1
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Naef P, Radpour R, Jaeger-Ruckstuhl CA, Bodmer N, Baerlocher GM, Doehner H, Doehner K, Riether C, Ochsenbein AF. IL-33-ST2 signaling promotes stemness in subtypes of myeloid leukemia cells through the Wnt and Notch pathways. Sci Signal 2023; 16:eadd7705. [PMID: 37643244 DOI: 10.1126/scisignal.add7705] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/02/2022] [Accepted: 08/10/2023] [Indexed: 08/31/2023]
Abstract
Cell stemness is characterized by quiescence, pluripotency, and long-term self-renewal capacity. Therapy-resistant leukemic stem cells (LSCs) are the primary cause of relapse in patients with chronic and acute myeloid leukemia (CML and AML). However, the same signaling pathways frequently support stemness in both LSCs and normal hematopoietic stem cells (HSCs), making LSCs difficult to therapeutically target. In cell lines and patient samples, we found that interleukin-33 (IL-33) signaling promoted stemness only in leukemia cells in a subtype-specific manner. The IL-33 receptor ST2 was abundant on the surfaces of CD34+ BCR/ABL1 CML and CD34+ AML cells harboring AML1/ETO and DEK/NUP214 translocations or deletion of chromosome 9q [del(9q)]. The cell surface abundance of ST2, which was lower or absent on other leukemia subtypes and HSCs, correlated with stemness, activated Wnt signaling, and repressed Notch signaling. IL-33-ST2 signaling promoted the maintenance and expansion of AML1/ETO-, DEK/NUP214-, and BCR/ABL1-positive LSCs in culture and in mice by activating Wnt, MAPK, and NF-κB signaling. Wnt signaling and its inhibition of the Notch pathway up-regulated the expression of the gene encoding ST2, thus forming a cell-autonomous loop. IL-33-ST2 signaling promoted the resistance of CML cells to the tyrosine kinase inhibitor (TKI) nilotinib and of AML cells to standard chemotherapy. Thus, inhibiting IL-33-ST2 signaling may target LSCs to overcome resistance to chemotherapy or TKIs in these subtypes of leukemia.
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Affiliation(s)
- Pascal Naef
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
- Tumor Immunology, Department for BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
- Graduate School of Cellular and Biomedical Sciences, University of Bern, Bern 3012, Switzerland
| | - Ramin Radpour
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
- Tumor Immunology, Department for BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
| | - Carla A Jaeger-Ruckstuhl
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
- Tumor Immunology, Department for BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
| | - Nils Bodmer
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
- Tumor Immunology, Department for BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
| | - Gabriela M Baerlocher
- Laboratory for Hematopoiesis and Molecular Genetics, Experimental Hematology, Department of BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
| | - Hartmut Doehner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm 89081, Germany
| | - Konstanze Doehner
- Department of Internal Medicine III, University Hospital of Ulm, Ulm 89081, Germany
| | - Carsten Riether
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
- Tumor Immunology, Department for BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
| | - Adrian F Ochsenbein
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern 3010, Switzerland
- Tumor Immunology, Department for BioMedical Research (DBMR), University of Bern, Bern 3008, Switzerland
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2
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Haubitz M, von Petersdorff VS, Helsen I, Brunold C, Oppliger Leibundgut E, Baerlocher GM. Higher Age (≥60 Years) Increases the Risk for Adverse Events during Autologous Hematopoietic Stem Cell Transplantation. Cancers (Basel) 2023; 15:cancers15051584. [PMID: 36900376 PMCID: PMC10000699 DOI: 10.3390/cancers15051584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
Autologous hematopoietic stem cell transplantation (autoHSCT) is a standard of care for patients with hemato-oncologic diseases. This procedure is highly regulated, and a quality assurance system needs to be in place. Deviations from defined processes and outcomes are reported as adverse events (AEs: any untoward medical occurrence temporally associated with an intervention that may or may not have a causal relationship), including adverse reactions (ARs: a response to a medicinal product which is noxious and unintended). Only a few reports on AEs cover the procedure of autoHSCT from collection until infusion. Our aim was to investigate the occurrence and severity of AEs in a large data set of patients who were treated by autoHSCT. In this retrospective, observational, single-center study on 449 adult patients during the years 2016-2019, AEs occurred in 19.6% of the patients. However, only 6.0% of patients had ARs, which is a low rate compared to the percentages (13.5-56.9%) found in other studies; 25.8% of the AEs were serious and 57.5% were potentially serious. Larger leukapheresis volumes, lower numbers of collected CD34+ cells and larger transplant volumes significantly correlated with the occurrence and number of AEs. Importantly, we found more AEs in patients >60 years (see graphical abstract). By preventing potentially serious AEs of quality and procedural issues, AEs could be reduced by 36.7%. Our results provide a broad view on AEs and point out steps and parameters for the potential optimization of the autoHSCT procedure, especially in elderly patients.
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Affiliation(s)
- Monika Haubitz
- Laboratory for Hematopoiesis and Molecular Genetics, Experimental Hematology, Department for BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Vittoria S. von Petersdorff
- Laboratory for Hematopoiesis and Molecular Genetics, Experimental Hematology, Department for BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Ingrid Helsen
- Laboratory for Hematopoiesis and Molecular Genetics, Experimental Hematology, Department for BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
| | - Claudio Brunold
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Elisabeth Oppliger Leibundgut
- Laboratory for Hematopoiesis and Molecular Genetics, Experimental Hematology, Department for BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Gabriela M. Baerlocher
- Laboratory for Hematopoiesis and Molecular Genetics, Experimental Hematology, Department for BioMedical Research (DBMR), University of Bern, 3008 Bern, Switzerland
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Correspondence:
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3
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Haas Q, Markov N, Muerner L, Rubino V, Benjak A, Haubitz M, Baerlocher GM, Ng CKY, Münz C, Riether C, Ochsenbein AF, Simon HU, von Gunten S. Siglec-7 represents a glyco-immune checkpoint for non-exhausted effector memory CD8+ T cells with high functional and metabolic capacities. Front Immunol 2022; 13:996746. [PMID: 36211376 PMCID: PMC9540514 DOI: 10.3389/fimmu.2022.996746] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 07/18/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
While inhibitory Siglec receptors are known to regulate myeloid cells, less is known about their expression and function in lymphocytes subsets. Here we identified Siglec-7 as a glyco-immune checkpoint expressed on non-exhausted effector memory CD8+ T cells that exhibit high functional and metabolic capacities. Seahorse analysis revealed higher basal respiration and glycolysis levels of Siglec-7+ CD8+ T cells in steady state, and particularly upon activation. Siglec-7 polarization into the T cell immune synapse was dependent on sialoglycan interactions in trans and prevented actin polarization and effective T cell responses. Siglec-7 ligands were found to be expressed on both leukemic stem cells and acute myeloid leukemia (AML) cells suggesting the occurrence of glyco-immune checkpoints for Siglec-7+ CD8+ T cells, which were found in patients’ peripheral blood and bone marrow. Our findings project Siglec-7 as a glyco-immune checkpoint and therapeutic target for T cell-driven disorders and cancer.
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Affiliation(s)
- Quentin Haas
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Nikita Markov
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Lukas Muerner
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- Bern Center for Precision Medicine (BCPM), University of Bern, Bern, Switzerland
| | - Viviana Rubino
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Andrej Benjak
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Monika Haubitz
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
- Experimental Hematology, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Gabriela M. Baerlocher
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
- Experimental Hematology, Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Charlotte K. Y. Ng
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Christian Münz
- Viral Immunobiology, Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Carsten Riether
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Adrian F. Ochsenbein
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Hans-Uwe Simon
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Department of Clinical Immunology and Allergology, Sechenov University, Moscow, Russia
- Laboratory of Molecular Immunology, Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia
- Institute of Biochemistry, Brandenburg Medical School, Neuruppin, Germany
| | - Stephan von Gunten
- Institute of Pharmacology, University of Bern, Bern, Switzerland
- Bern Center for Precision Medicine (BCPM), University of Bern, Bern, Switzerland
- *Correspondence: Stephan von Gunten,
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4
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Coukos A, Daccord C, Lazor R, Blum S, Naveiras O, Unger S, Vionnet J, Gaide O, Koutsokera A, Moschouri E, Sempoux C, Good JM, Moradpour D, Baerlocher GM, Fraga M. [Short telomere syndrome in adults: a rare entity that should be evoked]. Rev Med Suisse 2022; 18:1606-1613. [PMID: 36047552 DOI: 10.53738/revmed.2022.18.793.1606] [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: 06/15/2023]
Abstract
Short telomere syndrome (STS) is a group of rare, often underrecognized, diseases caused by defects in telomere-maintenance genes, leading to abnormal telomere shortening and associated with diverse multi-organ manifestations. In pediatric patients, STS typically presents with mucocutaneous or gastrointestinal lesions, bone marrow failure and neoplasia. In adulthood, aplastic bone marrow disease, liver disease and pulmonary fibrosis are classic clinical manifestations. At present, medical treatment options for STS remain limited. Danazol, a synthetic androgenic hormone, can slow down telomere shortening and thus limit the progression of the disease. Finally, hematopoietic, hepatic and pulmonary transplantation, sometimes combined, may be discussed in a multidisciplinary setting in certain situations.
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Affiliation(s)
- Alexander Coukos
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Cécile Daccord
- Service de pneumologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Romain Lazor
- Service de pneumologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Sabine Blum
- Service d'hématologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olaia Naveiras
- Service d'hématologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
- Département des sciences biomédicales, Faculté de biologie et de médecine, Université de Lausanne, 1011 Lausanne
| | - Sheila Unger
- Service de médecine génétique, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Julien Vionnet
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
- Centre de transplantation d'organes, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Olivier Gaide
- Service de dermatologie et vénéréologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Angela Koutsokera
- Service de pneumologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Eleni Moschouri
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Christine Sempoux
- Service de pathologie clinique, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Jean-Marc Good
- Service de médecine génétique, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Darius Moradpour
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
| | - Gabriela M Baerlocher
- Laboratoire d'hématopoïèse et de génétique moléculaire, Université de Berne, 3012 Berne
| | - Montserrat Fraga
- Service de gastroentérologie et d'hépatologie, Centre hospitalier universitaire vaudois et Université de Lausanne, 1011 Lausanne
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5
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Egeli DB, Hanfstein B, Lauseker M, Pfirrmann M, Saussele S, Baerlocher GM, Müller MC. SOCS-2 gene expression at diagnosis does not predict for outcome of chronic myeloid leukemia patients on imatinib treatment. Leuk Lymphoma 2021; 63:955-962. [PMID: 34872441 DOI: 10.1080/10428194.2021.2010059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
SOCS-2 gene expression at diagnosis has been suggested as a predictor of clinical outcome in chronic myeloid leukemia (CML). In this study SOCS-2 and GUS expression levels were determined by real-time PCR in pretherapeutic samples at diagnosis. First, three patient groups were compared after assessment at 48 months: optimal molecular responders (n = 35), patients with resistance to imatinib (n = 28), and blast crisis patients (n = 27). A significant difference in SOCS-2 gene expression at diagnosis was observed comparing blast crisis vs. resistant patients (p = 0.042) and optimal responders (p = 0.010). Second, a validation sample of consecutively randomized patients (n = 123) was investigated. No discriminative SOCS-2 gene expression cutoff could be derived to predict molecular or cytogenetic response, progression-free or overall survival. Although SOCS-2 gene was differentially expressed at the time of diagnosis in blast crisis patients when compared to other groups, a prognostic impact in consecutively randomized patients was not observed.
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Affiliation(s)
- Damla Buket Egeli
- III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Benjamin Hanfstein
- III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Susanne Saussele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Gabriela M Baerlocher
- Department of BioMedical Research and Department of Hematology and Central Hematology Department, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Martin C Müller
- Institute for Hematology and Oncology (IHO GmbH), Mannheim, Germany
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6
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Hinterbrandner M, Rubino V, Stoll C, Forster S, Schnüriger N, Radpour R, Baerlocher GM, Ochsenbein AF, Riether C. Tnfrsf4-expressing regulatory T cells promote immune escape of chronic myeloid leukemia stem cells. JCI Insight 2021; 6:151797. [PMID: 34727093 PMCID: PMC8675189 DOI: 10.1172/jci.insight.151797] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/27/2021] [Indexed: 11/17/2022] Open
Abstract
Leukemia stem cells (LSCs) promote the disease and seem resistant to therapy and immune control. Why LSCs are selectively resistant against elimination by CD8+ cytotoxic T cells (CTLs) is still unknown. In this study, we demonstrate that LSCs in chronic myeloid leukemia (CML) can be recognized and killed by CD8+ CTLs in vitro. However, Tregs, which preferentially localized close to CD8+ CTLs in CML BM, protected LSCs from MHC class I–dependent CD8+ CTL–mediated elimination in vivo. BM Tregs in CML were characterized by the selective expression of tumor necrosis factor receptor 4 (Tnfrsf4). Stimulation of Tnfrsf4 signaling did not deplete Tregs but reduced the capacity of Tregs to protect LSCs from CD8+ CTL–mediated killing. In the BM of newly diagnosed CML patients, TNFRSF4 mRNA levels were significantly increased and correlated with the expression of the Treg-restricted transcription factor FOXP3. Overall, these results identify Tregs as key regulators of immune escape of LSCs and TNFRSF4 as a potential target to reduce the function of Tregs and boost antileukemic immunity in CML.
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Affiliation(s)
| | - Viviana Rubino
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Carina Stoll
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Stefan Forster
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Noah Schnüriger
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Ramin Radpour
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | | | | | - Carsten Riether
- Department for BioMedical Research, University of Bern, Bern, Switzerland
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7
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Oppliger Leibundgut E, Haubitz M, Burington B, Ottmann OG, Spitzer G, Odenike O, McDevitt MA, Röth A, Snyder DS, Baerlocher GM. Dynamics of mutations in patients with essential thrombocythemia treated with imetelstat. Haematologica 2021; 106:2397-2404. [PMID: 32732354 PMCID: PMC8409045 DOI: 10.3324/haematol.2020.252817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Indexed: 01/14/2023] Open
Abstract
In a phase II study, the telomerase inhibitor imetelstat induced rapid hematologic responses in all patients with essential thrombocythemia who were refractory to or intolerant of prior therapies. Significant molecular responses were achieved within 3-6 months in 81% of patients with phenotypic driver mutations in JAK2, CALR and MPL. Here, we investigated the dynamics of additional somatic mutations in response to imetelstat. At study entry, 50% of patients carried one to five additional mutations in the genes ASXL1, CBL, DNMT3A, EZH2, IDH1, SF3B1, TET2, TP53 and U2AF1. Three patients with baseline mutations also had late-emerging mutations in TP53, IDH1 and TET2. Most clones with additional mutations were responsive to imetelstat and decreased with the driver mutation, including the poor prognostic ASXL1, EZH2 and U2AF1 mutations, while SF3B1 and TP53 mutations were associated with poorer molecular response. Overall, phenotypic driver mutation response was significantly deeper in patients without additional mutations (P=0.04) and correlated with longer duration of response. In conclusion, this detailed molecular analysis of heavily pretreated and partly resistant patients with essential thrombocythemia reveals a high individual patient complexity. Moreover, imetelstat demonstrates potential to inhibit efficiently co-incident mutations occurring in neoplastic clones in patients with essential thrombocythemia. (ClinicalTrials.gov number, NCT01243073).
