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Rahimian E, Amini A, Alikarami F, Pezeshki SMS, Saki N, Safa M. DNA repair pathways as guardians of the genome: Therapeutic potential and possible prognostic role in hematologic neoplasms. DNA Repair (Amst) 2020; 96:102951. [PMID: 32971475 DOI: 10.1016/j.dnarep.2020.102951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 11/30/2022]
Abstract
DNA repair pathways, which are also identified as guardians of the genome, protect cells from frequent damage that can lead to DNA breaks. The most deleterious types of damage are double-strand breaks (DSBs), which are repaired by homologous recombination (HR) and non-homologous end joining (NHEJ). Single strand breaks (SSBs) can be corrected through base excision repair (BER), nucleotide excision repair (NER), and mismatch repair (MMR). Failure to restore DNA lesions or inappropriately repaired DNA damage culminates in genomic instability and changes in the regulation of cellular functions. Intriguingly, particular mutations and translocations are accompanied by special types of leukemia. Besides, expression patterns of certain repair genes are altered in different hematologic malignancies. Moreover, analysis of mutations in key mediators of DNA damage repair (DDR) pathways, as well as investigation of their expression and function, may provide us with emerging biomarkers of response/resistance to treatment. Therefore, defective DDR pathways can offer a rational starting point for developing DNA repair-targeted drugs. In this review, we address genetic alterations and gene/protein expression changes, as well as provide an overview of DNA repair pathways.
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Affiliation(s)
- Elahe Rahimian
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Amini
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Alikarami
- Center for Childhood Cancer Research, Children's Hospital of Philadelphia (CHOP), Philadelphia, PA 19104, USA
| | - Seyed Mohammad Sadegh Pezeshki
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmaldin Saki
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Safa
- Department of Hematology and Blood Banking, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran; Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.
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2
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Sharifi Z, Faranoush M, Mohseni A, Rostami S, Ramzi M, Sharifi MJ. Genetic variants of nucleotide excision repair pathway and outcomes of induction therapy in acute myeloid leukemia. Per Med 2019; 16:479-490. [PMID: 31647372 DOI: 10.2217/pme-2018-0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Aim: Acute myeloid leukemia (AML) is a heterogeneous disease in pathogenesis and response to therapy. Nucleotide excision repair (NER) pathway has a major role in the elimination of genotoxic effects of chemotherapeutic agents. We aimed to clarify the effects of selected variants of XPD, XPC, ERCC5 and ERCC1 genes on the outcomes of induction therapy. Materials & methods: The prevalence of NER genetic variants was evaluated in 67 subjects with AML and their effects on clinical outcomes were analyzed by χ2 test. Results: The XPD 751 Lys variant was associated with improved response to chemotherapy compared with XPD 751 Gln and Lys/Gln variants (p = 0.023; odds ratio: 4.5; 95% CI: 1.14-17.73). There were no associations between other genotypes and any outcomes. Conclusion: Current findings suggest that XPD Lys751Gln variant could be considered as a prognostic factor in AML.
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Affiliation(s)
- Zohreh Sharifi
- Blood Transfusion Research Center, High Institute for Research & Education in Transfusion Medicine, Tehran, Iran
| | - Mohammad Faranoush
- Rasool Akram Complex Medical Center, Iran University ofMedical Sciences, Tehran, Iran
| | - Alireza Mohseni
- Thalassemia Research Center, Hemoglobinopthy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahrbano Rostami
- Haematology-Oncology & Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran,Iran
| | - Mani Ramzi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Mohammad J Sharifi
- Blood Transfusion Research Center, High Institute for Research & Education in Transfusion Medicine, Tehran, Iran.,Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences & Health Services, Isfahan, Iran
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3
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Azevedo AP, Silva SN, Reichert A, Lima F, Júnior E, Rueff J. Effects of polymorphic DNA genes involved in BER and caspase pathways on the clinical outcome of myeloproliferative neoplasms under treatment with hydroxyurea. Mol Med Rep 2018; 18:5243-5255. [PMID: 30320340 DOI: 10.3892/mmr.2018.9535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 06/01/2018] [Indexed: 11/06/2022] Open
Abstract
Several single nucleotide polymorphisms (SNPs) influencing DNA repair capacity and apoptotic status may confer genetic predisposition to Philadelphia‑chromosome negative myeloproliferative neoplasms (PN‑MPNs), and influence therapeutic response and the clinical course. In the present study, whether SNPs in genes involved in apoptosis and the base excision repair (BER) pathway was evaluated. In addition, some known risk factors in PN‑MPNs that may influence survival and therapeutic response to hydroxyurea (HU) were analyzed, taking into account three items: Disease progression, predisposition to new non‑myeloid neoplasms and thrombotic events. The present study involved a total of 133 Caucasian Portuguese PN‑MPNs patients treated with HU, whereby 17 cases showed progression to myelofibrosis/leukemia, 11 developed new non‑myeloid neoplasms and 22 presented with thrombotic events. Progression to secondary myelofibrosis/leukemia is influenced by exposure to cytoreductive agents, and caspase and BER polymorphisms {globally, CASP8 3'untranslated region [odds ratio (OR)=0.24; 95% confidence interval (CI), 0.08‑0.69], XRCC1 Arg194Trp [OR=3.58; 95% CI, 0.98‑13.01]; for essential thrombocythemia patients CASP9 Arg173His [OR=11.27; 95% CI, 1.13‑112.28], APEX1 Asp148Glu [OR=0.28; 95% CI, 0.74‑1.03], and XRCC1 Arg194Trp [OR=6.60; 95% CI, 1.60‑27.06]}. Moreover, globally caspase and BER polymorphisms influenced the development of new nonmyeloid malignancies [CASP8 Asp270His (OR=5.90; 95% CI, 1.42‑24.62) and XRCC1 Arg399Gln (OR=0.27; 95% CI, 0.07‑1.03)]. On the other hand, only the BER pathway had a role in the presence of thrombotic events [XRCC1 Gln399Arg (OR=0.35; 95% CI, 0.14‑0.88)]. JAK2 mutation had no influence on these complications. Larger studies are required to confirm these results, and to provide conclusive evidence of association between these and other variants with PN‑MPNs therapeutic response and clinical evolution. However, this study may allow the development of drugs more directly targeted to the pathophysiology of the disease, with high efficacy, fewer adverse effects, contributing to compliance of patients with treatments. The clinical indication for classical drugs, including HU, may be guided by variant genes, which may provide additional beneficial effects.
