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Koczkodaj D, Muzyka-Kasietczuk J, Chocholska S, Podhorecka M. Prognostic significance of isochromosome 17q in hematologic malignancies. Oncotarget 2021; 12:708-718. [PMID: 33868591 PMCID: PMC8021031 DOI: 10.18632/oncotarget.27914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/19/2021] [Indexed: 11/29/2022] Open
Abstract
Isochromosome 17q [i(17q)] with its two identical long arms is formed by duplication of the q arm and loss of the short p arm. The breakpoint in chromosome 17 that allows the formation of this isochromosome is located at 17p11.2, and the ~240 kb region with its large, palindromic, low-copy repeat sequences are present here. The region is highly unstable and susceptible to a variety of genomic alterations which may be induced by or without toxic agents. One molecular consequence of i(17q) development is the obligatory loss of a single TP53 allele of the tumor suppressor P53 protein located at 17p13.1. Isochromosome 17q is involved in cancer development and progression. It occurs in combination with other chromosomal defects (complex cytogenetics), and rarely as a single mutation. The i(17q) rearrangement has been described as the most common chromosomal aberration in primitive neuroectodermal tumors and medulloblastomas. This isochromosome is also detected in different hematological disorders. In this article, we analyze literature data on the presence of i(17q) in proliferative disorders of the hematopoietic system in the context of its role as a prognostic factor of disease progression. The case reports are added to support the presented data. Currently, there are no indications for the use of specific treatment regimens in the subjects with a presence of the isochromosome 17q. Thus, it is of importance to continue studies on the prognostic role of this abnormality and even single cases should be reported as they may be used for further statistical analyses or meta-analyses.
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Affiliation(s)
- Dorota Koczkodaj
- Department of Cancer Genetics with the Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Justyna Muzyka-Kasietczuk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Monika Podhorecka
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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2
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Ganguly S, Uvodich M, Dias A, McGuirk JP. Clinical characteristics and treatment outcome of patients with isochromosome 17q (i17q) abnormality and myeloid neoplasms: A single center experience. Leuk Res Rep 2019; 10:55-56. [PMID: 30596010 PMCID: PMC6308020 DOI: 10.1016/j.lrr.2018.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 06/16/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Siddhartha Ganguly
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
| | - Mason Uvodich
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
| | - Ajoy Dias
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
| | - Joseph P McGuirk
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
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3
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Isochromosome 17q in Chronic Lymphocytic Leukemia. LEUKEMIA RESEARCH AND TREATMENT 2015; 2015:489592. [PMID: 26697230 PMCID: PMC4677221 DOI: 10.1155/2015/489592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/21/2015] [Accepted: 11/17/2015] [Indexed: 11/17/2022]
Abstract
In chronic lymphocytic leukemia (CLL), presence of acquired cytogenetic abnormalities may help to estimate prognosis. However, deletion of TP53 gene, which is associated with an aggressive course of the disease and poor prognosis along with a lack of response to treatment, is one of the alterations which may escape cytogenetic diagnoses in CLL. Thus, other techniques have emerged such as interphase fluorescence in situ hybridization (iFISH). Deletion of TP53 may but must not go together with the formation of an isochromosome i(17q); surprisingly this subgroup of patients was not in the focus of CLL studies yet. This study was about if presence of i(17q) could be indicative for a new subgroup in CLL with more adverse prognosis. As a result, TP53 deletion was detected in 18 out of 150 (12%) here studied CLL cases. Six of those cases (~33%) had the TP53 deletion accompanied by an i(17q). Interestingly, the cases with i(17q) showed a tendency towards more associated chromosomal aberrations. These findings may be the bases for follow-up studies in CLL patients with TP53 deletion with and without i(17q); it may be suggested that the i(17q) presents an even more adverse prognostic marker than TP53 deletion alone.
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4
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Bhatti F, Ahmed S, Ali N. Clinical and Hematological Features of 335 Patients of Chronic Myelogenous Leukemia Diagnosed at Single Centre in Northern Pakistan. Gulf J Oncolog 2012. [DOI: 10.4137/cmbd.s10578] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
There are no studies regarding analysis of clinical and haematological features of chronic myelogenous leukemia (CML) from Pakistan. This study analyzes the data of patients suffering from CML, reporting to a major referral Institute in Northern Pakistan in the past 6 years and 3 months. CML constitutes approximately 80% of all myeloproliferative disorders, with a peak incidence between 21-50 years of age, and a male:female ratio of 2:1. Anaemia and massive splenomegaly were the main clinical features found in 92% and 47% patients respectively. There was significant correlation between anaemia and WBC counts with degree of splenomegaly. Three percent of all CML patients presented as de novo accelerated phase, and another 3% presented as blast crises without any previous history of chronic phase. The ratio of myeloid and lymphoid blast crisis was 2:1. Median duration of chronic phase in patients on hydroxyurea treatment was 6 years. Thirty six percent of patients in chronic phase of CML belonged to intermediate and high risk according to Sokal and Hasford scoring systems. In contrast to the Caucasian populations where the peak incidence of the disease is in 6th to 7th decade, CML occurs in Pakistan in a much younger population, with a broad peak between 21-50 years of age. Patients present in fairly advanced disease because of poor access to health care facilities, due to non-affordability and lack of health insurance coverage.
