1
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Kikuchi Y, Shimada H, Yamasaki F, Yamashita T, Araki K, Horimoto K, Yajima S, Yashiro M, Yokoi K, Cho H, Ehira T, Nakahara K, Yasuda H, Isobe K, Hayashida T, Hatakeyama S, Akakura K, Aoki D, Nomura H, Tada Y, Yoshimatsu Y, Miyachi H, Takebayashi C, Hanamura I, Takahashi H. Clinical practice guidelines for molecular tumor marker, 2nd edition review part 2. Int J Clin Oncol 2024; 29:512-534. [PMID: 38493447 DOI: 10.1007/s10147-024-02497-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/21/2024] [Indexed: 03/19/2024]
Abstract
In recent years, rapid advancement in gene/protein analysis technology has resulted in target molecule identification that may be useful in cancer treatment. Therefore, "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" was published in Japan in September 2021. These guidelines were established to align the clinical usefulness of external diagnostic products with the evaluation criteria of the Pharmaceuticals and Medical Devices Agency. The guidelines were scoped for each tumor, and a clinical questionnaire was developed based on a serious clinical problem. This guideline was based on a careful review of the evidence obtained through a literature search, and recommendations were identified following the recommended grades of the Medical Information Network Distribution Services (Minds). Therefore, this guideline can be a tool for cancer treatment in clinical practice. We have already reported the review portion of "Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition" as Part 1. Here, we present the English version of each part of the Clinical Practice Guidelines for Molecular Tumor Marker, Second Edition.
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Affiliation(s)
| | - Hideaki Shimada
- Department of Clinical Oncology, Toho University, Tokyo, Japan.
- Department of Surgery, Toho University, Tokyo, Japan.
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Taku Yamashita
- Department of Otorhinolaryngology-Head and Neck Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Koji Araki
- Department of Otorhinolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan
| | - Kohei Horimoto
- Department of Dermatology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | | | - Masakazu Yashiro
- Department of Molecular Oncology and Therapeutics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Keigo Yokoi
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Haruhiko Cho
- Department of Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan
| | - Takuya Ehira
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazunari Nakahara
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Hiroshi Yasuda
- Department of Gastroenterology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Kazutoshi Isobe
- Division of Respiratory Medicine, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Tetsu Hayashida
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | | | - Daisuke Aoki
- International University of Health and Welfare Graduate School, Tokyo, Japan
| | - Hiroyuki Nomura
- Department of Obstetrics and Gynecology, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yuji Tada
- Department of Pulmonology, School of Medicine, International University of Health and Welfare, Chiba, Japan
| | - Yuki Yoshimatsu
- Department of Patient-Derived Cancer Model, Tochigi Cancer Center Research Institute, Tochigi, Japan
| | - Hayato Miyachi
- Faculty of Clinical Laboratory Sciences, Nitobe Bunka College, Tokyo, Japan
| | - Chiaki Takebayashi
- Division of Hematology and Oncology, Department of Internal Medicine (Omori), Toho University, Tokyo, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
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2
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Karnan S, Hanamura I, Ota A, Vu LQ, Uchino K, Horio T, Murakami S, Mizuno S, Rahman ML, Wahiduzzaman M, Hasan MN, Biswas M, Hyodo T, Ito H, Suzuki A, Konishi H, Tsuzuki S, Hosokawa Y, Takami A. ARK5 enhances cell survival associated with mitochondrial morphological dynamics from fusion to fission in human multiple myeloma cells. Cell Death Discov 2024; 10:56. [PMID: 38282096 PMCID: PMC10822851 DOI: 10.1038/s41420-024-01814-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 01/30/2024] Open
Abstract
5' adenosine monophosphate-activated protein kinase-related kinase 5 (ARK5) is involved in mitochondrial ATP production and associated with poor prognosis of multiple myeloma (MM). However, the molecular mechanisms of ARK5 in MM remain largely unknown. This study examined the pathogenic role of ARK5 in mitochondria by using genetically modified isogenic cell clones with or without ARK5 in human myeloma cell lines, KMS-11 and Sachi, which overexpress ARK5. The biallelic knockout of ARK5 (ARK5-KO) inhibited cell proliferation, colony formation, and migration with increased apoptosis. Mitochondrial fusion was enhanced in ARK5-KO cells, unlike in ARK5 wild-type (ARK5-WT) cells, which exhibited increased mitochondrial fission. Furthermore, ARK5-KO cells demonstrated a lower phosphorylated dynamin-related protein 1 at serine 616, higher protein expression of mitofusin-1 (MFN1) and MFN2, optic atrophy 1 with a lower level of ATP, and higher levels of lactate and reactive oxygen species than ARK5-WT cells. Our findings suggest that ARK5-enhanced myeloma cells can survive associated mitochondrial fission and activity. This study first revealed the relationship between ARK5 and mitochondrial morphological dynamics. Thus, our outcomes show novel aspects of mitochondrial biology of ARK5, which can afford a more advanced treatment approach for unfavorable MM expressing ARK5.
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Grants
- 19K08825, 22K08516[Hanamura] Ministry of Education, Culture, Sports, Science and Technology (MEXT)
- 19K09292, 22K08985 [Karnan] Ministry of Education, Culture, Sports, Science and Technology (MEXT)
- 21K08426 [Ota] Ministry of Education, Culture, Sports, Science and Technology (MEXT)
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Affiliation(s)
- Sivasundaram Karnan
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan.
| | - Akinobu Ota
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
- Department of Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, 463-8521, Japan
| | - Lam Quang Vu
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Tomohiro Horio
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Satsuki Murakami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
| | - Md Lutfur Rahman
- EuGEF Research Foundation, Chattogram, Bangladesh
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Md Wahiduzzaman
- EuGEF Research Foundation, Chattogram, Bangladesh
- Department of Foundations of Medicine, NYU Grossman Long Island School of Medicine, 101 Mineola Blvd, Mineola, NY, 11501, USA
| | - Muhammad Nazmul Hasan
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
- EuGEF Research Foundation, Chattogram, Bangladesh
| | - Mrityunjoy Biswas
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
| | - Hideaki Ito
- Department of Pathology, Aichi Medical University, Nagakute, Aichi, Japan
| | - Atsushi Suzuki
- Hematology Medical Franchise, Department of Medical Affairs, Novartis Japan, Tokyo, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, Aichi Medical University, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Aichi, Japan
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3
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Takamatsu H, Matsuda T, Mizuno S, Takahashi T, Fuchida SI, Hanamura I, Kataoka K, Tsukada N, Matsumoto M, Hangaishi A, Doki N, Uchida N, Sawa M, Maruyama Y, Kurahashi S, Nagafuji K, Harazaki Y, Kako S, Iida S, Ichinohe T, Kanda Y, Atsuta Y, Sunami K. Changing trends in the risk factors for second primary malignancies after autologous stem cell transplantation for multiple myeloma before and after the introduction of proteasome inhibitors and immunomodulatory drugs. Haematologica 2023; 108:3399-3408. [PMID: 37470160 PMCID: PMC10690906 DOI: 10.3324/haematol.2023.283202] [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: 03/27/2023] [Accepted: 07/10/2023] [Indexed: 07/21/2023] Open
Abstract
The incidence of second primary malignancies (SPM) in long-term survivors of multiple myeloma (MM) is increasing because of increased life expectancy. We retrospectively analyzed the risk factors for SPM in patients with MM after autologous stem cell transplantation (ASCT) before and after the introduction of proteasome inhibitors and immunomodulatory drugs (IMiDs). In total, 2,340 patients newly diagnosed with MM who underwent ASCT between 1995 and 2016 were enrolled in this study. Forty-three patients developed SPM (29 solid, 12 hematological, and 2 unknown tumors), with cumulative incidence rates of 0.8% and 2.5% at 24 and 60 months, respectively. The cumulative incidence rates of hematological and solid SPM at 60 months were 0.8% and 1.8%, respectively. The overall survival (OS) rate at 60 months after ASCT was 62.9% and the OS rates after the diagnosis of SPM at 24 months were 72.2% for hematological SPM and 70.9% for solid SPM. Multivariate analysis revealed that the use of IMiDs (P=0.024) and radiation (P=0.002) were significant independent risk factors for SPM. The probabilities of developing SPM and death due to other causes (mainly MM) at 60 months were 2.5% and 36.5%, respectively, indicating that the risk of SPM was lower than that of death from MM. Furthermore, SPM between the pre-novel and novel agent eras (ASCT between 2007 and 2016) groups significantly increased (1.9% vs. 4.3% at 60 months; P=0.022). The early occurrence of SPM after ASCT should be monitored cautiously.
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Affiliation(s)
| | - Tomohiro Matsuda
- Division of International Health Policy Research, National Cancer Center Institute for Cancer Control, Tokyo
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute
| | | | - Shin-Ichi Fuchida
- Department of Hematology, Japan Community Health care Organization Kyoto Kuramaguchi Medical Center, Kyoto
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute
| | - Keisuke Kataoka
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan; Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo
| | - Nobuhiro Tsukada
- Division of Hematology, Japanese Red Cross Medical Center, Tokyo
| | - Morio Matsumoto
- Department of Hematology, National Hospital Organization Shibukawa Medical Center, Shibukawa
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, Tokyo
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo
| | - Naoyuki Uchida
- Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations TORANOMON HOSPITAL, Tokyo
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo
| | - Yumiko Maruyama
- Department of Hematology, University of Tsukuba Hospital, Tsukuba
| | - Shingo Kurahashi
- Division of Hematology and Oncology, Toyohashi Municipal Hospital, Toyohashi
| | - Koji Nagafuji
- Division of Hematology and Oncology, Department of Medicine, Kurume University Hospital, Kurume
| | | | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama
| | - Shinsuke Iida
- Division of Hematology and Oncology, Nagoya City University Hospital, Nagoya
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan; Division of Hematology, Department of Medicine, Jichi Medical University, Shimotsuke
| | - Yoshiko Atsuta
- Aichi Medical University School of Medicine / Department of Registry Science for Transplant and Cellular Therapy, Nagakute
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama
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4
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Karnan S, Ota A, Murakami H, Rahman ML, Wahiduzzaman M, Hasan MN, Vu LQ, Hanamura I, Inoko A, Riku M, Ito H, Kaneko Y, Hyodo T, Konishi H, Tsuzuki S, Hosokawa Y. CAMK2D: a novel molecular target for BAP1-deficient malignant mesothelioma. Cell Death Discov 2023; 9:257. [PMID: 37479714 PMCID: PMC10362017 DOI: 10.1038/s41420-023-01552-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/23/2023] Open
Abstract
Malignant mesothelioma (MMe) is a rare but aggressive malignancy. Although the molecular genetics of MMe is known, including BRCA1-associated protein-1 (BAP1) gene alterations, the prognosis of MMe patients remains poor. Here, we generated BAP1 knockout (BAP1-KO) human mesothelial cell clones to develop molecular-targeted therapeutics based on genetic alterations in MMe. cDNA microarray and quantitative RT-PCR (qRT-PCR) analyses revealed high expression of a calcium/calmodulin-dependent protein kinase type II subunit delta (CAMK2D) gene in the BAP1-KO cells. CAMK2D was highly expressed in 70% of the human MMe tissues (56/80) and correlated with the loss of BAP1 expression, making it a potential diagnostic and therapeutic target for BAP1-deficient MMe. We screened an anticancer drugs library using BAP1-KO cells and successfully identified a CaMKII inhibitor, KN-93, which displayed a more potent and selective antiproliferative effect against BAP1-deficient cells than cisplatin or pemetrexed. KN-93 significantly suppressed the tumor growth in mice xenografted with BAP1-deficient MMe cells. This study is the first to provide a potential molecular-targeted therapeutic approach for BAP1-deficient MMe.
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Affiliation(s)
- Sivasundaram Karnan
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
| | - Akinobu Ota
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
- Department of Nutritional Environment, College of Human Life and Environment, Kinjo Gakuin University, Nagoya, 463-8521, Japan
| | - Hideki Murakami
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Md Lutfur Rahman
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Md Wahiduzzaman
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, US
- Eukaryotic Gene Expression and Function (EuGEF) Research Group, Chattogram, 4000, Bangladesh
| | - Muhammad Nazmul Hasan
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
- Eukaryotic Gene Expression and Function (EuGEF) Research Group, Chattogram, 4000, Bangladesh
| | - Lam Quang Vu
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Akihito Inoko
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Miho Riku
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Hideaki Ito
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Yoshifumi Kaneko
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, , Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
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5
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Ogura M, Yamamoto K, Morishima Y, Wakabayashi M, Tobinai K, Ando K, Uike N, Kurosawa M, Gomyo H, Taniwaki M, Nosaka K, Tsukamoto N, Shimoyama T, Fukuhara N, Yakushijin Y, Ohnishi K, Miyazaki K, Kameoka Y, Takayama N, Hanamura I, Kobayashi H, Usuki K, Kobayashi N, Ohyashiki K, Utsumi T, Kumagai K, Maruyama D, Ohmachi K, Matsuno Y, Nakamura S, Hotta T, Tsukasaki K, Nagai H. Long-term follow-up after R-High CHOP/CHASER/LEED with Auto-PBSCT in untreated mantle cell lymphoma-Final analysis of JCOG0406. Cancer Sci 2023. [PMID: 37232264 PMCID: PMC10394137 DOI: 10.1111/cas.15849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/06/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
Progression-free survival after R-High CHOP/CHASER/LEED with auto-PBSCT in untreated mantle cell lymphoma in JCOG0406 study. A continuous pattern of relapse was observed.
