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Huang L, Wang F. Primary blastic plasmacytoid dendritic cell neoplasm: a US population-based study. Front Oncol 2023; 13:1178147. [PMID: 37251924 PMCID: PMC10213386 DOI: 10.3389/fonc.2023.1178147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and poorly understood hematopoietic malignancy. This study aimed to investigate the clinical characteristics and prognostic factors in patients with primary BPDCN. Methods Patients diagnosed with primary BPDCN from 2001 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Survival outcome was analysed with Kaplan-Meier method. Prognostic factors were evaluated based on the univariate and multivariate accelerated failure time (AFT) regression analysis. Results A total of 340 primary BPDCN patients were included in this study. The average age was 53.7 ± 19.4 years, with 71.5% being male. The mostly affected sites were lymph nodes (31.8%). Most patients (82.1%) received chemotherapy, while 14.7% received radiation therapy. For all the patients, the 1-year, 3-year, 5-year, and 10-year overall survival (OS) were 68.7%, 49.8%, 43.9%, and 39.2%, respectively, and the corresponding disease-specific survival (DSS) were 73.6%, 56.0%, 50.2%, and 48.1%, respectively. Univariate AFT analysis showed that older age, marital status of divorced, widowed and separated at diagnosis, primary BPDCN only, treatment delay for 3-6 months and without radiation therapy were significantly associated with poor prognosis of primary BPDCN patients. But multivariate AFT analysis indicated that older age was independently associated with worse survival, while second primary malignancies (SPMs) and radiation therapy were independently associated with extended survival. Conclusions Primary BPDCN is a rare disease with poor prognosis. Advanced age was linked independently to poorer survival, while SPMs and radiation therapy were linked independently to prolonged survival.
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Lu Y, Sun RJ, Zhang JP, Xu F, Du ZC, Tong GL, Wang Y, Lu DP. Allogeneic hematopoietic stem cell transplantation with myeloablative conditioning regimen for blastic plasmacytoid dendritic cell neoplasm patients in complete remission: a single center study. Leuk Lymphoma 2022; 63:3092-3099. [PMID: 36067510 DOI: 10.1080/10428194.2022.2118531] [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: 01/11/2023]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematopoietic malignancy characterized by poor prognosis even following an allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively analyzed 15 patients diagnosed with BPDCN who underwent an allo-HSCT with myeloablative conditioning (MAC) at our center. The male to female ratio was 11:4. The median age of 36 (range: 6-70) years, all patients initially presented with extramedullary lesions (13 with cutaneous lesions, 1 in the breast and 1 in the lymph nodes) and involved the bone marrow, two cases were diagnosed as central nervous system leukemia (CNSL). Nine patients were in CR1 and six patients were in CR2 status prior to HSCT. All patients received the MAC regimen and an unmanipulated graft. All patients successfully engraftment and achieved full donor chimerism. One patient developed poor graft function, three patients developed aGVHD (Grade I, II, and IV), and seven patients developed cGVHD (mild in 6; moderate in 1). The median follow-up time for survival was 34 (range: 6-64) months. The primary endpoint, overall leukemia-free survival (LFS) rate and overall survival rate was 73.3 ± 10.5%. Allo-HSCT with MAC is a valid option for BPDCN patients in complete remission.
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Affiliation(s)
- Yue Lu
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Rui-Juan Sun
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Jian-Ping Zhang
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Fang Xu
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Zhi-Cong Du
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Ge-Le Tong
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Yun Wang
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
| | - Dao-Pei Lu
- Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang, China
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Oza N, Rathnam K, Sumeet G, Honey SR, Saju SV, Shubhada K. Blastic Plasmacytoid Dendritic Cell Neoplasm: A Rare Case Report with Literature Review. Indian J Med Paediatr Oncol 2021. [DOI: 10.1055/s-0041-1736432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractBlastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematopoietic neoplasm for which there are no effective therapies. We present a 70-year-old male patient with multiple reddish painless, nonpruritic, and nonpedunculated nodules over the trunk, forearm, and thighs for a duration of 3 months. The nodules measured 0.5 to 2 cm in diameter. The peripheral smear findings were within normal limits. Excision biopsy was performed. Histomorphology and immunohistochemistry (CD123, CD 56, CD4, HLA-DR, CD43, and CD68) confirmed the diagnosis of BPDCN. Findings of marrow aspiration, biopsy and imaging studies were within normal limits. Patient demonstrated a good response with complete disappearance of all nodules by initial 2 weeks of therapy with a modified Berlin–Frankfurt–Munster (BFM) acute lymphoblastic leukemia (ALL) protocol and has completed 8 doses (LSAP [lincosamides, streptogramins A and pleuromutilins chemotherapy], 5,000 units/m2). The patient tolerated protocol extremely well.
