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Mazurek M, Szudy-Szczyrek A, Homa-Mlak I, Hus M, Małecka-Massalska T, Mlak R. IL1B Polymorphism (rs1143634) and IL-1β Plasma Concentration as Predictors of Nutritional Disorders and Prognostic Factors in Multiple Myeloma Patients. Cancers (Basel) 2024; 16:1263. [PMID: 38610941 PMCID: PMC11011170 DOI: 10.3390/cancers16071263] [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: 02/15/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Multiple myeloma (MM) is a hematological neoplasm of the early precursor of B-cells. The most characteristic symptoms observed during MM include hypocalcemia, anemia, bacterial infections, and renal damage. Nutritional disorders, especially malnutrition, are noted in about 35-71% of MM patients. Interleukin 1 beta (IL-1β) is a proinflammatory cytokine responsible for muscle atrophy and lipolysis during malnutrition and cachexia. This study aimed to evaluate the usefulness of the IL1B single-nucleotide polymorphism (SNP) (rs1143634) and plasma concentration of IL-1β in the assessment of the risk of nutritional disorders and prognosis in patients with MM. METHODS In our study, 93 patients with the de novo MM were enrolled. The real-time PCR with specific TaqMan probes method was used in genotyping. The IL-1β ELISA kit was used to determine IL-1β concentration in plasma samples. RESULTS Patients with the CC genotype, compared to the carriers of the other variants of the IL1B, demonstrated significantly higher concentrations of IL-1β in plasma (7.56 vs. 4.97 pg/mL), a significantly higher risk of cachexia (OR = 5.11), and a significantly higher risk of death (HR = 2.03). Moreover, high IL-1β plasma level was related to a significantly higher risk of cachexia (OR = 7.76); however, it was not significantly associated with progression-free survival (PFS) or overall survival (OS). CONCLUSIONS Determination of the IL1B SNP (rs1143634) and plasma concentration of IL-1β may be useful in the assessment of the risk of cachexia and prognosis in patients with MM.
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Affiliation(s)
- Marcin Mazurek
- Department of Human Physiology of Chair of Preclinical Sciences, Medical University of Lublin, 20-080 Lublin, Poland; (I.H.-M.); (T.M.-M.)
| | - Aneta Szudy-Szczyrek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-080 Lublin, Poland; (A.S.-S.); (M.H.)
| | - Iwona Homa-Mlak
- Department of Human Physiology of Chair of Preclinical Sciences, Medical University of Lublin, 20-080 Lublin, Poland; (I.H.-M.); (T.M.-M.)
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-080 Lublin, Poland; (A.S.-S.); (M.H.)
| | - Teresa Małecka-Massalska
- Department of Human Physiology of Chair of Preclinical Sciences, Medical University of Lublin, 20-080 Lublin, Poland; (I.H.-M.); (T.M.-M.)
| | - Radosław Mlak
- Department of Laboratory Diagnostics, Medical University of Lublin, 20-080 Lublin, Poland;
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Paganová V, Hus M, Lichtnerová H, Žiarovská J, Moravčíková D, Kučka M, Ražná K, Abbas A. Physiological and Molecular Responses of Pyrus pyraster Seedlings to Salt Treatment Analyzed by miRNA and Cytochrome P450 Gene-Based Markers. Plants (Basel) 2024; 13:261. [PMID: 38256814 PMCID: PMC10820964 DOI: 10.3390/plants13020261] [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] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024]
Abstract
Physiological and molecular marker-based changes were studied in the tissues of two-year-old Pyrus pyraster (L.) Burgsd. seedlings under salt treatment. For 60 days, 5 mL of 100 mM NaCl solution was applied to each plant per day to a cumulative volume of 300 mL in the substrate. In response to osmotic stress, the seedlings increased their water use efficiency (WUE) on day 20 of regular NaCl application and maintained a stable net photosynthetic rate (An) per unit area. Under conditions of increasing salinity, the young plants maintained a balanced water regime of the leaf tissues (Ψwl). The seedlings invested mass to their root growth (R/S), retained a substantial portion (72%) of Na+ ions in the roots, and protected their leaves against intoxication and damage. A significant decrease in the leaf gas exchange parameters (gs, E, An) was manifested on day 60 of the experiment when the cumulative NaCl intake was 300 mL per plant. The variability in the reactions of the seedlings to salinity is related to the use of open-pollinated progeny (54 genotypes) in the experiment. Lus-miR168 showed tissue- and genotype-specific genome responses to the applied stress. Polymorphic miRNA-based loci were mostly detected in the root samples on the 20th and 35th days of the experiment. The cumulative effect of the salt treatment was reflected in the predominance of polymorphic loci in the leaves. We can confirm that miRNA-based markers represent a sensitive detection tool for plant stress response on an individual level. The screening and selection of the optimal type of miRNA for this type of research is crucial. The cytochrome P450-Based Analog (PBA) techniques were unable to detect polymorphism among the control and treated seedlings, except for the primer pair CYP2BF+R, where, in the roots of the stressed plant, insertions in the amplicons were obtained. The expression ratios of cytochrome P450 in the salt-stressed plants were higher in the roots in the case of 20/100 mL and in the leaves with higher doses. The observed physiological and molecular responses to salinity reflect the potential of P. pyraster seedlings in adaptation to osmotic and ionic stress.
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Affiliation(s)
- Viera Paganová
- Institute of Landscape Architecture, Faculty of Horticulture and Landscape Engineering, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (M.H.); (H.L.)
| | - Marek Hus
- Institute of Landscape Architecture, Faculty of Horticulture and Landscape Engineering, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (M.H.); (H.L.)
| | - Helena Lichtnerová
- Institute of Landscape Architecture, Faculty of Horticulture and Landscape Engineering, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (M.H.); (H.L.)
| | - Jana Žiarovská
- Institute of Plant and Environmental Sciences, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (J.Ž.); (D.M.); (M.K.); (K.R.); (A.A.)
| | - Dagmar Moravčíková
- Institute of Plant and Environmental Sciences, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (J.Ž.); (D.M.); (M.K.); (K.R.); (A.A.)
| | - Matúš Kučka
- Institute of Plant and Environmental Sciences, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (J.Ž.); (D.M.); (M.K.); (K.R.); (A.A.)
| | - Katarína Ražná
- Institute of Plant and Environmental Sciences, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (J.Ž.); (D.M.); (M.K.); (K.R.); (A.A.)
| | - Aqsa Abbas
- Institute of Plant and Environmental Sciences, Faculty of Agrobiology and Food Resources, Slovak University of Agriculture, 949 76 Nitra, Slovakia; (J.Ž.); (D.M.); (M.K.); (K.R.); (A.A.)
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Mielnik M, Szudy-Szczyrek A, Homa-Mlak I, Mlak R, Podgajna-Mielnik M, Gorący A, Małecka-Massalska T, Hus M. The Clinical Relevance of Selected Cytokines in Newly Diagnosed Multiple Myeloma Patients. Biomedicines 2023; 11:3012. [PMID: 38002012 PMCID: PMC10669681 DOI: 10.3390/biomedicines11113012] [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: 09/09/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
Multiple myeloma (MM) is the second most common hematological neoplasm. Cytokines, chemokines, and their receptors, induced by the microenvironment of MM, participate in tumor growth, the attraction of leukocytes, cell homing, and bone destruction. This study aimed to assess the correlation between the pretreatment serum concentrations of interleukin-6 (IL-6), interleukin-8 (IL-8), angiogenic chemokine monocyte chemoattractant protein-1 (MCP-1), and vascular endothelial growth factor (VEGF) and the clinical outcomes and survival of patients newly diagnosed with MM. The study group consisted of 82 individuals. The IL-8 concentration was significantly positively correlated with the age of onset (p = 0.007), the International Staging System (ISS) stage (p = 0.03), the Eastern Cooperative Oncology Group (ECOG) performance status (p < 0.001), the degree of anemia before treatment (p < 0.0001), the degree of kidney disease (p < 0.001), and VEGF (p = 0.0364). Chemotherapy responders had significantly lower concentrations of IL-8 (p < 0.001), IL-6 (p < 0.001), and VEGF (p = 0.04) compared with non-responders. Patients with treatment-induced polyneuropathy had significantly higher levels of IL-8 (p = 0.033). Patients with a high level of IL-6 had a 2-fold higher risk of progression-free survival (PFS) reduction (17 vs. 35 months; HR = 1.89; p = 0.0078), and a more than 2.5-fold higher risk of overall survival (OS) reduction (28 vs. 78 months; HR = 2.62; p < 0.001). High levels of IL-6, IL-8, and VEGF demonstrated significant predictive values for some clinical conditions or outcomes of newly diagnosed MM patients. Patients with an early response to chemotherapy had a significantly lower concentration of these cytokines. A high pretreatment IL-6 concentration was an independent negative prognostic marker for newly diagnosed MM patients.
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Affiliation(s)
- Michał Mielnik
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
| | - Aneta Szudy-Szczyrek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
| | - Iwona Homa-Mlak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (I.H.-M.)
| | - Radosław Mlak
- Department of Laboratory Diagnostics, Medical University of Lublin, Doktora Witolda Chodźki 1 Str., 20-093 Lublin, Poland;
| | - Martyna Podgajna-Mielnik
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
| | - Aneta Gorący
- Department of Hematology and Bone Marrow Transplantation, Saint Jan of Dukla Oncology Centre of the Lublin Region, Doktora Kazimierza Jaczewskiego 7 Str., 20-090 Lublin, Poland
| | | | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
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Karwicka K, Jankowska-Łęcka O, Hus M. Chronic active Epstein-Barr virus infection as the basis of neoplasm development. Transformation of chronic lymphocytic leukaemia to NK-cell lymphoma/leukaemia was observed by flow cytometry - a diagnostic report. Cent Eur J Immunol 2023; 48:257-266. [PMID: 37901865 PMCID: PMC10604644 DOI: 10.5114/ceji.2023.130865] [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: 10/05/2022] [Accepted: 06/01/2023] [Indexed: 10/31/2023] Open
Abstract
The case report presents a patient with chronic lymphocytic leukaemia that was diagnosed in 2006 in Rotterdam, the Netherlands. In September 2010, the patient was admitted to the Department of Haematology in Poland due to progression of the underlying disease. The clinical problem during treatment was the suspicion of Richter's transformation into another, more aggressive non-Hodgkin lymphoma. The diagnosis was based on the peripheral blood immunophenotype. The patient was diagnosed with an immunoglobulin deficiency. Unfortunately, repeated examinations did not confirm the transformation hypothesis, despite the increasing symptoms. The patient was treated with various therapeutic regimens until May 2021, when an increased number of NK cells was diagnosed in the peripheral blood. NK-cell lymphoproliferative disease was finally diagnosed de novo. Nevertheless, it was found that the patient had active Epstein-Barr virus (EBV) and Cytomegalovirus (CMV) infection. The suspected NK-cell lymphoma/leukaemia was most likely a complication of the active EBV infection and severe immunodeficiency state.