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Affiliation(s)
- Ana P Azevedo
- Centre for Toxicogenomics and Human Health (Toxomics), Genetics, Oncology and Human Toxicology, NOVA Medical School/Faculty of Medical Sciences, Universidade Nova de Lisboa, 1150‑082 Lisbon, Portugal
| | - Susana N Silva
- Centre for Toxicogenomics and Human Health (Toxomics), Genetics, Oncology and Human Toxicology, NOVA Medical School/Faculty of Medical Sciences, Universidade Nova de Lisboa, 1150‑082 Lisbon, Portugal
| | - Alice Reichert
- Department of Clinical Haematology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449‑005 Lisbon, Portugal
| | - Fernando Lima
- Department of Clinical Haematology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449‑005 Lisbon, Portugal
| | - Esmeraldina Júnior
- Department of Clinical Pathology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449‑005 Lisbon, Portugal
| | - José Rueff
- Centre for Toxicogenomics and Human Health (Toxomics), Genetics, Oncology and Human Toxicology, NOVA Medical School/Faculty of Medical Sciences, Universidade Nova de Lisboa, 1150‑082 Lisbon, Portugal
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4
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New polymorphisms of Xeroderma Pigmentosum DNA repair genes in myelodysplastic syndrome. Leuk Res 2017; 58:73-82. [DOI: 10.1016/j.leukres.2017.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/16/2017] [Accepted: 03/19/2017] [Indexed: 11/21/2022]
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5
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Alvarez-Larrán A, Senín A, Fernández-Rodríguez C, Pereira A, Arellano-Rodrigo E, Gómez M, Ferrer-Marin F, Martínez-López J, Camacho L, Colomer D, Angona A, Navarro B, Cervantes F, Besses C, Bellosillo B, Hernández-Boluda JC. Impact of genotype on leukaemic transformation in polycythaemia vera and essential thrombocythaemia. Br J Haematol 2017; 178:764-771. [DOI: 10.1111/bjh.14762] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 03/29/2017] [Indexed: 12/25/2022]
Affiliation(s)
- Alberto Alvarez-Larrán
- Haematology Department; Hospital del Mar-IMIM; Universidad Autónoma de Barcelona; Barcelona Spain
| | - Alicia Senín
- Haematology Department; Hospital del Mar-IMIM; Universidad Autónoma de Barcelona; Barcelona Spain
| | | | - Arturo Pereira
- Haemotherapy and Haemostasis Department; Hospital Clínic-IDIBAPS; Barcelona Spain
| | | | - Montse Gómez
- Haematology Department; Hospital Clínico-INCLIVA; Valencia Spain
| | - Francisca Ferrer-Marin
- Haematology and Medical Oncology; Hospital Morales-Messeguer; CIBERER; UCAM; Murcia Spain
| | | | - Laura Camacho
- Pathology Department-IMIM; Hospital del Mar; Universidad Pompeu Fabra; Barcelona Spain
| | - Dolors Colomer
- Haematopathology Unit; Hospital Clínic-IDIBAPS; Barcelona Spain
| | - Anna Angona
- Haematology Department; Hospital del Mar-IMIM; Universidad Autónoma de Barcelona; Barcelona Spain
| | - Blanca Navarro
- Haematology Department; Hospital Clínico-INCLIVA; Valencia Spain
| | | | - Carlos Besses
- Haematology Department; Hospital del Mar-IMIM; Universidad Autónoma de Barcelona; Barcelona Spain
| | - Beatriz Bellosillo
- Pathology Department-IMIM; Hospital del Mar; Universidad Pompeu Fabra; Barcelona Spain
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6
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Grinfeld J, Godfrey AL. After 10 years of JAK2V617F: Disease biology and current management strategies in polycythaemia vera. Blood Rev 2017; 31:101-118. [DOI: 10.1016/j.blre.2016.11.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 11/08/2016] [Accepted: 11/14/2016] [Indexed: 12/12/2022]
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7
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Rumi E, Cazzola M. Advances in understanding the pathogenesis of familial myeloproliferative neoplasms. Br J Haematol 2017; 178:689-698. [PMID: 28444727 DOI: 10.1111/bjh.14713] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Myeloproliferative neoplasms (MPNs) are generally acquired as a result of a somatic stem cell mutation leading to clonal expansion of myeloid precursors. In addition to sporadic cases, familial MPN occurs when one or several MPN affect different relatives of the same family. MPN driver mutations (JAK2, CALR, MPL) are somatically acquired also in familial cases, so a genetic predisposition to acquire one of the MPN driver mutations would be inherited, even though the causative germline mutations underlying familial MPN remain largely unknown. Recently some germline variants [ATG2B and GSKIP duplication, RBBP6 mutations, SH2B3 (LNK) mutations], which can cause familial MPN, have been reported but these mutations are rare and do not explain most familial cases. Patients with familial MPN show the same clinical features and suffer the same complications as those with sporadic disease. This review aims to offer up-to-date information regarding the genetics of familial MPN.