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Affiliation(s)
| | - Monika Haubitz
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | | | - Oliver G Ottmann
- Department of Haematology, Cardiff University, Cardiff, United Kingdom
| | | | | | - Michael A McDevitt
- Divisions of Hematology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander Röth
- Department of Hematology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - David S Snyder
- Gehr Family Center for Leukemia Research, City of Hope National Medical Center, Duarte, CA, USA
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8
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Damonti L, Buetti N, Droz S, Bacher U, Pabst T, Taleghani BM, Baerlocher GM, Marschall J. Prevalence and significance of bacterial contamination of autologous stem cell products. J Hosp Infect 2021; 114:175-179. [PMID: 33864895 DOI: 10.1016/j.jhin.2021.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/06/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
There is limited and conflicting information on the prevalence of contamination of haematopoietic stem and progenitor cell products (HPCPs), and their optimal management remains unclear. The authors reviewed the microbial surveillance data of HPCPs collected between January 2002 and December 2019 for autologous transplantation at the study institution to determine the prevalence of microbial contamination and the potential infectious complications among recipients. Among 3935 HPCPs, 25 (0.6%) were contaminated. Ultimately, 22 patients received contaminated grafts, with pre-emptive antimicrobial therapy initiated in six of these patients. No patients developed subsequent infectious complications. These data suggest that microbial contamination of autologous HPCPs and associated adverse outcomes are rare.
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Affiliation(s)
- L Damonti
- Department of Infectious Diseases, Inselspital, University Hospital Bern, Bern, Switzerland; Ente Ospedaliero Cantonale, Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland.
| | - N Buetti
- Department of Infectious Diseases, Inselspital, University Hospital Bern, Bern, Switzerland; Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; UMR 1137 IAME Team 5 DeSCID: Decision Sciences in Infectious Diseases, Control and Care Inserm/University Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - S Droz
- Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - U Bacher
- Department of Haematology and Central Haematology Laboratory, Inselspital, University Hospital Bern, Bern, Switzerland
| | - T Pabst
- Department of Medical Oncology, Inselspital, University Hospital and University of Bern, Bern, Switzerland
| | - B M Taleghani
- Department of Haematology and Central Haematology Laboratory, Inselspital, University Hospital Bern, Bern, Switzerland
| | - G M Baerlocher
- Laboratory for Cellular Therapies, Department of Haematology and Central Haematology Laboratory, Inselspital, Bern University Hospital, Bern, Switzerland; Laboratory for Haematopoiesis and Molecular Genetics, Department of BioMedical Research, University of Bern, Bern, Switzerland
| | - J Marschall
- Department of Infectious Diseases, Inselspital, University Hospital Bern, Bern, Switzerland
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9
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Höpner SS, Raykova A, Radpour R, Amrein MA, Koller D, Baerlocher GM, Riether C, Ochsenbein AF. LIGHT/LTβR signaling regulates self-renewal and differentiation of hematopoietic and leukemia stem cells. Nat Commun 2021; 12:1065. [PMID: 33594067 PMCID: PMC7887212 DOI: 10.1038/s41467-021-21317-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 01/17/2021] [Indexed: 12/30/2022] Open
Abstract
The production of blood cells during steady-state and increased demand depends on the regulation of hematopoietic stem cell (HSC) self-renewal and differentiation. Similarly, the balance between self-renewal and differentiation of leukemia stem cells (LSCs) is crucial in the pathogenesis of leukemia. Here, we document that the TNF receptor superfamily member lymphotoxin-β receptor (LTβR) and its ligand LIGHT regulate quiescence and self-renewal of murine and human HSCs and LSCs. Cell-autonomous LIGHT/LTβR signaling on HSCs reduces cell cycling, promotes symmetric cell division and prevents primitive HSCs from exhaustion in serial re-transplantation experiments and genotoxic stress. LTβR deficiency reduces the numbers of LSCs and prolongs survival in a murine chronic myeloid leukemia (CML) model. Similarly, LIGHT/LTβR signaling in human G-CSF mobilized HSCs and human LSCs results in increased colony forming capacity in vitro. Thus, our results define LIGHT/LTβR signaling as an important pathway in the regulation of the self-renewal of HSCs and LSCs.
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MESH Headings
- Animals
- Antigens, CD34/metabolism
- Cell Cycle/drug effects
- Cell Cycle/genetics
- Cell Differentiation/drug effects
- Cell Proliferation/drug effects
- Cell Self Renewal/drug effects
- Cell Self Renewal/genetics
- DNA Damage
- Fluorouracil/pharmacology
- Gene Expression Regulation, Leukemic/drug effects
- Hematopoietic Stem Cells/drug effects
- Hematopoietic Stem Cells/metabolism
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Lymphotoxin beta Receptor/metabolism
- Mice, Inbred C57BL
- Mice, Knockout
- Neoplastic Stem Cells/drug effects
- Neoplastic Stem Cells/metabolism
- Neoplastic Stem Cells/pathology
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Signal Transduction/drug effects
- Tumor Necrosis Factor Ligand Superfamily Member 14/metabolism
- Mice
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Affiliation(s)
- S S Höpner
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - Ana Raykova
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - R Radpour
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - M A Amrein
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - D Koller
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - G M Baerlocher
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Riether
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department for BioMedical Research, University of Bern, Bern, Switzerland
| | - A F Ochsenbein
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Department for BioMedical Research, University of Bern, Bern, Switzerland.
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10
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Riether C, Radpour R, Kallen NM, Bürgin DT, Bachmann C, Schürch CM, Lüthi U, Arambasic M, Hoppe S, Albers CE, Baerlocher GM, Ochsenbein AF. Metoclopramide treatment blocks CD93-signaling-mediated self-renewal of chronic myeloid leukemia stem cells. Cell Rep 2021; 34:108663. [PMID: 33503440 DOI: 10.1016/j.celrep.2020.108663] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 11/20/2020] [Accepted: 12/28/2020] [Indexed: 12/17/2022] Open
Abstract
Self-renewal is a key characteristic of leukemia stem cells (LSCs) responsible for the development and maintenance of leukemia. In this study, we identify CD93 as an important regulator of self-renewal and proliferation of murine and human LSCs, but not hematopoietic stem cells (HSCs). The intracellular domain of CD93 promotes gene transcription via the transcriptional regulator SCY1-like pseudokinase 1 independently of ligation of the extracellular domain. In a drug library screen, we identify the anti-emetic agent metoclopramide as an efficient blocker of CD93 signaling. Metoclopramide treatment reduces murine and human LSCs in vitro and prolongs survival of chronic myeloid leukemia (CML) mice through downregulation of pathways related to stemness and proliferation in LSCs. Overall, these results identify CD93 signaling as an LSC-specific regulator of self-renewal and proliferation and a targetable pathway to eliminate LSCs in CML.
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Affiliation(s)
- Carsten Riether
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.
| | - Ramin Radpour
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Nils M Kallen
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Damian T Bürgin
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Chantal Bachmann
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland; Graduate School of Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Christian M Schürch
- Baxter Laboratory for Stem Cell Biology, Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
| | - Ursina Lüthi
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Miroslav Arambasic
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Sven Hoppe
- Wirbelsäulenmedizin Bern, Hirslanden Salem-Spital, Bern, Switzerland; Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph E Albers
- Department of Orthopedic Surgery and Traumatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Gabriela M Baerlocher
- Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland; Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Adrian F Ochsenbein
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland.
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11
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Hehlmann R, Voskanyan A, Lauseker M, Pfirrmann M, Kalmanti L, Rinaldetti S, Kohlbrenner K, Haferlach C, Schlegelberger B, Fabarius A, Seifarth W, Spieß B, Wuchter P, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Burchert A, Brümmendorf TH, Hasford J, Hochhaus A, Saußele S, Baccarani M. Correction: High-risk additional chromosomal abnormalities at low blast counts herald death by CML. Leukemia 2020; 34:2823. [PMID: 32913312 PMCID: PMC7608319 DOI: 10.1038/s41375-020-01039-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Rüdiger Hehlmann
- ELN Foundation, Weinheim, Germany. .,III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany.
| | - Astghik Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - Lida Kalmanti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Sebastien Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Katharina Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - Alice Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Wolfgang Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Birgit Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Patrick Wuchter
- Institut für Transfusionsmedizin und Immunologie, Medizinische Fakultät Mannheim, Universität Heidelberg und DRK-Blutspendedienst, Mannheim, Germany
| | - Stefan Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - Hans-Jochem Kolb
- Medizinische Klinik III, Universitätsklinikum Großhadern, München, Germany
| | - Andreas Neubauer
- Klinik für Innere Medizin, Universitätsklinikum, Marburg, Germany
| | - Dieter K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | | | | | | | - Andreas Burchert
- Klinik für Innere Medizin, Universitätsklinikum, Marburg, Germany
| | | | | | - Andreas Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany
| | - Susanne Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Michele Baccarani
- Department of Hematology-Oncology, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
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12
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Baerlocher GM, Rusbuldt J, Bussolari J, Huang F. Myelosuppression in Patients Treated with the Telomerase Inhibitor Imetelstat Is Not Mediated through Activation of Toll-Like Receptors. Int J Mol Sci 2020; 21:ijms21186550. [PMID: 32911605 PMCID: PMC7555816 DOI: 10.3390/ijms21186550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 01/04/2023] Open
Abstract
Imetelstat sodium (GRN163L; hereafter, imetelstat) is a first-in-class telomerase inhibitor that has demonstrated activity in patients with myeloproliferative neoplasms (MPNs). Treatment with imetelstat has been associated with thrombocytopenia and other hematologic adverse effects that were manageable and reversible. Toll-like receptors (TLRs) are proteins that recognize pathogen-associated molecular patterns and stimulate innate immune and pro-apoptotic responses. Because imetelstat is an oligonucleotide, and some oligonucleotides can activate TLRs, we conducted an in vitro study to rule out the possibility of imetelstat-associated thrombocytopenia by off-target effects through activation of TLRs. We used HEK293 cell lines stably co-expressing a human TLR gene and an NFκB-inducible reporter to investigate whether imetelstat can activate TLR signaling. We treated the cells with imetelstat or control oligonucleotides for 20 h, and used absorbance of the culture media to calculate the reporter activity. Treatment with imetelstat within or beyond the clinically relevant concentrations had no stimulatory effect on TLR2, TLR3, TLR4, TLR5, TLR7, or TLR9. This result was not surprising since the structure of imetelstat does not meet the reported minimal structural requirements for TLR9 activation. Furthermore, imetelstat treatment of the MPN cell line HEL did not impact the expression of TLR signaling pathway target genes that are commonly induced by activation of different TLRs, whereas it significantly reduced its target gene hTERT, human telomerase reverse transcriptase, in a dose- and time-dependent manner. Hence, cytopenias, especially thrombocytopenia observed in some patients treated with imetelstat, are not mediated by off-target interactions with TLRs.
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Affiliation(s)
- Gabriela M. Baerlocher
- Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Laboratory for Hematopoiesis and Molecular Genetics, Department of BioMedical Research (DBMR), University of Bern, 3010 Bern, Switzerland
- Correspondence: ; Tel.: +41-(0)31-632-33-06; Fax: +41-(0)31-632-58-29
| | - Joshua Rusbuldt
- Janssen Research & Development, LLC, Spring House, PA 19477, USA; (J.R.); (J.B.)
| | - Jacqueline Bussolari
- Janssen Research & Development, LLC, Spring House, PA 19477, USA; (J.R.); (J.B.)
| | - Fei Huang
- Geron Corporation, Parsippany, NJ 07054, USA;
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13
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Hehlmann R, Voskanyan A, Lauseker M, Pfirrmann M, Kalmanti L, Rinaldetti S, Kohlbrenner K, Haferlach C, Schlegelberger B, Fabarius A, Seifarth W, Spieß B, Wuchter P, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Burchert A, Brümmendorf TH, Hasford J, Hochhaus A, Saußele S, Baccarani M. High-risk additional chromosomal abnormalities at low blast counts herald death by CML. Leukemia 2020; 34:2074-2086. [PMID: 32382082 PMCID: PMC7387244 DOI: 10.1038/s41375-020-0826-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/02/2020] [Accepted: 03/30/2020] [Indexed: 11/09/2022]
Abstract
Blast crisis is one of the remaining challenges in chronic myeloid leukemia (CML). Whether additional chromosomal abnormalities (ACAs) enable an earlier recognition of imminent blastic proliferation and a timelier change of treatment is unknown. One thousand five hundred and ten imatinib-treated patients with Philadelphia-chromosome-positive (Ph+) CML randomized in CML-study IV were analyzed for ACA/Ph+ and blast increase. By impact on survival, ACAs were grouped into high risk (+8, +Ph, i(17q), +17, +19, +21, 3q26.2, 11q23, -7/7q abnormalities; complex) and low risk (all other). The presence of high- and low-risk ACAs was linked to six cohorts with different blast levels (1%, 5%, 10%, 15%, 20%, and 30%) in a Cox model. One hundred and twenty-three patients displayed ACA/Ph+ (8.1%), 91 were high risk. At low blast levels (1-15%), high-risk ACA showed an increased hazard to die compared to no ACA (ratios: 3.65 in blood; 6.12 in marrow) in contrast to low-risk ACA. No effect was observed at blast levels of 20-30%. Sixty-three patients with high-risk ACA (69%) died (n = 37) or were alive after progression or progression-related transplantation (n = 26). High-risk ACA at low blast counts identify end-phase CML earlier than current diagnostic systems. Mortality was lower with earlier treatment. Cytogenetic monitoring is indicated when signs of progression surface or response to therapy is unsatisfactory.
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Affiliation(s)
- Rüdiger Hehlmann
- ELN Foundation, Weinheim, Germany.
