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Paszkiewicz-Kozik E, Michalski W, Taszner M, Mordak-Domagała M, Romejko-Jarosińska J, Knopińska-Posłuszny W, Najda J, Borawska A, Chełstowska M, Świerkowska M, Dąbrowska-Iwanicka A, Malenda A, Druzd-Sitek A, Konecki R, Kumiega B, Osowiecki M, Ostrowska B, Szpila T, Szymański M, Targoński Ł, Domańska-Czyż K, Popławska L, Giebel S, Lange A, Pluta A, Zaucha JM, Rymkiewicz G, Walewski J. Ofatumumab with iphosphamide, etoposide and cytarabine for patients with transplantation-ineligible relapsed and refractory diffuse large B-cell lymphoma. Br J Haematol 2022; 198:73-81. [PMID: 35362096 PMCID: PMC9322457 DOI: 10.1111/bjh.18166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
The efficacy of salvage treatment of diffuse large B-cell lymphoma (DLBCL) patients who relapse or progress (rrDLBCL) after initial therapy is limited. Efficacy and safety of ofatumumab with iphosphamide, etoposide and cytarabine (O-IVAC) was evaluated in a single-arm study. Dosing was modified for elderly patients. Patients received up to six cycles of treatment. The primary end-point was the overall response rate (ORR). Patients were evaluated every two cycles and then six and 12 months after treatment. Other end-points included progression-free survival (PFS), event-free survival (EFS), overall survival (OS) and safety. Seventy-seven patients received salvage treatment with O-IVAC. The average age was 56.8 years; 39% had an Eastern Cooperative Oncology Group (ECOG) performance status of at least 3; 78% had disease of Ann Arbor stage 3 or 4; 58% received one or more prior salvage therapies. The ORR for O-IVAC was 54.5%. The median duration of study follow-up was 70 months. The median PFS and EFS were 16.3 months each. The median OS was 22.7 months. Age, ECOG performance status and the number of prior therapy lines were independent predictors of survival. Treatment-related mortality was 15.5%. O-IVAC showed a high response rate in a difficult-to-treat population and is an attractive treatment to bridge to potentially curative therapies.
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Affiliation(s)
| | - Wojciech Michalski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Monika Mordak-Domagała
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland
| | | | - Wanda Knopińska-Posłuszny
- Maritime Hospital, Gdynia, Poland.,Warmian-Masurian Cancer Center of the Ministry of the Interior and Administration's Hospital, Olsztyn, Poland
| | - Jacek Najda
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Anna Borawska
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Monika Świerkowska
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Agata Malenda
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Robert Konecki
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Beata Kumiega
- Sniadecki Memorial Specialist Hospital, Nowy Sacz, Poland
| | - Michał Osowiecki
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Beata Ostrowska
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Tomasz Szpila
- Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Marcin Szymański
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Łukasz Targoński
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | | | - Lidia Popławska
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Sebastian Giebel
- Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Andrzej Lange
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland
| | - Andrzej Pluta
- Department of Hematology, Brzozow Oncology Center, Brzozow, Poland
| | - Jan Maciej Zaucha
- Medical University of Gdansk, Gdansk, Poland.,Maritime Hospital, Gdynia, Poland
| | - Grzegorz Rymkiewicz
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Jan Walewski
- Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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Wołowiec D, Szymczyk A, Potoczek S, Krochmalczyk D, Zawirska D, Piotrowska M, Malenda A, Soroka-Wojtaszko M, Kopacz A, Wąsik-Szczepanek E, Graboś-Michalak J, Raźny M, Wichary R, Bramowicz-Jarosz B, Seweryn M, Długosz-Danecka M, Hus I. Safety and Efficacy of Bendamustine Monotherapy in the First-Line Treatment of Patients with Chronic Lymphocytic Leukemia: Polish Lymphoma Research Group Real-Life Analysis. Chemotherapy 2019; 64:155-162. [PMID: 31715597 DOI: 10.1159/000503220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 09/06/2019] [Indexed: 11/19/2022]