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Affiliation(s)
- Nikita Oza
- Department of Histopathology, SRL Diagnostics – Centre of Excellence, Goregaon West, Mumbai, Maharashtra, India
| | - Krishnakumar Rathnam
- Department of Medical Oncology, Meenakshi Mission Hospital & Research Centre, Madurai, Tamil Nadu, India
| | - Gujral Sumeet
- Department of Pathology, Tata Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Susan R. Honey
- Department of Medical Oncology, Meenakshi Mission Hospital & Research Centre, Madurai, Tamil Nadu, India
| | - S. V. Saju
- Department of Medical Oncology, Meenakshi Mission Hospital & Research Centre, Madurai, Tamil Nadu, India
| | - Kane Shubhada
- Department of Histopathology, SRL Diagnostics – Centre of Excellence, Goregaon West, Mumbai, Maharashtra, India
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Yao H, Kong P. Cladribine‐based salvage regimen‐induced deep remission of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in leukemia phase. Hematol Oncol 2020; 38:207-209. [PMID: 31999842 DOI: 10.1002/hon.2683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Han Yao
- Department of Hematology, Army Medical University affiliated Xinqiao Hospital, Chongqing, China
| | - Peiyan Kong
- Department of Hematology, Army Medical University affiliated Xinqiao Hospital, Chongqing, China
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Alfayez M, Konopleva M, Pemmaraju N. Role of tagraxofusp in treating blastic plasmacytoid dendritic cell neoplasm (BPDCN). Expert Opin Biol Ther 2019; 20:115-123. [PMID: 31801379 DOI: 10.1080/14712598.2020.1701651] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Introduction: Advances and drug development in rare diseases, such as blastic plasmacytoid dendritic cell neoplasm (BPDCN), has historically been limited by small numbers of patients in the target population. In recent years, the development of tagraxofusp (SL-401) (ELZONRIS, Stemline Therapeutics) for the treatment of adult and pediatric BPDCN has been a successful story that led to US FDA approval in December 2018.Areas covered: In this evaluation of tagraxofusp, we briefly review chemistry; pharmacokinetics and pharmacodynamics, as we focus on the clinical experience and future directions.Expert Opinion: Tagraxofusp has been a welcome new addition and a successful initial development step in the targeted treatment of BPDCN. In phase I/II clinical trial, major responses were observed in 90% of treatment-naïve patients, with 72% of the responses observed as complete remissions. Limitations on the usage of tagraxofusp and strategies to handle those limitations were further explored in this review.