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Affiliation(s)
- F.A. Bhatti
- Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - S. Ahmed
- Armed Forces Institute of Pathology, Rawalpindi, Pakistan
| | - N. Ali
- Armed Forces Institute of Pathology, Rawalpindi, Pakistan
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Sousa JC, Germano RT, Castro CCM, Magalhaes SMM, Pinheiro RF. Case report of isochromosome 17q in acute myeloid leukemia with myelodysplasia-related changes after treatment with a hypomethylating agent. GENETICS AND MOLECULAR RESEARCH 2012; 11:2045-50. [PMID: 22911588 DOI: 10.4238/2012.august.6.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Isochromosome 17q is a relatively common karyotypic abnormality in medulloblastoma, gastric, bladder, and breast cancers. In myeloid disorders, it is observed during disease progression and evolution to acute myeloid leukemia in Philadelphia-positive chronic myeloid leukemia. It has been reported in rare cases of myelodysplastic syndrome, with an incidence of 0.4-1.57%. Two new agents have been approved for treatment of myelodysplastic syndrome/chronic myelomonocytic leukemia. These are the hypomethylating agents, 5-azacytidine and decitabine, recommended by consensus guidelines for high-risk myelodysplastic syndrome patients not eligible for hematopoietic stem cell transplantation. We present a case of chronic myelomonocytic leukemia with normal cytogenetics at diagnosis treated with decitabine (with good response); however, the patient evolved to acute myeloid leukemia with i(17q) shortly after suspending treatment. To the best of our knowledge, this is the first report of acute myeloid leukemia with myelodysplasia-related changes with i(17q) after the use of a hypomethylating agent.
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Affiliation(s)
- J C Sousa
- Programa de Pós-Graduação em Ciências Médicas, Departamento de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brasil
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Vaidya S, Madkaikar M, Ghosh K, Vundinti BR. Deletion of ABL/BCR on der(9) associated with severe basophilia. INDIAN JOURNAL OF HUMAN GENETICS 2011; 17:100-3. [PMID: 22090723 PMCID: PMC3214311 DOI: 10.4103/0971-6866.86198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Chronic basophilic leukemia is a rare form in chronic myeloid leukemia patients. Only limited number of reports are available. Herein, we describe a patient who presented with fatigue, weight loss, leucocytosis, prominent basophilia, and mild eosinophilia. On biopsy, bone marrow was hypercellular with marked basophils. The immunophenotype showed abnormal expression of CD7, which is suggestive of basophilic maturation. Chromosomal analysis from GTG-banded metaphases revealed Ph positivity, and fluorescence in situ hybridization (FISH) with BCR/ABL dual color, dual fusion probe showed single fusion on the der(22) chromosome and ABL/BCR fusion was deleted on the der(9) chromosome. The deletion (ABL/BCR) on der(9) may be associated with basophilia which may be also indicative of the transformation of CML to acute myeloid leukemia.
