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Chee L, Ritchie D, Ludford-Menting M, Ripley J, Chung J, Park D, Norton S, Kenealy M, Koldej R. Dysregulation of immune cell and cytokine signaling correlates with clinical outcomes in myelodysplastic syndrome (MDS). Eur J Haematol 2021; 108:342-353. [PMID: 34963023 DOI: 10.1111/ejh.13742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis. Although hypomethylating agents (HMA) have improved survival in higher-risk MDS, most patients eventually succumb to progressive disease. Utilizing samples collected prospectively from three MDS clinical trials, we analyzed genetic and immunological biomarkers and correlated them with clinical outcomes. METHODS 154 samples were analyzed from 133 de novo MDS patients for T-cell and myeloid cell immunophenotyping and gene expression analysis. Treatments were with HMA or immunomodulatory drug (IMiD) alone or in combination. RESULTS We observed differences in immune cell subsets between lower and higher risk IPSS groups with NKT cells, MDSCs, intermediate-proinflammatory and non-classical monocytes being higher in the latter group while naïve CD4+ T-cells were reduced. Intermediate-proinflammatory monocytes were increased in non-responders and those failing to achieve at least a hematological improvement. Pro-inflammatory NKT cells were increased at diagnosis for patients failing to derive clinical benefit after 12 months of treatment. Gene expression analysis of paired bone marrow (BM) colony-forming units (CFUs) from diagnosis and 4 cycles post-treatment confirmed that genes involved in cytokine signaling were downregulated in C4 normal colonies. CONCLUSIONS These findings support the central roles of dysregulation in innate immunity and inflammatory signaling in the pathogenesis of MDS which correlated with clinical outcomes post-treatment.
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Affiliation(s)
- L Chee
- Australian Cancer Research Foundation (ACRF) Translational Laboratory, The Royal Melbourne Hospital, Melbourne, VIC, 3000, Australia.,Department of Clinical Haematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Parkville, VIC, 3050, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC, 3050, Australia.,The Australasian Leukaemia and Lymphoma Group, Richmond, VIC, 3121, Australia
| | - D Ritchie
- Australian Cancer Research Foundation (ACRF) Translational Laboratory, The Royal Melbourne Hospital, Melbourne, VIC, 3000, Australia.,Department of Clinical Haematology, The Royal Melbourne Hospital and Peter MacCallum Cancer Centre, Parkville, VIC, 3050, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC, 3050, Australia.,The Australasian Leukaemia and Lymphoma Group, Richmond, VIC, 3121, Australia
| | - M Ludford-Menting
- Australian Cancer Research Foundation (ACRF) Translational Laboratory, The Royal Melbourne Hospital, Melbourne, VIC, 3000, Australia
| | - J Ripley
- Australian Cancer Research Foundation (ACRF) Translational Laboratory, The Royal Melbourne Hospital, Melbourne, VIC, 3000, Australia.,Liverpool Hospital, Liverpool, NSW, 2170, Australia
| | - J Chung
- Melbourne Bioinformatics, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - D Park
- Melbourne Bioinformatics, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - S Norton
- Nanix Limited, Dunedin, New Zealand
| | - M Kenealy
- The Australasian Leukaemia and Lymphoma Group, Richmond, VIC, 3121, Australia.,Cabrini Hospital, Malvern, VIC, 3144, Australia.,Monash University, Clayton, VIC, 3800, Australia
| | - R Koldej
- Australian Cancer Research Foundation (ACRF) Translational Laboratory, The Royal Melbourne Hospital, Melbourne, VIC, 3000, Australia.,Department of Medicine, The University of Melbourne, Parkville, VIC, 3050, Australia
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2
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Kalff A, Khong T, Ramachandran M, Ho PJ, Mollee P, D'Rozario J, Taylor K, Estell J, Norton S, Kemp R, Mitchell AJ, Reynolds J, Kennedy N, Quach H, Spencer A. Planned withdrawal of dexamethasone after pomalidomide low dose dexamethasone induction for lenalidomide refractory multiple myeloma (ALLG MM14). Haematologica 2021; 107:321-325. [PMID: 34587718 PMCID: PMC8719089 DOI: 10.3324/haematol.2021.278655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Anna Kalff
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Victoria, Australia; Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Victoria, Australia; Department of Clinical Haematology, Monash University, Clayton, Victoria
| | - Tiffany Khong
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Victoria, Australia; Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Victoria
| | - Malarmathy Ramachandran
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Victoria, Australia; Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Victoria
| | - P Joy Ho
- Royal Prince Alfred Hospital, Sydney
| | - Peter Mollee
- Princess Alexandra Hospital and University of Queensland, Brisbane
| | | | | | - Jane Estell
- Concord Repatriation General Hospital, University of Sydney, Sydney
| | - Sam Norton
- Nanix Ltd., Dunedin, New Zealand; Department of Microbiology and Immunology, University of Otago
| | - Roslyn Kemp
- Department of Microbiology and Immunology, University of Otago
| | - Andrew J Mitchell
- Materials Characterisation and Fabrication Platform, Department of Chemical Engineering, University of Melbourne
| | - John Reynolds
- Department of Epidemiology and Preventive Medicine, Alfred Health - Monash University, Melbourne, Victoria
| | - Nola Kennedy
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Victoria
| | - Hang Quach
- Faculty of Medicine, University of Melbourne, St Vincent's Hospital Melbourne, Australia [on behalf of The Australasian Leukaemia and Lymphoma Group (ALLG)]
| | - Andrew Spencer
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Victoria, Australia; Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Victoria, Australia; Department of Clinical Haematology, Monash University, Clayton, Victoria.