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Affiliation(s)
- Michinori Ogura
- Department of Hematology, Aichi Sannomaru Clinic, Nagoya, Japan
- Department of Hematology and Oncology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, Nagoya, Japan
| | - Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
| | - Yasuo Morishima
- Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan
| | | | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Kiyoshi Ando
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Naokuni Uike
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Mitsutoshi Kurosawa
- Department of Hematology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroshi Gomyo
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | - Masafumi Taniwaki
- Department of Hematology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kisato Nosaka
- Department of Hematology, Kumamoto University School of Medicine, Kumamoto, Japan
| | | | - Tatsu Shimoyama
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Tokyo, Japan
| | - Noriko Fukuhara
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | - Yoshihiro Yakushijin
- First Department of Internal Medicine, Ehime University Graduate School of Medicine, Tohon-shi, Japan
| | - Kazunori Ohnishi
- Department of Hematology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshihiro Kameoka
- Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - Nobuyuki Takayama
- Second Department of Internal Medicine, Kyorin University School of Medicine, Mitaka, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Hirofumi Kobayashi
- Department of Hematology, Saitama Cancer Center Hospital, Saitama, Japan
| | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Naoki Kobayashi
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Kazuma Ohyashiki
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Takahiko Utsumi
- Department of Hematology, Shiga General Hospital, Moriyama, Japan
| | - Kyoya Kumagai
- Department of Hematology, Chiba Cancer Center, Chiba, Japan
| | - Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Ohmachi
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Shigeo Nakamura
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - Tomomitsu Hotta
- National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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6
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Maruyama D, Iida S, Machida R, Kusumoto S, Fukuhara N, Yamauchi N, Miyazaki K, Yoshimitsu M, Kuroda J, Tsukamoto N, Tsujimura H, Usuki K, Yamauchi T, Utsumi T, Mizuno I, Takamatsu Y, Nagata Y, Ota S, Ohtsuka E, Hanamura I, Suzuki Y, Yoshida S, Yamasaki S, Suehiro Y, Kamiyama Y, Fukuhara S, Tsukasaki K, Nagai H. Final analysis of randomized phase II study optimizing melphalan, prednisolone, bortezomib in multiple myeloma (
JCOG1105
). Cancer Sci 2022; 113:3267-3270. [PMID: 35909244 PMCID: PMC9459263 DOI: 10.1111/cas.15484] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 12/04/2022] Open
Affiliation(s)
- Dai Maruyama
- Department of Hematology Oncology, Cancer Institute Hospital Japanese Foundation for Cancer Research Tokyo Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology Nagoya City University Hospital Nagoya Japan
| | | | - Shigeru Kusumoto
- Department of Hematology and Oncology Nagoya City University Hospital Nagoya Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology Tohoku University Hospital Sendai Japan
| | - Nobuhiko Yamauchi
- Department of Hematology National Cancer Center Hospital East Kashiwa Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology Mie University School of Medicine Tsu Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology Kagoshima University Hospital Kagoshima Japan
| | - Junya Kuroda
- Division of Hematology and Oncology Kyoto Prefectural University of Medicine Kyoto Japan
| | | | | | - Kensuke Usuki
- Department of Hematology NTT Medical Center Tokyo Tokyo Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology University of Fukui Fukui Japan
| | - Takahiko Utsumi
- Department of Hematology Shiga General Hospital Moriyama Japan
| | | | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases Fukuoka University Hospital Fukuoka Japan
| | - Yasuyuki Nagata
- Department of Internal Medicine III Hamamatsu University School of Medicine Hamamatsu Japan
| | - Shuichi Ota
- Department of Hematology Sapporo Hokuyu Hospital Sapporo Japan
| | - Eiichi Ohtsuka
- Department of Hematology Oita Prefectural Hospital Oita Japan
| | - Ichiro Hanamura
- Division of Hematology Aichi Medical University Nagakute Japan
| | - Yasuhiro Suzuki
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
| | - Shinichiro Yoshida
- Department of Hematology National Hospital Organization Nagasaki Medical Center Ohmura Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute National Hospital Organization Kyushu Medical Center Fukuoka Japan
| | - Youko Suehiro
- Department of Hematology National Hospital Organization Kyushu Cancer Center Fukuoka Japan
| | - Yutaro Kamiyama
- Department of Clinical Oncology and Hematology The Jikei University Hospital Tokyo Japan
| | - Suguru Fukuhara
- Department of Hematology National Cancer Center Hospital Tokyo Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, International Medical Centre Saitama Medical University Saitama Japan
| | - Hirokazu Nagai
- Department of Hematology National Hospital Organization Nagoya Medical Center Nagoya Japan
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7
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Abstract
Despite substantial advances in anti-myeloma treatments, early recurrence and death remain an issue in certain subpopulations. Cytogenetic abnormalities (CAs) are the most widely accepted predictors for poor prognosis in multiple myeloma (MM), such as t(4;14), t(14;16), t(14;20), gain/amp(1q21), del(1p), and del(17p). Co-existing high-risk CAs (HRCAs) tend to be associated with an even worse prognosis. Achievement of sustained minimal residual disease (MRD)-negativity has recently emerged as a surrogate for longer survival, regardless of cytogenetic risk. Information from newer clinical trials suggests that extended intensified treatment can help achieve MRD-negativity in patients with HRCAs, which may lead to improved outcomes. Therapy should be considered to include a 3- or 4-drug induction regimen (PI/IMiD/Dex or PI/IMiD/Dex/anti-CD38 antibody), auto-transplantation, and consolidation/maintenance with lenalidomide ± a PI. Results from ongoing clinical trials for enriched high-risk populations will reveal the precise efficacy of the investigated regimens. Genetic abnormalities of MM cells are intrinsic critical factors determining tumor characteristics, which reflect the natural course and drug sensitivity of the disease. This paper reviews the clinicopathological features of genomic abnormalities related to adverse prognosis, focusing on HRCAs that are the most relevant in clinical practice, and outline current optimal therapeutic approaches for newly diagnosed MM with HRCAs.
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Affiliation(s)
- Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, 1 Karimata, Yazako, Nagakute, Aichi, 480-1195, Japan.
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8
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Mizuno S, Takami A, Takamatsu H, Hanamura I, Shimazu Y, Hangaishi A, Tsukada N, Kako S, Kikuchi T, Ota S, Shimizu H, Iida S, Yoshioka S, Sawa M, Fukuda T, Kanda Y, Atsuta Y, Kawamura K. Autologous hematopoietic cell transplantation for myeloma patients with hepatitis B virus or hepatitis C virus in the era of novel agents. Bone Marrow Transplant 2022; 57:846-848. [PMID: 35332303 DOI: 10.1038/s41409-022-01640-7] [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] [Received: 07/16/2021] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiroyuki Takamatsu
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences/ Faculty of Transdisciplinary Sciences, Institute of Transdisciplinary Sciences, Kanazawa University, Kanazawa, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yutaka Shimazu
- Department of Hematology, Kyoto University Hospital, Kyoto, Japan
| | - Akira Hangaishi
- Department of Hematology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuhiro Tsukada
- Division of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shinichi Kako
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Taku Kikuchi
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Shuichi Ota
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Hiroaki Shimizu
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Masashi Sawa
- Department of Hematology and Oncology, Anjo Kosei Hospital, Anjo, Japan
| | - Takahiro Fukuda
- Hematopoietic Stem Cell Transplantation Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshinobu Kanda
- Division of Hematology, Jichi Medical University Saitama Medical Center, Saitama, Japan.,Division of Hematology, Jichi Medical University, Shimotsuke, Japan
| | - Yoshiko Atsuta
- Japanese Data Center for Hematopoietic Cell Transplantation, Nagoya, Japan.,Department of Registry Science for Transplant and Cellular Therapy, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Koji Kawamura
- Department of Hematology, Tottori University Hospital, Yonago, Japan
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9
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Uchino K, Quang LV, Enomoto M, Nakano Y, Yamada S, Matsumura S, Kanasugi J, Takasugi S, Nakamura A, Horio T, Murakami S, Goto M, Mizuno S, Yamamoto H, Watarai M, Hanamura I, Takami A. Cytopenia associated with copper deficiency. eJHaem 2021; 2:729-737. [PMID: 35845195 PMCID: PMC9175927 DOI: 10.1002/jha2.278] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 11/07/2022]
Affiliation(s)
- Kaori Uchino
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Lam Vu Quang
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
| | - Megumi Enomoto
- Department of Clinical Laboratory Aichi Medical University Hospital Nagakute Japan
| | - Yuta Nakano
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Saki Yamada
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Saori Matsumura
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Soichi Takasugi
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Ayano Nakamura
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Tomohiro Horio
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Satsuki Murakami
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Mineaki Goto
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Keyaki Clinic Hashima‐gun Gifu Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Hidesuke Yamamoto
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Masaya Watarai
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Division of Hematology/chemotherapy Daido Hospital Nagoya Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine Aichi Medical University School of Medicine Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
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10
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Nakamura A, Suzuki S, Kanasugi J, Ejiri M, Hanamura I, Ueda R, Seto M, Takami A. Synergistic Effects of Venetoclax and Daratumumab on Antibody-Dependent Cell-Mediated Natural Killer Cytotoxicity in Multiple Myeloma. Int J Mol Sci 2021; 22:ijms221910761. [PMID: 34639102 PMCID: PMC8509545 DOI: 10.3390/ijms221910761] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/03/2021] [Revised: 09/27/2021] [Accepted: 10/01/2021] [Indexed: 02/06/2023] Open
Abstract
The prognosis of multiple myeloma (MM) has drastically improved owing to the development of new drugs, such as proteasome inhibitors and immunomodulatory drugs. Nevertheless, MM is an extremely challenging disease, and many patients are still refractory to the existing therapies, thus requiring new treatment alternatives. Venetoclax is a selective, orally bioavailable inhibitor of BCL-2 that shows efficacy in MM not only as a single agent but also in combination therapy, especially for MM patients with translocation t(11;14). However, many patients are refractory to this drug. Here, we treated the MM cell lines KMS12PE and KMS27 with a combination treatment of venetoclax targeting BCL-2 and daratumumab targeting CD38 to evaluate the synergistic cytotoxicity of these drugs in vitro. MM cell lines were co-cultured with natural killer (NK) cells at an effector:target ratio of 0.3:1 in the presence of serial concentrations of daratumumab and venetoclax, and the resulting apoptotic MM cells were detected by flow cytometry using annexin V. These results indicated that the antibody-dependent cell-mediated NK cytotoxicity was enhanced in KMS12PE and KMS27 cells harboring t(11;14) with a high BCL-2 expression, suggesting that the combination treatment of venetoclax and daratumumab should be especially effective in patients with these characteristics.
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Affiliation(s)
- Ayano Nakamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan; (A.N.); (J.K.); (I.H.); (M.S.); (A.T.)
| | - Susumu Suzuki
- Research Creation Support Center, Aichi Medical University, Nagakute 480-1195, Japan
- Department of Tumor Immunology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan;
- Correspondence: ; Tel.: +81-561-62-3311 (ext. 11426)
| | - Jo Kanasugi
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan; (A.N.); (J.K.); (I.H.); (M.S.); (A.T.)
| | - Masayuki Ejiri
- Department of Pharmacy, University Hospital, Aichi Medical University, Nagakute 480-1195, Japan;
| | - Ichiro Hanamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan; (A.N.); (J.K.); (I.H.); (M.S.); (A.T.)
| | - Ryuzo Ueda
- Department of Tumor Immunology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan;
| | - Masao Seto
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan; (A.N.); (J.K.); (I.H.); (M.S.); (A.T.)
| | - Akiyoshi Takami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute 480-1195, Japan; (A.N.); (J.K.); (I.H.); (M.S.); (A.T.)
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11
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Yamashita T, Takamatsu H, Kawamura K, Sunami K, Hagiwara S, Itagaki M, Takahashi T, Kondo T, Ikeda T, Watakabe-Inamoto K, Handa H, Imaizumi Y, Kuroda J, Murakami J, Nakamura Y, Nakazawa H, Ozaki S, Okura M, Takeuchi M, Nagai H, Hanamura I, Nakao S, Iida S. A nationwide survey on central nervous system multiple myeloma in Japan: analysis of prognostic and treatment factors that impact survival. Br J Haematol 2021; 195:217-229. [PMID: 34318926 DOI: 10.1111/bjh.17717] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 07/07/2021] [Indexed: 11/29/2022]
Abstract
This nationwide multicentre retrospective study was performed to analyze clinical features that predict the prognosis of central nervous system invasion in multiple myeloma (CNS-MM, approximately 1% of MM). Overall, of the 77 adult patients with CNS-MM identified between 2005 and 2016, those diagnosed at MM diagnosis (n = 3) had longer overall survival (OS) than those diagnosed at relapse (n = 74; median: 48·5 vs 2·7 months). Therefore, we compared the relapsed MM with CNS-MM in patients with any treatment (n = 60). Multivariate analyses revealed that lenalidomide treatment [hazard ratio (HR) 0·27, P = 0·003], intrathecal chemotherapy (IT; HR 0·54, P = 0·05), and radiation therapy (RTx; HR 0·33, P < 0·001) for CNS-MM had a positive effect on longer OS. These factors were used to develop a scoring system combining the number of treatments with lenalidomide, IT, and RTx (0, 1, 2, 3). The OS of CNS-MM patients was stratified based on these factors, with a median OS of 1·1, 4·5, and 7·5 months for patients with zero, one, two to three favourable features, respectively (0 vs 1, P = 0·0002; 1 vs 2-3, P = 0·08). Multimodal treatment including lenalidomide in addition to conventional IT and RTx can improve OS.
