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Witte HM, Riedl J, Künstner A, Fähnrich A, Ketzer J, Fliedner SMJ, Reimer N, Bernard V, von Bubnoff N, Merz H, Busch H, Feller A, Gebauer N. Molecularly Stratified Treatment Options in Primary Refractory DLBCL/HGBL with MYC and BCL2 or BCL6 Rearrangements (HGBL, NOS with MYC/BCL6). Target Oncol 2023; 18:749-765. [PMID: 37488307 PMCID: PMC10517902 DOI: 10.1007/s11523-023-00983-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND There is growing evidence supporting multidisciplinary molecular tumor boards (MTB) in solid tumors whereas hematologic malignancies remain underrepresented in this regard. OBJECTIVE The present study aimed to assess the clinical relevance of MTBs in primary refractory diffuse large B-cell lymphomas/high-grade B-cell lymphomas with MYC and BCL2 rearrangements (prDLBCL/HGBL-MYC/BCL2) (n = 13) and HGBL, not otherwise specified (NOS), with MYC and BCL6 rearrangements (prHGBL, NOS-MYC/BCL6) (n = 6) based on our previously published whole-exome sequencing (WES) cohort. PATIENTS AND METHODS For genomic analysis, the institutional MTB WES pipeline (University Cancer Center Schleswig-Holstein: UCCSH), certified for routine clinical diagnostics, was employed and supplemented by a comprehensive immunohistochemical work-up. Consecutive database research and annotation according to established evidence levels for molecularly stratified therapies was performed (NCT-DKTK/ESCAT). RESULTS Molecularly tailored treatment options with NCT-DKTK evidence level of at least m2A were identified in each case. We classified mutations in accordance with biomarker/treatment baskets and detected a heterogeneous spectrum of targetable alterations affecting immune evasion (IE; n = 30), B-cell targets (BCT; n = 26), DNA damage repair (DDR; n = 20), tyrosine kinases (TK; n = 13), cell cycle (CC; n = 7), PI3K-MTOR-AKT pathway (PAM; n = 2), RAF-MEK-ERK cascade (RME; n = 1), and others (OTH; n = 11). CONCLUSION Our virtual MTB approach identified potential molecularly targeted treatment options alongside targetable genomic signatures for both prDLBCL/HGBL-MYC/BCL2 and prHGBL, NOS-MYC/BCL6. These results underline the potential of MTB consultations in difficult-to-treat lymphomas early in the treatment sequence.
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Affiliation(s)
- Hanno M Witte
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
- Department of Hematology and Oncology, Federal Armed Forces Hospital Ulm, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany.
| | - Jörg Riedl
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
| | - Axel Künstner
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
- Medical Systems Biology Group, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- Institute for Cardiogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Anke Fähnrich
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
- Medical Systems Biology Group, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- Institute for Cardiogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Julius Ketzer
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
- Department of Pediatrics, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Stephanie M J Fliedner
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105, Kiel, Germany
| | - Niklas Reimer
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
- Medical Systems Biology Group, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- Institute for Cardiogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Veronica Bernard
- Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Maria-Goeppert-Straße 9a, 23562, Lübeck, Germany
| | - Nikolas von Bubnoff
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
| | - Hartmut Merz
- Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Maria-Goeppert-Straße 9a, 23562, Lübeck, Germany
| | - Hauke Busch
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
- Medical Systems Biology Group, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- Institute for Cardiogenetics, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - Alfred Feller
- Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Maria-Goeppert-Straße 9a, 23562, Lübeck, Germany
| | - Niklas Gebauer
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig-Holstein, Campus Lübeck, Ratzeburger Alee 160, 23538, Lübeck, Germany
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Witte HM, Fähnrich A, Künstner A, Riedl J, Fliedner SMJ, Reimer N, Hertel N, von Bubnoff N, Bernard V, Merz H, Busch H, Feller A, Gebauer N. Primary refractory plasmablastic lymphoma: A precision oncology approach. Front Oncol 2023; 13:1129405. [PMID: 36923431 PMCID: PMC10008852 DOI: 10.3389/fonc.2023.1129405] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/21/2022] [Accepted: 02/13/2023] [Indexed: 03/01/2023] Open
Abstract
Introduction Hematologic malignancies are currently underrepresented in multidisciplinary molecular-tumor-boards (MTB). This study assesses the potential of precision-oncology in primary-refractory plasmablastic-lymphoma (prPBL), a highly lethal blood cancer. Methods We evaluated clinicopathological and molecular-genetic data of 14 clinically annotated prPBL-patients from initial diagnosis. For this proof-of-concept study, we employed our certified institutional MTB-pipeline (University-Cancer-Center-Schleswig-Holstein, UCCSH) to annotate a comprehensive dataset within the scope of a virtual MTB-setting, ultimately recommending molecularly stratified therapies. Evidence-levels for MTB-recommendations were defined in accordance with the NCT/DKTK and ESCAT criteria. Results Median age in the cohort was 76.5 years (range 56-91), 78.6% of patients were male, 50% were HIV-positive and clinical outcome was dismal. Comprehensive genomic/transcriptomic analysis revealed potential recommendations of a molecularly stratified treatment option with evidence-levels according to NCT/DKTK of at least m2B/ESCAT of at least IIIA were detected for all 14 prPBL-cases. In addition, immunohistochemical-assessment (CD19/CD30/CD38/CD79B) revealed targeted treatment-recommendations in all 14 cases. Genetic alterations were classified by treatment-baskets proposed by Horak et al. Hereby, we identified tyrosine-kinases (TK; n=4), PI3K-MTOR-AKT-pathway (PAM; n=3), cell-cycle-alterations (CC; n=2), RAF-MEK-ERK-cascade (RME; n=2), immune-evasion (IE; n=2), B-cell-targets (BCT; n=25) and others (OTH; n=4) for targeted treatment-recommendations. The minimum requirement for consideration of a drug within the scope of the study was FDA-fast-track development. Discussion The presented proof-of-concept study demonstrates the clinical potential of precision-oncology, even in prPBL-patients. Due to the aggressive course of the disease, there is an urgent medical-need for personalized treatment approaches, and this population should be considered for MTB inclusion at the earliest time.
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Affiliation(s)
- Hanno M Witte
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.,Department of Hematology and Oncology, Federal Armed Forces Hospital, Ulm, Germany
| | - Anke Fähnrich
- Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Axel Künstner
- Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Jörg Riedl
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.,Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Lübeck, Germany
| | - Stephanie M J Fliedner
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Niklas Reimer
- Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Nadine Hertel
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Nikolas von Bubnoff
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Veronica Bernard
- Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Lübeck, Germany
| | - Hartmut Merz
- University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Hauke Busch
- Medical Systems Biology Group, Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Institute for Cardiogenetics, University of Lübeck, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
| | - Alfred Feller
- Hämatopathologie Lübeck, Reference Centre for Lymph Node Pathology and Hematopathology, Lübeck, Germany
| | - Niklas Gebauer
- Department of Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany.,University Cancer Center Schleswig-Holstein, University Hospital of Schleswig- Holstein, Lübeck, Germany
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Hartmann S, Soltani AS, Bankov K, Bein J, Hansmann ML, Rosenwald A, Bernd HW, Feller A, Ott G, Möller P, Stein H, Klapper W, Borchmann P, Engert A, Eichenauer DA. Tumour cell characteristics and microenvironment composition correspond to clinical presentation in newly diagnosed nodular lymphocyte-predominant Hodgkin lymphoma. Br J Haematol 2022; 199:382-391. [PMID: 35880396 DOI: 10.1111/bjh.18376] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 05/14/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 12/21/2022]
Abstract
Different studies have characterized the microenvironment and its prognostic impact in classic Hodgkin lymphoma whereas such analyses are pending for nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). We thus investigated characteristics of tumour cells and microenvironment in NLPHL and evaluated possible correlations with the clinical presentation. Lymph node samples from 152 NLPHL patients who had first-line treatment within the randomized German Hodgkin Study Group HD16-HD18 trials were available and analysed with regard to IgD status and nuclear size of the tumour cells as well as presence of PD1-positive follicular T helper cells and CD163-positive macrophages in the microenvironment. While large tumour cell nuclei and high numbers of PD1-positive follicular T helper cells in the microenvironment were more common in patients presenting with early/intermediate stages than in patients with advanced-stage disease (p < 0.0001, unpaired t-test; p = 0.0022, Mann-Whitney test), no differences between risk groups were observed in terms of the IgD status of the tumour cells and the content of CD163-positive macrophages in the microenvironment. PD1-positive follicular T helper cells were present in both cases with typical and variant growth patterns and rosetting around the tumour cells was observed in 96% of patients, indicating an important role of PD1-positive follicular T helper cells in NLPHL.
