1
|
Droc G, Stancioaica MC, Soare CG, Stefan MG, Ingustu D, Martac C, Coriu D, Isac S, Suciu N, Andrei S. Acute Promyelocytic Leukemia and Severe Differentiation Syndrome in Pregnancy-A Management Challenge. Life (Basel) 2023; 13:life13051141. [PMID: 37240786 DOI: 10.3390/life13051141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 05/03/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
Acute promyelocytic leukemia (APL) is generated by the PML-RARA fusion gene. In patients suffering from APL, the early diagnosis and treatment are essential in the successful management. We reported a case of a 27-year-old 17th-week pregnant patient diagnosed with APL. After an extensive hematological diagnostic panel, the acute promyelocytic leukemia was confirmed, and the patient received all-trans retinoic acid (ATRA), idarubicin (IDA), and dexamethasone, following national guidelines. Due to ATRA-related differentiation syndrome, the therapy was adjusted, and hydroxycarbamide was added with a good outcome. The patient was admitted to the ICU secondary to hypoxemic respiratory failure on the 2nd day after hospital admission. Our patient received an individualized drug combination, adjusted by the clinical response. Furthermore, the drugs used in APL treatment are all teratogenic. Despite various major complications, including severe acute respiratory distress syndrome (ARDS), which needed mechanical ventilation; ICU-acquired myopathy; and spontaneous abortion, the patient had a good outcome and was transferred from the ICU after a total stay of 40 days. APL during pregnancy is a rare entity of intermediate-risk APL. Our study emphasized the need for individualized therapy in a rare case of a pregnant woman diagnosed with a potentially fatal hematologic disease.
Collapse
Affiliation(s)
- Gabriela Droc
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
- Department of Anesthesiology and Intensive Care I, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | | | - Corina Gabriela Soare
- Department of Anaesthesiology, Cork University Hospital, College Rd. Wilton, T12 DC4A Cork, Ireland
| | - Mihai-Gabriel Stefan
- Department of Anaesthesiology and Intensive Care Medicine II, "Prof CC Iliescu" Emergency Institute for Cardiovascular Diseases, 022322 Bucharest, Romania
| | - Daiana Ingustu
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Cristina Martac
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| | - Daniel Coriu
- Department of Haematology, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
- Department of Haematology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Sebastian Isac
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
- Department of Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Nicolae Suciu
- Department of Obstetrics and Gynecology, National Institute Mothers and Children Health "Alessandrescu-Rusescu", 011061 Bucharest, Romania
| | - Stefan Andrei
- Department of Anesthesiology and Intensive Care I, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania
| |
Collapse
|
2
|
Freudenreich M, Tischer J, Kroell T, Kremser A, Dreyßig J, Beibl C, Liepert A, Kolb HJ, Schmid C, Schmetzer H. In Vitro Generated Dendritic Cells of Leukemic Origin Predict Response to Allogeneic Stem Cell Transplantation in Patients With AML and MDS. J Immunother 2022; 45:104-118. [PMID: 34864807 DOI: 10.1097/cji.0000000000000404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022]
Abstract
Allogeneic stem cell transplantation (alloSCT) is the treatment of choice for many patients with acute myeloid leukemia (AML) and myelodysplastic syndrome. The presentation of leukemic or allospecific antigens by malignant blasts is regarded as a crucial trigger for an effective allogeneic immune response. Conversely, insufficient stimulatory capacity by the leukemic blasts is thought to be a relevant escape mechanism from cellular immunotherapy (alloSCT). Our purpose was to test, whether the ability of malignant blasts to differentiate in vitro toward dendritic cells of leukemic origin (DCleu) is associated with clinical outcome. We isolated leukemic blasts from peripheral blood or bone marrow of AML and myelodysplastic syndrome patients before alloSCT (n=47) or at relapse after alloSCT (n=22). A panel of 6 different assays was used to generate DCleu in vitro. Results were correlated with clinical outcome. DCleu could be generated from all 69 samples. Significantly higher mean frequencies of DCleu were found in clinical long-term responders versus nonresponders to SCT (76.8% vs. 58.8%, P=0.006). Vice versa, the chance for response to SCT was significantly higher, if a DCleu+/dendritic cells (DC) ratio of >50% could be reached in vitro (P=0.004). Those patients were characterized by a longer time to relapse (P=0.04) and by a higher probability for leukemia-free survival (P=0.005). In vitro generation of DC and DCleu from leukemic blasts correlated with the clinical outcome. This observation may support a role of leukemic antigen presentation by "leukemia-derived DC" for the stimulation of an allogeneic immune response in AML.
Collapse
Affiliation(s)
- Markus Freudenreich
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Johanna Tischer
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Tanja Kroell
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Andreas Kremser
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Julia Dreyßig
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Christine Beibl
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Anja Liepert
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Hans J Kolb
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
| | - Christoph Schmid
- Department of Hematology and Oncology, Universitäts-Klinikum Augsburg, Augsburg, Germany
| | - Helga Schmetzer
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University
- Helmholtz Center Munich, German Research Center for Environmental Health/Clinical Cooperative Group Haematopoetic Cell Transplantation (CCG-HCT), Munich
| |
Collapse
|
3
|
Zhang L, Wang X, Wu J, Xiao R, Liu J. MiR-335-3p inhibits cell proliferation, induces cell cycle arrest and apoptosis in acute myeloid leukemia by targeting EIF3E. Biosci Biotechnol Biochem 2021; 85:1953-1961. [PMID: 34191006 DOI: 10.1093/bbb/zbab116] [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: 07/03/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023]
Abstract
Here, we aimed to investigate the biological roles and the regulatory mechanisms of miR-335-3p in acute myeloid leukemia (AML). We first found miR-335-3p was significantly down-regulated in blood samples from leukemia patients and cell lines using reverse transcription quantitative PCR. Through CCK-8 assay and flow cytometry, we observed that miR-335-3p overexpression significantly inhibited cell proliferation, induced cell cycle G0/G1 arrest and apoptosis in AML cell lines (THP-1 and U937). Moreover, miR-335-3p directly targets EIF3E and negatively regulated its expression. More importantly, EIF3E overexpression reversed the effects of miR-335-3p on cell proliferation, G1/S transition and apoptosis. Furthermore, miR-335-3p overexpression obviously downregulated the expression of CDK4, Cyclin D1 and Bcl-2, while upregulated the expression of p21 and Bad, which were significantly rescued by the co-transfection of pcDNA3.1-EIF3E. Collectively, our study proposes that miR-335-3p/EIF3E axis could be a promising therapeutic target to mitigate the progression of AML.
Collapse
Affiliation(s)
- Ling Zhang
- Department of Hematology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, P.R. China
| | - Xiaozhen Wang
- Department of Hematology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, P.R. China
| | - Jieying Wu
- Department of Hematology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, P.R. China
| | - Ruozhi Xiao
- Department of Hematology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, P.R. China
| | - Jiajun Liu
- Department of Hematology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou 510630, P.R. China
| |
Collapse
|
4
|
Cianga VA, Campos Catafal L, Cianga P, Pavel Tanasa M, Cherry M, Collet P, Tavernier E, Guyotat D, Rusu C, Aanei CM. Natural Killer Cell Subpopulations and Inhibitory Receptor Dynamics in Myelodysplastic Syndromes and Acute Myeloid Leukemia. Front Immunol 2021; 12:665541. [PMID: 33986753 PMCID: PMC8112610 DOI: 10.3389/fimmu.2021.665541] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/31/2021] [Indexed: 12/13/2022] Open
Abstract
Natural killer (NK) cells are key innate immunity effectors that play a major role in malignant cell destruction. Based on expression patterns of CD16, CD56, CD57, and CD94, three distinct NK cell maturation stages have been described, which differ in terms of cytokine secretion, tissue migration, and the ability to kill target cells. Our study addressed NK cell maturation in bone marrow under three conditions: a normal developmental environment, during pre-leukemic state (myelodysplastic syndrome, MDS), and during leukemic transformation (acute myeloblastic leukemia, AML). In this study, we used a new tool to perform multicolor flow cytometry data analysis, based on principal component analysis, which allowed the unsupervised, accurate discrimination of immature, mature, and hypermature NK subpopulations. An impaired NK/T cell distribution was observed in the MDS bone marrow microenvironment compared with the normal and AML settings, and a phenotypic shift from the mature to the immature state was observed in NK cells under both the MDS and AML conditions. Furthermore, an impaired NK cell antitumor response, resulting in changes in NK cell receptor expression (CD159a, CD158a, CD158b, and CD158e1), was observed under MDS and AML conditions compared with the normal condition. The results of this study provide evidence for the failure of this arm of the immune response during the pathogenesis of myeloid malignancies. NK cell subpopulations display a heterogeneous and discordant dynamic on the spectrum between normal and pathological conditions. MDS does not appear to be a simple, intermediate stage but rather serves as a decisive step for the mounting of an efficient or ineffective immune response, leading to either the removal of the tumor cells or to malignancy.
Collapse
Affiliation(s)
- Vlad Andrei Cianga
- Department of Hematology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania.,Department of Clinical Hematology, Regional Institute of Oncology Iasi, Iasi, Romania
| | - Lydia Campos Catafal
- Hematology Laboratory, Universitary Hospital of Saint-Etienne, Saint-Etienne, France
| | - Petru Cianga
- Department of Immunology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Mariana Pavel Tanasa
- Department of Immunology, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Mohamad Cherry
- Hematology Laboratory, Universitary Hospital of Saint-Etienne, Saint-Etienne, France
| | - Phillipe Collet
- Department of Hematology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Emmanuelle Tavernier
- Department of Hematology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Denis Guyotat
- Department of Hematology, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Cristina Rusu
- Department of Genetics, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Carmen Mariana Aanei
- Hematology Laboratory, Universitary Hospital of Saint-Etienne, Saint-Etienne, France
| |
Collapse
|
5
|
Ye L, Gao L, Cheng Q, Guo F, He L, Yuan T, Zhu M, Ma Y, Pan M, Chu X, Ding M, Yu G. Intermediate dose cytarabine improves survival and relapse-free rate compared with standard-dose cytarabine as post-remission treatment for acute myeloid leukemia: A retrospection study. Medicine (Baltimore) 2021; 100:e24273. [PMID: 33546048 PMCID: PMC7837979 DOI: 10.1097/md.0000000000024273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/11/2020] [Indexed: 11/25/2022] Open
Abstract
The exact dose of cytarabine still remain controversial for the management of patients with acute myeloid leukemia (AML) after complete remission (CR), but recent studies favor lower doses. This study aimed to investigate the toxic effects of single-intermediate dose (ID) cytarabine in patients with AML after achieving CR, compared with standard-dose cytarabine.In this retrospective study, AML patients who achieved CR after consolidation therapy before enrollment between 07/2008 and 05/2019 were included. All patients were divided into single-ID cytarabine and standard-dose cytarabine. The Kaplan-Meier method was used to compare overall survival (OS) and relapse-free time (RFS). Cox regression models were used to assess factors independently associated with OS and RFS. The toxic side effects of hematology and non-hematology were observed.52 patients were enrolled. There were 33 in ID group, 19 in Standard dose group. The 3-year RFS rate (40.4% vs 22.2%, P = .031) was better in the ID group than in the standard-dose group, while the 3-year OS rate was not different between the 2 groups (50.2% vs 27.8%, P = .074). Treatment stratage of ID cytarabine chemotherapy significantly improve the prognosis of AML regardless of patient age, risk grade, WBC count. There were no significant differences between the 2 groups in grade 3 to 4 bone marrow suppression, gastrointestinal symptoms, blood transfusion, infections.Patients with AML receiving ID cytarabine showed better survival and similar toxicity profiles compared with patients who received standard-dose cytarabine.
