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Firsova MV, Risinskaya NV, Solovev MV, Obukhova TN, Kislitsyna MA, Nikulina EE, Yakutik IA, Abramova TV, Sudarikov AB, Kovrigina AM, Mendeleeva LP. Multiple myeloma with extramedullary plasmacytoma: pathogenesis and clinical case. ONCOHEMATOLOGY 2022. [DOI: 10.17650/1818-8346-2022-17-4-67-80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Background. Multiple myeloma complicated by extramedullary plasmacytoma is an unfavorable variant of the disease. It remains unknown what triggers tumor transformation. The review presents literature data on the pathogenesis of extramedullary disease, as well as a clinical example of a comprehensive study of the tumor substrate.Aim. To study the molecular and biological characteristics of the tumor substrate of the bone marrow and extramedullary plasmacytoma using various research methods.Materials and methods. A 55-year-old patient was admitted to National Medical Research Center for Hematology with a diagnosis of multiple myeloma occurring with extramedullary plasmacytoma of the retroperitoneal space. dNA was isolated from samples of different localization (blood plasma, Cd138+ bone marrow cells, plasmacytoma and buccal epithelial cells). The profile of short tandem dNA repeats (STR) from the obtained samples was studied by multiplex polymerase chain reaction followed by fragment analysis. fluorescent in situ hybridization (fISH) of bone marrow Cd138+ cells was performed using various dNA probes. Comparative genomic hybridization on a microarray (arrayCGH) plasmacytoma dNA was also performed. The mutation profile of the KRAS, NRAS, BRAF genes was studied by Sanger sequencing in tumor samples of various localizations.Results. The induction therapy (vCd (bortezomib + cyclophosphamide + dexamethasone), vRd (bortezomib + lenalidomide + dexamethasone), daratumumab therapy) was ineffective, death occurred 4 months after the first clinical manifestations appeared. Comparison of STR markers of circulating cell-free tumor dNA (cfdNA), Cd138+ bone marrow cells, and plasmacytoma revealed the largest number of involved loci exactly in plasmacytoma’ dNA. A mutation in the NRAS gene was found only in plasmacytoma’ dNA. This indicates the presence of another clone of tumor cells in the extra-medullary plasmacytoma. Molecular karyotyping of plasmacytoma using the arrayCGH method revealed rearrangements of many chromosomes. 1p32.3 bi-allelic deletion, amplification of 1q21, 8q24/MyC rearrangements and del17p13 were confirmed by arrayCGH molecular karyotyping and fISH studies in bone marrow and plasmacytoma.Conclusion. A comprehensive molecular genetic study of the extramedullary plasmacytoma’ substrate is necessary to understand the pathogenesis mechanisms and, on this basis, to develop differentiated therapeutic approaches.
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Affiliation(s)
- M. V. Firsova
- National Research Center for Hematology, Ministry of Health of Russia
| | - N. V. Risinskaya
- National Research Center for Hematology, Ministry of Health of Russia
| | - M. V. Solovev
- National Research Center for Hematology, Ministry of Health of Russia
| | - T. N. Obukhova
- National Research Center for Hematology, Ministry of Health of Russia
| | - M. A. Kislitsyna
- National Research Center for Hematology, Ministry of Health of Russia
| | - E. E. Nikulina
- National Research Center for Hematology, Ministry of Health of Russia
| | - I. A. Yakutik
- National Research Center for Hematology, Ministry of Health of Russia
| | - T. V. Abramova
- National Research Center for Hematology, Ministry of Health of Russia
| | - A. B. Sudarikov
- National Research Center for Hematology, Ministry of Health of Russia
| | - A. M. Kovrigina
- National Research Center for Hematology, Ministry of Health of Russia
| | - L. P. Mendeleeva
- National Research Center for Hematology, Ministry of Health of Russia
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Borisov N, Sergeeva A, Suntsova M, Raevskiy M, Gaifullin N, Mendeleeva L, Gudkov A, Nareiko M, Garazha A, Tkachev V, Li X, Sorokin M, Surin V, Buzdin A. Machine Learning Applicability for Classification of PAD/VCD Chemotherapy Response Using 53 Multiple Myeloma RNA Sequencing Profiles. Front Oncol 2021; 11:652063. [PMID: 33937058 PMCID: PMC8083158 DOI: 10.3389/fonc.2021.652063] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/19/2021] [Indexed: 12/17/2022] Open
Abstract
Multiple myeloma (MM) affects ~500,000 people and results in ~100,000 deaths annually, being currently considered treatable but incurable. There are several MM chemotherapy treatment regimens, among which eleven include bortezomib, a proteasome-targeted drug. MM patients respond differently to bortezomib, and new prognostic biomarkers are needed to personalize treatments. However, there is a shortage of clinically annotated MM molecular data that could be used to establish novel molecular diagnostics. We report new RNA sequencing profiles for 53 MM patients annotated with responses on two similar chemotherapy regimens: bortezomib, doxorubicin, dexamethasone (PAD), and bortezomib, cyclophosphamide, dexamethasone (VCD), or with responses to their combinations. Fourteen patients received both PAD and VCD; six received only PAD, and 33 received only VCD. We compared profiles for the good and poor responders and found five genes commonly regulated here and in the previous datasets for other bortezomib regimens (all upregulated in the good responders): FGFR3, MAF, IGHA2, IGHV1-69, and GRB14. Four of these genes are linked with known immunoglobulin locus rearrangements. We then used five machine learning (ML) methods to build a classifier distinguishing good and poor responders for two cohorts: PAD + VCD (53 patients), and separately VCD (47 patients). We showed that the application of FloWPS dynamic data trimming was beneficial for all ML methods tested in both cohorts, and also in the previous MM bortezomib datasets. However, the ML models build for the different datasets did not allow cross-transferring, which can be due to different treatment regimens, experimental profiling methods, and MM heterogeneity.