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Affiliation(s)
- Shantashri Vaidya
- Department of Cytogenetics, National Institute of Immunohaematology (ICMR), K.E.M. Hospital Campus, Parel, Mumbai, India
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Sheth FJ, Sheth JJ, Desai C. Case of near triploidy with i(17)(q10) in blast crisis CML. ACTA ACUST UNITED AC 2006; 164:177-8. [PMID: 16434327 DOI: 10.1016/j.cancergencyto.2005.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2005] [Revised: 07/22/2005] [Accepted: 07/28/2005] [Indexed: 02/02/2023]
MESH Headings
- Adolescent
- Chromosomes, Human, Pair 17
- Humans
- Isochromosomes
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Polyploidy
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8
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Donato NJ, Wu JY, Stapley J, Lin H, Arlinghaus R, Aggarwal BB, Shishodia S, Albitar M, Hayes K, Kantarjian H, Talpaz M, Shishodin S. Imatinib Mesylate Resistance Through BCR-ABL Independence in Chronic Myelogenous Leukemia. Cancer Res 2004; 64:672-7. [PMID: 14744784 DOI: 10.1158/0008-5472.can-03-1484] [Citation(s) in RCA: 188] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Imatinib mesylate (IM) binds to the BCR-ABL protein, inhibiting its kinase activity and effectively controlling diseases driven by this kinase. IM resistance has been associated with kinase mutations or increased BCR-ABL expression. However, disease progression may be mediated by other mechanisms that render tumor cells independent of BCR-ABL. To demonstrate this potential, IM-resistant cells were found in chronic myelogenous leukemia patients with continuous BCR-ABL gene expression but undetectable BCR-ABL protein expression. These cells were unresponsive to IM and acquired BCR-ABL-independent signaling characteristics. IM resistance in some patients may be mediated through loss of kinase target dependence.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Benzamides
- Blotting, Northern
- Cell Line, Tumor
- Drug Resistance, Neoplasm
- Fusion Proteins, bcr-abl/drug effects
- Fusion Proteins, bcr-abl/genetics
- Humans
- Imatinib Mesylate
- In Situ Hybridization
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Philadelphia Chromosome
- Piperazines/therapeutic use
- Pyrimidines/therapeutic use
- Reverse Transcriptase Polymerase Chain Reaction
- Signal Transduction/drug effects
- Terminal Repeat Sequences/genetics
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Affiliation(s)
- Nicholas J Donato
- Department of Bioimmunotherapy, University of Texas, M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
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Pardanani AD, Morice WG, Hoyer JD, Tefferi A. Chronic basophilic leukemia: a distinct clinico-pathologic entity? Eur J Haematol 2003; 71:18-22. [PMID: 12801294 DOI: 10.1034/j.1600-0609.2003.00086.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We sought to better define a group of rare and poorly understood myeloproliferative disorders that are characterized by prominent chronic basophilia in the absence of the Philadelphia chromosome (Ph) or its molecular equivalent. METHODS We screened our institution's electronic database from 1975 onwards, and identified four such cases. Clinical data and bone marrow pathology were carefully reviewed for these patients. RESULTS Two patients had prominent manifestations of basophil mediator-release and another presented with pituitary dysfunction. Bone marrow examination uniformly revealed trilineage hyperplasia with basophilia and eosinophilia, dysplastic megakaryocytic hyperplasia, and the absence of megakaryocyte clustering. An abnormal pattern of atypical mast cells was noted in two cases. While disease palliation was effectively achieved with hydroxyurea for one patient, transformation to acute myeloid leukemia was eventually observed in this case. Another patient has achieved long-term disease-free survival after undergoing allogeneic stem cell transplantation. CONCLUSIONS Our observations reveal a striking pathologic similarity among all four cases, and suggest this disease, which may be aggressive with the potential to transform into acute leukemia, to possibly represent a distinct clinico-pathologic entity (chronic basophilic leukemia).
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MESH Headings
- Adult
- Aged
- Basophils/pathology
- Bone Marrow Examination
- Cytogenetic Analysis
- Diagnosis, Differential
- Humans
- Immunohistochemistry
- Leukemia, Basophilic, Acute/classification
- Leukemia, Basophilic, Acute/diagnosis
- Leukemia, Basophilic, Acute/therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/classification
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Philadelphia Chromosome
- Treatment Outcome
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Affiliation(s)
- Animesh D Pardanani
- Divisions of Hematology and Internal Medicine, Hematopathology, Mayo Clinic, Rochester, MN 55905, USA
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10
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Patsouris C, Michael PM, Campbell LJ. A new nonrandom unbalanced t(17;20) in myeloid malignancies. CANCER GENETICS AND CYTOGENETICS 2002; 138:32-7. [PMID: 12419582 DOI: 10.1016/s0165-4608(02)00579-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Deletions of chromosomes 17 and 20 are well-described abnormalities in myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML) but translocations involving these two chromosomes are uncommon. We present five male patients, one with MDS and four with AML, in whom a new, nonrandom unbalanced dicentric t(17;20), resulting in deletions of 17p and 20q, was identified. Conventional cytogenetics showed additional karyotypic abnormalities in most of the patients, including deletions of 5q, deletions or monosomy of chromosome 7, and deletions of 18q. Fluorescence in situ hybridization showed a deletion of the tumor suppressor gene TP53 on 17p. Of the four cases with follow-up data available, only two had received combination chemotherapy. Overall survival in these two cases was 6 and 7 weeks, respectively. Two other patients who had no active therapy administered died 6 weeks and 9 months after diagnosis, respectively. These five cases highlight a rare but recurrent abnormality in MDS and AML, potentially involving genes on 17p and 20q of importance in myeloid leukemogenesis.
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Affiliation(s)
- Crisoula Patsouris
- Victorian Cancer Cytogenetics Service, St. Vincent's Hospital Melbourne, P.O. Box 2900, Fitzroy, VIC, 3065, Australia.