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Affiliation(s)
- Sylvia Hartmann
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Ahmad Sajad Soltani
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Katrin Bankov
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Julia Bein
- Dr. Senckenberg Institute of Pathology, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Martin-Leo Hansmann
- Frankfurt Institute for Advanced Studies, Frankfurt am Main, Germany.,Institute of General Pharmacology and Toxicology, Goethe University Frankfurt, Frankfurt am Main, Germany.,Institute of Pathology and Molecular Pathology, Helios University Hospital Wuppertal, Wuppertal, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center (CCC) Mainfranken, Würzburg, Germany
| | | | | | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, and Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
| | - Peter Möller
- Institute of Pathology, University Hospital Ulm, Ulm, Germany
| | | | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - Peter Borchmann
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany.,German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - Andreas Engert
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany.,German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
| | - Dennis A Eichenauer
- First Department of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Cologne, Germany.,German Hodgkin Study Group (GHSG), University Hospital Cologne, Cologne, Germany
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4
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Wernecke M, Frieling D, Brandl U, Feller A, von Wichert G. [EBV-positive MTX-associated lymphoproliferative disorder and Ig M myeloma in rheumatoid arthritis]. Dtsch Med Wochenschr 2021; 146:262-265. [PMID: 33592662 DOI: 10.1055/a-1328-8468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
HISTORY An 80-year-old female patient arrived with a pronounced lymphadenopathy and weight loss. 6 years ago she had been diagnosed with rheumatoid arthritis. At the time of arrival, she was administered Methotrexate (MTX) 10 mg/week. FINDINGS AND DIAGNOSIS By lymph node biopsy, a clonal population of both EBV-positive B and T cells was seen. Newly occurring anemia (Hb 10 g/dl), monoclonal gammopathy of the Ig M isotype and detection of 40 % EBV-positive plasma cells in the bone marrow were consistent with the diagnosis of Ig M myeloma. We interpret these findings as a biclonal Epstein Barr Virus-positive Methotrexate-associated lymphoproliferative disorder (MTX-LPD). TREATMENT AND COURSE The clinical condition improved immediately after MTX discontinuation. In the follow-up after 4 months, the gamma globulin concentration in serum was significantly reduced (from 51.1 to 34.7 %) and a renewed immune electrophoresis of the serum was without evidence of monoclonal gammopathy. CONCLUSION Based on this case, the association of RA with lymphoproliferative disorders can be confirmed - here as an association of RA with biclonal MTX-LPD or multiple myeloma. Therapy with MTX and reactivation of EBV infection are important influencing factors.
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Affiliation(s)
| | - David Frieling
- Klinik für Diagnostische und Interventionelle Radiologie, Schönklinik Hamburg-Eilbek
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Affiliation(s)
- G W Basse
- Department of Statistics, University of California, 418 Evans Hall, Berkeley, California 94720, USA
| | - A Feller
- Goldman School of Public Policy, University of California, 2607 Hearst Avenue, Berkeley, California 94720, USA
| | - P Toulis
- Booth School of Business, University of Chicago, 5807 South Woodlawn Avenue, Chicago, Illinois 60637, USA
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6
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Reinke S, Richter J, Fend F, Feller A, Hansmann ML, Hüttl K, Oschlies I, Ott G, Möller P, Rosenwald A, Stein H, Altenbuchinger M, Spang R, Klapper W. Round-robin test for the cell-of-origin classification of diffuse large B-cell lymphoma-a feasibility study using full slide staining. Virchows Arch 2018; 473:341-349. [PMID: 29730836 DOI: 10.1007/s00428-018-2367-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 02/23/2018] [Revised: 04/24/2018] [Accepted: 04/26/2018] [Indexed: 12/21/2022]
Abstract
Diffuse large B-cell lymphoma (DLBCL) is subdivided by gene expression analysis (GEP) into two molecular subtypes named germinal center B-cell-like (GCB) and activated B-cell-like (ABC) after their putative cell-of-origin (COO). Determination of the COO is considered mandatory in any new-diagnosed DLBCL, not otherwise specified according to the updated WHO classification. Despite the fact that pathologists are free to choose the method for COO classification, immunohistochemical (IHC) assays are most widely used. However, to the best of our knowledge, no round-robin test to evaluate the interlaboratory variability has been published so far. Eight hematopathology laboratories participated in an interlaboratory test for COO classification of 10 DLBCL tumors using the IHC classifier comprising the expression of CD10, BCL6, and MUM1 (so-called Hans classifier). The results were compared with GEP for COO signature and, in a subset, with results obtained by image analysis. In 7/10 cases (70%), at least seven laboratories assigned a given case to the same COO subtype (one center assessed one sample as not analyzable), which was in agreement with the COO subtype determined by GEP. The results in 3/10 cases (30%) revealed discrepancies between centers and/or between IHC and GEP subtype. Whereas the CD10 staining results were highly reproducible, staining for MUM1 was inconsistent in 50% and for BCL6 in 40% of cases. Image analysis of 16 slides stained for BCL6 (N = 8) and MUM1 (N = 8) of the two cases with the highest disagreement in COO classification were in line with the score of the pathologists in 14/16 stainings analyzed (87.5%). This study describes the first round-robin test for COO subtyping in DLBCL using IHC and demonstrates that COO classification using the Hans classifier yields consistent results among experienced hematopathologists, even when variable staining protocols are used. Data from this small feasibility study need to be validated in larger cohorts.
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Affiliation(s)
- Sarah Reinke
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, D-24105, Kiel, Germany.
| | - Julia Richter
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, D-24105, Kiel, Germany
| | - Falko Fend
- Institute of Pathology and Neuropathology, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany
| | | | - Martin-Leo Hansmann
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Katrin Hüttl
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus und Dr. Margarete Fischer-Bosch Institut für Klinische Pharmakologie, Stuttgart, Germany
| | - Ilske Oschlies
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, D-24105, Kiel, Germany
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus und Dr. Margarete Fischer-Bosch Institut für Klinische Pharmakologie, Stuttgart, Germany
| | - Peter Möller
- Department of Pathology, University Hospital Ulm, Ulm, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | | | | | - Rainer Spang
- Institute of Functional Genomics, University of Regensburg, Regensburg, Germany
| | - Wolfram Klapper
- Department of Pathology, Hematopathology Section, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, D-24105, Kiel, Germany
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7
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Klapper W, Fend F, Feller A, Hansmann ML, Möller P, Stein H, Rosenwald A, Ott G. [Aggressive B‑cell lymphomas : Recommendations from the German Panel of Reference Pathologists in the Competence Network on Malignant Lymphomas on diagnostic procedures according to the current WHO classification, update 2017]. Pathologe 2018; 40:152-156. [PMID: 29666909 DOI: 10.1007/s00292-018-0440-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The update of the 4th edition of the WHO classification for hematopoietic neoplasms introduces changes in the field of mature aggressive B‑cell lymphomas that are relevant to diagnostic pathologists. In daily practice, the question arises of which analysis should be performed when diagnosing the most common lymphoma entity, diffuse large B‑cell lymphoma. We discuss the importance of the cell of origin, the analysis of MYC translocations, and the delineation of the new WHO entities of high-grade B‑cell lymphomas.
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Affiliation(s)
- W Klapper
- Institut für Pathologie, Sektion Hämatopathologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Haus 14, 24105, Kiel, Deutschland.