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany.
| | - Astghik Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - Lida Kalmanti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Sebastien Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Katharina Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - Alice Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Wolfgang Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Birgit Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Patrick Wuchter
- Institut für Transfusionsmedizin und Immunologie, Medizinische Fakultät Mannheim, Universität Heidelberg und DRK-Blutspendedienst, Mannheim, Germany
| | - Stefan Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - Hans-Jochem Kolb
- Medizinische Klinik III, Universitätsklinikum Großhadern, München, Germany
| | - Andreas Neubauer
- Klinik für Innere Medizin, Universitätsklinikum, Marburg, Germany
| | - Dieter K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | | | | | | | - Andreas Burchert
- Klinik für Innere Medizin, Universitätsklinikum, Marburg, Germany
| | | | | | - Andreas Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany
| | - Susanne Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - Michele Baccarani
- Department of Hematology-Oncology, Policlinico S.Orsola-Malpighi, University of Bologna, Bologna, Italy
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14
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Shouval R, Labopin M, Bomze D, Baerlocher GM, Capria S, Blaise D, Hänel M, Forcade E, Huynh A, Saccardi R, Milone G, Zuckerman T, Reményi P, Versluis J, Esteve J, Gorin NC, Mohty M, Nagler A. Risk stratification using FLT3 and NPM1 in acute myeloid leukemia patients autografted in first complete remission. Bone Marrow Transplant 2020; 55:2244-2253. [PMID: 32388535 DOI: 10.1038/s41409-020-0936-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 11/09/2022]
Abstract
FLT3-ITD and NPM1 mutation refine prognostic stratification in acute myeloid leukemia (AML) with intermediate-risk cytogenetics. However, data on their role in patients undergoing autologous stem cell transplantation (Auto-SCT) as post-remission therapy (PRT) are limited. We therefore sought to retrospectively evaluate the role of FLT3-ITD and NPM1 in a cohort of AML patients (n = 405) with intermediate-risk cytogenetics, autografted in first complete remission (CR1). Patients were transplanted between 2000 and 2014 and reported to the European Society for Blood and Marrow Transplantation (EBMT) registry. Leukemia-free survival (LFS) was the primary outcome. Median follow-up was 5.5 years. FLT3-ITDneg/NPM1WT was the leading molecular subtype (50%), followed by FLT3-ITDneg/NPM1mut (30%). In the univariate analysis, molecular subtype was associated with LFS, overall survival (OS), and relapse incidence (RI) (p < 0.001); 5-year LFS: FLT3-ITDneg/NPM1mut 62%, FLT3-ITDpos/NPM1mut 38%, FLT3-ITDneg/NPM1WT 32%, and FLT3-ITDpos/NPM1WT 21%. At 5 years, OS and RI in the FLT3-ITDneg/NPM1mut subtype were 74% and 35%, respectively. The corresponding OS and RI in other subtypes were below 48% and over 57%. In a Cox multivariable model, molecular subtype was the strongest predictor of LFS, OS, and relapse. In conclusion, AML patients with intermediate-risk cytogenetics and FLT3-ITDneg/NPM1mut experience favorable outcomes when autografted in CR1, suggesting that Auto-SCT is a valid PRT option.
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Affiliation(s)
- Roni Shouval
- Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. .,Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
| | - Myriam Labopin
- Acute Leukemia Working Party of EBMT, Paris, France.,Université Pierre et Marie Curie, Paris, France
| | - David Bomze
- Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gabriela M Baerlocher
- Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Saveria Capria
- Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University, Policlinico Umberto I, Rome, Italy
| | - Didier Blaise
- Department of Hematology, Institut Paoli Calmettes, Marseille, France
| | - Mathias Hänel
- Department of Hematology, Oncology, Stem Cell Transplantation, Hospital Chemnitz, Chemnitz, Germany
| | - Edouard Forcade
- Hématologie Clinique et Thérapie cellulaire, CHU Bordeaux, Pessac, France
| | - Anne Huynh
- CHU Toulouse, IUCT-Oncopole, Toulouse, France
| | | | | | - Tsila Zuckerman
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
| | - Péter Reményi
- St. István and St. László Hospital of Budapest, Budapest, Hungary
| | - Jurjen Versluis
- Department of Hematology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands
| | - Jordi Esteve
- Hematology Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Mohamad Mohty
- Hospital Saint-Antoine, APHP, Sorbonne University, INSERM U938, Paris, France
| | - Arnon Nagler
- Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Acute Leukemia Working Party of EBMT, Paris, France
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15
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Shouval R, Labopin M, Gorin NC, Bomze D, Houhou M, Blaise D, Zuckerman T, Baerlocher GM, Capria S, Forcade E, Huynh A, Saccardi R, Martino M, Schaap M, Wu D, Mohty M, Nagler A. Individualized prediction of leukemia‐free survival after autologous stem cell transplantation in acute myeloid leukemia. Cancer 2019; 125:3566-3573. [DOI: 10.1002/cncr.32344] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 12/16/2022]
Affiliation(s)
- Roni Shouval
- Hematology and Bone Marrow Transplantation Division Chaim Sheba Medical Center at Tel HaShomer Ramat‐Gan Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
- Dr. Pinchas Bornstein Talpiot Medical Leadership Program Chaim Sheba Medical Center at Tel HaShomer Ramat‐Gan Israel
| | - Myriam Labopin
- Department of Hematology and Cell Therapy Saint‐Antoine Hospital Paris France
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Saint‐Antoine Hospital Paris France
| | - Norbert C. Gorin
- Department of Hematology and Cell Therapy Saint‐Antoine Hospital Paris France
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Saint‐Antoine Hospital Paris France
| | - David Bomze
- Hematology and Bone Marrow Transplantation Division Chaim Sheba Medical Center at Tel HaShomer Ramat‐Gan Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
| | - Mohamed Houhou
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Saint‐Antoine Hospital Paris France
| | - Didier Blaise
- Transplantation and Cell Therapy Program Marseille Cancer Research Center, Paoli Calmettes Institute Marseille France
| | | | - Gabriela M. Baerlocher
- Department of Hematology, Inselspital Bern University Hospital, University of Bern Switzerland
| | | | - Edouard Forcade
- Service Hématologie Clinique et Thérapie CellulaireCentre Hospitalier Universitaire de Bordeaux Hôpital Haut‐Leveque Pessac France
| | - Anne Huynh
- Department of HematologyInstitut Universitaire du Cancer Toulouse Oncopole Toulouse France
| | - Riccardo Saccardi
- Department of Cellular Therapies and Transfusion MedicineCareggi University Hospital Firenze Italy
| | - Massimo Martino
- Stem Cell Transplant Unit, Hemato‐Oncology Department Grande Ospedale Metropolitano Bianchi Melacrino Morelli Reggio Calabria Italy
| | - Michel Schaap
- Department of HematologyRadboud University Medical Centre Nijmegen the Netherlands
| | - Depei Wu
- First Affiliated Hospital of Soochow University Suzhou China
| | - Mohamad Mohty
- Department of Hematology and Cell Therapy Saint‐Antoine Hospital Paris France
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Saint‐Antoine Hospital Paris France
| | - Arnon Nagler
- Hematology and Bone Marrow Transplantation Division Chaim Sheba Medical Center at Tel HaShomer Ramat‐Gan Israel
- Sackler School of Medicine Tel Aviv University Tel Aviv Israel
- Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation Saint‐Antoine Hospital Paris France
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16
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Haas Q, Boligan KF, Jandus C, Schneider C, Simillion C, Stanczak MA, Haubitz M, Seyed Jafari SM, Zippelius A, Baerlocher GM, Läubli H, Hunger RE, Romero P, Simon HU, von Gunten S. Siglec-9 Regulates an Effector Memory CD8+ T-cell Subset That Congregates in the Melanoma Tumor Microenvironment. Cancer Immunol Res 2019; 7:707-718. [DOI: 10.1158/2326-6066.cir-18-0505] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/10/2018] [Accepted: 04/08/2019] [Indexed: 11/16/2022]
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17
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Poiré X, Labopin M, Polge E, Blaise D, Chevallier P, Maertens J, Deconinck E, Forcade E, Rambaldi A, Baerlocher GM, Zuckerman T, Volin L, Schouten HC, Ifrah N, Mohty M, Esteve J, Nagler A. Hematopoietic stem cell transplantation for adult patients with isolated NPM1 mutated acute myeloid leukemia in first remission. Am J Hematol 2019; 94:231-239. [PMID: 30456896 DOI: 10.1002/ajh.25355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/11/2018] [Accepted: 11/13/2018] [Indexed: 11/11/2022]
Abstract
Acute myeloid leukemia (AML) in first remission (CR1) with isolated NPM1 mutation (iNPM1m) is considered a good prognosis genotype, although up to one-third relapse. To evaluate the best transplant strategy, we retrospectively compared autologous stem cell transplantation (auto-SCT), related (MSD), and fully matched unrelated (MUD) allogeneic stem cell transplantation (allo-SCT). We identified 256 adult patients including 125 auto-SCT, 72 MSD, and 59 MUD. The 2-year leukemia-free survival (LFS) was 62% in auto-SCT, 69% in MUD, and 81% in MSD (P = .02 for MSD vs others). The 2-year overall survival (OS) was not different among auto-SCT, MUD, and MSD, reaching 83% (P = .88). The 2-year non-relapse mortality (NRM) was 2.5% in auto-SCT and 7.5% in allo-SCT (P = .04). The 2-year cumulative incidence of relapse (RI) was higher after auto-SCT (30%) than after MUD (22%) and MSD (12%, P = .01). In multivariate analysis, MSD versus auto-SCT but not MUD versus auto-SCT was associated with lower RI (P < .01 and P = .13, respectively) and better LFS (P = .01 and P = .31, respectively). Age correlated with higher NRM (P < .01). Allo-SCT using MSD appears as a reasonable transplant option for young patients with iNPM1m AML in CR1. Auto-SCT was followed by worse RI and LFS, but similar OS to both allo-SCT modalities.
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Affiliation(s)
- Xavier Poiré
- Section of HematologyCliniques Universitaires St‐Luc Brussels Belgium
| | - Myriam Labopin
- Acute Leukemia Working Party of the EBMT Paris France
- Université Pierre et Marie Curie Paris France
- INSERM UMR 938 Paris France
- Programme de Transplantation & Thérapie CellulaireInstitut Paoli Calmette Marseille France
| | - Emmanuelle Polge
- Acute Leukemia Working Party of the EBMT Paris France
- Université Pierre et Marie Curie Paris France
- INSERM UMR 938 Paris France
- Programme de Transplantation & Thérapie CellulaireInstitut Paoli Calmette Marseille France
| | | | | | - Johan Maertens
- Hopital Jean Minjoz, Service d'Hématologie Besançon France
| | | | - Edouard Forcade
- University of Milan, Azienda Ospedaliera Papa Giovanni XXIII, Hematology and Bone Marrow Transplant Unit Bergamo Italy
| | - Alessandro Rambaldi
- Department of Hematology, InselspitalBern University Hospital, University of Bern Bern Switzerland
| | - Gabriela M. Baerlocher
- Department of Hematology and Bone Marrow TransplantationRambam Medical Center Haifa Israël
| | - Tsila Zuckerman
- HUCH Comprehensive Cancer CenterStem Cell Transplantation Unit Helsinki Finland
| | - Liisa Volin
- Department of HematologyUniversity Hospital Maastricht Maastricht The Netherlands
| | | | - Norbert Ifrah
- Service d'Hématologie, Hôpital Saint‐Antoine Paris France
| | - Mohamad Mohty
- Acute Leukemia Working Party of the EBMT Paris France
- Université Pierre et Marie Curie Paris France
- INSERM UMR 938 Paris France
- Programme de Transplantation & Thérapie CellulaireInstitut Paoli Calmette Marseille France
| | - Jordi Esteve
- Acute Leukemia Working Party of the EBMT Paris France
- Hematology DepartmentHospital Clinic Barcelona Spain
| | - Arnon Nagler
- Acute Leukemia Working Party of the EBMT Paris France
- Chaim Sheba Medical Center Tel‐Hashomer Israel
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18
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Michel C, Burchert A, Hochhaus A, Saussele S, Neubauer A, Lauseker M, Krause SW, Kolb HJ, Hossfeld DK, Nerl C, Baerlocher GM, Heim D, Brümmendorf TH, Fabarius A, Haferlach C, Schlegelberger B, Balleisen L, Goebeler ME, Hänel M, Ho A, Dengler J, Falge C, Möhle R, Kremers S, Kneba M, Stegelmann F, Köhne CH, Lindemann HW, Waller CF, Spiekermann K, Berdel WE, Müller L, Edinger M, Mayer J, Beelen DW, Bentz M, Link H, Hertenstein B, Fuchs R, Wernli M, Schlegel F, Schlag R, de Wit M, Trümper L, Hebart H, Hahn M, Thomalla J, Scheid C, Schafhausen P, Verbeek W, Eckart MJ, Gassmann W, Schenk M, Brossart P, Wündisch T, Geer T, Bildat S, Schäfer E, Hasford J, Hehlmann R, Pfirrmann M. Imatinib dose reduction in major molecular response of chronic myeloid leukemia: results from the German Chronic Myeloid Leukemia-Study IV. Haematologica 2018; 104:955-962. [PMID: 30514803 PMCID: PMC6518910 DOI: 10.3324/haematol.2018.206797] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 11/22/2018] [Indexed: 12/20/2022] Open
Abstract
Standard first-line therapy of chronic myeloid leukemia is treatment with imatinib. In the randomized German Chronic Myeloid Leukemia-Study IV, more potent BCR-ABL inhibition with 800 mg (‘high-dose’) imatinib accelerated achievement of a deep molecular remission. However, whether and when a de-escalation of the dose intensity under high-dose imatinib can be safely performed without increasing the risk of losing deep molecular response is unknown. To gain insights into this clinically relevant question, we analyzed the outcome of imatinib dose reductions from 800 mg to 400 mg daily in the Chronic Myeloid Leukemia-Study IV. Of the 422 patients that were randomized to the 800 mg arm, 68 reduced imatinib to 400 mg after they had achieved at least a stable major molecular response. Of these 68 patients, 61 (90%) maintained major molecular remission on imatinib at 400 mg. Five of the seven patients who lost major molecular remission on the imatinib standard dose regained major molecular remission while still on 400 mg imatinib. Only two of 68 patients had to switch to more potent kinase inhibition to regain major molecular remission. Importantly, the lengths of the intervals between imatinib high-dose treatment before and after achieving major molecular remission were associated with the probabilities of maintaining major molecular remission with the standard dose of imatinib. Taken together, the data support the view that a deep molecular remission achieved with high-dose imatinib can be safely maintained with standard dose in most patients. Study protocol registered at clinicaltrials.gov 00055874.