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Affiliation(s)
- Elisa Rumi
- Department of Haematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Mario Cazzola
- Department of Haematology Oncology, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
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8
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Azevedo AP, Silva SN, De Lima JP, Reichert A, Lima F, Júnior E, Rueff J. DNA repair genes polymorphisms and genetic susceptibility to Philadelphia-negative myeloproliferative neoplasms in a Portuguese population: The role of base excision repair genes polymorphisms. Oncol Lett 2017; 13:4641-4650. [PMID: 28599464 PMCID: PMC5452988 DOI: 10.3892/ol.2017.6065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 01/26/2017] [Indexed: 02/06/2023] Open
Abstract
The role of base excision repair (BER) genes in Philadelphia-negative (PN)-myeloproliferative neoplasms (MPNs) susceptibility was evaluated by genotyping eight polymorphisms [apurinic/apyrimidinic endodeoxyribonuclease 1, mutY DNA glycosylase, earlier mutY homolog (E. coli) (MUTYH), 8-oxoguanine DNA glycosylase 1, poly (ADP-ribose) polymerase (PARP) 1, PARP4 and X-ray repair cross-complementing 1 (XRCC1)] in a case-control study involving 133 Caucasian Portuguese patients. The results did not reveal a correlation between individual BER polymorphisms and PN-MPNs when considered as a whole. However, stratification for essential thrombocythaemia revealed i) borderline effect/tendency to increased risk when carrying at least one variant allele for XRCC1_399 single-nucleotide polymorphism (SNP); ii) decreased risk for Janus kinase 2-positive patients carrying at least one variant allele for XRCC1_399 SNP; and iii) decreased risk in females carrying at least one variant allele for MUTYH SNP. Combination of alleles demonstrated an increased risk to PN-MPNs for one specific haplogroup. These findings may provide evidence for gene variants in susceptibility to MPNs. Indeed, common variants in DNA repair genes may hamper the capacity to repair DNA, thus increasing cancer susceptibility.
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Affiliation(s)
- Ana P Azevedo
- Centre for Toxicogenomics and Human Health (ToxOmics), Genetics, Oncology and Human Toxicology, NOVA Medical School, Faculty of Medical Sciences, NOVA University of Lisbon, 1169-056 Lisbon, Portugal.,Department of Clinical Pathology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449-005 Lisbon, Portugal
| | - Susana N Silva
- Centre for Toxicogenomics and Human Health (ToxOmics), Genetics, Oncology and Human Toxicology, NOVA Medical School, Faculty of Medical Sciences, NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - João P De Lima
- Centre for Toxicogenomics and Human Health (ToxOmics), Genetics, Oncology and Human Toxicology, NOVA Medical School, Faculty of Medical Sciences, NOVA University of Lisbon, 1169-056 Lisbon, Portugal
| | - Alice Reichert
- Department of Clinical Haematology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449-005 Lisbon, Portugal
| | - Fernando Lima
- Department of Clinical Haematology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449-005 Lisbon, Portugal
| | - Esmeraldina Júnior
- Department of Clinical Pathology, Hospital of São Francisco Xavier, West Lisbon Hospital Centre, 1449-005 Lisbon, Portugal
| | - José Rueff
- Centre for Toxicogenomics and Human Health (ToxOmics), Genetics, Oncology and Human Toxicology, NOVA Medical School, Faculty of Medical Sciences, NOVA University of Lisbon, 1169-056 Lisbon, Portugal
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9
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ElMahgoub IR, Gouda HM, Samra MA, Shaheen IA, ElMaraashly AH. Polymorphisms of xeroderma pigmentosum genes (XPC, XPD, and XPG) and susceptibility to acute leukemia among a sample of Egyptian patients. J Hematop 2017. [DOI: 10.1007/s12308-017-0290-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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10
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Bănescu C, Iancu M, Trifa AP, Dobreanu M, Moldovan VG, Duicu C, Tripon F, Crauciuc A, Skypnyk C, Bogliș A, Lazar E. Influence of XPC, XPD, XPF, and XPG gene polymorphisms on the risk and the outcome of acute myeloid leukemia in a Romanian population. Tumour Biol 2016; 37:9357-66. [PMID: 26779634 DOI: 10.1007/s13277-016-4815-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Accepted: 01/06/2016] [Indexed: 02/05/2023] Open
Affiliation(s)
- Claudia Bănescu
- Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania.
