1
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Rodriguez-Otero P, Sirvent M, González-Rodríguez AP, Lavilla E, de Coca AG, Arguiñano JM, Martí JM, Cabañas V, Motlló C, de Cabo E, Encinas C, Murillo I, Hernández-Rivas JÁ, Pérez-Persona E, Casado F, Sampol A, García R, Blanchard MJ, Anguita M, Lafuente AP, Iñigo B, López A, Ribas P, Arnao M, Maldonado R, Bladé J, Mateos MV, Lahuerta JJ, San Miguel JF. Pomalidomide, Cyclophosphamide, and Dexamethasone for the Treatment of Relapsed/Refractory Multiple Myeloma: Real-World Analysis of the Pethema-GEM Experience. Clin Lymphoma Myeloma Leuk 2021; 21:413-420. [PMID: 33741302 DOI: 10.1016/j.clml.2021.02.004] [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] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Treatment of relapsed/refractory multiple myeloma (RRMM) is highly challenging, especially for patients with disease refractory to initial therapy, and in particular for disease developing refractoriness to lenalidomide. Indeed, with currently approved treatments, median progression-free survival (PFS) in the lenalidomide-refractory setting is less than 10 months, reflecting the difficulty in treating this patient population. Pomalidomide is a second-generation immunomodulatory drug that has shown activity in lenalidomide-refractory disease in the setting of different combinations. PATIENTS AND METHODS A real-world study was conducted by the Spanish Myeloma group in a cohort of patients with RRMM treated with pomalidomide, cyclophosphamide, and dexamethasone (PomCiDex). One hundred patients were treated with a median of 3 prior lines of therapy. RESULTS Overall response rate was 39%, with a clinical benefit rate of 93%. Median PFS was 7.6 months; median overall survival (OS) was 12.6 months. Median PFS and OS survival were consistent across the different subgroups analyzed. Prolonged PFS and OS were found in patients with responsive disease. CONCLUSION Our results compared favorably with those obtained with different pomalidomide-based combinations in a similar patient population. PomCiDex remains a manageable, cost-effective, and all-oral triplet combination for RRMM patients.
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Affiliation(s)
| | - Maialen Sirvent
- Department of Hematology, Hospital Donostia, San Sebastian, Spain
| | | | | | - Alfonso García de Coca
- Department of Hematology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | | | - Josep M Martí
- Department of Hematology, Hospital Universitari Mutua Terrassa, Terrassa, Spain
| | - Valentin Cabañas
- Department of Hematology, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Cristina Motlló
- Department of Hematology, Hospital de Sant Joan de Déu, Fundació Althaia, Manresa, Spain
| | - Erik de Cabo
- Department of Hematology, Hospital de El Bierzo, León, Spain
| | - Cristina Encinas
- Department of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Ilda Murillo
- Department of Hematology, Hospital General San Jorge, Huesca, Spain
| | | | | | - Felipe Casado
- Department of Hematology, Complejo Hospitalario de Toledo, Toledo, Spain
| | - Antonia Sampol
- Department of Hematology, Hospital Universitario Son Espases, Mallorca, Spain
| | - Ricarda García
- Department of Hematology, Complejo Hospitalario de Especialidades Virgen de la Victoria, Málaga, Spain
| | | | | | | | - Belén Iñigo
- Department of Hematology, Hospital Clinico San Carlos, Madrid, Spain
| | - Aurelio López
- Department of Hematology, Hospital Arnau de Vilanova, Lleida, Spain
| | - Paz Ribas
- Department of Hematology, Hospital Universitario Dr Peset Aleixandre, Valencia, Spain
| | - Mario Arnao
- Department of Hematology, Hospital Universitario La Fe, Valencia, Spain
| | | | - Joan Bladé
- Department of Hematology, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | | | - Juan José Lahuerta
- Department of Hematology, Hospital Universitario 12 de octubre, Madrid, Spain
| | - Jesús F San Miguel
- Department of Hematology, Clínica Universidad de Navarra, Pamplona, Spain
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2
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Quijada‐Álamo M, Pérez‐Carretero C, Hernández‐Sánchez M, Rodríguez‐Vicente A, Herrero A, Hernández‐Sánchez J, Martín‐Izquierdo M, Santos‐Mínguez S, del Rey M, González T, Rubio‐Martínez A, García de Coca A, Dávila‐Valls J, Hernández‐Rivas J, Parker H, Strefford JC, Benito R, Ordóñez J, Hernández‐Rivas J. Dissecting the role of TP53 alterations in del(11q) chronic lymphocytic leukemia. Clin Transl Med 2021; 11:e304. [PMID: 33634999 PMCID: PMC7862176 DOI: 10.1002/ctm2.304] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Several genetic alterations have been identified as driver events in chronic lymphocytic leukemia (CLL) pathogenesis and oncogenic evolution. Concurrent driver alterations usually coexist within the same tumoral clone, but how the cooperation of multiple genomic abnormalities contributes to disease progression remains poorly understood. Specifically, the biological and clinical consequences of concurrent high-risk alterations such as del(11q)/ATM-mutations and del(17p)/TP53-mutations have not been established. METHODS We integrated next-generation sequencing (NGS) and clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 techniques to characterize the in vitro and in vivo effects of concurrent monoallelic or biallelic ATM and/or TP53 alterations in CLL prognosis, clonal evolution, and therapy response. RESULTS Targeted sequencing analysis of the co-occurrence of high-risk alterations in 271 CLLs revealed that biallelic inactivation of both ATM and TP53 was mutually exclusive, whereas monoallelic del(11q) and TP53 alterations significantly co-occurred in a subset of CLL patients with a highly adverse clinical outcome. We determined the biological effects of combined del(11q), ATM and/or TP53 mutations in CRISPR/Cas9-edited CLL cell lines. Our results showed that the combination of monoallelic del(11q) and TP53 mutations in CLL cells led to a clonal advantage in vitro and in in vivo clonal competition experiments, whereas CLL cells harboring biallelic ATM and TP53 loss failed to compete in in vivo xenotransplants. Furthermore, we demonstrated that CLL cell lines harboring del(11q) and TP53 mutations show only partial responses to B cell receptor signaling inhibitors, but may potentially benefit from ATR inhibition. CONCLUSIONS Our work highlights that combined monoallelic del(11q) and TP53 alterations coordinately contribute to clonal advantage and shorter overall survival in CLL.