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Affiliation(s)
- Christian Michel
- Universitätsklinikum Gießen und Marburg, Campus Marburg, Klinik für Hämatologie, Onkologie und Immunologie, Philipps Universität Marburg, Germany
| | - Andreas Burchert
- Universitätsklinikum Gießen und Marburg, Campus Marburg, Klinik für Hämatologie, Onkologie und Immunologie, Philipps Universität Marburg, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Hämatologie und Internistische Onkologie, Jena, Germany
| | - Susanne Saussele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, University Heidelberg, Mannheim, Germany
| | - Andreas Neubauer
- Universitätsklinikum Gießen und Marburg, Campus Marburg, Klinik für Hämatologie, Onkologie und Immunologie, Philipps Universität Marburg, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stefan W Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | | | | | | | | | | | | | - Alice Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, University Heidelberg, Mannheim, Germany
| | | | | | | | - Maria-Elisabeth Goebeler
- Comprehensive Cancer Center Mainfranken und Medizinische Klinik II, Zentrum für Innere Medizin, Würzburg, Germany
| | | | - Anthony Ho
- Medizinische Klinik V, Universität Heidelberg, Germany
| | | | | | - Robert Möhle
- Medizinische Abteilung 2, Universitätsklinikum, Tübingen, Germany
| | | | - Michael Kneba
- 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | | | | | | | | | | | | | | | - Matthias Edinger
- Klinik und Poliklinik für Innere Medizin 3, Universitätsklinikum, Regensburg, Germany
| | - Jiri Mayer
- Masaryk University Hospital, Brno, Czech Republic
| | | | - Martin Bentz
- Medizinische Klinik 3, Städtisches Klinikum, Karlsruhe, Germany
| | - Hartmut Link
- Hematology, Medical Oncology, Kaiserslautern, Germany
| | | | | | | | | | - Rudolf Schlag
- Hämatologische-Onkologische Schwerpunktpraxis, Würzburg, Germany
| | - Maike de Wit
- Klinik für Innere Medizin II, Hämatologie, Onkologie und Palliativmedizin, Vivantes Klinikum Neukölln, Berlin, Germany
| | - Lorenz Trümper
- Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin, Göttingen, Germany
| | - Holger Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | | | - Jörg Thomalla
- Praxisklinik für Hämatologie und Onkologie, Koblenz, Germany
| | - Christof Scheid
- Klinik 1 für Innere Medizin, Universitätsklinikum, Köln, Germany
| | | | | | | | | | | | | | - Thomas Wündisch
- Universitätsklinikum Gießen und Marburg, Campus Marburg, Klinik für Hämatologie, Onkologie und Immunologie, Philipps Universität Marburg, Germany
| | | | | | | | - Joerg Hasford
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Rüdiger Hehlmann
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, University Heidelberg, Mannheim, Germany
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität München, Munich, Germany
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19
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Karow A, Wilhelm A, Ammann RA, Baerlocher GM, Pabst T, Mansouri Taleghani B, Roessler J, Leibundgut K. Peripheral blood progenitor cell collection in pediatric patients optimized by high pre-apheresis count of circulating CD34+ cells and high blood flow. Bone Marrow Transplant 2018; 54:885-893. [DOI: 10.1038/s41409-018-0353-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/05/2018] [Accepted: 09/20/2018] [Indexed: 01/09/2023]
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20
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Passweg JR, Baldomero H, Ansari M, Baerlocher GM, Bargetzi M, Chalandon Y, Duchosal MA, Gerull S, Güngör T, Halter JP, Heim D, Hess U, Leibundgut K, Masouridi-Levrat S, Müller A, Nair G, Pabst T, Renner C, Schmidt A, Stussi G, Nicoloso de Faveri G, Schanz U, For The Swiss Blood Stem Cell Transplantation Group Sbst. Haematopoietic cell transplantation in Switzerland, changes and results over 20 years: a report from the Swiss Blood Stem Cell Transplantation Working Group for Blood and Marrow Transplantation registry 1997-2016. Swiss Med Wkly 2018; 148:w14589. [PMID: 29493715 DOI: 10.4414/smw.2018.14589] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
In 1997, the Swiss Blood Stem Cell Transplantation Group (SBST) initiated a mandatory national registry for all haematopoietic stem cell transplants (HCTs) in Switzerland. As of 2016, after 20 years, information was available for 7899 patients who had received an HCT (2781 allogeneic [35%] and 5118 autologous [65%]). As some patients had more than one transplant the total number of transplants was 3067 allogeneic and 6448 autologous. We compared patient characteristics and outcome of the first decade (1997-2006) and second decade (2007-2016) of the registry. There were numerous changes over time. For allogeneic HCT, transplant rates, and therefore use of HCT technology, increased from 14 to 21.8 HCTs per 1 million inhabitants per year from the first to the second decade. Likewise autologous HCTs increased from 24.8 to 37.2 annually corrected for population growth. Allogeneic transplant recipients were older (38.4 vs 48.3 years) and more frequently had unrelated donors in the second decade. Similarly, age increased for recipients of autologous HCT (50.8 vs 56.4 years). Analysis of outcome showed that the probabilities of overall and progression-free survival were stable over time, in spite of the treatment of older and higher risk patients. In multivariate analysis, nonrelapse mortality decreased in recipients of allogeneic HCT (relative risk 0.68, 95% confidence interval 0.52-0.87) over the two decades. Improvement in adjusted nonrelapse mortality compensated for the fact that higher risk patients were treated in more recent years, resulting in similar overall survival. Five-year survival probabilities were 56% (53-59%) in the first and 54% (51-57%) in the second decade for allogeneic HCT, and 59% (57-61%) in the first and 61% (59-63%) in the second decade for autologous HCT. Detailed analyses of changes over time are presented. This study included all HCTs performed in Switzerland during the period of observation and the data are useful for quality assurance programmes, healthcare cost estimation and healthcare planning. Between 50 and 60% of patients were long-term survivors after both types of HCT, indicating growing populations of surviving patients requiring long-term care and observation.
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Affiliation(s)
- Jakob R Passweg
- Stem Cell Transplant Team, University Hospital and the Children's University Hospital, Basel, Switzerland
| | - Helen Baldomero
- SBST Data Registry Office, University Hospital, Basel, Switzerland
| | - Marc Ansari
- Division of Haematology/Oncology, Department of Paediatrics, Geneva University Hospital and University of Geneva, Switzerland
| | - Gabriela M Baerlocher
- Department of Haematology, University Hospital/Inselspital Bern and University of Bern, Switzerland
| | - Mario Bargetzi
- Division of Haematology/Oncology, Kantonsspital, Aarau, Switzerland
| | - Yves Chalandon
- Division of Haematology, University Hospital, Geneva and University of Geneva, Switzerland
| | - Michel A Duchosal
- Service and Central Laboratory of Haematology, Departments of Oncology and of Laboratories, University Hospital of Lausanne, Switzerland
| | - Sabine Gerull
- Stem Cell Transplant Team, University Hospital and the Children's University Hospital, Basel, Switzerland
| | - Tayfun Güngör
- Division of Immunology/Haematology/Oncology, University Children's Hospital, Zurich, Switzerland
| | - Jörg P Halter
- Stem Cell Transplant Team, University Hospital and the Children's University Hospital, Basel, Switzerland
| | - Dominik Heim
- Stem Cell Transplant Team, University Hospital and the Children's University Hospital, Basel, Switzerland
| | - Urs Hess
- Division of Medical Oncology and Haematology, Kantonsspital, St Gallen, Switzerland
| | - Kurt Leibundgut
- Division of Haematology/Oncology, Department of Paediatrics, University Hospital, Bern, Switzerland
| | | | - Antonia Müller
- Clinic of Oncology and Division of Haematology, University Hospital, Zurich, Switzerland
| | - Gayathri Nair
- Clinic of Oncology and Division of Haematology, University Hospital, Zurich, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, University Hospital/Inselspital Bern and University of Bern, Switzerland
| | | | | | - Georg Stussi
- Division of Haematology, Hospital San Giovanni, Bellinzona, Switzerland
| | | | - Urs Schanz
- Clinic of Oncology and Division of Haematology, University Hospital, Zurich, Switzerland
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21
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Trabanelli S, Chevalier MF, Martinez-Usatorre A, Gomez-Cadena A, Salomé B, Lecciso M, Salvestrini V, Verdeil G, Racle J, Papayannidis C, Morita H, Pizzitola I, Grandclément C, Bohner P, Bruni E, Girotra M, Pallavi R, Falvo P, Leibundgut EO, Baerlocher GM, Carlo-Stella C, Taurino D, Santoro A, Spinelli O, Rambaldi A, Giarin E, Basso G, Tresoldi C, Ciceri F, Gfeller D, Akdis CA, Mazzarella L, Minucci S, Pelicci PG, Marcenaro E, McKenzie ANJ, Vanhecke D, Coukos G, Mavilio D, Curti A, Derré L, Jandus C. Tumour-derived PGD2 and NKp30-B7H6 engagement drives an immunosuppressive ILC2-MDSC axis. Nat Commun 2017; 8:593. [PMID: 28928446 PMCID: PMC5605498 DOI: 10.1038/s41467-017-00678-2] [Citation(s) in RCA: 163] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 07/19/2017] [Indexed: 01/29/2023] Open
Abstract
Group 2 innate lymphoid cells (ILC2s) are involved in human diseases, such as allergy, atopic dermatitis and nasal polyposis, but their function in human cancer remains unclear. Here we show that, in acute promyelocytic leukaemia (APL), ILC2s are increased and hyper-activated through the interaction of CRTH2 and NKp30 with elevated tumour-derived PGD2 and B7H6, respectively. ILC2s, in turn, activate monocytic myeloid-derived suppressor cells (M-MDSCs) via IL-13 secretion. Upon treating APL with all-trans retinoic acid and achieving complete remission, the levels of PGD2, NKp30, ILC2s, IL-13 and M-MDSCs are restored. Similarly, disruption of this tumour immunosuppressive axis by specifically blocking PGD2, IL-13 and NKp30 partially restores ILC2 and M-MDSC levels and results in increased survival. Thus, using APL as a model, we uncover a tolerogenic pathway that may represent a relevant immunosuppressive, therapeutic targetable, mechanism operating in various human tumour types, as supported by our observations in prostate cancer.Group 2 innate lymphoid cells (ILC2s) modulate inflammatory and allergic responses, but their function in cancer immunity is still unclear. Here the authors show that, in acute promyelocytic leukaemia, tumour-activated ILC2s secrete IL-13 to induce myeloid-derived suppressor cells and support tumour growth.
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Affiliation(s)
- Sara Trabanelli
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland.
| | - Mathieu F Chevalier
- Urology Research Unit, Lausanne University Hospital (CHUV), 1011, Lausanne, Switzerland
| | - Amaia Martinez-Usatorre
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Alejandra Gomez-Cadena
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Bérengère Salomé
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Mariangela Lecciso
- Department of Specialistic, Diagnostic and Experimental Medicine, Institute of Hematology "Seràgnoli", University of Bologna, 40138, Bologna, Italy
| | - Valentina Salvestrini
- Department of Specialistic, Diagnostic and Experimental Medicine, Institute of Hematology "Seràgnoli", University of Bologna, 40138, Bologna, Italy
| | - Grégory Verdeil
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Julien Racle
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland.,Swiss Institute of Bioinformatics (SIB), 1015, Lausanne, Switzerland
| | - Cristina Papayannidis
- Department of Specialistic, Diagnostic and Experimental Medicine, Institute of Hematology "Seràgnoli", University of Bologna, 40138, Bologna, Italy
| | - Hideaki Morita
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7270, Davos, Switzerland.,Christine Kühne-Center for Allergy Research and Education, 7265, Davos, Switzerland
| | - Irene Pizzitola
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Camille Grandclément
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Perrine Bohner
- Urology Research Unit, Lausanne University Hospital (CHUV), 1011, Lausanne, Switzerland
| | - Elena Bruni
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20133, Milan, Italy.,Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, 20089, Rozzano-Milan, Italy
| | - Mukul Girotra
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Rani Pallavi
- Department of Experimental Oncology, European Institute of Oncology, 20139, Milan, Italy
| | - Paolo Falvo
- Department of Experimental Oncology, European Institute of Oncology, 20139, Milan, Italy
| | | | - Gabriela M Baerlocher
- Department of Hematology, Bern University Hospital, University of Bern, 3010, Bern, Switzerland
| | - Carmelo Carlo-Stella
- Humanitas Cancer Center, Humanitas Clinical and Research Center, 20089, Rozzano-Milan, Italy.,Department of Biomedical Sciences, Humanitas University, 20089, Rozzano-Milan, Italy
| | - Daniela Taurino
- Humanitas Cancer Center, Humanitas Clinical and Research Center, 20089, Rozzano-Milan, Italy.,Department of Biomedical Sciences, Humanitas University, 20089, Rozzano-Milan, Italy
| | - Armando Santoro
- Humanitas Cancer Center, Humanitas Clinical and Research Center, 20089, Rozzano-Milan, Italy.,Department of Biomedical Sciences, Humanitas University, 20089, Rozzano-Milan, Italy
| | - Orietta Spinelli
- Hematology and Bone Marrow Transplant Unit, Ospedale Papa Giovanni XXIII, 24127, Bergamo, Italy
| | - Alessandro Rambaldi
- Hematology and Bone Marrow Transplant Unit, Ospedale Papa Giovanni XXIII, 24127, Bergamo, Italy.,Università Statale di Milano, 20122, Milan, Italy
| | - Emanuela Giarin
- Dipartimento per la Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, University of Padova, 35128, Padova, Italy
| | - Giuseppe Basso
- Dipartimento per la Salute della Donna e del Bambino, Clinica di Oncoematologia Pediatrica, University of Padova, 35128, Padova, Italy
| | - Cristina Tresoldi
- Immunoematologia e Medicina Trasfusionale, Laboratorio Ematologia Molecolare, Biobanca Neoplasie Ematologiche, San Raffaele Hospital, 20132, Milano, Italy
| | - Fabio Ciceri
- Divisione di Ricerca di Medicina Rigenerativa, Terapia Cellulare e Genica IRCCS, San Raffaele Hospital, 20132, Milano, Italy
| | - David Gfeller
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland.,Swiss Institute of Bioinformatics (SIB), 1015, Lausanne, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, 7270, Davos, Switzerland
| | - Luca Mazzarella
- Department of Experimental Oncology, European Institute of Oncology, 20139, Milan, Italy.,Division of Innovative Therapies, European Institute of Oncology, 20141, Milan, Italy
| | - Saverio Minucci
- Department of Experimental Oncology, European Institute of Oncology, 20139, Milan, Italy
| | - Pier Giuseppe Pelicci
- Department of Experimental Oncology, European Institute of Oncology, 20139, Milan, Italy
| | - Emanuela Marcenaro
- Department of Experimental Medicine (DI.ME.S.)-Section of Histology, and Center of Excellent of Biomedical Research (CEBR), University of Genoa, 16132, Genoa, Italy
| | | | - Dominique Vanhecke
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - George Coukos
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland
| | - Domenico Mavilio
- Department of Medical Biotechnologies and Translational Medicine, University of Milan, 20133, Milan, Italy.,Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, 20089, Rozzano-Milan, Italy
| | - Antonio Curti
- Department of Specialistic, Diagnostic and Experimental Medicine, Institute of Hematology "Seràgnoli", University of Bologna, 40138, Bologna, Italy
| | - Laurent Derré
- Urology Research Unit, Lausanne University Hospital (CHUV), 1011, Lausanne, Switzerland
| | - Camilla Jandus
- Ludwig Institute for Cancer Research, Department of Fundamental Oncology, University of Lausanne, Biopole 3-02DB61, Ch. Des Boveresses 155, CH-1066, Epalinges, Switzerland.
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22
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Hehlmann R, Lauseker M, Saußele S, Pfirrmann M, Krause S, Kolb HJ, Neubauer A, Hossfeld DK, Nerl C, Gratwohl A, Baerlocher GM, Heim D, Brümmendorf TH, Fabarius A, Haferlach C, Schlegelberger B, Müller MC, Jeromin S, Proetel U, Kohlbrenner K, Voskanyan A, Rinaldetti S, Seifarth W, Spieß B, Balleisen L, Goebeler MC, Hänel M, Ho A, Dengler J, Falge C, Kanz L, Kremers S, Burchert A, Kneba M, Stegelmann F, Köhne CA, Lindemann HW, Waller CF, Pfreundschuh M, Spiekermann K, Berdel WE, Müller L, Edinger M, Mayer J, Beelen DW, Bentz M, Link H, Hertenstein B, Fuchs R, Wernli M, Schlegel F, Schlag R, de Wit M, Trümper L, Hebart H, Hahn M, Thomalla J, Scheid C, Schafhausen P, Verbeek W, Eckart MJ, Gassmann W, Pezzutto A, Schenk M, Brossart P, Geer T, Bildat S, Schäfer E, Hochhaus A, Hasford J. Assessment of imatinib as first-line treatment of chronic myeloid leukemia: 10-year survival results of the randomized CML study IV and impact of non-CML determinants. Leukemia 2017; 31:2398-2406. [PMID: 28804124 PMCID: PMC5668495 DOI: 10.1038/leu.2017.253] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/04/2017] [Indexed: 01/06/2023]
Abstract
Chronic myeloid leukemia (CML)-study IV was designed to explore whether treatment with imatinib (IM) at 400 mg/day (n=400) could be optimized by doubling the dose (n=420), adding interferon (IFN) (n=430) or cytarabine (n=158) or using IM after IFN-failure (n=128). From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase were randomized into a 5-arm study. The study was powered to detect a survival difference of 5% at 5 years. After a median observation time of 9.5 years, 10-year overall survival was 82%, 10-year progression-free survival was 80% and 10-year relative survival was 92%. Survival between IM400 mg and any experimental arm was not different. In a multivariate analysis, risk group, major-route chromosomal aberrations, comorbidities, smoking and treatment center (academic vs other) influenced survival significantly, but not any form of treatment optimization. Patients reaching the molecular response milestones at 3, 6 and 12 months had a significant survival advantage. For responders, monotherapy with IM400 mg provides a close to normal life expectancy independent of the time to response. Survival is more determined by patients' and disease factors than by initial treatment selection. Although improvements are also needed for refractory disease, more life-time can currently be gained by carefully addressing non-CML determinants of survival.
