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Al-Rabi K, Ma'koseh M, Al-Qadi F, Hanoon AA, Da'na W, Asha AJ, Abdel Rahman Z, Marie L, Shahin O, Ma'koseh R, Al-Ibraheem A, Zayed A, Yaseen A, Al-Rabee S, Farfoura H, Abdel-Razeq H. Clinical Characteristics and Outcomes of CML in Adolescents and Young Adults. CLINICAL LYMPHOMA, MYELOMA & LEUKEMIA 2024:S2152-2650(24)00208-8. [PMID: 38918115 DOI: 10.1016/j.clml.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/21/2024] [Accepted: 05/22/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND While Chronic Myeloid Leukemia (CML) is a disease of older adults, there is a growing population of adolescent and young adults (AYAs) with CML. This study evaluated the clinical characteristics and outcomes of CML in AYAs. PATIENTS AND METHODS Data from medical records of adults with chronic phase CML diagnosed and treated at our center from 2011until 2021were retrospectively analyzed. Age between 18 and 29 years was used to define AYAs. Response to tyrosine kinase inhibitors (TKIs), progression to accelerated phase (AP) or blast crisis (BC), event-free survival (EFS) and overall survival (OS) were compared between AYAs and older adults. RESULTS Among 163 patients included, 41 (25.1%) were AYAs. AYAs were more likely to be males (P = .02), to present with symptoms (P = .004), had a higher median white blood cell count (P = .007), neutrophil count (P = .029), eosinophil count (P = 0.01), low-risk Sokal (P = .033) and Hasford (P = .005) groups. TKI-sensitivity as well as median times for achievement of complete cytogenetic and major molecular response were comparable between both groups. After a median follow-up of 76 (range: 11-235) months, there was no difference in OS (P = .528), or cumulative incidence of transformation to accelerated phase or blast crisis (P = .11). On the other hand, AYA had an inferior EFS (P = .034). CONCLUSION A quarter of the patients diagnosed with CML in our population were AYAs. Despite being characterized as "lower-risk," they presented with a greater disease burden, had a shorter EFS but comparable OS. Further studies are needed to better understand the disease biology of this group.
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Affiliation(s)
- Kamal Al-Rabi
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; Departement of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Mohammad Ma'koseh
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; Departement of Medicine, School of Medicine, The University of Jordan, Amman, Jordan.
| | - Fadwa Al-Qadi
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Ali A Hanoon
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Waleed Da'na
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Abdallah J Asha
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Zaid Abdel Rahman
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Lina Marie
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Omar Shahin
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Roa'a Ma'koseh
- Departement of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Anas Zayed
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Abeer Yaseen
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Saleh Al-Rabee
- Departement of Medicine, Faculty of Medicine, St. Martinus University, Willemstad, Curaçao
| | - Heba Farfoura
- Department of Radiology, King Hussein Cancer Center, Amman, Jordan
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan; Departement of Medicine, School of Medicine, The University of Jordan, Amman, Jordan
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Agarwal D, Paul S, Lele P, Piprode V, Kawade A, Hajela N, Bavdekar A, Parulekar V, Ginde M, Paranjape G, Matsuda K, Hori T, Juvekar S, Lal G. Changes in immunological parameters by ageing in rural healthy Indian adults and their associations with sex and lifestyle. Sci Rep 2022; 12:15012. [PMID: 36056136 PMCID: PMC9438881 DOI: 10.1038/s41598-022-19227-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/25/2022] [Indexed: 11/09/2022] Open
Abstract
Several factors including sex and lifestyle have been reported to contribute to the age-related alteration of immune functions. The study was undertaken to determine age-related differences in the proportion of peripheral blood mononuclear lymphocytes in the Indian population using blood samples from 67 healthy adults (33 females and 34 males) aged between 20 and 80 years old. In the linear regression analysis to estimate the relationship with age categories, there was a significant increase in the frequency of natural killer cells with ageing, while their cytolytic activity significantly declined. The frequency of CD4+ T cells increased with age, whereas that of CD8+ T cells decreased, resulting in the age-associated increase of the CD4/CD8 ratio. The subsets of B cells did not show any significant relationship with age. Although there were variations between the male and female subgroups in effect size of ageing, the trends were in the same direction in all the parameters. Reduced fat intake was associated with a lower frequency of CD4+ T cells, and higher serum cotinine level was associated with a higher CD4/CD8 ratio. The results indicate that cellular immunity in the Indian population is affected by ageing, while humoral immunity is less susceptible to ageing.