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Affiliation(s)
- Miguel Quijada‐Álamo
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Claudia Pérez‐Carretero
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - María Hernández‐Sánchez
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
- Department of Medical OncologyDana‐Farber Cancer InstituteBostonMassachusettsUSA
- Broad Institute of Harvard and MITCambridgeMassachusettsUSA
| | - Ana‐Eugenia Rodríguez‐Vicente
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Ana‐Belén Herrero
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Jesús‐María Hernández‐Sánchez
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Marta Martín‐Izquierdo
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Sandra Santos‐Mínguez
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Mónica del Rey
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Teresa González
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | | | | | | | | | - Helen Parker
- School of Cancer SciencesFaculty of MedicineUniversity of SouthamptonSouthamptonUK
| | | | - Rocío Benito
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - José‐Luis Ordóñez
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
| | - Jesús‐María Hernández‐Rivas
- Cancer Research CenterUniversity of Salamanca, IBSAL, IBMCC, CSICSalamancaSpain
- Department of HematologyUniversity Hospital of SalamancaSalamancaSpain
- Department of MedicineUniversity of SalamancaSalamancaSpain
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3
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Pérez-Carretero C, Hernández-Sánchez M, González T, Quijada-Álamo M, Martín-Izquierdo M, Hernández-Sánchez JM, Vidal MJ, de Coca AG, Aguilar C, Vargas-Pabón M, Alonso S, Sierra M, Rubio-Martínez A, Dávila J, Díaz-Valdés JR, Queizán JA, Hernández-Rivas JÁ, Benito R, Rodríguez-Vicente AE, Hernández-Rivas JM. Chronic lymphocytic leukemia patients with IGH translocations are characterized by a distinct genetic landscape with prognostic implications. Int J Cancer 2020; 147:2780-2792. [PMID: 32720348 DOI: 10.1002/ijc.33235] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 01/16/2020] [Revised: 06/19/2020] [Accepted: 07/07/2020] [Indexed: 12/29/2022]
Abstract
Chromosome 14q32 rearrangements/translocations involving the immunoglobulin heavy chain (IGH) are rarely detected in chronic lymphocytic leukemia (CLL). The prognostic significance of the IGH translocation is controversial and its mutational profile remains unknown. Here, we present for the first time a comprehensive next-generation sequencing (NGS) analysis of 46 CLL patients with IGH rearrangement (IGHR-CLLs) and we demonstrate that IGHR-CLLs have a distinct mutational profile with recurrent mutations in NOTCH1, IGLL5, POT1, BCL2, FBXW7, ZMYM3, MGA, BRAF and HIST1H1E genes. Interestingly, BCL2 and FBXW7 mutations were significantly associated with this subgroup and almost half of BCL2, IGLL5 and HISTH1E mutations reported were previously identified in non-Hodgkin lymphomas. Notably, IGH/BCL2 rearrangements were associated with a lower mutation frequency and carried BCL2 and IGLL5 mutations, while the other IGHR-CLLs had mutations in genes related to poor prognosis (NOTCH1, SF3B1 and TP53) and shorter time to first treatment (TFT). Moreover, IGHR-CLLs patients showed a shorter TFT than CLL patients carrying 13q-, normal fluorescence in situ hybridization (FISH) and +12 CLL, being this prognosis particularly poor when NOTCH1, SF3B1, TP53, BIRC3 and BRAF were also mutated. The presence of these mutations not only was an independent risk factor within IGHR-CLLs, but also refined the prognosis of low-risk cytogenetic patients (13q-/normal FISH). Hence, our study demonstrates that IGHR-CLLs have a distinct mutational profile from the majority of CLLs and highlights the relevance of incorporating NGS and the status of IGH by FISH analysis to refine the risk-stratification CLL model.
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Affiliation(s)
- Claudia Pérez-Carretero
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - María Hernández-Sánchez
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain.,Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Teresa González
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Miguel Quijada-Álamo
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Marta Martín-Izquierdo
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Jesús-María Hernández-Sánchez
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | | | | | - Carlos Aguilar
- Servicio de Hematología, Complejo Hospitalario de Soria, Soria, Spain
| | | | - Sara Alonso
- Servicio de Hematología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Magdalena Sierra
- Servicio de Hematología, Hospital Virgen de la Concha, Zamora, Spain
| | | | - Julio Dávila
- Servicio de Hematología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
| | | | | | | | - Rocío Benito
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Ana E Rodríguez-Vicente
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Jesús-María Hernández-Rivas
- Universidad de Salamanca, IBSAL, Centro de Investigación del Cáncer, IBMCC-CSIC, Salamanca, Spain.,Servicio de Hematología, Hospital Universitario de Salamanca, Salamanca, Spain
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4
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García-Sanz R, Dogliotti I, Zaccaria GM, Ocio EM, Rubio A, Murillo I, Escalante F, Aguilera C, García-Mateo A, García de Coca A, Hernández R, Dávila J, Puig N, García-Álvarez M, Chillón MDC, Alcoceba M, Medina A, González de la Calle V, Sarasquete ME, González M, Gutiérrez NC, Jiménez C. 6q deletion in Waldenström macroglobulinaemia negatively affects time to transformation and survival. Br J Haematol 2020; 192:843-852. [PMID: 32780894 DOI: 10.1111/bjh.17028] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 05/18/2020] [Accepted: 07/12/2020] [Indexed: 12/20/2022]
Abstract
Deletion of the long arm of chromosome 6 (del6q) is the most frequent cytogenetic abnormality in Waldenström macroglobulinaemia (WM), occurring in approximately 50% of patients. Its effect on patient outcome has not been completely established. We used fluorescence in situ hybridisation to analyse the prevalence of del6q in selected CD19+ bone marrow cells of 225 patients with newly diagnosed immunoglobulin M (IgM) monoclonal gammopathies. Del6q was identified in one of 27 (4%) cases of IgM-monoclonal gammopathy of undetermined significance, nine of 105 (9%) of asymptomatic WM (aWM), and 28/93 (30%) of symptomatic WM (sWM), and was associated with adverse prognostic features and higher International Prognostic Scoring System for WM (IPSSWM) score. Asymptomatic patients with del6q ultimately required therapy more often and had a shorter time to transformation (TT) to symptomatic disease (median TT, 30 months vs. 199 months, respectively, P < 0·001). When treatment was required, 6q-deleted patients had shorter progression-free survival (median 20 vs. 47 months, P < 0·001). The presence of del6q translated into shorter overall survival (OS), irrespective of the initial diagnosis, with a median OS of 90 compared with 131 months in non-del6q patients (P = 0·01). In summary, our study shows that del6q in IgM gammopathy is associated with symptomatic disease, need for treatment and poorer clinical outcomes.