| | - F Fend
- Institut für Pathologie und Neuropathologie, Eberhard Karls Universität Tübingen, Tübingen, Deutschland
| | - A Feller
- Hämatopathologie Lübeck, Lübeck, Deutschland
| | - M L Hansmann
- Dr. Senckenbergisches Institut für Pathologie, Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - P Möller
- Institut für Pathologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - H Stein
- Pathodiagnostik Berlin, Berlin, Deutschland
| | - A Rosenwald
- Pathologisches Institut, Universität Würzburg, Comprehensive Cancer Center Mainfranken, Mainfranken, Deutschland
| | - G Ott
- Abteilung für Klinische Pathologie, Robert-Bosch-Krankenhaus, Dr. Margarete Fischer-Bosch-Institut für Klinische Pharmakologie, Stuttgart, Deutschland
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8
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Pohlen U, Feller A, Holmer C. Transvaginal Hybrid NOTES Cholecystectomy: A Single-Centre Long-Term Experience on Sexual Function. World J Surg 2017; 42:1960-1964. [DOI: 10.1007/s00268-017-4412-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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9
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Zenz T, Kreuz M, Fuge M, Klapper W, Horn H, Staiger AM, Winter D, Helfrich H, Huellein J, Hansmann ML, Stein H, Feller A, Möller P, Schmitz N, Trümper L, Loeffler M, Siebert R, Rosenwald A, Ott G, Pfreundschuh M, Stilgenbauer S. TP53 mutation and survival in aggressive B cell lymphoma. Int J Cancer 2017; 141:1381-1388. [PMID: 28614910 DOI: 10.1002/ijc.30838] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [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: 02/03/2017] [Revised: 04/08/2017] [Accepted: 04/25/2017] [Indexed: 12/11/2022]
Abstract
TP53 is mutated in 20-25% of aggressive B-cell lymphoma (B-NHL). To date, no studies have addressed the impact of TP53 mutations in prospective clinical trial cohorts. To evaluate the impact of TP53 mutation to current risk models in aggressive B-NHL, we investigated TP53 gene mutations within the RICOVER-60 trial. Of 1,222 elderly patients (aged 61-80 years) enrolled in the study and randomized to six or eight cycles of CHOP-14 with or without Rituximab (NCT00052936), 265 patients were analyzed for TP53 mutations. TP53 mutations were demonstrated in 63 of 265 patients (23.8%). TP53 mutation was associated with higher LDH (65% vs. 37%; p < 0.001), higher international prognostic index-Scores (IPI 4/5 27% vs. 12%; p = 0.025) and B-symptoms (41% vs. 24%; p = 0.011). Patients with TP53 mutation were less likely to obtain a complete remission CR/CRu (CR unconfirmed) 61.9% (mut) vs. 79.7% (wt) (p = 0.007). TP53 mutations were associated with decreased event-free (EFS), progression-free (PFS) and overall survival (OS) (median observation time of 40.2 months): the 3 year EFS, PFS and OS were 42% (vs. 60%; p = 0.012), 42% (vs. 67.5%; p < 0.001) and 50% (vs. 76%; p < 0.001) for the TP53 mutation group. In a Cox proportional hazard analysis adjusting for IPI-factors and treatment arms, TP53 mutation was shown to be an independent predictor of EFS (HR 1.5), PFS (HR 2.0) and OS (HR 2.3; p < 0.001). TP53 mutations are independent predictors of survival in untreated patients with aggressive CD20+ lymphoma. TP53 mutations should be considered for risk models in DLBCL and strategies to improve outcome for patients with mutant TP53 must be developed.
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Affiliation(s)
- Thorsten Zenz
- Molecular Therapy in Haematology and Oncology and Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (dkfz), Heidelberg, Germany.,Dept. of Medicine V, University Hospital Heidelberg, Heidelberg, Germany.,Dept. of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Markus Kreuz
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Leipzig, Germany
| | - Maxi Fuge
- Dept. of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Wolfram Klapper
- Institute of Pathology, Hematopathology Section and Lymph Node Registry, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Heike Horn
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, and Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, and University of Tübingen, Stuttgart, Germany
| | - Annette M Staiger
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, and Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, and University of Tübingen, Stuttgart, Germany
| | - Doris Winter
- Dept. of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Hanne Helfrich
- Dept. of Internal Medicine III, University of Ulm, Ulm, Germany
| | - Jennifer Huellein
- Molecular Therapy in Haematology and Oncology and Department of Translational Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Martin-Leo Hansmann
- Dr. Senckenberg Institute of Pathology, Universitätsklinikum Frankfurt, Frankfurt, Germany
| | | | - Alfred Feller
- Institute of Pathology, University Hospital Schleswig-Holstein, Campus Lübeck, and Hämatopathologie Lübeck, Germany
| | - Peter Möller
- Institute of Pathology, Universitätsklinikum Ulm, Ulm, Germany
| | - Norbert Schmitz
- Department of Hematology, Oncology and Pneumonology, University Hospital of Muenster, Muenster, Germany
| | - Lorenz Trümper
- Department of Hematology and Oncology, Georg-August Universität, Göttingen, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology, Universität Leipzig, Leipzig, Germany
| | - Reiner Siebert
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Andreas Rosenwald
- Institute of Pathology, and Comprehensive Cancer Center Mainfranken (CCC MF), University of Würzburg, Würzburg, Germany
| | - German Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus, Stuttgart, Germany
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Fayyad-Kazan M, Feller A, Bodo E, Boeckstaens M, Marini AM, Dubois E, Georis I. Yeast nitrogen catabolite repression is sustained by signals distinct from glutamine and glutamate reservoirs. Mol Microbiol 2015; 99:360-79. [DOI: 10.1111/mmi.13236] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2015] [Indexed: 01/29/2023]
Affiliation(s)
- Mohammad Fayyad-Kazan
- Institut de Recherches Microbiologiques J.-M. Wiame; 1070 Brussels Belgium
- Laboratoire de Biologie du Transport Membranaire; Institut de Biologie et de Médecine Moléculaires; Université Libre de Bruxelles; 6041 Gosselies Belgium
| | - A. Feller
- Institut de Recherches Microbiologiques J.-M. Wiame; 1070 Brussels Belgium
- Laboratoire de Microbiologie; Institut de Biologie et de Médecine Moléculaires; Université Libre de Bruxelles; 6041 Gosselies Belgium
| | - E. Bodo
- Unité de Biotechnologie; 1070 Brussels Belgium
| | - M. Boeckstaens
- Laboratoire de Biologie du Transport Membranaire; Institut de Biologie et de Médecine Moléculaires; Université Libre de Bruxelles; 6041 Gosselies Belgium
| | - A. M. Marini
- Laboratoire de Biologie du Transport Membranaire; Institut de Biologie et de Médecine Moléculaires; Université Libre de Bruxelles; 6041 Gosselies Belgium
| | - E. Dubois
- Institut de Recherches Microbiologiques J.-M. Wiame; 1070 Brussels Belgium
- Laboratoire de Microbiologie; Institut de Biologie et de Médecine Moléculaires; Université Libre de Bruxelles; 6041 Gosselies Belgium
| | - I. Georis
- Institut de Recherches Microbiologiques J.-M. Wiame; 1070 Brussels Belgium
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Mauz-Körholz C, Lange T, Hasenclever D, Burkhardt B, Feller A, Dörffel W, Kluge R, Vordermark D, Körholz D. Pediatric Nodular Lymphocyte-predominant Hodgkin Lymphoma: Treatment Recommendations of the GPOH-HD Study Group. Klin Padiatr 2015; 227:314-21. [DOI: 10.1055/s-0035-1559664] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- C. Mauz-Körholz
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle/ Wittenberg, Halle/ Saale, Germany
| | - T. Lange
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle/ Wittenberg, Halle/ Saale, Germany
| | - D. Hasenclever
- Institut für Medizinische Informatik, Statistik & Epidemiologie (IMISE), Universität Leipzig, Leipzig, Germany
| | - B. Burkhardt
- Clinic for Pediatric Hematology and Oncology, University Hospital Münster, Münster, Germany
| | - A. Feller
- Institute for Pathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - W. Dörffel
- Clinic for Pediatric and Youth Medicine, Helios Hospital Berlin-Buch, Berlin, Germany
| | - R. Kluge
- Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany
| | - D. Vordermark
- Clinic and Policlinic for Radiation Therapy, University Hospital Halle (Saale), Halle (Saale), Germany
| | - D. Körholz
- Klinik für Kinder- und Jugendmedizin, Martin-Luther-Universität Halle/ Wittenberg, Halle/ Saale, Germany
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Hartmann S, Mauz-Körholz C, Eichenauer D, Mottok A, Bob R, Koch K, Bernd HW, Cogliatti S, Hummel M, Feller A, Ott G, Möller P, Rosenwald A, Stein H, Hansmann ML, Körholz D, Klapper W. Variant Histological Patterns of Nodular Lymphocyte Predominant Hodgkin Lymphoma in Children Treated in Trials of the GPOH-HD. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Feller A, Langer A. STRAHLENMESSUNGEN AN MIT RADIOLOGISCHEN ARBEITEN BESCHAFTIGTEM PERSONAL UND EINIGE SCHUTZMASSNAHMEN GEGEN -STRAHLEN. Acta Radiol 2013. [DOI: 10.1177/028418513701800402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Åkerström T, Crona J, Delgado Verdugo A, Starker LF, Cupisti K, Willenberg HS, Knoefel WT, Saeger W, Feller A, Ip J, Soon P, Anlauf M, Alesina PF, Schmid KW, Decaussin M, Levillain P, Wängberg B, Peix JL, Robinson B, Zedenius J, Bäckdahl M, Caramuta S, Iwen KA, Botling J, Stålberg P, Kraimps JL, Dralle H, Hellman P, Sidhu S, Westin G, Lehnert H, Walz MK, Åkerström G, Carling T, Choi M, Lifton RP, Björklund P. Comprehensive re-sequencing of adrenal aldosterone producing lesions reveal three somatic mutations near the KCNJ5 potassium channel selectivity filter. PLoS One 2012; 7:e41926. [PMID: 22848660 PMCID: PMC3407065 DOI: 10.1371/journal.pone.0041926] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 06/29/2012] [Indexed: 11/19/2022] Open
Abstract
Background Aldosterone producing lesions are a common cause of hypertension, but genetic alterations for tumorigenesis have been unclear. Recently, either of two recurrent somatic missense mutations (G151R or L168R) was found in the potassium channel KCNJ5 gene in aldosterone producing adenomas. These mutations alter the channel selectivity filter and result in Na+ conductance and cell depolarization, stimulating aldosterone production and cell proliferation. Because a similar mutation occurs in a Mendelian form of primary aldosteronism, these mutations appear to be sufficient for cell proliferation and aldosterone production. The prevalence and spectrum of KCNJ5 mutations in different entities of adrenocortical lesions remain to be defined. Materials and Methods The coding region and flanking intronic segments of KCNJ5 were subjected to Sanger DNA sequencing in 351 aldosterone producing lesions, from patients with primary aldosteronism and 130 other adrenocortical lesions. The specimens had been collected from 10 different worldwide referral centers. Results G151R or L168R somatic mutations were identified in 47% of aldosterone producing adenomas, each with similar frequency. A previously unreported somatic mutation near the selectivity filter, E145Q, was observed twice. Somatic G151R or L168R mutations were also found in 40% of aldosterone producing adenomas associated with marked hyperplasia, but not in specimens with merely unilateral hyperplasia. Mutations were absent in 130 non-aldosterone secreting lesions. KCNJ5 mutations were overrepresented in aldosterone producing adenomas from female compared to male patients (63 vs. 24%). Males with KCNJ5 mutations were significantly younger than those without (45 vs. 54, respectively; p<0.005) and their APAs with KCNJ5 mutations were larger than those without (27.1 mm vs. 17.1 mm; p<0.005). Discussion Either of two somatic KCNJ5 mutations are highly prevalent and specific for aldosterone producing lesions. These findings provide new insight into the pathogenesis of primary aldosteronism.