Abstract
Bendamustine is a cytostatic drug with a unique structure, combining the features of purine nucleoside analogs and alkylating agents. In patients with chronic lymphocytic leukemia (CLL) it is commonly used in combination with rituximab (BR protocol) both in the first-line as well as subsequent lines of therapy, and in clinical trials it is often combined with new targeted therapies. Therefore, the data on its real-life safety and efficacy are of clinical significance. As the Polish Lymphoma Research Group (PLRG), we retrospectively analyzed the efficacy and tolerability of bendamustine monotherapy in 96 patients with CLL. The median number of bendamustine cycles was 5, and 44 patients did not complete the planned 6 cycles (46%). Among the adverse events associated with the earlier termination of bendamustine treatment, infections were the most common (20.5%), followed by neutropenia (15.9%) and thrombocytopenia (15.9%). Dose reductions and/or delays occurred in 31% of treatment cycles (132 of 425) with neutropenia (17.9%) as the most frequent cause. Efficacy analysis showed an overall response rate of 88.2% with complete remission and partial remission achieved in 43.8 and 41.7% of patients, respectively. At the 24th month of follow-up, progression-free survival was 52% and overall survival was 69.7%. Bendamustine in monotherapy was found to be safe and efficacious, at least in terms of early response. Special attention should be paid to infectious complications, and especially that immune disorders are characteristic in the clinical course of CLL. Our observations suggest efforts must be made to ensure the proper timing and proper dose in the administration of the drug, and to avoid the premature termination of the treatment.
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Affiliation(s)
- Dariusz Wołowiec
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Szymczyk
- Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland,
| | - Stanisław Potoczek
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Dorota Krochmalczyk
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kracow, Poland
| | - Daria Zawirska
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kracow, Poland
| | - Magdalena Piotrowska
- Department of Hematology, Collegium Medicum, Jagiellonian University, Kracow, Poland
| | - Agata Malenda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Lublin, Poland
| | - Maria Soroka-Wojtaszko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Kopacz
- Department of Hematology, Clinical Hospital No. 2 in Rzeszów, Rzeszów, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | | | - Małgorzata Raźny
- Department of Hematology, Ludwik Rydygier Memorial Specialized Hospital, Kracow, Poland
| | - Ryszard Wichary
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | | | - Marek Seweryn
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | | | - Iwona Hus
- Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland
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3
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Malenda A, Kołkowska‐Leśniak A, Puła B, Długosz‐Danecka M, Chełstowska M, Końska A, Giza A, Lech‐Marańda E, Jurczak W, Warzocha K. Outcomes of treatment with dose‐adjusted EPOCH‐R or R‐CHOP in primary mediastinal large B‐cell lymphoma. Eur J Haematol 2019; 104:59-66. [DOI: 10.1111/ejh.13337] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/21/2019] [Accepted: 10/01/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Agata Malenda
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | | | - Bartosz Puła
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | | | - Monika Chełstowska
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | - Agnieszka Końska
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
| | - Agnieszka Giza
- Department of Hematology Jagiellonian University Cracow Poland
| | - Ewa Lech‐Marańda
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
- Department of Hematology and Transfusion Medicine Centre of Postgraduate Medicine Warsaw Poland
| | | | - Krzysztof Warzocha
- Department of Hematology Institute of Hematology and Transfusion Medicine Warsaw Poland
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4