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Affiliation(s)
- Ramón García-Sanz
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Irene Dogliotti
- Unit of Haematology, Department of Biotechnology & Health Sciences, University of Torino, Torino, Italy
| | - Gian Maria Zaccaria
- Unit of Haematology, Department of Biotechnology & Health Sciences, University of Torino, Torino, Italy
| | - Enrique María Ocio
- Haematology Department, University Hospital of Marqués de Valdecilla, Santander, Spain
| | - Araceli Rubio
- Haematology Department, Miguel Servet Hospital, Zaragoza, Spain
| | - Ilda Murillo
- Haematology Department, Miguel Servet Hospital, Zaragoza, Spain
| | | | - Carmen Aguilera
- Haematology Department, Regional Hospital of El Bierzo, León, Spain
| | | | | | | | - Julio Dávila
- Haematology Department, Nuestra Señora de Sonsoles Hospital, Ávila, Spain
| | - Noemí Puig
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - María García-Álvarez
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - María Del Carmen Chillón
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Miguel Alcoceba
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Alejandro Medina
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Verónica González de la Calle
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - María Eugenia Sarasquete
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Marcos González
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Norma Carmen Gutiérrez
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Cristina Jiménez
- Haematology Department, University Hospital of Salamanca, Research Biomedical Institute of Salamanca (IBSAL), CIBERONC and Center for Cancer Research-IBMCC (USAL-CSIC), Salamanca, Spain
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5
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Forero-Castro M, Montaño A, Robledo C, García de Coca A, Fuster JL, de las Heras N, Queizán JA, Hernández-Sánchez M, Corchete-Sánchez LA, Martín-Izquierdo M, Ribera J, Ribera JM, Benito R, Hernández-Rivas JM. Integrated Genomic Analysis of Chromosomal Alterations and Mutations in B-Cell Acute Lymphoblastic Leukemia Reveals Distinct Genetic Profiles at Relapse. Diagnostics (Basel) 2020; 10:diagnostics10070455. [PMID: 32635531 PMCID: PMC7400270 DOI: 10.3390/diagnostics10070455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/17/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022] Open
Abstract
The clonal basis of relapse in B-cell precursor acute lymphoblastic leukemia (BCP-ALL) is complex and not fully understood. Next-generation sequencing (NGS), array comparative genomic hybridization (aCGH), and multiplex ligation-dependent probe amplification (MLPA) were carried out in matched diagnosis–relapse samples from 13 BCP-ALL patients to identify patterns of genetic evolution that could account for the phenotypic changes associated with disease relapse. The integrative genomic analysis of aCGH, MLPA and NGS revealed that 100% of the BCP-ALL patients showed at least one genetic alteration at diagnosis and relapse. In addition, there was a significant increase in the frequency of chromosomal lesions at the time of relapse (p = 0.019). MLPA and aCGH techniques showed that IKZF1 was the most frequently deleted gene. TP53 was the most frequently mutated gene at relapse. Two TP53 mutations were detected only at relapse, whereas the three others showed an increase in their mutational burden at relapse. Clonal evolution patterns were heterogeneous, involving the acquisition, loss and maintenance of lesions at relapse. Therefore, this study provides additional evidence that BCP-ALL is a genetically dynamic disease with distinct genetic profiles at diagnosis and relapse. Integrative NGS, aCGH and MLPA analysis enables better molecular characterization of the genetic profile in BCP-ALL patients during the evolution from diagnosis to relapse.
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Affiliation(s)
- Maribel Forero-Castro
- Escuela de Ciencias Biológicas, Universidad Pedagógica y Tecnológica de Colombia. Avenida Central del Norte 39-115, Tunja 150003, Boyacá, Colombia;
| | - Adrián Montaño
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
| | - Cristina Robledo
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
| | - Alfonso García de Coca
- Servicio de Hematología, Hospital Clínico de Valladolid, Av. Ramón y Cajal, 3, 47003 Valladolid, Spain;
| | - José Luis Fuster
- Servicio de Oncohematología Pediátrica, Hospital Universitario Virgen de la Arrixaca, Murcia, Ctra. Madrid-Cartagena, s/n, 30120 Murcia, El Palmar, Spain;
| | - Natalia de las Heras
- Servicio de Hematología, Hospital Virgen Blanca, Altos de Nava s/n, 24071 León, Spain;
| | - José Antonio Queizán
- Servicio de Hematología, Hospital General de Segovia, C/Luis Erik Clavería Neurólogo S/N, 40002 Segovia, Spain;
| | - María Hernández-Sánchez
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
| | - Luis A. Corchete-Sánchez
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
- Servicio de Hematología, Hospital Universitario de Salamanca, Paseo de San Vicente, 88-182, 37007 Salamanca, Spain
| | - Marta Martín-Izquierdo
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
| | - Jordi Ribera
- Acute Lymphoblastic Leukemia Group, Josep Carreras Leukaemia Research Institute, Carretera de Canyet, s/n, Barcelona, 08916 Badalona, Spain;
| | - José-María Ribera
- Servicio de Hematología Clínica, Institut Català d’Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Research Institute, Universitat Autònoma de Barcelona, Carretera de Canyet, s/n, Barcelona, 08916 Badalona, Spain;
| | - Rocío Benito
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
- Correspondence: (R.B.); (J.M.H.-R.); Tel.: +34-923294812 (R.B.); +34-923291384 (J.M.H.-R.)
| | - Jesús M. Hernández-Rivas
- IBSAL, IBMCC, Universidad de Salamanca-CSIC, Cancer Research Center, Campus Miguel de Unamuno, 37007 Salamanca, Spain; (A.M.); (C.R.); (M.H.-S); (L.A.C.-S.); (M.M.-I.)
- Servicio de Hematología, Hospital Universitario de Salamanca, Paseo de San Vicente, 88-182, 37007 Salamanca, Spain
- Departamento de Medicina, Universidad de Salamanca, Campus Miguel de Unamuno. C/Alfonso X El Sabio s/n, 37007 Salamanca, Spain
- Correspondence: (R.B.); (J.M.H.-R.); Tel.: +34-923294812 (R.B.); +34-923291384 (J.M.H.-R.)