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Affiliation(s)
- R Hehlmann
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - M Lauseker
- IBE, Universität München, Munich, Germany
| | - S Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - S Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - H J Kolb
- Medizinische Klinik III, Universität München, Munich, Germany
| | - A Neubauer
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - D K Hossfeld
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - C Nerl
- Klinikum Schwabing, Munich, Germany
| | | | | | - D Heim
- Universitätsspital, Basel, Switzerland
| | | | - A Fabarius
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | | | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - U Proetel
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - K Kohlbrenner
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Voskanyan
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - S Rinaldetti
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - W Seifarth
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - B Spieß
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | | | - M C Goebeler
- Medizinische Klinik und Poliklinik, Universitätsklinikum, Würzburg, Germany
| | - M Hänel
- Klinik für innere Medizin 3, Chemnitz, Germany
| | - A Ho
- Medizinische Klinik V, Universität Heidelberg, Heidelberg, Germany
| | - J Dengler
- Onkologische Schwerpunktpraxis, Heilbronn, Germany
| | - C Falge
- Medizinische Klinik 5, Klinikum Nürnberg-Nord, Nürnberg, Germany
| | - L Kanz
- Medizinische Abteilung 2, Universitätsklinikum, Tübingen, Germany
| | - S Kremers
- Caritas Krankenhaus, Lebach, Germany
| | - A Burchert
- Klinik für innere Medizin, Universitätsklinikum, Marburg, Germany
| | - M Kneba
- 2. Medizinische Klinik und Poliklinik, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - F Stegelmann
- Klinik für Innere Medizin 3, Universitätsklinikum, Ulm, Germany
| | - C A Köhne
- Klinik für Onkologie und Hämatologie, Oldenburg, Germany
| | | | - C F Waller
- Innere Medizin 1, Universitätsklinikum, Freiburg, Germany
| | - M Pfreundschuh
- Klinik für Innere Medizin 1, Universität des Saarlandes, Homburg, Germany
| | - K Spiekermann
- Medizinische Klinik III, Universität München, Munich, Germany
| | - W E Berdel
- Medizinische Klinik A, Universitätsklinikum, Münster, Germany
| | - L Müller
- Onkologie Leer UnterEms, Leer, Germany
| | - M Edinger
- Klinik und Poliklinik für Innere Medizin 3, Universitätsklinikum, Regensburg, Germany
| | - J Mayer
- Masaryk University Hospital, Brno, Czech Republic
| | - D W Beelen
- Klinik für Knochenmarktransplantation, Essen, Germany
| | - M Bentz
- Medizinische Klinik 3, Städtisches Klinikum, Karlsruhe, Germany
| | - H Link
- Klinik für Innere Medizin 3, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - B Hertenstein
- 1. Medizinische Klinik, Klinikum Bremen Mitte, Bremen, Germany
| | | | - M Wernli
- Kantonsspital, Aarau, Switzerland
| | - F Schlegel
- St Antonius-Hospital, Eschweiler, Germany
| | - R Schlag
- Hämatologische-Onkologische Schwerpunktpraxis, Würzburg, Germany
| | - M de Wit
- Vivantes Klinikum Neukölln, Berlin, Germany
| | - L Trümper
- Klinik für Hämatologie und medizinische Onkologie, Universitätsmedizin, Göttingen, Germany
| | - H Hebart
- Stauferklinikum Schwäbisch Gmünd, Mutlangen, Germany
| | - M Hahn
- Onkologie Zentrum, Ansbach, Germany
| | - J Thomalla
- Praxisklinik für Hämatologie und Onkologie, Koblenz, Germany
| | - C Scheid
- Klinik 1 für Innere Medizin, Universitätsklinikum, Köln, Germany
| | - P Schafhausen
- 2. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - W Verbeek
- Ambulante Hämatologie und Onkologie, Bonn, Germany
| | - M J Eckart
- Internistische Schwerpunktpraxis, Erlangen, Germany
| | | | | | - M Schenk
- Barmherzige Brüder, Regensburg, Germany
| | - P Brossart
- Medizinische Klinik 3, Universität, Bonn, Germany
| | - T Geer
- Diakonie, Schwäbisch Hall, Germany
| | - S Bildat
- Medizinische Klinik 2, Herford, Germany
| | - E Schäfer
- Onkologische Schwerpunktpraxis, Bielefeld, Germany
| | - A Hochhaus
- Klinik für Innere Medizin 2, Universitätsklinikum, Jena, Germany
| | - J Hasford
- IBE, Universität München, Munich, Germany
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23
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Hehlmann R, Lauseker M, Saussele S, Pfirrmann M, Neubauer A, Krause SW, Hossfeld DK, Nerl C, Baerlocher GM, Heim D, Kolb HJ, Proetel U, Kohlbrenner K, Gratwohl A, Burchert A, Voskanyan A, Rinaldetti SL, Hochhaus A, Hasford J. Ten-year survival after randomized comparison of imatinib (IM) 400 mg vs. IM 800 mg vs. IM + IFN vs. IM + Ara C vs. IM after IFN in chronic myeloid leukemia (CML). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.7049] [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: 11/20/2022] Open
Abstract
7049 Background: It is unclear whether IM 400 mg is the optimum choice for the successful treatment of CML. Treatment optimization was therefore attempted. Methods: From July 2002 to March 2012, 1551 newly diagnosed patients in chronic phase (CP) were randomized into a 5-arm study to analyze 2 IM doses and 3 combinations. 1536 patients were evaluable, 400 for IM 400 mg, 420 for IM 800 mg, 430 for IM + Interferon (IFN), 158 for IM + Ara C and 128 for IM after IFN. Recruitment to the latter two arms was stopped after a pilot phase. Results: 10-year overall survival (OS) of all patients was 82%, 10-year progression free survival (PFS) 80%. 10-year OS was 80% with IM 400 mg, 79% with IM 800 mg, 84% with IM + IFN, 84% with IM + Ara C and 79% with IM after IFN. The differences were not significant. 10-year PFS was 80% with IM 400mg, 77% with IM 800mg, 83% with IM + IFN, 82% with IM + Ara C and 75% with IM after IFN. The differences were not significant either. Survival with any treatment was not significantly different from IM 400mg at any risk level by any risk score (Euro Sokal, EUTOS, ELTS). 87 patients progressed to blast crisis (BC). The 10-year cumulative incidence of BC was 5.8% (95% CI: 4.7%; 7.1%) equally distributed across treatment arms. Most BC occurred in the first 2 years. Median survival after BC was 7.9 months across treatment arms. 275 patients have died, 23 after stem cell transplantation in first CP. Two thirds of deaths were unrelated to CML. Incidence of death due to CML by competing risk analysis with death unrelated to CML as competing risk was not different between the 5-treatment arms. 10-year relative survival probability was 92% when compared to matched general population data. Patients reaching the cytogenetic or molecular response landmarks according to European LeukemiaNet criteria ( < 10% BCR-ABL IS at 3 months, < 1% BCR-ABL IS or complete cytogenetic remission at 6 months, < 0.1% BCR-ABL IS (MMR) at 12 months) had a significantly better survival than those not reaching the landmarks regardless of therapy. Conclusions: In conclusion, outcome of CML is currently more determined by prognostic markers than by choice of therapy. IM400 mg remains an excellent choice for initial therapy of CP-CML. Clinical trial information: NCT00055874.
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Affiliation(s)
- Ruediger Hehlmann
- Medizinische Fakultaet Mannheim Universitaet Heidelberg, Mannheim, Germany
| | | | - Susanne Saussele
- Medizinische Fakultaet Mannheim der Universitaet Heidelberg, Mannheim, Germany
| | - Markus Pfirrmann
- Institute for Medical Informatics and Biometry, LMU Muenchen, Munich, Germany
| | | | - Stefan W. Krause
- Medizinische Klinik 5, Universitaetsklinikum Erlangen, Erlangen, Germany
| | | | | | | | | | | | - Ulrike Proetel
- Med. Fakultaet Mannheim,. Universitaet Heidelberg, Mannheim, Germany
| | | | | | | | - Astghik Voskanyan
- Medizinische Fakultaet Mannheim der Universitaet Heidelberg, Mannheim, Germany
| | | | | | - Joerg Hasford
- Institute for Medical Informatics and Biometry, Munich, Germany
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24
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Poiré X, Labopin M, Blaise D, Chevallier P, Maertens JA, Deconinck E, Forcade E, Rambaldi A, Baerlocher GM, Zuckerman T, Volin L, Schouten HC, Ifrah N, Esteve J, Mohty M, Nagler A. Autologous Vs Related Vs Unrelated Hematopoietic Stem Cell Transplantation for Adults with NPM1 Mutated/FLT3-ITD Negative Acute Myeloid Leukemia in First Remission: A Study from the Acute Leukemia Working Party (ALWP) of the EBMT. Biol Blood Marrow Transplant 2017. [DOI: 10.1016/j.bbmt.2016.12.421] [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: 11/25/2022]
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25
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Blum V, Heini AD, Novak U, Taleghani BM, Baerlocher GM, Leibundgut K, Seipel K, Banz Y, Bargetzi M, Pabst T. Hematopoietic stem cell remobilization with vinorelbine and filgrastim in AML. Bone Marrow Transplant 2017; 52:786-788. [PMID: 28194031 DOI: 10.1038/bmt.2017.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- V Blum
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - A D Heini
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - U Novak
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - B M Taleghani
- Department of Hematology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - G M Baerlocher
- Department of Hematology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland.,Department of Clinical Research, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - K Leibundgut
- Department of Pediatric Hemato-Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - K Seipel
- Department of Clinical Research, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Y Banz
- Institute of Pathology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - M Bargetzi
- Department of Hematology, Kantonsspital, Aarau, Switzerland
| | - T Pabst
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
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26
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Jenkinson EM, Rodero MP, Kasher PR, Uggenti C, Oojageer A, Goosey LC, Rose Y, Kershaw CJ, Urquhart JE, Williams SG, Bhaskar SS, O'Sullivan J, Baerlocher GM, Haubitz M, Aubert G, Barañano KW, Barnicoat AJ, Battini R, Berger A, Blair EM, Brunstrom-Hernandez JE, Buckard JA, Cassiman DM, Caumes R, Cordelli DM, De Waele LM, Fay AJ, Ferreira P, Fletcher NA, Fryer AE, Goel H, Hemingway CA, Henneke M, Hughes I, Jefferson RJ, Kumar R, Lagae L, Landrieu PG, Lourenço CM, Malpas TJ, Mehta SG, Metz I, Naidu S, Õunap K, Panzer A, Prabhakar P, Quaghebeur G, Schiffmann R, Sherr EH, Sinnathuray KR, Soh C, Stewart HS, Stone J, Van Esch H, Van Mol CEG, Vanderver A, Wakeling EL, Whitney A, Pavitt GD, Griffiths-Jones S, Rice GI, Revy P, van der Knaap MS, Livingston JH, O'Keefe RT, Crow YJ. Erratum: Corrigendum: Mutations in SNORD118 cause the cerebral microangiopathy leukoencephalopathy with calcifications and cysts. Nat Genet 2017; 49:317. [DOI: 10.1038/ng0217-317b] [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: 11/09/2022]
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27
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Gilli S, Novak U, Taleghani BM, Baerlocher GM, Leibundgut K, Banz Y, Zander T, Betticher D, Egger T, Rauch D, Pabst T. BeEAM conditioning with bendamustine-replacing BCNU before autologous transplantation is safe and effective in lymphoma patients. Ann Hematol 2016; 96:421-429. [DOI: 10.1007/s00277-016-2900-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 12/09/2016] [Indexed: 11/29/2022]
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28
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Heini AD, Berger MD, Seipel K, Taleghani BM, Baerlocher GM, Leibundgut K, Banz Y, Novak U, Pabst T. Consolidation with autologous stem cell transplantation in first remission is safe and effective in AML patients above 65 years. Leuk Res 2016; 53:28-34. [PMID: 27978458 DOI: 10.1016/j.leukres.2016.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 12/05/2016] [Accepted: 12/08/2016] [Indexed: 01/01/2023]
Abstract
The outcome of AML patients ≥65 years remains disappointing. Current post-induction strategies for elderly AML patients fit for intensive treatment involve additional cycles of chemotherapy or allogeneic transplantation. Consolidation with autologous transplantation (ASCT) is poorly studied in these patients. In this single-center retrospective analysis, we determined survival rates of AML patients ≥65 years undergoing busulfan/cyclophosphamide conditioning before ASCT in first remission between 2007 and 2015. We found elderly AML patients with ASCT to have longer progression-free survival (PFS; 16.3 vs. 5.1 months, P=0.0166) and overall survival (OS; n.r. vs. 8.2 months; P=0.0255) than elderly AML patients without ASCT consolidation. In addition, elderly AML patients undergoing ASCT had comparable PFS (P=0.9462) and OS (P=0.7867) as AML patients below 65 years receiving ASCT consolidation in CR1. Our data suggest that ASCT is an option in elderly fit AML patients who appear to benefit from autologous consolidation similarly to younger AML patients.
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Affiliation(s)
- Alexander D Heini
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | - Martin D Berger
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | - Katja Seipel
- Department of Clinical Research, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | | | - Gabriela M Baerlocher
- Department of Hematology, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | - Kurt Leibundgut
- Department of Pediatric Hemato-Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | - Yara Banz
- Institute of Pathology, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | - Urban Novak
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, Switzerland.