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11
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Shet AS, Jahagirdar BN, Verfaillie CM. Chronic myelogenous leukemia: mechanisms underlying disease progression. Leukemia 2002; 16:1402-11. [PMID: 12145676 DOI: 10.1038/sj.leu.2402577] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2001] [Accepted: 08/31/2001] [Indexed: 11/09/2022]
Abstract
Chronic myelogenous leukemia (CML), characterized by the BCR-ABL gene rearrangement, has been extensively studied. Significant progress has been made in the area of BCR-ABL-mediated intracellular signaling, which has led to a better understanding of BCR-ABL-mediated clinical features in chronic phase CML. Disease progression and blast crisis CML is associated with characteristic non-random cytogenetic and molecular events. These can be viewed as increased oncogenic activity or loss of tumor suppressor activity. However, what causes transformation and disease progression to blast crisis is only poorly understood. This is in part due to the lack of a good in vivo model of chronic phase CML even though animal models developed over the last few years have started to provide insights into blast crisis development. Thus, additional in vitro and in vivo studies will be needed to provide a complete understanding of the contribution of BCR-ABL and other genes to disease progression and to improve therapeutic approaches for blast crisis CML.
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MESH Headings
- Animals
- Apoptosis
- Blast Crisis/genetics
- Blast Crisis/pathology
- Cell Differentiation
- Chromosome Aberrations
- DNA Repair
- Disease Progression
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/physiology
- Genes, Tumor Suppressor
- Hematopoietic Stem Cells/pathology
- Humans
- Immunologic Surveillance
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Mice
- Mice, Knockout
- Models, Animal
- Models, Biological
- Neoplastic Stem Cells/pathology
- Oncogenes
- Signal Transduction
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Affiliation(s)
- A S Shet
- Stem Cell Institute and Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
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12
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Abstract
The standard Philadelphia (Ph) translocation t(9;22), its variants and a proportion of Ph-negative cases are positive for the BCR-ABL fusion gene, as determined by molecular analysis. Extensive deletions of chromosome 9 and 22 derived sequences around the translocation breakpoints on the derivative 9 are seen in 10-30% of patients at diagnosis and may confer a worse prognosis. Additional cytogenetic changes can occur in the few months before or during disease progression and are often specific for blast morphology; however, the molecular basis of the most common additional cytogenetic abnormalities is largely unknown. Cytogenetics is important for monitoring patient response to treatment but is increasingly being replaced by the more sensitive and less invasive techniques of RT-PCR and FISH.
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MESH Headings
- Antineoplastic Agents
- Bone Marrow Transplantation
- Chromosome Aberrations
- Cytogenetic Analysis
- Disease Progression
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Philadelphia Chromosome
- Prognosis
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Affiliation(s)
- A Chase
- Wessex Regional Genetics Laboratory, Salisbury District Hospital, Salisbury, Wilts SP2 8BJ, UK
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13
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Abstract
The BCR-ABL oncogene is essential to the pathogenesis of chronic myelogenous leukemia, and immune mechanisms play an important role in control of this disease. Understanding of the molecular pathogenesis of chronic myelogenous leukemia has led to the development of several novel therapies, which can be broadly divided into therapies based on 1) inhibition of the BCR-ABL oncogene expression, 2) inhibition of other genes important to the pathogenesis of chronic myelogenous leukemia, 3) inhibition of BCR-ABL protein function, and 4) immunomodulation. We have systematically reviewed each of these novel therapeutic approaches in this article.
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MESH Headings
- Alkyl and Aryl Transferases/antagonists & inhibitors
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Benzamides
- Cancer Vaccines/therapeutic use
- Cell Transformation, Neoplastic/genetics
- Clinical Trials, Phase II as Topic
- Clinical Trials, Phase III as Topic
- Drug Resistance, Neoplasm/genetics
- Enzyme Inhibitors/therapeutic use
- Farnesyltranstransferase
- Fusion Proteins, bcr-abl/antagonists & inhibitors
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/physiology
- Genes, myb
- Hematopoietic Stem Cell Transplantation
- Humans
- Imatinib Mesylate
- Immunotherapy, Adoptive
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Methotrexate/pharmacology
- Models, Biological
- Multicenter Studies as Topic
- Neoplasm Proteins/metabolism
- Oligonucleotides, Antisense/pharmacology
- Oligonucleotides, Antisense/therapeutic use
- Phosphorylation
- Piperazines/pharmacology
- Piperazines/therapeutic use
- Protein Processing, Post-Translational
- Pyrimidines/pharmacology
- Pyrimidines/therapeutic use
- RNA, Messenger/antagonists & inhibitors
- RNA, Neoplasm/antagonists & inhibitors
- Signal Transduction/drug effects
- Tetrahydrofolate Dehydrogenase/genetics
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Affiliation(s)
- B N Jahagirdar
- Stem Cell Institute, Division of Hematology-Oncology and Transplantation, University of Minnesota, Minneapolis, Minn 55455, USA
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