Collapse
|
6
|
Wang H, Liu YC, Zhu CY, Yan F, Wang MZ, Chen XS, Wang XK, Pang BX, Li YH, Liu DH, Gao CJ, Liu SJ, Dou LP. Chidamide increases the sensitivity of refractory or relapsed acute myeloid leukemia cells to anthracyclines via regulation of the HDAC3 -AKT-P21-CDK2 signaling pathway. J Exp Clin Cancer Res 2020; 39:278. [PMID: 33298132 PMCID: PMC7724824 DOI: 10.1186/s13046-020-01792-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 11/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Induction therapy for acute myeloid leukemia (AML) is an anthracycline-based chemotherapy regimen. However, many patients experience a relapse or exhibit refractory disease (R/R). There is an urgent need for more effective regimens to reverse anthracycline resistance in these patients. METHODS In this paper, Twenty-seven R/R AML patients with anthracycline resistance consecutively received chidamide in combination with anthracycline-based regimen as salvage therapy at the Chinese PLA General Hospital. RESULTS Of the 27 patients who had received one course of salvage therapy, 13 achieved a complete response and 1 achieved a partial response. We found that the HDAC3-AKT-P21-CDK2 signaling pathway was significantly upregulated in anthracycline-resistant AML cells compared to non-resistant cells. AML patients with higher levels of HDAC3 had lower event-free survival (EFS) and overall survival (OS) rates. Moreover, anthracycline-resistant AML cells are susceptible to chidamide, a histone deacetylase inhibitor which can inhibit cell proliferation, increase cell apoptosis and induce cell-cycle arrest in a time- and dose-dependent manner. Chidamide increases the sensitivity of anthracycline-resistant cells to anthracycline drugs, and these effects are associated with the inhibition of the HDAC3-AKT-P21-CDK2 signaling pathway. CONCLUSION Chidamide can increase anthracycline drug sensitivity by inhibiting HDAC3-AKT-P21-CDK2 signaling pathway, thus demonstrating the potential for application.
Collapse
MESH Headings
- Adolescent
- Adult
- Aged
- Aminopyridines/administration & dosage
- Animals
- Anthracyclines/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Apoptosis
- Benzamides/administration & dosage
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Cell Cycle
- Cell Proliferation
- Child
- Cyclin-Dependent Kinase 2/genetics
- Cyclin-Dependent Kinase 2/metabolism
- Cyclin-Dependent Kinase Inhibitor p21/genetics
- Cyclin-Dependent Kinase Inhibitor p21/metabolism
- Drug Resistance, Neoplasm
- Female
- Gene Expression Regulation, Neoplastic/drug effects
- Histone Deacetylases/genetics
- Histone Deacetylases/metabolism
- Humans
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/metabolism
- Leukemia, Myeloid, Acute/pathology
- Male
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/pathology
- Prognosis
- Proto-Oncogene Proteins c-akt/genetics
- Proto-Oncogene Proteins c-akt/metabolism
- Salvage Therapy
- Survival Rate
- Tumor Cells, Cultured
- Xenograft Model Antitumor Assays
- Young Adult
Collapse
Affiliation(s)
- Hao Wang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yu-Chen Liu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Cheng-Ying Zhu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Fei Yan
- State Key Laboratory of Inorganic Synthesis and Preparative Chemistry, International Joint Research Laboratory of Nano-Micro Architecture Chemistry (NMAC), International Research Center for Chemistry-Medicine Joint Innovation, College of Chemistry, Jilin University, 2699 Qianjin Street, Changchun, 130012, China
| | - Meng-Zhen Wang
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Xiao-Su Chen
- School of Medicine, Nankai University, 94 Weijin Road, Tianjin, 300071, China
| | - Xiao-Kai Wang
- Department of Orthopedics, Xiqing Hospital, 403 Xiqing Road, Yangliuqing, Tianjin, 300000, China
| | - Bao-Xu Pang
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Yong-Hui Li
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Dai-Hong Liu
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Chun-Ji Gao
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Shu-Jun Liu
- The Hormel Institute, University of Minnesota, 801 16th Avenue NE, Austin, MN, 55912, USA.
| | - Li-Ping Dou
- Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| |
Collapse
|
7
|
Steger B, Floro L, Amberger DC, Kroell T, Tischer J, Kolb HJ, Schmetzer HM. WT1, PRAME, and PR3 mRNA Expression in Acute Myeloid Leukemia (AML). J Immunother 2020; 43:204-215. [DOI: 10.1097/cji.0000000000000322] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
8
|
Xiao Y, Deng T, Ming X, Xu J. TRIM31 promotes acute myeloid leukemia progression and sensitivity to daunorubicin through the Wnt/β-catenin signaling. Biosci Rep 2020; 40:BSR20194334. [PMID: 32232394 PMCID: PMC7160243 DOI: 10.1042/bsr20194334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/27/2020] [Accepted: 03/09/2020] [Indexed: 12/27/2022] Open
Abstract
Tripartite motif (TRIM) 31 is a member of TRIM family and exerts oncogenic role in the progression and drug resistance of several cancers. However, little is known about the relevance of TRIM31 in acute myeloid leukemia (AML). Herein, we investigated the role of TRIM31 in AML. We examined the expression levels of TRIM31 in the blood samples from 34 patients with AML and 34 healthy volunteers using qRT-PCR. The mRNA levels of TRIM31 in human bone marrow stromal cells (HS-5) and five AML cell lines were also detected. Loss/gain-of-function assays were performed to assess the role of TRIM31 in AML cells proliferation, apoptosis and sensitivity to daunorubicin. The expression levels of pro-caspase 3, cleaved caspase 3, Wnt3a, β-catenin, cyclin D1 and c-Myc were measured using Western blot. TRIM31 expression levels were significantly up-regulated in AML patients and cell lines. Knockdown of TRIM31 suppressed cell proliferation and promoted apoptosis in AML-5 and U937 cells. The IC50 of daunorubicin was significantly decreased in TRIM31 siRNA (si-TRIM31) transfected cells. Oppositely, induced cell proliferation and decreased cell apoptosis were observed in pcDNA-3.1-TRIM31 transfected cells. Furthermore, knockdown of TRIM31 suppressed the activation of Wnt/β-catenin pathway in AML cells. Activation of Wnt/β-catenin pathway by LiCl abolished the effects of si-TRIM31 on cell proliferation, apoptosis and sensitivity to daunorubicin in AML cells. In conclusion, the results indicated that TRIM31 promoted leukemogenesis and chemoresistance to daunorubicin in AML. The oncogenic role of TRIM31 in AML was mediated by the Wnt/β-catenin pathway. Thus, TRIM31 might serve as a therapeutic target for the AML treatment.
Collapse
MESH Headings
- Antibiotics, Antineoplastic/pharmacology
- Antibiotics, Antineoplastic/therapeutic use
- Apoptosis/drug effects
- Case-Control Studies
- Cell Line, Tumor
- Cell Proliferation/drug effects
- Daunorubicin/pharmacology
- Daunorubicin/therapeutic use
- Disease Progression
- Drug Resistance, Neoplasm
- Healthy Volunteers
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/pathology
- Lithium Chloride/pharmacology
- RNA, Small Interfering/metabolism
- Tripartite Motif Proteins/blood
- Tripartite Motif Proteins/genetics
- Tripartite Motif Proteins/metabolism
- Ubiquitin-Protein Ligases/blood
- Ubiquitin-Protein Ligases/genetics
- Ubiquitin-Protein Ligases/metabolism
- Wnt Signaling Pathway/drug effects
Collapse
Affiliation(s)
- Yi Xiao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Taoran Deng
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xi Ming
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jinhuang Xu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| |
Collapse
|
9
|
Gado MM, Mousa NO, Badawy MA, El Taweel MA, Osman A. Assessment of the Diagnostic Potential of miR-29a-3p and miR-92a-3p as Circulatory Biomarkers in Acute Myeloid Leukemia. Asian Pac J Cancer Prev 2019; 20:3625-3633. [PMID: 31870103 PMCID: PMC7173384 DOI: 10.31557/apjcp.2019.20.12.3625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Acute myeloid leukemia (AML) is a set of Myeloproliferative neoplasms that are identified by excessive growth of myeloid blasts and production of abnormal blood cells. AML is the most common type of acute leukemia that occurs in adults. In addition, AML progresses rapidly and is considered a fatal disease. Thus, there is an urgent need to find new targets for molecularly designed therapies. In This study, we evaluated the circulatory levels of microRNA-29a-3p (miR-29a-3p) and miR-92a-3p beside exploring the expression pattern of their target gene myeloid cell leukemia sequence1 (MCL1) to investigate the role of these molecules in AML pathophysiology and to assess their ability to diagnose AML patients. Methods: 40 adult AML patients along with 20 healthy subjects were enrolled in this study. Plasma were separated from venous blood samples, collected on EDTA, of all individuals were used to assess circulating miRNAs’ levels. In the meantime, total RNA was extracted from isolated leukocytes and was used to quantify target mRNA transcript levels. Results: Our data revealed that the circulating levels of miR-29a-3p and miR-92a-3p exhibited significant reduction in 90% and 100% of AML patients, respectively, when compared to the control group (p<0.001). On the other hand, the transcript level of the target gene of these miRNAs, MCL1, showed a sharp increase in 77.5% (p<0.001) of AML patients, along with a negative correlation with its regulatory miRNAs, miR-29a-3p and miR-92a-3p. Conclusion: Our data validates the negative regulatory role of miR-29a-3p and miR-92a-3p to the expression levels of MCL1 in peripheral blood and indicates that these miRNAs can be used as non-invasive diagnostic markers. Furthermore, our study highlights the therapeutic potential of miR-29a-3p and miR-92a-3p to target and downregulate a very important gene (MCL1), which is highly implicated in the pathogenesis of AML.
Collapse
Affiliation(s)
- Marwa M Gado
- Biotechnology/Biomolecular Chemistry program, Chemistry Department, faculty of Science, Cairo University, Giza, Egypt
| | - Nahla O Mousa
- Biotechnology/Biomolecular Chemistry program, Chemistry Department, faculty of Science, Cairo University, Giza, Egypt.,Biotechnology Program, Biology Department, The American University in Cairo, Cairo, Egypt
| | - M A Badawy
- Department of Chemistry, Faculty of Science, Cairo University, Giza, Egypt
| | - Maha A El Taweel
- Clinical Pathology Department, National Cancer institute, Cairo university, Giza, Egypt
| | - Ahmed Osman
- 5Biochemistry Department, faculty of science, Ain Shams university, Abbasyia, Cairo, Egypt.,Biotechnology Program, Basic and Applied Sciences Institute, Egypt-Japan University of Science and Technology, Borg Al Arab, Alexandria, Egypt
| |
Collapse
|
10
|
Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage. Brain Sci 2019; 9:brainsci9080207. [PMID: 31434194 PMCID: PMC6721397 DOI: 10.3390/brainsci9080207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 08/12/2019] [Accepted: 08/17/2019] [Indexed: 11/17/2022] Open
Abstract
Intracranial hemorrhage (ICH) is a catastrophic complication in patients with acute myeloid leukemia (AML). AML cells, especially in the acute promyelocytic leukemia subtype, may release microparticles (MPs), tissue factor (TF), and cancer procoagulant (CP) to promote coagulopathy. Hyperfibrinolysis is also triggered via release of annexin II, t-PA, u-PA, and u-PAR. Various inflammatory cytokines from cancer cells, such as IL-1β and TNF-α, activate endothelial cells and promote leukostasis. This condition may increase the ICH risk and lead to poor clinical outcomes. Here, we present a case under a unique situation with acute ICH detected prior to the diagnosis of AML. The patient initially presented with two episodes of syncope. Rapidly progressive ICH was noted in follow-up computed tomography (CT) scans. Therefore, we highlight that AML should be among the differential diagnoses of the etiologies of ICH. Early diagnosis and timely intervention are very important for AML patients.