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Affiliation(s)
- Dhiraj Agarwal
- KEM Hospital Research Centre, Vadu Rural Health Program, Pune, Maharashtra, 412216, India
| | - Sourav Paul
- National Centre for Cell Science, NCCS Complex, Ganeshkhind, Pune, Maharashtra, 411007, India
| | - Pallavi Lele
- KEM Hospital Research Centre, Vadu Rural Health Program, Pune, Maharashtra, 412216, India
| | - Vikrant Piprode
- National Centre for Cell Science, NCCS Complex, Ganeshkhind, Pune, Maharashtra, 411007, India
| | - Anand Kawade
- KEM Hospital Research Centre, Vadu Rural Health Program, Pune, Maharashtra, 412216, India
| | - Neerja Hajela
- Yakult Danone India Pvt. Ltd., 212, Ground Floor, Okhla Industrial Estate Phase-III, New Delhi, Delhi, 110020, India
| | - Ashish Bavdekar
- Paediatrics Department, KEM Hospital Research Centre, Pune, Maharashtra, 411011, India
| | - Varsha Parulekar
- DiagnoSearch Life Sciences Pvt. Ltd., 702, Dosti Pinnacle Plot No. E-7, Road No. 22 Wagle Industrial Estate, Thane, Maharashtra, 400604, India
| | - Manisha Ginde
- DiagnoSearch Life Sciences Pvt. Ltd., 702, Dosti Pinnacle Plot No. E-7, Road No. 22 Wagle Industrial Estate, Thane, Maharashtra, 400604, India
| | - Gandhali Paranjape
- DiagnoSearch Life Sciences Pvt. Ltd., 702, Dosti Pinnacle Plot No. E-7, Road No. 22 Wagle Industrial Estate, Thane, Maharashtra, 400604, India
| | - Kazunori Matsuda
- Yakult Central Institute, 5-11 Izumi, Kunitachi-Shi, Tokyo, 186-8650, Japan
| | - Tetsuji Hori
- Yakult Central Institute, 5-11 Izumi, Kunitachi-Shi, Tokyo, 186-8650, Japan
| | - Sanjay Juvekar
- KEM Hospital Research Centre, Vadu Rural Health Program, Pune, Maharashtra, 412216, India
| | - Girdhari Lal
- National Centre for Cell Science, NCCS Complex, Ganeshkhind, Pune, Maharashtra, 411007, India.