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6
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Cuenca I, Alameda D, Sanchez-Vega B, Gomez-Sanchez D, Alignani D, Lasa M, Onecha E, Lecumberri R, Prosper F, Ocio EM, González ME, García de Coca A, De La Rubia J, Gironella M, Palomera L, Oriol A, Casanova M, Cabañas V, Taboada F, Pérez-Montaña A, De Arriba F, Puig N, Carreño-Tarragona G, Barrio S, Enrique de la Puerta J, Ramirez-Payer A, Krsnik I, Bargay JJ, Lahuerta JJ, Mateos MV, San-Miguel JF, Paiva B, Martinez-Lopez J. Immunogenetic characterization of clonal plasma cells in systemic light-chain amyloidosis. Leukemia 2020; 35:245-249. [PMID: 32203144 PMCID: PMC7787969 DOI: 10.1038/s41375-020-0800-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Isabel Cuenca
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | - Daniel Alameda
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | | | - David Gomez-Sanchez
- Clinical and Traslational Lung Cancer Research Unit, i+12 Research Institute and Biomedical Research Networking Center in Oncology (CIBERONC), Madrid, Spain
| | - Diego Alignani
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Marta Lasa
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Esther Onecha
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | - Ramon Lecumberri
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Felipe Prosper
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Enrique M Ocio
- Universidad de Cantabria, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | | | | | | | - Luis Palomera
- Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | - Valentin Cabañas
- Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - Felipe De Arriba
- Hospital Universitario Morales Meseguer. IMIB-Arrixaca, Murcia, Spain
| | - Noemi Puig
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), Salamanca, Spain
| | | | - Santiago Barrio
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | | | | | | | | | - Juan Jose Lahuerta
- Hospital 12 de Octubre, Madrid, CNIO, Universidad Complutese, Madrid, Spain
| | - Maria-Victoria Mateos
- Hospital Universitario de Salamanca, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Centro de Investigación del Cancer (IBMCC-USAL, CSIC), Salamanca, Spain
| | - Jesus F San-Miguel
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
| | - Bruno Paiva
- Clinica Universidad de Navarra, Centro de Investigacion Medica Aplicada (CIMA), IDISNA, CIBERONC Pamplona, Pamplona, Spain
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7
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Hernández-Sánchez M, Kotaskova J, Rodríguez AE, Radova L, Tamborero D, Abáigar M, Plevova K, Benito R, Tom N, Quijada-Álamo M, Bikos V, Martín AÁ, Pal K, García de Coca A, Doubek M, López-Bigas N, Hernández-Rivas JM, Pospisilova S. CLL cells cumulate genetic aberrations prior to the first therapy even in outwardly inactive disease phase. Leukemia 2018; 33:518-558. [PMID: 30209402 PMCID: PMC6756121 DOI: 10.1038/s41375-018-0255-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 08/03/2018] [Accepted: 08/09/2018] [Indexed: 01/04/2023]
Affiliation(s)
- María Hernández-Sánchez
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain.,IBSAL, IBMCC-Cancer Research Center, University of Salamanca, Salamanca, Spain
| | - Jana Kotaskova
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Center of Molecular Biology and Gene Therapy, Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Ana E Rodríguez
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain.,IBSAL, IBMCC-Cancer Research Center, University of Salamanca, Salamanca, Spain
| | - Lenka Radova
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - David Tamborero
- Research Programon Biomedical Informatics, IMIM Hospital del Mar Medical Research Institute and Universitat Pompeu Fabra, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - María Abáigar
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain.,IBSAL, IBMCC-Cancer Research Center, University of Salamanca, Salamanca, Spain
| | - Karla Plevova
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Center of Molecular Biology and Gene Therapy, Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Rocío Benito
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain.,IBSAL, IBMCC-Cancer Research Center, University of Salamanca, Salamanca, Spain
| | - Nikola Tom
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Miguel Quijada-Álamo
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain.,IBSAL, IBMCC-Cancer Research Center, University of Salamanca, Salamanca, Spain
| | - Vasileos Bikos
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Ana África Martín
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain
| | - Karol Pal
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | | | - Michael Doubek
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Center of Molecular Biology and Gene Therapy, Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Nuria López-Bigas
- Research Programon Biomedical Informatics, IMIM Hospital del Mar Medical Research Institute and Universitat Pompeu Fabra, Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Jesús-María Hernández-Rivas
- Hematology Department, Hospital Universitario Salamanca, Salamanca, Spain. .,IBSAL, IBMCC-Cancer Research Center, University of Salamanca, Salamanca, Spain.
| | - Sarka Pospisilova
- Center of Molecular Medicine, Central European Institute of Technology, Masaryk University, Brno, Czech Republic. .,Center of Molecular Biology and Gene Therapy, Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic.
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8
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Jiménez C, Prieto-Conde MI, García-Álvarez M, Alcoceba M, Escalante F, Chillón MDC, García de Coca A, Balanzategui A, Cantalapiedra A, Aguilar C, Corral R, González-López T, Marín LA, Bárez A, Puig N, García-Mateo A, Gutiérrez NC, Sarasquete ME, González M, García-Sanz R. Unraveling the heterogeneity of IgM monoclonal gammopathies: a gene mutational and gene expression study. Ann Hematol 2018; 97:475-484. [PMID: 29353304 DOI: 10.1007/s00277-017-3207-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 09/04/2017] [Accepted: 12/13/2017] [Indexed: 12/15/2022]
Abstract
Immunoglobulin M (IgM) monoclonal gammopathies show considerable variability, involving three different stages of presentation: IgM monoclonal gammopathy of undetermined significance (IgM-MGUS), asymptomatic Waldenström's macroglobulinemia (AWM), and symptomatic WM (SWM). Despite recent findings about the genomic and transcriptomic characteristics of such disorders, we know little about the causes of this clinical heterogeneity or the mechanisms involved in the progression from indolent to symptomatic forms. To clarify these matters, we have performed a gene expression and mutational study in a well-characterized cohort of 69 patients, distinguishing between the three disease presentations in an attempt to establish the relationship with the clinical and biological features of the patients. Results showed that the frequency of genetic alterations progressively increased from IgM-MGUS to AWM and SWM. This means that, in contrast to MYD88 p.L265P and CXCR4 WHIM mutations, present from the beginning of the pathogenesis, most of them would be acquired during the course of the disease. Moreover, the expression study revealed a higher level of expression of genes belonging to the Toll-like receptor (TLR) signaling pathway in symptomatic versus indolent forms, which was also reflected in the disease presentation and prognosis. In conclusion, our findings showed that IgM monoclonal gammopathies present higher mutational burden as the disease progresses, in parallel to the upregulation of relevant pathogenic pathways. This study provides a translational view of the genomic basis of WM pathogenesis.
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Affiliation(s)
- Cristina Jiménez
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - María Isabel Prieto-Conde
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - María García-Álvarez
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - Miguel Alcoceba
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.,Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain
| | | | - María Del Carmen Chillón
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.,Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain
| | | | - Ana Balanzategui
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | | | - Carlos Aguilar
- Hematology Department, Santa Bárbara Hospital, Soria, Spain
| | - Rocío Corral
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | | | - Luis A Marín
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - Abelardo Bárez
- Hematology Department, Nuestra Señora de Sonsoles Hospital, Ávila, Spain
| | - Noemí Puig
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | | | - Norma C Gutiérrez
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - María Eugenia Sarasquete
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.,Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain
| | - Marcos González
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain. .,Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain.
