1
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Hurtado-Navarro L, Cuenca-Zamora EJ, Zamora L, Bellosillo B, Such E, Soler-Espejo E, Martínez-Banaclocha H, Hernández-Rivas JM, Marco-Ayala J, Martínez-Alarcón L, Linares-Latorre L, García-Ávila S, Amat-Martínez P, González T, Arnan M, Pomares-Marín H, Carreño-Tarragona G, Chen-Liang TH, Herranz MT, García-Palenciano C, Morales ML, Jerez A, Lozano ML, Teruel-Montoya R, Pelegrín P, Ferrer-Marín F. NLRP3 inflammasome activation and symptom burden in KRAS-mutated CMML patients is reverted by IL-1 blocking therapy. Cell Rep Med 2023; 4:101329. [PMID: 38118408 PMCID: PMC10772462 DOI: 10.1016/j.xcrm.2023.101329] [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: 06/22/2023] [Revised: 09/21/2023] [Accepted: 11/17/2023] [Indexed: 12/22/2023]
Abstract
Chronic myelomonocytic leukemia (CMML) is frequently associated with mutations in the rat sarcoma gene (RAS), leading to worse prognosis. RAS mutations result in active RAS-GTP proteins, favoring myeloid cell proliferation and survival and inducing the NLRP3 inflammasome together with the apoptosis-associated speck-like protein containing a caspase recruitment domain (ASC), which promote caspase-1 activation and interleukin (IL)-1β release. Here, we report, in a cohort of CMML patients with mutations in KRAS, a constitutive activation of the NLRP3 inflammasome in monocytes, evidenced by ASC oligomerization and IL-1β release, as well as a specific inflammatory cytokine signature. Treatment of a CMML patient with a KRASG12D mutation using the IL-1 receptor blocker anakinra inhibits NLRP3 inflammasome activation, reduces monocyte count, and improves the patient's clinical status, enabling a stem cell transplant. This reveals a basal inflammasome activation in RAS-mutated CMML patients and suggests potential therapeutic applications of NLRP3 and IL-1 blockers.
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Affiliation(s)
| | - Ernesto José Cuenca-Zamora
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain; CIBERER CB15/00055 (U765), Murcia, Spain
| | - Lurdes Zamora
- Myeloid Neoplasms Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias I Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Beatriz Bellosillo
- Molecular Biology Laboratory, Pathology Department, Hospital Del Mar, Hospital Del Mar Medical Research Institute, IMIM, Barcelona, Spain
| | - Esperanza Such
- Hematology Department, La Fe University Hospital, Valencia, Spain
| | - Eva Soler-Espejo
- Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain
| | - Helios Martínez-Banaclocha
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Immunology Service, Hospital Universitario Virgen de La Arrixaca, Murcia, Spain
| | - Jesús M Hernández-Rivas
- Department of Medicine, Universidad de Salamanca, Servicio de Hematología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Javier Marco-Ayala
- Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain
| | | | - Lola Linares-Latorre
- Service of Clinical Analysis and Microbiology, Fundación Instituto Valenciano de Oncología, Valencia, Spain
| | - Sara García-Ávila
- Department of Hematology, Hospital Del Mar, Barcelona, Spain; IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain
| | - Paula Amat-Martínez
- Hematology Service, Clinic University Hospital, INCLIVA Health Research Institute, Valencia, Spain
| | - Teresa González
- Department of Medicine, Universidad de Salamanca, Servicio de Hematología, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Montserrat Arnan
- Hematology Department, Institut Català D'Oncologia (ICO)-Hospital Duran I Reynals, IDIBELL, Barcelona, Spain
| | - Helena Pomares-Marín
- Hematology Department, Institut Català D'Oncologia (ICO)-Hospital Duran I Reynals, IDIBELL, Barcelona, Spain
| | | | - Tzu Hua Chen-Liang
- Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain
| | - María T Herranz
- Internal Medicine Service, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Carlos García-Palenciano
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario Virgen de La Arrixaca, Murcia, Spain
| | - María Luz Morales
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain
| | - Andrés Jerez
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain; CIBERER CB15/00055 (U765), Murcia, Spain
| | - María L Lozano
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain; CIBERER CB15/00055 (U765), Murcia, Spain
| | - Raúl Teruel-Montoya
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain; CIBERER CB15/00055 (U765), Murcia, Spain; Universidad Católica San Antonio (UCAM), Murcia, Spain
| | - Pablo Pelegrín
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Department of Biochemistry and Molecular Biology B and Immunology, University of Murcia, Murcia, Spain.