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, 8 Victor Babes St, 400012, Cluj-Napoca, Romania
| | - Adrian P Trifa
- Department of Medical Genetics, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, 8 Victor Babes St, 400012, Cluj-Napoca, Romania
| | - Minodora Dobreanu
- Department of Laboratory Medicine, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
| | - Valeriu G Moldovan
- Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
| | - Carmen Duicu
- Pediatric Clinic, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
| | - Florin Tripon
- Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
| | - Andrei Crauciuc
- Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
| | - Cristina Skypnyk
- Al Jawhara Center for Molecular Medicine, College of Medicine, Arabian Gulf University, P.O. Box 26671, Manama, Bahrain
| | - Alina Bogliș
- Department of Medical Genetics, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
| | - Erzsebeth Lazar
- Hematology Clinic 2, University of Medicine and Pharmacy Tirgu Mures, 38 Gh Marinescu St, 540139, Tirgu Mures, Romania
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11
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Alvarez-Larrán A, Kerguelen A, Hernández-Boluda JC, Pérez-Encinas M, Ferrer-Marín F, Bárez A, Martínez-López J, Cuevas B, Mata MI, García-Gutiérrez V, Aragües P, Montesdeoca S, Burgaleta C, Caballero G, Hernández-Rivas JA, Durán MA, Gómez-Casares MT, Besses C. Frequency and prognostic value of resistance/intolerance to hydroxycarbamide in 890 patients with polycythaemia vera. Br J Haematol 2015; 172:786-93. [PMID: 26898196 DOI: 10.1111/bjh.13886] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 10/30/2015] [Indexed: 01/23/2023]
Abstract
The clinical significance of resistance/intolerance to hydroxycarbamide (HC) was assessed in a series of 890 patients with polycythaemia vera (PV). Resistance/intolerance to HC was recorded in 137 patients (15·4%), consisting of: need for phlebotomies (3·3%), uncontrolled myeloproliferation (1·6%), failure to reduce massive splenomegaly (0·8%), development of cytopenia at the lowest dose of HC to achieve a response (1·7%) and extra-haematological toxicity (9%). With a median follow-up of 4·6 years, 99 patients died, resulting in a median survival of 19 years. Fulfilling any of the resistance/intolerance criteria had no impact on survival but when the different criteria were individually assessed, an increased risk of death was observed in patients developing cytopenia [Hazard ratio (HR): 3·5, 95% confidence interval (CI): 1·5-8·3, P = 0·003]. Resistance/intolerance had no impact in the rate of thrombosis or bleeding. Risk of myelofibrotic transformation was significantly higher in those patients developing cytopenia (HR: 5·1, 95% CI: 1·9-13·7, P = 0·001) and massive splenomegaly (HR: 9·1, 95% CI: 2·3-35·9, P = 0·002). Cytopenia at the lowest dose required to achieve a response was also an independent risk factor for transformation to acute leukaemia (HR: 20·3, 95% CI: 5·4-76·5, P < 0·001). In conclusion, the unified definition of resistance/intolerance to HC delineates a heterogeneous group of PV patients, with those developing cytopenia being associated with an adverse outcome.
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Affiliation(s)
| | - Ana Kerguelen
- Haematology Department, Hospital La Paz, Madrid, Spain
| | | | | | | | - Abelardo Bárez
- Haematology Department, Hospital Nuestra Señora de Sonsoles, Avila, Spain
| | | | - Beatriz Cuevas
- Haematology Department, Hospital Universitario de Burgos, Burgos, Spain
| | - M Isabel Mata
- Haematology Department, Hospital Costa del Sol, Marbella, Spain
| | | | - Pilar Aragües
- Haematology Department, Hospital de Cruces, Bilbao, Spain
| | | | - Carmen Burgaleta
- Haematology Department, Hospital Príncipe de Asturias, Alcalá de Henares, Spain
| | | | | | | | | | - Carles Besses
- Haematology Department, Hospital del Mar, Barcelona, Spain
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12
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Gómez M, Guillem V, Pereira A, Ferrer-Marín F, Álvarez-Larrán A, Kerguelen A, Estrada N, Martínez-López J, Angona A, Amat P, Navarro B, Besses C, Hernández-Boluda JC. Risk factors for non-melanoma skin cancer in patients with essential thrombocythemia and polycythemia vera. Eur J Haematol 2015; 96:285-90. [DOI: 10.1111/ejh.12588] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2015] [Indexed: 12/20/2022]
Affiliation(s)
- Montse Gómez
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Vicent Guillem
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Arturo Pereira
- Hemotherapy and Hemostasis Department; Hospital Clínic; Barcelona Spain
| | | | | | - Ana Kerguelen
- Hematology Department; Hospital La Paz; Madrid Spain
| | - Natàlia Estrada
- Hematology Department; Institut Català d'Oncologia-Hospital Germans Trias i Pujol; Badalona Spain
| | | | - Anna Angona
- Hematology Department; Hospital del Mar-IMIM; Barcelona Spain
| | - Paula Amat
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Blanca Navarro