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Affiliation(s)
- Takeshi Yamashita
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.,Division of Internal Medicine, Keiju Kanazawa Hospital, Ishikawa, Japan
| | - Hiroyuki Takamatsu
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Koji Kawamura
- Division of Clinical Laboratory Medicine, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University, Tottori, Japan
| | - Kazutaka Sunami
- Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - Shotaro Hagiwara
- Division of Hematology, Internal Medicine, National Center for Global Health and Medicine/Department of Hematology, Tsukuba University, Faculty of Medicine, Ibaraki, Japan
| | - Mitsuhiro Itagaki
- Department of Hematology, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital, Hiroshima, Japan
| | - Tsutomu Takahashi
- Department of Hematology, Shimane University Hospital, Shimane, Japan
| | - Tadakazu Kondo
- Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Ikeda
- Division of Hematology and Stem Cell Transplantation, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kyoko Watakabe-Inamoto
- Hematology Division, Tokyo Metropolitan Center and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Hospital, Gunma, Japan
| | | | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jun Murakami
- Department of Clinical Laboratory and Transfusion Medicine & Cell therapy, Toyama University Hospital, Toyama, Japan
| | - Yuichi Nakamura
- Department of Hematology, Saitama Medical University Hospital, Saitama, Japan
| | - Hideyuki Nakazawa
- Division of Hematology, Internal Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Shuji Ozaki
- Department of Hematology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Miyuki Okura
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Masami Takeuchi
- Division of Hematology/Oncology, Department of Medicine, Kameda Medical Center, Chiba, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Aichi, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Aichi, Japan
| | - Shinji Nakao
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, Aichi, Japan
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12
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Hosen N, Yoshihara S, Takamatsu H, Ri M, Nagata Y, Kosugi H, Shimomura Y, Hanamura I, Fuji S, Minauchi K, Kuroda J, Suzuki R, Nishimura N, Uoshima N, Nakamae H, Kawano Y, Mizuno I, Gomyo H, Suzuki K, Ozaki S, Nakamura S, Imai Y, Kizaki M, Negoro E, Handa H, Iida S. Expression of activated integrin β7 in multiple myeloma patients. Int J Hematol 2021; 114:3-7. [PMID: 33999338 DOI: 10.1007/s12185-021-03162-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/27/2021] [Accepted: 05/12/2021] [Indexed: 12/14/2022]
Abstract
Multiple myeloma (MM) is still extremely difficult to cure, and new therapeutic drugs are needed. We recently found that integrin β7 is constitutively activated in MM cells, and chimeric antigen receptor (CAR) T cells targeting activated integrin β7 have a significant anti-MM effect. In this study, we performed flow cytometry analysis of the expression of activated integrin β7 in bone marrow cells from 137 symptomatic MM patients. In 60/137 (44%) MM patients, activated integrin β7 was detected in most MM cells (> 80% of MM cells were in the positive gate). Activated integrin β7 was highly expressed in MM cells even in heavily treated patients. It also showed high expression in many CD38lo/-CD138-CD19+B cells, which reportedly include clonotypic B cells, in the bone marrow of MM patients. Taken together, these results suggest that CAR T-cell therapy targeting activated integrin β7 has the potential to benefit many patients with relapsed or refractory MM.
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Affiliation(s)
- Naoki Hosen
- Department of Hematology and Oncology, Osaka University Graduate School of Medicine, 2-2 Yamada-Oka, Suita, Osaka, 565-0871, Japan. .,Department of Cellular Immunotherapy, Osaka University Immunology Frontier Research Center, Suita, Japan.
| | - Satoshi Yoshihara
- Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Hiroyuki Takamatsu
- Department of Hematology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan
| | - Masaki Ri
- Department of Hematology and Oncology, Institute of Medical and Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yasuyuki Nagata
- Division of Hematology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroshi Kosugi
- Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shigeo Fuji
- Department of Hematology, Osaka International Cancer Institute, Osaka, Japan
| | | | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Rikio Suzuki
- Department of Hematology/Oncology, Tokai University School of Medicine, Tokyo, Japan
| | - Noriko Nishimura
- Department of Hematology Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Nobuhiko Uoshima
- Department of Hematology, Japanese Red Cross Kyoto Daini Hospital, Kyoto, Japan
| | - Hirohisa Nakamae
- Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Yawara Kawano
- Department of Hematology, Rheumatology, and Infectious Diseases, Graduate School of Medical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Ishikazu Mizuno
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | - Hiroshi Gomyo
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | - Kenshi Suzuki
- Department of Hematology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Shuji Ozaki
- Department of Hematology, Tokushima Prefectural Central Hospital, Tokushima, Japan
| | - Shingen Nakamura
- Department of Community Medicine and Medical Science, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Yoichi Imai
- Department of Hematology/Oncology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Masahiro Kizaki
- Department of Hematology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Eiju Negoro
- Department of Hematology and Oncology, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Hiroshi Handa
- Department of Hematology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Institute of Medical and Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
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13
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Azami Y, Tsuyama N, Abe Y, Sugai-Takahashi M, Kudo KI, Ota A, Sivasundaram K, Muramatsu M, Shigemura T, Sasatani M, Hashimoto Y, Saji S, Kamiya K, Hanamura I, Ikezoe T, Onodera M, Sakai A. Chromosomal translocation t(11;14) and p53 deletion induced by the CRISPR/Cas9 system in normal B cell-derived iPS cells. Sci Rep 2021; 11:5216. [PMID: 33664418 PMCID: PMC7933289 DOI: 10.1038/s41598-021-84628-5] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/18/2021] [Indexed: 01/31/2023] Open
Abstract
Multiple myeloma (MM) cells are derived from mature B cells based on immunoglobulin heavy chain (IgH) gene analysis. The onset of MM is often caused by a reciprocal chromosomal translocation (cTr) between chr 14 with IgH and chr 11 with CCND1. We propose that mature B cells gain potential to transform by reprograming, and then chromosomal aberrations cause the development of abnormal B cells as a myeloma-initiating cell during B cell redifferentiation. To study myeloma-initiating cells, we have already established normal B cell-derived induced pluripotent stem cells (BiPSCs). Here we established two BiPSCs with reciprocal cTr t(11;14) using the CRISPR/Cas9 system; the cleavage site were located in the IgH Eμ region of either the VDJ rearranged allele or non-rearranged allele of IgH and the 5'-upsteam region of the CCND1 (two types of BiPSC13 with t(11;14) and MIB2-6 with t(11;14)). Furthermore, p53 was deleted using the CRISPR/Cas9 system in BiPSC13 with t(11;14). These BiPSCs differentiated into hematopoietic progenitor cells (HPCs). However, unlike cord blood, those HPCs did not differentiated into B lymphocytes by co-culture with BM stromal cell. Therefore, further ingenuity is required to differentiate those BiPSCs-derived HPCs into B lymphocytes.
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Affiliation(s)
- Yusuke Azami
- Department of Medical Oncology, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan
| | - Naohiro Tsuyama
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Yu Abe
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Misaki Sugai-Takahashi
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Ken-Ichi Kudo
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Akinobu Ota
- Department of Hematology, Aichi Medical University School of Medicine, Nagakute, 480-1195, Japan
| | - Karnan Sivasundaram
- Department of Hematology, Aichi Medical University School of Medicine, Nagakute, 480-1195, Japan
| | - Moe Muramatsu
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan
| | - Tomonari Shigemura
- Department of Pediatrics, Shinshu University, Matsumoto, 390-8621, Japan
| | - Megumi Sasatani
- Department of Experimental Oncology, RIRBM, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Yuko Hashimoto
- Department of Diagnostic Pathology, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan
| | - Shigehira Saji
- Department of Medical Oncology, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan
| | - Kenji Kamiya
- Department of Experimental Oncology, RIRBM, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Ichiro Hanamura
- Department of Hematology, Aichi Medical University School of Medicine, Nagakute, 480-1195, Japan
| | - Takayuki Ikezoe
- Department of Hematology, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan
| | - Masafumi Onodera
- Department of Genetics, National Research Institute for Child Health, Development, Tokyo, 157-8535, Japan
| | - Akira Sakai
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
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14
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Satou A, Banno S, Kohno K, Takahara T, Takahashi E, Nobata H, Iwagaitsu S, Watanabe D, Hanamura I, Takami A, Ito Y, Nakamura S, Tsuzuki T. Primary cutaneous methotrexate-associated B-cell lymphoproliferative disorders other than EBV-positive mucocutaneous ulcer: clinical, pathological, and immunophenotypic features. Pathology 2021; 53:595-601. [PMID: 33618861 DOI: 10.1016/j.pathol.2020.10.019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/07/2020] [Accepted: 10/15/2020] [Indexed: 11/25/2022]
Abstract
Methotrexate (MTX)-associated B-cell lymphoproliferative disorders (B-LPD) may first present in the skin. Epstein-Barr virus (EBV)-positive mucocutaneous ulcer (EBVMCU) is now a well known disease listed in the 2017 World Health Organization classification. However, primary cutaneous MTX-associated B-LPD (pcMTX B-LPD), other than EBVMCU, appear to be underestimated, and their distinctiveness remains unproven. This study aimed to document the clinicopathological characteristics of nine patients with pcMTX B-LPD that were not EBVMCU to extend our understanding of this peculiar disease. The cohort included three males and six females, with a median age of 74 years (range 54-83 years). All patients were treated with MTX for RA. Of nine patients, four presented with a solitary lesion, and five had multiple lesions. Histologically, five cases showed a polymorphic pattern, and four showed a monomorphic pattern. Immunohistochemically, four cases showed positive EBER staining, and one showed positive CD5 staining. In eight cases, once pcMTX B-LPD was diagnosed, methotrexate was immediately withdrawn. All eight of these patients experienced spontaneous regression and achieved complete remission (CR), without relapse. The patient with CD5 positivity received cytotoxic chemotherapy as the initial treatment. This patient achieved a CR after the initial treatment, but eventually experienced disease relapse resulting in death. We also revealed that pcMTX B-LPD and MTX-associated EBVMCU exhibited similar biological behaviours. We concluded that most pcMTX B-LPD cases could be cured by stopping MTX treatment. We also highlighted the fact that pcMTX B-LPD and MTX-EBVMCU had overlapping features. This finding suggested that pcMTX B-LPD and MTX-EBVMCU might share an underlying mechanism.
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Affiliation(s)
- Akira Satou
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan.
| | - Shogo Banno
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Kei Kohno
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan; Department of Pathology, School of Medicine, Kurume University, Kurume, Japan
| | - Taishi Takahara
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Emiko Takahashi
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Hironobu Nobata
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Shiho Iwagaitsu
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Daisuke Watanabe
- Department of Dermatology, Aichi Medical University Hospital, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Yasuhiko Ito
- Division of Nephrology and Rheumatology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
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15
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Hanamura I. Gain/Amplification of Chromosome Arm 1q21 in Multiple Myeloma. Cancers (Basel) 2021; 13:cancers13020256. [PMID: 33445467 PMCID: PMC7827173 DOI: 10.3390/cancers13020256] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/07/2021] [Accepted: 01/09/2021] [Indexed: 02/06/2023] Open
Abstract
Simple Summary Multiple myeloma (MM), a plasma cell neoplasm, is an incurable hematological malignancy. Gain/amplification of chromosome arm 1q21 (1q21+) is the most common adverse genomic abnormality associated with disease progression and drug resistance. While possible mechanisms of 1q21+ occurrence and candidate genes in the 1q21 amplicon have been suggested, the precise pathogenesis of MM with 1q21+ is unknown. Herein, we review the current knowledge about the clinicopathological features of 1q21+ MM, which can assist in effective therapeutic approaches for MM patients with 1q21+. Abstract Multiple myeloma (MM), a plasma cell neoplasm, is an incurable hematological malignancy characterized by complex genetic and prognostic heterogeneity. Gain or amplification of chromosome arm 1q21 (1q21+) is the most frequent adverse chromosomal aberration in MM, occurring in 40% of patients at diagnosis. It occurs in a subclone of the tumor as a secondary genomic event and is more amplified as the tumor progresses and a risk factor for the progression from smoldering multiple myeloma to MM. It can be divided into either 1q21 gain (3 copies) or 1q21 amplification (≥4 copies), and it has been suggested that the prognosis is worse in cases of amplification than gain. Trisomy of chromosome 1, jumping whole-arm translocations of chromosome1q, and tandem duplications lead to 1q21+ suggesting that its occurrence is not consistent at the genomic level. Many studies have reported that genes associated with the malignant phenotype of MM are situated on the 1q21 amplicon, including CKS1B, PSMD4, MCL1, ANP32E, and others. In this paper, we review the current knowledge regarding the clinical features, prognostic implications, and the speculated pathology of 1q21+ in MM, which can provide clues for an effective treatment approach to MM patients with 1q21+.
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Affiliation(s)
- Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, 1-1, Karimata, Yazako, Nagakute, Aichi 480-1195, Japan
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16
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Horio T, Enomoto M, Watarai M, Nakano Y, Yamada S, Matsumura S, Kanasugi J, Takasugi S, Nakamura A, Uchino K, Mizuno S, Murakami S, Yamamoto H, Hanamura I, Takami A. Favorable prognostic phenotype in myelodysplastic syndrome with der(1;7)(q10;p10). eJHaem 2020; 1:558-562. [PMID: 35844998 PMCID: PMC9175747 DOI: 10.1002/jha2.115] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 11/18/2022]
Abstract
Unbalanced translocation der(1;7)(q10;p10) is a characteristic chromosomal abnormality in myelodysplastic syndrome (MDS). The current study revealed that among 13 MDS patients with der(1;7)(q10;p10), seven cases with no apparent dysplasia also had low numbers of myeloblasts in the bone marrow and a 3‐year survival rate of 86%; in contrast, the remaining six cases had a 3‐year survival rate of 0% (P = .003). It was therefore suggested that MDS patients with der(1;7)(q10;p10) are classified into a distinct group with a favorable prognosis and another distinct group with a very poor prognosis.
