vía del Este 80, 28031 Madrid, Spain
| | - J. A. Hernández
- Servicio de Hematología, Departamento de Medicina, Hospital Universitario Infanta Leonor, Calle Gran Vía del Este 80, 28031 Madrid, Spain
- Universidad Complutense de Madrid, Avenida Séneca 2, 28040 Madrid, Spain
| | - A. Martín
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - M. Alcoceba
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - M. E. Sarasquete
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
| | - A. Rodríguez-Vicente
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC), Calle Zacarías González 2, 37007 Salamanca, Spain
| | - C. Heras
- Servicio de Hematología, Departamento de Medicina, Hospital Universitario Infanta Leonor, Calle Gran Vía del Este 80, 28031 Madrid, Spain
| | - N. de las Heras
- Servicio de Hematología, Hospital Virgen Blanca, Calle Altos de Nava, s/n, 24071 León, Spain
| | - R. Fisac
- Servicio de Hematología, Hospital General de Segovia, Calle Miguel Servet, s/n, 4002 Segovia, Spain
| | - A. García de Coca
- Servicio de Hematología, Hospital Clínico Universitario de Valladolid, Avenida Ramón y Cajal 3, 47005 Valladolid, Spain
| | - I. de la Fuente
- Servicio de Hematología, Hospital del Río Hortega, Calle Dulzaina 2, 47012 Valladolid, Spain
| | - M. Hernández-Sánchez
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC), Calle Zacarías González 2, 37007 Salamanca, Spain
| | - I. Recio
- Servicio de Hematología, Hospital Nuestra Señora de Sonsoles, Plaza de Santiago 1, 05002 Ávila, Spain
| | - J. Galende
- Servicio de Hematología, Hospital El Bierzo, Calle Médicos sin Fronteras 7, 24411 Ponferrada, León, Spain
| | - G. Martín-Núñez
- Servicio de Hematología, Hospital Virgen del Puerto, Paraje Valcorchero, 10600 Plasencia, Cáceres, Spain
| | - J. M. Alonso
- Servicio de Hematología, Hospital Río Carrión, Avenida Donantes de Sangre, s/n, 34005 Palencia, Spain
| | - J. M. Hernández-Rivas
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
- Centro de Investigación del Cáncer-IBMCC, Universidad de Salamanca (USAL-CSIC), Calle Zacarías González 2, 37007 Salamanca, Spain
| | - M. González
- Servicio de Hematología, IBSAL-Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, 37007 Salamanca, Spain
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Kotsianidis I. Surface antigen expression in CLL: a new member among the mnesteres for the prognosis of bad risk disease. Leuk Res 2014; 38:423-4. [PMID: 24636703 DOI: 10.1016/j.leukres.2014.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 01/19/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Ioannis Kotsianidis
- Department of Hematology, Democritus University of Thrace, Medical School, Alexandroupolis, Greece.
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Shvidel L, Tadmor T, Braester A, Bairey O, Rahimi-Levene N, Herishanu Y, Klepfish A, Ruchlemer R, Berrebi A, Polliack A. Serum immunoglobulin levels at diagnosis have no prognostic significance in stage A chronic lymphocytic leukemia: a study of 1113 cases from the Israeli CLL Study Group. Eur J Haematol 2014; 93:29-33. [PMID: 24547751 DOI: 10.1111/ejh.12290] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVES Hypogammaglobulinemia, commonly encountered in chronic lymphocytic leukemia (CLL), is one of the main causes of morbidity and mortality; however, its prognostic significance in patients diagnosed in early stages of disease remains uncertain. The aim of this study was to evaluate the predictive power of hypogammaglobulinemia at Bonet stage A. METHODS Using the database of the Israeli CLL Study Group, we analyzed the relationship between low serum levels of IgG, IgA, and IgM; the presence of paraproteinemia, as well as other well-recognized prognostic markers in CLL; and time to first treatment (TTT) and overall survival. A total of 1113 patients consecutively diagnosed during the last 25 yrs with Binet stage A CLL were evaluated, and baseline information on serum immunoglobulin levels was found in 857 of the cases. RESULTS Overall survival times correlated with age >65 yr, male gender, the presence of lymphadenopathy, high serum beta 2-microglobulin (b2m), CD38 and ZAP-70 expression, but not with low levels of immunoglobulin or the presence of paraproteinemia. By univariate analysis, patients with low IgA levels had a shorter TTT; however, on multivariate analysis, the presence of lymphadenopathy (P 0.02), b2m (P 0.04), CD38 (P < 0.001), and ZAP-70 (P < 0.001) was the only laboratory parameters with prognostic significance. CONCLUSIONS In our cohort of patients with early-stage CLL, baseline hypogammaglobulinemia and the presence of paraproteinemia were not found to correlate with prognosis.