- Hematology and Medical Oncology Department; Hospital Clínico Universitario; INCLIVA; Valencia Spain
| | - Carles Besses
- Hematology Department; Hospital del Mar-IMIM; Barcelona Spain
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13
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The Effects of Alcohol and Aldehyde Dehydrogenases on Disorders of Hematopoiesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 815:349-59. [DOI: 10.1007/978-3-319-09614-8_20] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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14
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Offenmüller S, Ravindranath Y, Goyette G, Kanakapalli D, Miller KS, Brecht IB, Zolk O. Focused screening of a panel of cancer-related genetic polymorphisms reveals new susceptibility loci for pediatric acute lymphoblastic leukemia. Pediatr Blood Cancer 2014; 61:1411-5. [PMID: 24604828 DOI: 10.1002/pbc.25011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 02/03/2014] [Indexed: 12/17/2022]
Abstract
BACKGROUND A genetic predisposition to acute lymphoblastic leukemia (ALL) in childhood is well established. Currently known risk loci, however, explain only one third of the estimated total risk related to common genetic variations. PROCEDURE We genotyped 1,421 polymorphisms in 407 candidate genes from the SNP500Cancer database (National Cancer Institute) using the Illumina Cancer SNP Panel. We investigated 78 cases (aged 0-19 years at diagnosis, and mixed ethnic background) of childhood B-precursor ALL and compared genotype data with those of 1,417 HapMap controls. To account for the ethnic diversity of the study population, structured association by genetically matching cases and controls using identity-by-state similarity was used. Case-control association analyses were performed using Cochran-Mantel-Haenszel tests, adjusted for the population substructure. RESULTS Common variations rs6966 (3' UTR of PPP1R13L, chr 19q13.32, P = 4.55 × 10(-9)) and rs414580 (intron 2 of MSR1, chr 8p22, P = 6.09 × 10(-8)) were significantly associated with ALL. These SNPs remained significant after adjustment for multiple testing. The SNP rs6966 tags a haplotype block which includes SNPs in PPP1R13L and ERCC2 genes, which are related to DNA repair and cell survival. rs6966 and rs414580 conferred allelic odds ratios of 3.74 (95% confidence interval [CI] 2.31-6.04) and 3.93 (95% CI 2.31-6.69), respectively. CONCLUSIONS These findings reveal two independent novel susceptibility loci for childhood ALL.
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Affiliation(s)
- Sonja Offenmüller
- Pediatric Oncology and Hematology, University Children's Hospital, Erlangen, Germany
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15
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Liu D, Wu D, Li H, Dong M. The effect of XPD/ERCC2 Lys751Gln polymorphism on acute leukemia risk: a systematic review and meta-analysis. Gene 2014; 538:209-16. [PMID: 24486506 DOI: 10.1016/j.gene.2014.01.049] [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: 05/22/2013] [Revised: 01/06/2014] [Accepted: 01/14/2014] [Indexed: 11/24/2022]
Abstract
AIMS Epidemiological studies have assessed the association between xeroderma pigmentosum group D (XPD) Lys751Gln and acute leukemia risk with conflicting results. We performed this meta-analysis to derive a more precise estimation of the relationship. Pooled odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the strength of the association. RESULTS Ten published case-control studies including a total of 1494 cases and 2259 controls were identified. Overall, significant risk effects of Lys751Gln genotype was found under the dominant model (OR=1.16; 95% CI=1.01-1.34; P=0.032). When stratified by clinical types, the variant genotype was associated with the acute myeloid leukemia (AML) risk under the heterozygote comparison (OR=1.20; 95% CI=1.00-1.43; P=0.048), the homozygote comparison (OR=1.35; 95% CI=1.05-1.74; P=0.019) and the dominant model (OR=1.23; 95% CI=1.04-1.45; P=0.015), respectively. Furthermore, significantly increased risks were also pronounced in Caucasian AML patients (the homozygote comparison: OR=1.38; 95% CI=1.07-1.78; P=0.013; the dominant model: OR=1.23; 95% CI=1.03-1.46; P=0.020; and the recessive model: OR=1.26; 95% CI=1.00-1.60; P=0.050). No evident heterogeneities were observed for the overall data under all genetic models. In addition, no statistical evidence for publication bias was found using the method of Begg's and Egger's tests. CONCLUSION This meta-analysis suggested that XPD Lys751Gln polymorphism might be a risk factor for AML and Caucasian acute leukemia patients.
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Affiliation(s)
- Duo Liu
- Department of pharmacy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Dongyuan Wu
- Department of pharmacy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Hongbin Li
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China
| | - Mei Dong
- Department of pharmacy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, China.