| | - Ramón García-Sanz
- Hematology Department, University Hospital of Salamanca and Research Biomedical Institute of Salamanca (IBSAL), Paseo de San Vicente, 58-182, 37007, Salamanca, Spain.,Center for Biomedical Research in Network of Cancer (CIBERONC), Salamanca, Spain
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9
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Quijada-Álamo M, Hernández-Sánchez M, Robledo C, Hernández-Sánchez JM, Benito R, Montaño A, Rodríguez-Vicente AE, Quwaider D, Martín AÁ, García-Álvarez M, Vidal-Manceñido MJ, Ferrer-Garrido G, Delgado-Beltrán MP, Galende J, Rodríguez JN, Martín-Núñez G, Alonso JM, García de Coca A, Queizán JA, Sierra M, Aguilar C, Kohlmann A, Hernández JÁ, González M, Hernández-Rivas JM. Next-generation sequencing and FISH studies reveal the appearance of gene mutations and chromosomal abnormalities in hematopoietic progenitors in chronic lymphocytic leukemia. J Hematol Oncol 2017; 10:83. [PMID: 28399885 PMCID: PMC5387353 DOI: 10.1186/s13045-017-0450-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 01/28/2017] [Accepted: 03/24/2017] [Indexed: 12/26/2022] Open
Abstract
Background Chronic lymphocytic leukemia (CLL) is a highly genetically heterogeneous disease. Although CLL has been traditionally considered as a mature B cell leukemia, few independent studies have shown that the genetic alterations may appear in CD34+ hematopoietic progenitors. However, the presence of both chromosomal aberrations and gene mutations in CD34+ cells from the same patients has not been explored. Methods Amplicon-based deep next-generation sequencing (NGS) studies were carried out in magnetically activated-cell-sorting separated CD19+ mature B lymphocytes and CD34+ hematopoietic progenitors (n = 56) to study the mutational status of TP53, NOTCH1, SF3B1, FBXW7, MYD88, and XPO1 genes. In addition, ultra-deep NGS was performed in a subset of seven patients to determine the presence of mutations in flow-sorted CD34+CD19− early hematopoietic progenitors. Fluorescence in situ hybridization (FISH) studies were performed in the CD34+ cells from nine patients of the cohort to examine the presence of cytogenetic abnormalities. Results NGS studies revealed a total of 28 mutations in 24 CLL patients. Interestingly, 15 of them also showed the same mutations in their corresponding whole population of CD34+ progenitors. The majority of NOTCH1 (7/9) and XPO1 (4/4) mutations presented a similar mutational burden in both cell fractions; by contrast, mutations of TP53 (2/2), FBXW7 (2/2), and SF3B1 (3/4) showed lower mutational allele frequencies, or even none, in the CD34+ cells compared with the CD19+ population. Ultra-deep NGS confirmed the presence of FBXW7, MYD88, NOTCH1, and XPO1 mutations in the subpopulation of CD34+CD19− early hematopoietic progenitors (6/7). Furthermore, FISH studies showed the presence of 11q and 13q deletions (2/2 and 3/5, respectively) in CD34+ progenitors but the absence of IGH cytogenetic alterations (0/2) in the CD34+ cells. Combining all the results from NGS and FISH, a model of the appearance and expansion of genetic alterations in CLL was derived, suggesting that most of the genetic events appear on the hematopoietic progenitors, although these mutations could induce the beginning of tumoral cell expansion at different stage of B cell differentiation. Conclusions Our study showed the presence of both gene mutations and chromosomal abnormalities in early hematopoietic progenitor cells from CLL patients. Electronic supplementary material The online version of this article (doi:10.1186/s13045-017-0450-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Miguel Quijada-Álamo
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - María Hernández-Sánchez
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - Cristina Robledo
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | | | - Rocío Benito
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - Adrián Montaño
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - Ana E Rodríguez-Vicente
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain.,Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
| | - Dalia Quwaider
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - Ana-África Martín
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - María García-Álvarez
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | | | | | | | - Josefina Galende
- Servicio de Hematología, Hospital del Bierzo, Ponferrada, León, Spain
| | | | | | | | | | - José A Queizán
- Servicio de Hematología, Hospital General de Segovia, Segovia, Spain
| | - Magdalena Sierra
- Servicio de Hematología, Hospital Virgen de la Concha, Zamora, Spain
| | - Carlos Aguilar
- Servicio de Hematología, Hospital Santa Bárbara, Soria, Spain
| | - Alexander Kohlmann
- MLL Munich, Munich, Germany.,AstraZeneca, Personalized Healthcare and Biomarkers, Innovative Medicines, Cambridge, UK
| | - José-Ángel Hernández
- Servicio de Hematología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
| | - Marcos González
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain
| | - Jesús-María Hernández-Rivas
- Servicio de Hematología & IBSAL, IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario, Salamanca, Spain. .,IBMCC, CIC Universidad de Salamanca-CSIC, Hospital Universitario de Salamanca, Paseo de San Vicente s/n, 37007, Salamanca, Spain.
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10
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González-Calle V, Cerdá S, Labrador J, Sobejano E, González-Mena B, Aguilera C, Ocio EM, Vidriales MB, Puig N, Gutiérrez NC, García-Sanz R, Alonso JM, López R, Aguilar C, de Coca AG, Hernández R, Hernández JM, Escalante F, Mateos MV. Recovery of polyclonal immunoglobulins one year after autologous stem cell transplantation as a long-term predictor marker of progression and survival in multiple myeloma. Haematologica 2017; 102:922-931. [PMID: 28126960 PMCID: PMC5477611 DOI: 10.3324/haematol.2016.158345] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 01/11/2017] [Indexed: 12/22/2022] Open
Abstract
Immunoparesis or suppression of polyclonal immunoglobulins is a very common condition in newly diagnosed myeloma patients. However, the recovery of polyclonal immunoglobulins in the setting of immune reconstitution after autologous stem cell transplantation and its effect on outcome has not yet been explored. We conducted this study in a cohort of 295 patients who had undergone autologous transplantation. In order to explore the potential role of immunoglubulin recovery as a dynamic predictor of progression or survival after transplantation, conditional probabilities of progression-free survival and overall survival were estimated according to immunoglobulin recovery at different time points using a landmark approach. One year after transplant, when B-cell reconstitution is expected to be completed, among 169 patients alive and progression free, 88 patients (52%) showed immunoglobulin recovery and 81 (48%) did not. Interestingly, the group with immunoglobulin recovery had a significantly longer median progression-free survival than the group with persistent immunoparesis (median 60.4 vs. 27.9 months, respectively; Hazard Ratio: 0.45, 95%Confidence Interval: 0.31-0.66; P<0.001), and improved overall survival (11.3 vs. 7.3 years; Hazard Ratio: 0.45, 95%Confidence Interval: 0.27-0.74; P=0.002). Furthermore, the percentage of normal plasma cells detected by flow cytometry in the bone marrow assessed at day 100 after transplantation was associated with the immunoglobulin recovery at that time and may predict immunoglobulin recovery in the subsequent months: nine months and one year. In conclusion, the recovery of polyclonal immunoglobulins one year after autologous transplantation in myeloma patients is an independent long-term predictor marker for progression and survival.