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Affiliation(s)
- Katarzyna Karwicka
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Olga Jankowska-Łęcka
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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Verstovsek S, Mesa R, Gupta V, Lavie D, Dubruille V, Cambier N, Platzbecker U, Hus M, Xicoy B, Oh ST, Kiladjian JJ, Vannucchi AM, Gerds A, Egyed M, Mayer J, Sacha T, Kawashima J, Morris M, Huang M, Harrison C. Momelotinib long-term safety and survival in myelofibrosis: integrated analysis of phase 3 randomized controlled trials. Blood Adv 2023; 7:3582-3591. [PMID: 37042865 PMCID: PMC10368854 DOI: 10.1182/bloodadvances.2022009311] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/08/2023] [Accepted: 03/06/2023] [Indexed: 04/13/2023] Open
Abstract
Momelotinib is the first inhibitor of Janus kinase 1 (JAK1) and JAK2 shown to also inhibit activin A receptor type 1 (ACVR1), a key regulator of iron homeostasis, and has demonstrated improvements in splenomegaly, constitutional symptoms, and anemia in myelofibrosis (MF). This long-term analysis pooled data from 3 randomized phase 3 studies of momelotinib (MOMENTUM, SIMPLIFY-1, and SIMPLIFY-2), representing MF disease from early (JAK inhibitor-naive) to late (JAK inhibitor-experienced) stages. Patients in the control arms (danazol in MOMENTUM, ruxolitinib in SIMPLIFY-1, and best available therapy in SIMPLIFY-2) could cross over to receive momelotinib at the end of the 24-week randomized period, and all patients could continue momelotinib treatment after the completion of these studies via an extended access protocol (XAP). Across these studies, 725 patients with MF received momelotinib; 12% remained on therapy for ≥5 years, with a median treatment exposure of 11.3 months (range, 0.1-90.4 months). The most common nonhematologic treatment-emergent adverse event (AE) occurring in ≥20% of patients was diarrhea (any grade, 27% and grade ≥3, 3%). Any-grade thrombocytopenia, anemia, and neutropenia occurred in 25%, 23%, and 7% of patients, respectively. The most common reason for momelotinib discontinuation was thrombocytopenia (4% discontinuation rate). The incidence of AEs of clinical importance (eg, infections, malignant transformation, peripheral neuropathy, and hemorrhage) did not increase over time. This analysis of one of the largest randomized trial databases for a JAK inhibitor to date in MF demonstrated a consistent safety profile of momelotinib without long-term or cumulative toxicity. These trials were registered at www.clinicaltrials.gov as: MOMENTUM (#NCT04173494), SIMPLIFY-1 (#NCT01969838), SIMPLIFY-2 (#NCT02101268), and XAP (#NCT03441113).
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Affiliation(s)
| | - Ruben Mesa
- UT Health San Antonio Cancer Center, San Antonio, TX
| | - Vikas Gupta
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - David Lavie
- Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Viviane Dubruille
- Centre Hospitalier Universitaire de Nantes (CHU de Nantes), Nantes, France
| | - Nathalie Cambier
- Service d’hématologie, Centre hospitalier régional universitaire de Lille (CHRU Lille), Lille, France
| | - Uwe Platzbecker
- Clinic of Hematology, Cellular Therapy, and Hemostaseology, University of Leipzig, Leipzig, Germany
| | - Marek Hus
- Uniwersytet Medyczny w Lublinie, Lublin, Poland
| | - Blanca Xicoy
- Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Josep Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Stephen T. Oh
- Division of Hematology, Department of Medicine, Washington University School of Medicine, St. Louis, MO
| | - Jean-Jacques Kiladjian
- Université de Paris, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM, Paris, France
| | - Alessandro M. Vannucchi
- Center of Research and Innovation of Myeloproliferative Neoplasms (CRIMM), Department of Experimental and Clinical Medicine, University of Florence, Careggi University Hospital, Florence, Italy
| | | | | | - Jiří Mayer
- Department of Internal Medicine, Haematology and Oncology, University Hospital Brno, Brno, Czech Republic
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomasz Sacha
- Uniwersytet Jagielloński Collegium Medicum, Krakow, Poland
| | | | | | | | - Claire Harrison
- Guy's and St Thomas' National Health Services (NHS) Foundation Trust, London, United Kingdom
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Szudy-Szczyrek A, Juda A, Kokoć A, Krupski W, Szumiło J, Hus M. Efficacy of avapritinib in refractory aggressive systemic mastocytosis: a single-patient case. Pol Arch Intern Med 2023; 133:16471. [PMID: 36994901 DOI: 10.20452/pamw.16471] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Affiliation(s)
- Aneta Szudy-Szczyrek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.
| | - Adrian Juda
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Anna Kokoć
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Witold Krupski
- Second Department of Medical Radiology, Medical University of Lublin, Lublin, Poland
| | - Justyna Szumiło
- Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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Szudy-Szczyrek A, Mlak R, Mazurek M, Krajka T, Chocholska S, Bitkowska P, Jutrzenka M, Szczyrek M, Homa-Mlak I, Krajka A, Małecka-Massalska T, Hus M. The TT Genotype of the KIAA1524 rs2278911 Polymorphism Is Associated with Poor Prognosis in Multiple Myeloma. Cells 2023; 12:cells12071029. [PMID: 37048102 PMCID: PMC10093279 DOI: 10.3390/cells12071029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Background: The KIAA1524 gene encodes an oncoprotein, CIP2A, which inhibits the phosphorylation of the Akt kinase B, stabilizes the c-Myc protein, and, through that, promotes cancerogenesis. An increase in CIP2A expression has been observed in numerous solid tumors and hematologic malignancies, including multiple myeloma (MM). The aim of our study was to evaluate the clinical impact of the functional single nucleotide polymorphisms (SNP) of the KIAA1524 gene (rs2278911, 686C > T) in MM patients. Methods: The study group consisted of 128 patients with de novo MM. EDTA venous blood samples were collected prior to the treatment. The SNPs were analyzed by Real-Time PCR with the use of specific Taqman probes. Results: Multivariable analysis revealed that variables independently associated with shorter progression-free survival (PFS) included thrombocytopenia, delTP53 and IGH/CCND1 translocation and the TT genotype of the KIAA1524 gene (686C > T) (median PFS: 6 vs. 25 months; HR = 7.18). On the other hand, autologous haematopoietic stem cell transplantation (AHSCT) was related to a lower risk of early disease progression. Moreover, light chain disease, International Staging System (ISS) 3, poor performance status, hypoalbuminemia, IGH/FGFR3 translocation and the TT genotype of the KIAA1524 gene (686C > T) were independent prognostic factors associated with shorter overall survival (OS) (median OS: 8 vs. 45 months; HR = 7.08). Conclusion: The evaluation of the SNP 686C > T of the KIAA1524 gene could be used as a diagnostic tool in MM patients at risk of early disease progression and death.
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Góra-Tybor J, Gołos A, Mikulski D, Helbig G, Sacha T, Lewandowski K, Niesiobędzka-Krężel J, Bieniaszewska M, Wysogląd H, Grzybowska-Izydorczyk O, Seferyńska I, Sobas M, Czyżewska M, Michalska A, Sawicki W, Mazur M, Hus M, Bodzenta E, Olszewska-Szopa M, Włodarczyk M, Patkowska E, Świstek W, Jamroziak K. Analysis of Predictive Factors for Early Response to Ruxolitinib in 320 Patients with Myelofibrosis From the Polish Adult Leukemia Group (PALG) Registry. Clin Lymphoma Myeloma Leuk 2023; 23:e19-e26. [PMID: 36396583 DOI: 10.1016/j.clml.2022.10.002] [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] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/11/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Ruxolitinib is widely used in myelofibrosis (MF). However, some patients do not optimally respond and require more efficacious treatment. Our analysis aimed to establish predictors of ruxolitinib response. PATIENTS AND METHODS We designed a multicenter, retrospective analysis of the efficacy of ruxolitinib treatment in patients with MF in 15 Polish hematology centers. As responses to ruxolitinib occur within the first 6 months, we used this point to evaluate the efficacy of treatment. Symptoms response was defined as ≥50% reduction of the MF constitutional symptoms assessed by Myeloproliferative Neoplasm Symptom Assessment Form Total Symptom Score (MPN-SAF TSS). Spleen response was defined as ≥50% reduction of the difference between the spleen's baseline length and the upper limit norm measured by ultrasonography. RESULTS 320 MF patients were enrolled. At 6 months of therapy, the spleen response was detected in 140 (50%) patients, and symptoms response in 241 patients (76%). Multivariable analysis identified leukocytosis <25 G/L (OR 2.06, 95%CI: 1.12-3.88, P = .0200), and reticulin fibrosis MF 1 (OR 2.22, 95%CI: 1.11-4.46, P = .0249) contributed to better spleen response. The time interval between MF diagnosis and ruxolitinib administration shorter than 3 months, and platelets ≥150 G/L (OR 1.69, 95% CI 1.01-2.83, P = .0466) influenced symptoms response. CONCLUSION Establishing predictive factors for ruxolitinib response is particularly important given the potential for new therapies in MF. In patients with a low likelihood of responding to ruxolitinib, using other JAK inhibitors or adding a drug with a different mechanism of action to ruxolitinib may be of clinical benefit.
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Affiliation(s)
- Joanna Góra-Tybor
- Department of Hematology, Medical University of Lodz, Copernicus Memorial Hospital, Lodz, Poland.
| | - Aleksandra Gołos
- Hematooncology Department, Copernicus Memorial Hospital, Lodz, Lodz, Poland
| | - Damian Mikulski
- Hematooncology Department, Copernicus Memorial Hospital, Lodz, Lodz, Poland; Department of Biostatistics and Translational Medicine, Medical University of Lodz, Lodz Poland
| | - Grzegorz Helbig
- School of Medicine in Katowice, Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - Tomasz Sacha
- Department of Hematology, Jagiellonian University Hospital, Krakow, Ploland
| | - Krzysztof Lewandowski
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Joanna Niesiobędzka-Krężel
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Maria Bieniaszewska
- Department of Hematology and Transplantology, Medical University of Gdansk, Gdansk, Poland
| | - Hubert Wysogląd
- Department of Hematology, Jagiellonian University Hospital, Krakow, Ploland
| | | | - Ilona Seferyńska
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Marta Sobas
- Department of Hematology, Wroclaw Medical University, Wroclaw, Wroclaw, Poland
| | - Maria Czyżewska
- Department of Hematology, Nicolaus Copernicus Specialist Municipal Hospital, Torun, Poland
| | | | - Waldemar Sawicki
- Department of Internal Diseases and Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Malwina Mazur
- Department of Hematology, Teaching Hospital No 1, Rzeszow, Poland
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Ewa Bodzenta
- Department of Hematology and Cancer Prevention, Chorzow, Poland
| | | | - Martyna Włodarczyk
- School of Medicine in Katowice, Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - Elżbieta Patkowska
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Wojciech Świstek
- Hematology Department, Jan Biziel University Hospital No. 2, Bydgoszcz, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
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Surdacki G, Sokołowska B, Gorący A, Chyl-Surdacka K, Hus M. Expression of immune checkpoints on peripheral blood cells in patients with prostate cancer. Oncol Clin Pract 2022. [DOI: 10.5603/ocp.2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Szudy-Szczyrek A, Ahern S, Krawczyk J, Szczyrek M, Hus M. MiRNA as a Potential Target for Multiple Myeloma Therapy–Current Knowledge and Perspectives. J Pers Med 2022; 12:jpm12091428. [PMID: 36143213 PMCID: PMC9503263 DOI: 10.3390/jpm12091428] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/16/2022] Open
Abstract
Multiple myeloma (MM) is the second most common hematological malignancy. Despite the huge therapeutic progress thanks to the introduction of novel therapies, MM remains an incurable disease. Extensive research is currently ongoing to find new options. MicroRNAs (miRNAs) are small, non-coding RNA molecules that regulate gene expression at a post-transcriptional level. Aberrant expression of miRNAs in MM is common. Depending on their role in MM development, miRNAs have been reported as oncogenes and tumor suppressors. It was demonstrated that specific miRNA alterations using miRNA mimics or antagomirs can normalize the gene regulatory network and signaling pathways in the microenvironment and MM cells. These properties make miRNAs attractive targets in anti-myeloma therapy. However, only a few miRNA-based drugs have been entered into clinical trials. In this review, we discuss the role of the miRNAs in the pathogenesis of MM, their current status in preclinical/clinical trials, and the mechanisms by which miRNAs can theoretically achieve therapeutic benefit in MM treatment.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
- Correspondence: (A.S.-S.); (M.H.)