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Affiliation(s)
- Mansour Alfayez
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naveen Pemmaraju
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Wen SP, Wang BY, Xing LN, Lu X, Wang FY, Cheng ZY, Geng L, Wang ZZ, Niu ZY, Wang Y, Wang FX, Zhang XJ. [Chemotherapy followed by allo-hematopoietic stem cell transplantation for the treatment of blastic plasmacytoid dendritic cell neoplasm: two case reports and literatures review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:874-877. [PMID: 31775492 PMCID: PMC7364993 DOI: 10.3760/cma.j.issn.0253-2727.2019.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Indexed: 11/05/2022]
Affiliation(s)
- S P Wen
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - B Y Wang
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - L N Xing
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - X Lu
- Department of Hematology, the Xingtai People's Hospital Affiliated to Hebei Medical Univeresity, Xingtai 054000, China
| | - F Y Wang
- Department of Hematology, the First hospital of Baoding City, Baoding 071000, China
| | - Z Y Cheng
- Department of Hematology, the First hospital of Baoding City, Baoding 071000, China
| | - L Geng
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - Z Z Wang
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - Z Y Niu
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - Y Wang
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - F X Wang
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
| | - X J Zhang
- Department of Hematology, the Second Hospital of Hebei Medical Univeresity, Shijiazhuang 050000, China
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Sapienza MR, Pileri A, Derenzini E, Melle F, Motta G, Fiori S, Calleri A, Pimpinelli N, Tabanelli V, Pileri S. Blastic Plasmacytoid Dendritic Cell Neoplasm: State of the Art and Prospects. Cancers (Basel) 2019; 11:cancers11050595. [PMID: 31035408 PMCID: PMC6562663 DOI: 10.3390/cancers11050595] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/16/2019] [Accepted: 04/25/2019] [Indexed: 12/13/2022] Open
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is an extremely rare tumour, which usually affects elderly males and presents in the skin with frequent involvement of the bone-marrow, peripheral blood and lymph nodes. It has a dismal prognosis, with most patients dying within one year when treated by conventional chemotherapies. The diagnosis is challenging, since neoplastic cells can resemble lymphoblasts or small immunoblasts, and require the use of a large panel of antibodies, including those against CD4, CD56, CD123, CD303, TCL1, and TCF4. The morphologic and in part phenotypic ambiguity explains the uncertainties as to the histogenesis of the neoplasm that led to the use of various denominations. Recently, a series of molecular studies based on karyotyping, gene expression profiling, and next generation sequencing, have largely unveiled the pathobiology of the tumour and proposed the potentially beneficial use of new drugs. The latter include SL-401, anti-CD123 immunotherapies, venetoclax, BET-inhibitors, and demethylating agents. The epidemiologic, clinical, diagnostic, molecular, and therapeutic features of BPDCN are thoroughly revised in order to contribute to an up-to-date approach to this tumour that has remained an orphan disease for too long.
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Affiliation(s)
- Maria Rosaria Sapienza
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Alessandro Pileri
- Unit of Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, School of Medicine, Via Massarenti 1, 40138 Bologna, Italy.
| | - Enrico Derenzini
- Division of Haematology, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy.
| | - Federica Melle
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Giovanna Motta
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Stefano Fiori
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Angelica Calleri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Nicola Pimpinelli
- Dermatology Unit, Department of Health and Science, University of Florence, School of Medicine, Viale Michelangiolo 104, 50100 Firenze, Italy.
| | - Valentina Tabanelli
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
| | - Stefano Pileri
- Division of Diagnostic Haematopathology, European Institute of Oncology, IRCCS, Via Ripamonti 435, 20141 Milano, Italy.
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Han X, Ouyang MQ, Pei Q, Duan MH, Jiang XY, Zhou DB. [Clinical characteristics of 6 patients with blastic plasmacytoid dendritic cell neoplasm]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 38:700-705. [PMID: 28954350 PMCID: PMC7348252 DOI: 10.3760/cma.j.issn.0253-2727.2017.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
目的 探讨母细胞性浆细胞样树突细胞肿瘤(BPDCN)的临床特征、治疗和预后。 方法 回顾性分析2008年1月至2016年5月北京协和医院确诊的6例BPDCN患者的临床资料。 结果 6例患者起病时均有皮肤受累,常见表现包括骨髓受累(5例)、淋巴结肿大(4例)、脾大(4例)和肝大(3例)。皮肤外的结外器官受累包括乳腺、上颌窦、椎体和中枢神经系统各1例。肿瘤细胞特征性的免疫表型CD4、CD56、CD123均为阳性。治疗均采用急性淋巴细胞白血病样方案,4例达到完全缓解。中位随访9.5(7~37)个月,中位无进展生存期7个月,中位总生存期9个月。死亡3例,均在诊断后1年内死于原发病复发或进展。 结论 BPDCN侵袭性强,常以皮肤受累为首发症状,骨髓受累、淋巴结和肝脾大较为常见;特征性免疫标志包括CD4、CD56和CD123;目前缺乏有效、标准的治疗方案,预后不良。