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Affiliation(s)
- Verónica González-Calle
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | | | | | - Eduardo Sobejano
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | | | | | - Enrique María Ocio
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | - María Belén Vidriales
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | - Noemí Puig
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | - Norma Carmen Gutiérrez
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | - Ramón García-Sanz
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
| | | | - Rosa López
- Hospital Virgen del Puerto de Plasencia, Spain
| | | | | | | | | | | | - María-Victoria Mateos
- Complejo Asistencial Universitario de Salamanca/Instituto de Investigación Biomédica de Salamanca (CAUSA/IBSAL), Spain
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11
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Hernández-Sánchez M, Rodríguez-Vicente AE, Hernández JÁ, Lumbreras E, Sarasquete ME, Martín AÁ, Benito R, Vicente-Gutiérrez C, Robledo C, Heras NDL, Rodríguez JN, Alcoceba M, Coca AGD, Aguilar C, González M, Hernández-Rivas JM. MiRNA expression profile of chronic lymphocytic leukemia patients with 13q deletion. Leuk Res 2016; 46:30-6. [DOI: 10.1016/j.leukres.2016.04.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 03/29/2016] [Accepted: 04/08/2016] [Indexed: 01/02/2023]
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12
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Forero-Castro M, Robledo C, Lumbreras E, Benito R, Hernández-Sánchez JM, Hernández-Sánchez M, García JL, Corchete-Sánchez LA, Tormo M, Barba P, Menárguez J, Ribera J, Grande C, Escoda L, Olivier C, Carrillo E, García de Coca A, Ribera JM, Hernández-Rivas JM. The presence of genomic imbalances is associated with poor outcome in patients with burkitt lymphoma treated with dose-intensive chemotherapy including rituximab. Br J Haematol 2015; 172:428-38. [DOI: 10.1111/bjh.13849] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 09/22/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Maribel Forero-Castro
- Cancer Research Centre; IBSAL; IBMCC; University of Salamanca; CSIC; Salamanca Spain
- School of Biological Sciences (GEBIMOL); Pedagogical and Technological University of Colombia (UPTC); Colombia IN USA
| | - Cristina Robledo
- Cancer Research Centre; IBSAL; IBMCC; University of Salamanca; CSIC; Salamanca Spain
| | - Eva Lumbreras
- Cancer Research Centre; IBSAL; IBMCC; University of Salamanca; CSIC; Salamanca Spain
| | - Rocio Benito
- Cancer Research Centre; IBSAL; IBMCC; University of Salamanca; CSIC; Salamanca Spain
| | | | | | - Juan L. García
- Studies Institute of Health Sciences of Castilla and León (IESCYL); Salamanca Spain
| | | | - Mar Tormo
- Haematology Department; Clinical University Hospital of Valencia; Valencia Spain
| | - Pere Barba
- Haematology Department; Vall d'Hebron Hospital; Barcelona Spain
| | | | - Jordi Ribera
- Clinical Haematology Department ICO-Hospital Germans Trias i Pujol; Jose Carreras Research Institute; Badalona Spain
| | - Carlos Grande
- Haematology Department; University Hospital October 12; Madrid Spain
| | - Lourdes Escoda
- Haematology Department; University Hospital of Tarragona Joan XXIII; Tarragona Spain
| | - Carmen Olivier
- Haematology Department; General Hospital of Segovia; Segovia Spain
| | - Estrella Carrillo
- Haematology Department; University Hospital Virgen del Rocío; Seville Spain
| | | | - Josep-María Ribera
- Clinical Haematology Department ICO-Hospital Germans Trias i Pujol; Jose Carreras Research Institute; Badalona Spain
| | - Jesús M. Hernández-Rivas
- Cancer Research Centre; IBSAL; IBMCC; University of Salamanca; CSIC; Salamanca Spain
- Haematology Department; University Hospital of Salamanca; Salamanca Spain
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13
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Rodríguez-Vicente AE, Quwaider D, Benito R, Misiewicz-Krzeminska I, Hernández-Sánchez M, de Coca AG, Fisac R, Alonso JM, Zato C, de Paz JF, García JL, Sarasquete ME, Hernández JÁ, Corchado JM, González M, Gutiérrez NC, Hernández-Rivas JM. MicroRNA-223 is a novel negative regulator of HSP90B1 in CLL. BMC Cancer 2015; 15:238. [PMID: 25880332 PMCID: PMC4404064 DOI: 10.1186/s12885-015-1212-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 03/18/2015] [Indexed: 12/20/2022] Open
Abstract
Background MicroRNAs are known to inhibit gene expression by binding to the 3′UTR of the target transcript. Downregulation of miR-223 has been recently reported to have prognostic significance in CLL. However, there is no evidence of the pathogenetic mechanism of this miRNA in CLL patients. Methods By applying next-generation sequencing techniques we have detected a common polymorphism (rs2307842), in 24% of CLL patients, which disrupts the binding site for miR-223 in HSP90B1 3′UTR. We investigated whether miR-223 directly targets HSP90B1 through luciferase assays and ectopic expression of miR-223. Quantitative real-time polymerase chain reaction and western blot were used to determine HSP90B1 expression in CLL patients. The relationship between rs2307842 status, HSP90B1 expression and clinico-biological data were assessed. Results HSP90B1 is a direct target for miR-223 by interaction with the putative miR-223 binding site. The analysis in paired samples (CD19+ fraction cell and non-CD19+ fraction cell) showed that the presence of rs2307842 and IGHV unmutated genes determined HSP90B1 overexpression in B lymphocytes from CLL patients. These results were confirmed at the protein level by western blot. Of note, HSP90B1 overexpression was independently predictive of shorter time to the first therapy in CLL patients. By contrast, the presence of rs2307842 was not related to the outcome. Conclusions HSP90B1 is a direct target gene of miR-223. Our results provide a plausible explanation of why CLL patients harboring miR-223 downregulation are associated with a poor outcome, pointing out HSP90B1 as a new pathogenic mechanism in CLL and a promising therapeutic target. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1212-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ana E Rodríguez-Vicente
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | - Dalia Quwaider
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | - Rocío Benito
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | - Irena Misiewicz-Krzeminska
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain. .,National Medicines Institute, Warsaw, Poland.
| | - María Hernández-Sánchez
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | | | - Rosa Fisac
- Servicio de Hematología, Hospital General de Segovia, Segovia, Spain.
| | | | - Carolina Zato
- Departamento de Informática y Automática, Universidad de Salamanca, Salamanca, Spain.
| | - Juan Francisco de Paz
- Departamento de Informática y Automática, Universidad de Salamanca, Salamanca, Spain.
| | - Juan Luis García
- Instituto de Estudios de Ciencias de la Salud de Castilla y León, (IECSCYL)-HUSAL, Castilla y León, Spain.
| | - Ma Eugenia Sarasquete
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | - José Ángel Hernández
- Servicio de Hematología, Hospital Universitario Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain.
| | - Juan M Corchado
- Departamento de Informática y Automática, Universidad de Salamanca, Salamanca, Spain.
| | - Marcos González
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | - Norma C Gutiérrez
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
| | - Jesús-María Hernández-Rivas
- Servicio de Hematología, IBSAL, IBMCC, CIC, Universidad de Salamanca, CSIC, Hospital Universitario, Salamanca, Spain.