| | - Sean Ahern
- Department of Haematology, University Hospital Galway, H91 Galway, Ireland
- National University of Ireland, H91 Galway, Ireland
| | - Janusz Krawczyk
- Department of Haematology, University Hospital Galway, H91 Galway, Ireland
- National University of Ireland, H91 Galway, Ireland
| | - Michał Szczyrek
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-950 Lublin, Poland
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
- Correspondence: (A.S.-S.); (M.H.)
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Mesa R, Harrison C, Oh ST, Gerds AT, Gupta V, Catalano J, Cervantes F, Devos T, Hus M, Kiladjian JJ, Lech-Maranda E, McLornan D, Vannucchi AM, Platzbecker U, Huang M, Strouse B, Klencke B, Verstovsek S. Overall survival in the SIMPLIFY-1 and SIMPLIFY-2 phase 3 trials of momelotinib in patients with myelofibrosis. Leukemia 2022; 36:2261-2268. [PMID: 35869266 PMCID: PMC9417985 DOI: 10.1038/s41375-022-01637-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/17/2022] [Accepted: 06/23/2022] [Indexed: 11/09/2022]
Abstract
Janus kinase inhibitors (JAKi) approved for myelofibrosis provide spleen and symptom improvements but do not address anemia, a negative prognostic factor. Momelotinib, an inhibitor of ACVR1/ALK2, JAK1 and JAK2, demonstrated activity against anemia, symptoms, and splenomegaly in the phase 3 SIMPLIFY trials. Here, we report mature overall survival (OS) and leukemia-free survival (LFS) from both studies, and retrospective analyses of baseline characteristics and efficacy endpoints for OS associations. Survival distributions were similar between JAKi-naïve patients randomized to momelotinib, or ruxolitinib then momelotinib, in SIMPLIFY-1 (OS HR = 1.02 [0.73, 1.43]; LFS HR = 1.08 [0.78, 1.50]). Two-year OS and LFS were 81.6% and 80.7% with momelotinib and 80.6% and 79.3% with ruxolitinib then momelotinib. In ruxolitinib-exposed patients in SIMPLIFY-2, two-year OS and LFS were 65.8% and 64.2% with momelotinib and 61.2% and 59.7% with best available therapy then momelotinib (OS HR = 0.98 [0.59, 1.62]; LFS HR = 0.97 [0.59, 1.60]). Baseline transfusion independence (TI) was associated with improved survival in both studies (SIMPLIFY-1 HR = 0.474, p = 0.0001; SIMPLIFY-2 HR = 0.226, p = 0.0005). Week 24 TI response in JAKi-naïve, momelotinib-randomized patients was associated with improved OS in univariate (HR = 0.323; p < 0.0001) and multivariate (HR = 0.311; p < 0.0001) analyses. These findings underscore the importance of achieving or maintaining TI in myelofibrosis, supporting the clinical relevance of momelotinib’s pro-erythropoietic mechanism of action, and potentially informing treatment decision-making.
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Mesa R, Oh ST, Gerds AT, Gupta V, Catalano J, Cervantes F, Devos T, Hus M, Kiladjian JJ, Lech-Maranda E, McLornan D, Palmer J, Platzbecker U, Treliński J, Shimoda K, Donahue R, D'Hollander K, Kowalski M, Verstovsek S. Momelotinib reduces transfusion requirements in patients with myelofibrosis. Leuk Lymphoma 2022; 63:1718-1722. [PMID: 35255234 DOI: 10.1080/10428194.2022.2043304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Ruben Mesa
- Mays Cancer Center, UT Health San Antonio Cancer Center, San Antonio, TX, USA
| | - Stephen T Oh
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Aaron T Gerds
- Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Vikas Gupta
- Department of Medicine, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - John Catalano
- Haematology Department, Monash University & Frankston Hospital, Frankston, Australia
| | - Francisco Cervantes
- Hematology Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Timothy Devos
- Department of Hematology, University Hospitals Leuven and Department of Microbiology and Immunology, Laboratory of Molecular Immunology (Rega Institute), KU Leuven, Leuven, Belgium
| | - Marek Hus
- Hematooncology Department, Medical University of Lublin, Lublin, Poland
| | - Jean-Jacques Kiladjian
- Université de Paris, AP-HP, Hôpital Saint-Louis, Centre d'Investigations Cliniques, INSERM, Paris, France
| | - Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Donal McLornan
- Department of Haematology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jeanne Palmer
- Division of Hematology and Medical Oncology, Mayo Clinic Hospital, Phoenix, AZ, USA
| | - Uwe Platzbecker
- Department of Hematology, Cellular Therapy and Hemostaseology, Leipzig University Hospital, Leipzig, Germany
| | - Jacek Treliński
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Kazuya Shimoda
- Department of Internal Medicine, University of Miyazaki, Miyazaki, Japan
| | - Rafe Donahue
- Biometrics, Sierra Oncology Inc, San Mateo, CA, USA
| | - Koenraad D'Hollander
- Biostatistics, International Drug Development Institute, Louvain-la-Neuve, Belgium
| | - Mark Kowalski
- Research and Early Development, Sierra Oncology Inc, San Mateo, CA, USA
| | - Srdan Verstovsek
- Leukemia Department, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Lonial S, Grosicki S, Hus M, Song KW, Facon T, Callander NS, Ribrag V, Uttervall K, Quach H, Vorobyev VI, Min CK, Cheng S, Smith LM, Yu J, Collingwood T, Holkova B, Kremer B, Gupta I, Richardson PG, Minnema MC. Synergistic effects of low-dose belantamab mafodotin in combination with a gamma-secretase inhibitor (nirogacestat) in patients with relapsed/refractory multiple myeloma (RRMM): DREAMM-5 study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.8019] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8019 Background: Preclinical data demonstrate that nirogacestat, a gamma-secretase inhibitor, may increase cell-surface levels of a B-cell maturation antigen (BCMA) and reduce soluble BCMA levels, which could enhance anti-BCMA agent activity in multiple myeloma. In the DREAMM-5 (NCT04126200) Phase I/II platform trial belantamab mafodotin (belamaf; BLENREP), a BCMA-targeting antibody-drug conjugate, is being evaluated in combination with nirogacestat to determine if the combination can result in similar efficacy and an improved ocular safety profile compared to the currently approved belamaf schedule (single agent dose 2.5 mg/kg Q3W) in patients with RRMM which showed a 31% overall response rate (ORR) and 44.5% Gr3/4 keratopathy (BLENREP US prescribing information). Methods: This cohort within the DREAMM-5 nirogacestat combination sub-study has a sequential dose-exploration (DE) phase evaluating 0.95 mg/kg Q3W belamaf with 100 mg BID nirogacestat continuously, followed by a randomized cohort expansion (CE) comparing the combination to a belamaf 2.5 mg/kg Q3W arm. Results: Preliminary results from the 10 patients (pts) in the DE cohort with low-dose belamaf + nirogacestat are presented in this abstract. Pts had a median (range) of 4.5 (3–10) prior lines of therapy. At time of data cut-off (Nov 15, 2021), pts received a median (range) of 7 cycles (1–26). The ORR was 60% (n=6/10) and 20% (n=2) achieved a very good partial response (Table). The key emergent adverse events (AEs) included ocular events (n=7 [70%]; ≥Grade [Gr] 3, n=2 [20%] of which Gr 3 keratopathy was reported in 1 pt [10%]), diarrhea (n=7 [70%]; Gr 3, n=1 [10%]) and hypophosphatemia (n=7 [70%]; Gr 3, n=1, [10%]). There were 2 Grade 5 AEs, neither of which were related to study treatment. No pt permanently discontinued study due to treatment related AEs. Conclusions: Encouraging clinical activity and a manageable safety profile is observed with low dose belamaf (0.95 mg/kg Q3W) + nirogacestat (100 mg BID continuously) in pts with RRMM. This ongoing sub-study is actively recruiting patients and will continue to evaluate belamaf + nirogacestat efficacy and safety. Updated results will be reported at the congress. Funding: GSK (208887); drug linker technology licensed from Seagen Inc.; mAb produced using POTELLIGENT Technology licensed from BioWa. Clinical trial information: NCT04126200. [Table: see text]
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Affiliation(s)
- Sagar Lonial
- Emory University, Winship Cancer Institute, Atlanta, GA
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention, School of Public Health, Silesian Medical University, Katowice, Poland
| | - Marek Hus
- Katedra i Klinika Hematoonkologii i Transplantacji Szpiku, Lublin, Poland
| | | | - Thierry Facon
- Department of Haematology, Lille University Hospital, Lille, France
| | | | | | | | - Hang Quach
- University of Melbourne, St. Vincent's Hospital Melbourne, Melbourne, Australia
| | | | - Chang Ki Min
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | | | | | - Jing Yu
- GlaxoSmithKline, Upper Providence, PA
| | | | | | | | - Ira Gupta
- GlaxoSmithKline, Upper Providence, PA
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Szudy-Szczyrek A, Chocholska S, Bachanek-Mitura O, Czabak O, Mlak R, Szczyrek M, Muzyka-Kasietczuk J, Hus M. Efficacy of ixazomib-lenalidomide-dexamethasone in high-molecular-risk relapsed/refractory multiple myeloma - case series and literature review. Ann Agric Environ Med 2022; 29:103-109. [PMID: 35352912 DOI: 10.26444/aaem/137788] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND OBJECTIVE Multiple myeloma (MM) is an incurable condition with variable clinical course. The study included a group of patients with especially poor-prognosis, individuals with relapsed/refractory multiple myeloma (RRMM) and specific cytogenetic disorders. Among the currently used therapies the ixazomib-lenalidomid-dexamethasone (IRd) is considered as a candidate to improve outcomes. The aim of the study was to evaluate the safety and efficacy of IRd regimen in the treatment of patients with RMMM. MATERIAL AND METHODS Nine patients aged 52-82 years who received ixazomib in the early access programme, were included in the study. All patients met the criteria for recurrent/relapsed MM and had high (t(4:14), t(14:16), del17p or +1q21) risk aberrations. Previous chemotherapy regimens included thalidomide and bortezomib. Median duration of exposure to ixazomib was 12 months. RESULTS One patient with multiple cytogenetic aberrations and extramedullary plasmocytoma died because of progression after two months of treatment. In the remaining patients, the objective response to treatment was reached, and in four cases it was qualified as a very good partial response (VGPR). Observed adverse effects included neutropenia, infections, and oedema (in three cases Grade 3). Eight patients continue treatment, in two cases the decision was made to reduce lenalidomide doses. CONCLUSIONS Preliminary results suggest potentially high efficacy and good safety profile of IRd therapy in patients with RRMM and unfavourable cytogenetics.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Sylwia Chocholska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Oliwia Bachanek-Mitura
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Olga Czabak
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, Poland
| | - Michał Szczyrek
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Poland
| | | | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
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Karczmarczyk A, Korpysz M, Bilska S, Purkot J, Hus M, Giannopoulos K. Programmed Cell Death-1 and Its Ligands as Targets for Therapy of Multiple Myeloma Patients. Cancer Manag Res 2022; 14:1267-1281. [PMID: 35370422 PMCID: PMC8974248 DOI: 10.2147/cmar.s351383] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/01/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Among hematological malignancies, the expression profile of programmed cell death-1 (PD-1) and its ligands in multiple myeloma (MM) is still debated by numerous research groups. In current study, we characterized the expression of PD-1 and its ligands both on RNA and protein levels in MM patients. We have also attempted to analyze whether daratumumab therapy might overcome CD38-mediated immunosuppression that inhibits in particular CD8+ T-cell function. Patients and Methods This study included 149 newly diagnosed MM patients and 15 relapsed/refractory MM patients before and after daratumumab treatment. The mRNA levels of PDCD1, PDCD1LG1, PDCD1LG2 and their splicing variants was assessed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR). Flow cytometry was used to characterize the surface expression of PD-1 and its ligands on plasma cells, B and T cells. The surface expression of PD-1 on T cells was assessed by flow cytometry before and after daratumumab treatment. Results The mRNA expression of PDCD1LG1, PDCD1LG2 and their splicing variants were higher in plasma cells as compared to bone marrow mononuclear cells (BMMCs). Our results show that the percentage of plasma cells expressing PD-L1 was significantly higher than plasma cells expressing PD-L2 (p<0.0001) in bone marrow (BM) of MM patients. There was no significant difference between the percentage of plasma cells expressing PD-1 and B cells expressing PD-1 in BM of MM patients (11.19% vs 8.91%). We also found that the percentage of CD8+PD-1+ T cells was significantly higher than CD4+PD-1+T cells in BM (p<0.0001) of MM patients. Here, we observed no change in PD-1 expression on CD4+ and CD8+ T cells after the daratumumab treatment. Conclusion The PD-1 and its ligands might represent an interesting target for MM immunotherapy, as one would target both malignant plasma cells as well as the immune cells that play a key role in tumor escape mechanisms.