Collapse
|
11
|
Drokow EK, Sun K, Ahmed HAW, Akpabla GS, Song J, Shi M. Circulating microRNA as diagnostic biomarkers for haematological cancers: a systematic review and meta-analysis. Cancer Manag Res 2019; 11:4313-4326. [PMID: 31190996 PMCID: PMC6520596 DOI: 10.2147/cmar.s199126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/10/2019] [Indexed: 12/31/2022] Open
Abstract
Purpose: Recent studies have validated microRNAs (miRNAs) as a diagnostic biomarker for haematological cancers. This study aimed to estimate the overall diagnostic accuracy of circulating miRNAs in haematological malignancies. Materials and Methods: Multiple databases (Google Scholar, PubMed, EMBASE, Cochrane Library,) were searched until 19th August 2017. Results: The meta-analysis included 50 studies from 20 publications. The diagnostic accuracy was assessed by pooled specificity, sensitivity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve area (AUC) by random effect model. We used QUADAS (Quality Assessment for diagnostic accuracy studies) to evaluate the quality of the included studies. To perform the meta-analysis, we used Meta-Disk 1.4, Revman 5.3 and Stata 12.0 software. High diagnostic accuracy was demonstrated, with a sensitivity of 0.81, a specificity of 0.85, a PLR of 5.28, an NLR of 0.22, a DOR of 30.39, and an AUC of 0.91. Subgroup analyses showed better outcomes for the African population, combined miRNAs and leukaemia patients compared with other subgroups. Conclusion: Our results indicated that circulating miRNAs especially combined miRNA can be used as a diagnostic marker in haematological cancers.
Collapse
Affiliation(s)
- Emmanuel Kwateng Drokow
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Kai Sun
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Hafiz Abdul Waqas Ahmed
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Gloria Selorm Akpabla
- Department of Pathophysiology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, People’s Republic of China
| | - Juanjuan Song
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| | - Mingyue Shi
- Department of Haematology, Zhengzhou University People’s Hospital & Henan Provincial People’s Hospital Henan, Zhengzhou, People’s Republic of China
| |
Collapse
|
12
|
Li L, Zhang X, Yu H, Zhang M, Xu M, Liu J, Fu Y, Meng H, Lyu C, Li X, Zhou J. Low-dose hypomethylating agent decitabine in combination with aclacinomycin and cytarabine achieves a better outcome than standard FLAG chemotherapy in refractory/relapsed acute myeloid leukemia patients with poor-risk cytogenetics and mutations. Onco Targets Ther 2018; 11:6863-6870. [PMID: 30349319 PMCID: PMC6190628 DOI: 10.2147/ott.s161919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Relapsed and refractory acute myeloid leukemia (RR-AML) still poses major treatment concerns. Current treatments include high doses of cytarabine or fludarabine in combination with cytarabine and G-CSF (FLAG), but provide mixed results. Low-dose decitabine, a hypomethylating drug, in combination with aclarubicin and cytarabine (DAC) has shown safety and efficacy in the treatment of AML; however, clinical data are limited for the treatment of RR-AML. Methods In this study, we retrospectively compared the response and safety of DAC vs FLAG for RR-AML patients. Results For the 35 patients with RR-AML enrolled in this study, the overall response rates reached 100% and 55.6% in the DAC group and FLAG group, respectively (P=0.002). Complete response rates after DAC and FLAG treatment were 64.7% and 33.3%, respectively (P=0.002). Median overall survival (95% CI) of the DAC treatment group was significantly higher than for the FLAG group (median not achieved vs 16.8 months, P=0.021). Conclusion DAC treatment was also more effective in those patients with poor prognosis, suggesting that DAC resulted in a better outcome for RR-AML treatment. In conclusion, in our study, DAC therapy provided more safety and effectiveness and lower toxicity in the treatment of RR-AML compared to FLAG therapy.
Collapse
Affiliation(s)
- Limin Li
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Xiaoqian Zhang
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Hongjuan Yu
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Mingwen Zhang
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Mengyuan Xu
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Jie Liu
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Yueyue Fu
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Hongbin Meng
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Chengfang Lyu
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Xiaoxia Li
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| | - Jin Zhou
- Department of Hematology, Institute of Hematology and Oncology of Heilongjiang Province, Hematology and Oncology Hospital of Harbin Medical University, Harbin, Heilongjiang, People's Republic of China, ;
| |
Collapse
|
13
|
Cardiac Tamponade as the Initial Presentation of Acute Myeloid Leukemia: A Case Report with Review of the Literature. Case Rep Oncol Med 2018; 2018:8201917. [PMID: 29780652 PMCID: PMC5892271 DOI: 10.1155/2018/8201917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 02/22/2018] [Indexed: 11/17/2022] Open
Abstract
Acute myeloid leukemia (AML) is a complex disease with a variety of presentations. A large pericardial effusion is rare, occurring in less than 0.5% of all patients with AML prior to treatment. A 34-year-old male presented with dyspnea, malaise, and weight loss. On physical exam, he was noted to be hypoxic, tachypneic, tachycardic, and hypotensive. He had cervical lymphadenopathy and jugular venous distention. His WBC count was 110 bil/L with 33% blasts. Bone marrow biopsy confirmed AML with 60% blasts. Leukemic cells were also seen in the cerebrospinal fluid on lumbar puncture. An echocardiogram revealed a large pericardial effusion causing tamponade. He underwent emergent pericardiocentesis, and malignant cells were present in the pericardial fluid. Induction therapy with standard dose cytarabine and daunorubicin was initiated, and bone marrow biopsy 14 days later showed no residual AML. This case demonstrates the importance of a thorough evaluation of each organ system when caring for a patient with AML.
Collapse
|
14
|
Wang D, Huang XF, Hong B, Song XT, Hu L, Jiang M, Zhang B, Ning H, Li Y, Xu C, Lou X, Li B, Yu Z, Hu J, Chen J, Yang F, Gao H, Ding G, Liao L, Rollins L, Jones L, Chen SY, Chen H. Efficacy of intracellular immune checkpoint-silenced DC vaccine. JCI Insight 2018; 3:98368. [PMID: 29415891 PMCID: PMC5821183 DOI: 10.1172/jci.insight.98368] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 12/28/2017] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND DC-based tumor vaccines have had limited clinical success thus far. SOCS1, a key inhibitor of inflammatory cytokine signaling, is an immune checkpoint regulator that limits DC immunopotency. METHODS We generated a genetically modified DC (gmDC) vaccine to perform immunotherapy. The adenovirus (Ad-siSSF) delivers two tumor-associated antigens (TAAs), survivin and MUC1; secretory bacterial flagellin for DC maturation; and an RNA interference moiety to suppress SOCS1. A 2-stage phase I trial was performed for patients with relapsed acute leukemia after allogenic hematopoietic stem cell transplantation: in stage 1, we compared the safety and efficacy between gmDC treatment (23 patients) and standard donor lymphocyte infusion (25 patients); in stage 2, we tested the efficacy of the gmDC vaccine for 12 acute myeloid leukemia (AML) patients with early molecular relapse. RESULTS gmDCs elicited potent TAA-specific CTL responses in vitro, and the immunostimulatory activity of gmDC vaccination was demonstrated in rhesus monkeys. A stage 1 study established that this combinatory gmDC vaccine is safe in acute leukemia patients and yielded improved survival rate. In stage 2, we observed a complete remission rate of 83% in 12 relapsed AML patients. Overall, no grade 3 or grade 4 graft-versus-host disease incidence was detected in any of the 35 patients enrolled. CONCLUSIONS This study, with combinatory modifications in DCs, demonstrates the safety and efficacy of SOCS1-silenced DCs in treating relapsed acute leukemia. TRIAL REGISTRATION ClinicalTrials.gov NCT01956630. FUNDING National Institute of Health (R01CA90427); the Key New Drug Development and Manufacturing Program of the "Twelfth Five-Year Plan" of China (2011ZX09102-001-29); and Clinical Application Research of Beijing (Z131107002213148).
Collapse
MESH Headings
- Adenoviridae/genetics
- Adolescent
- Adult
- Antigens, Neoplasm/genetics
- Antigens, Neoplasm/immunology
- Cancer Vaccines/administration & dosage
- Cancer Vaccines/adverse effects
- Cancer Vaccines/genetics
- Cancer Vaccines/immunology
- Cell Engineering/methods
- Child
- Dendritic Cells/immunology
- Dendritic Cells/transplantation
- Female
- Follow-Up Studies
- Genetic Vectors/genetics
- Graft vs Host Disease/epidemiology
- Graft vs Host Disease/immunology
- Hematopoietic Stem Cell Transplantation/adverse effects
- Humans
- Immunotherapy, Adoptive/methods
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/mortality
- Leukemia, Myeloid, Acute/therapy
- Lymphocyte Transfusion
- Male
- Middle Aged
- Neoplasm Recurrence, Local/immunology
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/mortality
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
- Survival Analysis
- Transplantation, Autologous
- Treatment Outcome
- Young Adult
Collapse
Affiliation(s)
- Danhong Wang
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Xue F. Huang
- Department of Molecular Microbiology and Immunology and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Bangxing Hong
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas, USA
| | - Xiao-Tong Song
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas, USA
| | - Liangding Hu
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Min Jiang
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Bin Zhang
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Hongmei Ning
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Yuhang Li
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Chen Xu
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Xiao Lou
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Botao Li
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Zhiyong Yu
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Jiangwei Hu
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Jianlin Chen
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Fan Yang
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Haiyan Gao
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Guoliang Ding
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| | - Lianming Liao
- Department of Oncology, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lisa Rollins
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas, USA
| | - Lindsey Jones
- Department of Molecular Microbiology and Immunology and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Si-Yi Chen
- Department of Molecular Microbiology and Immunology and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
- Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas, USA
| | - Hu Chen
- Department of Hematopoietic Stem Cell Transplantation, Affiliated Hospital of Academy of Military Medical Sciences, Beijing, China
| |
Collapse
|
15
|
Mohammadi Najafabadi M, Shamsasenjan K, Akbarzadehlaleh P. The Angiogenic Chemokines Expression Profile of Myeloid Cell Lines Co-Cultured with Bone Marrow-Derived Mesenchymal Stem Cells. CELL JOURNAL 2017; 20:19-24. [PMID: 29308614 PMCID: PMC5759676 DOI: 10.22074/cellj.2018.4924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/03/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Angiogenesis, the process of formation of new blood vessels, is essential for development of solid tumors. At first, it was first assumed that angiogenesis is not implicated in the development of acute myeloid leukemia (AML) as a liquid tumor. One of the most important elements in bone marrow microenvironment is mesenchymal stem cells (MSCs). These cells possess an intrinsic tropism for sites of tumor in various types of cancers and have an impact on solid tumors growth by affecting the angiogenic process. But so far, our knowledge is limited about MSCs' role in liquid tumors angiogenesis. By increasing our knowledge about the role of MSCs on angiogenesis, new therapeutic strategies can be used to improve the status of patients with leukemia. MATERIALS AND METHODS In this experimental study, HL-60, K562 and U937 cells were separately co-cultured with bone marrow derived-MSCs and after 8, 16 and 24 hours, alterations in the expression of 10 chemokine genes involved in angiogenesis, were evaluated by quantitative real time-polymerase chain reaction (qRT-PCR). Mono-cultures of leukemia cell lines were used as controls. RESULTS We observed that in HL-60 and K562 cells co-cultured with MSCs, the expression of CXCL10 and CXCL3 genes are increased, respectively as compared to the control cells. Also, in U937 cells co-cultured with MSCs, the expression of CXCL6 gene was upgraded. Moreover in U937 cells, CCL2 gene expression in the first 16 hours was lower than the control cells, while within 24 hours its expression augmented. CONCLUSIONS Our observations, for the first time, demonstrated that bone marrow (BM)-MSCs are able to alter the expression profile of chemokine genes involved in angiogenesis, in acute myeloid leukemia cell lines. MSCs cause different effects on angiogenesis in different leukemia cell lines; in some cases, MSCs promote angiogenesis, and in others, inhibit it.
