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Caballero JC, Dávila J, López-Pavía M, Such E, Bernal T, Ramos F, Calabuig M, Hernández Sánchez JM, Pomares H, Sánchez Barba M, Abáigar M, González B, Merchán B, Sancho-Tello R, Callejas M, Muñoz-Novas C, Cerveró C, Sanz G, Hernández Rivas JM, Díez Campelo M. Outcomes and effect of somatic mutations after erythropoiesis stimulating agents in patients with lower-risk myelodysplastic syndromes. Ther Adv Hematol 2024; 15:20406207231218157. [PMID: 38186638 PMCID: PMC10768603 DOI: 10.1177/20406207231218157] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/15/2023] [Indexed: 01/09/2024] Open
Abstract
Background Erythropoiesis stimulating agents (ESAs) are the first-line therapy in patients with lower-risk myelodysplastic syndromes (LR-MDS). Some predictive factors for ESAs response have been identified. Type and number of somatic mutations have been associated with prognosis and response to therapies in MDS patients. Objectives The objective was to evaluate the outcomes after ESAs in patients with LR-MDS and to address the potential predictive value of somatic mutations in ESAs-treated patients. Design Multi-center retrospective study of a cohort of 722 patients with LR-MDS included in the SPRESAS (Spanish Registry of Erythropoietic Stimulating Agents Study) study. Retrospective analysis of 65 patients with next generation sequencing (NGS) data from diagnosis. Methods ESAs' efficacy and safety were evaluated in patients receiving ESAs and best supportive care (BSC). To assess the potential prognostic value of somatic mutations in erythroid response (ER) rate and outcome, NGS was performed in responders and non-responders. Results ER rate for ESAs-treated patients was 65%. Serum erythropoietin (EPO) level <200 U/l was the only variable significantly associated with a higher ER rate (odds ratio, 2.45; p = 0.036). Median overall survival (OS) in patients treated with ESAs was 6.7 versus 3.1 years in patients receiving BSC (p < 0.001). From 65 patients with NGS data, 57 (87.7%) have at least one mutation. We observed a trend to a higher frequency of ER among patients with a lower number of mutated genes (40.4% in <3 mutated genes versus 22.2% in ⩾3; p = 0.170). The presence of ⩾3 mutated genes was also significantly associated with worse OS (hazard ratio, 2.8; p = 0.015), even in responders. A higher cumulative incidence of acute myeloid leukemia progression at 5 years was also observed in patients with ⩾3 mutated genes versus <3 (33.3% and 10.7%, respectively; p < 0.001). Conclusion This large study confirms the beneficial effect of ESAs and the adverse effect of somatic mutations in patients with LR-MDS.
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Affiliation(s)
- Juan Carlos Caballero
- Hematology Department, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - Julio Dávila
- Hematology Department, Hospital Nuestra Señora de Sonsoles, Ávila, Spain
| | - María López-Pavía
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Universidad de Valencia, Valencia, Spain
| | - Esperanza Such
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Universidad de Valencia, Valencia, Spain
| | - Teresa Bernal
- Hematology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Fernando Ramos
- Hematology Department, Hospital Universitario de León, León, Spain
| | - Marisa Calabuig
- Hematology Department, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Jesús María Hernández Sánchez
- Instituto de Biología Molecular y Celular del Cáncer, Instituto Biosanitario de Salamanca, Centro de Investigación del Cáncer, USAL-CSIC, Salamanca, Spain
| | - Helena Pomares
- Hematology Department, Hospital Universitario de Bellvitge-Hospital Duran I Reynals, Instituto Catalán de Oncología, L’Hospitalet del Llobregat, Spain
| | | | - María Abáigar