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Affiliation(s)
- Tobias Åkerström
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Joakim Crona
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Alberto Delgado Verdugo
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Lee F. Starker
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Kenko Cupisti
- Department of General, Visceral and Pediatric Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Holger S. Willenberg
- Department of Endocrinology, Diabetes and Rheumatology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Wolfram T. Knoefel
- Department of General, Visceral and Pediatric Surgery, University Hospital Düsseldorf, Düsseldorf, Germany
| | | | - Alfred Feller
- Department of Pathology, University Hospital Lübeck, Lübeck, Germany
| | - Julian Ip
- University of Sydney, Endocrine Surgical Unit and Cancer Genetics, Hormones and Cancer Group , Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, Australia
| | - Patsy Soon
- University of Sydney, Endocrine Surgical Unit and Cancer Genetics, Hormones and Cancer Group , Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, Australia
- Department of Surgery, Bankstown Hospital, South Western Sydney Clinical School, University of New South Wales, Sydney, Australia
| | - Martin Anlauf
- Institute of Pathology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Pier F. Alesina
- Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Universität Duisburg-Essen, Essen, Germany
| | - Kurt W. Schmid
- Institut für Pathologie und Neuropathologie Universitätsklinikum, Universität Duisburg-Essen, Essen, Germany
| | - Myriam Decaussin
- Department of Pathology, Centre Hospitalier Lyon Sud, Lyon, France
| | - Pierre Levillain
- Pathology Department, Centre Hospitalier Poitiers, Poitiers, France
| | - Bo Wängberg
- Sahlgrenska akademin, Göteborg University, Göteborg, Sweden
| | - Jean-Louis Peix
- Department of Endocrine Surgery, Centre Hospitalier Lyon Sud, Lyon, France
| | - Bruce Robinson
- University of Sydney, Endocrine Surgical Unit and Cancer Genetics, Hormones and Cancer Group , Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, Australia
| | - Jan Zedenius
- Department of Molecular Medicine and Surgery, Endocrine Surgery Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Martin Bäckdahl
- Department of Molecular Medicine and Surgery, Endocrine Surgery Unit, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Stefano Caramuta
- Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - K. Alexander Iwen
- Medizinischen Klinik Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Johan Botling
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Peter Stålberg
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Henning Dralle
- Department of General, Visceral and Vascular Surgery, University Hospital, University of Halle-Wittenberg, Halle/Saale, Germany
| | - Per Hellman
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Stan Sidhu
- University of Sydney, Endocrine Surgical Unit and Cancer Genetics, Hormones and Cancer Group , Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, Australia
| | - Gunnar Westin
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Hendrik Lehnert
- Medizinischen Klinik Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Martin K. Walz
- Klinik für Chirurgie und Zentrum für Minimal Invasive Chirurgie, Kliniken Essen-Mitte, Universität Duisburg-Essen, Essen, Germany
| | - Göran Åkerström
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Tobias Carling
- Department of Surgery, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Murim Choi
- Department of Genetics, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Richard P. Lifton
- Department of Genetics, School of Medicine, Yale University, New Haven, Connecticut, United States of America
| | - Peyman Björklund
- Department of Surgical Sciences, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- * E-mail:
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Bartels C, Malisius R, Sayk F, Bechtel M, Leyh R, Feller A, Sievers HH. Accelerated smooth muscle cell apoptosis in occluded aorto-coronary saphenous vein grafts. Int J Angiol 2011. [DOI: 10.1007/bf01637040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Heitmann C, Richter-Heine I, Schmiel M, Feller A. Plastisch-chirurgische Versorgung des fortgeschrittenen Mammakarzinoms. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1250679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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17
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Feller A, Langer A. Strahlenmessungen an Mit Radiologischen Arbeiten Beschaftigtem Personal Und Einige Schutzmassnahmen Gegen γ-Strahlen. Acta Radiol 2010. [DOI: 10.3109/00016923709132410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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18
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Glass B, Ziepert M, Reiser M, Freund M, Trümper L, Metzner B, Feller A, Loeffler M, Pfreundschuh M, Schmitz N. High-dose therapy followed by autologous stem-cell transplantation with and without rituximab for primary treatment of high-risk diffuse large B-cell lymphoma. Ann Oncol 2010; 21:2255-2261. [DOI: 10.1093/annonc/mdq235] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hallermann C, Bendick C, Mey S, Feller A, Schulze HJ. Testen Sie Ihr Fachwissen. Akt Dermatol 2010. [DOI: 10.1055/s-0029-1215240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lyon CE, Sadigh KS, Carmolli MP, Harro C, Sheldon E, Lindow JC, Larsson CJ, Martinez T, Feller A, Ventrone CH, Sack DA, DeNearing B, Fingar A, Pierce K, Dill EA, Schwartz HI, Beardsworth EE, Kilonzo B, May JP, Lam W, Upton A, Budhram R, Kirkpatrick BD. In a randomized, double-blinded, placebo-controlled trial, the single oral dose typhoid vaccine, M01ZH09, is safe and immunogenic at doses up to 1.7 x 10(10) colony-forming units. Vaccine 2010; 28:3602-8. [PMID: 20188175 DOI: 10.1016/j.vaccine.2010.02.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Revised: 01/18/2010] [Accepted: 02/10/2010] [Indexed: 11/19/2022]
Abstract
M01ZH09, S. Typhi (Ty2 Delta aroC Delta ssaV) ZH9, is a single oral dose typhoid vaccine with independently attenuating deletions. A phase II randomized, double-blind, placebo-controlled, dose-escalating trial evaluated the safety and immunogenicity of M01ZH09 to 1.7 x 10(10) colony-forming units (CFU). 187 Healthy adults received vaccine or placebo in four cohorts. Serologic responses and IgA ELISPOT were measured. At all doses, the vaccine was well tolerated and without bacteremias. One subject had a transient low-grade fever. 62.2-86.1% of subjects seroconverted S. Typhi-specific LPS IgG and 83.3-97.4% IgA; 92.1% had a positive S. Typhi LPS ELISPOT. M01ZH09 is safe and immunogenic up to 1.7 x 10(10)CFU. Efficacy testing of this single-dose oral typhoid vaccine is needed.