| | - Francisca Ferrer-Marín
- Biomedical Research Institute of Murcia (IMIB-Pascual Parrilla), Murcia, Spain; Hematology Department, Hospital Universitario Morales-Meseguer, Centro Regional de Hemodonación, Murcia, Spain; CIBERER CB15/00055 (U765), Murcia, Spain; Universidad Católica San Antonio (UCAM), Murcia, Spain.
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2
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Solves P, Marco-Ayala J, Sanz MÁ, Gómez-Seguí I, Balaguer-Roselló A, Facal A, Villalba M, Montoro J, Sanz G, de la Rubia J, Sanz J. Transfusion Burden in Allogeneic Hematopoietic Stem Cell Transplantation over Time: Experience from a Single Institution. J Clin Med 2023; 12:jcm12103467. [PMID: 37240573 DOI: 10.3390/jcm12103467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
INTRODUCTION Transfusion plays a main role in supportive treatment for patients who receive an allogeneic hematopoietic stem cell transplantation (HSCT). In this study, we compare the transfusion requirements of patients undergoing different modalities of HSCT according to different time periods. The objective is to assess the evolution of HSCT transfusion requirements over time, from a single institution. METHODS The clinical charts and transfusion records of patients who underwent HSCT of different modalities at La Fe University Hospital during a twelve-year period were reviewed (2009-2020). For analysis, we divided the overall time into three periods: 1 from 2009 to 2012, 2 from 2013 to 2016 and 3 from 2017 to 2020. The study included 855 consecutive adult HSCT: 358 HLA-matched related donors (MRD), 134 HLA-matched unrelated donors (MUD), 223 umbilical cord blood transplantation (UCBT) and 140 haploidentical transplants (Haplo-HSCT). RESULTS There were no significant differences in RBC and PLT requirements or transfusion independence among the three time periods for MUD and Haplo-HSCT. However, the transfusion burden increased significantly for MRD HSCT during the 2017-2020 period. CONCLUSION despite HSCT modalities having evolved and changed over time, overall transfusion requirements have not significantly decreased and continue to be a cornerstone of transplantation-supportive care.
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Affiliation(s)
- Pilar Solves
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
| | - Javier Marco-Ayala
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Haematology Department, University Hospital "Morales Meseguer", 30007 Murcia, Spain
| | - Miguel Ángel Sanz
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
| | - Inés Gómez-Seguí
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
| | - Aitana Balaguer-Roselló
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
| | - Ana Facal
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Marta Villalba
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | - Juan Montoro
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
| | - Guillermo Sanz
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
| | - Javier de la Rubia
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
- School of Medicine and Dentistry, Catholic University of Valencia, 46010 Valencia, Spain
| | - Jaime Sanz
- Haematology Department, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
- Centro de Investigación Biomédica en red Cancer, Instituto Carlos III, 28029 Madrid, Spain
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3
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Soler-Espejo E, Marco-Ayala J, Chen-Liang TH, López-Poveda MJ, Teruel-Montoya R, Ortuño FJ. CD5+ follicular lymphoma rapidly transformed to high-grade B-cell lymphoma with double-hit: from BCL2 to MYC disruption. Blood Res 2023; 58:79-82. [PMID: 36987619 PMCID: PMC10063588 DOI: 10.5045/br.2023.2023039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Affiliation(s)
| | | | | | - María José López-Poveda
- S. de Anatomía Patológica. H. S. H.G.U. Morales Meseguer, IMIB-Arrixaca, 3CIBERER (U765), Murcia, Spain
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4
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Marco-Ayala J, Sanz J, Gómez-Seguí I, Balaguer-Rosello A, Montoro J, Guerreiro M, Chorao P, Facal A, Villalba M, Sanz MÁ, de la Rubia J, Solves P. Impact of Post-Transplantation Cyclophosphamide on Transfusion Requirements in HLA-Matched Sibling Peripheral Blood Stem Cell Transplantation. Transplant Cell Ther 2023; 29:313.e1-313.e10. [PMID: 36646324 DOI: 10.1016/j.jtct.2023.01.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