Collapse
Affiliation(s)
| | - Karim Shamsasenjan
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Akbarzadehlaleh
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.
| |
Collapse
|
16
|
Therapeutic decision-making in elderly patients with acute myeloid leukemia: conventional intensive chemotherapy versus hypomethylating agent therapy. Ann Hematol 2017; 96:1801-1809. [DOI: 10.1007/s00277-017-3104-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 08/10/2017] [Indexed: 01/23/2023]
|
17
|
Jabbour E, Strati P, Cabrero M, O'Brien S, Ravandi F, Bueso-Ramos C, Wei Q, Hu J, Abi Aad S, Short NJ, Dinardo C, Daver N, Kadia T, Wierda W, Wei Y, Colla S, Borthakur G, Cortes J, Estrov Z, Kantarjian H, Garcia-Manero G. Impact of achievement of complete cytogenetic response on outcome in patients with myelodysplastic syndromes treated with hypomethylating agents. Am J Hematol 2017; 92:351-358. [PMID: 28076892 DOI: 10.1002/ajh.24650] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 01/05/2017] [Accepted: 01/07/2017] [Indexed: 11/10/2022]
Abstract
Two hundred and sixteen consecutive patients with MDS and abnormal karyotype treated with hypomethylating agents between 4/04 and 10/12 were reviewed. Median follow-up was 17 months. Using IWG criteria, best responses were complete response (CR) in 79 patients (37%), partial response (PR) in 4 (2%), and hematologic improvement (HI) in 10 (5%). Cytogenetic response (CyR) was achieved in 78 patients (36%): complete (CCyR) in 62 (29%) and partial in 16 (7%). CyR was achieved in 48 of 79 patients (61%) with CR, 1 of 14 (7%) with PR/HI, and in 29 of the 123 (24%) with no morphologic response. Median overall survival (OS) and leukemia-free survival (LFS) for patients with and without CCyR were 21 and 13 months (P = .007), and 16 and 9 months (P = .001), respectively. By multivariate analysis, the achievement of CCyR was predictive for better OS (HR = 2.1; P < .001). In conclusion, CyR occurs at a rate of 36% (complete in 29%) in patients with MDS treated with HMA and is not always associated with morphological response. The achievement of CCyR is associated with survival improvement and constitutes a major predictive factor for outcome particularly in patients without morphologic response. Therefore, the achievement of CCyR should be considered a milestone in the management of patients with MDS.
Collapse
Affiliation(s)
- Elias Jabbour
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Paolo Strati
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Monica Cabrero
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Susan O'Brien
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Farhad Ravandi
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Carlos Bueso-Ramos
- Department of Hematopathology; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Qiao Wei
- Department of Biostatistics; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Jianhua Hu
- Department of Biostatistics; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Simon Abi Aad
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Nicholas J. Short
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Courtney Dinardo
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Naval Daver
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Tapan Kadia
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - William Wierda
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Yue Wei
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Simona Colla
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Gautam Borthakur
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Jorge Cortes
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Zeev Estrov
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Hagop Kantarjian
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| | - Guillermo Garcia-Manero
- Department of Leukemia; University of Texas M.D. Anderson Cancer Center; Houston Texas 77030 USA
| |
Collapse
|
18
|
Espirito Santo A, Chacim S, Ferreira I, Leite L, Moreira C, Pereira D, Dantas M, Nunes M, Viterbo L, Moreira I, Martins A, Oliveira I, Domingues N, Mariz J, Medeiros R. Southwestern Oncology Group pretreatment risk criteria as predictive or prognostic factors in acute myeloid leukemia. Mol Clin Oncol 2017; 6:384-388. [PMID: 28451418 DOI: 10.3892/mco.2017.1134] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 07/25/2017] [Indexed: 11/05/2022] Open
Abstract
Acute myeloid leukemia (AML) is a clonal hematological malignant condition and the implications of pretreatment risk criteria as predictive or prognostic factors are constantly under evaluation. With this study, the authors' intent was to characterize AML patients and to evaluate the clinical outcome associated with Southwestern Oncology Group (SWOG) coding pretreatment risk criteria/cytogenetic score. Between 2002 and 2010, 225 patients were diagnosed with AML at the Portuguese Institute of Oncology (Porto, Portugal). From this patient group, 128 patients aged <65 years were selected. The patients were treated using a combination of cytarabine and anthracycline, with the addition of cyclosporine when bone marrow dysplasia was observed. A median survival of 24 months was observed in this group. The patients were divided in subgroups according to the SWOG pretreatment risk criteria. We observed a statistically significant association of non-favorable SWOG coding with female gender [P=0.025; risk ratio (RR)=3.632, 95% confidence interval (CI): 1.113-11.852], indication for allogeneic bone marrow transplantation (P=0.023, RR=1.317, 95% CI: 1.184-1.465), complete response achievement (P=0.013, RR=1.385, 95% CI: 11.232-1.556) and relapse (P=0.048, RR=3.181, 95% CI: 10.966-10.478). Furthermore, SWOG pretreatment risk criteria also significantly affected global overall survival (OS; P=0.003) and OS at 5 years (P=0.001). A multivariate Cox regression analysis supported response to induction therapy (3-year OS: P=0.011, RR=0.385, 95% CI: 10.184-0.806; 5-year OS: P=0.012, RR=0.388, 95% CI: 10.597-1.994), consolidation (3-year OS: P=0.005, RR=0.328, 95% CI: 0.150-0.720; 5-year OS: P=0.002, RR=0.308, 95% CI: 0.144-0.657) and the diagnosis of therapy-related aml (3-year OS: P=0.016, RR=2.756, 95% CI: 0.486-1.281; 5-year OS: P=0.031, RR=2.369, 95% CI: 1.081-5.189) as prognostic factors, but this was not confirmed for SWOG pretreatment risk criteria. Therefore, we concluded that the reproducibility of the application of the SWOG pretreatment risk criteria may not be available as a prognostic factor in every acute leukemia population. However, its application as a predictive factor of response has been confirmed in our population.
Collapse
Affiliation(s)
- Ana Espirito Santo
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal.,Faculty of Medicine, University of Porto, 4000-286 Porto, Portugal
| | - Sergio Chacim
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Isabel Ferreira
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Luis Leite
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Claudia Moreira
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Dulcineia Pereira
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Margarida Dantas
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Marta Nunes
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Luisa Viterbo
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Ilidia Moreira
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Angelo Martins
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Isabel Oliveira
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Nelson Domingues
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Jose Mariz
- Department of Onco-Hematology, Portuguese Institute of Oncology, 4200-072 Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology Group-CI, Portuguese Institute of Oncology, 4200-072 Porto, Portugal.,Abel Salazar Institute of Biomedical Sciences, University of Porto, 4000-286 Porto, Portugal.,Oncology Department, Portuguese Institute of Oncology, 4200-072 Porto, Portugal.,Biomedical Research Center, Faculty of Health Sciences, Fernando Pessoa University, 4000-286 Porto, Portugal.,Research Department, Portuguese League Against Cancer, 4200-072 Porto, Portugal
| |
Collapse
|
19
|
All-trans retinoic acid enhances cytotoxic effect of T cells with an anti-CD38 chimeric antigen receptor in acute myeloid leukemia. Clin Transl Immunology 2016; 5:e116. [PMID: 28090317 PMCID: PMC5192064 DOI: 10.1038/cti.2016.73] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 11/01/2016] [Accepted: 11/02/2016] [Indexed: 02/07/2023] Open
Abstract
We reported that T cells with anti-CD38-chimeric antigen receptors (CAR) eliminated B-cell lymphoma cells expressing CD38. To employ anti-CD38-CAR against acute myeloid leukemia (AML) blasts not expressing CD38, it is necessary to induce or increase the intensity of CD38 expression. A lactate dehydrogenase (LDH)-releasing assay and flow cytometry showed that anti-CD38-CAR T cells were cytotoxic against AML lines (THP-1 and CMK) expressing high CD38 levels (>99%), in time- and number of effector-dependent manners. In other AML lines (KG1, U937 and HL60) partially expressing CD38, CD38+ AML cells were killed by CD38-specific T cells, but CD38− AML cells remained survived. Intriguingly, 10 nM all-trans retinoic acid (ATRA) augmented CD38 expression in KG1, U937 and HL60 cells and primary leukemic cells from AML patients. Moreover, the withdrawal of ATRA from the medium decreased CD38 expression in AML cells. Killing effects of anti-CD38-CAR T cells against AML lines and AML cells were limited without ATRA, whereas CD38-specific T cells enhanced cytotoxicity on AML cells by ATRA in association with enhanced CD38 expression. These results indicate that anti-CD38-CAR T cells eliminate AML cells through CD38 expression induced by ATRA.
Collapse
|
20
|
Li Q, Tang Y, Qin J, Yi L, Yang Y, Wang J, He J, Su Q, Tan H. Subcellular localization of DJ-1 in human HL-60 leukemia cells in response to diallyl disulfide treatment. Mol Med Rep 2016; 14:4666-4672. [PMID: 27748821 PMCID: PMC5102037 DOI: 10.3892/mmr.2016.5831] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 09/02/2016] [Indexed: 11/25/2022] Open
Abstract
Diallyl disulfide (DADS) has been demonstrated to exert potent anticancer effects in vitro and in vivo. Previous studies indicate that DADS may induce the differentiation and/or apoptosis of human leukemia cells in vitro. However, the mechanisms underlying these anticancer effects remain elusive. The aim of the present study was to investigate alterations in the subcellular localization of protein deglycase DJ-1 (also known as Parkinsonism associated deglycase-7, PARK-7) in the cytoplasm, nucleus and mitochondria of human leukemia HL-60 cells induced by DADS, in order to provide novel experimental evidence for the molecular mechanisms underlying the anticancer mechanisms of DADS in leukemia cells. HL-60 cells induced by DADS were collected at different time points, and proteins from the cytoplasm, nucleus and mitochondria of the cells were isolated using specific cellular component isolation kits. The protein expression levels of DJ-1 in these subcellular fractions of HL60 cells following exposure to DADS for varying lengths of time, were determined using western blotting, immunocytochemistry and immunofluorescence techniques. Following exposure of HL-60 cells to 1.25 mg/l DADS for 8 h, the protein expression levels of DJ-1 were significantly decreased in the cytoplasm, while nuclear fractions exhibited a significant increase in DJ-1 expression when compared with untreated controls. The protein expression levels of DJ-1 in mitochondria of HL-60 cells were significantly decreased following treatment with 5 and 10 mg/l DADS. These results demonstrate that exposure of HL-60 cells to low concentrations of DADS may promote DJ-1 protein translocation from the cytoplasm to the nucleus, which suggests that DJ-1 may function as a transcription factor or cofactor binding protein in the process of cell differentiation. The expression of DJ-1 in mitochondria may be associated with induction of apoptosis in HL-60 cells treated with moderate doses of DADS.
Collapse
Affiliation(s)
- Qingye Li
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yuxian Tang
- Department of Pathology, The Central Hospital of Yongzhou, Yongzhou, Hunan 425000, P.R. China
| | - Jing Qin
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Lan Yi
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Yening Yang
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Juan Wang
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Jie He
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Qi Su
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| | - Hui Tan
- Cancer Research Institute, University of South China, Hengyang, Hunan 421001, P.R. China
| |
Collapse
|
21
|
Cytosine arabinoside and daunorubicin induction therapy in a patient with acute myeloid leukemia on chronic hemodialysis. Anticancer Drugs 2016; 27:800-3. [DOI: 10.1097/cad.0000000000000382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
High Expression of Human Homologue of Murine Double Minute 4 and the Short Splicing Variant, HDM4-S, in Bone Marrow in Patients With Acute Myeloid Leukemia or Myelodysplastic Syndrome. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2016; 16 Suppl:S30-8. [DOI: 10.1016/j.clml.2016.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 03/23/2016] [Indexed: 12/19/2022]
|
23
|
Van de Velde AL, Beutels P, Smits EL, Van Tendeloo VF, Nijs G, Anguille S, Verlinden A, Gadisseur AP, Schroyens WA, Dom S, Cornille I, Goossens H, Berneman ZN. Medical costs of treatment and survival of patients with acute myeloid leukemia in Belgium. Leuk Res 2016; 46:26-9. [PMID: 27111858 DOI: 10.1016/j.leukres.2016.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/31/2016] [Indexed: 12/26/2022]
Abstract
The advent of new cell-based immunotherapies for leukemia offers treatment possibilities for certain leukemia subgroups. The wider acceptability of these new technologies in clinical practice will depend on its impact on survival and costs. Due to the small patient groups who have received it, these aspects have remained understudied. This non-randomized single-center study evaluated medical costs and survival for acute myeloid leukemia between 2005 and 2010 in 50 patients: patients treated with induction and consolidation chemotherapy (ICT) alone; patients treated with ICT plus allogeneic hematopoietic stem cell transplantation (HCT), which is the current preferred post-remission therapy in patients with intermediate- and poor-risk AML with few co-morbidities, and patients treated with ICT plus immunotherapy using autologous dendritic cells (DC) engineered to express the Wilms' tumor protein (WT1). Total costs including post- consolidation costs on medical care at the hematology ward and outpatient clinic, pharmaceutical prescriptions, intensive care ward, laboratory tests and medical imaging were analyzed. Survival was markedly better in HCT and DC. HCT and DC were more costly than ICT. The median total costs for HCT and DC were similar. These results need to be confirmed to enable more thorough cost-effectiveness analyses, based on observations from multicenter, randomized clinical trials and preferably using quality-adjusted life-years as an outcome measure.