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Affiliation(s)
- C E Lyon
- The University of Vermont College of Medicine, Burlington, VT 05405, USA
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Mourad N, Mounier N, Brière J, Raffoux E, Delmer A, Feller A, Meijer CJLM, Emile JF, Bouabdallah R, Bosly A, Diebold J, Haioun C, Coiffier B, Gisselbrecht C, Gaulard P. Clinical, biologic, and pathologic features in 157 patients with angioimmunoblastic T-cell lymphoma treated within the Groupe d'Etude des Lymphomes de l'Adulte (GELA) trials. Blood 2008; 111:4463-70. [PMID: 18292286 PMCID: PMC2343588 DOI: 10.1182/blood-2007-08-105759] [Citation(s) in RCA: 225] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2007] [Accepted: 02/13/2008] [Indexed: 12/11/2022] Open
Abstract
To evaluate the prognostic significance of clinicobiologic and pathological features in angioimmunoblastic T-cell lymphoma (AITL), 157 AITL patients were retrieved from the GELA LNH87-LNH93 randomized clinical trials. One hundred forty-seven patients received a cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-like regimen with intensified courses in half of them. Histologically, 41 cases were classified as "rich in large cells" and 116 as "classic" (including 19 rich in epithelioid cells, 14 rich in clear cells, and 4 with hyperplastic germinal centers). Sixty-two cases were scored for CD10 and CXCL13 expression according to the abundance of positive lymphoid cells. Median age was 62 years, with 81% advanced stage, 72% B symptoms, 65% anemia, 50% hypergammaglobulinemia, and 66% elevated LDH. Overall 7-year survival was 30%. In multivariate analysis, only male sex (P = .004), mediastinal lymphadenopathy (P = .041), and anemia (P = .042) adversely affected overall survival. Increase in large cells and high level of CD10 and CXCL13 did not affect survival. Intensive regimen did not improve survival. In conclusion, AITL is a morphologically heterogeneous T-cell lymphoma commonly expressing CXCL13 and CD10 and carrying few prognostic factors. It portends a poor prognosis even when treated intensively. However, AITL is not always lethal with 30% of patients alive at 7 years.
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Wagner P, Welker L, Feller A, Magnussen H. Pulmonaler Befall eines multiplen Myelom, einen Pancoast Tumor vortäuschend. Pneumologie 2008. [DOI: 10.1055/s-2008-1074302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hoffmann W, Terschüeren C, Heimpel H, Feller A, Butte W, Hostrup O, Richardson D, Greiser E. Population-based research on occupational and environmental factors for leukemia and non-Hodgkin's lymphoma: the Northern Germany Leukemia and Lymphoma Study (NLL). Am J Ind Med 2008; 51:246-57. [PMID: 18270999 DOI: 10.1002/ajim.20551] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [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: 11/10/2022]
Abstract
BACKGROUND The Northern Germany Leukemia and Lymphoma Study (NLL) is a population-based study designed to provide a quantitative basis for investigations into occupational and environmental risk factors for leukemia and lymphoma. METHODS All incident cases of leukemia and lymphoma diagnosed between 1/1/1986 and 12/31/1998 in six counties in Northern Germany were actively ascertained. Controls were selected from population registries. Use of pesticides, sources of food supply, time spent at home and work, medical and family history were assessed via face-to-face interview. This self-reported information was used in conjunction with direct environmental measurements of pesticides in household dust and electromagnetic fields (EMFs). In addition, geographical information system (GIS) data were used to derive estimates of environmental exposure to pesticides, EMFs associated with transmission lines, and ionizing radiation from routine nuclear power reactor operations. Occupational exposure assessment was based on lifetime work history. For each job, information on branch of industry, company, job description, and duration of employment were ascertained. RESULTS Fourteen hundred thirty cases and 3041 controls were recruited. Lifetime residential and workplace histories totaled 49,628 addresses. Occupational exposure to pesticides was reported by 15% of the male participants (women: 16%). Four percent of the men (women: 8%) were occupationally exposed to ionizing radiation for >or=1 year over their lifetime. Sixty four percent of the participants had lived in the vicinity (20 km) of a nuclear power plant in operation. CONCLUSIONS The NLL illustrates the successful application of innovative methods to simultaneously assess occupational and environmental risk factors for leukemia and lymphoma including radiological hazards, pesticides, and EMFs.
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Affiliation(s)
- W Hoffmann
- Institute for Community Medicine, Section of Health Care Epidemiology and Community Health, Ernst-Moritz-Arndt University of Greifswald, Greifswald, Germany.
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Klapper W, Hoster E, Rölver L, Schrader C, Janssen D, Tiemann M, Bernd HW, Determann O, Hansmann ML, Möller P, Feller A, Stein H, Wacker HH, Dreyling M, Unterhalt M, Hiddemann W, Ott G. Tumor sclerosis but not cell proliferation or malignancy grade is a prognostic marker in advanced-stage follicular lymphoma: the German Low Grade Lymphoma Study Group. J Clin Oncol 2007; 25:3330-6. [PMID: 17664481 DOI: 10.1200/jco.2006.10.5833] [Citation(s) in RCA: 46] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Follicular lymphoma is an indolent lymphoma with a long median overall survival. However, a considerable number of patients die within the first 2 years after the onset of the disease. Because the treatment options vary with respect to antitumor effect and potential toxic adverse effects, the identification of high-risk patients would be helpful in directing therapeutic decisions in individual patients. Several histopathologic biomarkers for risk stratification have been suggested, but most markers have not been validated in patients treated in prospective trials. PATIENTS AND METHODS We report a comprehensive approach to evaluate histopathologic biomarkers, including WHO grade, histology, and proliferation and quantitation of immune bystander cells, in 158 patients with nodal advanced-stage follicular lymphoma treated first line within a randomized trial. RESULTS Tumor sclerosis was a significant prognostic marker of poor overall survival that was independent of the Follicular Lymphoma International Prognostic Index (FLIPI). WHO grade, proliferation, and total T-cell or macrophage content were not associated with overall survival. CONCLUSION The presence of sclerosis within the lymphoma is a marker of poor overall survival that is independent of the FLIPI. The quantification of macrophage or absolute T-cell content, grading, and proliferation are of no help in predicting the outcome of FL. Future studies need to identify surrogate markers for the prognostic immune signatures identified by gene expression profiling. Most importantly, new prognostic markers need to be confirmed in patients treated within prospective trials.
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Affiliation(s)
- Wolfram Klapper
- Department of Pathology, Hematopathology Section and Lymph Node Registry, Kiel, Germany.
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Heller G, Günster C, Misselwitz B, Feller A, Schmidt S. [Annual patient volume and survival of very low birth weight infants (VLBWs) in Germany--a nationwide analysis based on administrative data]. Z Geburtshilfe Neonatol 2007; 211:123-31. [PMID: 17541879 DOI: 10.1055/s-2007-960747] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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: 10/23/2022]
Abstract
BACKGROUND Despite numerous international analyses addressing survival of very low birthweight infants (VLBWs) in relation to patient volume, only few regional analyses from Germany exist. Thus, the aim of this study was to perform analyses on a nationwide database relating to this topic. MATERIALS AND METHODS We used nationwide hospital claims data according to data exchange processes designated in section sign 301 Social Security Code, of patients insured with the local healthcare insurance fund (AOK), with a hospital admission weight of 300-1 499 g, an age of less than 29 days, and a hospital discharge date between 1 Jan 2002 and 30 June 2006. Mortality within 30 days of hospital admission was used as end point. Crude and risk adjusted analyses were performed using logistic regression. RESULTS A comparison with federal statistics data showed that our dataset covers 28 % of all VLBWs born in Germany during the study period. 9 487 VLBWs could be included in risk adjusted volume-outcome analyses. Significantly increased risk adjusted 30-day-mortality rates in smaller units were observed using different thresholds. The relationship was more pronounced in the most recent time period starting from 2004. CONCLUSION Adoption of a minimum VLBW patient volume in addition to the structural requirements consented by the Federal Joint Committee (G-BA) seems reasonable, to maintain or improve the quality of VLBW health care provision in Germany.
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Affiliation(s)
- G Heller
- Wissenschaftliches Institut der AOK (WIdO), Kortrijker Strasse 1, 53177 Bonn.
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Glass B, Kloess M, Bentz M, Schlimok G, Berdel WE, Feller A, Trümper L, Loeffler M, Pfreundschuh M, Schmitz N. Dose-escalated CHOP plus etoposide (MegaCHOEP) followed by repeated stem cell transplantation for primary treatment of aggressive high-risk non-Hodgkin lymphoma. Blood 2005; 107:3058-64. [PMID: 16384932 DOI: 10.1182/blood-2005-04-1570] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [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: 01/14/2023] Open
Abstract
Feasibility, safety, and efficacy of a 4-course high-dose chemotherapy (HDT) protocol including autologous stem cell transplantation (SCT) after courses 2, 3, and 4 was investigated in 110 patients, aged 18 to 60 years, with primary diagnosis of aggressive NHL (aNHL), and lactic dehydrogenase (LDH) levels above normal. At dose level 1 (DL1), course 1 consisted of cyclophosphamide 1500 mg/m2, doxorubicin (Adriamycin) 70 mg/m2, vincristine 2 mg, etoposide 450 mg/m2, and prednisone 500 mg. With courses 2 and 3 cyclophosphamide and etoposide were escalated to 4500 mg/m2 and 600 mg/m2, respectively. With course 4 cyclophosphamide and etoposide were given at 6000 mg/m2 and 1000 mg/m2, respectively. At DL2 etoposide was further increased to 600, 960, 960, and 1480 mg/m2 with courses 1 to 4, respectively. Therapy as per protocol was completed by 81.8% of patients. Overall survival at 5 years was 67.2%, freedom from treatment failure (FFTF) was 62.1%, and treatment-related mortality was 4.5%. There was a trend to better FFTF at DL2 compared to DL1 (66.9% versus 54.2%). Repetitive HDT with escalated CHOP plus etoposide is feasible and effective treatment of patients with aNHL. DL2 of this therapy is being used in an ongoing phase 3 study.