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Affiliation(s)
- Tomohiro Horio
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Megumi Enomoto
- Department of Clinical Laboratory Aichi Medical University Hospital Nagakute Japan
| | - Masaya Watarai
- Department of Hematology and Chemotherapy Daido Hospital Nagoya Japan
| | - Yuuta Nakano
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Saki Yamada
- Department of Hematology and Chemotherapy Daido Hospital Nagoya Japan
| | - Saori Matsumura
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Jo Kanasugi
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Soichi Takasugi
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Ayano Nakamura
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Kaori Uchino
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Shohei Mizuno
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Satsuki Murakami
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Hidesuke Yamamoto
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Ichiro Hanamura
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
| | - Akiyoshi Takami
- Division of Hematology Department of Internal Medicine School of Medicine Aichi Medical University Nagakute Japan
- Hematopoietic Cell Transplantation Center Aichi Medical University Hospital Nagakute Japan
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17
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Takami A, Mizuno S, Nakamura A, Kanasugi J, Yamamoto H, Vu Quang L, Nakagami Y, Nakano Y, Yamada S, Matsumura S, Takasugi S, Uchino K, Horio T, Murakami S, Oohigashi Y, Nakayama T, Tani H, Enomoto M, Hanamura I. Pretreatment Immature Platelet Fraction as a Surrogate of Reticulated Platelets Predicts the Response to Corticosteroids in Adults with Immune Thrombocytopenia. Acta Haematol 2020; 144:345-349. [PMID: 32942280 DOI: 10.1159/000510460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/26/2020] [Accepted: 07/27/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVES Reticulated platelets circulating in the blood reflect megakaryopoietic activity and platelet turnover and can be automatically and low-invasively measured as the immature platelet fraction (IPF) using a Sysmex XN hematocytometer. The present study retrospectively investigated whether or not the IPF can predict the treatment response to corticosteroids in adult patients with primary immune thrombocytopenia (ITP). METHODS Forty-six patients who had been newly diagnosed with primary treatment-naïve ITP and started treatment with corticosteroids were analyzed. RESULTS Among the 46 primary ITP patients, 33 (72%) responded to the treatment and 13 (28%) did not. The percentage of IPF (IPF%) among the nonresponders was significantly lower than that of the responders (6.6 vs. 16.0%; p < 0.001). In the receiver operating characteristics analysis, the optimum IPF% cut-off value for predicting the treatment response was 12%, with a specificity of 85% and a sensitivity of 76%. CONCLUSIONS Our findings thus suggest that measuring the IPF% as a surrogate of reticulated platelets is useful to identify patients likely to respond to corticosteroids.
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Affiliation(s)
- Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan,
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ayano Nakamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hidesuke Yamamoto
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Lam Vu Quang
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yuya Nakagami
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Japan
| | - Yuta Nakano
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Saki Yamada
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Saori Matsumura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Souichi Takasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tomohiro Horio
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Satsuki Murakami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yuka Oohigashi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Takayuki Nakayama
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Japan
| | - Hiroya Tani
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Japan
| | - Megumi Enomoto
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
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18
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Murakami S, Suzuki S, Hanamura I, Yoshikawa K, Ueda R, Seto M, Takami A. Combining T-cell-based immunotherapy with venetoclax elicits synergistic cytotoxicity to B-cell lines in vitro. Hematol Oncol 2020; 38:705-714. [PMID: 32822067 DOI: 10.1002/hon.2794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 01/19/2023]
Abstract
Alterations of B-cell lymphoma 2 (BCL-2) family proteins contribute to the survival of B-cell malignancies. Recently, venetoclax, a BCL-2 inhibitor, was approved for B-cell chronic lymphocytic leukemia therapy and is being investigated in clinical trials for a variety of hematologic cell malignancies. Furthermore, combination therapy with other molecularly targeted drugs was reported to be more effective than monotherapy. However, combining venetoclax with immunotherapy based on T-cells has not been tested. Because both venetoclax and granzyme B activate the mitochondrial apoptosis pathway by targeting different BCL-2 family molecules, it is possible that combinations of venetoclax with immunotherapy will be effective treatments. We examined the effect of combining venetoclax with immunotherapy using an in vitro model system involving cytomegalovirus (CMV) pp65 antigen-specific cytotoxic T-cells (CMV-CTLs) as the effector cells and CMVpp65 antigen-expressing B-cell lines as the target cells. Cytotoxicity of CMV-CTLs to the target B-cell lines was enhanced by venetoclax with combination index values of 0.47-0.83. This suggests that venetoclax synergizes with T-cell-based immunotherapy to affect B-cell malignancies. Interestingly, venetoclax synergized not only with antigen-specific cytotoxicity but also with nonspecific cytotoxicity. Importantly, CMV-CTLs could be expanded in the presence of venetoclax at the maximum concentration (5 μM) that induced apoptosis in resting CMV-CTLs. B-cell lymphoma-extra large (BCL-xL) expression in CMV-CTLs increased transiently after activation by CMVpp65-transfected B-cell lines, indicating that the expression of BCL-xL was important for the effectiveness of combination treatment with venetoclax. These findings suggest that T-cell-based immunotherapy combined with venetoclax is effective against B-cell malignancies.
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Affiliation(s)
- Satsuki Murakami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Susumu Suzuki
- Research Creation Support Center, Aichi Medical University, Nagakute, Aichi, Japan.,Department of Tumor Immunology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Kazuhiro Yoshikawa
- Research Creation Support Center, Aichi Medical University, Nagakute, Aichi, Japan
| | - Ryuzo Ueda
- Department of Tumor Immunology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Masao Seto
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
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19
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Ota A, Hanamura I, Karnan S, Inaguma S, Takei N, Lam VQ, Mizuno S, Kanasugi J, Wahiduzzaman M, Rahman ML, Hyodo T, Konishi H, Tsuzuki S, Ikeda H, Takami A, Hosokawa Y. Novel Interleukin-6 Inducible Gene PDZ-Binding Kinase Promotes Tumor Growth of Multiple Myeloma Cells. J Interferon Cytokine Res 2020; 40:389-405. [PMID: 32721246 PMCID: PMC7462034 DOI: 10.1089/jir.2020.0111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Multiple myeloma (MM) remains an intractable hematological malignancy, despite recent advances in anti-MM drugs. Here, we show that role of PDZ binding kinase (PBK) in MM tumor growth. We identified that interleukin-6 (IL-6) readily increases PBK expression. Kaplan–Meier analysis showed that the MM patients with higher expression of PBK have a significant shorter survival time compared with those with moderate/lower expression of PBK. Knockout of PBK dramatically suppressed in vivo tumor growth in MM cells, while genome editing of PBK changing from asparagine to serine substitution (rs3779620) slightly suppresses the tumor formation. Mechanistically, loss of PBK increased the number of apoptotic cells with concomitant decrease in the phosphorylation level of Stat3 as well as caspase activities. A novel PBK inhibitor OTS514 significantly decreased KMS-11-derived tumor growth. These findings highlight the novel oncogenic role of PBK in tumor growth of myeloma, and it might be a novel therapeutic target for the treatment of patients with MM.
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Affiliation(s)
- Akinobu Ota
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Sivasundaram Karnan
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shingo Inaguma
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Norio Takei
- Institute for Animal Experimentation, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Vu Quang Lam
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Md Wahiduzzaman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Md Lutfur Rahman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiroshi Ikeda
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
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20
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Maruyama D, Iida S, Ogawa G, Fukuhara N, Seo S, Miyazaki K, Yoshimitsu M, Kuroda J, Tsukamoto N, Tsujimura H, Hangaishi A, Yamauchi T, Utsumi T, Mizuno I, Takamatsu Y, Nagata Y, Minauchi K, Ohtsuka E, Hanamura I, Yoshida S, Yamasaki S, Suehiro Y, Kamiyama Y, Tsukasaki K, Nagai H. Randomised phase II study to optimise melphalan, prednisolone, and bortezomib in untreated multiple myeloma (JCOG1105). Br J Haematol 2020; 192:531-541. [PMID: 32583431 PMCID: PMC7891591 DOI: 10.1111/bjh.16878] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 01/04/2023]
Abstract
We conducted a randomised phase II study to determine the optimal dose and schedule of melphalan, prednisone, and bortezomib (MPB) (jRCTs031180097). Transplant‐ineligible untreated multiple myeloma patients were randomised to Arm A (twice weekly bortezomib in one six‐week cycle followed by eight five‐week cycles of four times once weekly bortezomib with melphalan and prednisolone on days 1–4) or Arm B (nine four‐week cycles of three times once weekly bortezomib with melphalan and prednisolone on days 1–4). The primary end‐point was complete response (CR) rate. Of 91 patients randomised to two arms, 88 were eligible. The median cumulative bortezomib doses were 45·8 and 35·1 mg/m2, CR rate was 18·6% [95% confidence interval (CI) 8·4–33·4] and 6·7% (95% CI 1·4–18·3), and the median progression‐free survival (PFS) was 2·5 and 1·4 years in Arms A and B [hazard ratio (HR) 1·93 (95% CI 1·09–3·42)], respectively. Frequent grade ≥3 haematologic toxicities in Arms A and B were neutropenia (64·4% vs. 28·3%) and thrombocytopenia (35·6% vs. 10·9%). Grade 2/3 peripheral neuropathy was observed in 24·4/2·2% in Arm A and 8·7/0% in Arm B. In conclusion, Arm A was the more promising regimen, suggesting that the twice weekly schedule of bortezomib in the first cycle and higher cumulative dose of both bortezomib and melphalan influences the efficacy of modified MPB.
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Affiliation(s)
- Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Gakuto Ogawa
- JCOG Data Center/Operating Office, National Cancer Center Hospital, Tokyo, Japan
| | - Noriko Fukuhara
- Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai, Japan
| | - Sachiko Seo
- Department of Hematology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University School of Medicine, Tsu, Japan
| | - Makoto Yoshimitsu
- Department of Hematology and Rheumatology, Kagoshima University Hospital, Kagoshima, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Hideki Tsujimura
- Division of Hematology-Oncology, Chiba Cancer Center, Chiba, Japan
| | - Akira Hangaishi
- Division of Hematology, NTT Medical Center Tokyo, Tokyo, Japan
| | - Takahiro Yamauchi
- Department of Hematology and Oncology, University of Fukui Hospital, Fukui, Japan
| | - Takahiko Utsumi
- Department of Hematology, Shiga General Hospital, Moriyama, Japan
| | | | - Yasushi Takamatsu
- Division of Medical Oncology, Hematology and Infectious Diseases, Fukuoka University Hospital, Fukuoka, Japan
| | - Yasuyuki Nagata
- Department of Internal Medicine III, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Eiichi Ohtsuka
- Department of Hematology, Oita Prefectural Hospital, Oita, Japan
| | - Ichiro Hanamura
- Division of Hematology, Aichi Medical University, Nagakute, Japan
| | - Shinichiro Yoshida
- Department of Hematology, National Hospital Organization Nagasaki Medical Center, Ohmura, Japan
| | - Satoshi Yamasaki
- Department of Hematology and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Japan
| | - Youko Suehiro
- Department of Hematology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yutaro Kamiyama
- Department of Clinical Oncology and Hematology, The Jikei University Hospital, Tokyo, Japan
| | - Kunihiro Tsukasaki
- Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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21
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Nakagami Y, Uchino K, Okada H, Suzuki K, Enomoto M, Mizuno S, Yamamoto H, Hanamura I, Nakayama T, Tani H, Takami A. Potential role of Howell-Jolly bodies in identifying functional hyposplenism: a prospective single-institute study. Int J Hematol 2020; 112:544-552. [PMID: 32572828 DOI: 10.1007/s12185-020-02925-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 11/29/2022]
Abstract
Although patients with cancer and immunosuppression are at a risk of functional hyposplenism, how to detect it promptly remains unclear. Since hyposplenism allows erythrocytes with nuclear remnants (Howell-Jolly bodies [HJBs]) to appear in the peripheral blood, HJB detection by a routine microscopic examination may help identify patients with functional hyposplenism. This prospective study was thus performed to determine the underlying diseases in patients who presented with HJBs. Of 100 consecutive patients presenting with HJBs, 73 had a history of splenectomy. The remaining 27 had hematologic cancer (n = 6, 22%), non-hematologic cancer (n = 8, 30%), hepatic disorders (n = 4, 15%), premature neonates (n = 3, 11%), hemolytic anemia (n = 2, 7%), autoimmune disorders (n = 2, 7%) and miscellaneous diseases (n = 2, 7%), and their prior treatments included chemotherapy (n = 8, 30%), steroids (n = 7, 26%) and molecular-targeted therapy (n = 3, 11%). Among the 27 patients, 22 had computed tomography scans available: 3 (14%) had underlying diseases in the spleen, and the remaining 19 (86%) were all found to have a decreased splenic volume, including 11 (50%) with more than 50% of the ideal value. The present findings suggest that HJB detection identifies patients with potentially functional hyposplenism who should receive appropriate interventional treatment, such as vaccination and prophylactic antibiotics.
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Affiliation(s)
- Yuya Nakagami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Kaori Uchino
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroaki Okada
- Department of Radiology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Kojiro Suzuki
- Department of Radiology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
| | - Megumi Enomoto
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Shohei Mizuno
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hidesuke Yamamoto
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Ichiro Hanamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Takayuki Nakayama
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan.,Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Hiroya Tani
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Akiyoshi Takami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, 480-1195, Japan. .,Hematopoietic Cell Transplantation Center, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
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22
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Kanasugi J, Hanamura I, Ota A, Karnan S, Lam VQ, Mizuno S, Wahiduzzaman M, Rahman ML, Hyodo T, Konishi H, Tsuzuki S, Hosokawa Y, Takami A. Biallelic loss of FAM46C triggers tumor growth with concomitant activation of Akt signaling in multiple myeloma cells. Cancer Sci 2020; 111:1663-1675. [PMID: 32176823 PMCID: PMC7226186 DOI: 10.1111/cas.14386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 11/10/2019] [Revised: 02/21/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022] Open
Abstract
Loss of heterozygosity or mutation of the family with sequence similarity 46, member C (FAM46C) gene on chromosome band 1p12 is associated with shorter overall survival of patients with multiple myeloma (MM). In this study, using human MM cell lines (KMS‐11, OCI‐My5, and ANBL‐6), we generated FAM46C−/− cell clones and examined the effect of disruption of FAM46C on cell survival and cellular signaling. Cell proliferation assays showed increased clonogenicity of FAM46C−/− KMS‐11 cells compared to WT cells. Xenograft experiments showed significantly shorter overall survival of mice harboring the FAM46C−/− cell‐derived tumors than mice with the FAM46CWT cell‐derived tumors. Notably, levels of phosphorylated Akt and its substrates increased both in vitro and in vivo in the FAM46C−/− cells compared to WT cells. In addition, caspase activities decreased in the FAM46C−/− cells. Results of gene set enrichment analysis showed that loss of FAM46C significantly activated serum‐responsive genes while inactivating phosphatase and tensin homolog (PTEN)‐related genes. Mechanistically, loss of FAM46C decreased the PTEN activity, number of apoptotic cells, and caspase activities. PF‐04691502, a selective PI3K inhibitor, suppressed the augmented phosphorylation of Akt and its substrate FoxO3a. Treatment with afuresertib (a specific Akt inhibitor) in combination with bortezomib additively decreased FAM46C−/− MM cell survival. Collectively, this study is the first to report that loss of FAM46C triggers the concomitant activation of the PI3K‐Akt signaling pathway, which might be a therapeutic target for MM with abnormalities in the FAM46C gene.