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Affiliation(s)
| | - Maciej Korpysz
- Department of Biochemical Diagnostics, Medical University of Lublin, Lublin, Poland
| | - Sylwia Bilska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Joanna Purkot
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Giannopoulos
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
- Department of Hematology, St. John’s Cancer Centre, Lublin, Poland
- Correspondence: Krzysztof Giannopoulos, Department of Experimental Hematooncology, Medical University of Lublin, Chodzki 1, Lublin, 20-093, Poland, Tel + 48 81448 6632, Fax + 48 81448 6634, Email
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Szudy-Szczyrek A, Mlak R, Mielnik M, Mazurek M, Chocholska S, Podgajna M, Szczyrek M, Homa-Mlak I, Małecka-Massalska T, Hus M. Circulating Serum MiRNA-8074 as a Novel Prognostic Biomarker for Multiple Myeloma. Cells 2022; 11:cells11040752. [PMID: 35203396 PMCID: PMC8870602 DOI: 10.3390/cells11040752] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 02/06/2023] Open
Abstract
MiRNA-8074 is a molecule with the potential to regulate the expression of key genes related to the pathogenesis of multiple myeloma (MM), i.e., TP53, MYC, MAPK1, and KIAA. We analyzed the predictive and prognostic value of miRNA-8074 expression in MM patients. In total, 105 newly diagnosed MM patients treated with thalidomide (n = 27), bortezomib (n = 41) and bortezomib with thalidomide (n = 37) were studied. For miRNA analysis, the column method and the Real-Time PCR technique with specific TaqMan Fast Advanced Master Mix and TaqMan probes were used. Factors that were associated with a significant reduction in progression-free survival (PFS) included: ECOG > 1, ISS stage III, low hemoglobin, thrombocytopenia, hypoalbuminemia, abnormal renal function, elevated creatinine, GFR < 60 mL/min/1.73 m2, elevated LDH, del(17p), t(11;14), the use of a single drug regimen (thalidomide or bortezomib) and high miRNA-8074 expression (HR = 2.01, 95% CI: 1.16–3.49; p = 0.0233). In addition to the known prognostic factors, such as ECOG > 1, Durie–Salmon stage III, diagnosis of light chain disease or non-secreting MM, renal failure, hypoalbuminemia, hypercalcemia, high β2-microglobulin, elevated LDH, and t(14;16), a high expression of miRNA-8074 was significantly associated with a higher risk of death (HR = 4.12, 95% CI: 2.20–7.70; p = 0.0009). In summary, miRNA-8074 may be a useful diagnostic tool to assess the prognosis in MM patients.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (S.C.); (M.P.)
- Correspondence: (A.S.-S.); (M.H.)
| | - Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (M.M.); (I.H.-M.); (T.M.-M.)
| | - Michał Mielnik
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (S.C.); (M.P.)
| | - Marcin Mazurek
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (M.M.); (I.H.-M.); (T.M.-M.)
| | - Sylwia Chocholska
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (S.C.); (M.P.)
| | - Martyna Podgajna
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (S.C.); (M.P.)
| | - Michał Szczyrek
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-950 Lublin, Poland;
| | - Iwona Homa-Mlak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (M.M.); (I.H.-M.); (T.M.-M.)
| | - Teresa Małecka-Massalska
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland; (R.M.); (M.M.); (I.H.-M.); (T.M.-M.)
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (S.C.); (M.P.)
- Correspondence: (A.S.-S.); (M.H.)
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Korona-Głowniak I, Mielnik M, Podgajna M, Grywalska E, Hus M, Matuska K, Wojtysiak-Duma B, Duma D, Glowniak A, Malm A. SARS-CoV-2 Seroprevalence in Healthcare Workers before the Vaccination in Poland: Evolution from the First to the Second Pandemic Outbreak. Int J Environ Res Public Health 2022; 19:ijerph19042319. [PMID: 35206504 PMCID: PMC8871845 DOI: 10.3390/ijerph19042319] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/30/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023]
Abstract
Healthcare workers (HCWs) are on the frontline, struggling with the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To describe recent or past infections, the serological assays enabled the assessment of the immune response developed in coronavirus disease (COVID-19) in the period when testing was hardly available. In this study, we investigated SARS-CoV-2 seroprevalence in HCWs in a Polish teaching hospital and the Regional Occupational Medicine Center after both the first and the second waves. ELISA-based tests for anti-SARS-CoV-2 IgA and IgG were used to determine immune response to SARS-CoV-2 in volunteer HCWs who worked in those institutions in May 2020 (208 participants aged 47.1 ± 12.5, 88% women) and in December 2020 (179 participants aged 45.2 ± 12.4, 86% woman). Risk factors for seropositivity were also assessed using a questionnaire filled out by all participants. We reported a significant increase in seroprevalence after the second wave (22.9%) compared with the first outbreak (2.4%) (OR 12.1; 95%CI 4.6–31.3; p < 0.0001). An association between IgG seroprevalence and severity of infections was noted. Furthermore, we demonstrated that amongst medical personnel, nurses exhibited a proportionally higher SARS-CoV-2 seroprevalence. Moreover, given the high seroprevalence in non-clinical group of HCWs, we suggest that community transmission can play a superior role to workplace exposure.
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Affiliation(s)
- Izabela Korona-Głowniak
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland; (K.M.); (A.M.)
- Correspondence:
| | - Michał Mielnik
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (M.H.)
| | - Martyna Podgajna
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (M.P.); (E.G.)
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (M.P.); (E.G.)
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (M.H.)
| | - Katarzyna Matuska
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland; (K.M.); (A.M.)
| | - Beata Wojtysiak-Duma
- Department of Laboratory Diagnostics, Medical University, 20-093 Lublin, Poland; (B.W.-D.); (D.D.)
| | - Dariusz Duma
- Department of Laboratory Diagnostics, Medical University, 20-093 Lublin, Poland; (B.W.-D.); (D.D.)
| | - Andrzej Glowniak
- Department of Cardiology, Medical University of Lublin, 20-093 Lublin, Poland;
- Clinical Department of Electrocardiology, SPSK-4 University Hospital, 20-090 Lublin, Poland
| | - Anna Malm
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland; (K.M.); (A.M.)
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Sokołowska B, Majowicz D, Kozioł M, Czabak O, Wąsik-Szczepanek E, Juda A, Soroka-Wojtaszko M, Hus M. RAEB II type of myelodysplastic syndrome associated with axillary abscesses - Case Report. Ann Agric Environ Med 2021; 28:733-736. [PMID: 34969238 DOI: 10.26444/aaem/140006] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Myelodysplastic syndromes (MDS) are clonal haematopoetic stem cells disorders, characterized by bone marrow dysplasia, ineffecitive haematopoesis and cytopenias. Due to neutropenia, infections are common. A case is presented of a patient with high-risk myelodysplastic syndrome (MDS) complicated by hidradenitis suppurativa that developed in both axillae. Abscesses required multiple incisions and drainage. After five cycles of treatment with azacitidine, the patient underwent allogenic bone marrow transplantation. Unfortunately, six months after the procedure, the patient lost post-transplant chimerism.Treatment with azacitidine was re-started. After the subsequent ten months, blast transformation was observed. Skin lesions in the course of hidradenitis suppurative persisted and were still considerably active.