- Instituto de Biología Molecular y Celular del Cáncer, Instituto Biosanitario de Salamanca, Centro de Investigación del Cáncer, USAL-CSIC, Salamanca, Spain
| | - Bernardo González
- Hematology Department, Hospital Universitario de Canarias, La Laguna, Spain
| | - Brayan Merchán
- Hematology Department, Hospital Universitario Vall d’Hebron, Barcelona, Spain
| | | | - Marta Callejas
- Hematology Department, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
| | | | - Carlos Cerveró
- Hematology Department, Hospital Virgen de la Luz, Cuenca, Spain
| | - Guillermo Sanz
- Hematology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Universidad de Valencia, Valencia, Spain
| | - Jesús María Hernández Rivas
- Instituto de Biología Molecular y Celular del Cáncer, Instituto Biosanitario de Salamanca, Centro de Investigación del Cáncer, USAL-CSIC, Salamanca, Spain Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain Instituto Biosanitario de Salamanca, Salamanca, Spain
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain Instituto Biosanitario de Salamanca, Salamanca, Spain
- Instituto Biosanitario de Salamanca, Salamanca, Spain
| | - María Díez Campelo
- Hematology Department, Hospital Universitario de Salamanca, Paseo de San Vicente 58-182, Salamanca 37007, Spain
- Instituto Biosanitario de Salamanca, Salamanca, Spain
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2
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Mansouri L, Thorvaldsdottir B, Sutton LA, Karakatsoulis G, Meggendorfer M, Parker H, Nadeu F, Brieghel C, Laidou S, Moia R, Rossi D, Catherwood M, Kotaskova J, Delgado J, Rodríguez-Vicente AE, Benito R, Rigolin GM, Bonfiglio S, Scarfo L, Mattsson M, Davis Z, Gogia A, Rani L, Baliakas P, Foroughi-Asl H, Jylhä C, Skaftason A, Rapado I, Miras F, Martinez-Lopez J, de la Serna J, Rivas JMH, Thornton P, Larráyoz MJ, Calasanz MJ, Fésüs V, Mátrai Z, Bödör C, Smedby KE, Espinet B, Puiggros A, Gupta R, Bullinger L, Bosch F, Tazón-Vega B, Baran-Marszak F, Oscier D, Nguyen-Khac F, Zenz T, Terol MJ, Cuneo A, Hernández-Sánchez M, Pospisilova S, Mills K, Gaidano G, Niemann CU, Campo E, Strefford JC, Ghia P, Stamatopoulos K, Rosenquist R. Different prognostic impact of recurrent gene mutations in chronic lymphocytic leukemia depending on IGHV gene somatic hypermutation status: a study by ERIC in HARMONY. Leukemia 2023; 37:339-347. [PMID: 36566271 PMCID: PMC9898037 DOI: 10.1038/s41375-022-01802-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022]
Abstract
Recent evidence suggests that the prognostic impact of gene mutations in patients with chronic lymphocytic leukemia (CLL) may differ depending on the immunoglobulin heavy variable (IGHV) gene somatic hypermutation (SHM) status. In this study, we assessed the impact of nine recurrently mutated genes (BIRC3, EGR2, MYD88, NFKBIE, NOTCH1, POT1, SF3B1, TP53, and XPO1) in pre-treatment samples from 4580 patients with CLL, using time-to-first-treatment (TTFT) as the primary end-point in relation to IGHV gene SHM status. Mutations were detected in 1588 (34.7%) patients at frequencies ranging from 2.3-9.8% with mutations in NOTCH1 being the most frequent. In both univariate and multivariate analyses, mutations in all genes except MYD88 were associated with a significantly shorter TTFT. In multivariate analysis of Binet stage A patients, performed separately for IGHV-mutated (M-CLL) and unmutated CLL (U-CLL), a different spectrum of gene alterations independently predicted short TTFT within the two subgroups. While SF3B1 and XPO1 mutations were independent prognostic variables in both U-CLL and M-CLL, TP53, BIRC3 and EGR2 aberrations were significant predictors only in U-CLL, and NOTCH1 and NFKBIE only in M-CLL. Our findings underscore the need for a compartmentalized approach to identify high-risk patients, particularly among M-CLL patients, with potential implications for stratified management.