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Affiliation(s)
- Bertram Glass
- Department of Hematology and Oncology, University Hospital of Göttingen, Robert-Koch-Strasse 40, D-37075 Göttingen, Germany.
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Mahnken A, Kausch I, Feller A, Krüger S. E-cadherin immunoreactivity correlates with recurrence and progression of minimally invasive transitional cell carcinomas of the urinary bladder. Oncol Rep 2005. [DOI: 10.3892/or.14.4.1065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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28
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Shah PM, Sen S, Perlmuter LC, Feller A. Survival after percutaneous endoscopic gastrostomy: the role of dementia. J Nutr Health Aging 2005; 9:255-9. [PMID: 15980926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Percutaneous Endoscopic Gastrostomy (PEG) is a widely used technique for enteral feeding in nursing home patients. Several factors including malnutrition, hypoalbuminemia, older age, number of co-morbidities and cognitive impairment adversely affect survival. OBJECTIVE This study evaluated the relative impact of age, serum albumin, number of co-morbid illnesses and dementia on survival in male nursing home patients who had undergone percutaneous endoscopic gastrostomy (PEG). DESIGN In a retrospective study the hospital records of all North Chicago Veterans Affair (VA) male nursing home residents (n=88) who had PEG placed between 1990 through 2000 were reviewed. Of the 88 charts reviewed, 17 were eliminated from analysis due to incomplete data. Following data was examined: Age, serum albumin, number of co-morbid illnesses, presence of dementia, survival in years following PEG placement. RESULTS Advancing age was associated with increasing probability of dementia and increased number of co-morbidities. Post PEG survival decreased with increasing age, with lower serum albumin, and increased number of co-morbidities. Age and serum albumin were strong predictors of survival in PEG recipients without the diagnosis of dementia. However, in PEG recipients with a diagnosis of dementia, age and serum albumin no longer predicted survival. Dementia appears to attenuate the effects of age and serum albumin on survival following PEG placement. CONCLUSION In the presence of dementia, none of the usual predictors of survival in PEG recipients remain significant.
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Affiliation(s)
- P M Shah
- Gastroenterology Section, Medical Service, VA Medical Center, 3001 Green Bay Road, North Chicago, IL 60064, USA.
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29
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Krüger S, Noack F, Böhle A, Feller A. Histologic tumor growth pattern is significantly associated with disease-related survival in muscle-invasive transitional cell carcinoma of the urinary bladder. Oncol Rep 2004. [DOI: 10.3892/or.12.3.609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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30
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31
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Krüger S, Mess F, Böhle A, Feller A. Numerical aberrations of chromosome 17 and the 9p21 locus are independent predictors of tumor recurrence in non-invasive transitional cell carcinoma of the urinary bladder. Int J Oncol 2003. [DOI: 10.3892/ijo.23.1.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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32
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Harder L, Gesk S, Martin-Subero JI, Merz H, Hochhaus A, Maass E, Feller A, Grote W, Siebert R, Fetscher S. Cytogenetic and molecular characterization of simultaneous chronic and acute myelocytic leukemia. Cancer Genet Cytogenet 2003; 142:80-2. [PMID: 12660040 DOI: 10.1016/s0165-4608(02)00793-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe a patient initially diagnosed with a chronic myeloproliferative disorder in the accelerated phase. Cytogenetic analysis showed the presence of two independent clones. One clone contained a typical Philadelphia (Ph) chromosome due to t(9;22)(q34;q11), as the sole abnormality which was proven molecularly to result in the b2a2-BCR/ABL fusion. The other clone displayed a complex karyotype with several structural and numerical aberrations including trisomy 11 and 22 but lacking a t(9;22) or any other structural abnormalities involving chromosomes 9 and 22. Fluorescence in situ hybridization demonstrated that the t(9;22) was present only in cells with two copies of chromosomes 11 and 22. In contrast, cells with trisomies 11 and 22 lacked evidence for a BCR/ABL fusion. Based on the genetic findings, simultaneous chronic and acute myelocytic leukemias were diagnosed rather than a blastic phase of a chronic myelocytic leukemia.
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MESH Headings
- Aged
- Bone Marrow/physiology
- Chromosome Aberrations
- Chromosomes, Human
- Cytogenetic Analysis
- Diagnosis, Differential
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Male
- Philadelphia Chromosome
- Translocation, Genetic
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Affiliation(s)
- L Harder
- Institut für Humangenetik, Universitätsklinikum, Kiel, Germany.
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33
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Kruger S, Weitsch G, Buttner H, Matthiensen A, Bohmer T, Marquardt T, Sayk F, Feller A, Bohle A. Overexpression of c-erbB-2 oncoprotein in muscle-invasive bladder carcinoma: relationship with gene amplification, clinicopathological parameters and prognostic outcome. Int J Oncol 2002. [DOI: 10.3892/ijo.21.5.981] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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34
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Chedid A, Sung CC, Lepe MR, Ahmed SA, Iftikhar SA, Feller A, Beaman KD. Expression of a novel protein by regenerating hepatocytes and peripheral blood lymphocytes. Clin Diagn Lab Immunol 2001; 8:1292-4. [PMID: 11687481 PMCID: PMC96267 DOI: 10.1128/cdli.8.6.1292-1294.2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Regeneration and tolerance factor (RTF) is a protein with immunosuppressive activity and is normally present in the thymus and placenta. RTF was measured in the livers of patients with regenerating nodules due to alcoholic cirrhosis and hepatitis C. RTF was expressed in the regenerating nodules of 26 patients with alcoholic cirrhosis. All patients with chronic hepatitis C without cirrhosis failed to express RTF. Flow cytometry revealed upregulation of RTF on the lymphocytes from alcoholic cirrhosis and downregulation in hepatitis C disease.
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Affiliation(s)
- A Chedid
- Department of Pathology, Finch University of Health Sciences/Chicago Medical School and Veterans Affairs Medical Center, North Chicago, Illinois 60064, USA
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35
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Abstract
Changes in systolic blood pressure following the consumption of a standard meal were measured. We hypothesized that larger postprandial drops in systolic blood pressure would be associated with elevated subsyndromal depressive symptomatology. Following an overnight fast, individuals consumed a liquid meal. Blood pressure and pulse were measured preprandially and during the 90-min postprandial period. Several days later, individuals completed a test for depression. Men and women, patients and caregivers, aged 51 to 82 years, were recruited at an outpatient geriatric day care center. Measurements included systolic and diastolic blood pressures, pulse, and Zung Self-Rating Depression Scale. Results showed that the larger the drop in systolic blood pressure, the higher level of somatic depressive symptomatology. This is the first study to identify depressive symptomatology associated with postprandial systolic blood pressure. These results parallel those reported by Perlmuter and Greenberg (Experimental Aging Research, 22, 325-341, 1996) showing that orthostatic changes in systolic blood pressure were associated with elevated subsyndromal depression.