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Affiliation(s)
- Bożena Sokołowska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Daria Majowicz
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Magdalena Kozioł
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Olga Czabak
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Adrian Juda
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Maria Soroka-Wojtaszko
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
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19
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Szudy-Szczyrek A, Ahern S, Kozioł M, Majowicz D, Szczyrek M, Krawczyk J, Hus M. Therapeutic Potential of Innate Lymphoid Cells for Multiple Myeloma Therapy. Cancers (Basel) 2021; 13:4806. [PMID: 34638291 PMCID: PMC8507621 DOI: 10.3390/cancers13194806] [Citation(s) in RCA: 3] [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: 08/31/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 01/08/2023] Open
Abstract
Innate lymphoid cells (ILCs) are a recently identified family of lymphocyte-like cells lacking a specific antigen receptor. They are part of the innate immune system. They play a key role in tissue homeostasis and also control inflammatory and neoplastic processes. In response to environmental stimuli, ILCs change their phenotype and functions, and influence the activity of other cells in the microenvironment. ILC dysfunction can lead to a wide variety of diseases, including cancer. ILC can be divided into three subgroups: ILC Group 1, comprising NK cells and ILC1; Group 2, including ILC2 alone; and Group 3, containing Lymphoid Tissue inducers (LTi) and ILC3 cells. While Group 1 ILCs mainly exert antitumour activity, Group 2 and Group 3 ILCs are protumorigenic in nature. A growing body of preclinical and clinical data support the role of ILCs in the pathogenesis of multiple myeloma (MM). Therefore, targeting ILCs may be of clinical benefit. In this manuscript, we review the available data on the role of ILCs in MM immunology and therapy.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.K.); (D.M.)
| | - Sean Ahern
- Department of Haematology, University Hospital Galway, H91 TK33 Galway, Ireland; (S.A.); (J.K.)
- National University of Ireland, H91 TK33 Galway, Ireland
| | - Magdalena Kozioł
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.K.); (D.M.)
| | - Daria Majowicz
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.K.); (D.M.)
| | - Michał Szczyrek
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-954 Lublin, Poland;
| | - Janusz Krawczyk
- Department of Haematology, University Hospital Galway, H91 TK33 Galway, Ireland; (S.A.); (J.K.)
- National University of Ireland, H91 TK33 Galway, Ireland
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.K.); (D.M.)
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20
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Sokołowska B, Kozińska J, Szczepanek D, Wąsik-Szczepanek E, Kozioł M, Majowicz D, Juda A, Hus M. An epileptic seizure and haemorrhage into the ventricular system of the brain as the first manifestations of acquired haemophilia A - Case report. Ann Agric Environ Med 2021; 28:531-533. [PMID: 34558281 DOI: 10.26444/aaem/140306] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Acquired haemophilia (AH) is a suddenly occurring severe blood diathesis that affects both males and females and is caused by autoantibodies which inhibit coagulation factor VIII. The report describes an unusual case of acquired haemophilia in which an epileptic seizure and haemorrhage into the ventricular system of the brain were the first manifestations of the disease. In addition, APTT was prolonged to 94.6 seconds and the factor VIII level was as low as 1.5%. The level of anti-FVIII antibody was extremely high - 272BU/ml. The patient did not undergo invasive diagnostic procedure or an operation. Recombinant factor VIIa was used to control the bleeding. In order to eradicate the inhibitor, the patient received prednisone and cyclophosphamide. Complete remission was achieved after 5.5 weeks of treatment.
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Affiliation(s)
- Bożena Sokołowska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Justyna Kozińska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Dariusz Szczepanek
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University, Lublin, Poland
| | - Ewa Wąsik-Szczepanek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Magdalena Kozioł
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Daria Majowicz
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Adrian Juda
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
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21
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Bury-Kamińska M, Szudy-Szczyrek A, Nowaczyńska A, Jankowska-Łęcka O, Hus M, Kot K. Chemotherapy-Related Differences in Cognitive Functioning and Their Biological Predictors in Patients with Multiple Myeloma. Brain Sci 2021; 11:1166. [PMID: 34573187 PMCID: PMC8466339 DOI: 10.3390/brainsci11091166] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/10/2021] [Accepted: 08/29/2021] [Indexed: 11/21/2022] Open
Abstract
The paper presents a study on the changes in cognitive functioning in patients undergoing chemotherapy with diagnosed multiple myeloma (MM). The aim of the study was to answer the following two main research questions: Does the treatment stage differentiate the functioning of cognitive processes in patients with diagnosed MM and to what extent? Is it possible to treat biological factors (TNF-α, IL-6, IL-10, and BDNF) as predictors of patients' cognitive functioning? The patients were examined twice, before the treatment and after 4-6 cycles of chemotherapy. Selected neuropsychological research methods as well as experimental and clinical trials were employed to diagnose the patients' general cognitive state, attention, memory, and executive functions. The level of biological factors was assessed with the ELISA test. The results show that the patients' cognitive functioning was worse before the treatment than during the cytostatic therapy. It was also possible to predict the cognitive state of patients suffering from multiple myeloma based on a selected biological parameter (neurotrophin BDNF).
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Affiliation(s)
- Magdalena Bury-Kamińska
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Maria Curie-Skłodowska University in Lublin, 45 Głęboka, 20-612 Lublin, Poland
| | - Aneta Szudy-Szczyrek
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, 2 Karmelicka, 20-400 Lublin, Poland; (A.S.-S.); (A.N.); (O.J.-Ł.); (M.H.); (K.K.)
| | - Aleksandra Nowaczyńska
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, 2 Karmelicka, 20-400 Lublin, Poland; (A.S.-S.); (A.N.); (O.J.-Ł.); (M.H.); (K.K.)
| | - Olga Jankowska-Łęcka
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, 2 Karmelicka, 20-400 Lublin, Poland; (A.S.-S.); (A.N.); (O.J.-Ł.); (M.H.); (K.K.)
| | - Marek Hus
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, 2 Karmelicka, 20-400 Lublin, Poland; (A.S.-S.); (A.N.); (O.J.-Ł.); (M.H.); (K.K.)
| | - Klaudia Kot
- Department of Hemato-Oncology and Bone Marrow Transplantation, Medical University of Lublin, 2 Karmelicka, 20-400 Lublin, Poland; (A.S.-S.); (A.N.); (O.J.-Ł.); (M.H.); (K.K.)
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22
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Drozd-Sokołowska J, Waszczuk-Gajda A, Biecek P, Kobylińska K, Mańko J, Hus I, Szmigielska-Kapłon A, Nowicki M, Romejko-Jarosińska J, Kozioł M, Sędzimirska M, Sachs W, Mądry K, Boguradzki P, Król M, Hus M, Basak G, Dwilewicz-Trojaczek J. Salvage autologous hematopoietic stem cell transplantation for multiple myeloma performed with stem cells procured after previous high dose therapy - a multicenter report by the Polish Myeloma Study Group. Leuk Lymphoma 2021; 62:3226-3234. [PMID: 34396931 DOI: 10.1080/10428194.2021.1950712] [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: 10/20/2022]
Abstract
Salvage autologous hematopoietic stem cell transplantation (auto-HSCT) constitutes a therapeutic option for a group of well-selected patients with relapsed multiple myeloma (MM). However, if an insufficient number of stem cells were harvested and stored before the first auto-HSCT, stem cells need to be remobilized. Patients diagnosed with MM who following relapse after auto-HSCT, had remobilization and afterward, auto-HSCT with remobilized cells were included in this retrospective analysis. Thirty-three patients, 61% males, the median age 61 years, were included. With a median follow-up of 1.8 years, 2-year progression-free survival was 56.2%, non-relapse mortality 4.8%. The 2-year cumulative incidence of t-MDS was 4.9%. Factors important for the outcome were: the quality of response, previous radiotherapy, the time between the first and salvage auto-HSCT. To conclude, salvage auto-HSCT performed with cells procured after the previous auto-HSCT can be efficacious in relapsed MM, especially if a sufficiently long response had been obtained to the first auto-HSCT(s).
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Affiliation(s)
- Joanna Drozd-Sokołowska
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Biecek
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Katarzyna Kobylińska
- Faculty of Mathematics and Information Science, Warsaw University of Technology, Warsaw, Poland
| | - Joanna Mańko
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.,Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Iwona Hus
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.,Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland
| | | | - Mateusz Nowicki
- Department of Hematology, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland
| | - Joanna Romejko-Jarosińska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Magdalena Kozioł
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Mariola Sędzimirska
- Lower Silesian Center for Cellular Transplantation with National Bone Marrow Donor Registry, Wroclaw, Poland
| | - Wojciech Sachs
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Mądry
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Boguradzki
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Król
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Grzegorz Basak
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Jadwiga Dwilewicz-Trojaczek
- Department of Hematology, Transplantation and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
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23
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Ostrowska B, Szymczyk A, Olszewska-Szopa M, Romejko-Jarosińska J, Domańska-Czyż K, Dąbrowska-Iwanicka A, Tomczak W, Rybski S, Hus M, Wróbel T, Walewski J. Efficacy of siltuximab in the treatment of idiopathic multicentric castleman disease, the first Polish, real-world experience with long-term observation. Leuk Lymphoma 2021; 62:3031-3034. [PMID: 34159888 DOI: 10.1080/10428194.2021.1941926] [Citation(s) in RCA: 1] [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] [Indexed: 12/16/2022]
Affiliation(s)
- Beata Ostrowska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Agnieszka Szymczyk
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | | | - Joanna Romejko-Jarosińska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Katarzyna Domańska-Czyż
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Anna Dąbrowska-Iwanicka
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Waldemar Tomczak
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Sebastian Rybski
- Mathematical Oncology Unit, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Tomasz Wróbel
- Department of Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Jan Walewski
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
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24
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Łuczkowska K, Rogińska D, Ulańczyk Z, Safranow K, Paczkowska E, Baumert B, Milczarek S, Osękowska B, Górska M, Borowiecka E, Sommerfeld K, Zawodny P, Szudy-Szczyrek A, Hus M, Machaliński B. microRNAs as the biomarkers of chemotherapy-induced peripheral neuropathy in patients with multiple myeloma. Leuk Lymphoma 2021; 62:2768-2776. [PMID: 34092168 DOI: 10.1080/10428194.2021.1933478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Multiple myeloma (MM) is a malignant, incurable neoplastic disease. The currently used treatment significantly improves the prognosis and extends the survival time of patients. Unfortunately, a common side effect of the therapy is peripheral neuropathy, which may lead to dose reduction or complete treatment discontinuation/modification. In this study, we examined the changes in plasma levels of circulating miRNAs in myeloma patients to define potential factors characteristic for drug-induced peripheral neuropathy (DiPN). Global miRNA expression profile in the plasma of patients with MM during treatment was determined using miRNA microarray technology. Receiver operating characteristic (ROC) analysis allowed the identification of three miRNAs (miR-22-3p; miR-23a-3p; miR-24-3p) that could be a potential biomarker of PN. The most promising results were obtained for miR-22-3p, which was characterized by ROC area under curve (AUC) = 0.807. Our results suggest a relationship between the DiPN in patients with MM and the level of selected miRNAs in the plasma.