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Affiliation(s)
- Larry Mansouri
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Birna Thorvaldsdottir
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Lesley-Ann Sutton
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Georgios Karakatsoulis
- Centre for Research and Technology Hellas, Institute of Applied Biosciences, Thessaloniki, Greece
- Department of Mathematics, University of Ioannina, Ioannina, Greece
| | | | - Helen Parker
- Cancer Genomics, School for Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ferran Nadeu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Christian Brieghel
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Stamatia Laidou
- Centre for Research and Technology Hellas, Institute of Applied Biosciences, Thessaloniki, Greece
| | - Riccardo Moia
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Davide Rossi
- Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
- Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Mark Catherwood
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Jana Kotaskova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Julio Delgado
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Ana E Rodríguez-Vicente
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Rocío Benito
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Gian Matteo Rigolin
- Hematology-Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Silvia Bonfiglio
- Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Lydia Scarfo
- Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Mattias Mattsson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Zadie Davis
- Molecular Pathology Department, University Hospitals Dorset, Bournemouth, UK
| | - Ajay Gogia
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Lata Rani
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Panagiotis Baliakas
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Hassan Foroughi-Asl
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Jylhä
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Aron Skaftason
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Inmaculada Rapado
- Hospital Universitario 12 Octubre, Madrid, Spain
- Spanish National Cancer Research (CNIO), Madrid, Spain
| | - Fatima Miras
- Hospital Universitario 12 Octubre, Madrid, Spain
| | - Joaquín Martinez-Lopez
- Hospital Universitario 12 Octubre, Madrid, Spain
- Spanish National Cancer Research (CNIO), Madrid, Spain
| | - Javier de la Serna
- Hospital Universitario 12 Octubre, Madrid, Spain
- Spanish National Cancer Research (CNIO), Madrid, Spain
| | - Jesús María Hernández Rivas
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | | | - María José Larráyoz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - María José Calasanz
- Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Viktória Fésüs
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Zoltán Mátrai
- Central Hospital of Southern Pest-National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Csaba Bödör
- HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Karin E Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Blanca Espinet
- Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Anna Puiggros
- Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Ritu Gupta
- All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Lars Bullinger
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Francesc Bosch
- Department of Hematology, Hospital Universitari Vall d'Hebron (HUVH), Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bárbara Tazón-Vega
- Department of Hematology, Hospital Universitari Vall d'Hebron (HUVH), Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fanny Baran-Marszak
- Service d'hématologie Biologique Hôpital Avicenne Assistance Publique des Hôpitaux de Paris, Bobigny, France
| | - David Oscier
- Molecular Pathology Department, University Hospitals Dorset, Bournemouth, UK
| | - Florence Nguyen-Khac
- Sorbonne Université, Service d'Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Thorsten Zenz
- Department of Oncology and Haematology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Maria Jose Terol
- Department of Hematology, INCLIVA Research Insitute, University of Valencia, Valencia, Spain
| | - Antonio Cuneo
- Hematology-Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - María Hernández-Sánchez
- Cancer Research Center (IBMCC) CSIC-University of Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain
- Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Sarka Pospisilova
- Department of Internal Medicine-Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Ken Mills
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, UK
| | - Gianluca Gaidano
- Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Carsten U Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Elias Campo
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
- Hospital Clínic of Barcelona, Barcelona, Spain