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Paszkiewicz-Kozik E, Michalski W, Taszner M, Knopińska-Posłuszny W, Mordak-Domagała M, Najda J, Borawska A, Romejko-Jarosińska J, Chełstowska M, Świerkowska M, Dąbrowska-Iwanicka A, Malenda A, Druzd-Sitek A, Konecki R, Kuniega B, Osowiecki M, Ostrowska B, Szpila T, Domańska-Czyż K, Szymański M, Targoński Ł, Poplawska L, Kotarska M, Giebel S, Lange A, Pluta A, Warzocha K, Zaucha J, Rymkiewicz G, Walewski J. OFATUMUMAB WITH IVAC FOR DLBCL PATIENTS WHO FAILED R-CHOP AND WERE NOT CANDIDATES FOR HIGH-DOSE THERAPY AND ASCT - PHASE 2 TRIAL OF THE POLISH LYMPHOMA RESEARCH GROUP (PLRG-8). Hematol Oncol 2019. [DOI: 10.1002/hon.111_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- E. Paszkiewicz-Kozik
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - W. Michalski
- Biostatistics Unit; Maria Sklodowska-Curie Institute - Oncology Center; Warsaw Poland
| | - M. Taszner
- Hematology Department; Medical University; Gdansk Poland
| | - W. Knopińska-Posłuszny
- Hematology Department; Independent Public Health Care of the Ministry of the Internal Affairs with the Oncology Centre; Olsztyn Poland
| | - M. Mordak-Domagała
- Hematology Department; Lower Silesia Cell Transplantation Center; Wroclaw Poland
| | - J. Najda
- Hematology Department; Maria Sklodowska-Curie Institute - Oncology Center; Gliwice Poland
| | - A. Borawska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - J. Romejko-Jarosińska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Chełstowska
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - M. Świerkowska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - A. Dąbrowska-Iwanicka
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - A. Malenda
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - A. Druzd-Sitek
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - R. Konecki
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - B. Kuniega
- Hematology Department; Oncology Centre of the Podkarpackie Province; Brzozów Poland
| | - M. Osowiecki
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - B. Ostrowska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - T. Szpila
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - K. Domańska-Czyż
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Szymański
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - Ł. Targoński
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - L. Poplawska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - M. Kotarska
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - S. Giebel
- Hematology Department; Maria Sklodowska-Curie Institute - Oncology Center; Gliwice Poland
| | - A. Lange
- Hematology Department; Lower Silesia Cell Transplantation Center; Wroclaw Poland
| | - A. Pluta
- Hematology Department; Oncology Centre of the Podkarpackie Province; Brzozów Poland
| | - K. Warzocha
- Lymphoma Department; Institute of Hematology and Transfusiology; Warszawa Poland
| | - J. Zaucha
- Oncology Department; Maritime Hospital; Gdynia Poland
| | - G. Rymkiewicz
- Pathology Department; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
| | - J. Walewski
- Department of Lymphoid Malignancies; Maria Sklodowska-Curie Institute - Oncology Center; Warszawa Poland
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5
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Usnarska-Zubkiewicz L, Dębski J, Butrym A, Legieć W, Hus M, Dmoszyńska A, Stella-Hołowiecka B, Zaucha JM, Januszczyk J, Rymko M, Torosian T, Charliński G, Lech-Marańda E, Malenda A, Jurczyszyn A, Urbańska-Ryś H, Druzd-Sitek A, Błońska D, Urbanowicz A, Hołojda J, Pogrzeba J, Rzepecki P, Hałka J, Subocz E, Becht R, Zdziarska B, Dytfeld D, Nowicki A, Bołkun Ł, Kłoczko J, Knopińska-Posłuszny W, Zubkiewicz-Kucharska A, Kuliczkowski K. Efficacy and safety of lenalidomide treatment in multiple myeloma (MM) patients--Report of the Polish Myeloma Group. Leuk Res 2015; 40:90-9. [PMID: 26626207 DOI: 10.1016/j.leukres.2015.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 10/06/2015] [Accepted: 11/03/2015] [Indexed: 11/19/2022]
Abstract