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29
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Stettler J, Novak U, Baerlocher GM, Seipel K, Mansouri Taleghani B, Pabst T. Autologous stem cell transplantation in elderly patients with multiple myeloma: evaluation of its safety and efficacy. Leuk Lymphoma 2016; 58:1076-1083. [DOI: 10.1080/10428194.2016.1233542] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Jasmin Stettler
- Department of Medical Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Urban Novak
- Department of Medical Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
| | | | - Katja Seipel
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | | | - Thomas Pabst
- Department of Medical Oncology, Inselspital, University Hospital Bern, Bern, Switzerland
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30
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Riether C, Schürch CM, Flury C, Hinterbrandner M, Drück L, Huguenin AL, Baerlocher GM, Radpour R, Ochsenbein AF. Tyrosine kinase inhibitor-induced CD70 expression mediates drug resistance in leukemia stem cells by activating Wnt signaling. Sci Transl Med 2016. [PMID: 26223302 DOI: 10.1126/scitranslmed.aab1740] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In chronic myelogenous leukemia (CML), oncogenic BCR-ABL1 activates the Wnt pathway, which is fundamental for leukemia stem cell (LSC) maintenance. Tyrosine kinase inhibitor (TKI) treatment reduces Wnt signaling in LSCs and often results in molecular remission of CML; however, LSCs persist long term despite BCR-ABL1 inhibition, ultimately causing disease relapse. We demonstrate that TKIs induce the expression of the tumor necrosis factor (TNF) family ligand CD70 in LSCs by down-regulating microRNA-29, resulting in reduced CD70 promoter DNA methylation and up-regulation of the transcription factor specificity protein 1. The resulting increase in CD70 triggered CD27 signaling and compensatory Wnt pathway activation. Combining TKIs with CD70 blockade effectively eliminated human CD34(+) CML stem/progenitor cells in xenografts and LSCs in a murine CML model. Therefore, targeting TKI-induced expression of CD70 and compensatory Wnt signaling resulting from the CD70/CD27 interaction is a promising approach to overcoming treatment resistance in CML LSCs.
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Affiliation(s)
- Carsten Riether
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland
| | - Christian M Schürch
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland. Institute of Pathology, University of Bern, Murtenstrasse 31, 3010 Bern, Switzerland
| | - Christoph Flury
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland
| | - Magdalena Hinterbrandner
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland
| | - Linda Drück
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland
| | - Anne-Laure Huguenin
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland
| | - Gabriela M Baerlocher
- Experimental Hematology, Department of Clinical Research, Inselspital, University Hospital and University of Bern, 3010 Bern, Switzerland. Department of Hematology, Inselspital, University Hospital and University of Bern, 3010 Bern, Switzerland
| | - Ramin Radpour
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland
| | - Adrian F Ochsenbein
- Tumor Immunology, Department of Clinical Research, University of Bern, Murtenstrasse 35, 3010 Bern, Switzerland. Department of Medical Oncology, Inselspital, University Hospital and University of Bern, 3010 Bern, Switzerland.
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31
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Wagner AM, Krenger W, Stettler S, Beutler E, Herbst J, Surbek DV, Baerlocher GM. A novel, bedside technique to rapidly identify umbilical cord blood units with high total nucleated cell numbers. Transfusion 2016; 56:1406-12. [PMID: 27184144 DOI: 10.1111/trf.13610] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 02/22/2016] [Accepted: 03/01/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND With increasing demand for umbilical cord blood units (CBUs) with total nucleated cell (TNC) counts of more than 150 × 10(7) , preshipping assessment is mandatory. Umbilical cord blood processing requires aseptic techniques and laboratories with specific air quality and cleanliness. Our aim was to establish a fast and efficient method for determining TNC counts at the obstetric ward without exposing the CBU to the environment. STUDY DESIGN AND METHODS Data from a total of 151 cord blood donations at a single procurement site were included in this prospective study. We measured TNC counts in cord blood aliquots taken from the umbilical cord (TNCCord ), from placenta (TNCPlac ), and from a tubing segment of the sterile collection system (TNCTS ). TNC counts were compared to reference TNC counts in the CBU which were ascertained at the cord blood bank (TNCCBU ). RESULTS TNCTS counts (173 ± 33 × 10(7) cells; calculated for 1 unit) correlated fully with the TNCCBU reference counts (166 ± 33 × 10(7) cells, Pearson's r = 0.97, p < 0.0001). In contrast, TNCCord and TNCPlac counts were more disparate from the reference (r = 0.92 and r = 0.87, respectively). CONCLUSIONS A novel method of measuring TNC counts in tubing segments from the sterile cord blood collection system allows rapid and correct identification of CBUs with high cell numbers at the obstetric ward without exposing cells to the environment. This approach may contribute to cost efficacy as only CBUs with satisfactory TNC counts need to be shipped to the cord blood bank.
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Affiliation(s)
- Anna Margareta Wagner
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern
| | - Werner Krenger
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Shamsiya Stettler
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern
| | - Elke Beutler
- Department of Hematology, University Hospital and University of Bern, Bern, Switzerland
| | - Judith Herbst
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern
| | - Daniel V Surbek
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern
| | - Gabriela M Baerlocher
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern
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32
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Miranda MB, Lauseker M, Kraus MP, Proetel U, Hanfstein B, Fabarius A, Baerlocher GM, Heim D, Hossfeld DK, Kolb HJ, Krause SW, Nerl C, Brümmendorf TH, Verbeek W, Fauser AA, Prümmer O, Neben K, Hess U, Mahlberg R, Plöger C, Flasshove M, Rendenbach B, Hofmann WK, Müller MC, Pfirrmann M, Hochhaus A, Hasford J, Hehlmann R, Saußele S. Secondary malignancies in chronic myeloid leukemia patients after imatinib-based treatment: long-term observation in CML Study IV. Leukemia 2016; 30:1255-62. [PMID: 26859076 PMCID: PMC4895174 DOI: 10.1038/leu.2016.20] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/14/2015] [Accepted: 12/23/2015] [Indexed: 01/20/2023]
Abstract
Treatment of chronic myeloid leukemia (CML) has been profoundly improved by the introduction of tyrosine kinase inhibitors (TKIs). Long-term survival with imatinib is excellent with a 8-year survival rate of ∼88%. Long-term toxicity of TKI treatment, especially carcinogenicity, has become a concern. We analyzed data of the CML study IV for the development of secondary malignancies. In total, 67 secondary malignancies were found in 64 of 1525 CML patients in chronic phase treated with TKI (n=61) and interferon-α only (n=3). The most common malignancies (n⩾4) were prostate, colorectal and lung cancer, non-Hodgkin's lymphoma (NHL), malignant melanoma, non-melanoma skin tumors and breast cancer. The standardized incidence ratio (SIR) for all malignancies excluding non-melanoma skin tumors was 0.88 (95% confidence interval (0.63-1.20)) for men and 1.06 (95% CI 0.69-1.55) for women. SIRs were between 0.49 (95% CI 0.13-1.34) for colorectal cancer in men and 4.29 (95% CI 1.09-11.66) for NHL in women. The SIR for NHL was significantly increased for men and women. An increase in the incidence of secondary malignancies could not be ascertained. The increased SIR for NHL has to be considered and long-term follow-up of CML patients is warranted, as the rate of secondary malignancies may increase over time.
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Affiliation(s)
- M B Miranda
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - M Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany
| | - M-P Kraus
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - U Proetel
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - B Hanfstein
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - A Fabarius
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - G M Baerlocher
- Universitätsklinik für Hämatologie und Hämatologisches Zentrallabor, Inselspital, Bern, Switzerland
| | - D Heim
- Klinik für Hämatologie, Universitätsspital, Basel, Switzerland
| | - D K Hossfeld
- II. Medizinische Klinik, Universitätsklinikum Eppendorf, Hamburg, Germany
| | - H-J Kolb
- Medizinische Klinik und Poliklinik III, Klinikum der Ludwig-Maximilians-Universität, München, Germany
| | - S W Krause
- Medizinische Klinik 5, Universitätsklinikum, Erlangen, Germany
| | - C Nerl
- Klinik für Hämatologie, Onkologie, Immunologie, Palliativmedizin, Infektiologie und Tropenmedizin, Klinikum Schwabing, München, Germany
| | | | - W Verbeek
- Zentrum für ambulante Hämatologie und Onkologie, Bonn, Germany
| | - A A Fauser
- Klinik für Knochenmarktransplantation und Hämatologie/Onkologie, Klinikum, Idar-Oberstein, Germany
| | - O Prümmer
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Klinikum, Kempten, Germany
| | - K Neben
- Medizinische Klinik 2, Klinikum Mittelbaden, Standort Balg, Baden-Baden, Germany
| | - U Hess
- Klinik für Onkologie/Hämatologie, Kantonsspital, St Gallen, Switzerland
| | - R Mahlberg
- Innere Medizin 1, Klinikum Mutterhaus der Borromäerinnen, Trier, Germany
| | - C Plöger
- Mannheimer Onkologie Praxis, Mannheim, Germany
| | - M Flasshove
- Medizinische Klinik III, Krankenhaus, Düren, Germany
| | - B Rendenbach
- Praxis für Innere Medizin, Nephrologie, Hämatologie und Onkologie, Trier, Germany
| | - W-K Hofmann
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - M C Müller
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - M Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany
| | - A Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany
| | - J Hasford
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany
| | - R Hehlmann
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - S Saußele
- III. Medizinische Klinik, Universitätsmedizin, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
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Sellmann L, Scholtysik R, de Beer D, Eisele L, Klein-Hitpass L, Nückel H, Dührsen U, Dürig J, Röth A, Baerlocher GM. Shorter telomeres correlate with an increase in the number of uniparental disomies in patients with chronic lymphocytic leukemia. Leuk Lymphoma 2015; 57:590-5. [DOI: 10.3109/10428194.2015.1076929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Ludger Sellmann
- Department of Haematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany,
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Rene Scholtysik
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Dirk de Beer
- Experimental Haematology, Department of Clinical Research, University Bern, Switzerland, and
| | - Lewin Eisele
- Department of Haematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Ludger Klein-Hitpass
- Institute of Cell Biology (Cancer Research), Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Holger Nückel
- Department of Haematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Ulrich Dührsen
- Department of Haematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Jan Dürig
- Department of Haematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Alexander Röth
- Department of Haematology, Medical Faculty, University of Duisburg-Essen, Essen, Germany,
| | - Gabriela M. Baerlocher
- Experimental Haematology, Department of Clinical Research, University Bern, Switzerland, and
- Department of Haematology, University Hospital, Bern, Switzerland
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Baerlocher GM, Oppliger Leibundgut E, Ottmann OG, Spitzer G, Odenike O, McDevitt MA, Röth A, Daskalakis M, Burington B, Stuart M, Snyder DS. Telomerase Inhibitor Imetelstat in Patients with Essential Thrombocythemia. N Engl J Med 2015; 373:920-8. [PMID: 26332546 DOI: 10.1056/nejmoa1503479] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Imetelstat, a 13-mer oligonucleotide that is covalently modified with lipid extensions, competitively inhibits telomerase enzymatic activity. It has been shown to inhibit megakaryocytic proliferation in vitro in cells obtained from patients with essential thrombocythemia. In this phase 2 study, we investigated whether imetelstat could elicit hematologic and molecular responses in patients with essential thrombocythemia who had not had a response to or who had had unacceptable side effects from prior therapies. METHODS A total of 18 patients in two sequential cohorts received an initial dose of 7.5 or 9.4 mg of imetelstat per kilogram of body weight intravenously once a week until attainment of a platelet count of approximately 250,000 to 300,000 per cubic millimeter. The primary end point was the best hematologic response. RESULTS Imetelstat induced hematologic responses in all 18 patients, and 16 patients (89%) had a complete hematologic response. At the time of the primary analysis, 10 patients were still receiving treatment, with a median follow-up of 17 months (range, 7 to 32 [ongoing]). Molecular responses were seen in 7 of 8 patients who were positive for the JAK2 V617F mutation (88%; 95% confidence interval, 47 to 100). CALR and MPL mutant allele burdens were also reduced by 15 to 66%. The most common adverse events during treatment were mild to moderate in severity; neutropenia of grade 3 or higher occurred in 4 of the 18 patients (22%) and anemia, headache, and syncope of grade 3 or higher each occurred in 2 patients (11%). All the patients had at least one abnormal liver-function value; all persistent elevations were grade 1 or 2 in severity. CONCLUSIONS Rapid and durable hematologic and molecular responses were observed in patients with essential thrombocythemia who received imetelstat. (Funded by Geron; ClinicalTrials.gov number, NCT01243073.).
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Affiliation(s)
- Gabriela M Baerlocher
- From the Department of Hematology, University Hospital of Bern and University of Bern, Bern, Switzerland (G.M.B., E.O.L., M.D.); the Department of Hematology, School of Medicine, Cardiff University, Cardiff, United Kingdom (O.G.O.); Upstate Oncology Associates, Greenville, SC (G.S.); the Section of Hematology and Oncology, University of Chicago, Chicago (O.O.); the Divisions of Hematologic Malignancies and Hematology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore (M.A.M.); the Department of Hematology, University Hospital Essen, Essen, Germany (A.R.); and Geron, Menlo Park (B.B., M.S.), and the Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Gehr Family Center for Leukemia Research, Duarte (D.S.S.) - both in California
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Mager LF, Riether C, Schürch CM, Banz Y, Wasmer MH, Stuber R, Theocharides AP, Li X, Xia Y, Saito H, Nakae S, Baerlocher GM, Manz MG, McCoy KD, Macpherson AJ, Ochsenbein AF, Beutler B, Krebs P. IL-33 signaling contributes to the pathogenesis of myeloproliferative neoplasms. J Clin Invest 2015; 125:2579-91. [PMID: 26011644 DOI: 10.1172/jci77347] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 04/23/2015] [Indexed: 12/16/2022] Open
Abstract
Myeloproliferative neoplasms (MPNs) are characterized by the clonal expansion of one or more myeloid cell lineage. In most cases, proliferation of the malignant clone is ascribed to defined genetic alterations. MPNs are also associated with aberrant expression and activity of multiple cytokines; however, the mechanisms by which these cytokines contribute to disease pathogenesis are poorly understood. Here, we reveal a non-redundant role for steady-state IL-33 in supporting dysregulated myelopoiesis in a murine model of MPN. Genetic ablation of the IL-33 signaling pathway was sufficient and necessary to restore normal hematopoiesis and abrogate MPN-like disease in animals lacking the inositol phosphatase SHIP. Stromal cell-derived IL-33 stimulated the secretion of cytokines and growth factors by myeloid and non-hematopoietic cells of the BM, resulting in myeloproliferation in SHIP-deficient animals. Additionally, in the transgenic JAK2V617F model, the onset of MPN was delayed in animals lacking IL-33 in radio-resistant cells. In human BM, we detected increased numbers of IL-33-expressing cells, specifically in biopsies from MPN patients. Exogenous IL-33 promoted cytokine production and colony formation by primary CD34+ MPN stem/progenitor cells from patients. Moreover, IL-33 improved the survival of JAK2V617F-positive cell lines. Together, these data indicate a central role for IL-33 signaling in the pathogenesis of MPNs.
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de Beer D, Völzmann J, Kalka C, Baerlocher GM. Longitudinal Telomere Erosion in Lymphocyte Subsets of Patients with Atherosclerotic Peripheral Arterial Disease (PAD). J Clin Diagn Res 2015; 9:OM01-3. [PMID: 25954657 DOI: 10.7860/jcdr/2015/10931.5684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 12/01/2014] [Indexed: 11/24/2022]
Abstract
Telomere attrition has been linked to accelerate vascular ageing and seems to predispose for vascular disease. Our aim was to study the telomere length dynamics over time and in subsets of leukocytes from 15 patients with peripheral arterial disease (PAD). The mean telomere length in subsets of leukocytes of patients with PAD was in the normal range of age-related telomere length values from healthy individuals. However, we found significant higher telomere attrition for T-cells from patients with PAD over a time period of six months when compared to the controls. The higher telomere loss in T-cells of patients with PAD most likely reflects a higher cell turnover of this leukocyte subset, which is involved in the process of chronic inflammatory disease underlying vascular disease. Further studies are needed to confirm these data and to assess how far this T-cell telomere attrition will correlate to the extent of the disease.