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Affiliation(s)
- Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Akinobu Ota
- Department of Biochemistry, Aichi Medical University, Nagakute, Japan
| | | | - Vu Quang Lam
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Md Wahiduzzaman
- Department of Biochemistry, Aichi Medical University, Nagakute, Japan
| | - Md Lutfur Rahman
- Department of Biochemistry, Aichi Medical University, Nagakute, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, Aichi Medical University, Nagakute, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, Aichi Medical University, Nagakute, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, Aichi Medical University, Nagakute, Japan
| | | | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
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Uchino K, Ato F, Yamada S, Matsumura S, Kanasugi J, Nakamura A, Takasugi S, Horio T, Murakami S, Mizuno S, Yamamoto H, Watarai M, Hanamura I, Takami A. [Emergence of Howell-Jolly bodies in a patient with splenic hypoplasia complicated by fulminant pneumococcal infection]. Rinsho Ketsueki 2020; 61:318-321. [PMID: 32378573 DOI: 10.11406/rinketsu.61.318] [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] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We report the case of a patient with fulminant pneumococcal infection along with the presence of Howell-Jolly bodies (HJBs) and splenic hypoplasia at the onset. A 71-year-old man developed fever during outpatient chemotherapy for IgG-κ multiple myeloma and was diagnosed with septic shock due to invasive pneumococcal infection. HJBs were observed on peripheral blood smears at this visit. Computed tomography revealed marked hypoplasia of spleen, suggesting the presence of hyposplenic function. Antibacterial therapy was initiated and the pneumococcal infection was cured; however, there was no notable change in his splenic hypoplasia. Splenic hypoplasia can be associated with fatal infections; hence, care should be taken when it is found in the elderly and in patients with cancer and those receiving immunosuppressive treatment. Even today, when automated hematology analyzers have become common, not all patients with hematological diseases have peripheral blood smears checked with a normal optical microscope. This study suggests that HJBs may be useful for simple and rapid screening of splenic hypofunction. The importance of detecting HJBs in peripheral blood smears with a normal optical microscope should be re-recognized.
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Affiliation(s)
- Kaori Uchino
- Department of Hematology, Aichi Medical University School of Medicine
| | - Fuminori Ato
- Postgraduate clinical training center, Aichi Medical University Hospital
| | - Saki Yamada
- Department of Hematology, Aichi Medical University School of Medicine
| | - Saori Matsumura
- Department of Hematology, Aichi Medical University School of Medicine
| | - Jo Kanasugi
- Department of Hematology, Aichi Medical University School of Medicine
| | - Ayano Nakamura
- Department of Hematology, Aichi Medical University School of Medicine
| | - Soichi Takasugi
- Department of Hematology, Aichi Medical University School of Medicine
| | - Tomohiro Horio
- Department of Hematology, Aichi Medical University School of Medicine
| | - Satsuki Murakami
- Department of Hematology, Aichi Medical University School of Medicine
| | - Shohei Mizuno
- Department of Hematology, Aichi Medical University School of Medicine
| | - Hidesuke Yamamoto
- Department of Hematology, Aichi Medical University School of Medicine
| | - Masaya Watarai
- Department of Hematology, Aichi Medical University School of Medicine
| | - Ichiro Hanamura
- Department of Hematology, Aichi Medical University School of Medicine
| | - Akiyoshi Takami
- Department of Hematology, Aichi Medical University School of Medicine
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24
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Hanamura I. [Advances in multiple myeloma molecular biology research]. Rinsho Ketsueki 2019; 60:1236-1242. [PMID: 31597849 DOI: 10.11406/rinketsu.60.1236] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent technology advances in genomic analysis have unraveled the genomic complexity and evolutionary process of multiple myeloma (MM). Hyperdiploidy or IgH translocations t (4;14), t (11;14), t (6;14), t (14;16), and t (14;20), leading to ectopic overexpression of MMSET/FGFR3, CCND1, CCND3, MAF, and MAFB, respectively, are initiating events. Subsequent secondary events, such as gene copy number alterations, and gene somatic mutations, participate in tumor progression in a branching pattern consistent with Darwin's evolutionary model. Copy number alterations, such as 1q21 amplification and del (17p), have been associated with adverse outcomes. N/KRAS mutations are most commonly found in around 20% of patients, but numerous gene mutations are infrequent. Pathological and clinical relevance of gene mutations combined with cytogenetic abnormalities are currently under investigation. Additionally, detailed genomic analysis of individual patients using targeted-sequencing panels has been facilitated, and efforts toward personalized therapy based on molecular features have begun. This paper outlines MM molecular pathology and its clinical application in Japanese patients.
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Affiliation(s)
- Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine
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25
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Murase T, Inagaki A, Masaki A, Fujii K, Narita T, Ri M, Hanamura I, Iida S, Inagaki H. Plasma cell myeloma positive for t(14;20) with relapse in the central nervous system. J Clin Exp Hematop 2019; 59:135-139. [PMID: 31391406 PMCID: PMC6798141 DOI: 10.3960/jslrt.19011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
t(14;20)(q32;q11)/IGH-MAFB is a rare chromosomal abnormality in plasma cell myeloma (PCM), accounting for 1-2% of PCM cases. Patients with this translocation may have a poor prognosis. However, the clinicopathological features and response to novel agents have not been well clarified. We present a 63-year-old Japanese female with PCM positive for t(14;20). The tumor responded well to a proteasome inhibitor, bortezomib, and the patient achieved complete remission. Six months after remission, tumor relapse was noted in the left cerebellum and the right frontal lobe of the cerebrum. After whole brain radiation therapy, the tumor masses decreased in size. The patient was followed up with best-care support, but died of the disease 29 months after the initial PCM diagnosis. t(14;20)-positive PCM responded well to bortezomib at the time of the initial treatment. The CNS tumor involvement, which is rare in PCM, may be associated with the clinical aggressiveness of the t(14;20)-positive form of this myeloma.
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26
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Nakagami Y, Suzuki S, Espinoza JL, Vu Quang L, Enomoto M, Takasugi S, Nakamura A, Nakayama T, Tani H, Hanamura I, Takami A. Immunomodulatory and Metabolic Changes after Gnetin-C Supplementation in Humans. Nutrients 2019; 11:nu11061403. [PMID: 31234376 PMCID: PMC6628299 DOI: 10.3390/nu11061403] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 05/16/2019] [Revised: 06/11/2019] [Accepted: 06/17/2019] [Indexed: 12/14/2022] Open
Abstract
Gnetin-C is a naturally occurring stilbene derived from the seeds of Gnetum gnemon L., an edible plant native to Southeast Asia that is called melinjo. Although the biological properties and safety of G. gnemon extract, which contains nearly 3% Gnetin-C, have been confirmed in various human studies, whether or not pure Gnetin-C is safe for humans is unclear at present. We conducted a randomized, double-blind, placebo-controlled trial. Healthy subjects were randomly divided into two groups. The interventional group (n = 6) was given Gnetin-C, and the control group (n = 6) was provided a placebo, for 14 days. Lipid profiles, biomarkers of oxidative stress and circulating blood cells were assessed before and after the intervention. All subjects completed the study, with no side effects reported across the study duration. Gnetin-C supplementation demonstrated a statistically significant increase in the absolute number of circulating natural killer (NK) cells expressing the activating receptors NKG2D and NKp46. NK cells derived from subjects who received Gnetin-C for two weeks showed higher cytotoxicity against K562 target cells than those before receiving Gnetin-C. In addition, Gnetin-C also resulted in a significant decrease in the absolute neutrophil count in the blood compared with the placebo. Furthermore, Gnetin-C significantly reduced the levels of uric acid, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total adiponectin, and high-molecular-weight adiponectin. These data indicate that Gnetin-C has biological effects of enhancing the NK activity on circulating human immune cells. The immunomodulatory effects are consistent with a putative improvement in cancer immunosurveillance via the upregulation of the NKG2D receptor. The study was registered with UMIN-CTR, number 000030364, on 12 December 2017.
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Affiliation(s)
- Yuya Nakagami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan.
| | - Susumu Suzuki
- Department of Tumor Immunology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
- Research Creation Support Center, Aichi Medical University, Nagakute, Aichi 480-1195, Japan.
| | - J Luis Espinoza
- Department of Hematology and Rheumatology, Faculty of Medicine, Kindai University, Osakasayama 589-8511, Japan.
| | - Lam Vu Quang
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
| | - Megumi Enomoto
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan.
| | - Souichi Takasugi
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
| | - Ayano Nakamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
| | - Takayuki Nakayama
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan.
| | - Hiroya Tani
- Department of Clinical Laboratory, Aichi Medical University Hospital, Nagakute, Aichi 480-1195, Japan.
| | - Ichiro Hanamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
| | - Akiyoshi Takami
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi 480-1195, Japan.
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Oyake T, Takemasa-Fujisawa Y, Sugawara N, Mine T, Tsukushi Y, Hanamura I, Fujishima Y, Aoki Y, Kowata S, Ito S, Ishida Y. Doripenem versus meropenem as first-line empiric therapy of febrile neutropenia in patients with acute leukemia: a prospective, randomized study. Ann Hematol 2019; 98:1209-1216. [PMID: 30824955 DOI: 10.1007/s00277-019-03634-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/09/2018] [Accepted: 02/03/2019] [Indexed: 10/27/2022]
Abstract
Febrile neutropenia is often observed in patients with hematologic malignancies, especially in those with acute leukemia. Meropenem has potent and broad antibacterial activity against gram-positive and gram-negative bacteria, and is recommended as first-line empiric therapy for febrile neutropenia. In contrast, the safety and efficacy of doripenem in patients with febrile neutropenia and hematologic malignancies is limited. In this randomized, prospective, cooperative, open-label trial, we compared doripenem (1.0 g every 8 h) to meropenem (1.0 g every 8 h) as first-line empiric antibacterial treatment of febrile neutropenia. To evaluate efficacy and safety, 133 hospitalized patients with acute leukemia or high-risk myelodysplastic syndrome, who developed febrile neutropenia during or after chemotherapy, were randomized to each drug. Resolution of fever within 3 to 5 days without treatment modification (i.e., the primary endpoint) did not significantly differ between the doripenem and meropenem groups (60.0% vs. 45.6%, respectively; P = 0.136). However, resolution of fever within 7 days of treatment was significantly higher in the doripenem group than in the meropenem group (78.4% vs. 60.2%, respectively; P = 0.037). Similar rates of adverse events (grades 1-2) were observed in both groups. Thus, we conclude that both drugs are safe and well-tolerated for the treatment of febrile neutropenia in patients with acute leukemia or high-risk myelodysplastic syndrome, and that the clinical efficacy of doripenem is noninferior to that of meropenem. UMIN Clinical Trial Registry number: 000006124.
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Affiliation(s)
- Tatsuo Oyake
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan.
| | - Yuka Takemasa-Fujisawa
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
| | - Norifumi Sugawara
- Division of Hematology, Department of Internal Medicine, Iwate Prefectural Chubu Hospital, Kitakami, Japan
| | - Takahiro Mine
- Division of Hematology, Department of Internal Medicine, Morioka Red Cross Hospital, Morioka, Japan
| | - Yasuhiko Tsukushi
- Division of Hematology, Department of Internal Medicine, Hachinohe Red Cross Hospital, Hachinohe, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagoya, Japan
| | - Yukiteru Fujishima
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
| | - Yusei Aoki
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
| | - Shugo Kowata
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
| | - Shigeki Ito
- Department of Clinical Oncology, Iwate Medical University School of Medicine, Morioka, Japan
| | - Yoji Ishida
- Division of Hematology and Oncology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka City, Iwate, 020-8505, Japan
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28
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Satou A, Banno S, Hanamura I, Takahashi E, Takahara T, Nobata H, Katsuno T, Takami A, Ito Y, Ueda R, Nakamura S, Tsuzuki T. EBV-positive mucocutaneous ulcer arising in rheumatoid arthritis patients treated with methotrexate: Single center series of nine cases. Pathol Int 2019; 69:21-28. [PMID: 30615240 DOI: 10.1111/pin.12745] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [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: 08/06/2018] [Accepted: 10/31/2018] [Indexed: 12/21/2022]
Abstract
Methotrexate (MTX) is currently used as first-line anchor drug for rheumatoid arthritis (RA). Therefore, the number of MTX-associated lymphoproliferative disorders, including Epstein-Barr virus-positive mucocutaneous ulcer (EBVMCU), has increased. Some aspects of MTX-associated EBVMCU (MTX-EBVMCU), particularly clinical behavior and treatment for RA after MTX cessation, have not been well described. Herein, we report nine cases of MTX-EBVMCU with clinical information regarding RA. Seven of nine patients showed spontaneous regression (SR) after immunosuppressive (IS) cessation. The other two required cytotoxic chemotherapy. Eventually, all achieved complete remission. No patients experienced EBVMCU relapse. Eight patients had RA flare after IS cessation. To control the RA activity, rituximab was administered to three patients. The remaining patients were treated by other agents. Regarding the RA activity, all were in the status of low disease activity or clinical remission. In conclusion, MTX-associated EBVMCU has an indolent clinical course and SR after IS cessation can be expected. After the withdrawal of MTX, the majority of patients experience RA flare and required treatment. In our series, RA was well controlled without reinitiating MTX. Therefore, to prevent the EBVMCU relapse, it might be advisable to avoid MTX reintroduction, and rituximab might be the more preferable agent for RA treatment.