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Affiliation(s)
- Karolina Łuczkowska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Dorota Rogińska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Zofia Ulańczyk
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland
| | - Edyta Paczkowska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland.,Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Bartłomiej Baumert
- Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Sławomir Milczarek
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland.,Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Bogumiła Osękowska
- Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Martyna Górska
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Borowiecka
- Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Krzysztof Sommerfeld
- Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
| | - Piotr Zawodny
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Aneta Szudy-Szczyrek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University, Szczecin, Poland.,Department of Bone Marrow Transplantation, Pomeranian Medical University, Szczecin, Poland
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25
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Mesa RA, Oh ST, Gerds AT, Gupta V, Catalano JV, Cervantes F, Devos T, Hus M, Kiladjian JJ, Lech-Maranda E, Mclornan DP, Palmer J, Platzbecker U, Treliński J, Shimoda K, Donahue R, Strouse B, Kowalski MM, Verstovsek S. Association of transfusion independence with improved overall survival in myelofibrosis patients receiving momelotinib. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.7046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7046 Background: Momelotinib (MMB) is a potent JAK1, JAK2 and ACVR1 inhibitor with clinical activity against the hallmark features of myelofibrosis (MF), namely anemia, constitutional symptoms and splenomegaly, across the continuum of JAKi naïve or previously JAKi treated intermediate/high risk MF patients as demonstrated in the previously conducted Phase 3 SIMPLIFY-1 & -2 clinical trials (S1, S2). S1 enrolled JAKi-naïve patients with MF (n = 432) double-blind randomized 1:1 to MMB or ruxolitinib (RUX). S2 enrolled patients with MF with hematological toxicity during prior RUX therapy (n = 156) randomized 2:1 to open-label MMB or best available therapy (BAT; consisting of RUX in 88% of patients). In both trials, following the 24-week randomized treatment (RT) period, patients could continue MMB (MMB→MMB) and those randomized to RUX/BAT could cross-over to MMB (RUX/BAT→MMB) for extended treatment (ET). Previously published data from the SIMPLIFY studies demonstrate robust overall survival (OS) for MMB-treated patients in S1 and S2 (median not reached and 34.3 months, respectively) with a maximum follow up of approximately 5 years and median of 2.9 years in S1 and 2.3 years in S2. Methods: OS data for patients receiving MMB in S1 and S2 are reported here for subgroups defined by Week 24 (W24) transfusion independence (TI) responders vs non-responders, and also other efficacy endpoints. Survival was estimated using KM analysis with descriptive log-rank tests for comparison applied (all p-values are descriptive). Results: As previously reported, W24 TI rates were higher in the MMB arms of S1 (67% vs 49%) and S2 (43% vs 21%). In S1, W24 TI responders in the MMB group show an OS advantage, with median OS not reached and 3-year survival of 80% (HR = 0.30; p = 0.0001) compared to MMB TI non-responders. Similarly in S2, W24 TI responders in the MMB group show a trend toward better OS compared to TI non-responders (HR = 0.57; p = 0.0652). The HRs in S1 for MMB responders vs non-responders for W24 SRR and TSS were 0.59 (p = 0.0904) and 0.65 (p = 0.1657), respectively. Alternative analyses using OS defined from W24 demonstrated consistent results. Conclusions: These new analyses suggest JAKi naïve patients receiving MMB who maintain or achieve TI at W24 have favorable OS compared to MMB TI non-responders, with a similar trend observed in S2. These findings are consistent with anemia and transfusion dependency being key predictors of shortened OS in MF and suggest that TI response at W24 may become a surrogate for clinical benefit, supporting the clinical relevance of MMB’s differentiated pro-erythropoietic ACVR1 inhibition. Clinical trial information: NCT01969838.
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Affiliation(s)
| | - Stephen T. Oh
- Washington University School of Medicine, St. Louis, MO
| | - Aaron Thomas Gerds
- Cleveland Clinic Taussig Cancer Institute and Case Comprehensive Cancer Center, Cleveland, OH
| | - Vikas Gupta
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - John V. Catalano
- Frankston Hospital and Department of Clinical Haematology, Frankston, Australia
| | | | - Timothy Devos
- Universitaire Ziekenhuizen Leuven (UZ Leuven), Leuven, Belgium
| | - Marek Hus
- Medical University in Lublin, Lublin, Poland
| | | | - Ewa Lech-Maranda
- Institute of Hematology and Transfusion Medicine, Department of Hematology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Donal P. Mclornan
- Guy's and Saint Thomas' NHS Foundation Trust, London, United Kingdom
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26
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Szudy-Szczyrek A, Bachanek-Mitura O, Gromek T, Chromik K, Mital A, Szczyrek M, Krupski W, Szumiło J, Kanduła Z, Helbig G, Hus M. Real-World Efficacy of Midostaurin in Aggressive Systemic Mastocytosis. J Clin Med 2021; 10:jcm10051109. [PMID: 33799933 PMCID: PMC7961806 DOI: 10.3390/jcm10051109] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 01/08/2023] Open
Abstract
In April 2017 midostaurin was approved by the US Food and Drug Administration for the treatment of patients with aggressive systemic mastocytosis (ASM). So far, very limited real world data on its efficacy is available. Thirteen patients aged from 48 to 79 years, who received midostaurin in the early access program, were included in the study. Midostaurin was used both in first (n = 5) and subsequent lines of treatment (n = 8). The median duration of exposure was 9 months. Most patients (77%, n = 10) had a clinical improvement already as soon as the second month of therapy. Objective response was noted in 4 (50%) of eight evaluated patients. Among responders, we observed a decrease in serum tryptase level (median 74.14%) and bone marrow infiltration by mast cells (median 50%) in the sixth month of treatment. In one case, in the 10th month of treatment, allogenic stem cell transplantation was performed, achieving complete remission. Five patients died, three due to progression of disease, one in the course of secondary acute myeloid leukemia and one due to reasons not related to mastocytosis. Treatment is ongoing in seven patients. We found that midostaurin therapy is beneficial to patients with ASM.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin Staszica Street 11, 20-081 Lublin, Poland; (O.B.-M.); (T.G.)
- Correspondence: (A.S.-S.); (M.H.)
| | - Oliwia Bachanek-Mitura
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin Staszica Street 11, 20-081 Lublin, Poland; (O.B.-M.); (T.G.)
| | - Tomasz Gromek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin Staszica Street 11, 20-081 Lublin, Poland; (O.B.-M.); (T.G.)
| | - Karolina Chromik
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia in Katowice, 40-032 Katowice, Poland; (K.C.); (G.H.)
| | - Andrzej Mital
- Department of Hematology and Transplantology, Medical University of Gdańsk, 80-211 Gdańsk, Poland;
| | - Michał Szczyrek
- Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Witold Krupski
- II Department of Medical Radiology, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Justyna Szumiło
- Chair and Department of Clinical Pathomorphology, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Zuzanna Kanduła
- Department of Hematology and Bone Marrow Transplantation, University of Medical Sciences in Poznan, 61-001 Poznań, Poland;
| | - Grzegorz Helbig
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia in Katowice, 40-032 Katowice, Poland; (K.C.); (G.H.)
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin Staszica Street 11, 20-081 Lublin, Poland; (O.B.-M.); (T.G.)
- Correspondence: (A.S.-S.); (M.H.)
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27
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Drozd-Sokołowska J, Waszczuk-Gajda A, Topczewska M, Mańko J, Hus I, Szmigielska-Kapłon A, Nowicki M, Grygoruk-Wiśniowska I, Krawczyk-Kuliś M, Romejko-Jarosińska J, Frączak E, Wróbel T, Piątkowska-Jakubas B, Mądry K, Boguradzki P, Król M, Kozioł M, Hus M, Kopińska A, Dmoszyńska A, Basak GW, Dwilewicz-Trojaczek J. Stem cell mobilization in multiple myeloma patients relapsing after previous autologous hematopoietic stem cell transplantation: A multicenter report by the Polish Myeloma Study Group. J Clin Apher 2021; 36:443-453. [PMID: 33592119 DOI: 10.1002/jca.21885] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Revised: 12/05/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Salvage autologous hematopoietic stem cell transplantation (autoHSCT) may be used to treat relapse of multiple myeloma occurring after previous autoHSCT. When insufficient number of hematopoietic stem cells was stored from the initial harvest, remobilization of stem cells is necessary. PURPOSE The analysis of stem cell remobilization after previous autoHSCT. PATIENTS AND METHODS Fifty-eight patients, 60% males, median 59 years, were included. Median time interval between autoHSCT and remobilization was 42 months. The first remobilization was performed mostly after chemotherapy: cyclophosphamide (33%), cytarabine (43%), and etoposide (19%). RESULTS The first remobilization was successful in 67% patients. About 19% patients required plerixafor rescue, among whom it allowed for successful harvesting in 14%. Use of cyclophosphamide, cytarabine, and etoposide allowed for successful remobilization in 53%, 84%, and 55% patients, respectively. Patients treated with cytarabine had the highest yield of CD34+ cells (median 7.5 × 106 /kg vs 5.8 and 2.4 for etoposide and cyclophosphamide, P = .001). Higher percentage of patients was able to collect ≥2 × 106 CD34+ cells/kg during one leukapheresis after cytarabine (76% vs 21% for cyclophosphamide vs 36% for etoposide, P = .001). Cytarabine use was associated with lower risk of remobilization failure OR = 0.217, P = .02. Toxicity comprised mostly hematological toxicity (thrombocytopenia and neutropenia). One patient succumbed to septic shock. CONCLUSION Remobilization after previous autoHSCT is feasible only in a proportion of patients. Cytarabine is associated with the highest rate of successful mobilization and the highest yield of mobilized CD34+ cells. The toxicity requires careful surveillance of these patients.
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Affiliation(s)
- Joanna Drozd-Sokołowska
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Topczewska
- Faculty of Computer Science, Bialystok University of Technology, Bialystok, Poland
| | - Joanna Mańko
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.,Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Iwona Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.,Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Mateusz Nowicki
- Department of Hematology, Copernicus Memorial Hospital in Lodz Comprehensive Cancer Center and Traumatology, Lodz, Poland
| | - Iwona Grygoruk-Wiśniowska
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Krawczyk-Kuliś
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland.,Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Institute-Cancer Center, Gliwice, Poland
| | - Joanna Romejko-Jarosińska
- Department of Lymphoid Malignancies, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland
| | - Ewa Frączak
- Department of Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Wróbel
- Department of Hematology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Krzysztof Mądry
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Boguradzki
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Małgorzata Król
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Magdalena Kozioł
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Anna Kopińska
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
| | - Anna Dmoszyńska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Grzegorz Władysław Basak
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Jadwiga Dwilewicz-Trojaczek
- Department of Hematology, Transplantation and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
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Giannopoulos K, Karczmarczyk A, Karp M, Bojarska-Junak A, Kosior K, Kowal M, Tomczak W, Hus M, Machnicki M, Stokłosa T. In vivo, ex vivo and in vitro dasatinib activity in chronic lymphocytic leukemia. Oncol Lett 2021; 21:285. [PMID: 33732361 PMCID: PMC7905539 DOI: 10.3892/ol.2021.12546] [Citation(s) in RCA: 3] [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: 02/11/2020] [Accepted: 12/30/2020] [Indexed: 01/02/2023] Open
Abstract
Dasatinib inhibits the breakpoint cluster region-Abelson murine leukemia 1 (BCR-ABL1) gene along with other kinases known to be overexpressed and abnormally active in patients with chronic lymphocytic leukemia (CLL). The current study used primary leukemic cells obtained from 53 patients with CLL that were treated with dasatinib. A 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide (XTT) assay and Annexin V staining was performed to assess the cytotoxic effects of dasatinib treatment. The XTT assay revealed that the median cytotoxicity of dasatinib was 8.30% (range, 0.00–77.89%). Due to high dispersion of dasatinib activity, patients were divided into sensitive (n=27; 50.94%; median cytotoxicity, 22.81%) and resistant groups (n=26; 49.06%; median cytotoxicity, 0.00%). A median cytotoxicity of 8.30% was selected as a cut off value. Using Annexin V staining and flow cytometry on exemplary sensitive and resistant CLL samples, it was revealed that 17.71 and 1.84% of cells were apoptotic, respectively. The current study presented a case of a patient with concomitant occurrence of CLL and chronic myeloid leukemia (CML) with a major molecular response after dasatinib treatment. A simultaneous reduction of circulating CLL cells indicated in vivo anti-CLL activity induced by dasatinib. After an in vitro culture of the patient's mononuclear cells with subsequent dasatinib treatment, a higher percentage of CLL cells undergoing apoptosis was obsevered when compared with untreated samples (38.19 vs. 21.99%, respectively). Similarly, the percentage of CLL apoptotic cells (ΔΨmlow) measured by chloromethyl-X-rosamine was higher after incubation with dasatinib (7.28%) than in the negative control (2.86%). In conclusion, dasatinib induced antileukemic effects against CML and CLL cells. The results of the current study indicated that dasatinib may induce apoptosis ex vivo, in vitro and in vivo in CLL.