Collapse
Affiliation(s)
- A L Van de Velde
- Division of Hematology, Antwerp University Hospital, Edegem, Belgium.
| | - P Beutels
- Centre for Health Economics Research & Modeling Infectious Diseases, University of Antwerp, Antwerp, Belgium
| | - E L Smits
- Center for Cell Therapy and Regenerative Medicine (CCRG), Antwerp University Hospital, Edegem, Belgium; Center for Oncological Research, University of Antwerp, Antwerp, Belgium
| | - V F Van Tendeloo
- Center for Cell Therapy and Regenerative Medicine (CCRG), Antwerp University Hospital, Edegem, Belgium
| | - G Nijs
- Center for Cell Therapy and Regenerative Medicine (CCRG), Antwerp University Hospital, Edegem, Belgium
| | - S Anguille
- Division of Hematology, Antwerp University Hospital, Edegem, Belgium
| | - A Verlinden
- Division of Hematology, Antwerp University Hospital, Edegem, Belgium
| | - A P Gadisseur
- Division of Hematology, Antwerp University Hospital, Edegem, Belgium
| | - W A Schroyens
- Division of Hematology, Antwerp University Hospital, Edegem, Belgium
| | - S Dom
- Business Intelligence, Antwerp University Hospital, Edegem, Belgium
| | - I Cornille
- Business Intelligence, Antwerp University Hospital, Edegem, Belgium
| | - H Goossens
- Vaccine and Infectious Disease Institute (Vaxinfectio), University of Antwerp, Belgium
| | - Z N Berneman
- Division of Hematology, Antwerp University Hospital, Edegem, Belgium; Center for Cell Therapy and Regenerative Medicine (CCRG), Antwerp University Hospital, Edegem, Belgium
| |
Collapse
|
24
|
Sanchez-Correa B, Campos C, Pera A, Bergua JM, Arcos MJ, Bañas H, Casado JG, Morgado S, Duran E, Solana R, Tarazona R. Natural killer cell immunosenescence in acute myeloid leukaemia patients: new targets for immunotherapeutic strategies? Cancer Immunol Immunother 2016; 65:453-63. [PMID: 26059279 PMCID: PMC11029066 DOI: 10.1007/s00262-015-1720-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Accepted: 05/22/2015] [Indexed: 12/19/2022]
Abstract
Several age-associated changes in natural killer (NK) cell phenotype have been reported that contribute to the defective NK cell response observed in elderly patients. A remodelling of the NK cell compartment occurs in the elderly with a reduction in the output of immature CD56(bright) cells and an accumulation of highly differentiated CD56(dim) NK cells. Acute myeloid leukaemia (AML) is generally a disease of older adults. NK cells in AML patients show diminished expression of several activating receptors that contribute to impaired NK cell function and, in consequence, to AML blast escape from NK cell immunosurveillance. In AML patients, phenotypic changes in NK cells have been correlated with disease progression and survival. NK cell-based immunotherapy has emerged as a possibility for the treatment of AML patients. The understanding of age-associated alterations in NK cells is therefore necessary to define adequate therapeutic strategies in older AML patients.
Collapse
Affiliation(s)
| | - Carmen Campos
- Department of Immunology, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Avenida Menendez Pidal s/n, 14004, Córdoba, Spain
| | - Alejandra Pera
- Department of Immunology, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Avenida Menendez Pidal s/n, 14004, Córdoba, Spain
| | - Juan M Bergua
- Department of Hematology, Hospital San Pedro de Alcantara, Cáceres, Spain
| | - Maria Jose Arcos
- Department of Hematology, Hospital San Pedro de Alcantara, Cáceres, Spain
| | - Helena Bañas
- Department of Hematology, Hospital San Pedro de Alcantara, Cáceres, Spain
| | - Javier G Casado
- Immunology Unit, University of Extremadura, Cáceres, Spain
- Stem Cell Therapy Unit, Minimally Invasive Surgery Centre Jesus Uson, Cáceres, Spain
| | - Sara Morgado
- Immunology Unit, University of Extremadura, Cáceres, Spain
| | - Esther Duran
- Histology and Pathology Unit, Faculty of Veterinary, University of Extremadura, Cáceres, Spain
| | - Rafael Solana
- Department of Immunology, IMIBIC, Reina Sofia University Hospital, University of Cordoba, Avenida Menendez Pidal s/n, 14004, Córdoba, Spain.
| | | |
Collapse
|
25
|
Lamba JK, Pounds S, Cao X, Crews KR, Cogle CR, Bhise N, Raimondi SC, Downing JR, Baker SD, Ribeiro RC, Rubnitz JE. Clinical significance of in vivo cytarabine-induced gene expression signature in AML. Leuk Lymphoma 2015; 57:909-20. [PMID: 26366682 DOI: 10.3109/10428194.2015.1086918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Despite initial remission, ∼60-70% of adult and 30% of pediatric patients experience relapse or refractory AML. Studies so far have identified base line gene expression profiles of pathogenic and prognostic significance in AML; however, the extent of change in gene expression post-initiation of treatment has not been investigated. Exposure of leukemic cells to chemotherapeutic agents such as cytarabine, a mainstay of AML chemotherapy, can trigger adaptive response by influencing leukemic cell transcriptome and, hence, development of resistance or refractory disease. It is, however, challenging to perform such a study due to lack of availability of specimens post-drug treatment. The primary objective of this study was to identify in vivo cytarabine-induced changes in leukemia cell transcriptome and to evaluate their impact on clinical outcome. The results highlight genes relevant to cytarabine resistance and support the concept of targeting cytarabine-induced genes as a means of improving response.
Collapse
Affiliation(s)
- Jatinder K Lamba
- a Pharmacotherapy and Translational Research, University of Florida , Gainesville , FL , USA
| | - Stanley Pounds
- b Biostatistics, St Jude Children's Research Hospital , Memphis , TN , USA
| | - Xueyuan Cao
- b Biostatistics, St Jude Children's Research Hospital , Memphis , TN , USA
| | - Kristine R Crews
- c Pharmaceutical Sciences, St Jude Children's Research Hospital , Memphis , TN , USA
| | - Christopher R Cogle
- d Division of Hematology and Oncology, Department of Medicine , University of Florida , Gainesville , FL , USA
| | - Neha Bhise
- a Pharmacotherapy and Translational Research, University of Florida , Gainesville , FL , USA
| | - Susana C Raimondi
- e Pathology, St Jude Children's Research Hospital , Memphis , TN , USA , and
| | - James R Downing
- e Pathology, St Jude Children's Research Hospital , Memphis , TN , USA , and
| | - Sharyn D Baker
- c Pharmaceutical Sciences, St Jude Children's Research Hospital , Memphis , TN , USA
| | - Raul C Ribeiro
- f Oncology, St Jude Children's Research Hospital , Memphis , TN , USA
| | - Jeffrey E Rubnitz
- f Oncology, St Jude Children's Research Hospital , Memphis , TN , USA
| |
Collapse
|
26
|
Li X, Xu S, Tan Y, Chen J. The effects of idarubicin versus other anthracyclines for induction therapy of patients with newly diagnosed leukaemia. Cochrane Database Syst Rev 2015; 2015:CD010432. [PMID: 26037486 PMCID: PMC11218035 DOI: 10.1002/14651858.cd010432.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Anthracycline combined with cytarabine has been the standard for induction therapy of newly diagnosed acute myeloid leukaemia (AML) for several decades. Due to theoretical advantages, idarubicin (IDA) might be the most effective and tolerable anthracycline. However, there is no evidence that would definitively prove the superiority of IDA over other anthracyclines. OBJECTIVES To assess the efficacy and safety of IDA versus other anthracyclines in induction therapy of newly diagnosed AML. SEARCH METHODS We identified relevant randomised controlled trials (RCTs) by searching the Cochrane Central Register of Controlled Trials (The Cochrane Library 2014, Issue 8), MEDLINE (from 1946 to 3 August 2014), EMBASE (from 1974 to 3 August 2014), Chinese BioMedical Literature Database (1978 to 3 August 2014), relevant conference proceedings and databases of ongoing trials. SELECTION CRITERIA RCTs that compared IDA with other anthracyclines in induction therapy of newly diagnosed AML. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the quality of studies according to methodological standards of the Cochrane Collaboration. We estimated hazard ratios (HRs) for time-to-event data outcomes using the inverse variance method, and risk ratios (RRs) for dichotomous data outcomes using the Mantel-Haenszel method. We adopted a fixed-effect model and repeated the main meta-analysis by a random-effects model in a sensitivity analysis. MAIN RESULTS We identified 2017 references. Ultimately, 27 RCTs (including 22 two-armed RCTs and five three-armed RCTs) involving 9549 patients were eligible. The consolidation treatments adopted in the studies were comparable and had no impact on the results. Overall, the risk of bias of the studies was unclear to high.Eighteen RCTs (N = 6755) assessed IDA versus daunorubicin (DNR). The main meta-analyses showed that IDA compared with DNR prolonged overall survival (OS) (12 studies, 5976 patients; HR 0.90, 95% confidence interval (CI) 0.84 to 0.96, P = 0.0008; high quality of evidence) and disease-free survival (DFS) (eight studies, 3070 patients; HR 0.88, 95% CI 0.81 to 0.96, P = 0.004; moderate quality of evidence), increased complete remission (CR) rate (18 studies, 6692 patients; RR 1.04, 95% CI 1.01 to 1.07, P = 0.009; moderate quality of evidence), and reduced relapse rate (four studies, 1091 patients; RR 0.88, 95% CI 0.80 to 0.98, P = 0.02; moderate quality of evidence), although increased the risks of death on induction therapy (14 studies, 6349 patients; RR 1.18, 95% CI 1.01 to 1.36, P = 0.03; moderate quality of evidence) and grade 3/4 mucositis (five studies, 2000 patients; RR 1.22, 95% CI 1.04 to 1.44, P = 0.02; moderate quality of evidence). There was no evidence for difference in the risks of grade 3/4 cardiac toxicity (six studies, 2795 patients; RR 0.98, 95% CI 0.70 to 1.37, P = 0.91; moderate quality of evidence) and other grade 3/4 adverse events (AEs). None of the studies reported on quality of life (QoL).Eight RCTs (N = 2419) evaluated IDA versus mitoxantrone (MIT). The main meta-analyses showed that there was no evidence for difference between arms in OS (six studies, 2171 patients; HR 0.98, 95% CI 0.89 to 1.08, P = 0.69; high quality of evidence), DFS (four studies, 249 patients; HR 0.88, 95% CI 0.70 to 1.10, P = 0.26; low quality of evidence), CR rate (eight studies, 2411 patients; RR 0.97, 95% CI 0.92 to 1.03, P = 0.32;moderate quality of evidence), the risks of death on induction therapy (five studies, 2055 patients; RR 1.10, 95% CI 0.88 to 1.38, P = 0.39; moderate quality of evidence) and relapse (three studies, 328 patients; RR 0.99, 95% CI 0.80 to 1.22, P = 0.89; moderate quality of evidence). There was no evidence for difference in the risks of grade 3/4 cardiac toxicity (one study, 160 patients; RR 0.67, 95% CI 0.11 to 3.88, P = 0.65; low quality of evidence) and other grade 3/4 AEs. None of the studies reported on QoL.Two RCTs (N = 211) compared IDA with doxorubicin (DOX). Neither study assessed OS. One study showed that there was no evidence for difference in DFS (63 patients; HR 0.62, 95% CI 0.34 to 1.14, P = 0.12; low quality of evidence). The main meta-analysis for CR rate showed an improved CR rate with IDA (two studies, 187 patients; RR 1.28, 95% CI 1.03 to 1.59, P = 0.02; low quality of evidence). Neither study provided data for the risks of death on induction therapy and relapse. One trial showed that there was no evidence for difference in the risk of grade 3/4 cardiac toxicity (one study, 100 patients; RR 0.31, 95% CI 0.01 to 7.39, P = 0.47; very low quality of evidence). Neither study reported on QoL.Two RCTs (N = 1037) evaluated IDA versus zorubicin (ZRB). Neither study assessed OS. One trial showed that there was no evidence for difference in DFS (one study, 155 patients; HR 1.25, 95% CI 0.83 to 1.88, P = 0.29; low quality of evidence). The main meta-analyses for CR and death on induction therapy both showed that there was no evidence for difference (CR rate: two studies, 964 patients; RR 1.04, 95% CI 0.96 to 1.13, P = 0.31; low quality of evidence. risk of death on induction therapy: two studies, 964 patients; RR 0.75, 95% CI 0.50 to 1.13, P = 0.17; moderate quality of evidence). Neither study reported the risks of relapse and grade 3/4 cardiotoxicity. One trial showed that IDA reduced the risk of grade 3/4 mucositis. Neither study reported on QoL. AUTHORS' CONCLUSIONS Compared with DNR in induction therapy of newly diagnosed AML, IDA prolongs OS and DFS, increases CR rate and reduces relapse rate, although increases the risks of death on induction therapy and grade 3/4 mucositis. The currently available evidence does not show any difference between IDA and MIT used in induction therapy of newly diagnosed AML. There is insufficient evidence regarding IDA versus DOX and IDA versus ZRB to make final conclusions. Additionally, there is no evidence for difference on the effect of IDA compared with DNR, MIT, DOX or ZRB on QoL.