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Affiliation(s)
- Lev Shvidel
- Kaplan Medical Center, Rehovot, Hadassah and Hebrew University Medical School, Jerusalem, Israel
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Treatment of older patients with chronic lymphocytic leukemia: key questions and current answers. Hematology 2013; 2013:158-67. [DOI: 10.1182/asheducation-2013.1.158] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AbstractDespite the advanced age at onset, chronic lymphocytic leukemia (CLL) shortens the life expectancy of the majority of newly diagnosed patients. The management of elderly patients with CLL is more complex than that of younger patients due to the greater frequency of comorbidities and functional impairment as well as reduced organ function. Many of the recent advances in the care of CLL patients (prognostication, more intense combination therapy regimens) are of unclear relevance for elderly patients. This review addresses 5 key questions in the management of elderly patients with CLL: (1) why is classifying the “fitness” of CLL patients necessary; (2) what criteria should be used to classify patient fitness; (3) when should elderly patients be treated; (4) how should therapy be selected for elderly patients; and (5) which therapy is best (for this patient)?
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Chillemi A, Zaccarello G, Quarona V, Ferracin M, Ghimenti C, Massaia M, Horenstein AL, Malavasi F. Anti-CD38 antibody therapy: windows of opportunity yielded by the functional characteristics of the target molecule. Mol Med 2013; 19:99-108. [PMID: 23615966 DOI: 10.2119/molmed.2013.00009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 04/16/2013] [Indexed: 01/20/2023] Open
Abstract
In vivo use of monoclonal antibodies (mAbs) has become a mainstay of routine clinical practice in the treatment of various human diseases. A number of molecules can serve as targets, according to the condition being treated. Now entering human clinical trials, CD38 molecule is a particularly attractive target because of its peculiar pattern of expression and its twin role as receptor and ectoenzyme. This review provides a range of analytical perspectives on the current progress in and challenges to anti-CD38 mAb therapy. We present a synopsis of the evidence available on CD38, particularly in myeloma and chronic lymphocytic leukemia (CLL). Our aim is to make the data from basic science helpful and accessible to a diverse clinical audience and, at the same time, to improve its potential for in vivo use. The topics covered include tissue distribution and signal implementation by mAb ligation and the possibility of increasing cell density on target cells by exploiting information about the molecule's regulation in combination with drugs approved for in vivo use. Also analyzed is the behavior of CD38 as an enzyme: CD38 is a component of a pathway leading to the production of adenosine in the tumor microenvironment, thus inducing local anergy. Consequently, not only might CD38 be a prime target for mAb-mediated therapy, but its functional block may contribute to general improvement in cancer immunotherapy and outcomes.
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Affiliation(s)
- Antonella Chillemi
- Laboratory of Immunogenetics, Department of Medical Sciences, University of Torino Medical School, Torino, Italy
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Quarona V, Zaccarello G, Chillemi A, Brunetti E, Singh VK, Ferrero E, Funaro A, Horenstein AL, Malavasi F. CD38 and CD157: a long journey from activation markers to multifunctional molecules. CYTOMETRY PART B-CLINICAL CYTOMETRY 2013; 84:207-17. [PMID: 23576305 DOI: 10.1002/cyto.b.21092] [Citation(s) in RCA: 208] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/06/2013] [Accepted: 03/21/2013] [Indexed: 12/17/2022]
Abstract
CD38 (also known as T10) was identified in the late 1970s in the course of pioneering work carried out at the Dana-Farber Cancer Center (Boston, MA) that focused on the identification of surface molecules involved in antigen recognition. CD38 was initially found on thymocytes and T lymphocytes, but today we know that the molecule is found throughout the immune system, although its expression levels vary. Because of this, CD38 was considered an "activation marker," a term still popular in routine flow cytometry. This review summarizes the findings obtained from different approaches, which led to CD38 being re-defined as a multifunctional molecule. CD38 and its homologue CD157 (BST-1), contiguous gene duplicates on human chromosome 4 (4p15), are part of a gene family encoding products that modulate the social life of cells by means of bidirectional signals. Both CD38 and CD157 play dual roles as receptors and ectoenzymes, endowed with complex activities related to signaling and cell homeostasis. The structure-function analysis presented here is intended to give clinical scientists and flow cytometrists a background knowledge of these molecules. The link between CD38/CD157 and human diseases will be explored here in the context of chronic lymphocytic leukemia, myeloma and ovarian carcinoma, although other disease associations are also known. Thus CD38 and CD157 have evolved from simple leukocyte activation markers to multifunctional molecules involved in health and disease. Future tasks will be to explore their potential as targets for in vivo therapeutic interventions and as regulators of the immune response.
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Affiliation(s)
- Valeria Quarona
- Department of Medical Sciences, Laboratory of Immunogenetics, University of Torino Medical School, Torino, Italy
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