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Affiliation(s)
- Krzysztof Giannopoulos
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin 20-093, Poland
| | - Agnieszka Karczmarczyk
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin 20-093, Poland
| | - Marta Karp
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin 20-093, Poland
| | | | - Kamila Kosior
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin 20-093, Poland
| | - Małgorzata Kowal
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin 20-093, Poland
| | - Waldemar Tomczak
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin 20-093, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin 20-093, Poland
| | - Marcin Machnicki
- Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Warsaw 02-097, Poland
| | - Tomasz Stokłosa
- Department of Immunology, Center for Biostructure Research, Medical University of Warsaw, Warsaw 02-097, Poland
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Machnicki MM, Górniak P, Pępek M, Szymczyk A, Iskierka-Jażdżewska E, Steckiewicz P, Bluszcz A, Rydzanicz M, Hus M, Płoski R, Makuch-Łasica H, Nowak G, Juszczyński P, Jamroziak K, Stokłosa T, Puła B. Predictive significance of selected gene mutations in relapsed and refractory chronic lymphocytic leukemia patients treated with ibrutinib. Eur J Haematol 2020; 106:320-326. [PMID: 33190294 DOI: 10.1111/ejh.13550] [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: 08/26/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Ibrutinib, an inhibitor of the Bruton's kinase (BTK), is characterized by high efficacy in the therapy of patients with relapsed and refractory chronic lymphocytic leukemia (RR-CLL). AIMS To analyze the potential significance of the mutational status of selected 30 genes on the disease outcome in 45 patients with RR-CLL using custom-made gene panel and sequencing on Illumina MiSeq FGx platform. RESULTS The highest rate of mutations was observed in TP53 (n = 18; 40.0%), NOTCH1 (n = 13; 28.8%), SF3B1 (n = 11; 24.4%), ATM (n = 7; 15.6%), MED12 (n = 6, 13.3%), CHD2 (n = 5; 11.1%), XPO1 (n = 5; 11.1%), NFKBIE (n = 5; 11.1%), BIRC3 (n = 4; 8.9%), SPEN (n = 4; 8.9%), POT1 (n = 4; 8.9%), EGR2 (n = 3; 6.7%), and RPS15 (n = 3; 6.7%). With a median observation time of 45.9 months, the median progression-free survival (PFS) and overall survival (OS) were not reached. The 36-month estimated rate of PFS and OS were 64% and 68.2%, respectively. The overall response rate was noted in 23 patients (51.1%), while twenty (44.4%) patients achieved stability. Progression was noted in 2 (4.5%) cases. Analyzed molecular factors had no impact on PFS and OS. CONCLUSION Despite accumulation of several poor prognostic factors in our real-life cohort of heavily pretreated patients with CLL, ibrutinib treatment showed long-term clinical benefit.
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Affiliation(s)
- Marcin M Machnicki
- Department of Tumor Biology and Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Patryk Górniak
- Department of Experimental Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Monika Pępek
- Department of Tumor Biology and Genetics, Medical University of Warsaw, Warsaw, Poland.,Postgraduate School of Molecular Medicine, Warsaw, Poland
| | - Agnieszka Szymczyk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | | | | | - Aleksandra Bluszcz
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Rafał Płoski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Hanna Makuch-Łasica
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Grażyna Nowak
- Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Przemysław Juszczyński
- Department of Experimental Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Tomasz Stokłosa
- Department of Tumor Biology and Genetics, Medical University of Warsaw, Warsaw, Poland
| | - Bartosz Puła
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
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Paganová V, Hus M, Jureková Z. Physiological Performance of Pyrus pyraster L. (Burgsd.) and Sorbus torminalis (L.) Crantz Seedlings under Drought Treatment. Plants 2020; 9:plants9111496. [PMID: 33167517 PMCID: PMC7694486 DOI: 10.3390/plants9111496] [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: 10/08/2020] [Revised: 10/30/2020] [Accepted: 11/01/2020] [Indexed: 12/04/2022]
Abstract
In this study, seedlings of Pyrus pyraster and Sorbus torminalis were grown for 60 days in the regulated environment of a growth chamber under different water regimes. The measured indicators were the growth and distribution of mass to organs, total biomass, root to shoot mass ratio (R:S), and gas exchange parameters (gs, E, An, and water use efficiency (WUE)). The amount of total biomass was negatively affected by drought. Differences between species were confirmed only for the dry matter of the leaves. P. pyraster maintained the ratio of the mass distribution between belowground and aboveground organs in both variants of the water regime. S. torminalis created more root length for a given dry-mass under drought treatment, but its R:S was lower compared to P. pyraster. The water potential of the leaves (Ψwl) was affected by substrate saturation and interspecific differences. P. pyraster had a demonstrably higher water potential and maintained this difference even after prolonged exposure to drought. After 30 days of different water regimes, Pyrus maintained higher values of gs, An, and E in control and drought treatments, but over a longer period of drought (after 50 days), the differences between species were equalized. The changes of the leaf gas exchange for Pyrus were accompanied by a significant increase in WUE, which was most pronounced on the 40th day of the experiment. A significant and strong relationship between WUE and gs was demonstrated. The results confirmed the different physiological performances of seedlings of tree species and the different mechanisms of their response to water scarcity during drought treatment. P. pyraster presented more acclimation traits, which allowed this taxon to exhibit better performance over a longer period of water scarcity.
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Affiliation(s)
- Viera Paganová
- Faculty of Horticulture and Landscape Engineering, Slovak University of Agriculture, 949 76 Nitra, Slovakia;
- Correspondence:
| | - Marek Hus
- Faculty of Horticulture and Landscape Engineering, Slovak University of Agriculture, 949 76 Nitra, Slovakia;
| | - Zuzana Jureková
- Faculty of European Studies and Regional Development, Slovak University of Agriculture, 949 76 Nitra, Slovakia;
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Karp M, Karczmarczyk A, Bojarska-Junak A, Purkot J, Chojnacki M, ZajĄc M, Korpysz M, Tomczak W, Hus M, Morawska M, Giannopoulos K. Cofilin-1 Maintains Prosurvival Signaling in Chronic Lymphocytic Leukemia Cells. Anticancer Res 2020; 40:6327-6335. [PMID: 33109570 DOI: 10.21873/anticanres.14653] [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: 09/10/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Despite numerous studies, the etiology of chronic lymphocytic leukemia (CLL) remains unknown. A hypothesis of autoantigen stimulation in leukemic clone selection might explain 'stereotypy' of B-cell receptors. In healthy cells, cofilin-1 (CFL1) has multiple functions. Its role was described in several malignancies. The aim of this study was characterization of the role of CFL1 in CLL. Materialas and Methods: Cells from peripheral blood of 180 patients and 42 healthy volunteers (HVs) were isolated. Gene expression was assessed with reverse transcription polymerase chain reaction (RT-qPCR); western blot was performed for determination of protein level and activity. After silencing of CFL1 gene, cell ability for migration and chemotaxis was investigated with Transwell method. Post-silencing, apoptosis and cell cycle was determined by flow cytometry. RESULTS In RT-qPCR, we observed significantly higher expression of CFL1. Higher activity of protein in CLL cells when compared to HVs was detected. Knock-down of CFL1 led to decreased chemotaxis and migration of CLL cells versus cells from HVs. Apoptosis was increased amongst cells with silenced CFL1 and correlated with higher proportion of cells in the G2/M phase. CONCLUSION Significantly higher expression of CFL1 mRNA in CLL and higher protein activity might indicate high utilization of CFL1 in malignant cells, maintaining their viability, as its inhibition affected viability, cell-cycle progression and motility of leukemia cells.
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Affiliation(s)
- Marta Karp
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | | | | | - Joanna Purkot
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - MichaŁ Chojnacki
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - MaŁgorzata ZajĄc
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Maciej Korpysz
- Department of Biochemical Diagnostics, Medical University of Lublin, Lublin, Poland
| | - Waldemar Tomczak
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marta Morawska
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland.,Hematology Department, St John's Cancer Center, Lublin, Poland
| | - Krzysztof Giannopoulos
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland .,Hematology Department, St John's Cancer Center, Lublin, Poland
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Masternak M, Puła B, Knap J, Waszczuk-Gajda A, Drozd-Sokołowska J, Wdowiak K, Grosicki S, Kozłowska I, Kaźmierczak M, Łabędź A, Szukalski Ł, Wiśniewski K, Subocz E, Hałka J, Szymczyk A, Hus M, Jamroziak K, Giannopoulos K. Mean Platelet Volume Has Prognostic Value in Chronic Lymphocytic Leukemia. Cancer Manag Res 2020; 12:9977-9985. [PMID: 33116854 PMCID: PMC7567945 DOI: 10.2147/cmar.s246385] [Citation(s) in RCA: 6] [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: 01/17/2020] [Accepted: 09/08/2020] [Indexed: 01/11/2023] Open
Abstract
Purpose Mean platelet volume (MPV) is a readily accessible and commonly tested hematological indicator. Recent studies revealed a significant impact of MPV on the course and prognosis of many diseases, including some types of cancer, as well as on the incidence of atrial fibrillation and bleeding. The study aimed to perform a retrospective analysis of MPV in terms of time to first treatment (TTFT) and to determine its prognostic value in the group of patients with chronic lymphocytic leukemia (CLL). Moreover, the study includes a retrospective analysis of platelet parameters in patients treated with ibrutinib concerning bleeding and atrial fibrillation. Patients and Methods The study included 523 patients with CLL, for 344 the most important cytogenetic aberrations were reported. The Mann–Whitney, Kruskal–Wallis, Kaplan–Meier, chi-squared, log‑rank tests and multivariate Cox proportional hazard regression model were used to analyze collected data. Results The receiver operating characteristic curve analysis was performed to identify optimal cut-off value for MPV. The analysis of survival curves showed that in the group of patients with higher values of MPV TTFT was significantly longer than in the group with lower MPV (17.9 vs 36 months, p=0.0015, cut-off value for MPV= 10.4 fl). In multivariate Cox proportional hazard regression model low MPV, the presence of del11q and del13q provided independent prognostic value for TTFT (HR=0.69, 95%-CI, 0.5293 to 0.9081; p=0.0078; HR=1.76, 95%-CI, 1.3000 to 2.3882, p=0.0003, HR=0.74, 95%-Cl, 0.5674 to 0.9588, p=0.0229, respectively). In the group treated with ibrutinib, 59 patients had no significant correlation between MPV level and the incidence of therapy complications, although in the group of patients with low MPV there was a tendency for more frequent occurrence of atrial fibrillation (p=0.259). Conclusion Low MPV values are associated with unfavorable prognosis and might represent a novel, independent prognostic factor in CLL.