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3
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Marsh‐Wakefield FMD, Mitchell AJ, Norton SE, Ashhurst TM, Leman JKH, Roberts JM, Harte JE, McGuire HM, Kemp RA. Making the most of high-dimensional cytometry data. Immunol Cell Biol 2021; 99:680-696. [PMID: 33797774 PMCID: PMC8453896 DOI: 10.1111/imcb.12456] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 01/03/2023]
Abstract
High-dimensional cytometry represents an exciting new era of immunology research, enabling the discovery of new cells and prediction of patient responses to therapy. A plethora of analysis and visualization tools and programs are now available for both new and experienced users; however, the transition from low- to high-dimensional cytometry requires a change in the way users think about experimental design and data analysis. Data from high-dimensional cytometry experiments are often underutilized, because of both the size of the data and the number of possible combinations of markers, as well as to a lack of understanding of the processes required to generate meaningful data. In this article, we explain the concepts behind designing high-dimensional cytometry experiments and provide considerations for new and experienced users to design and carry out high-dimensional experiments to maximize quality data collection.
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Affiliation(s)
- Felix MD Marsh‐Wakefield
- Vascular Immunology UnitDiscipline of PathologyThe University of SydneySydneyNSWAustralia
- Charles Perkins CentreThe University of SydneySydneyNSWAustralia
- School of Medical SciencesFaculty of Medicine and HealthThe University of SydneySydneyNSWAustralia
| | - Andrew J Mitchell
- Department of Chemical EngineeringMaterials Characterisation and Fabrication PlatformThe University of MelbourneParkvilleVICAustralia
| | - Samuel E Norton
- Nanix LtdDunedinNew Zealand
- Department of Microbiology and ImmunologyUniversity of OtagoDunedinNew Zealand
| | - Thomas Myles Ashhurst
- Charles Perkins CentreThe University of SydneySydneyNSWAustralia
- Sydney CytometryUniversity of SydneySydneyNSWAustralia
- Ramaciotti Facility for Human Systems BiologyThe University of SydneySydneyNSWAustralia
| | - Julia KH Leman
- Department of Microbiology and ImmunologyUniversity of OtagoDunedinNew Zealand
| | | | - Jessica E Harte
- Department of Microbiology and ImmunologyUniversity of OtagoDunedinNew Zealand
| | - Helen M McGuire
- Charles Perkins CentreThe University of SydneySydneyNSWAustralia
- Ramaciotti Facility for Human Systems BiologyThe University of SydneySydneyNSWAustralia
- Translational Immunology GroupDiscipline of PathologyThe University of SydneySydneyNSWAustralia
| | - Roslyn A Kemp
- Department of Microbiology and ImmunologyUniversity of OtagoDunedinNew Zealand
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4
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Kalff A, Khong T, Ramachandran M, Walker P, Schwarer A, Roberts AW, Campbell P, Filshie R, Norton S, Reynolds J, Young M, Pierceall W, Thakurta A, Guo M, Oppermann U, Wang M, Ren Y, Kennedy N, Parekh S, Spencer A. Cereblon pathway biomarkers and immune profiles in patients with myeloma receiving post-ASCT lenalidomide maintenance (LEOPARD). Leuk Lymphoma 2021; 62:2981-2991. [PMID: 34263697 DOI: 10.1080/10428194.2021.1948030] [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: 10/20/2022]
Abstract
LEOPARD was a single arm, phase II study of lenalidomide (LEN) and alternate day prednisolone maintenance in patients with newly diagnosed multiple myeloma (MM) following autologous stem cell transplantation (ASCT). Sixty patients were enrolled. Estimated median potential follow-up was 44 m, median PFS was 38.3 m, median OS was not reached (landmark 36 m OS: 71.4%). Correlative immunohistochemistry performed on pre-ASCT trephines demonstrated high MM tumor cereblon (total/cytoplasmic) was associated with superior OS (p = .045, p = .031, respectively), whereas high c-Myc was associated with inferior PFS (p = .04). Patients with high cereblon (total/nuclear) were more likely to improve depth of response, whereas patients with high c-Myc were less likely, suggesting alternative/more effective post-ASCT strategies for patients with high c-Myc need identification. Peripheral blood immune profiling (mass cytometry) informed a more sustained response to LEN maintenance, demonstrating enrichment of activated/cytotoxic NK cells and cytotoxic T cells in patients with durable responses, contrasting with enrichment of B-regs in early relapsers.
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Affiliation(s)
- Anna Kalff
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia.,Department of Clinical Haematology, Monash University, Clayton, Australia
| | - Tiffany Khong
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia
| | - Malarmathy Ramachandran
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia
| | - Patricia Walker
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia
| | | | - Andrew W Roberts
- Clinical Haematology Department, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Australia
| | | | | | | | - John Reynolds
- Epidemiology and Preventive Medicine Department, Alfred Health - Monash University, Melbourne, Australia
| | - Mary Young
- Bristol-Myers Squibb Corporation, Summit, NJ, USA
| | | | | | - Manman Guo
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Udo Oppermann
- Botnar Research Centre, University of Oxford, Oxford, UK
| | - Maria Wang
- Bristol-Myers Squibb Corporation, Summit, NJ, USA
| | - Yan Ren
- Bristol-Myers Squibb Corporation, Summit, NJ, USA
| | - Nola Kennedy
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia
| | - Samir Parekh
- Icahn School of Medicine, Mt Sinai Hospital, New York City, NY, USA
| | - Andrew Spencer
- Malignant Haematology and Stem Cell Transplantation, Alfred Hospital, Melbourne, Australia.,Myeloma Research Group, Australian Centre for Blood Diseases, Alfred Hospital-Monash University, Melbourne, Australia.,Department of Clinical Haematology, Monash University, Clayton, Australia
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