Collapse
Affiliation(s)
- Xi Li
- Southwest Hospital, Third Military Medical UniversityCenter for Hematology38 Gao Tanyan StreetChongqingChina400038
| | - ShuangNian Xu
- Southwest Hospital, Third Military Medical UniversityCenter for Hematology38 Gao Tanyan StreetChongqingChina400038
| | - Ya Tan
- Southwest Hospital, Third Military Medical UniversityCenter for Hematology38 Gao Tanyan StreetChongqingChina400038
| | - JiePing Chen
- Southwest Hospital, Third Military Medical UniversityCenter for Hematology38 Gao Tanyan StreetChongqingChina400038
| | | |
Collapse
|
27
|
Identification of circulating microRNAs as biomarkers in diagnosis of hematologic cancers: a meta-analysis. Tumour Biol 2014; 35:10467-78. [DOI: 10.1007/s13277-014-2364-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/14/2014] [Indexed: 01/08/2023] Open
|
28
|
Zhang X, Su Y, Song H, Yu Z, Zhang B, Chen H. Attenuated A20 expression of acute myeloid leukemia-derived dendritic cells increased the anti-leukemia immune response of autologous cytolytic T cells. Leuk Res 2014; 38:673-81. [DOI: 10.1016/j.leukres.2014.03.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/13/2014] [Accepted: 03/15/2014] [Indexed: 11/26/2022]
|
29
|
Xiao Q, Deng D, Li H, Ye F, Huang L, Zhang B, Ye B, Mo Z, Yang X, Liu Z. GSTT1 and GSTM1 polymorphisms predict treatment outcome for acute myeloid leukemia: a systematic review and meta-analysis. Ann Hematol 2014; 93:1381-90. [PMID: 24994605 DOI: 10.1007/s00277-014-2050-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 03/03/2014] [Indexed: 01/01/2023]
Abstract
Glutathione S-transferases (GSTs) contribute to the metabolism of different xenobiotics and anticancer drugs and confer protection against oxidative stress thus may influence the treatment outcome of acute myeloid leukemia (AML). Studies regarding the association between GSTT1 and GSTM1 polymorphisms and treatment outcome in AML patients showed an inconsistent result. A systematic review and meta-analysis were performed to further explore this association. PubMed, Hartford User Group Exchange (HUGE), and China National Knowledge Infrastructure (CNKI) databases were searched for all related publications. Statistical analyses were analyzed by using RevMan 5.0 and Stata 9.0 softwares. A total of 1,837 patients in 11 studies were included. GSTT1 null genotype was found to be significantly associated with a reduced response after first course of induction chemotherapy (odds ratio (OR) = 0.894, 95 % confidence interval (CI) = 0.818-0.977, P = 0.013), progression-free survival (PFS; hazard ratio (HR) = 0.698, 95 % CI = 0.520-0.937, P = 0.017), and overall survival (OS; HR = 0.756, 95 % CI = 0.618-0.925, P = 0.007) in Asian population. GSTM1/GSTT1 double-null genotype was also identified to be significantly associated with response after the first course of induction chemotherapy (OR = 0.40, 95 % CI = 0.24-0.67, P = 0.0003). Our study suggested that GSTT1 null genotype and GSTT1/GSTM1 double-null genotype were associated with a worse treatment outcome for AML patients, especially in Asian population.
Collapse
Affiliation(s)
- Qiang Xiao
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Shuang Yong Rd. 6, Nanning, 530021, Guangxi Zhuang Autonomous Region, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Ravandi F, Erba HP, Pollyea DA. Expert insights into the contemporary management of older adults with acute myeloid leukemia. Cancer Control 2013; 20:5-16. [PMID: 24077448 DOI: 10.1177/107327481302004s02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
31
|
The role of hypomethylating agents in the treatment of elderly patients with AML. J Geriatr Oncol 2013; 5:89-105. [PMID: 24484723 DOI: 10.1016/j.jgo.2013.08.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Revised: 06/24/2013] [Accepted: 08/26/2013] [Indexed: 11/20/2022]
Abstract
There is a major unmet medical need for treatment options in elderly patients with acute myeloid leukemia (AML) who are deemed ineligible for intensive treatment. The recent approval of decitabine in the European Union for the treatment of patients with AML≥ 65 years old highlights the potential for hypomethylating agents in this setting. Here, we review evidence to support the use of hypomethylating agents in elderly patients and emphasize the importance of tolerability and quality of life considerations. We focus on the rationale for the continued clinical development of the ribonucleoside analog azacitidine in this setting. We discuss potential differences in the activity of azacitidine and decitabine in different patient subgroups that could possibly be explained by important differences in mechanism of action. Finally, we assess practical challenges that will be faced when integrating hypomethylating agents into clinical practice, such as how to define ineligibility for intensive treatment.
Collapse
|
32
|
Goldschmidt N, Cohen SB, Gatt ME, Safrai M, Rund D. Influence of ethnicity and improved outcome of acute myeloid leukaemia: two decades of follow-up of Israeli patient cohort. Hematol Oncol 2013; 32:94-101. [PMID: 24038510 DOI: 10.1002/hon.2092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 07/24/2013] [Indexed: 11/07/2022]
Abstract
Acute myeloid leukaemia is a disease with unfavourable prognosis. The significance of various prognostic parameters is not fully understood. We studied 293 patients to examine the influence of ethnicity and molecular markers. The median survival for all patients was correlated with age, white blood cell count and karyotype, and marginally with FLT3 internal tandem duplication. Arab patients were younger than Jewish patients; however, their survival was poorer albeit being treated with the same protocols and having more favourable cytogenetics. Survival rates improved over time but only for patients undergoing allogeneic bone marrow transplantation (alloBMT). We conclude that in our young patient cohort, recent improvement in survival is attributed to alloBMT therapy and that ethnicity affected treatment outcome.
Collapse
Affiliation(s)
- Neta Goldschmidt
- Hematology Department, Hebrew-University Hadassah Medical Center, Jerusalem, Israel
| | | | | | | | | |
Collapse
|
33
|
Wang YH, Xu XJ, Zhang LF, Li HL. Mimic of manganese superoxide dismutase induces apoptosis in human acute myeloid leukemia cells. Leuk Lymphoma 2013; 55:1166-75. [PMID: 23879200 DOI: 10.3109/10428194.2013.825904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract Increasing manganese superoxide dismutase (MnSOD) expression can suppress the malignant phenotype in various cancer cell lines and suppress tumor formation in xenograft and transgenic mouse models. A mimic of manganese superoxide dismutase (MnSODm), synthesized by a chemical method, has been shown to possess antitumor properties. However, the anticancer activity of MnSODm in acute myeloid leukemia (AML) is still obscure. In this study, we investigated the effects of MnSODm on the apoptosis of human leukemia HL-60 cells. Results showed that MnSODm significantly reduced the proliferation of HL-60 cells in a concentration- and time-dependent manner. By flow cytometric analysis, we found that MnSODm treatment resulted in increased apoptosis in HL-60 cells. Further analysis demonstrated involvement of activation of the caspase cascade, cleavage of poly(ADP-ribose) polymerase (PARP) and release of cytochrome c in MnSODm-induced apoptosis. The results also showed that the expression of anti-apoptotic Bcl-2 and Bid were dose-dependently decreased, whereas the expression of pro-apoptotic Bax protein was increased. Thus, MnSODm induced apoptosis in HL-60 cells via mitochondria-mediated, caspase-dependent pathways. MnSODm inhibition of Akt phosphorylation may contribute to MnSODm-mediated acute myeloid leukemia cell growth inhibition and apoptosis induction.
Collapse
|
34
|
Sampath D, Malik A, Plunkett W, Nowak B, Williams B, Burton M, Verstovsek S, Faderl S, Garcia-Manero G, List AF, Sebti S, Kantarjian HM, Ravandi F, Lancet JE. Phase I clinical, pharmacokinetic, and pharmacodynamic study of the Akt-inhibitor triciribine phosphate monohydrate in patients with advanced hematologic malignancies. Leuk Res 2013; 37:1461-7. [PMID: 23993427 DOI: 10.1016/j.leukres.2013.07.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 07/27/2013] [Indexed: 01/17/2023]
Abstract
Akt, a serine/threonine protein kinase, is constitutively phosphorylated and hyperactivated in multiple cancers, including acute myeloid leukemia. High levels are linked to poor survival and inferior responses to chemotherapy, making Akt inhibition an attractive therapeutic target. In this phase I/II study of TCN-PM, a small-molecule Akt inhibitor, TCN-PM therapy was well tolerated in patients with advanced hematological malignancies, and reduced levels of phosphorylation of Akt and its substrate Bad were shown, consistent with inhibition of this survival pathway and induction of cell death. Further investigation of TCN-PM alone or in combination in patients with high Akt levels is warranted.