- Universitat de Barcelona, Barcelona, Spain
| | - Jonathan C Strefford
- Cancer Genomics, School for Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paolo Ghia
- Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Kostas Stamatopoulos
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Centre for Research and Technology Hellas, Institute of Applied Biosciences, Thessaloniki, Greece
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
- Clinical Genetics, Karolinska University Hospital, Solna, Sweden.
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3
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Mansouri L, Thorvaldsdottir B, Sutton LA, Karakatsoulis G, Meggendorfer M, Parker H, Nadeu F, Brieghel C, Laidou S, Moia R, Rossi D, Catherwood M, Kotaskova J, Delgado J, Rodríguez-Vicente AE, Benito R, Rigolin GM, Bonfiglio S, Scarfo L, Mattsson M, Davis Z, Gogia A, Rani L, Baliakas P, Foroughi-Asl H, Jylhä C, Skaftason A, Rapado I, Miras F, Martinez-Lopez J, de la Serna J, Rivas JMH, Thornton P, Larráyoz MJ, Calasanz MJ, Fésüs V, Mátrai Z, Bödör C, Smedby KE, Espinet B, Puiggros A, Gupta R, Bullinger L, Bosch F, Tazón-Vega B, Baran-Marszak F, Oscier D, Nguyen-Khac F, Zenz T, Terol MJ, Cuneo A, Hernández-Sánchez M, Pospisilova S, Mills K, Gaidano G, Niemann CU, Campo E, Strefford JC, Ghia P, Stamatopoulos K, Rosenquist R. Correction: Different prognostic impact of recurrent gene mutations in chronic lymphocytic leukemia depending on IGHV gene somatic hypermutation status: a study by ERIC in HARMONY. Leukemia 2023; 37:504. [PMID: 36635392 PMCID: PMC9898025 DOI: 10.1038/s41375-023-01813-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Larry Mansouri
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Birna Thorvaldsdottir
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Lesley-Ann Sutton
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Georgios Karakatsoulis
- grid.423747.10000 0001 2216 5285Centre for Research and Technology Hellas, Institute of Applied Biosciences, Thessaloniki, Greece ,grid.9594.10000 0001 2108 7481Department of Mathematics, University of Ioannina, Ioannina, Greece
| | - Manja Meggendorfer
- grid.420057.40000 0004 7553 8497MLL Munich Leukemia Laboratory, Munich, Germany
| | - Helen Parker
- grid.5491.90000 0004 1936 9297Cancer Genomics, School for Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Ferran Nadeu
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain
| | - Christian Brieghel
- grid.4973.90000 0004 0646 7373Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Stamatia Laidou
- grid.423747.10000 0001 2216 5285Centre for Research and Technology Hellas, Institute of Applied Biosciences, Thessaloniki, Greece
| | - Riccardo Moia
- grid.16563.370000000121663741Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Davide Rossi
- grid.419922.5Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland ,grid.419922.5Laboratory of Experimental Hematology, Institute of Oncology Research, Bellinzona, Switzerland
| | - Mark Catherwood
- grid.4777.30000 0004 0374 7521Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, UK
| | - Jana Kotaskova
- grid.412554.30000 0004 0609 2751Department of Internal Medicine—Hematology and Oncology, University Hospital Brno, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Faculty of Medicine, Masaryk University, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Julio Delgado
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hospital Clínic of Barcelona, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Universitat de Barcelona, Barcelona, Spain
| | - Ana E. Rodríguez-Vicente
- grid.11762.330000 0001 2180 1817Cancer Research Center (IBMCC) CSIC—University of Salamanca, Salamanca, Spain ,grid.452531.4Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain ,grid.411258.bDepartment of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Rocío Benito
- grid.11762.330000 0001 2180 1817Cancer Research Center (IBMCC) CSIC—University of Salamanca, Salamanca, Spain ,grid.452531.4Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain ,grid.411258.bDepartment of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Gian Matteo Rigolin
- grid.8484.00000 0004 1757 2064Hematology—Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Silvia Bonfiglio
- grid.15496.3f0000 0001 0439 0892Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Lydia Scarfo
- grid.15496.3f0000 0001 0439 0892Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Mattias Mattsson
- grid.8993.b0000 0004 1936 9457Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Zadie Davis
- Molecular Pathology Department, University Hospitals Dorset, Bournemouth, UK
| | - Ajay Gogia
- grid.413618.90000 0004 1767 6103All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Lata Rani
- grid.413618.90000 0004 1767 6103All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Panagiotis Baliakas
- grid.8993.b0000 0004 1936 9457Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Hassan Foroughi-Asl