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Affiliation(s)
- Dirk de Beer
- Experimental Hematology, Department of Clinical Research, University of Bern, Bern Switzerland; Department of Hematology, University Hospital/Inselspital Bern , Bern, Switzerland
| | - Jan Völzmann
- Department of Clinical and Interventional Angiology, University Hospital Bern , Bern
| | - Christoph Kalka
- Department of Clinical and Interventional Angiology, University Hospital Bern , Bern
| | - Gabriela M Baerlocher
- Experimental Hematology, Department of Clinical Research, University of Bern, Bern Switzerland; Department of Hematology, University Hospital/Inselspital Bern , Bern, Switzerland
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Berger MD, Branger G, Leibundgut K, Baerlocher GM, Seipel K, Mueller BU, Gregor M, Ruefer A, Pabst T. CD34+ selected versus unselected autologous stem cell transplantation in patients with advanced-stage mantle cell and diffuse large B-cell lymphoma. Leuk Res 2015; 39:561-7. [PMID: 25890431 DOI: 10.1016/j.leukres.2015.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 10/14/2014] [Revised: 03/02/2015] [Accepted: 03/05/2015] [Indexed: 11/16/2022]
Abstract
Novel strategies aiming to increase survival rates in patients with advanced-stage mantle cell lymphoma (MCL) and relapsing diffuse large B-cell lymphoma (DLBCL) are a clinical need. High-dose chemotherapy (HDCT) with autologous stem cell transplantation (ASCT) has improved progression-free (PFS) and overall survival (OS) in MCL and relapsed DLBCL. However, the role of CD34+ cell selection before ASCT in MCL and DLBCL is unclear. We retrospectively analyzed the outcome of 62 consecutive patients with advanced-stage MCL or relapsed DLBCL undergoing ASCT with (n=31) or without (n=31) prior CD34+ selection. All patients had stage III or IV disease, with 47% having DLBCL and 53% MCL. The median duration for neutrophil and platelet recovery was 12 and 16 days in CD34+ selected patients, and 11 (P<.001) and 14 days (P=.012) in the group without selection, respectively. No differences in toxicities were observed. The 5-year PFS for CD34+ selected versus not selected patients was 67% and 39% (P=.016), and the 5-year OS was 86% and 54% (P=.007). Our data suggest that using CD34+ selected autografts for ASCT in advanced stage MCL and DLBCL is associated with longer PFS and OS without increased toxicity.
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Affiliation(s)
- Martin D Berger
- Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland
| | - Giacomo Branger
- Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland
| | - Kurt Leibundgut
- Department of Pediatrics, University Hospital and University of Berne, Berne, Switzerland
| | - Gabriela M Baerlocher
- Department of Hematology, University Hospital and University of Berne, Berne, Switzerland
| | - Katja Seipel
- Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland
| | - Beatrice U Mueller
- Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland
| | - Michael Gregor
- Department of Hematology, Kantonsspital, Lucerne, Switzerland
| | - Axel Ruefer
- Department of Hematology, Kantonsspital, Lucerne, Switzerland
| | - Thomas Pabst
- Department of Medical Oncology, University Hospital and University of Berne, Berne, Switzerland; Department of Clinical Research, University Hospital and University of Berne, Berne, Switzerland.
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Gotta V, Widmer N, Decosterd LA, Chalandon Y, Heim D, Gregor M, Benz R, Leoncini-Franscini L, Baerlocher GM, Duchosal MA, Csajka C, Buclin T. Clinical usefulness of therapeutic concentration monitoring for imatinib dosage individualization: results from a randomized controlled trial. Cancer Chemother Pharmacol 2014; 74:1307-19. [PMID: 25297989 DOI: 10.1007/s00280-014-2599-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 09/22/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE This study assessed whether a cycle of "routine" therapeutic drug monitoring (TDM) for imatinib dosage individualization, targeting an imatinib trough plasma concentration (C min) of 1,000 ng/ml (tolerance: 750-1,500 ng/ml), could improve clinical outcomes in chronic myelogenous leukemia (CML) patients, compared with TDM use only in case of problems ("rescue" TDM). METHODS Imatinib concentration monitoring evaluation was a multicenter randomized controlled trial including adult patients in chronic or accelerated phase CML receiving imatinib since less than 5 years. Patients were allocated 1:1 to "routine TDM" or "rescue TDM." The primary endpoint was a combined outcome (failure- and toxicity-free survival with continuation on imatinib) over 1-year follow-up, analyzed in intention-to-treat (ISRCTN31181395). RESULTS Among 56 patients (55 evaluable), 14/27 (52 %) receiving "routine TDM" remained event-free versus 16/28 (57 %) "rescue TDM" controls (P = 0.69). In the "routine TDM" arm, dosage recommendations were correctly adopted in 14 patients (median C min: 895 ng/ml), who had fewer unfavorable events (28 %) than the 13 not receiving the advised dosage (77 %; P = 0.03; median C min: 648 ng/ml). CONCLUSIONS This first target concentration intervention trial could not formally demonstrate a benefit of "routine TDM" because of small patient number and surprisingly limited prescriber's adherence to dosage recommendations. Favorable outcomes were, however, found in patients actually elected for target dosing. This study thus shows first prospective indication for TDM being a useful tool to guide drug dosage and shift decisions. The study design and analysis provide an interesting paradigm for future randomized TDM trials on targeted anticancer agents.
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Affiliation(s)
- V Gotta
- Division of Clinical Pharmacology, Service of Biomedicine, Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Bugnon 17-1, 1011, Lausanne, Switzerland
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Wetzel D, Mueller BU, Mansouri Taleghani B, Baerlocher GM, Seipel K, Leibundgut K, Pabst T. Delayed Haematological recovery after autologous stem cell transplantation is associated with favourable outcome in acute myeloid leukaemia. Br J Haematol 2014; 168:268-73. [DOI: 10.1111/bjh.13118] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 07/29/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Dana Wetzel
- Department of Medical Oncology; University Hospital and University of Berne; Berne Switzerland
| | - Beatrice U. Mueller
- Department of Clinical Research; University Hospital and University of Berne; Berne Switzerland
| | | | - Gabriela M. Baerlocher
- Department of Haematology; University Hospital and University of Berne; Berne Switzerland
| | - Katja Seipel
- Department of Clinical Research; University Hospital and University of Berne; Berne Switzerland
| | - Kurt Leibundgut
- Department of Paediatric Haemato-Oncology; University Hospital and University of Berne; Berne Switzerland
| | - Thomas Pabst
- Department of Medical Oncology; University Hospital and University of Berne; Berne Switzerland
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Proetel U, Pletsch N, Lauseker M, Müller MC, Hanfstein B, Krause SW, Kalmanti L, Schreiber A, Heim D, Baerlocher GM, Hofmann WK, Lange E, Einsele H, Wernli M, Kremers S, Schlag R, Müller L, Hänel M, Link H, Hertenstein B, Pfirrmann M, Hochhaus A, Hasford J, Hehlmann R, Saußele S. Older patients with chronic myeloid leukemia (≥65 years) profit more from higher imatinib doses than younger patients: a subanalysis of the randomized CML-Study IV. Ann Hematol 2014; 93:1167-76. [PMID: 24658964 PMCID: PMC4050299 DOI: 10.1007/s00277-014-2041-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 11/28/2022]
Abstract
The impact of imatinib dose on response rates and survival in older patients with chronic myeloid leukemia in chronic phase has not been studied well. We analyzed data from the German CML-Study IV, a randomized five-arm treatment optimization study in newly diagnosed BCR-ABL-positive chronic myeloid leukemia in chronic phase. Patients randomized to imatinib 400 mg/day (IM400) or imatinib 800 mg/day (IM800) and stratified according to age (≥65 years vs. <65 years) were compared regarding dose, response, adverse events, rates of progression, and survival. The full 800 mg dose was given after a 6-week run-in period with imatinib 400 mg/day. The dose could then be reduced according to tolerability. A total of 828 patients were randomized to IM400 or IM800. Seven hundred eighty-four patients were evaluable (IM400, 382; IM800, 402). One hundred ten patients (29 %) on IM400 and 83 (21 %) on IM800 were ≥65 years. The median dose per day was lower for patients ≥65 years on IM800, with the highest median dose in the first year (466 mg/day for patients ≥65 years vs. 630 mg/day for patients <65 years). Older patients on IM800 achieved major molecular remission and deep molecular remission as fast as younger patients, in contrast to standard dose imatinib with which older patients achieved remissions much later than younger patients. Grades 3 and 4 adverse events were similar in both age groups. Five-year relative survival for older patients was comparable to that of younger patients. We suggest that the optimal dose for older patients is higher than 400 mg/day. ClinicalTrials.gov identifier: NCT00055874
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Affiliation(s)
- Ulrike Proetel
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Nadine Pletsch
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany
| | - Martin C. Müller
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Benjamin Hanfstein
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | | | - Lida Kalmanti
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Annette Schreiber
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Dominik Heim
- Klinik für Hämatologie, Universitätsspital, Basel, Switzerland
| | - Gabriela M. Baerlocher
- Universitätsklinik für Hämatologie und hämatologisches Zentrallabor, Inselspital, Bern, Switzerland
| | - Wolf-Karsten Hofmann
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Elisabeth Lange
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Evangelisches Krankenhaus, Hamm, Germany
| | - Hermann Einsele
- Medizinische Klinik und Poliklinik II, Universitätsklinikum, Würzburg, Germany
| | - Martin Wernli
- Onkologie/Hämatologie, Kantonsspital, Aarau, Switzerland
| | | | - Rudolf Schlag
- Hämatologisch-Onkologische Praxis, Würzburg, Germany
| | | | - Mathias Hänel
- Klinik für Innere Medizin III, Klinikum, Chemnitz, Germany
| | - Hartmut Link
- Medizinische Klinik I, Westpfalz-Klinikum, Kaiserslautern, Germany
| | | | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany
| | - Joerg Hasford
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany
| | - Rüdiger Hehlmann
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
| | - Susanne Saußele
- III. Medizinische Klinik, Universitätsmedizin Mannheim der Universität Heidelberg, Pettenkoferstrasse 22, 68169 Mannheim, Germany
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Schmid A, Friess D, Mansouri Taleghani B, Keller P, Mueller BU, Baerlocher GM, Leibundgut K, Pabst T. Role of plerixafor in autologous stem cell mobilization with vinorelbine chemotherapy and granulocyte-colony stimulating factor in patients with myeloma: a phase II study (PAV-trial). Leuk Lymphoma 2014; 56:608-14. [DOI: 10.3109/10428194.2014.927454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [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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Hehlmann R, Kalmanti L, Dietz C, Lauseker M, Heinrich L, Proetel U, Hochhaus A, Müller MC, Fabarius A, Krause SW, Dengler J, Falge C, Baerlocher GM, Kanz L, Stegelmann F, Pfreundschuh M, Spiekermann K, Pfirrmann M, Saussele S, Hasford J. Efficacy and safety of imatinib in CML over 10 years. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.7021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rüdiger Hehlmann
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Lida Kalmanti
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Christian Dietz
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig Maximilians Universität, München, Germany
| | - Lisa Heinrich
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Ulrike Proetel
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Andreas Hochhaus
- Klinik für Innere Medizin II, Universitätsklinikum, Jena, Germany
| | - Martin C. Müller
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Alice Fabarius
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | | | - Jolanta Dengler
- Abteilung Innere Medizin V, Universitätsklinikum, Heidelberg, Germany
| | - Christiane Falge
- Hämatologisch-onkologische Ambulanz, Klinikum Nord, Nürnberg, Germany
| | | | - Lothar Kanz
- Klinik für Innere Medizin II, Universitätsklinikum, Tübingen, Germany
| | - Frank Stegelmann
- Klinik für Innere Medizin III, Universitätsklinikum, Ulm, Germany
| | | | - Karsten Spiekermann
- Medizinischen Klinik III und Poliklinik, Klinikum der Universität, München, Germany
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig Maximilians Universität, München, Germany
| | - Susanne Saussele
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Joerg Hasford
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig Maximilians Universität, München, Germany
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Hanfstein B, Lauseker M, Hehlmann R, Saussele S, Erben P, Dietz C, Fabarius A, Proetel U, Schnittger S, Haferlach C, Krause SW, Schubert J, Einsele H, Hänel M, Dengler J, Falge C, Kanz L, Neubauer A, Kneba M, Stegelmann F, Pfreundschuh M, Waller CF, Spiekermann K, Baerlocher GM, Pfirrmann M, Hasford J, Hofmann WK, Hochhaus A, Müller MC. Distinct characteristics of e13a2 versus e14a2 BCR-ABL1 driven chronic myeloid leukemia under first-line therapy with imatinib. Haematologica 2014; 99:1441-7. [PMID: 24837466 DOI: 10.3324/haematol.2013.096537] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The vast majority of chronic myeloid leukemia patients express a BCR-ABL1 fusion gene mRNA encoding a 210 kDa tyrosine kinase which promotes leukemic transformation. A possible differential impact of the corresponding BCR-ABL1 transcript variants e13a2 ("b2a2") and e14a2 ("b3a2") on disease phenotype and outcome is still a subject of debate. A total of 1105 newly diagnosed imatinib-treated patients were analyzed according to transcript type at diagnosis (e13a2, n=451; e14a2, n=496; e13a2+e14a2, n=158). No differences regarding age, sex, or Euro risk score were observed. A significant difference was found between e13a2 and e14a2 when comparing white blood cells (88 vs. 65 × 10(9)/L, respectively; P<0.001) and platelets (296 vs. 430 × 10(9)/L, respectively; P<0.001) at diagnosis, indicating a distinct disease phenotype. No significant difference was observed regarding other hematologic features, including spleen size and hematologic adverse events, during imatinib-based therapies. Cumulative molecular response was inferior in e13a2 patients (P=0.002 for major molecular response; P<0.001 for MR4). No difference was observed with regard to cytogenetic response and overall survival. In conclusion, e13a2 and e14a2 chronic myeloid leukemia seem to represent distinct biological entities. However, clinical outcome under imatinib treatment was comparable and no risk prediction can be made according to e13a2 versus e14a2 BCR-ABL1 transcript type at diagnosis. (clinicaltrials.gov identifier:00055874).