Post-transplantation cyclophosphamide (PTCy)-based graft-versus-host disease (GVHD) prophylaxis is being increasingly used in allogeneic hematopoietic stem cell transplantation (allo-HSCT) from HLA-matched related donors (MRDs); however, information regarding the transfusion needs in this setting is lacking. This study compared RBC and platelet units transfused and time to transfusion independence according to the GVHD prophylaxis regimen in MRD HSCT. We performed a matched-pair analysis comparing the transfusion requirements and the clinical outcomes of patients who underwent MRD peripheral blood HSCT using PTCy between January 2017 and June 2021 (n = 100) with historical MRD HSCTs using standard cyclosporine A (CsA)-based prophylaxis (n = 100). Neutrophil engraftment was significantly delayed in the PTCy group compared with the CsA group (16 days versus 13 days; P = .003). PTCy was associated with increased RBC (median, 5 units versus 4 units; P = .04) and platelet (median, 6 units versus 3 units; P = .01) transfusion requirements during the first 30 days after transplantation. The proportion of patients requiring platelet transfusion during days 31 to 90 after transplantation was also higher in the PTCy group (55% versus 25%; P < .0001). In multivariate analysis, PTCy was associated with delayed RBC and platelet transfusion independence (hazard ratio, .61 [P = .007] and .51 [P < .0001], respectively). The cumulative incidence (CuI) of BK polyomavirus-associated hemorrhagic cystitis grade ≥2 at 100 days was higher in the PTCy group (34% versus 12%; P < .0001); however, the PTCy group had lower rates of grade II-IV acute GVHD (100-day CuI, 57% versus 23%; P < .0001) and moderate to severe chronic GVHD (1-year CuI, 49% versus 28%; P = .003), as well as better 2-year overall survival (74% versus 56%; P = .01). Our study shows that although PTCy increases the transfusion burden in MRD HSCT, it is associated with a low incidence of severe GVHD and with encouraging survival outcomes.
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Affiliation(s)
| | - Jaime Sanz
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain
| | - Inés Gómez-Seguí
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain
| | | | - Juan Montoro
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Faculty of Medicine, Catholic University "San Vicente Mártir", Valencia, Spain
| | - Manuel Guerreiro
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Pedro Chorao
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Ana Facal
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Marta Villalba
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Miguel Ángel Sanz
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain
| | - Javier de la Rubia
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain; Faculty of Medicine, Catholic University "San Vicente Mártir", Valencia, Spain
| | - Pilar Solves
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Centro de Investigación Biomédica en Red de Cáncer, Instituto Carlos III, Madrid, Spain
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5
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Boluda B, Martínez-Cuadrón D, Algarra L, Cano I, Sayas MJ, Acuña-Cruz E, Blanco A, Marco-Ayala J, DeLapuerta R, Díaz-González Á, Tormo M, Rodríguez-Veiga R, García R, Piñana JL, López-Pavía M, Barragán E, Amigo ML, Sargas C, López A, Solana-Altabella A, Gil C, Megías-Vericat JE, Sanz MA, Montesinos P. Evolving patterns of care and outcomes in relapsed/refractory FLT3 mutated acute myeloid leukemia adult patients. Leuk Lymphoma 2021; 62:2727-2736. [PMID: 34121593 DOI: 10.1080/10428194.2021.1938031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We have analyzed treatment patterns and outcomes of relapsed/refractory(R/R) FLT3mut AML adult patients registered in our institutional data base between 1998 and 2018. Overall, 147 patients were evaluable: 34 from 1998 to 2009, 113 from 2010 to 2018. Salvage treatments were intensive chemotherapy (n = 25, 74%), and supportive care (n = 9, 26%) in the 1998-2009 period, and intensive chemotherapy (n = 63, 56%), hypomethylating agent (n = 7, 6%), low-dose cytarabine-based (n = 8, 7%), clinical trial (n = 16, 14%) and supportive care (n = 19, 17%) in the 2010-2018 period. Complete remission (CR) or with incomplete recovery (CRi) rate was 44%, 49% among patients treated intensively (vs 30% with non-intensive p = 0.005). Median overall survival since first R/R was 5.8 months, and 16.3 months in subjects receiving an allo-HSCT in CR/CRi after first salvage (vs 3.8 in the remaining patients p < 0.0001). Clinical outcomes of R/R FLT3mut AML remain unsatisfactory. Inclusion in clinical trials and expanding options could lead to improved outcomes.