Collapse
Affiliation(s)
- Deepa Sampath
- Departments of Experimental Therapeutics, M.D. Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Li X, Xu S, Tan Y, Chen J. Idarubicin compared to other anthracyclines for treatment of newly diagnosed acute myeloid leukaemia. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2013. [DOI: 10.1002/14651858.cd010432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
36
|
Nishi R, Yamauchi T, Negoro E, Takemura H, Ueda T. Combination of guanine arabinoside and Bcl-2 inhibitor YC137 overcomes the cytarabine resistance in HL-60 leukemia cell line. Cancer Sci 2013; 104:502-7. [PMID: 23320492 DOI: 10.1111/cas.12103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 12/24/2012] [Accepted: 12/27/2012] [Indexed: 11/28/2022] Open
Abstract
Cytarabine (ara-C) is the key agent for treating acute myeloid leukemia. After being transported into leukemic cells, ara-C is phosphorylated, by several enzymes including deoxycytidine kinase (dCK), to ara-C triphosphate (ara-CTP), an active metabolite, and then incorporated into DNA, thereby inhibiting DNA synthesis. Therefore, the cytotoxicity of ara-C depends on the production of ara-CTP and the induction of apoptosis. Here, we established a new ara-C-resistant acute myeloid leukemia cell line (HL-60/ara-C60) with dual resistance characteristics of the anti-antimetabolic character of decreased ara-CTP production and an increase in the antiapoptotic factors Bcl-2 and Bcl-XL. We further attempted to overcome resistance by augmenting ara-CTP production and stimulating apoptosis. A relatively new nucleoside analog, 9-β-d-arabinofuranosylguanine (ara-G), and the small molecule Bcl-2 antagonist YC137 were used for this purpose. HL-60/ara-C60 was 60-fold more ara-C-resistant than the parental HL-60 cells. HL-60/ara-C60 cells exhibited low dCK protein expression, which resulted in decreased ara-CTP production. HL-60/ara-C60 cells were also refractory to ara-C-induced apoptosis due to overexpression of Bcl-2 and Bcl-XL. Combination treatment of ara-C with ara-G augmented the dCK protein level, thereby increasing ara-CTP production and subsequent cytotoxicity. Moreover, the combination of ara-C with YC137 produced a greater amount of apoptosis than ara-C alone. Importantly, the three-drug combination of ara-C, ara-G and YC137 provided greater cytotoxicity than ara-C+ara-G or ara-C+YC137. These findings suggest possible combination strategies for overcoming ara-C resistance by augmenting ara-CTP production and reversing refractoriness against the induction of apoptosis in ara-C resistant leukemic cells.
Collapse
Affiliation(s)
- Rie Nishi
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | | | | | | | | |
Collapse
|
37
|
Fayyad-Kazan H, Bitar N, Najar M, Lewalle P, Fayyad-Kazan M, Badran R, Hamade E, Daher A, Hussein N, ElDirani R, Berri F, Vanhamme L, Burny A, Martiat P, Rouas R, Badran B. Circulating miR-150 and miR-342 in plasma are novel potential biomarkers for acute myeloid leukemia. J Transl Med 2013; 11:31. [PMID: 23391324 PMCID: PMC3579719 DOI: 10.1186/1479-5876-11-31] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 01/29/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND MicroRNAs (miRNAs) are small (19-22-nt) single-stranded noncoding RNA molecules whose deregulation of expression can contribute to human disease including the multistep processes of carcinogenesis in human. Circulating miRNAs are emerging biomarkers in many diseases and cancers such as type 2 diabetes, pulmonary disease, colorectal cancer, and gastric cancer among others; however, defining a plasma miRNA signature in acute myeloblastic leukemia (AML) that could serve as a biomarker for diagnosis or in the follow-up has not been done yet. METHODS TaqMan miRNA microarray was performed to identify deregulated miRNAs in the plasma of AML patients. Quantitative real-time RT-PCR was used to validate the results. Receiver-operator characteristic (ROC) curve analysis was conducted to evaluate the diagnostic accuracy of the highly and significantly identified deregulated miRNA(s) as potential candidate biomarker(s). RESULTS The plasma expression level of let-7d, miR-150, miR-339, and miR-342 was down-regulated whilst that of let-7b, and miR-523 was up-regulated in the AML group at diagnosis compared to healthy controls. ROC curve analyses revealed an AUC (the areas under the ROC curve) of 0.835 (95% CI: 0.7119- 0.9581; P<0.0001) and 0.8125 (95% CI: 0.6796-0.9454; P=0.0005) for miR-150, and miR-342 respectively. Combined ROC analyses using these 2 miRNAs revealed an elevated AUC of 0.86 (95% CI: 0.7819-0.94; P<0.0001) indicating the additive effect in the diagnostic value of these 2 miRNAs. QRT-PCR results showed that the expression level of these two miRs in complete remission AML patients resembled that of healthy controls. CONCLUSIONS Our findings indicated that plasma miR-150 and miR-342 are novel important promising biomarkers in the diagnosis of AML. These novel and promising markers warrant validation in larger prospective studies.
Collapse
Affiliation(s)
- Hussein Fayyad-Kazan
- Laboratory of Experimental Hematology, Institut Jules Bordet, Université Libre de Bruxelles, 121, Boulevard de Waterloo, Bruxelles 1000, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Schiller GJ. High-risk acute myelogenous leukemia: treatment today ... and tomorrow. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2013; 2013:201-208. [PMID: 24319182 DOI: 10.1182/asheducation-2013.1.201] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
High-risk acute myelogenous leukemia (AML) constitutes a distinct subset of disease based on clinical and biological characteristics and comprises a significant percentage of all cases of adult AML. Biologic features such as distinct clonal cytogenetic and molecular abnormalities identify a subgroup of AML patients characterized by poor response to induction chemotherapy and poor long-term survival after treatment with consolidation chemotherapy. Clinical variables that predict for poor response include AML relapsed after less than 1 year of remission and AML characterized by resistance to conventional agents. We review here our understanding of the defining biologic subtypes of AML and discuss how adequate initial evaluation can be used to inform the choice of treatment. By defining high-risk biologic and clinical variables, a strong case can be made for treating patients with investigational agents, with treatment directed at distinct cytogenetic or molecular abnormalities. Allogeneic transplantation is the only form of therapy available outside of the setting of a clinical trial that may offer a chance for long-term survival for patients with high-risk AML.
Collapse
Affiliation(s)
- Gary J Schiller
- 1Hematological Malignancy/Stem Cell Transplant Program, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| |
Collapse
|
39
|
Djunic I, Virijevic M, Novkovic A, Djurasinovic V, Colovic N, Vidovic A, Suvajdzic-Vukovic N, Tomin D. Pretreatment risk factors and importance of comorbidity for overall survival, complete remission, and early death in patients with acute myeloid leukemia. ACTA ACUST UNITED AC 2012; 17:53-8. [PMID: 22664041 DOI: 10.1179/102453312x13221316477651] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The objective of this single-center study was to determine the pretreatment risk factors and influence of comorbidity on outcome in patients with acute myeloid leukemia (AML). The research involved 145 patients with AML during a 58-month follow-up period. The results suggest that the most significant predictor of poor overall survival (OS) is an adverse karyotype (P = 0.007), while for poor rate of complete remission (CR) it is age ≥55 years, and for early death the most significant predictor is comorbidity, as scored by the Hematopoetic Cell Transplantation Comorbidity Index (HCT-CI), P = 0.001. When we divided the patients into two groups: aged ≥55 years and aged <55 years, these predictors differed. In the group aged ≥55 years the most significant predictor of OS (P = 0.013) and for early death (P = 0.003) was HCT-CI (P = 0.013), while in the younger group it was karyotype (P < 0.001). The most significant predictor of CR in the elderly was increased serum lactate dehydrogenase (LDH) level (P = 0.045). In the younger patients, the most significant predictor of CR was leukocytosis (P = 0.001) and for early death it was infection as the comorbidity (P = 0.007). We point out the importance of comorbidity for OS and early death, as well as the impact of infection in patients with AML.
Collapse
Affiliation(s)
- Irena Djunic
- Clinic for Hematology, Clinical Center of Serbia, Belgrade, Serbia.
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Upregulation of CD200 is associated with Foxp3+ regulatory T cell expansion and disease progression in acute myeloid leukemia. Tumour Biol 2012. [DOI: 10.1007/s13277-012-0578-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
41
|
Ganetsky A. The role of decitabine for the treatment of acute myeloid leukemia. Ann Pharmacother 2012; 46:1511-7. [PMID: 23115225 DOI: 10.1345/aph.1r151] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review the available literature addressing the role of decitabine for the treatment of acute myeloid leukemia (AML). DATA SOURCES Relevant literature was identified by a PubMed search (January 1970-March 2012) of English-language literature using the terms decitabine, acute myeloid leukemia, and DNA methyltransferase inhibitors. STUDY SELECTION AND DATA EXTRACTION All published studies and abstracts, as well as relevant consensus guidelines, evaluating the current literature about the role of decitabine for the treatment of AML were included. DATA SYNTHESIS Decitabine has been evaluated for the treatment of AML in several different settings. In patients with newly diagnosed AML who are not candidates for standard remission induction chemotherapy, a Phase 2 trial of decitabine administered for 5 days per cycle demonstrated a 24% complete remission rate (CR). A subsequent Phase 3 trial comparing decitabine and low-dose cytarabine or best supportive care in a similar patient population showed a greater CR rate (18% vs 8%; p = 0.001) but no overall survival benefit. A Phase 2 trial demonstrated a 47% CR rate with decitabine initially administered for 10 days per cycle, with subsequent doses customized to individual response and toxicity. This novel dosing schedule has yet to be evaluated in a Phase 3 trial. Decitabine is also being investigated for the treatment of relapsed/refractory AML and as bridge therapy to allogeneic hematopoietic stem cell transplantation. CONCLUSIONS Decitabine offers a promising alternative therapeutic option for patients with AML who are not candidates for standard remission induction chemotherapy. Because of its acceptable safety profile, research is investigating the clinical benefit of decitabine in combination with other antileukemic therapies. The potential roles of decitabine in the treatment of AML continue to be explored in numerous clinical trials.
Collapse
Affiliation(s)
- Alex Ganetsky
- Pharmacy Department, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
| |
Collapse
|
42
|
Wang HR, Xiao ZY, Chen M, Wang FL, Liu J, Zhong H, Zhong JH, Ou-Yang RR, Shen YL, Pan SM. Anti-CHMP5 single chain variable fragment antibody retrovirus infection induces programmed cell death of AML leukemic cells in vitro. Acta Pharmacol Sin 2012; 33:809-16. [PMID: 22609838 DOI: 10.1038/aps.2012.38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM Over-expressed CHMP5 was found to act as oncogene that probably participated in leukemogenesis. In this study, we constructed the CHMP5 single chain variable fragment antibody (CHMP5-scFv) retrovirus and studied the changes of programmed cell death (PCD) of AML leukemic cells after infection by the retrovirus. METHODS The anti-CHMP5 KC14 hybridoma cell line was constructed to generate monoclonal antibody of CHMP5. The protein expression of CHMP5 was studied using immunofluorescence analysis. pMIG-CHMP5 scFv antibody expressible retroviral vector was constructed to prepare CHMP5-scFv retrovirus. AML leukemic U937 cells were infected with the retrovirus, and programmed cell death was studied using confocal microscope, FCM and Western blot. RESULTS We obtained a monoclonal antibody of CHMP5, and found the expression of CHMP5 was up-regulated in the leukemic cells. After U937 cells were infected with CHMP5-scFv retrovirus, CHMP5 protein was neutralized. Moreover, the infection resulted in a significant increase in apoptosis and necrosis of U937 cells. In U937 cells infected with CHMP5-scFv retrovirus, apoptosis-inducing factor (AIF)-mediated caspase-independent necrotic PCD was activated, but autophagic programmed cell death was not observed. Neither the intrinsic nor extrinsic apoptotic PCD pathway was activated. The granzyme B/perforin-mediated caspase-dependent apoptotic PCD pathway was not activated. CONCLUSION CHMP5-scFv retrovirus can neutralize the abnormally high levels of the CHMP5 protein in the cytosol of AML leukemic U937 cells, thereby inducing the programmed cell death of the leukemic cells via AIF-mediated caspase-independent necrosis and apoptosis.