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Drawz SM, Marschner S, Yañez M, García de Coca A, Feys HB, Deeren D, Coene J. Observational study of corrected count increments after transfusion of platelets treated with riboflavin pathogen reduction technology in additive solutions. Transfusion 2015; 55:1745-51. [PMID: 25702711 DOI: 10.1111/trf.13026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 12/29/2014] [Accepted: 01/06/2015] [Indexed: 01/03/2023]
Abstract
BACKGROUND Mirasol pathogen reduction technology (PRT) treatment inactivates bacteria, viruses, and parasites in plasma products and platelets (PLTs) suspended in plasma and PLT additive solutions (PAS). Few clinical studies exist documenting transfusions with PAS. This study objective was to evaluate the count increments of PRT-treated PAS-C and PAS-E buffy coat (BC) PLTs in routine use observational settings. STUDY DESIGN AND METHODS PLT pools of five or six BCs were collected, processed, and suspended in PAS-C or PAS-E, respectively. Products were exposed to ultraviolet light in the presence of riboflavin and then transfused into 19 patients with hematologic diseases. Patients were monitored for PLT corrected count increment (CCI) at 1 and 24 hours and for any adverse events in the 72 hours after transfusion. Sterility monitoring was performed with a microbial detection system (BacT/ALERT, bioMérieux). RESULTS The PAS-E products had significantly higher PLT concentrations and counts than the PAS-C products. The mean CCIs of per-protocol (PP) units at 1 and 24 hours were 11,900 (n=27) and 5500 (n=30), respectively. Seventy-eight percent of PP transfusions classify as successful with CCIs at 1 hour of higher than 7500, and 63% higher than 4500 at 24 hours. One patient was excluded from all analyses as she was refractory to Mirasol-treated PLT transfusions and follow-up untreated transfusion products. No adverse events were observed and no contaminated products were detected by BacT/ALERT. CONCLUSION PRT-treated BC PLTs in PAS-C or PAS-E demonstrate PLT transfusion success rates in hematology patients with thrombocytopenia that are comparable to previous studies examining PLTs stored in plasma.
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Affiliation(s)
- Sarah M Drawz
- Department of Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | | | | | | | - Hendrik B Feys
- Transfusion Research Center, Belgian Red Cross-Flanders, Ghent, Belgium
| | | | - José Coene
- Blood Service of the Belgian Red Cross-Flanders, Mechelen, Belgium
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15
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Arefi M, Robledo C, Peñarrubia MJ, García de Coca A, Cordero M, Hernández-Rivas JM, García JL. Genomic analysis of clonal eosinophils by CGH arrays reveals new genetic regions involved in chronic eosinophilia. Eur J Haematol 2014; 93:422-8. [PMID: 24813417 DOI: 10.1111/ejh.12379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2014] [Indexed: 12/22/2022]
Abstract
To assess the presence of genetic imbalances in patients with myeloproliferative neoplasms (MPNs), 38 patients with chronic eosinophilia were studied by array comparative genomic hybridization (aCGH): seven had chronic myelogenous leukaemia (CML), BCR-ABL1 positive, nine patients had myeloproliferative neoplasia Ph- (MPN-Ph-), three had a myeloid neoplasm associated with a PDGFRA rearrangement, and the remaining two cases were Lymphoproliferative T neoplasms associated with eosinophilia. In addition, 17 patients had a secondary eosinophilia and were used as controls. Eosinophilic enrichment was carried out in all cases. Genomic imbalances were found in 76% of all MPN patients. Losses on 20q were the most frequent genetic abnormality in MPNs (32%), affected the three types of MPN studied. This study also found losses at 11q13.3 in 26% of patients with MPN-Ph- and in 19p13.11 in two of the three patients with an MPN associated with a PDGFRA rearrangement. In addition, 29% of patients with CML had losses on 8q24. In summary, aCGH revealed clonality in eosinophils in most MPNs, suggesting that it could be a useful technique for defining clonality in these diseases. The presence of genetic losses in new regions could provide new insights into the knowledge of these MPN associated with eosinophilia.
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Affiliation(s)
- Maryam Arefi
- Department of Hematology, Hospital Clínico Universitario, Valladolid, Spain
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16
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Rodríguez AE, Hernández JÁ, Benito R, Gutiérrez NC, García JL, Hernández-Sánchez M, Risueño A, Sarasquete ME, Fermiñán E, Fisac R, de Coca AG, Martín-Núñez G, de las Heras N, Recio I, Gutiérrez O, De Las Rivas J, González M, Hernández-Rivas JM. Molecular characterization of chronic lymphocytic leukemia patients with a high number of losses in 13q14. PLoS One 2012; 7:e48485. [PMID: 23152777 PMCID: PMC3496725 DOI: 10.1371/journal.pone.0048485] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 10/02/2012] [Indexed: 12/22/2022] Open
Abstract
Background Patients with chronic lymphocytic leukemia and 13q deletion as their only FISH abnormality could have a different outcome depending on the number of cells displaying this aberration. Thus, cases with a high number of 13q- cells (13q-H) had both shorter overall survival and time to first therapy. The goal of the study was to analyze the genetic profile of 13q-H patients. Design and Methods: A total of 102 samples were studied, 32 of which served as a validation cohort and five were healthy donors. Results Chronic lymphocytic leukemia patients with higher percentages of 13q- cells (>80%) showed a different level of gene expression as compared to patients with lower percentages (<80%, 13q-L). This deregulation affected genes involved in apoptosis and proliferation (BCR and NFkB signaling), leading to increased proliferation and decreased apoptosis in 13q-H patients. Deregulation of several microRNAs, such as miR-15a, miR-155, miR-29a and miR-223, was also observed in these patients. In addition, our study also suggests that the gene expression pattern of 13q-H cases could be similar to the patients with 11q- or 17p-. Conclusions This study provides new evidence regarding the heterogeneity of 13q deletion in chronic lymphocytic leukemia patients, showing that apoptosis, proliferation as well as miRNA regulation are involved in cases with higher percentages of 13q- cells.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Alleles
- Case-Control Studies
- Chromosome Deletion
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 13
- Chromosomes, Human, Pair 17
- Cluster Analysis
- Female
- Gene Expression Profiling
- Gene Expression Regulation, Leukemic
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Variable Region/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Male
- MicroRNAs/genetics
- MicroRNAs/metabolism
- Middle Aged
- Mutation
- Signal Transduction
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Affiliation(s)
- Ana Eugenia Rodríguez
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | | | - Rocío Benito
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Norma C. Gutiérrez
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Juan Luis García
- Instituto de Estudios de Ciencias de la Salud de Castilla y León, (IECSCYL)–HUSAL, Castilla y León, Spain
| | - María Hernández-Sánchez
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Alberto Risueño
- Grupo de Bioinformática y Genómica Funcional, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Celgene Institute for Translational Research Europe (CITRE), Sevilla, Spain
| | - M. Eugenia Sarasquete
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Encarna Fermiñán
- Unidad de Genómica, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Rosa Fisac
- Servicio de Hematología, Hospital General de Segovia, Segovia, Spain