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16
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[Treatment of essential thrombocythemia]. Med Clin (Barc) 2013; 141:260-4. [PMID: 23490491 DOI: 10.1016/j.medcli.2013.01.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 12/05/2012] [Accepted: 01/10/2013] [Indexed: 01/14/2023]
Abstract
Essential thrombocythemia is a chronic myeloproliferative neoplasm characterized by sustained thrombocytosis, bone marrow megakaryocytic hyperplasia and an increased risk of thrombosis and hemorrhage. The goal of treatment is to prevent the development of vascular complications without increasing the risk of transformation. Patients aged>60 years or a history of thrombosis have a high risk of thrombosis while those with a platelet count>1,500 x 10(9)/l have a higher risk of hemorrhage. Patients with low-risk essential thrombocythemia can be managed appropriately with low-dose of acetylsalicylic acid or even observation only, while patients with a high-risk disease are candidates to receive cytoreductive treatment, hydroxyurea being the first choice therapy. Anagrelide is the most suitable option for patients with resistance or intolerance to hydroxyurea. All patients must be submitted to a rigorous control of cardiovascular risk factors.
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Abstract
Myeloproliferative neoplasms (MPNs) are haematological disorders characterized by an overproduction of mature myeloid cells with a tendency to transform to acute myeloid leukaemia. Clonal proliferation of myeloid progenitor cells is driven by somatically acquired mutations, most notably JAK2 V617F, but there are important features relating to pathogenesis and phenotypic diversity that cannot be explained by acquired mutations alone. In this review we consider what is currently known about the role that inherited factors play in the development and biology of both sporadic and familial forms of MPN. Although most MPN cases appear to be sporadic, familial predisposition has been recognized for many years in a subset of cases and epidemiological studies have indicated the presence of common susceptibility alleles. Currently the JAK2 46/1 haplotype (also referred to as 'GGCC') is the strongest known predisposition factor for sporadic MPNs carrying a JAK2 V617F mutation, explaining a large proportion of the heritability of this disorder. Less is known about what genetic variants predispose to MPNs that lack JAK2 V617F, but there have been recent reports of interesting associations in biologically plausible candidates, and more loci are set to emerge with the application of systematic genome-wide association methodologies. Several highly penetrant predisposition variants that affect erythropoietin signalling, thrombopoietin signalling or oxygen sensing have been characterized in families with nonclonal hereditary erythrocytosis or thrombocytosis, but much less is known about familial predisposition to true clonal MPN. The heterogeneous pattern of inheritance and presumed genetic heterogeneity in these families makes analysis difficult, but whole exome or genome sequencing should provide novel insights into these elusive disorders.
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Affiliation(s)
- Amy V Jones
- Wessex Regional Genetics Laboratory, Salisbury, UK, Faculty of Medicine, University of Southampton, Southampton, UK
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18
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Second primary malignancies in head and neck cancer patients: high prevalence of curable-stage disease. Strahlenther Onkol 2013; 189:874-80. [PMID: 23842636 DOI: 10.1007/s00066-013-0404-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 06/03/2013] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Patients treated for squamous cell carcinoma of the head and neck (HNSCC) carry a high risk of second primary malignancies (SPM). Recently, computed tomography (CT) of the chest was shown to significantly decrease the risk of death due to bronchial carcinoma (BC) in a cohort of smokers whose risk of BC is increased but might be lower than that of patients previously treated for HNSCC. Thus, the present study evaluated the potential benefit of CT and other examinations in the detection of SPM in HNSCC patients. PATIENTS AND METHODS Between July 2008 and November 2011, 118 participants underwent a prospective, systematic examination for SPM (13 women, 105 men, median age 62 years). All patients had been previously treated for HNSCC and showed no recurrence or distant metastases at the time of the study start. CT scans, ear-nose-throat endoscopy, and endoscopy of the esophagus and stomach were performed. RESULTS Overall, 33 suspicious findings were clarified by additional investigations. In all, 26 SPM were confirmed in 21 of 118 patients (18%; 10 lung, 7 HNSCC, 3 gastrointestinal, 1 renal). Eighteen of these 21 patients (86%) underwent therapy with curative intent. CONCLUSION The examinations revealed a high prevalence of curable stage SPM in HNSCC patients. Adapting a surveillance scheme including a chest CT is recommended.