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Affiliation(s)
- Benjamin Hanfstein
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig-Maximilians-Universität München, Germany
| | - Rüdiger Hehlmann
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Susanne Saussele
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Philipp Erben
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Christian Dietz
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Alice Fabarius
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Ulrike Proetel
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | | | | | - Stefan W Krause
- Medizinische Klinik 5, Universitätsklinikum Erlangen, Germany
| | - Jörg Schubert
- Klinik für Hämatologie, Onkologie und Palliativmedizin, Evangelisches Krankenhaus Hamm, Germany
| | - Hermann Einsele
- Medizinische Klinik und Poliklinik II, Universitätsklinikum Würzburg, Germany
| | - Mathias Hänel
- Klinik für Innere Medizin III, Klinikum Chemnitz, Germany
| | - Jolanta Dengler
- Medizinische Universitätsklinik, Abteilung Innere Medizin V, Ruprecht-Karls-Universität Heidelberg, Germany
| | | | - Lothar Kanz
- Medizinische Klinik II, Universitätsklinikum Tübingen, Germany
| | - Andreas Neubauer
- Klinik für Innere Medizin, Schwerpunkt Hämatologie, Onkologie und Immunologie, Universitätsklinikum Gießen und Marburg, Marburg, Germany
| | - Michael Kneba
- II. Medizinische Klinik und Poliklinik im Städtischen Krankenhaus, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
| | - Frank Stegelmann
- Klinik für Innere Medizin III, Universitätsklinikum Ulm, Germany
| | | | | | - Karsten Spiekermann
- Medizinische Klinik und Poliklinik III, Ludwig-Maximilians-Universität München, Germany
| | | | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig-Maximilians-Universität München, Germany
| | - Joerg Hasford
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig-Maximilians-Universität München, Germany
| | - Wolf-Karsten Hofmann
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
| | - Andreas Hochhaus
- Abteilung für Hämatologie und Onkologie, Klinik für Innere Medizin II, Universitätsklinikum Jena, Germany
| | - Martin C Müller
- III. Medizinische Klinik - Hämatologie und Onkologie, Universitätsmedizin Mannheim, Germany
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Hanfstein B, Shlyakhto V, Lauseker M, Hehlmann R, Saussele S, Dietz C, Erben P, Fabarius A, Proetel U, Schnittger S, Krause SW, Schubert J, Einsele H, Hänel M, Dengler J, Falge C, Kanz L, Neubauer A, Kneba M, Stegelmann F, Pfreundschuh M, Waller CF, Spiekermann K, Baerlocher GM, Pfirrmann M, Hasford J, Hofmann WK, Hochhaus A, Müller MC. Velocity of early BCR-ABL transcript elimination as an optimized predictor of outcome in chronic myeloid leukemia (CML) patients in chronic phase on treatment with imatinib. Leukemia 2014; 28:1988-92. [DOI: 10.1038/leu.2014.153] [Citation(s) in RCA: 106] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 03/30/2014] [Accepted: 04/21/2014] [Indexed: 11/09/2022]
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46
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Jandus C, Boligan KF, Chijioke O, Liu H, Dahlhaus M, Démoulins T, Schneider C, Wehrli M, Hunger RE, Baerlocher GM, Simon HU, Romero P, Münz C, von Gunten S. Interactions between Siglec-7/9 receptors and ligands influence NK cell-dependent tumor immunosurveillance. J Clin Invest 2014; 124:1810-20. [PMID: 24569453 DOI: 10.1172/jci65899] [Citation(s) in RCA: 287] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/19/2013] [Indexed: 12/15/2022] Open
Abstract
Alteration of the surface glycosylation pattern on malignant cells potentially affects tumor immunity by directly influencing interactions with glycan-binding proteins (lectins) on the surface of immunomodulatory cells. The sialic acid-binding Ig-like lectins Siglec-7 and -9 are MHC class I-independent inhibitory receptors on human NK cells that recognize sialic acid-containing carbohydrates. Here, we found that the presence of Siglec-9 defined a subset of cytotoxic NK cells with a mature phenotype and enhanced chemotactic potential. Interestingly, this Siglec-9+ NK cell population was reduced in the peripheral blood of cancer patients. Broad analysis of primary tumor samples revealed that ligands of Siglec-7 and -9 were expressed on human cancer cells of different histological types. Expression of Siglec-7 and -9 ligands was associated with susceptibility of NK cell-sensitive tumor cells and, unexpectedly, of presumably NK cell-resistant tumor cells to NK cell-mediated cytotoxicity. Together, these observations have direct implications for NK cell-based therapies and highlight the requirement to consider both MHC class I haplotype and tumor-specific glycosylation.
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MESH Headings
- Animals
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Antigens, Tumor-Associated, Carbohydrate/metabolism
- Cell Line, Tumor
- Cytotoxicity, Immunologic
- Female
- Glycosylation
- HeLa Cells
- Humans
- Immunity, Innate
- K562 Cells
- Killer Cells, Natural/classification
- Killer Cells, Natural/immunology
- Lectins/metabolism
- Ligands
- Male
- Mice
- Mice, Inbred NOD
- Mice, SCID
- Monitoring, Immunologic
- Neoplasms/immunology
- Sialic Acid Binding Immunoglobulin-like Lectins/metabolism
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47
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Hehlmann R, Müller MC, Lauseker M, Hanfstein B, Fabarius A, Schreiber A, Proetel U, Pletsch N, Pfirrmann M, Haferlach C, Schnittger S, Einsele H, Dengler J, Falge C, Kanz L, Neubauer A, Kneba M, Stegelmann F, Pfreundschuh M, Waller CF, Spiekermann K, Baerlocher GM, Ehninger G, Heim D, Heimpel H, Nerl C, Krause SW, Hossfeld DK, Kolb HJ, Hasford J, Saußele S, Hochhaus A. Deep Molecular Response Is Reached by the Majority of Patients Treated With Imatinib, Predicts Survival, and Is Achieved More Quickly by Optimized High-Dose Imatinib: Results From the Randomized CML-Study IV. J Clin Oncol 2014; 32:415-23. [DOI: 10.1200/jco.2013.49.9020] [Citation(s) in RCA: 246] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Deep molecular response (MR4.5) defines a subgroup of patients with chronic myeloid leukemia (CML) who may stay in unmaintained remission after treatment discontinuation. It is unclear how many patients achieve MR4.5 under different treatment modalities and whether MR4.5 predicts survival. Patients and Methods Patients from the randomized CML-Study IV were analyzed for confirmed MR4.5 which was defined as ≥ 4.5 log reduction of BCR-ABL on the international scale (IS) and determined by reverse transcriptase polymerase chain reaction in two consecutive analyses. Landmark analyses were performed to assess the impact of MR4.5 on survival. Results Of 1,551 randomly assigned patients, 1,524 were assessable. After a median observation time of 67.5 months, 5-year overall survival (OS) was 90%, 5-year progression-free-survival was 87.5%, and 8-year OS was 86%. The cumulative incidence of MR4.5 after 9 years was 70% (median, 4.9 years); confirmed MR4.5 was 54%. MR4.5 was reached more quickly with optimized high-dose imatinib than with imatinib 400 mg/day (P = .016). Independent of treatment approach, confirmed MR4.5 at 4 years predicted significantly higher survival probabilities than 0.1% to 1% IS, which corresponds to complete cytogenetic remission (8-year OS, 92% v 83%; P = .047). High-dose imatinib and early major molecular remission predicted MR4.5. No patient with confirmed MR4.5 has experienced progression. Conclusion MR4.5 is a new molecular predictor of long-term outcome, is reached by a majority of patients treated with imatinib, and is achieved more quickly with optimized high-dose imatinib, which may provide an improved therapeutic basis for treatment discontinuation in CML.
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Affiliation(s)
- Rüdiger Hehlmann
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Martin C. Müller
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Michael Lauseker
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Benjamin Hanfstein
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Alice Fabarius
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Annette Schreiber
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Ulrike Proetel
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Nadine Pletsch
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Markus Pfirrmann
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Claudia Haferlach
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Susanne Schnittger
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Hermann Einsele
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Jolanta Dengler
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Christiane Falge
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Lothar Kanz
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Andreas Neubauer
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Michael Kneba
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Frank Stegelmann
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Michael Pfreundschuh
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Cornelius F. Waller
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Karsten Spiekermann
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Gabriela M. Baerlocher
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Gerhard Ehninger
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Dominik Heim
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Hermann Heimpel
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Christoph Nerl
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Stefan W. Krause
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Dieter K. Hossfeld
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Hans-Jochem Kolb
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Joerg Hasford
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Susanne Saußele
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
| | - Andreas Hochhaus
- Rüdiger Hehlmann, Martin C. Müller, Benjamin Hanfstein, Alice Fabarius, Annette Schreiber, Ulrike Proetel, Nadine Pletsch, Susanne Saußele, Universitätsmedizin Mannheim Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim; Jolanta Dengler Universitätsklinikum Heidelberg, Heidelberg; Michael Lauseker, Markus Pfirrmann, Joerg Hasford, Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität; Christoph Nerl, Städtisches Klinikum
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de Wreede LC, Watson M, van Os M, Milligan D, van Gelder M, Michallet M, Dreger P, Dearden CE, Homewood J, Dupuis J, Leporrier M, Karas M, Corront B, Baerlocher GM, Herr W, Choquet S, Niederwieser DW, Sutton L, Kröger N, de Witte TM, Schetelig J. Improved relapse-free survival after autologous stem cell transplantation does not translate into better quality of life in chronic lymphocytic leukemia: lessons from the randomized European Society for Blood and Marrow Transplantation-Intergroup study. Am J Hematol 2014; 89:174-80. [PMID: 24123244 DOI: 10.1002/ajh.23610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 10/02/2013] [Accepted: 10/03/2013] [Indexed: 12/21/2022]
Abstract
In chronic lymphocytic leukemia (CLL) medical progress is driven by clinical studies with relapse-free survival (RFS) as the primary endpoint. The randomized EBMT-Intergroup trial compared high-dose therapy and autologous stem cell transplantation (ASCT) to observation and demonstrated a substantial improvement of RFS without showing improved overall survival for the transplant arm. Here we report quality of life (QoL) information of the first 3 years following randomization from that study. The main objective was to assess the impact of treatment on QoL over time. Two secondary analyses were performed to further investigate the impact of ASCT and relapse on QoL. In the primary analysis, we demonstrate an adverse impact of ASCT on QoL which was largest at 4 months and continued throughout the first year after randomization. Further, we demonstrated a sustained adverse impact of relapse on QoL which worsened over time. Despite better disease control by ASCT the side effects thus turned the net effect towards inferior QoL in the first year and comparable QoL in the following 2 years after randomization. This study emphasizes the importance of information concerning QoL impacts when patients are counseled about treatments aimed at improving RFS in the absence of a survival benefit.
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Affiliation(s)
| | | | - Marleen van Os
- EBMT/Dept of Medical Statistics & Bioinformatics LUMC; Leiden The Netherlands
| | | | | | | | | | | | - Janis Homewood
- Institute of Cancer Research / Royal Marsden Hospital; Sutton United Kingdom
| | - Jehan Dupuis
- CHU Henri Mondor Assistance Publique-Hôpitaux de Paris; Creteil France
| | - Michel Leporrier
- Université de Caen Basse-Normandie & UMR 6301 ISTCT, LDM-TEP, GIP Cyceron; France
| | - Michal Karas
- Charles University Hospital; Pilsen Czech Republic
| | | | | | | | | | | | | | | | - Theo M. de Witte
- Radboud University Nijmegen Medical Center; Nijmegen The Netherlands
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49
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Jandus C, Boligan KF, Chijioke O, Liu H, Dahlhaus M, Démoulins T, Schneider C, Wehrli M, Hunger RE, Baerlocher GM, Simon HU, Romero P, Münz C, von Gunten S. Siglec-7/-9 ligands shield tumor cells from NK cell attack. J Immunother Cancer 2013. [PMCID: PMC3991059 DOI: 10.1186/2051-1426-1-s1-p157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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50
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Hehlmann R, Lauseker M, Hanfstein B, Müller MC, Schreiber A, Proetel U, Pfirrmann M, Schnittger S, Dengler J, Falge C, Neubauer A, Stegelmann F, Pfreundschuh M, Waller CF, Spiekermann K, Baerlocher GM, Krause SW, Hochhaus A, Hasford J, Saussele S. Effect of dose-optimized imatinib (IM) 800 mg on deep molecular responses (CMR 4.5) and prediction of survival: Results from the randomized CML-study IV. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.7051] [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: 11/20/2022] Open
Abstract
7051 Background: Since complete molecular remission (CMR 4.5) defines a subgroup of patients who may stay in remission even after discontinuation of treatment, we analysed whether CMR 4.5 is reached faster with dose optimized IM 800 mg and whether the achievement of CMR 4.5 at specified points in time results in better survival than the achievement of less deep remissions. Methods: Confirmed CMR 4 and CMR 4.5 are defined as ≤ 0.01% BCR-ABL IS or ≥ 4 log reduction and ≤ 0.0032% BCR-ABL IS or ≥ 4.5 log reduction, respectively, from standardized baseline as determined by real-time PCR in 2 independent analyses. Details on CML-Study IV have been published (Hehlmann et al., JCO 2011). Cumulative incidences were estimated under consideration of competing risks. Landmark analyses were performed to evaluate the prognostic impact of different remissions at 4 years on survival. Results: Of 1551 randomized patients with newly diagnosed chronic phase CML 1525 were evaluable. Median age was 52 years, 88% were EUTOS low risk, 12% high risk. 113 patients were transplanted (73 in first chronic phase), 246 received 2nd generation TKI. 152 patients have died. After a median observation time of 67.5 months, 6-year OS was 88.2%.CMR 4.5 was reached after a median of about 76.1 months with IM 800 and 107.3 months with IM 400. EUTOS low-risk patients reached all remissions faster than high-risk patients. Independent of treatment approach CMR 4.5 at 4 years predicted OS significantly better than complete cytogenetic remission (p=0.043), but not significantly better than major molecular remission (MMR) or CMR4. After a median observation of 3.9 years 1 of 626 patients with CMR 4 has progressed. Only six of the 394 patients with CMR 4.5 have died after a median observation time of 3.0 years, no patient has progressed. An additional finding was that achieving MMR at 3 and at 6 months predicts faster achievement of CMR 4.5. Conclusions: We conclude that dose optimized IM 800 induces CMR 4.5 faster than IM 400 and that CMR 4.5 at 4 years is associated with a survival advantage. Dose optimized IM 800 may provide an improved therapeutic basis for treatment discontinuation in patients with CML. Clinical trial information: NCT00055874.
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Affiliation(s)
- Rüdiger Hehlmann
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Michael Lauseker
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig Maximilians Universität, München, Germany
| | - Benjamin Hanfstein
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Martin C. Müller
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Annette Schreiber
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Ulrike Proetel
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - Markus Pfirrmann
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig Maximilians Universität, München, Germany
| | | | - Jolanta Dengler
- Medizinische Universitätsklinik, Abteilung Innere Medizin V, Ruprecht-Karls-Universität, Heidelberg, Germany
| | | | - Andreas Neubauer
- Klinik für Innere Medizin, Schwerpunkt Hämatologie, Onkologie und Immunologie, Universitätsklinikum, Marburg, Germany
| | - Frank Stegelmann
- Klinik für Innere Medizin III, Universitätsklinikum, Ulm, Germany
| | | | | | - Karsten Spiekermann
- Medizinische Klinik und Poliklinik III, Ludwig-Maximilians Universität, München, Germany
| | | | | | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Universitätsklinikum Jena, Jena, Germany
| | - Joerg Hasford
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie der Ludwig Maximilians Universität, München, Germany
| | - Susanne Saussele
- III. Medizinische Universitätsklinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
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