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Affiliation(s)
- Blanca Boluda
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - David Martínez-Cuadrón
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Lorenzo Algarra
- Hematology Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Isabel Cano
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - María J Sayas
- Hematology Department, Hospital Doctor Peset, Valencia, Spain
| | - Evelyn Acuña-Cruz
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Albert Blanco
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Javier Marco-Ayala
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Rosalía DeLapuerta
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Álvaro Díaz-González
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario, Valencia, Spain
| | - Rebeca Rodríguez-Veiga
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Raimundo García
- Hematology Department, Hospital General Castellón, Castellón, Spain
| | - José L Piñana
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - María López-Pavía
- Hematology Department, Hospital General Universitario, Valencia, Spain
| | - Eva Barragán
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - María L Amigo
- Hematology Department, Hospital Morales Meseguer, Murcia, Spain
| | - Claudia Sargas
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Aurelio López
- Hematology Department, Hospital Arnau de Vilanova, Valencia, Spain
| | - Antonio Solana-Altabella
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Cristina Gil
- Hematology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - Juan Eduardo Megías-Vericat
- Instituto de Investigación Sanitaria La Fe, Valencia, Spain.,Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Miguel A Sanz
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Pau Montesinos
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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6
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Solana-Altabella A, Boluda B, Rodríguez-Veiga R, Cano I, Acuña-Cruz E, Blanco A, Marco-Ayala J, de la Puerta R, Díaz-González Á, Piñana JL, Sanz J, Sempere A, Cervera J, Barragán E, Sargas C, Ballesta-López O, Megías-Vericat JE, Martínez-Cuadrón D, Sanz MÁ, Montesinos P. Healthcare resource utilization in adult patients with relapsed/refractory FLT3 mutated acute myeloid leukemia: A retrospective chart review from Spain. Eur J Haematol 2021; 106:724-733. [PMID: 33609315 DOI: 10.1111/ejh.13604] [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: 11/28/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Information regarding impact on healthcare systems of relapsed or refractory (R/R) FLT3 mutated (FLT3mut) acute myeloid leukemia (AML) is scarce. OBJECTIVE To assess the time and reimbursement associated with hospitalizations of patients with R/R FLT3mut AML in a tertiary Spanish hospital. METHODS Retrospective review of medical charts identified patients aged ≥ 18 years with R/R FLT3mut AML between 1998 and 2018. Data were collected from the date of first diagnosis of R/R FLT3mut AML (index) until death or loss to follow-up. The primary end point was duration and frequency of hospitalization, use of outpatient resources and transfusion burden. Reimbursement associated with hospitalizations (including associated chemotherapy) was also assessed. RESULTS Thirty-eight patients were eligible for inclusion. Their median age was 52 years, and 30 (79%) received intensive salvage chemotherapy; FLAG-IDA-based regimens were the most frequent (24 patients, 63%). Overall, there were 150 hospitalizations (mean 3.9/patient; mean duration 21 days). Patients spent a mean of 24% of the study period in hospital. Total mean reimbursement was €108 293 per patient; the majority (€89 834) attributable to inpatient stays (€22 576 /hospitalization). During chemotherapy period (prior to first alloHSCT), there were 73 hospitalizations (mean duration 22 days); mean reimbursement was €19 776 per hospitalization and €49 819 per patient. AlloHSCT (n = 16) involved 77 hospitalizations (mean duration 21 days), mean reimbursement €25 231/hospitalization and €131 515 per patient. CONCLUSION Data from this study suggest that there is a substantial healthcare resource utilization and cost burden on R/R FLT3mut AML patients in Spain receiving active treatments.