Collapse
|
43
|
Tran H, Yang D. Clofarabine in the treatment of newly diagnosed acute myeloid leukemia in older adults. Ann Pharmacother 2011; 46:89-96. [PMID: 22170975 DOI: 10.1345/aph.1q295] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review the literature evaluating the efficacy and tolerability of clofarabine, a second-generation purine nucleoside analogue, for the treatment of previously untreated acute myeloid leukemia (AML) in older adults. DATA SOURCE A literature search of the PubMed database (1972-October 2011) using the search terms clofarabine and acute myeloid leukemia was performed. STUDY SELECTION AND DATA EXTRACTION All relevant English-language articles were reviewed, and clinical trials with patients aged 50 years or older who were newly diagnosed with AML were included. DATA SYNTHESIS Two studies evaluating clofarabine as monotherapy and 2 studies evaluating clofarabine in combination with cytarabine were reviewed. Clofarabine demonstrated activity in older adults with previously untreated AML. Response rates and median overall survival (OS) for patients receiving clofarabine were similar to those reported for conventional intensive chemotherapy regimens. Responses to the 2 types of treatment remained similar in the presence of unfavorable prognostic factors, such as secondary AML or adverse cytogenetics. Although clofarabine was associated with a lower induction mortality rate versus intensive chemotherapy regimens, a significant percentage of patients experienced severe complications, including sepsis. Compared to single-agent clofarabine, response rates and median OS were higher for clofarabine combined with cytarabine. CONCLUSIONS Based on published data, adverse effect profiles, and cost, clofarabine may be an appropriate alternative to intensive chemotherapy regimens in certain subsets of older patients with newly diagnosed AML. These include patients with a baseline decreased performance status or history of cardiovascular disease who may not tolerate anthracyclines, which are typically a component of most intensive chemotherapy regimens. Additional randomized controlled trials are needed to directly compare the efficacy of clofarabine with that of intensive chemotherapy regimens and to evaluate the potential benefit of combining clofarabine with cytarabine.
Collapse
Affiliation(s)
- Huyentran Tran
- Division of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | |
Collapse
|
44
|
Angiogenesis in acute myeloid leukemia and opportunities for novel therapies. JOURNAL OF ONCOLOGY 2011; 2012:128608. [PMID: 21904549 PMCID: PMC3167188 DOI: 10.1155/2012/128608] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 07/03/2011] [Accepted: 07/05/2011] [Indexed: 12/11/2022]
Abstract
Acute myeloid leukemia (AML) arises from neoplastic transformation of hematopoietic stem and progenitor cells, and relapsed disease remains one of the greater challenges in treating this hematologic malignancy. This paper focuses on angiogenic aspects of AML including the significance and prognostic value of bone marrow microvessel density and circulating cytokine levels. We show three general mechanisms whereby AML exploits angiogenic pathways, including direct induction of angiogenesis, paracrine regulation, and autocrine stimulation. We also present early evidence that leukemia cells contribute directly to vascular endothelia. Novel treatment strategies are proposed, and a review of relevant antiangiogenic clinical trials is presented. By understanding how blood vessels can serve as a reservoir for refractory and relapsed AML, new diagnostics and promising treatment strategies can be developed.
Collapse
|
45
|
Dreyssig J, Kremser A, Liepert A, Grabrucker C, Freudenreich M, Schmid C, Kroell T, Scholl N, Tischer J, Kufner S, Salih H, Kolb HJ, Schmetzer HM. Various ‘dendritic cell antigens’ are already expressed on uncultured blasts in acute myeloid leukemia and myelodysplastic syndromes. Immunotherapy 2011; 3:1113-24. [DOI: 10.2217/imt.11.108] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim and methods: Leukemia-derived dendritic cells (DCleu) potentially present the whole leukemic antigen repertoire. We studied antigen-expression profiles of blasts/dendritic cells (DCs) generated from 137 acute myeloid leukemia (AML)/49 myelodysplastic syndromes (MDS) patients with six different DC-generating media by flow-cytometry combining expression of blast/maturation and DC antigens (DCA:CD1a,b,c, CD25, CD40, CD80, CD83, CD86, CD137-L and CD206). Results: First, DCA are regularly and variably expressed on uncultured blasts/mononuclear cells (MNCs). Individual patients’ DCA profiles must be evaluated before DC-culture to find suitable DCA to estimate quality/quantity of DC after culture. Second, after culture in every patient, at least one marker fulfilled these criteria. Third, different DC-generating methods showed varying efficiency to generate DC: not every method was always successful. Fourth, individual FACS-DCA profiles showed a successful DC/DCleu generation with at least one of three previously tested methods in every given AML/MDS case. Fifth, pooling results of all selected best methods in every given case, 28/30% DC were generated from AML/MDS samples: >60% viable DC, on average 49/56% mature DC and on average 36% of blasts were convertible to DCleu resulting in on average 49% DCleu of AML-DC. Conclusions: Individual DCA-expression profiles should be evaluated before culture to evaluate DC counts/subtypes (mature/viableDC, DCleu) in individual patients.
Collapse
Affiliation(s)
- Julia Dreyssig
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Andreas Kremser
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Anja Liepert
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Christine Grabrucker
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Freudenreich
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | | | - Tanja Kroell
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Nina Scholl
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Johanna Tischer
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Stephany Kufner
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
| | - Helmut Salih
- Department of Internal Medicine II, University Hospital of the Eberhard Karls University, Tuebingen, Germany
| | - Hans-Jochem Kolb
- Medical Department III, University Hospital Großhadern, Ludwig-Maximilians-University, Munich, Germany
- Helmholtz Center Munich, German Research Center for Environmental Health/Clinical Cooperative Group Haematopoetic Cell Transplantation (CCG-HCT), Marchioninistr. 15, 81377 Munich, Germany
| | | |
Collapse
|
46
|
Sanchez-Correa B, Morgado S, Gayoso I, Bergua JM, Casado JG, Arcos MJ, Bengochea ML, Duran E, Solana R, Tarazona R. Human NK cells in acute myeloid leukaemia patients: analysis of NK cell-activating receptors and their ligands. Cancer Immunol Immunother 2011; 60:1195-205. [PMID: 21644031 PMCID: PMC11028638 DOI: 10.1007/s00262-011-1050-2] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 05/21/2011] [Indexed: 12/22/2022]
Abstract
Natural killer (NK) cell activation is strictly regulated to ensure that healthy cells are preserved, but tumour-transformed or virus-infected cells are recognized and eliminated. To carry out this selective killing, NK cells have an ample repertoire of receptors on their surface. Signalling by inhibitory and activating receptors by interaction with their ligands will determine whether the NK cell becomes activated and kills the target cell. Here, we show reduced expression of NKp46, NKp30, DNAM-1, CD244 and CD94/NKG2C activating receptors on NK cells from acute myeloid leukaemia patients. This reduction may be induced by chronic exposure to their ligands on leukaemic blasts. The analysis of ligands for NK cell-activating receptors showed that leukaemic blasts from the majority of patients express ligands for NK cell-activating receptors. DNAM-1 ligands are frequently expressed on blasts, whereas the expression of the NKG2D ligand MICA/B is found in half of the patients and CD48, a ligand for CD244, in only one-fourth of the patients. The decreased expression of NK cell-activating receptors and/or the heterogeneous expression of ligands for major receptors on leukaemic blasts can lead to an inadequate tumour immunosurveillance by NK cells. A better knowledge of the activating receptor repertoire on NK cells and their putative ligands on blasts together with the possibility to modulate their expression will open new possibilities for the use of NK cells in immunotherapy against leukaemia.
Collapse
MESH Headings
- Animals
- Cytotoxicity, Immunologic
- Gene Expression Regulation, Neoplastic
- Humans
- Immunomodulation
- Immunotherapy
- Killer Cells, Natural/immunology
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Ligands
- Receptors, Natural Killer Cell/genetics
- Receptors, Natural Killer Cell/immunology
- Receptors, Natural Killer Cell/metabolism
- Signal Transduction/immunology
- Tumor Escape
Collapse
Affiliation(s)
- Beatriz Sanchez-Correa
- Immunology Unit, Department of Physiology, Faculty of Veterinary, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Sara Morgado
- Immunology Unit, Department of Physiology, Faculty of Veterinary, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Inmaculada Gayoso
- Immunology Unit, Instituto Maimonides para la Investigacion Biomedica de Cordoba (IMIBIC)-University of Cordoba-Hospital Reina Sofia, Cordoba, Spain
| | - Juan M. Bergua
- Department of Hematology, Hospital San Pedro de Alcantara, Caceres, Spain
| | - Javier G. Casado
- Immunology Unit, Department of Physiology, Faculty of Veterinary, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| | - Maria Jose Arcos
- Department of Hematology, Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - Esther Duran
- Histology and Pathology Unit, Faculty of Veterinary, University of Extremadura, Caceres, Spain
| | - Rafael Solana
- Immunology Unit, Instituto Maimonides para la Investigacion Biomedica de Cordoba (IMIBIC)-University of Cordoba-Hospital Reina Sofia, Cordoba, Spain
| | - Raquel Tarazona
- Immunology Unit, Department of Physiology, Faculty of Veterinary, University of Extremadura, Avenida de la Universidad s/n, 10003 Caceres, Spain
| |
Collapse
|
47
|
Kim HP, Gerhard B, Harasym TO, Mayer LD, Hogge DE. Liposomal encapsulation of a synergistic molar ratio of cytarabine and daunorubicin enhances selective toxicity for acute myeloid leukemia progenitors as compared to analogous normal hematopoietic cells. Exp Hematol 2011; 39:741-50. [DOI: 10.1016/j.exphem.2011.04.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2011] [Revised: 03/31/2011] [Accepted: 04/04/2011] [Indexed: 12/11/2022]
|
48
|
Haouas H, Haouas S, Hafsia A. A retrospective study of leukemia epidemiology in Northern Tunisia. Hematology 2011; 16:151-4. [PMID: 21669054 DOI: 10.1179/102453311x12953015767374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
A hospital-based epidemiological study of leukemia was carried out in the northern part of Tunisia during a 5-year period, from 1999 to 2003. Of 402 Tunisians diagnosed with leukemia, 344 (85.6%) had acute leukemia and 58 (14.4%) had chronic leukemia. Age-specific incidence rates for acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), chronic lymphoid leukemia (CLL) and chronic myeloid leukemia (CML) are described. The distribution of leukemia in the governorate of Nabeul was established. These results are useful for the organization and follow-up of medical care.
Collapse
Affiliation(s)
- Houda Haouas
- Department of Biological and Chemical Engineering, National Institute of Applied Sciences and Technology, Tunis, Tunisia.
| | | | | |
Collapse
|
49
|
Colado E, Paíno T, Maiso P, Ocio EM, Chen X, Alvarez-Fernández S, Gutiérrez NC, Martín-Sánchez J, Flores-Montero J, San Segundo L, Garayoa M, Fernández-Lázaro D, Vidriales MB, Galmarini CM, Avilés P, Cuevas C, Pandiella A, San-Miguel JF. Zalypsis has in vitro activity in acute myeloid blasts and leukemic progenitor cells through the induction of a DNA damage response. Haematologica 2011; 96:687-95. [PMID: 21330323 DOI: 10.3324/haematol.2010.036400] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Although the majority of patients with acute myeloid leukemia initially respond to conventional chemotherapy, relapse is still the leading cause of death, probably because of the presence of leukemic stem cells that are insensitive to current therapies. We investigated the antileukemic activity and mechanism of action of zalypsis, a novel alkaloid of marine origin. DESIGN AND METHODS The activity of zalypsis was studied in four acute myeloid leukemia cell lines and in freshly isolated blasts taken from patients with acute myeloid leukemia before they started therapy. Zalypsis-induced apoptosis of both malignant and normal cells was measured using flow cytometry techniques. Gene expression profiling and western blot studies were performed to assess the mechanism of action of the alkaloid. RESULTS Zalypsis showed a very potent antileukemic activity in all the cell lines tested and potentiated the effect of conventional antileukemic drugs such as cytarabine, fludarabine and daunorubicin. Interestingly, zalypsis showed remarkable ex vivo potency, including activity against the most immature blast cells (CD34(+) CD38(-) Lin(-)) which include leukemic stem cells. Zalypsis-induced apoptosis was the result of an important deregulation of genes involved in the recognition of double-strand DNA breaks, such as Fanconi anemia genes and BRCA1, but also genes implicated in the repair of double-strand DNA breaks, such as RAD51 and RAD54. These gene findings were confirmed by an increase in several proteins involved in the pathway (pCHK1, pCHK2 and pH2AX). CONCLUSIONS The potent and selective antileukemic effect of zalypsis on DNA damage response mechanisms observed in acute myeloid leukemia cell lines and in patients' samples provides the rationale for the investigation of this compound in clinical trials.
Collapse
Affiliation(s)
- Enrique Colado
- Centro de Investigación del Cáncer, IBMCC/CSIC-Universidad de Salamanca, Salamanca, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
|