UNLABELLED The aim of the multi-centre retrospective study was to evaluate the efficacy and safety of lenalidomide (LEN) therapy in patients with resistant or relapsed multiple myeloma (MM) as well as in patients with stable disease (LEN used due to neurological complications). The primary endpoint of this study was an overall response rate (ORR). The secondary endpoints were as follows: time to progression (TTP), overall survival (OS) and the safety of drug use. Data were collected in 19 centres of the Polish Multiple Myeloma Study Group. The study group consisted of 306 subjects: 153 females and 153 males. In 115 patients (38.8%, group A), a resistant myeloma was diagnosed; in 135 (44.1%, group B) a relapse, and in 56 (18.3%, group C) a stable disease were stated. In 92.8% of patients, LEN+DEX combination was used; in remaining group, LEN monotherapy or a combination therapy LEN+bortezomib or LEN+bendamustine and other were used. In the entire study group, ORR was 75.5% (including 12.4% patients achieving complete remission [CR] or stringent CR [sCR]). Median time to progression (TTP) was 20 months. Median overall survival (OS) was 33.3 months. The regression model for "treatment response" was on the borderline of statistical significance (p=0.07), however the number of LEN treatment cycles ≥ 6 (R(2)=17.2%), baseline LDH level (R(2)=1.1%) and no ASCT use (R(2)=1.7%) where the factors most affecting treatment response achievement. The regression model for dependant variable--"overall survival"--was statistically significant (p=0.0000004). Factors with the most impact on OS were as follows: number of LEN cycles treatment ≥ 6 (R(2)=16.7%), treatment response achievement (R(2)=6.9%), β-2-microglobulin (β-2-M) level (R(2)=4.8%), renal function (R(2)=3.0%) and lack of 3/4 grade adverse events (R(2)=1.4%). SUMMARY LEN is an effective and safe therapeutic option, even in intensively treated resistant and relapsed MM patients, as well as in patients with stable disease and previous treatment-induced neurological complications. In particular, the number of LEN treatment cycles ≥ 6 was the factor which affected treatment response achievement the most, together with an important impact on OS.
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Affiliation(s)
- L Usnarska-Zubkiewicz
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland.
| | - J Dębski
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland
| | - A Butrym
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland; Department of Physiology, Wroclaw Medical University, Poland
| | - W Legieć
- Department of Haematology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - M Hus
- Department of Haematology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - A Dmoszyńska
- Department of Haematology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - B Stella-Hołowiecka
- Department of Haematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | | | | | - M Rymko
- Department of Haematology, District Hospital in Torun, Poland
| | - T Torosian
- Department of Haematology, Oncology and Internal Medicine, Warsaw Medical University, Poland
| | - G Charliński
- Department of Haematology, Oncology and Internal Medicine, Warsaw Medical University, Poland
| | - E Lech-Marańda
- Department of Haematology, Institute of Haematology and Blood Transfusion, Warsaw, Poland; Centre of Postgraduate Medical Education, Warsaw, Poland
| | - A Malenda
- Department of Haematology, Institute of Haematology and Blood Transfusion, Warsaw, Poland
| | - A Jurczyszyn
- Department of Haematology, Collegium Medicum at the Jagiellonian University, Cracow, Poland
| | - H Urbańska-Ryś
- Department of Haematology, Medical University of Lodz, Poland
| | - A Druzd-Sitek
- Department of Lymphoproliferative Diseases, Maria Sklodowska-Curie Memorial Institute and Oncology Centre, Warsaw, Poland
| | - D Błońska
- Department of Haematology and Neoplasmatic Diseases of Haematopoiesis, Bydgoszcz, Poland
| | - A Urbanowicz
- Department of Clinical Oncology and Haematology, District Hospital in Suwalki, Poland
| | - J Hołojda
- Department of Haematology, District Specialist Hospital in Legnica, Poland
| | - J Pogrzeba
- Department of Haematology and Haematooncology, District Hospital in Opole, Poland
| | - P Rzepecki
- Department of Internal Diseases and Haematology, Military Institute of Medicine, Central Clinical Hospital of the Ministry of National Defence, Warsaw, Poland
| | - J Hałka
- Department of Internal Diseases and Haematology, Military Institute of Medicine, Central Clinical Hospital of the Ministry of National Defence, Warsaw, Poland
| | - E Subocz
- Department of Internal Diseases and Haematology, Military Institute of Medicine, Central Clinical Hospital of the Ministry of National Defence, Warsaw, Poland
| | - R Becht
- Department of Haematology, Pomeranian Medical University, Szczecin, Poland
| | - B Zdziarska