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Affiliation(s)
- Akira Satou
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Shogo Banno
- Division of Nephrology and Rheumatology, Aichi Medical University Hospital, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Emiko Takahashi
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Taishi Takahara
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Hironobu Nobata
- Division of Nephrology and Rheumatology, Aichi Medical University Hospital, Nagakute, Japan
| | - Takayuki Katsuno
- Division of Nephrology and Rheumatology, Aichi Medical University Hospital, Nagakute, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University Hospital, Nagakute, Japan
| | - Yasuhiko Ito
- Division of Nephrology and Rheumatology, Aichi Medical University Hospital, Nagakute, Japan
| | - Ryuzo Ueda
- Department of Tumor Immunology, Aichi Medical University, Nagakute, Japan
| | - Shigeo Nakamura
- Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan
| | - Toyonori Tsuzuki
- Department of Surgical Pathology, Aichi Medical University Hospital, Nagakute, Japan
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Wahiduzzaman M, Karnan S, Ota A, Hanamura I, Murakami H, Inoko A, Rahman ML, Hyodo T, Konishi H, Tsuzuki S, Hosokawa Y. Establishment and characterization of CRISPR/Cas9-mediated NF2 -/- human mesothelial cell line: Molecular insight into fibroblast growth factor receptor 2 in malignant pleural mesothelioma. Cancer Sci 2018; 110:180-193. [PMID: 30417500 PMCID: PMC6317947 DOI: 10.1111/cas.13871] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 12/12/2022] Open
Abstract
Malignant pleural mesothelioma (MPM), a highly refractory tumor, is currently incurable due to the lack of an early diagnosis method and medication, both of which are urgently needed to improve the survival and/or quality of life of patients. NF2 is a tumor suppressor gene and is frequently mutated in MPM. Using a CRISPR/Cas9 system, we generated an NF2‐knockout human mesothelial cell line, MeT‐5A (NF2‐KO). In NF2‐KO cell clones, cell growth, clonogenic activity, migration activity, and invasion activity significantly increased compared with those in NF2‐WT cell clones. Complementary DNA microarray analysis clearly revealed the differences in global gene expression profile between NF2‐WT and NF2‐KO cell clones. Quantitative PCR analysis and western blot analysis showed that the upregulation of fibroblast growth factor receptor 2 (FGFR2) was concomitant with the increases in phosphorylation levels of JNK, c‐Jun, and retinoblastoma (Rb) in NF2‐KO cell clones. These increases were all abrogated by the exogenous expression of NF2 in the NF2‐KO clone. In addition, the disruption of FGFR2 in the NF2‐KO cell clone suppressed cell proliferation as well as the phosphorylation levels of JNK, c‐Jun, and Rb. Notably, FGFR2 was found to be highly expressed in NF2‐negative human mesothelioma tissues (11/12 cases, 91.7%) but less expressed in NF2‐positive tissues. Collectively, these findings suggest that NF2 deficiency might play a role in the tumorigenesis of human mesothelium through mediating FGFR2 expression; FGFR2 would be a candidate molecule to develop therapeutic and diagnostic strategies for targeting MPM with NF2 loss.
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Affiliation(s)
- Md Wahiduzzaman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Sivasundaram Karnan
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akinobu Ota
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hideki Murakami
- Department of Pathology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Akihito Inoko
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Md Lutfur Rahman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Japan
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30
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Mizuno S, Hanamura I, Ota A, Karnan S, Kanasugi J, Nakamura A, Takasugi S, Uchino K, Horio T, Goto M, Murakami S, Gotou M, Yamamoto H, Watarai M, Shikami M, Hosokawa Y, Miwa H, Taniwaki M, Ueda R, Nitta M, Takami A. Establishment and characterization of a novel vincristine-resistant diffuse large B-cell lymphoma cell line containing the 8q24 homogeneously staining region. FEBS Open Bio 2018; 8:1977-1991. [PMID: 30524948 PMCID: PMC6275272 DOI: 10.1002/2211-5463.12538] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 11/27/2022] Open
Abstract
Chromosome band 8q24 is the most frequently amplified locus in various types of cancers. MYC has been identified as the primary oncogene at the 8q24 locus, whereas a long noncoding gene, PVT1, which lies adjacent to MYC, has recently emerged as another potential oncogenic regulator at this position. In this study, we established and characterized a novel cell line, AMU‐ML2, from a patient with diffuse large B‐cell lymphoma (DLBCL), displaying homogeneously staining regions at the 8q24 locus. Fluorescence in situ hybridization clearly detected an elevation in MYC copy numbers corresponding to the homogenously staining region. In addition, a comparative genomic hybridization analysis using high‐resolution arrays revealed that the 8q24 amplicon size was 1.4 Mb, containing the entire MYC and PVT1 regions. We also demonstrated a loss of heterozygosity for TP53 at 17p13 in conjunction with a TP53 frameshift mutation. Notably, AMU‐ML2 cells exhibited resistance to vincristine, and cell proliferation was markedly inhibited by MYC‐shRNA‐mediated knockdown. Furthermore, genes involved in cyclin D, mTOR, and Ras signaling were downregulated following MYC knockdown, suggesting that MYC expression was closely associated with tumor cell growth. In conclusion, AMU‐ML2 cells are uniquely characterized by homogenously staining regions at the 8q24 locus, thus providing useful insights into the pathogenesis of DLBCL with 8q24 abnormalities.
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Affiliation(s)
- Shohei Mizuno
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Ichiro Hanamura
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Akinobu Ota
- Department of Biochemistry Aichi Medical University Japan
| | | | - Jo Kanasugi
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Ayano Nakamura
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Souichi Takasugi
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Kaori Uchino
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Tomohiro Horio
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Mineaki Goto
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Satsuki Murakami
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Mayuko Gotou
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Hidesuke Yamamoto
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Masaya Watarai
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Masato Shikami
- Department of Hematology Daiyukai General Hospital Aichi Japan
| | | | | | - Masafumi Taniwaki
- Department of Hematology and Oncology Graduate School of Medical Science Kyoto Prefectural University of Medicine Japan
| | - Ryuzo Ueda
- Department of Tumor Immunology Aichi Medical University School of Medicine Japan
| | - Masakazu Nitta
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
| | - Akiyoshi Takami
- Division of Hematology Department of Internal Medicine Aichi Medical University Japan
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Ogura M, Yamamoto K, Morishima Y, Wakabayashi M, Tobinai K, Ando K, Uike N, Kurosawa M, Gomyo H, Taniwaki M, Nosaka K, Tsukamoto N, Shimoyama T, Fukuhara N, Yakushijin Y, Ohnishi K, Miyazaki K, Sawada K, Takayama N, Hanamura I, Nagai H, Kobayashi H, Usuki K, Kobayashi N, Ohyashiki K, Utsumi T, Kumagai K, Maruyama D, Ohmachi K, Matsuno Y, Nakamura S, Hotta T, Tsukasaki K. R-High-CHOP/CHASER/LEED with autologous stem cell transplantation in newly diagnosed mantle cell lymphoma: JCOG0406 STUDY. Cancer Sci 2018; 109:2830-2840. [PMID: 29957865 PMCID: PMC6125440 DOI: 10.1111/cas.13719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 03/27/2018] [Revised: 06/19/2018] [Accepted: 06/23/2018] [Indexed: 01/03/2023] Open
Abstract
Although induction immunochemotherapy including high‐dose cytarabine and rituximab followed by high‐dose chemotherapy (HDC) with autologous stem cell transplantation (ASCT) is recommended for younger patients (≤65 years old) with untreated mantle cell lymphoma (MCL), no standard induction and HDC regimen has been established. We conducted a phase II study of induction immunochemotherapy of R‐High‐CHOP/CHASER followed by HDC of LEED with ASCT in younger patients with untreated advanced MCL. Eligibility criteria included untreated MCL, stage II bulky to IV, and age 20‐65 years. Patients received 1 cycle of R‐High‐CHOP followed by 3 cycles of CHASER every 3 weeks. Peripheral blood stem cells (PBSC) were harvested during CHASER. LEED with ASCT was delivered to patients who responded to R‐High‐CHOP/CHASER. Primary endpoint was 2‐year progression‐free survival (PFS). From June 2008 to June 2012, 45 patients (median age 59 years; range 38‐65 years) were enrolled. PBSC were successfully harvested from 36 of 43 patients. Thirty‐five patients completed ASCT. Two‐year PFS was 77% (80% CI 68‐84), which met the primary endpoint. Five‐year PFS and overall survival were 52% (95% CI 34‐68%) and 71% (95% CI 51‐84%), respectively. Overall response and complete response rates after induction immunochemotherapy were 96% and 82%, respectively. The most common grade 4 toxicities were hematological. In younger patients with untreated MCL, R‐High‐CHOP/CHASER/LEED with ASCT showed high efficacy and acceptable toxicity, and it can now be considered a standard treatment option.
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Affiliation(s)
- Michinori Ogura
- Department of Hematology and Oncology, Kasugai Municipal Hospital, Kasugai, Japan.,Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, Nagoya, Japan
| | - Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yasuo Morishima
- Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya, Japan
| | | | - Kensei Tobinai
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Kiyoshi Ando
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Naokuni Uike
- Department of Hematology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Mitsutoshi Kurosawa
- Department of Hematology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroshi Gomyo
- Department of Hematology, Hyogo Cancer Center, Akashi, Japan
| | - Masafumi Taniwaki
- Center for Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kisato Nosaka
- Department of Hematology, Kumamoto University Hospital, Kumamoto, Japan
| | | | - Tatsu Shimoyama
- Department of Medical Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Noriko Fukuhara
- Department of Hematology, Tohoku University Hospital, Sendai, Japan
| | - Yoshihiro Yakushijin
- First Department of Internal Medicine, Ehime University Graduate School of Medicine, Toon, Japan
| | - Kazunori Ohnishi
- Department of Hematology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kenichi Sawada
- Department of Hematology, Akita University Graduate School of Medicine and Faculty of Medicine, Akita, Japan
| | - Nobuyuki Takayama
- Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Nagakute, Japan
| | - Hirokazu Nagai
- Department of Hematology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | | | - Kensuke Usuki
- Department of Hematology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Naoki Kobayashi
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - Kazuma Ohyashiki
- Department of Hematology, Tokyo Medical University, Tokyo, Japan
| | - Takahiko Utsumi
- Department of Hematology, Shiga General Hospital, Moriyama City, Japan
| | - Kyoya Kumagai
- Department of Hematology, Chiba Cancer Center, Chiba, Japan
| | - Dai Maruyama
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Ohmachi
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - Shigeo Nakamura
- Department of Pathology, Nagoya University School of Medicine, Nagoya, Japan
| | | | - Kunihiro Tsukasaki
- Department of Hematology, National Cancer Center Hospital East, Kashiwa, Japan
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Wahiduzzaman M, Ota A, Karnan S, Hanamura I, Mizuno S, Kanasugi J, Rahman ML, Hyodo T, Konishi H, Tsuzuki S, Takami A, Hosokawa Y. Novel combined Ato-C treatment synergistically suppresses proliferation of Bcr-Abl-positive leukemic cells in vitro and in vivo. Cancer Lett 2018; 433:117-130. [PMID: 29944906 DOI: 10.1016/j.canlet.2018.06.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 05/31/2018] [Accepted: 06/18/2018] [Indexed: 12/28/2022]
Abstract
Chronic myelogenous leukemia (CML) accounts for 15-20% of all leukemias affecting adults. Despite recent advances in the development of specific Bcr-Abl tyrosine kinase inhibitors (TKIs), some CML patients suffer from relapse due to TKI resistance. Here, we assessed the efficacy of a novel combinatorial arsenic trioxide (ATO) and cisplatin (CDDP) treatment (Ato-C) in human Bcr-Abl-positive leukemic cells. Combination index analyses revealed that a synergistic interaction of ATO and CDDP elicits a wide range of effects in K562, KU-812, MEG-A2, and KCL-22 cells. Notably, Ato-C synergistically enhanced apoptosis and decreased the survival of both acquired TKI-resistant CML cells and the cells expressing mutant Bcr-AblT315I. In addition, Ato-C dramatically decreased the phosphorylation level of forkhead transcription factor FOXO1/3a and STAT5 as well as c-Myc protein level. Interestingly, results of gene set enrichment analysis showed that Ato-C significantly downregulates the expression of MYC- and/or E2F1-target genes. Furthermore, Ato-C significantly suppressed the proliferation of MEG-A2-derived tumor when compared with that following monotherapy in vivo. Collectively, these results suggest that combined Ato-C treatment could be a promising alternative to the current therapeutic regime in CML.
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Affiliation(s)
- Md Wahiduzzaman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Akinobu Ota
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan.
| | - Sivasundaram Karnan
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
| | - Jo Kanasugi
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
| | - Md Lutfur Rahman
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Toshinori Hyodo
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Hiroyuki Konishi
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Shinobu Tsuzuki
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University, Aichi, Japan
| | - Yoshitaka Hosokawa
- Department of Biochemistry, Aichi Medical University School of Medicine, Nagakute, Aichi, 480-1195, Japan
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Hanamura I, Iida S. [Multiple myeloma: update on pathophysiology and management]. Rinsho Ketsueki 2018; 59:529-538. [PMID: 29877243 DOI: 10.11406/rinketsu.59.529] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Proteasome inhibitors and immunomodulatory drugs have substantially improved the clinical outcomes in patients with multiple myeloma (MM) since 2000. In 2015, the new monoclonal antibodies, daratumumab and elotuzumab, were approved for treating relapsed and/or refractory MM (RRMM). Furthermore, venetoclax, a selective BCL-2 inhibitor, and chimeric antigen receptor (CAR) T-cell therapy that work against B-cell maturation antigen (BCMA) have reportedly shown great efficacy in phase 1 studies. The efficacy of venetoclax has been observed in RRMM with t (11;14) and higher BCL-2/BCL-XL expression. BCMA CAR-T therapies have caused considerable remissions in highly refractory MM. These suggest that personalized medicine and therapy aiming at cure are becoming reality in the near future. MM is a genetically complex and heterogeneous disease that develops via a multistep transformation process. Recent next-generation sequencing (NGS) studies have revealed the molecular landscape, providing insights into the biology, including the intraclonal heterogeneity and disease progression in MM. In this review, we discuss the current knowledge regarding MM genomics reported by NGS studies as well as the recent progress in MM therapy. The agents and treatment reviewed here include elotuzumab, daratumumab, ixazomib, venetoclax, and BCMA CAR-T therapies.