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Affiliation(s)
- Nicolas Borisov
- Moscow Institute of Physics and Technology, Laboratory for Translational Genomic Bioinformatics, Dolgoprudny, Russia
| | - Anna Sergeeva
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Maria Suntsova
- I.M. Sechenov First Moscow State Medical University, Institute of Personalized Medicine, Moscow, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Group for Genomic Analysis of Cell Signaling Systems, Moscow, Russia
| | - Mikhail Raevskiy
- Moscow Institute of Physics and Technology, Laboratory for Translational Genomic Bioinformatics, Dolgoprudny, Russia
| | - Nurshat Gaifullin
- Department of Pathology, Faculty of Medicine, Lomonosov Moscow State University, Moscow, Russia
| | - Larisa Mendeleeva
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Alexander Gudkov
- I.M. Sechenov First Moscow State Medical University, Institute of Personalized Medicine, Moscow, Russia
| | - Maria Nareiko
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrew Garazha
- Omicsway Corp., Research Department, Walnut, CA, United States
- Oncobox Ltd., Research Department, Moscow, Russia
| | - Victor Tkachev
- Omicsway Corp., Research Department, Walnut, CA, United States
- Oncobox Ltd., Research Department, Moscow, Russia
| | - Xinmin Li
- Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - Maxim Sorokin
- I.M. Sechenov First Moscow State Medical University, Institute of Personalized Medicine, Moscow, Russia
- Omicsway Corp., Research Department, Walnut, CA, United States
- Oncobox Ltd., Research Department, Moscow, Russia
| | - Vadim Surin
- National Research Center for Hematology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Anton Buzdin
- I.M. Sechenov First Moscow State Medical University, Institute of Personalized Medicine, Moscow, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Group for Genomic Analysis of Cell Signaling Systems, Moscow, Russia
- Omicsway Corp., Research Department, Walnut, CA, United States
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Zheng Z, Fan S, Zheng J, Huang W, Gasparetto C, Chao NJ, Hu J, Kang Y. Inhibition of thioredoxin activates mitophagy and overcomes adaptive bortezomib resistance in multiple myeloma. J Hematol Oncol 2018; 11:29. [PMID: 29482577 PMCID: PMC5828316 DOI: 10.1186/s13045-018-0575-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/12/2018] [Indexed: 11/25/2022] Open
Abstract
Background Although current chemotherapy using bortezomib (Velcade) against multiple myeloma in adults has achieved significant responses and even remission, a majority of patients will develop acquired resistance to bortezomib. Increased thioredoxin level has been reported to be associated with carcinogenesis; however, the role of thioredoxin in bortezomib drug resistance of myeloma remains unclear. Methods We generated several bortezomib-resistant myeloma cell lines by serially passaging with increased concentrations of bortezomib over a period of 1.5 years. Thioredoxin expression was measured by real-time PCR and western blot. Results The role of thioredoxin in the survival of bortezomib-resistant myeloma cells was determined by specific shRNA knockdown in vitro and in vivo. Thioredoxin inhibitor (PX12) was used to determine the effectiveness of thioredoxin inhibition in the treatment of bortezomib-resistant myeloma cells. The effect of thioredoxin inhibition on mitophagy induction was examined. The correlation of thioredoxin expression with patient overall survival was interrogated. Thioredoxin expression was significantly upregulated in bortezomib-resistant myeloma cells and the change correlated with the increase of bortezomib concentration. Thioredoxin gene knockdown using specific shRNA sensitized bortezomib-resistant myeloma cells to bortezomib efficiency in vitro and in vivo. Similarly, pharmacological inhibition with PX12 inhibited the growth of bortezomib-resistant myeloma cells and overcame bortezomib resistance in vitro and in vivo. Furthermore, inhibition of thioredoxin resulted in the activation of mitophagy and blockage of mitophagy prevented the effects of PX12 on bortezomib-resistant myeloma cells, indicating that mitophagy is the important molecular mechanism for the induction of cell death in bortezomib-resistant myeloma cells by PX12. Moreover, inhibition of thioredoxin resulted in downregulation of phosphorylated mTOR and ERK1/2. Finally, thioredoxin was overexpressed in primary myeloma cells isolated from bortezomib-resistant myeloma patients and overexpression of thioredoxin correlated with poor overall survival in patients with multiple myeloma. Conclusions Our findings demonstrated that increased thioredoxin plays a critical role in bortezomib resistance in multiple myeloma through mitophagy inactivation and increased mTOR and ERK1/2 phosphorylation. Thioredoxin provides a potential target for clinical therapeutics against multiple myeloma, particularly for bortezomib-resistant/refractory myeloma patients. Electronic supplementary material The online version of this article (10.1186/s13045-018-0575-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zhihong Zheng
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, Fujian, 350001, China.,Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 3961, Durham, NC, 27710, USA
| | - Shengjun Fan
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 3961, Durham, NC, 27710, USA
| | - Jing Zheng
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, Fujian, 350001, China
| | - Wei Huang
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 3961, Durham, NC, 27710, USA
| | - Cristina Gasparetto
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 3961, Durham, NC, 27710, USA
| | - Nelson J Chao
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 3961, Durham, NC, 27710, USA
| | - Jianda Hu
- Department of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, 29 Xinquan Road, Fuzhou, Fujian, 350001, China.
| | - Yubin Kang
- Division of Hematologic Malignancies and Cellular Therapy, Duke University Medical Center, 3961, Durham, NC, 27710, USA.
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