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Affiliation(s)
- S Schwartz
- Department of Psychology, Finch University of Health Sciences, Chicago Medical School, 3333 Green Bay Road, North Chicago, IL 60064, USA
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36
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Kluin PM, Feller A, Gaulard P, Jaffe ES, Meijer CJ, Müller-Hermelink HK, Pileri S. Peripheral T/NK-cell lymphoma: a report of the IXth Workshop of the European Association for Haematopathology. Histopathology 2001; 38:250-70. [PMID: 11260307 DOI: 10.1046/j.1365-2559.2001.01058.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [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]
Abstract
AIMS In April 1998, The European Association for Haematopathology organized the IXth workshop on peripheral T-cell and NK-cell lymphomas and leukaemias. The workshop focused on unusual subtypes of these rare malignancies, allowing evaluation of the recently published WHO classification of neoplastic diseases of the lymphoid tissues. METHODS AND RESULTS One-hundred and three cases were centrally immunophenotyped and hybridized for EBER1/2 of Epstein--Barr virus. All cases were reviewed by a panel of experienced haematopathologists and classified according to the new WHO classification for lymphoid neoplasms. Three cases were considered as precursor T-cell and 95 cases as peripheral T/NK-cell lymphoma/leukaemia. Although the cases represented a selected series of unusual cases, the following conclusions could be made: (i) Most lymphomas except the hepatosplenic gamma/delta T-cell lymphomas showed a rather broad morphological spectrum, with differences both between and within individual tumours. (ii) This heterogeneity was also reflected by the immunophenotype, for instance a variable expression of CD30 was found in many enteropathy type T-cell lymphomas. (iii) Exceptions in phenotype were regularly found in almost all categories, indicating that phenotype should not be the final determining factor in classification. (iv) The great majority of T-cell lymphomas expressed the alpha/beta T-cell receptor, with the exception of all but one hepatosplenic T-cell lymphomas and a few other extranodal peripheral T cell lymphomas. (v) Malignancies of precursor cells, blastic NK-cell lymphoma/leukaemia, adult T-cell lymphoma/leukaemia and most AIL-type T-cell lymphomas did not express cytotoxic molecules such as TIA1 and granzyme-B. In contrast, all five aggressive NK/T-cell lymphomas/leukaemias, a single case of large granular lymphocyte leukaemia and 40 of 47 primary extranodal lymphoma/leukaemias expressed these molecules. In hepatosplenic gamma/delta T-cell lymphoma, five of six cases showed expression of TIA1 but not of granzyme-B. (vi) Seven tumours developed after organ-transplant, four cases being EBV-positive. No distinct phenotype could be attributed to these cases. CONCLUSIONS Most peripheral T/NK cell lymphomas could be categorized as distinct entities as described in the recently proposed WHO classification for lymphoid neoplasms.
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MESH Headings
- Adult
- Child, Preschool
- Female
- Humans
- Immunoblastic Lymphadenopathy/genetics
- Immunoblastic Lymphadenopathy/immunology
- Immunoblastic Lymphadenopathy/pathology
- Immunochemistry
- Immunophenotyping
- Intestinal Neoplasms/genetics
- Intestinal Neoplasms/immunology
- Intestinal Neoplasms/pathology
- Killer Cells, Natural/immunology
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Non-Hodgkin/classification
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/immunology
- Lymphoma, Non-Hodgkin/pathology
- Male
- Middle Aged
- RNA, Viral/genetics
- Skin Neoplasms/genetics
- Skin Neoplasms/immunology
- Skin Neoplasms/pathology
- T-Lymphocytes/immunology
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Affiliation(s)
- P M Kluin
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
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37
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El Alami M, Feller A, Piérard A, Dubois E. Characterisation of a tripartite nuclear localisation sequence in the regulatory protein Lys14 of Saccharomyces cerevisiae. Curr Genet 2000; 38:78-86. [PMID: 10975256 DOI: 10.1007/s002940000134] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/30/2022]
Abstract
The Lys14 regulatory protein of Saccharomyces cerevisiae activates the expression of the LYS genes involved in the lysine biosynthetic pathway. Studies with a fused Lys14-green fluorescent protein reveal that Lys14p is localised to the nucleus, even under growth conditions leading to the absence of LYS gene expression. Lys14p nuclear localisation is mediated by a tripartite sequence made up of three short basic motifs located on the C-terminal side of the Zn cluster domain of Lys14p. Substitution of basic residues by alanines in any of the three motifs partially prevents the nuclear import of the protein. Simultaneous mutations in the three basic domains are required to completely abolish the entry into the nucleus and to impair the Lys14 function.
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Affiliation(s)
- M El Alami
- Laboratoire de Microbiologie, Faculté des Sciences, Université Libre de Bruxelles and Institut de Recherches Microbiologiques Jean-Marie Wiame, Belgium
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38
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Kühnert M, Schmidt S, Feller A, Vonderheit KHKH. Sectio caesarea: ein harmloser Eingriff aus mütterlicher Sicht? - Cesarean Section: A Harmless Operation for the Mother? -. Geburtshilfe Frauenheilkd 2000. [DOI: 10.1055/s-2000-7390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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39
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Sung CC, Boomer JS, Givens TS, DuChateau BK, Lepe MR, Feller A, Westerman MP, Gilman-Sachs A, Chedid A, Beaman KD. Expression of regeneration and tolerance factor correlates directly with human immunodeficiency virus infection and inversely with hepatitis C virus infection. Clin Diagn Lab Immunol 2000; 7:200-5. [PMID: 10702493 PMCID: PMC95849 DOI: 10.1128/cdli.7.2.200-205.2000] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Hepatitis C virus (HCV) and human immunodeficiency virus (HIV) cause two of the most prevalent debilitating viral infections. HIV appears to induce a skewing toward a Th2 response, while in HCV infection a Th1 response appears to dominate. Regeneration and tolerance factor (RTF) may participate in driving or sustaining a Th2 cytokine response. The expression of RTF on CD3(+) T cells of HIV-seropositive (HIV(+)) individuals is increased. The purpose of this study was to compare the expression of RTF during HIV infections with that during HCV infections. Three-color flow-cytometric analysis of peripheral blood collected from HIV(+) HCV-seropositive (HCV(+)), HIV- and HCV-seropositive (HIV(+) HCV(+)), and HIV- and HCV-seronegative (HIV(-) HCV(-)) individuals was performed. Levels of RTF expression on T-lymphocyte subsets from these groups were compared, as were levels of RTF expression on activated T cells expressing CD38 and HLA-DR, to determine the relationship of RTF expression to these infections. We demonstrated that the expression of RTF on surfaces of T cells from HIV(+) individuals is upregulated and that its expression on T cells from HCV(+) individuals is downregulated. A twofold increase in the mean channel fluorescence of RTF on CD3(+) T cells was seen in both HIV(+) and HIV(+) HCV(+) individuals compared to HIV(-) HCV(-) individuals. HCV(+) individuals had lower levels of RTF expression than HIV(-) HCV(-) individuals (P < 0.005 for CD4(+); P < 0.0005 for CD8(+)). In terms of percentages of T cells expressing RTF, the groups were ranked as follows: HIV(+) > HIV(+) HCV(+) > HIV(-) HCV(-) > HCV(+). The results indicate that RTF expression correlates with HIV-associated immune activation and may be associated with Th2-type responses.
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Affiliation(s)
- C C Sung
- Clinical Immunology Laboratory, Department of Microbiology and Immunology, North Chicago, Illinois 60064, USA
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40
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Reddy V, Kruss D, Feller A, Singh SK. Self-expanding metallic stent for the palliation of malignant esophageal obstruction complicated by vertebral erosion and esophagorespiratory fistula. Gastrointest Endosc 2000; 51:83-5. [PMID: 10625806 DOI: 10.1016/s0016-5107(00)70394-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- V Reddy
- Department of Medicine, GI Section, the Finch University of Health Sciences/The Chicago Medical School, IL, USA
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Schlegelberger B, Zwingers T, Harder L, Nowotny H, Siebert R, Vesely M, Bartels H, Sonnen R, Hopfinger G, Nader A, Ott G, Müller-Hermelink K, Feller A, Heinz R. Clinicopathogenetic significance of chromosomal abnormalities in patients with blastic peripheral B-cell lymphoma. Kiel-Wien-Lymphoma Study Group. Blood 1999; 94:3114-20. [PMID: 10556197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
So far, reproducible histomorphologic and immunological criteria to distinguish clinicopathologic subtypes of blastic peripheral B-cell non-Hodgkin's lymphoma (BBCL), especially centroblastic (cb) and immunoblastic (ib) lymphomas, for daily diagnostic use are still lacking. Therefore, we correlated the cytogenetic findings in 126 patients with BBCL with histopathologic diagnoses. Subclassification of cb and ib lymphomas relied on the criteria defined in the updated Kiel classification; these subtypes are also listed in the Revised European-American Lymphoma (REAL) classification and in a preliminary report on the newly established World Health Organization classification, to investigate their clinical significance. Moreover, we performed a multivariate analysis to compare the prognostic significance of cytogenetic findings with the International Index. There were significant differences in the frequency of chromosome aberrations between different BBCL subtypes: t(8;14) was predominantly present in Burkitt's lymphomas, t(14;18) in centroblastic lymphomas, deletions in 8q and 14q, changes of 4q and losses of chromosome 10 in immunoblastic lymphomas; t(11;14) was restricted to blastoid mantle cell lymphomas and associated with a poor prognosis. In cb lymphomas, deletions in 1q42-qter, duplications in 1q23-32, trisomy 5, and changes of 15q were identified as independent prognostic factors. In ib lymphomas, changes of 7q and 8q had stronger impact on survival than the International Index. These findings underline that Burkitt's, cb, ib, and blastoid mantle-cell lymphoma are biologically distinct and clinically relevant entities and that cytogenetic findings can be helpful to subtype BBCL.