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Affiliation(s)
- Ichiro Hanamura
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences
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Iida S, Wakabayashi M, Tsukasaki K, Miyamoto K, Maruyama D, Yamamoto K, Takatsuka Y, Kusumoto S, Kuroda J, Ando K, Kikukawa Y, Masaki Y, Kobayashi M, Hanamura I, Asai H, Nagai H, Shimada K, Tsukamoto N, Inoue Y, Tobinai K. Bortezomib plus dexamethasone vs thalidomide plus dexamethasone for relapsed or refractory multiple myeloma. Cancer Sci 2018; 109:1552-1561. [PMID: 29478257 PMCID: PMC5980148 DOI: 10.1111/cas.13550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 01/31/2018] [Accepted: 02/19/2018] [Indexed: 12/18/2022] Open
Abstract
A randomized phase II selection design study (JCOG0904) was carried out to evaluate the more promising regimen between bortezomib (Bor) plus dexamethasone (Dex; BD) and thalidomide (Thal) plus Dex (TD) in Bor and Thal‐naïve patients with relapsed or refractory multiple myeloma (RRMM). Patients ≥20 and <80 years old with a documented diagnosis of symptomatic multiple myeloma (MM) who received one or more prior therapies were randomized to receive BD (Bor 1.3 mg/m2) or TD (Thal 200 mg/d). In both arms, 8 cycles of induction (3‐week cycle) were followed by maintenance phase (5‐week cycle) until disease progression, unacceptable toxicity, or patient refusal. The primary end‐point was 1‐year progression‐free survival (PFS). Forty‐four patients were randomized and assigned to receive BD and TD (n = 22, each group). At a median follow‐up of 34.3 months, the 1‐year PFS in the BD and TD arms were 45.5% (95% confidence interval (CI), 24.4%‐64.3%) and 31.8% (95% CI, 14.2%‐51.1%), respectively, and the overall response rates were 77.3% and 40.9%, respectively. The 3‐year overall survival (OS) was 70.0% (95% CI, 44.9%‐85.4%) in the BD, and 48.8% (95% CI, 25.1%‐69.0%) in the TD arm. Among grade 3/4 adverse events, thrombocytopenia (54.5% vs 0.0%) and sensory peripheral neuropathy (22.7% vs 9.1%) were more frequent in BD when compared with the TD arm. Patients treated with BD had better outcomes than those treated with TD with regard to 1‐year PFS and 3‐year OS. Thus, BD was prioritized over TD for further investigations in Bor and Thal‐naïve RRMM patients. (Clinical trial registration no. UMIN000003135.)
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Affiliation(s)
- Shinsuke Iida
- Department of Hematology and Oncology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Nagoya City University Hospital, Nagoya, Japan
| | | | - Kunihiro Tsukasaki
- Department of Hematology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), National Cancer Center Hospital East, Kashiwa, Japan
| | - Kenichi Miyamoto
- JCOG Data Center/Operations Office, National Cancer Center, Tokyo, Japan
| | - Dai Maruyama
- Department of Hematology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhito Yamamoto
- Department of Hematology and Cell Therapy, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yoshifusa Takatsuka
- Department of Hematology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Imamura General Hospital, Kagoshima, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Nagoya City University Hospital, Nagoya, Japan
| | - Junya Kuroda
- Division of Hematology and Oncology, Department of Medicine, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Kyoto Prefectural University, Kyoto, Japan
| | - Kiyoshi Ando
- Department of Hematology and Oncology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Tokai University of School of Medicine, Isehara, Japan
| | - Yoshitaka Kikukawa
- Department of Hematology, Rheumatology and Infectious Diseases, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Kumamoto University Hospital, Kumamoto, Japan
| | - Yasufumi Masaki
- Department of Hematology and Immunology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Kanazawa Medical University, Kahoku, Japan
| | - Miki Kobayashi
- Department of Hematology and Oncology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Aichi Medical University, Nagakute, Japan
| | - Hiroaki Asai
- First Department of Internal Medicine, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Ehime University Hospital, Toon, Japan
| | - Hirokazu Nagai
- Department of Hematology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), National Hospital Organization Nagoya Medical Center, Nagoya, Japan
| | - Kazuyuki Shimada
- Department of Hematology and Oncology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Norifumi Tsukamoto
- Oncology Center, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), Gunma University Hospital, Maebashi, Japan
| | - Yoshiko Inoue
- Department of Hematology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Kensei Tobinai
- Department of Hematology, Lymphoma Study Group of the Japan Clinical Oncology Group (JCOG-LSG), National Cancer Center Hospital, Tokyo, Japan
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Uchino K, Mizuno S, Sato-Otsubo A, Nannya Y, Mizutani M, Horio T, Hanamura I, Espinoza JL, Onizuka M, Kashiwase K, Morishima Y, Fukuda T, Kodera Y, Doki N, Miyamura K, Mori T, Ogawa S, Takami A. Toll-like receptor genetic variations in bone marrow transplantation. Oncotarget 2018; 8:45670-45686. [PMID: 28484092 PMCID: PMC5542217 DOI: 10.18632/oncotarget.17315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 03/31/2017] [Indexed: 11/25/2022] Open
Abstract
The Toll-like receptor family mediates the innate immune system through recognizing the molecular patterns of microorganisms and self-components and leading the synthesis of the inflammatory mediators. We retrospectively examined whether or not genetic variations in toll-like receptor 1 (rs5743551, -7202GQ>A), toll-like receptor 2 (rs7656411, 22215G>T), and toll-like receptor 4 (rs11536889, +3725G>C) affected transplant outcomes in a cohort of 365 patients who underwent unrelated HLA-matched bone marrow transplantation (for hematologic malignancies through the Japan Marrow Donor Program. Only donor toll-like receptor 4 variation significantly improved the survival outcomes. A multivariate analysis showed that the donor toll-like receptor 4 +3725G/G genotype was significantly associated with a better 5-year progression-free survival and a lower 5-year transplant-related mortality than other variations. Furthermore, the donor toll-like receptor 4 +3725G/G genotype was associated with a significantly lower incidence of fatal infections than other variations. The validation study of 502 patients confirmed that the donor toll-like receptor 4 +3725G/G genotype was associated with better survival outcomes. Toll-like receptor4 genotyping in transplant donors may therefore be a useful tool for optimizing donor selection and evaluating pretransplantation risks.
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Affiliation(s)
- Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Aiko Sato-Otsubo
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yasuhito Nannya
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Motonori Mizutani
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Tomohiro Horio
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
| | - J Luis Espinoza
- Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan
| | - Koichi Kashiwase
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan
| | - Yasuo Morishima
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Takahiro Fukuda
- Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshihisa Kodera
- Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University, Nagakute, Japan
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Koichi Miyamura
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan
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Horio T, Mizuno S, Uchino K, Mizutani M, Hanamura I, Espinoza JL, Onizuka M, Kashiwase K, Morishima Y, Fukuda T, Kodera Y, Doki N, Miyamura K, Mori T, Takami A. The recipient CCR5 variation predicts survival outcomes after bone marrow transplantation. Transpl Immunol 2017; 42:34-39. [PMID: 28487238 DOI: 10.1016/j.trim.2017.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 04/24/2017] [Accepted: 05/05/2017] [Indexed: 12/18/2022]
Abstract
The chemokine receptor CCR5 plays roles in the trafficking of effector cells towards the site of inflammation. We retrospectively examined the impact of the CCR5 variation (rs1800023, -2086A>G) on transplant outcomes in a cohort of 329 patients who underwent unrelated HLA-matched bone marrow transplantation (BMT) for hematologic malignancies through the Japan Marrow Donor Program. A multivariate analysis showed that the recipient CCR5 -2086A/A genotype was significantly associated with a lower relapse rate but not with the development of graft-versus-host disease (GVHD) or transplant-related mortality, thereby resulting in better disease-free and overall survival rates than other variations. The donor CCR5 -2086A/A genotype was associated with a lower incidence of grades 3-4 acute GVHD, which did not improve the survival outcomes. These findings suggest that the recipient CCR5 -2086A/A genotype affects the induction of the graft-versus-tumor effect without augmenting the development of GVHD. CCR5 genotyping in transplant recipients may therefore be a useful tool for evaluating pretransplantation risks.
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Affiliation(s)
- Tomohiro Horio
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Motonori Mizutani
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - J Luis Espinoza
- Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan.
| | - Koichi Kashiwase
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan.
| | - Yasuo Morishima
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
| | - Takahiro Fukuda
- Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan.
| | - Yoshihisa Kodera
- Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University, Nagoya, Japan.
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
| | - Koichi Miyamura
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
| | - Takehiko Mori
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
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Oyake T, Fujisawa Y, Sugawara N, Mine T, Tsukushi Y, Hanamura I, Aoki Y, Kowata S, Ito S, Ishida Y. Comparison of DRPM and MEPM as the first-line therapy in FN patients with acute leukemia: A randomized, controlled trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw521.054] [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: 11/12/2022] Open
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38
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Nakayama T, Mizutani K, Hanamura I, Kato H, Takami A, Takeshita K, Watanabe D. Livedoid vasculopathy and popliteal artery occlusion in a patient with protein S deficiency. J Dermatol 2016; 44:198-201. [DOI: 10.1111/1346-8138.13652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 09/10/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Takayuki Nakayama
- Department of Transfusion Medicine; Aichi Medical University; Nagakute Japan
| | - Kentaro Mizutani
- Department of Dermatology; Aichi Medical University; Nagakute Japan
| | - Ichiro Hanamura
- Department of Hematology; Aichi Medical University; Nagakute Japan
| | - Hidefumi Kato
- Department of Transfusion Medicine; Aichi Medical University; Nagakute Japan
| | - Akiyoshi Takami
- Department of Hematology; Aichi Medical University; Nagakute Japan
| | - Kyosuke Takeshita
- Department of Cardiology; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Daisuke Watanabe
- Department of Dermatology; Aichi Medical University; Nagakute Japan
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Uchino K, Mizuno S, Mizutani M, Horio T, Hanamura I, Espinoza JL, Matsuo K, Onizuka M, Kashiwase K, Morishima Y, Fukuda T, Kodera Y, Doki N, Miyamura K, Mori TMT, Takami A. Toll-like receptor 1 variation increases the risk of transplant-related mortality in hematologic malignancies. Transpl Immunol 2016; 38:60-6. [PMID: 27369862 DOI: 10.1016/j.trim.2016.06.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 05/31/2016] [Accepted: 06/24/2016] [Indexed: 11/24/2022]
Abstract
Toll-like receptor 1 (TLR1) genetic variant (rs5743551, -7202A>G) has been reported to be associated with susceptibility to various infectious diseases. We retrospectively examined the impact of TLR1 variation on transplant outcomes in a cohort of 320 patients who underwent unrelated HLA-matched bone marrow transplantation (BMT) for hematologic malignancies. A multivariate analysis showed that the G/G genotype in the recipients and the donors was associated with a significantly lower 3-year transplant-related mortality (TRM). The recipient G/G genotype also resulted in a better 3-year progression-free survival. This study suggests that the recipient and donor TLR1 G/G genotypes are comparably associated with a reduced risk of death that was not related to relapse. Thus, TLR1 genotyping may be useful for selecting the donor, managing patients in a risk-adapted manner, and creating therapeutic strategies to prevent complications after hematopoietic stem cell transplantation.
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Affiliation(s)
- Kaori Uchino
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Shohei Mizuno
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Motonori Mizutani
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Tomohiro Horio
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
| | - J Luis Espinoza
- Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
| | - Keitaro Matsuo
- Division of Molecular Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.
| | - Makoto Onizuka
- Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Japan.
| | - Koichi Kashiwase
- Japanese Red Cross Kanto-Koshinetsu Block Blood Center, Tokyo, Japan.
| | - Yasuo Morishima
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
| | - Takahiro Fukuda
- Hematopoietic Stem Cell Transplantation Unit, National Cancer Center Hospital, Tokyo, Japan.
| | - Yoshihisa Kodera
- Department of Promotion for Blood and Marrow Transplantation, Aichi Medical University, Nagoya, Japan.
| | - Noriko Doki
- Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
| | - Koichi Miyamura
- Department of Hematology, Japanese Red Cross Nagoya First Hospital, Nagoya, Japan.
| | | | - Akiyoshi Takami
- Division of Hematology, Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Japan.
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40
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Hanamura I, Iida S. [Classification and genetic abnormalities of multiple myeloma]. Nihon Rinsho 2015; 73:17-27. [PMID: 25626298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Multiple myeloma (MM) is a malignancy of plasma cells which develops through genetic aberrations, epigenetic changes and the bone marrow microenvironment interaction. Despite recent tremendous progress in treatments for MM, a complete cure remains elusive. Further development of more effective therapeutic strategies is needed. The International Staging System (ISS) reported in 2005 has been used widely as the most simple and powerful prognostic classification in MM, but genetic abnormalities affecting prognosis were not considered in this model. In the past decade, non-random chromosomal aberrations such as t(4;14), t(14;16), t(14;20), amp1q21 and del17p have shown to be poor prognostic value, and moreover, recent progress in genome-wide deep sequencing studies has revealed novel mutations and intra-tumor subclonal heterogeneity which may explain clinical phenotype and therapeutic resistance. Here we review the current understanding of genetic abnormalities in MM for developing better prognostic classification and molecular targeted therapies leading to the stratified or personalized medicine.