- Department of Haematology, Pomeranian Medical University, Szczecin, Poland
| | - D Dytfeld
- Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poland
| | - A Nowicki
- Department of Haematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poland
| | - Ł Bołkun
- Department of Haematology, University Clinical Hospital of Białystok, Poland
| | - J Kłoczko
- Department of Haematology, University Clinical Hospital of Białystok, Poland
| | - W Knopińska-Posłuszny
- Ministry of the Interior Hospital in Olsztyn with Warmia and Masuria Oncology Center, Poland
| | - A Zubkiewicz-Kucharska
- Department of Endocrinology and Diabetology for Children and Adolescents, Wroclaw Medical University, Poland
| | - K Kuliczkowski
- Department of Haematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland
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6
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Nowis D, Malenda A, Furs K, Oleszczak B, Sadowski R, Chlebowska J, Firczuk M, Bujnicki JM, Staruch AD, Zagozdzon R, Glodkowska-Mrowka E, Szablewski L, Golab J. Statins impair glucose uptake in human cells. BMJ Open Diabetes Res Care 2014; 2:e000017. [PMID: 25452863 PMCID: PMC4212557 DOI: 10.1136/bmjdrc-2014-000017] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/22/2014] [Accepted: 04/06/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Considering the increasing number of clinical observations indicating hyperglycemic effects of statins, this study was designed to measure the influence of statins on the uptake of glucose analogs by human cells derived from liver, adipose tissue, and skeletal muscle. DESIGN Flow cytometry and scintillation counting were used to measure the uptake of fluorescently labeled or tritiated glucose analogs by differentiated visceral preadipocytes, skeletal muscle cells, skeletal muscle myoblasts, and contact-inhibited human hepatocellular carcinoma cells. A bioinformatics approach was used to predict the structure of human glucose transporter 1 (GLUT1) and to identify the presence of putative cholesterol-binding (cholesterol recognition/interaction amino acid consensus (CRAC)) motifs within this transporter. Mutagenesis of CRAC motifs in SLC2A1 gene and limited proteolysis of membrane GLUT1 were used to determine the molecular effects of statins. RESULTS Statins significantly inhibit the uptake of glucose analogs in all cell types. Similar effects are induced by methyl-β-cyclodextrin, which removes membrane cholesterol. Statin effects can be rescued by addition of mevalonic acid, or supplementation with exogenous cholesterol. Limited proteolysis of GLUT1 and mutagenesis of CRAC motifs revealed that statins induce conformational changes in GLUTs. CONCLUSIONS Statins impair glucose uptake by cells involved in regulation of glucose homeostasis by inducing cholesterol-dependent conformational changes in GLUTs. This molecular mechanism might explain hyperglycemic effects of statins observed in clinical trials.
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Affiliation(s)
- Dominika Nowis
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
- Genomic Medicine, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Agata Malenda
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Karolina Furs
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Bozenna Oleszczak
- Chair of General Biology and Parasitology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Radoslaw Sadowski
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Chlebowska
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Malgorzata Firczuk
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Janusz M Bujnicki
- Laboratory of Bioinformatics and Protein Engineering, International Institute of Molecular and Cell Biology in Warsaw, Warsaw, Poland
- Bioinformatics Laboratory, Institute of Molecular Biology and Biotechnology, Adam Mickiewicz University, Poznan, Poland
| | - Adam D Staruch
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Radoslaw Zagozdzon
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Eliza Glodkowska-Mrowka
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Leszek Szablewski
- Chair of General Biology and Parasitology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Jakub Golab
- Department of Immunology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
- Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland
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