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Affiliation(s)
- X Han
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China
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Kharfan-Dabaja MA, Al Malki MM, Deotare U, Raj RV, El-Jurdi N, Majhail N, Cherry MA, Bashir Q, Darrah J, Nishihori T, Sibai H, Hamadani M, de Lima M, Gerds AT, Selby G, Qazilbash MH, Forman SJ, Ayala E, Lipton JH, Hari PN, Muzzafar T, Zhang L, Olteanu H, Perkins J, Sokol L, Kumar A, Ahmed S. Haematopoietic cell transplantation for blastic plasmacytoid dendritic cell neoplasm: a North American multicentre collaborative study. Br J Haematol 2017; 179:781-789. [PMID: 28980314 DOI: 10.1111/bjh.14954] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 08/14/2017] [Indexed: 12/22/2022]
Abstract
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is incurable with conventional therapies. Limited retrospective data have shown durable remissions after haematopoietic cell transplantation (HCT) [allogeneic (allo) or autologous (auto)]. We conducted a multicentre retrospective study in BPDCN patients treated with allo-HCT and auto-HCT at 8 centres in the United States and Canada. Primary endpoint was overall survival (OS). The population consisted of 45 consecutive patients who received an allo-HCT (n = 37) or an auto-HCT (n = 8) regardless of age, pre-transplant therapies, or remission status at transplantation. Allo-HCT recipients were younger (50 (14-74) vs. 67 (45-72) years, P = 0·01) and had 1-year and 3-year OS of 68% [95% confidence interval (CI) = 49-81%] and 58% (95% CI = 38-75%), respectively. Allo-HCT in first complete remission (CR1) yielded superior 3-year OS (versus not in CR1) [74% (95% CI = 48-89%) vs. 0, P < 0·0001]. Allo-HCT outcomes were not impacted by regimen intensity [3-year OS for myeloablative conditioning = 61% (95% CI = 28-83%) vs. reduced-intensity conditioning = 55% (95% CI = 28-76%)]. One-year OS for auto-HCT recipients was 11% (95% CI = 8-50%). These results demonstrate efficacy of allo-HCT in BPDCN, especially in patients in CR1. Pertaining to auto-HCT, our results suggest lack of efficacy against BPDCN, but this observation is limited by the small sample size. Larger prospective studies are needed to better define the role of HCT in BPDCN.
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Affiliation(s)
- Mohamed A Kharfan-Dabaja
- Deptartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Monzr M Al Malki
- Deptartment of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Uday Deotare
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Renju V Raj
- Deptartment of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Najla El-Jurdi
- Div. of Hematology-Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Navneet Majhail
- Deptartment of Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH, USA
| | - Mohamad A Cherry
- Section of Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Qaiser Bashir
- Division of Cancer Medicine, Deptartment of Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Justin Darrah
- Deptartment of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Taiga Nishihori
- Deptartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Hassan Sibai
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Mehdi Hamadani
- Deptartment of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Marcos de Lima
- Div. of Hematology-Oncology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Aaron T Gerds
- Deptartment of Blood and Marrow Transplantation, Cleveland Clinic, Cleveland, OH, USA
| | - George Selby
- Section of Hematology-Oncology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Muzaffar H Qazilbash
- Division of Cancer Medicine, Deptartment of Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen J Forman
- Deptartment of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA, USA
| | - Ernesto Ayala
- Deptartment of Blood and Marrow Transplantation and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, FL, USA
| | - Jeffrey H Lipton
- Leukemia Program, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada
| | - Parameswaran N Hari
- Deptartment of Hematology-Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Tariq Muzzafar
- Deptartment of Hematopathology, The University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Ling Zhang
- Deptartment of Hematopathology, Moffitt Cancer Center, Tampa, FL, USA
| | - Horatiu Olteanu
- Deptartment of Hematopathology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Janelle Perkins
- College of Pharmacy, University of South Florida, Tampa, FL, USA
| | - Lubomir Sokol
- Deptartment of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Ambuj Kumar
- Program for Comparative Effectiveness Research, University of South Florida College of Medicine, Tampa, FL, USA
| | - Sairah Ahmed
- Division of Cancer Medicine, Deptartment of Stem Cell Transplantation and Cellular Therapy, UT MD Anderson Cancer Center, Houston, TX, USA
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