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Poletto V, Villani L, Catarsi P, Campanelli R, Massa M, Vannucchi AM, Rosti V, Barosi G. No association between the XPD Lys751Gln (rs13181) polymorphism and disease phenotype or leukemic transformation in primary myelofibrosis. Haematologica 2013; 98:e83-4. [PMID: 23716550 DOI: 10.3324/haematol.2013.086496] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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20
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Susini MC, Guglielmelli P, Spolverini A, Biamonte F, Mannarelli C, Barosi G, Zoi K, Reiter A, Duncombe A, Cervantes F, Cazzola M, Cross N, Vannucchi AM. TheERCC2Gln/Gln polymorphism at codon 751 is not associated with leukaemic transformation in primary myelofibrosis. Br J Haematol 2013; 162:424-7. [DOI: 10.1111/bjh.12376] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria C. Susini
- Department of Experimental and Clinical Medicine; University of Florence; Florence; Italy
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine; University of Florence; Florence; Italy
| | - Ambra Spolverini
- Department of Experimental and Clinical Medicine; University of Florence; Florence; Italy
| | - Flavia Biamonte
- Department of Experimental and Clinical Medicine; University of Florence; Florence; Italy
| | - Carmela Mannarelli
- Department of Experimental and Clinical Medicine; University of Florence; Florence; Italy
| | - Giovanni Barosi
- Centro per la Mielofibrosi; Fondazione Policlinico San matteo; IRCCS; Pavia; Italy
| | - Katerina Zoi
- Haematology Research Laboratory; Academy of Athens; Athens; Greece
| | - Andreas Reiter
- III Medizinische Klinik; University of Mannheim; Mannheim; Germany
| | - Andrew Duncombe
- Department of Haematology; Southampton University Hospitals Trust; Southampton; UK
| | - Francisco Cervantes
- Haematology Department; Hospital Clinic; University of Barcelona; Barcelona; Spain
| | - Mario Cazzola
- Division of Hematology; Fondazione IRCCS Policlinico San Matteo; University of Pavia; Pavia; Italy
| | - Nick Cross
- Wessex Regional Genetics Laboratory; Salisbury District Hospital; University of Southampton; Salisbury; UK
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21
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Aetiology, genetics and prevention of secondary neoplasms in adult cancer survivors. Nat Rev Clin Oncol 2013; 10:289-301. [PMID: 23529000 DOI: 10.1038/nrclinonc.2013.41] [Citation(s) in RCA: 182] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Second and higher-order malignancies now comprise about 18% of all incident cancers in the USA, superseding first primary cancers of the breast, lung, and prostate. The occurrence of second malignant neoplasms (SMN) is influenced by a myriad of factors, including the late effects of cancer therapy, shared aetiological factors with the primary cancer (such as tobacco use, excessive alcohol intake, and obesity), genetic predisposition, environmental determinants, host effects, and combinations of factors, including gene-environment interactions. The influence of these factors on SMN in survivors of adult-onset cancer is reviewed here. We also discuss how modifiable behavioural and lifestyle factors may contribute to SMN, and how these factors can be managed. Cancer survivorship provides an opportune time for oncologists and other health-care providers to counsel patients with regard to health promotion, not only to reduce SMN risk, but to minimize co-morbidities. In particular, the importance of smoking cessation, weight control, physical activity, and other factors consonant with adoption of a healthy lifestyle should be consistently emphasized to cancer survivors. Clinicians can also play a critical role by endorsing genetic counselling for selected patients and making referrals to dieticians, exercise trainers, and others to assist with lifestyle change interventions.
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22
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Ray A, Milum K, Battu A, Wani G, Wani AA. NER initiation factors, DDB2 and XPC, regulate UV radiation response by recruiting ATR and ATM kinases to DNA damage sites. DNA Repair (Amst) 2013; 12:273-83. [PMID: 23422745 DOI: 10.1016/j.dnarep.2013.01.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 01/07/2013] [Accepted: 01/16/2013] [Indexed: 12/27/2022]
Abstract
ATR and ATM kinases are central to the checkpoint activation in response to DNA damage and replication stress. However, the nature of the signal, which initially activates these kinases in response to UV damage, is unclear. Here, we have shown that DDB2 and XPC, two early UV damage recognition factors, are required for the damage-specific ATR and ATM recruitment and phosphorylation. ATR and ATM physically interacted with XPC and promptly localized to the UV damage sites. ATR and ATM recruitment and their phosphorylation were negatively affected in cells defective in DDB2 or XPC functions. Consequently, the phosphorylation of ATR and ATM substrates, Chk1, Chk2, H2AX, and BRCA1 was significantly reduced or abrogated in mutant cells. Furthermore, UV exposure of cells defective in DDB2 or XPC resulted in a marked decrease in BRCA1 and Rad51 recruitment to the damage site. Conversely, ATR- and ATM-deficiency failed to affect the recruitment of DDB2 and XPC to the damage site, and therefore did not influence the NER efficiency. These findings demonstrate a novel function of DDB2 and XPC in maintaining a vital cross-talk with checkpoint proteins, and thereby coordinating subsequent repair and checkpoint activation.
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Affiliation(s)
- Alo Ray
- Department of Radiology, The Ohio State University, Columbus, OH 43210, United States.
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23
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Milosevic JD, Kralovics R. Genetic and epigenetic alterations of myeloproliferative disorders. Int J Hematol 2012; 97:183-97. [PMID: 23233154 DOI: 10.1007/s12185-012-1235-2] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 11/27/2012] [Accepted: 11/27/2012] [Indexed: 01/07/2023]
Abstract
The classical BCR-ABL negative myeloproliferative neoplasms (MPN) polycythemia vera, essential thrombocythemia, and primary myelofibrosis are clonal hematopoietic disorders characterized by excessive production of terminally differentiated myeloid cells. In MPN patients, the disease can progress to secondary myelofibrosis or acute myeloid leukemia. Clonal hematopoiesis, disease phenotype, and progression are caused by somatically acquired genetic lesions of genes involved in cytokine signaling, RNA splicing, as well as epigenetic regulation. This review provides an overview of point mutations and cytogenetic lesions associated with MPN and addresses the role of these somatic lesions in MPN disease progression.