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Jylhä
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Aron Skaftason
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Inmaculada Rapado
- grid.144756.50000 0001 1945 5329Hospital Universitario 12 Octubre, Madrid, Spain ,grid.7719.80000 0000 8700 1153Spanish National Cancer Research (CNIO), Madrid, Spain
| | - Fatima Miras
- grid.144756.50000 0001 1945 5329Hospital Universitario 12 Octubre, Madrid, Spain
| | - Joaquín Martinez-Lopez
- grid.144756.50000 0001 1945 5329Hospital Universitario 12 Octubre, Madrid, Spain ,grid.7719.80000 0000 8700 1153Spanish National Cancer Research (CNIO), Madrid, Spain
| | - Javier de la Serna
- grid.144756.50000 0001 1945 5329Hospital Universitario 12 Octubre, Madrid, Spain ,grid.7719.80000 0000 8700 1153Spanish National Cancer Research (CNIO), Madrid, Spain
| | - Jesús María Hernández Rivas
- grid.11762.330000 0001 2180 1817Cancer Research Center (IBMCC) CSIC—University of Salamanca, Salamanca, Spain ,grid.452531.4Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain ,grid.411258.bDepartment of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Patrick Thornton
- grid.414315.60000 0004 0617 6058Haematology Department, Beaumont Hospital, Dublin, Ireland
| | - María José Larráyoz
- grid.5924.a0000000419370271Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, Pamplona, Spain ,grid.508840.10000 0004 7662 6114IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - María José Calasanz
- grid.5924.a0000000419370271Hematological Diseases Laboratory, CIMA LAB Diagnostics, University of Navarra, Pamplona, Spain ,grid.508840.10000 0004 7662 6114IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Viktória Fésüs
- grid.11804.3c0000 0001 0942 9821HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Zoltán Mátrai
- Central Hospital of Southern Pest—National Institute of Hematology and Infectious Diseases, Budapest, Hungary
| | - Csaba Bödör
- grid.11804.3c0000 0001 0942 9821HCEMM-SE Molecular Oncohematology Research Group, Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Karin E. Smedby
- grid.4714.60000 0004 1937 0626Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Blanca Espinet
- grid.411142.30000 0004 1767 8811Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Anna Puiggros
- grid.411142.30000 0004 1767 8811Molecular Cytogenetics Laboratory, Pathology Department, Hospital del Mar and Translational Research on Hematological Neoplasms Group, Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Ritu Gupta
- grid.413618.90000 0004 1767 6103All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Lars Bullinger
- grid.6363.00000 0001 2218 4662Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Francesc Bosch
- grid.411083.f0000 0001 0675 8654Department of Hematology, Hospital Universitari Vall d’Hebron (HUVH), Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bárbara Tazón-Vega
- grid.411083.f0000 0001 0675 8654Department of Hematology, Hospital Universitari Vall d’Hebron (HUVH), Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fanny Baran-Marszak
- grid.50550.350000 0001 2175 4109Service d’hématologie Biologique Hôpital Avicenne Assistance Publique des Hôpitaux de Paris, Bobigny, France
| | - David Oscier
- Molecular Pathology Department, University Hospitals Dorset, Bournemouth, UK
| | - Florence Nguyen-Khac
- grid.462844.80000 0001 2308 1657Sorbonne Université, Service d’Hématologie Clinique, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Thorsten Zenz
- grid.7400.30000 0004 1937 0650Department of Oncology and Haematology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Maria Jose Terol
- grid.5338.d0000 0001 2173 938XDepartment of Hematology, INCLIVA Research Insitute, University of Valencia, Valencia, Spain
| | - Antonio Cuneo
- grid.8484.00000 0004 1757 2064Hematology—Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - María Hernández-Sánchez
- grid.11762.330000 0001 2180 1817Cancer Research Center (IBMCC) CSIC—University of Salamanca, Salamanca, Spain ,grid.452531.4Instituto de Investigación Biomédica (IBSAL), Salamanca, Spain ,grid.411258.bDepartment of Hematology, University Hospital of Salamanca, Salamanca, Spain
| | - Sarka Pospisilova
- grid.412554.30000 0004 0609 2751Department of Internal Medicine—Hematology and Oncology, University Hospital Brno, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Faculty of Medicine, Masaryk University, Brno, Czech Republic ,grid.10267.320000 0001 2194 0956Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Ken Mills
- grid.4777.30000 0004 0374 7521Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, UK
| | - Gianluca Gaidano
- grid.16563.370000000121663741Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale, Novara, Italy
| | - Carsten U. Niemann
- grid.4973.90000 0004 0646 7373Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Elias Campo