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Fortes-Andrade T, Almeida JS, Sousa LM, Santos-Rosa M, Freitas-Tavares P, Casanova JM, Rodrigues-Santos P. The Role of Natural Killer Cells in Soft Tissue Sarcoma: Prospects for Immunotherapy. Cancers (Basel) 2021; 13:cancers13153865. [PMID: 34359767 PMCID: PMC8345358 DOI: 10.3390/cancers13153865] [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: 05/31/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Soft-tissue sarcomas (STS) represent about 80% of sarcomas, and are a heterogeneous group of rare and malignant tumors. Morphological evaluation has been the standard model for the diagnosis of sarcomas, and even in samples with similar characteristics, they present genetic differences, which further increases the diversity of sarcomas. This variety is one of the main challenges for the classification and understanding of STS patterns, as well as for the respective treatments, which further decreases patient survival (<5 years). Natural Killer (NK) cells have a fundamental role in the control and immune surveillance of cancer development, progression and metastases. Notwithstanding the scarcity of studies to characterize NK cells in STS, it is noteworthy that the progression of these malignancies is associated with altered NK cells. These findings support the additional need to explore NK cell-based immunotherapy in STS; some clinical trials, although very tentatively, are already underway. Abstract Soft-tissue sarcomas (STS) represent about 80% of sarcomas, and are a heterogeneous group of rare and malignant tumors. STS arise from mesenchymal tissues and can grow into structures such as adipose tissue, muscles, nervous tissue and blood vessels. Morphological evaluation has been the standard model for the diagnosis of sarcomas, and even in samples with similar characteristics, they present a diversity in cytogenetic and genetic sequence alterations, which further increases the diversity of sarcomas. This variety is one of the main challenges for the classification and understanding of STS patterns, as well as for their respective treatments, which further decreases patient survival (<5 years). Despite some studies, little is known about the immunological profile of STS. As for the immunological profile of STS in relation to NK cells, there is also a shortage of studies. Observations made in solid tumors show that the infiltration of NK cells in tumors is associated with a good prognosis of the disease. Notwithstanding the scarcity of studies to characterize NK cells, their receptors, and ligands in STS, it is noteworthy that the progression of these malignancies is associated with altered NK phenotypes. Despite the scarcity of information on the function of NK cells, their phenotypes and their regulatory pathways in STS, the findings of this study support the additional need to explore NK cell-based immunotherapy in STS further. Some clinical trials, very tentatively, are already underway. STS clinical trials are still the basis for adoptive NK-cell and cytokine-based therapy.
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Affiliation(s)
- Tânia Fortes-Andrade
- Center for Neuroscience and Cell Biology (CNC), Laboratory of Immunology and Oncology, University of Coimbra, 3004-504 Coimbra, Portugal; (T.F.-A.); (J.S.A.); (L.M.S.)
| | - Jani Sofia Almeida
- Center for Neuroscience and Cell Biology (CNC), Laboratory of Immunology and Oncology, University of Coimbra, 3004-504 Coimbra, Portugal; (T.F.-A.); (J.S.A.); (L.M.S.)
- Faculty of Medicine, Immunology Institute, University of Coimbra, 3004-504 Coimbra, Portugal;
- Center of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Luana Madalena Sousa
- Center for Neuroscience and Cell Biology (CNC), Laboratory of Immunology and Oncology, University of Coimbra, 3004-504 Coimbra, Portugal; (T.F.-A.); (J.S.A.); (L.M.S.)
| | - Manuel Santos-Rosa
- Faculty of Medicine, Immunology Institute, University of Coimbra, 3004-504 Coimbra, Portugal;
- Center of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
| | - Paulo Freitas-Tavares
- Coimbra Hospital and University Center (CHUC), Tumor Unit of the Locomotor Apparatus (UTAL), University Clinic of Orthopedics, Orthopedics Service, 3000-075 Coimbra, Portugal;
| | - José Manuel Casanova
- Center of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Coimbra Hospital and University Center (CHUC), Tumor Unit of the Locomotor Apparatus (UTAL), University Clinic of Orthopedics, Orthopedics Service, 3000-075 Coimbra, Portugal;
| | - Paulo Rodrigues-Santos
- Center for Neuroscience and Cell Biology (CNC), Laboratory of Immunology and Oncology, University of Coimbra, 3004-504 Coimbra, Portugal; (T.F.-A.); (J.S.A.); (L.M.S.)
- Faculty of Medicine, Immunology Institute, University of Coimbra, 3004-504 Coimbra, Portugal;
- Center of Investigation in Environment, Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, 3000-548 Coimbra, Portugal;
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal
- Center for Innovation in Biomedicine and Biotechnology (CIBB), University of Coimbra, 3000-548 Coimbra, Portugal
- Correspondence: ; Tel.: +351-239-85-77-77 (ext. 24-28-44)
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