| | | | | | | | - Isabel Recio
- Servicio de Hematología, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
| | - Oliver Gutiérrez
- Servicio de Hematología, Hospital del Río Hortega, Valladolid, Spain
| | - Javier De Las Rivas
- Grupo de Bioinformática y Genómica Funcional, IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
| | - Marcos González
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
| | - Jesús M. Hernández-Rivas
- IBSAL,IBMCC, Centro de Investigación del Cáncer, Universidad de Salamanca-CSIC, Salamanca, Spain
- Servicio de Hematología, Hospital Clínico Universitario de Salamanca, Salamanca, Spain
- * E-mail:
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17
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Chillón MC, Santamaría C, García-Sanz R, Balanzategui A, Sarasquete ME, Alcoceba M, Marín L, Caballero MD, Vidriales MB, Ramos F, Bernal T, Díaz-Mediavilla J, García de Coca A, Peñarrubia MJ, Queizán JA, Giraldo P, San Miguel JF, González M. Long FLT3 internal tandem duplications and reduced PML-RARα expression at diagnosis characterize a high-risk subgroup of acute promyelocytic leukemia patients. Haematologica 2010; 95:745-51. [PMID: 20133893 DOI: 10.3324/haematol.2009.015073] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Internal tandem duplications of the FLT3 gene (FLT3-ITDs) are frequent in patients with acute promyelocytic leukemia (APL), however its clinical impact remains controversial. DESIGN AND METHODS We analyzed the prognostic significance of FLT3-ITD mutant level and size, as well as FLT3-D835 point mutations, PML-RARalpha expression and other predictive factors in 129 APL patients at diagnosis enrolled on the Spanish LPA96 (n=43) or LPA99 (n=86) PETHEMA trials. RESULTS FLT3-ITDs and D835 mutations were detected in 21% and 9% of patients, respectively. Patients with increased ITD mutant/wild-type ratio or longer ITD size displayed shorter 5-year relapse-free survival (RFS) (P=0.048 and P<0.0001, respectively). However, patients with D835 mutations did not show differences in RFS or overall survival (OS). Moreover, patients with initial normalized copy number (NCN) of PML-RARalpha transcripts less than the 25(th) percentile had adverse clinical features and shorter 5-year RFS (P<0.0001) and OS (P=0.004) compared to patients with higher NCN. Patients with low NCN showed increased incidence of ITDs (P=0.001), with higher ratios (P<0.0001) and/or longer sizes (P=0.007). Multivariate analysis showed that long FLT3-ITD (P=0.001), low PML-RARalpha levels (P=0.004) and elevated WBC counts (>10x10(9)/L) (P=0.018) were independent predictors for shorter RFS. We identified a subgroup of patients with high WBC, long FLT3-ITD and low NCN of transcripts that showed an extremely bad prognosis (5-year RFS 23.4%, P<0.0001). CONCLUSIONS In conclusion, FLT3-ITD size and PML-RARalpha transcript levels at diagnosis could contribute to improve the risk stratification in APL.
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Affiliation(s)
- María Carmen Chillón
- Department of Hematology, University Hospital of Salamanca, Paseo San Vicente 58-182, Salamanca, 37007, Spain.
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18
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Hernández JA, Rodríguez AE, González M, Benito R, Fontanillo C, Sandoval V, Romero M, Martín-Núñez G, de Coca AG, Fisac R, Galende J, Recio I, Ortuño F, García JL, de las Rivas J, Gutiérrez NC, San Miguel JF, Hernández JM. A high number of losses in 13q14 chromosome band is associated with a worse outcome and biological differences in patients with B-cell chronic lymphoid leukemia. Haematologica 2009; 94:364-71. [PMID: 19252174 DOI: 10.3324/haematol.13862] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Among patients with B-cell chronic lymphoid leukemia, those with 13q14 deletion have a favorable outcome. However, whether the percentage of cells with 13q- influences the prognosis or the biological characteristics of this disease is unknown. We analyzed the clinico-biological characteristics and outcome of patients with B-cell chronic lymphoid leukemia with loss of 13q as the sole cytogenetic aberration. DESIGN AND METHODS Three hundred and fifty patients with B-cell chronic lymphoid leukemia were studied. Clinical data were collected and fluorescence in situ hybridization and molecular studies were carried out. In addition, a gene expression profile was obtained by microarray-based analysis. RESULTS In 109 out of the 350 cases (31.1%) loss of 13q was the sole cytogenetic aberration at diagnosis. In the subgroup of patients with 80% or more of cells with loss of 13q (18 cases), the overall survival was 56 months compared with not reached in the 91 cases in whom less than 80% of cells had loss of 13q (p< 0.0001). The variables included in the multivariate analysis for overall survival were the percentage of losses of 13q14 (p=0.001) and B symptoms (p=0.007). The time to first therapy in the group with 80% or more vs. less than 80% of losses was 38 months vs. 87 months, respectively (p=0.05). In the multivariate analysis the variables selected were unmutated status of IgV(H) (p=0.001) and a high level of beta(2)microglobulin (p=0.003). Interestingly, these differences regarding overall survival and time to first therapy were also present when other cut-offs were considered. The gene expression profile of patients with a high number of losses in 13q14 showed a high proliferation rate, downregulation of apoptosis-related genes, and dysregulation of genes related to mitochondrial functions. CONCLUSIONS Patients with B-cell chronic lymphoid leukemia with a high number of losses in 13q14 as the sole cytogenetic aberration at diagnosis display different clinical and biological features: short overall survival and time to first therapy as well as more proliferation and less apoptosis. A quantification of the number of cells showing a genetic abnormality should, therefore, be included in the study of the prognostic factors of B-cell chronic lymphoid leukemia.
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19
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Pérez-Persona E, Vidriales MB, Mateo G, García-Sanz R, Mateos MV, de Coca AG, Galende J, Martín-Nuñez G, Alonso JM, de Las Heras N, Hernández JM, Martín A, López-Berges C, Orfao A, San Miguel JF. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood 2007; 110:2586-92. [PMID: 17576818 DOI: 10.1182/blood-2007-05-088443] [Citation(s) in RCA: 371] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Monoclonal gammopathy of uncertain significance (MGUS) and smoldering multiple myeloma (SMM) are plasma cell disorders with a risk of progression of approximately 1% and 10% per year, respectively. We have previously shown that the proportion of bone marrow (BM) aberrant plasma cells (aPCs) within the BMPC compartment (aPC/BMPC) as assessed by flow cytometry (FC) contributes to differential diagnosis between MGUS and multiple myloma (MM). The goal of the present study was to investigate this parameter as a marker for risk of progression in MGUS (n = 407) and SMM (n = 93). Patients with a marked predominance of aPCs/BMPC (≥ 95%) at diagnosis displayed a significantly higher risk of progression both in MGUS and SMM (P< .001). Multivariate analysis for progression-free survival (PFS) selected the percentage aPC/BMPC (≥ 95%) as the most important independent variable, together with DNA aneuploidy and immunoparesis, for MGUS and SMM, respectively. Using these independent variables, we have identified 3 risk categories in MGUS (PFS at 5 years of 2%, 10%, and 46%, respectively; P< .001) and SMM patients (PFS at 5 years of 4%, 46%, and 72%, respectively; P < .001). Our results show that multiparameter FC evaluation of BMPC at diagnosis is a valuable tool that could help to individualize the follow-up strategy for MGUS and SMM patients.
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