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Abstract
One million individuals in the United States alone are estimated to be current or past users of anabolic-androgenic steroids. In the United States fifty-percent of anabolic-androgenic steroid users administer their compounds intramuscularly, and twenty-five percent of adolescent anabolic-androgenic steroid users share needles, placing these young adults at risk for infections related to injection. To examine the medical literature for reports of infections attributable to anabolic-androgenic steroids, we conducted a MEDLINE (1966-1998) and AIDSLINE (1980-1998) world literature review to examine all references that attributed infections to anabolic-androgenic steroid injection. Infections associated with anabolic-androgenic steroid injection include three cases of HIV, one case of hepatitis B, one case of hepatitis C, eight abscesses, and a case of fungal endophthalmitis. No cross-sectional or prospective studies exist that document the risk of infections related to anabolic-androgenic steroid injection. These serious infectious complications of anabolic-androgenic steroid injection may be avoided with education and prevention techniques. Infections occurring in anabolic-androgenic steroid users are not as common as in intravenous drug users.
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Affiliation(s)
- J D Rich
- The Miriam Hospital and Brown University, Providence, Rhode Island 02906, USA.
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Penson R, Kronish K, Duan Z, Feller A, Stark P, Cook S, Duska L, Fuller A, Goodman A, Nikrui N, MacNeill K, Matulonis U, Preffer F, Seiden M. Cytokines IL-1b, IL-2, IL-6, IL-8, MCP-1, GM-CSF and TNFa in patients with epithelial ovarian cancer and their relationship to treatment with paclitaxel. Eur J Cancer 1999. [DOI: 10.1016/s0959-8049(99)81362-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Feller A, Ramos F, Piérard A, Dubois E. In Saccharomyces cerevisae, feedback inhibition of homocitrate synthase isoenzymes by lysine modulates the activation of LYS gene expression by Lys14p. Eur J Biochem 1999; 261:163-70. [PMID: 10103047 DOI: 10.1046/j.1432-1327.1999.00262.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Expression of the structural genes for lysine biosynthesis responds to an induction mechanism mediated by the transcriptional activator Lys14p in the presence of alpha-aminoadipate semialdehyde (alphaAASA), an intermediate of the pathway acting as a coinducer. This activation is reduced by the presence of lysine in the growth medium, leading to apparent repression. In this report we demonstrate that Saccharomyces cerevisiae possesses two genes, LYS20 and LYS21, encoding two homocitrate synthase isoenzymes which are located in the nucleus. Each isoform is inhibited by lysine with a different sensitivity. Lysine-overproducing mutants were isolated as resistant to aminoethylcysteine, a toxic lysine analog. Mutations, LYS20fbr and LYS21fbr, are allelic to LYS20 and LYS21, and lead to desensitization of homocitrate synthase activity towards lysine and to a loss of apparent repression by this amino acid. There is a fair correlation between the I0.5 of homocitrate synthase for lysine, the intracellular lysine pool and the levels of Lys enzymes, confirming the importance of the activity control of the first step of the pathway for the expression of LYS genes. The data are consistent with the conclusion that inhibition by lysine of Lys14p activation results from the control of alphaAASA production through the feedback inhibition of homocitrate synthase activity.
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Affiliation(s)
- A Feller
- Laboratoire de Microbiologie, Faculté des Sciences, Université Libre de Bruxelles, Institut de Recherches Microbiologiques Jean-Marie Wiame, Brussels, Belgium
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Mylonakis E, Dickinson B, Feller A, Sweeney J, Schiffman FJ, Rich J, Flanigan T. Combination antiretroviral therapy including a protease inhibitor eliminated the transfusion requirements of HIV-infected individuals with anemia of chronic disease. J Acquir Immune Defic Syndr Hum Retrovirol 1998; 19:306-7. [PMID: 9803974 DOI: 10.1097/00042560-199811010-00014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Becker B, Feller A, el Alami M, Dubois E, Piérard A. A nonameric core sequence is required upstream of the LYS genes of Saccharomyces cerevisiae for Lys14p-mediated activation and apparent repression by lysine. Mol Microbiol 1998; 29:151-63. [PMID: 9701810 DOI: 10.1046/j.1365-2958.1998.00916.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [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: 11/20/2022]
Abstract
The expression of the structural genes for lysine (LYS) biosynthesis is controlled by a pathway-specific regulation mediated by the transcriptional activator Lys14 in the presence of alpha-aminoadipate semialdehyde, an intermediate of the pathway acting as a co-inducer. Owing to end product inhibition of the first step of the pathway, excess lysine reduces the production of the co-inducer and causes apparent repression of the LYS genes. Analysis of LYS promoters and insertions within an heterologous reporter gene have allowed the characterization of an upstream activating element (UASLYS) able to confer Lys14- and alpha-amino-adipate semialdehyde-dependent activation as well as apparent repression by lysine to another yeast gene. This DNA motif is present as one of several copies in the promoters of at least six LYS genes. The consensus sequence derived from the comparison of the UASLYS showing the highest activation capacities comprises the nonameric core sequence TCCRNYGGA. The RNY sequence of the 3 bp spacer as well as the presence of flanking AT-rich regions on both sides of the core sequence appear essential for optimal activation. Further evidence that this element is the target of Lys14p was provided by the demonstration that Lys14p binds to UASLYS in vitro. The binding is independent of the presence of the co-inducer and is not affected by lysine. It depends on the integrity of the putative Zn(II)2Cys6 binuclear cluster contained in the Lys14p.
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Affiliation(s)
- B Becker
- Laboratoire de Microbiologie, Faculté des Sciences, Université Libre de Bruxelles, Brussels, Belgium
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Feller A, Ramos F, Piérard A, Dubois E. Lys80p of Saccharomyces cerevisiae, previously proposed as a specific repressor of LYS genes, is a pleiotropic regulatory factor identical to Mks1p. Yeast 1997; 13:1337-46. [PMID: 9392078 DOI: 10.1002/(sici)1097-0061(199711)13:14<1337::aid-yea186>3.0.co;2-o] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.3] [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: 02/05/2023] Open
Abstract
In Saccharomyces cerevisiae, an intermediate of the lysine pathway, alpha-aminoadipate semialdehyde (alpha AASA), acts as a coinducer for the transcriptional activation of LYS genes by Lys14p. The limitation of the production of this intermediate through feedback inhibition of the first step of the pathway results in apparent repression by lysine. Previously, the lys80 mutations, reducing the lysine repression and increasing the production of lysine, were interpreted as impairing a repressor of LYS genes expression. In order to understand the role of Lys80p in the control of the lysine pathway, we have analysed the effects of mutations epistatic to lys80 mutations. The effects of lys80 mutations on LYS genes expression were dependent on the integrity of the activation system (Lys14p and alpha AASA). The increased production of lysine in lys80 mutants appeared to result from an improvement of the metabolic flux through the pathway and was correlated to an increase of the alpha-ketoglutarate pool and of the level of several enzymes of the tricarboxylic acid cycle. The LYS80 genes has been cloned and sequenced; it turned out to be identical to gene MKS1 cloned as a gene encoding a negative regulator of the RAS-cAMP pathway. We conclude that Lys80p is a pleiotropic regulatory factor rather than a specific repressor of LYS genes.
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Affiliation(s)
- A Feller
- Laboratoire de Microbiologie, Faculté des Sciences, Université Libre de Bruxelles, Belgium
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Affiliation(s)
- A Feller
- Graduate School of Biomedical Sciences, Bryn Mawr College, PA, USA
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Abstract
In Saccharomyces cerevisiae, most of the LYS structural genes have been identified except the genes encoding homocitrate synthase and alpha-aminoadipate aminotransferase. Expression of several LYS genes responds to an induction mechanism mediated by the product of LYS14 and an intermediate of the pathway, alpha-aminoadipate semialdehyde (alpha AASA) as an inducer. This activation is modulated by the presence of lysine in the growth medium leading to an apparent repression. Since the first enzyme of the pathway, homocitrate synthase, is feedback inhibited by lysine, it could be a major element in the control of alpha AASA supply. During the sequencing of chromosome IV of S. cerevisiae, the sequence of ORF D1298 showing a significant similarity with the nifV gene of Azotobacter vinelandii was reported. Disruption and overexpression of ORF D1298 demonstrate that this gene, named LYS20, encodes a homocitrate synthase. The disrupted segregants are able to grow on minimal medium and exhibit reduced but significant homocitrate synthase indicating that this activity is catalysed by at least two isoenzymes. We have also shown that the product of LYS20 is responsible for the greater part of the lysine production. The different isoforms are sensitive to inhibition by lysine but only the expression of LYS20 is strongly repressed by lysine. The N-terminal end of homocitrate synthase isoform coded by LYS20 contains no typical mitochondrial targeting sequence, suggesting that this enzyme is not located in the mitochondria.
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Affiliation(s)
- F Ramos
- Institut de Recherches du CERIA, Faculté des Sciences, Université Libre de Bruxelles, Bruxelles, Belgium
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