- grid.10403.360000000091771775Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain ,grid.510933.d0000 0004 8339 0058Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain ,grid.410458.c0000 0000 9635 9413Hospital Clínic of Barcelona, Barcelona, Spain ,grid.5841.80000 0004 1937 0247Universitat de Barcelona, Barcelona, Spain
| | - Jonathan C. Strefford
- grid.5491.90000 0004 1936 9297Cancer Genomics, School for Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paolo Ghia
- grid.15496.3f0000 0001 0439 0892Università Vita Salute San Raffaele and IRCCS Ospedale San Raffaele, Milano, Italy
| | - Kostas Stamatopoulos
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.423747.10000 0001 2216 5285Centre for Research and Technology Hellas, Institute of Applied Biosciences, Thessaloniki, Greece
| | - Richard Rosenquist
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Clinical Genetics, Karolinska University Hospital, Solna, Sweden
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4
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Cerisoli F, Ali F, Bereczky T, Bolaños N, Bullinger L, Dhanasiri S, Gallagher J, Pérez SG, Geissler J, Guillevic Y, Harrison K, Naoum A, Portulano C, Rodríguez Vicente AE, Schulze-Rath R, Gómez GY, Sanz G, Hernández Rivas JM. Building a Healthcare Alliance for Resourceful Medicine Offensive Against Neoplasms in Hematology Added Value Framework for Hematologic Malignancies: A Comparative Analysis of Existing Tools. Value Health 2022; 25:1760-1767. [PMID: 35595634 DOI: 10.1016/j.jval.2022.04.1729] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 02/18/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The Innovative Medicines Initiative-funded, multistakeholders project Healthcare Alliance for Resourceful Medicine Offensive Against Neoplasms in Hematology (HARMONY) created a task force involving patient organizations, medical associations, pharmaceutical companies, and health technology assessment/regulator agencies' representatives to evaluate the suitability of previously established value frameworks (VFs) for assessing the clinical and societal impact of new interventions for hematologic malignancies (HMs). METHODS Since the HARMONY stakeholders identified the inclusion of patients' points of view on evaluating VFs as a priority, surveys were conducted with the patient organizations active in HMs and part of the HARMONY network, together with key opinion leaders, pharmaceutical companies, and regulators, to establish which outcomes were important for each HM. Next, to evaluate VFs against the sources of information taken into account (randomized clinical trials, registries, real-world data), structured questionnaires were created and filled by HARMONY health professionals to specify preferred data sources per malignancy. Finally, a framework evaluation module was built to analyze existing clinical VFs (American Society of Clinical Oncology, European Society of Medical Oncology, Magnitude of Clinical Benefit Scale, Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, Institute for Clinical and Economic Review, National Comprehensive Cancer Network Evidence Blocks, and patient-perspective VF). RESULTS The comparative analysis describes challenges and opportunities for the use of each framework in the context of HMs and drafts possible lines of action for creating or integrating a more specific, patient-focused clinical VF for HMs. CONCLUSIONS None of the frameworks meets the HARMONY goals for a tool that applies to HMs and assesses in a transparent, reproducible, and systematic way the therapeutic value of innovative health technologies versus available alternatives, taking a patient-centered approach and using real-world evidence.
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Affiliation(s)
| | - Farzad Ali
- Patient Health Impact, Pfizer, Montreal, Quebec, Canada
| | | | - Natacha Bolaños
- Regional Management Europe, Lymphoma Coalition, Madrid, Spain
| | - Lars Bullinger
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt, Berlin, Germany
| | - Sujith Dhanasiri
- Global Medical Affairs, Celgene International - A Bristol Myers Squibb Company, Boudry, Switzerland
| | | | - Sonia García Pérez
- Department of Medicines for Human Use, Spanish Agency of Medicines and Medical Devices (AEMPS), Madrid, Spain
| | | | - Yann Guillevic
- Global Medical Affairs, Celgene International - A Bristol Myers Squibb Company, Boudry, Switzerland
| | - Kathryn Harrison
- Science Policy and Research Programme, National Institute for Health and Care Excellence (NICE), Manchester, England, UK
| | | | | | | | - Renate Schulze-Rath
- Medical Affairs & Pharmacovigilance, Pharmaceuticals, Bayer AG, Berlin, Germany
| | - Gabriela Yumi Gómez
- Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, Spain
| | - Guillermo Sanz
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain; Hospital Universitari i Politècnic la Fe, Valencia, Spain
| | - Jesús María Hernández Rivas
- Servicio de Hematología, Instituto de Investigación Biomédica de Salamanca (IBSAL), Departamento de Medicina, Hospital Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain.