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Affiliation(s)
- Jelena D Milosevic
- CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Lazarettgasse 14, AKH BT25.3, 1090 Vienna, Austria
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Janjetovic S, Bacher U, Haalck T, Janning M, Bokemeyer C, Fiedler W. Acute megakaryoblastic leukemia in a patient with xeroderma pigmentosum: discussion of pathophysiological, prognostic, and toxicological aspects. Acta Haematol 2012. [PMID: 23207728 DOI: 10.1159/000342897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Xeroderma pigmentosum (XP) is an autosomal recessive inherited disease characterized by extreme sensitivity to sunlight. Normal individuals harboring XPD polymorphisms are at increased risk for developing acute lymphoblastic leukemia and acute myeloid leukemia (AML). CASE REPORT A 33-year-old male XP patient was diagnosed with acute megakaryoblastic leukemia with a complex karyotype. He received standard induction chemotherapy with cytarabine and daunorubicin. After the first cycle of chemotherapy, persistence of blasts was seen and a re-induction cycle with cytarabine, fludarabine, and idarubicin was administered resulting in complete remission. Due to the high-risk profile of his AML, allogeneic stem cell transplantation (SCT) was performed. Following a conditioning regimen with busulfan and cyclophosphamide, the patient received a matched related SCT from his HLA-identical sister. Despite the existence of his DNA repair gene mutation, chemotherapy was normally tolerated by the patient. Unfortunately, he died due to severe sepsis and relapse of AML 45 days after SCT. CONCLUSION The XPD mutation in our patient may have contributed to the emergence of his high-risk AML. Despite the existence of a DNA repair gene mutation, our XP patient could be treated with full doses of AML-type chemotherapy including allogeneic SCT without encountering unusual toxicity.
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MESH Headings
- Adult
- Aneuploidy
- Cytarabine/administration & dosage
- DNA Repair/genetics
- Daunorubicin/administration & dosage
- Fatal Outcome
- Hematopoietic Stem Cell Transplantation
- Humans
- Idarubicin/administration & dosage
- Leukemia, Megakaryoblastic, Acute/etiology
- Leukemia, Megakaryoblastic, Acute/genetics
- Leukemia, Megakaryoblastic, Acute/therapy
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/therapy
- Male
- Neoadjuvant Therapy
- Recurrence
- Remission Induction
- Transplantation, Homologous
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
- Xeroderma Pigmentosum/complications
- Xeroderma Pigmentosum/genetics
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Affiliation(s)
- Snjezana Janjetovic
- Department of Oncology and Hematology, BMT with Section of Pneumology, Hubertus Wald Tumorzentrum, University Cancer Center Hamburg, Hamburg, Germany.
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Poletto V, Rosti V, Villani L, Catarsi P, Carolei A, Campanelli R, Massa M, Martinetti M, Viarengo G, Malovini A, Migliaccio AR, Barosi G. A3669G polymorphism of glucocorticoid receptor is a susceptibility allele for primary myelofibrosis and contributes to phenotypic diversity and blast transformation. Blood 2012; 120:3112-7. [PMID: 22879541 PMCID: PMC3628115 DOI: 10.1182/blood-2012-05-433466] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 07/28/2012] [Indexed: 11/20/2022] Open
Abstract
The frequency of A3669G single nucleotide polymorphism (SNP) of human glucocorticoid receptor has been reported increased in polycythemia vera. We investigated the frequency of A3669G SNP and its impact on disease phenotype and progression in 499 patients with primary myelofibrosis (PMF). The distribution of the A3669G allele differed between PMF patients and 2 healthy control populations (odds ratio, 1.6 and 1.8). The variant allele at the homozygous state (G/G) was associated with higher white blood cell count, larger spleen index, and higher frequency of circulating CD34(+) cells at diagnosis. The latter association remained significant after correction for the JAK2V617F genotype. In patients JAK2V617F mutated, the G/G genotype was associated with shorter overall survival (77.6 months vs 298 months, P = .049) and blast transformation (BT)-free survival (76.7 months vs 261 months; P = .018). The latter association remained significant after correction for the known BT risk factors, such as age, sex, white blood cell count, percentage of blasts, IPSS prognostic score, and homozygosity for JAK2V617F (hazard ratio = 3.3; P = .006). In conclusion, the glucocorticoid receptor A3669G is a susceptibility allele for PMF: it contributes to confer the phenotype of excess myeloproliferation, and it cooperates with the JAK2V617F mutation in determining BT.
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Affiliation(s)
- Valentina Poletto
- Unit of Clinical Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico S. Matteo Foundation, Pavia, Italy
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Abstract
It is thought that myeloproliferative neoplasms (MPNs) are driven by somatic mutations, although hereditary factors also play a prominent role in the pathogenesis of the disease. Hereditary thrombocytosis and erythrocytosis are not malignant disorders but are clinically similar to MPNs. Several mutations have been found that explain a proportion of hereditary thrombocytosis and hereditary erythrocytosis. Germline variants can influence the risk of leukemic transformation in MPNs and the course of the disease through interaction with acquired chromosomal aberrations. Overall, it has been shown that germline factors play an important part in MPN pathogenesis.
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