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Oyake T, Fujisawa Y, Sugawara N, Nakagawa Y, Hanamura I, Mine T, Aoki Y, Kowata S, Ito S, Ishida Y. Comparison of Doripenem and Meropenem as the First-Line Mono-Therapy in Febrile Neutropenic Patients with Acute Leukemia. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu433.1] [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: 11/14/2022] Open
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42
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Goto M, Miwa H, Shikami M, Tsunekawa-Imai N, Suganuma K, Mizuno S, Takahashi M, Mizutani M, Hanamura I, Nitta M. Importance of glutamine metabolism in leukemia cells by energy production through TCA cycle and by redox homeostasis. Cancer Invest 2014; 32:241-7. [PMID: 24762082 DOI: 10.3109/07357907.2014.907419] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Some cancer cells depend on glutamine despite of pronounced glycolysis. We examined the glutamine metabolism in leukemia cells, and found that HL-60 cells most depended on glutamine in the 4 acute myelogenous leukemia (AML) cell lines examined: growth of HL-60 cells was most suppressed by glutamine deprivation and by inhibition of glutaminolysis, which was rescued by tricarboxylic acid (TCA) cycle intermediate, oxaloacetic acid. Glutamine is also involved in antioxidant defense function by increasing glutathione. Glutamine deprivation suppressed the glutathione content and elevated reactive oxygen species most evidently in HL-60 cells. Glutamine metabolism might be a therapeutic target in some leukemia.
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Affiliation(s)
- Mineaki Goto
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine , Nagakute, Aichi , Japan
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43
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Goto M, Miwa H, Suganuma K, Tsunekawa-Imai N, Shikami M, Mizutani M, Mizuno S, Hanamura I, Nitta M. Adaptation of leukemia cells to hypoxic condition through switching the energy metabolism or avoiding the oxidative stress. BMC Cancer 2014; 14:76. [PMID: 24506813 PMCID: PMC3922169 DOI: 10.1186/1471-2407-14-76] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [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: 07/29/2013] [Accepted: 02/06/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Like normal hematopoietic stem cells, leukemia cells proliferate in bone marrow, where oxygen supply is limited. However, the growth and energy metabolism of leukemia cells under hypoxia have not been well understood. Although it has been known that reactive oxygen species (ROS) is generated under hypoxic conditions, normal and leukemia stem cells were characterized by relatively low levels of ROS. Roles of ROS on leukemia cells under hypoxia also have not been well understood. METHODS Four Leukemia cell lines were cultured under normoxia (21% O2) or hypoxia (1% O2), where NB4 and THP-1 were most extensively studied. To evaluate energy metabolism, we estimated whole cell number or apoptotic cells with or without a glycolysis inhibitor or an oxidative phosphorylation (OXPHOS) inhibitor. Glucose consumption and lactate production were also measured. To evaluate oxidative stress in hypoxic condition, the ROS level and GSH (reduced glutathione) / GSSG (oxidized glutathione) ratio was measured. In addition, pyruvate dehydrogenase kinase 1 (PDK1) and cytochrome c oxidase subunit 4 (COX4) were examined by western blotting or RT-PCR. RESULTS NB4, which grows well under normoxia depending on glycolysis, demonstrated prominent apoptosis and growth suppression after 48 hours culture under hypoxia. NB4 cells cultured under hypoxia showed significantly increased ROS. Culture with a ROS scavenger resulted in decrease of apoptotic cell death of NB4 under hypoxia. NB4 cells cultured for longer period (7 days) under hypoxia did not come to extinction, but grew slowly by upregulating GSH synthesis to protect from ROS generated in hypoxic condition. By contrast, THP-1, which largely depends on OXPHOS in mitochondria under normoxia, demonstrated more growth under hypoxia by changing metabolism from OXPHOS to glycolysis through upregulating PDK1. Moreover, THP-1 avoided ROS generation by substituting COX 4 subunit (from COX 4-1 to COX 4-2) through upregulation of LON, a mitochondrial protease under hypoxia. CONCLUSIONS We showed that leukemia cells survive and adapt to the hypoxic condition through various pathways. Our results will help understanding energy metabolism of leukemia cells and creating novel therapeutics.
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Affiliation(s)
| | - Hiroshi Miwa
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
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44
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Inagaki A, Tajima E, Uranishi M, Totani H, Asao Y, Ogura H, Masaki A, Yoshida T, Mori F, Ito A, Yano H, Ri M, Kayukawa S, Kataoka T, Kusumoto S, Ishida T, Hayami Y, Hanamura I, Komatsu H, Inagaki H, Matsuda Y, Ueda R, Iida S. Global real-time quantitative reverse transcription-polymerase chain reaction detecting proto-oncogenes associated with 14q32 chromosomal translocation as a valuable marker for predicting survival in multiple myeloma. Leuk Res 2013; 37:1648-55. [PMID: 24210217 DOI: 10.1016/j.leukres.2013.09.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [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: 07/29/2013] [Revised: 09/17/2013] [Accepted: 09/28/2013] [Indexed: 11/25/2022]
Abstract
CCND1, FGFR3 and c-MAF mRNA expression of tumor samples from 123 multiple myeloma patients were analyzed by global RQ/RT-PCR. CCND1, FGFR3 and c-MAF were positive in 44 (36%), 28 (23%) and 16 (13%) of patients, respectively. In 7 patients, both FGFR3 and c-MAF were positive. The expression of c-MAF was independent unfavorable prognostic factors for overall survival (OS). Autologous stem cell transplantation improved progression-free survival of CCND1-positive patients. Bortezomib, thalidomide or lenalidomide extended OS of FGFR3 and/or c-MAF-positive patients. Thus, CCND1, FGFR3 and c-MAF mRNA expression can predict survival and is useful for planning stratified treatment strategies for myeloma patients.
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Affiliation(s)
- Atsushi Inagaki
- Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, Nagoya City, Japan.
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45
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Miwa H, Shikami M, Goto M, Mizuno S, Takahashi M, Tsunekawa-Imai N, Ishikawa T, Mizutani M, Horio T, Gotou M, Yamamoto H, Wakabayashi M, Watarai M, Hanamura I, Imamura A, Mihara H, Nitta M. Leukemia cells demonstrate a different metabolic perturbation provoked by 2-deoxyglucose. Oncol Rep 2013; 29:2053-7. [PMID: 23440281 DOI: 10.3892/or.2013.2299] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 01/30/2013] [Indexed: 11/06/2022] Open
Abstract
The shift in energy metabolism from oxidative phosphorylation to glycolysis can serve as a target for the inhibition of cancer growth. Here, we examined the metabolic changes induced by 2-deoxyglucose (2-DG), a glycolysis inhibitor, in leukemia cells by metabolome analysis. NB4 cells mainly utilized glucose as an energy source by glycolysis and oxidative phosphorylation in mitochondria, since metabolites in the glycolytic pathway and in the tricarboxylic acid (TCA) cycle were significantly decreased by 2-DG. In THP-1 cells, metabolites in the TCA cycle were not decreased to the same extent by 2-DG as in NB4 cells, which indicates that THP-1 utilizes energy sources other than glucose. TCA cycle metabolites in THP-1 cells may be derived from acetyl-CoA by fatty acid β-oxidation, which was supported by abundant detection of carnitine and acetylcarnitine in THP-1 cells. 2-DG treatment increased the levels of pentose phosphate pathway (PPP) metabolites and augmented the generation of NADPH by glucose-6-phosphate dehydrogenase. An increase in NADPH and upregulation of glutathione synthetase expression resulted in the increase in the reduced form of glutathione by 2-DG in NB4 cells. We demonstrated that a combination of 2-DG and inhibition of PPP by dehydroepiandrosterone (DHEA) effectively suppressed the growth of NB4 cells. The replenishment of the TCA cycle by fatty acid oxidation by carnitine palmitoyltransferase in THP-1 cells, treated by 2-DG, might be regulated by AMPK, as the combination of 2-DG and inhibition of AMPK by compound C potently suppressed the growth of THP-1 cells. Although 2-DG has been effective in preclinical and clinical studies, this treatment has not been fully explored due to concerns related to potential toxicities such as brain toxicity at high doses. We demonstrated that a combination of 2-DG and DHEA or compound C at a relatively low concentration effectively inhibits the growth of NB4 and THP-1 cells, respectively. These observations may aid in the identification of appropriate combinations of metabolic inhibitors at low concentrations which do not cause toxicities.
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Affiliation(s)
- Hiroshi Miwa
- Department of Internal Medicine, Division of Hematology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
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Nagoshi H, Taki T, Hanamura I, Nitta M, Otsuki T, Nishida K, Okuda K, Sakamoto N, Kobayashi S, Yamamoto-Sugitani M, Tsutsumi Y, Kobayashi T, Matsumoto Y, Horiike S, Kuroda J, Taniwaki M. Frequent PVT1 rearrangement and novel chimeric genes PVT1-NBEA and PVT1-WWOX occur in multiple myeloma with 8q24 abnormality. Cancer Res 2012; 72:4954-62. [PMID: 22869583 DOI: 10.1158/0008-5472.can-12-0213] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Chromosome 8q24 rearrangements are occasionally found in multiple myeloma and are associated with tumor progression. The 8q24 rearrangements were detected by FISH in 12 of 54 patients with multiple myeloma (22.2%) and in 8 of 11 multiple myeloma cell lines (72.7%). The breakpoints of 8q24 in 10 patients with multiple myeloma and in all multiple myeloma cell lines were assigned to a 360 kb segment, which was divided into 4 regions: approximately 120 kb centromeric to MYC (5' side of MYC), the region centromerically adjacent to PVT1 (~ 170 kb region, including MYC, of 5' side of PVT1), the PVT1 region, and the telomeric region to PVT1. PVT1 rearrangements were most common and found in 7 of 12 patients (58.3%) and 5 of 8 cell lines (62.5%) with 8q24 abnormalities. A combination of spectral karyotyping (SKY), FISH, and oligonucleotide array identified several partner loci of PVT1 rearrangements, such as 4p16, 4q13, 13q13, 14q32, and 16q23-24. Two novel chimeric genes were identified: PVT1-NBEA in the AMU-MM1 cell line harboring t(8;13)(q24;q13) and PVT1-WWOX in RPMI8226 cell line harboring der(16)t(16;22)ins(16;8)(q23;q24). The PVT1-NBEA chimera in which PVT1 exon 1 was fused to NBEA exon 2 and the PVT1-WWOX in which PVT1 exon 1 was fused to WWOX exon 9 were associated with the expression of abnormal NBEA and WWOX lacking their N-terminus, respectively. These findings suggest that PVT1 rearrangements may represent a novel molecular paradigm underlying the pathology of 8q24 rearrangement-positive multiple myeloma.
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Affiliation(s)
- Hisao Nagoshi
- Department of Hematology and Oncology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
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Hanamura I, Iida S. [Genetic and cytogenetic abnormalities of multiple myeloma]. Nihon Rinsho 2012; 70 Suppl 2:126-132. [PMID: 23133940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Ichiro Hanamura
- Division of Hematology, Department of Internal Medicine, Aichi Medical University
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48
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Gotou M, Hanamura I, Nagoshi H, Wakabayashi M, Sakamoto N, Tsunekawa N, Horio T, Goto M, Mizuno S, Takahashi M, Suganuma K, Yamamoto H, Hiramatsu A, Watarai M, Shikami M, Imamura A, Mihara H, Taki T, Miwa H, Taniwaki M, Nitta M. Establishment of a novel human myeloid leukemia cell line, AMU-AML1, carrying t(12;22)(p13;q11) without chimeric MN1-TEL and with high expression of MN1. Genes Chromosomes Cancer 2011; 51:42-53. [DOI: 10.1002/gcc.20929] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 08/09/2011] [Accepted: 08/12/2011] [Indexed: 11/10/2022] Open
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Suganuma K, Miwa H, Imai N, Shikami M, Gotou M, Goto M, Mizuno S, Takahashi M, Yamamoto H, Hiramatsu A, Wakabayashi M, Watarai M, Hanamura I, Imamura A, Mihara H, Nitta M. Energy metabolism of leukemia cells: glycolysis versus oxidative phosphorylation. Leuk Lymphoma 2010; 51:2112-9. [PMID: 20860495 DOI: 10.3109/10428194.2010.512966] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
For generation of energy, cancer cells utilize glycolysis more vigorously than oxidative phosphorylation in mitochondria (Warburg effect). We examined the energy metabolism of four leukemia cell lines by using glycolysis inhibitor, 2-deoxy-d-glucose (2-DG) and inhibitor of oxidative phosphorylation, oligomycin. NB4 was relatively sensitive to 2-DG (IC(50): 5.75 mM), consumed more glucose and produced more lactate (waste product of glycolysis) than the three other cell lines. Consequently, NB4 was considered as a "glycolytic" leukemia cell line. Dependency on glycolysis in NB4 was confirmed by the fact that glucose (+) FCS (-) medium showed more growth and survival than glucose (-) FCS (+) medium. Alternatively, THP-1, most resistant to 2-DG (IC(50): 16.14 mM), was most sensitive to oligomycin. Thus, THP-1 was recognized to be dependent on oxidative phosphorylation. In THP-1, glucose (-) FCS (+) medium showed more growth and survival than glucose (+) FCS (-) medium. The dependency of THP-1 on FCS was explained, at least partly, by fatty acid oxidation because inhibitor of fatty acid β-oxidation, etomoxir, augmented the growth suppression of THP-1 by 2-DG. We also examined the mechanisms by which THP-1 was resistant to, and NB4 was sensitive to 2-DG treatment. In THP-1, AMP kinase (AMPK), which is activated when ATP becomes limiting, was rapidly phosphorylated by 2-DG, and expression of Bcl-2 was augmented, which might result in resistance to 2-DG. On the other hand, AMPK phosphorylation and augmentation of Bcl-2 expression by 2-DG were not observed in NB4, which is 2-DG sensitive. These results will facilitate the future leukemia therapy targeting metabolic pathways.
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Affiliation(s)
- Kazuto Suganuma
- Department of Internal Medicine, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
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Hanamura I, Iida S. [Multiple melanoma-progress in understanding of molecular mechanism and improvement in treatment outcome with introduction of new drugs for multiple myeloma]. Gan To Kagaku Ryoho 2010; 37:816-821. [PMID: 20524255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Ichiro Hanamura
- Department of Hematology, Division of Internal Medicine, Aichi Medical University
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