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5
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D'Agostino M, Cairns DA, Lahuerta JJ, Wester R, Bertsch U, Waage A, Zamagni E, Mateos MV, Dall'Olio D, van de Donk NWCJ, Jackson G, Rocchi S, Salwender H, Bladé Creixenti J, van der Holt B, Castellani G, Bonello F, Capra A, Mai EK, Dürig J, Gay F, Zweegman S, Cavo M, Kaiser MF, Goldschmidt H, Hernández Rivas JM, Larocca A, Cook G, San-Miguel JF, Boccadoro M, Sonneveld P. Second Revision of the International Staging System (R2-ISS) for Overall Survival in Multiple Myeloma: A European Myeloma Network (EMN) Report Within the HARMONY Project. J Clin Oncol 2022; 40:3406-3418. [PMID: 35605179 DOI: 10.1200/jco.21.02614] [Citation(s) in RCA: 103] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE Patients with newly diagnosed multiple myeloma (NDMM) show heterogeneous outcomes, and approximately 60% of them are at intermediate-risk according to the Revised International Staging system (R-ISS), the standard-of-care risk stratification model. Moreover, chromosome 1q gain/amplification (1q+) recently proved to be a poor prognostic factor. In this study, we revised the R-ISS by analyzing the additive value of each single risk feature, including 1q+. PATIENTS AND METHODS The European Myeloma Network, within the HARMONY project, collected individual data from 10,843 patients with NDMM enrolled in 16 clinical trials. An additive scoring system on the basis of top features predicting progression-free survival (PFS) and overall survival (OS) was developed and validated. RESULTS In the training set (N = 7,072), at a median follow-up of 75 months, ISS, del(17p), lactate dehydrogenase, t(4;14), and 1q+ had the highest impact on PFS and OS. These variables were all simultaneously present in 2,226 patients. A value was assigned to each risk feature according to their OS impact (ISS-III 1.5, ISS-II 1, del(17p) 1, high lactate dehydrogenase 1, and 1q+ 0.5 points). Patients were stratified into four risk groups according to the total additive score: low (Second Revision of the International Staging System [R2-ISS]-I, 19.2%, 0 points), low-intermediate (II, 30.8%, 0.5-1 points), intermediate-high (III, 41.2%, 1.5-2.5 points), high (IV, 8.8%, 3-5 points). Median OS was not reached versus 109.2 versus 68.5 versus 37.9 months, and median PFS was 68 versus 45.5 versus 30.2 versus 19.9 months, respectively. The score was validated in an independent validation set (N = 3,771, of whom 1,214 were with complete data to calculate R2-ISS) maintaining its prognostic value. CONCLUSION The R2-ISS is a simple prognostic staging system allowing a better stratification of patients with intermediate-risk NDMM. The additive nature of this score fosters its future implementation with new prognostic variables.
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Affiliation(s)
- Mattia D'Agostino
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - David A Cairns
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Juan José Lahuerta
- Instituto de Investigación del Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ruth Wester
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Uta Bertsch
- University Hospital Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Anders Waage
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Elena Zamagni
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - María-Victoria Mateos
- Complejo Asistencial Universitario de Salamanca/IBSAL/CIC/Ciberonc, Salamanca, Spain
| | - Daniele Dall'Olio
- Dipartimento di Fisica e Astronomia, Università di Bologna, Bologna, Italy
| | - Niels W C J van de Donk
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Graham Jackson
- University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
| | - Serena Rocchi
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Hans Salwender
- Asklepios Tumorzentrum Hamburg, AK Altona and AK St Georg, Hamburg, Germany
| | | | - Bronno van der Holt
- HOVON Data Center, Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | - Gastone Castellani
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Francesca Bonello
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Andrea Capra
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Elias K Mai
- University Hospital Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Jan Dürig
- Department of Hematology, University Clinic Essen, Essen, Germany
| | - Francesca Gay
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Sonja Zweegman
- Department of Hematology, Amsterdam UMC, Cancer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Michele Cavo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy.,Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Martin F Kaiser
- The Institute of Cancer Research, London, United Kingdom and The Royal Marsden Hospital, London, United Kingdom
| | - Hartmut Goldschmidt
- University Hospital Heidelberg, Internal Medicine V and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - Jesús María Hernández Rivas
- Department of Medicine, University of Salamanca, Institute of Biomedical Research of Salamanca (IBSAL), University of Salamanca-Cancer Research Center of Salamanca (IBMCC, USAL-CSIG). Hematology Department, Hospital Universitario de Salamanca (CAUSA/IBSAL), Salamanca, Spain
| | - Alessandra Larocca
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Gordon Cook
- Leeds Cancer Research UK Clinical Trials Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, United Kingdom