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Affiliation(s)
- Antonio Solana-Altabella
- Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Blanca Boluda
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Rebeca Rodríguez-Veiga
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Isabel Cano
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Evelyn Acuña-Cruz
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Albert Blanco
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Javier Marco-Ayala
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Rosalía de la Puerta
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Álvaro Díaz-González
- Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - José L Piñana
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Jaime Sanz
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Amparo Sempere
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - José Cervera
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Eva Barragán
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Claudia Sargas
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Octavio Ballesta-López
- Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Juan Eduardo Megías-Vericat
- Pharmacy Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - David Martínez-Cuadrón
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Miguel Á Sanz
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Pau Montesinos
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain.,Hematology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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7
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Marco-Ayala J, Vicente AI, Such E, Luna I, Andreu R, Sempere A, Romero S, Peris MLS. Lineage switch from B lymphoblastic leukemia with KMT2A-rearranged to mixed-phenotype acute leukemia under daratumumab. Blood Res 2020; 55:75. [PMID: 32375465 PMCID: PMC7343553 DOI: 10.5045/br.2020.2020059] [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: 03/29/2020] [Revised: 04/03/2020] [Accepted: 04/21/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
| | | | - Esperanza Such
- Department of Hematology, La Fe University Hospital, Valencia, Spain
| | - Irene Luna
- Department of Hematology, La Fe University Hospital, Valencia, Spain
| | - Rafael Andreu
- Department of Hematology, La Fe University Hospital, Valencia, Spain
| | - Amparo Sempere
- Department of Hematology, La Fe University Hospital, Valencia, Spain
| | - Samuel Romero
- Department of Hematology, La Fe University Hospital, Valencia, Spain
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Such E, Liquori A, Mora E, Marco-Ayala J, Avetisyan G, Regadera A, Ibañez F, Panadero J, Senent L, Llop M, Díaz A, Vicente A, Luna I, Ibáñez M, Barragán E, Sanz MA, Sanz G, Cervera J. RNA Sequencing Analysis for the Identification of a PCM1/PDGFRB Fusion Gene Responsive to Imatinib. Acta Haematol 2019; 142:92-97. [PMID: 31085913 DOI: 10.1159/000497348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 12/05/2018] [Accepted: 01/18/2019] [Indexed: 01/01/2023]
Abstract
The platelet-derived growth factor receptor β (PDGFRB) gene translocations lead to a spectrum of chronic myeloid neoplasms, frequently associated with eosinophilia. Clinical heterogeneity is associated with a molecular one. Here, we report a novel case of a patient harboring a t(5;8)(q33;p22) translocation, resulting in the PCM1/PDGFRB fusion. Conventional cytogenetics and RNA sequencing were performed to identify the chromosomes and the genes involved in the rearrangement, respectively. This study shows that the combination of different strategies is pivotal to fine-tune the diagnosis and the clinical management of the patient. After 1 year of treatment with imatinib, the patient achieves hematological and molecular remission. We present an attractive strategy to identify novel and/or cryptic fusions, which will be relevant for clinicians dealing with the diagnosis of the patients with myelodysplastic syndrome/myeloproliferative diseases with atypical manifestations.
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MESH Headings
- Autoantigens/genetics
- Autoantigens/metabolism
- Cell Cycle Proteins/genetics
- Cell Cycle Proteins/metabolism
- Chromosomes, Human, Pair 5/genetics
- Chromosomes, Human, Pair 5/metabolism
- Chromosomes, Human, Pair 8/genetics
- Chromosomes, Human, Pair 8/metabolism
- Humans
- Imatinib Mesylate/administration & dosage
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Middle Aged
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Receptor, Platelet-Derived Growth Factor beta/genetics
- Receptor, Platelet-Derived Growth Factor beta/metabolism
- Sequence Analysis, RNA
- Translocation, Genetic
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Affiliation(s)
- Esperanza Such
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Alessandro Liquori
- Hematology Department, University Hospital La Fe, Valencia, Spain,
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain,
| | - Elvira Mora
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | | | - Gayane Avetisyan
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Anabel Regadera
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | | | - Joaquin Panadero
- Genomics Unit, Health Research Institute Hospital La Fe, Valencia, Spain
| | - Leonor Senent
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Marta Llop
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Alvaro Díaz
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Ana Vicente
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Irene Luna
- Hematology Department, University Hospital La Fe, Valencia, Spain
| | - Mariam Ibáñez
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Eva Barragán
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Miguel A Sanz
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Guillermo Sanz
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - José Cervera
- Hematology Department, University Hospital La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Genomics Unit, Health Research Institute Hospital La Fe, Valencia, Spain
- Genetics Unit, University Hospital La Fe, Valencia, Spain
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