| | - Jesús F San-Miguel
- Clínica Universidad de Navarra, CIMA, IDISNA, CIBER-ONC (CB16/12/00369), Pamplona, Spain
| | - Mario Boccadoro
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Pieter Sonneveld
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
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6
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Hernández-Sánchez JM, Bastida JM, Alonso-López D, Benito R, González-Porras JR, De Las Rivas J, Hernández Rivas JM, Rodríguez-Vicente AE. Transcriptomic analysis of patients with immune thrombocytopenia treated with eltrombopag. Platelets 2019; 31:993-1000. [PMID: 31838946 DOI: 10.1080/09537104.2019.1702156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the last years, the use of thrombopoietin receptor agonists (TPO-RA), eltrombopag and romiplostim, has improved the management of immune thrombocytopenia (ITP). Moreover, eltrombopag is also active in patients with aplastic anemia and myelodysplastic syndrome. However, their mechanisms of action and signaling pathways still remain controversial. In order to gain insight into the mechanisms underlying eltrombopag therapy, a gene expression profile (GEP) analysis in patients treated with this drug was carried out. Fourteen patients with chronic ITP were studied by means of microarrays before and during eltrombopag treatment. Median age was 78 years (range, 35-87 years); median baseline platelet count was 14 × 109/L (range, 2-68 × 109/L). Ten patients responded to the therapy, two cases relapsed after an initial response and the remaining two were refractory to the therapy. Eltrombopag induced relevant changes in the hematopoiesis, platelet activation and degranulation, as well as in megakaryocyte differentiation, with overexpression of some transcription factors and the genes PPBP, ITGB3, ITGA2B, F13A1, F13A1, MYL9 and ITGA2B. In addition, GP1BA, PF4, ITGA2B, MYL9, HIST1H4H and HIST1H2BH, genes regulated by RUNX1 were also significantly enriched after eltrombopag therapy. Furthermore, in non-responder patients, an overexpression of Bcl-X gene and genes involved in erythropoiesis, such as SLC4A1 and SLC25A39, was also observed. To conclude, overexpression in genes involved in megakaryopoiesis, platelet adhesion, degranulation and aggregation was observed in patients treated with eltrombopag. Moreover, an important role regarding heme metabolism was also present in non-responder patients.
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Affiliation(s)
- Jesús María Hernández-Sánchez
- Department of Hematology, Hospital Universitario Salamanca , Salamanca, Spain.,IBSAL,IBMCC-Cancer Research Center, University of Salamanca , Salamanca, Spain
| | - José María Bastida
- Department of Hematology, Hospital Universitario Salamanca , Salamanca, Spain.,IBSAL,IBMCC-Cancer Research Center, University of Salamanca , Salamanca, Spain
| | - Diego Alonso-López
- Bioinformatics Unit, Cancer Research Center (CSIC-USAL) , Salamanca, Spain
| | - Rocío Benito
- Department of Hematology, Hospital Universitario Salamanca , Salamanca, Spain.,IBSAL,IBMCC-Cancer Research Center, University of Salamanca , Salamanca, Spain
| | - José Ramón González-Porras
- Department of Hematology, Hospital Universitario Salamanca , Salamanca, Spain.,IBSAL,IBMCC-Cancer Research Center, University of Salamanca , Salamanca, Spain
| | | | - Jesús María Hernández Rivas
- Department of Hematology, Hospital Universitario Salamanca , Salamanca, Spain.,IBSAL,IBMCC-Cancer Research Center, University of Salamanca , Salamanca, Spain
| | - Ana Eugenia Rodríguez-Vicente
- Department of Hematology, Hospital Universitario Salamanca , Salamanca, Spain.,IBSAL,IBMCC-Cancer Research Center, University of Salamanca , Salamanca, Spain
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7
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López-Holgado N, Arroyo JL, Pata C, Villarón E, Sánchez Guijo F, Martín A, Hernández Rivas JM, Orfao A, San Miguel JF, Del Cañizo Fernández-Roldán MC. Analysis of hematopoietic progenitor cells in patients with myelodysplastic syndromes according to their cytogenetic abnormalities. Leuk Res 2004; 28:1181-7. [PMID: 15380343 DOI: 10.1016/j.leukres.2004.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2003] [Accepted: 02/23/2004] [Indexed: 11/18/2022]
Abstract
The present work analyzes the hematopoietic progenitor cells (HPC) in myelodysplastic syndrome (MDS) patients using both an immunophenotypical and a functional approaches in order to know whether they are similar in patients with or without cytogenetic abnormalities. Among CD34+ HPC, the proportion of myeloid committed progenitors was higher in patients with an abnormal karyotype. Ninety MDS patients were studied. Patients with abnormal karyotype showed a similar platting efficiency than patients with normal cytogenetics. Trisomy 8 and 5q- showed a significant higher P.E. than patients with normal karyotype or monosomy 7. We observed that when the most immature HPC were studied, the total number of granulo-monocytic colonies produced by LTBMC was higher in the normal karyotype group. In summary, the present study shows that in MDS the HPC are impaired; this impairment is deeper in patients with abnormal karyotype.
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Affiliation(s)
- Natalia López-Holgado
- Department of Hematology, Hospital Clínico Universitario de Salamanca, Paseo de San Vicente 58-182, 37007, Spain
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