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Affiliation(s)
- Marta Masternak
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Bartosz Puła
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Joanna Knap
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Kamil Wdowiak
- Department of Internal Medicine and Oncological Chemotherapy, Silesian Medical University, Katowice, Poland
| | - Sebastian Grosicki
- Department of Hematology and Cancer Prevention in Chorzow, Faculty of Health Sciences in Bytom, Silesian Medical University, Katowice, Poland
| | - Izabela Kozłowska
- Department of Hematology and Cancer Prevention, Municipal Hospital in Chorzów, Chorzów, Poland
| | - Marta Kaźmierczak
- Department of Hematology and Cancer Prevention, Municipal Hospital in Chorzów, Chorzów, Poland
| | - Anna Łabędź
- Department of Hematology, Rydrygier's Hospital in Cracow, Cracow, Poland
| | - Łukasz Szukalski
- Department of Hematology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Toruń, Poland
| | - Kamil Wiśniewski
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Edyta Subocz
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland; Clinical Department of Hematology, Independent Public Healthcare Centre of the Ministry of Internal Affairs and Administration with Warmia-Mazury Region's Oncology Centre in Olsztyn, Olsztyn, Poland
| | - Janusz Hałka
- Clinical Department of Hematology, Independent Public Healthcare Centre of the Ministry of Internal Affairs and Administration with Warmia-Mazury Region's Oncology Centre in Olsztyn, Olsztyn, Poland
| | - Agnieszka Szymczyk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland; Hematology Department, St John's Cancer Center, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Krzysztof Giannopoulos
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland; Hematology Department, St John's Cancer Center, Lublin, Poland
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Karczmarczyk A, Bilska S, Korpysz M, Purkot J, GrzĄŚko N, Hus M, Giannopoulos K. Expression and Clinical Significance of Neuropilin-1 in Patients With Multiple Myeloma. Anticancer Res 2020; 40:5437-5443. [PMID: 32988865 DOI: 10.21873/anticanres.14554] [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: 06/16/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Neuropilin-1 (NRP1) is a receptor for vascular endothelial growth factor A (VEGFA), and has been reported to be overexpressed in several malignancies. Since angiogenesis plays an important role in pathogenesis of multiple myeloma (MM) and the role of NRP1 in MM has not been studied yet, we characterized the expression of NRP1 in this disease. MATERIALS AND METHODS The expression level of NRP1 was measured in 140 patients newly diagnosed with MM and 28 healthy controls by flow cytometry and quantitative reverse transcriptase polymerase chain reaction. RESULTS Expression of NRP1 was significantly reduced on plasma cells (median=2.05%) compared to that on B-cells (median=10.05%, p<0.0001) in bone marrow of patients with MM. In MM, the expression of NRP1 was high on plasmacytoid dendritic cells (median=85.85%) and low on regulatory T-cells (median=0.6%). CONCLUSION In MM, NRP1 is regulated differentially as compared to other B-cell malignancies at both the RNA and protein level.
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Affiliation(s)
| | - Sylwia Bilska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Maciej Korpysz
- Department of Biochemical Diagnostics, Medical University of Lublin, Lublin, Poland
| | - Joanna Purkot
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Norbert GrzĄŚko
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland.,Department of Hematology, St. John's Cancer Center, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Giannopoulos
- Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland .,Department of Hematology, St. John's Cancer Center, Lublin, Poland
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Szczepanek D, Szumiło J, Stoma F, Szymczyk A, Jarosz B, Szczepanek A, Hus M, Trojanowski T, Wasik-Szczepanek E. A Case Report of a Female Patient With Hodgkin Lymphoma Localized in the Central Nervous System and With Concomitant Pulmonary Lymphomatoid Granulomatosis. Front Neurol 2020; 11:963. [PMID: 33013640 PMCID: PMC7506053 DOI: 10.3389/fneur.2020.00963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 07/24/2020] [Indexed: 11/29/2022] Open
Abstract
The involvement of the central nervous system (CNS) in Hodgkin lymphoma (HL) has been rarely reported, especially in its primary isolated form. Herein, we present a case of a 33-year-old woman, who received immunosuppressive treatment due to ulcerative colitis (at the beginning azathioprine and sulfasalazine, changed to mesalazine), with repetitive episodes of loss of consciousness for a few weeks and with no other symptoms. Magnetic resonance imaging scans of the head revealed a tumor in the lateral part of the left temporal lobe and in the cerebellum. Moreover, a subsequent computed tomographic scan of the chest revealed diffuse tumorous lesions in the lungs. The brain tumor was resected and a tumorous lesion resected from the lungs was biopsied. The histopathological analysis confirmed the final diagnosis of HL localized in the CNS with concomitant pulmonary lymphomatoid granulomatosis (LYG) grade 1. After the patient underwent radiotherapy and chemotherapy, the patient showed complete regression of lesions in the CNS and lungs, which was confirmed by positron emission tomographic scan. LYG and CNS-HL are rare proliferative disease derived from lymphocytes B and associated with EBV infections. An association between LYG and other autoimmune disorders has been reported, but to the best of our knowledge, this is the first case of the CNS-HL associated with lymphatoid granulomatosis.
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Affiliation(s)
- Dariusz Szczepanek
- Chair and Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Justyna Szumiło
- Chair and Department of Clinical Pathomorphology, Medical University of Lublin, Lublin, Poland
| | - Filip Stoma
- Chair and Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Szymczyk
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
- Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland
- *Correspondence: Agnieszka Szymczyk
| | - Bożena Jarosz
- Chair and Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Szczepanek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Tomasz Trojanowski
- Chair and Department of Neurosurgery and Paediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Ewa Wasik-Szczepanek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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35
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Puła B, Długosz-Danecka M, Salomon-Perzyński A, Szymczyk A, Subocz E, Budziszewska BK, Rybka J, Gil L, Waszczuk-Gajda A, Iskierka-Jażdżewska E, Zaucha JM, Osowiecki M, Piszczek W, Steckiewicz P, Szukalski Ł, Hus M, Lech-Marańda E, Jurczak W, Jamroziak K. Efficacy of high-dose corticosteroid-based treatment for chronic lymphocytic leukemia patients with p53 abnormalities in the era of B-cell receptor inhibitors. Adv Med Sci 2020; 65:371-377. [PMID: 32659728 DOI: 10.1016/j.advms.2020.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/04/2020] [Accepted: 06/06/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE High-dose methylprednisolone (HDMP) with or without anti-CD20 antibody treatment in the pre B-cell receptor inhibitor (BCRi) era was used as potential salvage therapy for relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (r/r CLL/SLL) patients bearing the 17p deletion. PATIENTS AND METHODS Outcomes were compared in retrospect between r/r patients treated with HDMP (n = 20), ibrutinib (n = 39) and idelalisib with rituximab (n = 14). RESULTS Higher overall response rates were found in those patients undergoing BCRi therapy compared to HDMP (79.2% vs. 0%; p < 0.0001), along with longer median progression-free survival (not reached vs. 24.1 months; p < 0.01). Nevertheless, there were no differences in the overall survival (HDMP 35.87 months vs. not reached; p = 0.58). CONCLUSION HDMP treatment was significantly inferior in terms of response rate and progression-free survival in r/r CLL/SLL patients with the 17p deletion, and may only be used whenever novel compounds are unavailable.
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Szudy-Szczyrek A, Mlak R, Bury-Kamińska M, Mielnik M, Podgajna M, Kuśmierczuk K, Mazurek M, Homa-Mlak I, Szczyrek M, Krawczyk J, Małecka-Massalska T, Hus M. Serum brain-derived neurotrophic factor (BDNF) concentration predicts polyneuropathy and overall survival in multiple myeloma patients. Br J Haematol 2020; 191:77-89. [PMID: 32567687 DOI: 10.1111/bjh.16862] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/16/2020] [Indexed: 02/06/2023]
Abstract
Brain-derived neurotrophic factor (BDNF) is a protein with a potent influence on several aspects of neuronal and blood vessel functions. However, its prognostic potential and functional role in multiple myeloma (MM) remain largely unknown. In this study, we investigated the influence of BDNF on the risk of chemotherapy-induced peripheral neuropathy (CIPN) and clinical outcome. Study group consisted of 91 newly-diagnosed MM patients treated with bortezomib and/or thalidomide-based chemotherapy. Detection of BDNF in serum was performed using ELISA. Polyneuropathy was assessed according to the CTCAE Criteria v5. We observed that BDNF concentration correlated with the severity of polyneuropathy (P = 0·0463). Higher BDNF values were noted in patients who responded to treatment (P = 0·0326), and BDNF proved to be a useful marker to predict lack of response after eight cycles of treatment (sensitivity - 100%, specificity - 61·5%, P = 0·0142). Moreover this marker showed significant diagnostic usefulness in diagnosis of CIPN (sensitivity - 76%, specificity - 71·43%; area under the curve (AUC)= 0·77, 95%, confidence interval (CI): 0·64-0·88; P < 0·0001). Low BDNF was an independent, unfavourable prognostic factor associated with reduced overall survival (OS) (hazard ratio (HR) = 2·79, P = 0·0470). In conclusion, BDNF level may play a prognostic role and constitute a useful biomarker in predicting CIPN in MM patients.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Magdalena Bury-Kamińska
- Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Maria Curie-Skłodowska University, Lublin, Poland
| | - Michał Mielnik
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Martyna Podgajna
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Kinga Kuśmierczuk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marcin Mazurek
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Iwona Homa-Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Michał Szczyrek
- Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland
| | - Janusz Krawczyk
- Department of Haematology, University Hospital Galway, Galway, Republic of Ireland.,National University of Ireland, Galway, Republic of Ireland
| | | | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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Weisel K, Dimopoulos M, Moreau P, Yagci M, Larocca A, Kanate AS, Vural F, Cascavilla N, Basu S, Johnson P, Byeff P, Hus M, Rodríguez-Otero P, Muelduer E, Anttila P, Hayden PJ, Krauth MT, Lucio P, Ben-Yehuda D, Mendeleeva L, Guo S, Yu X, Grote L, Biyukov T, Dhanasiri S, Richardson P. Health-related quality-of-life results from the phase 3 OPTIMISMM study: pomalidomide, bortezomib, and low-dose dexamethasone versus bortezomib and low-dose dexamethasone in relapsed or refractory multiple myeloma. Leuk Lymphoma 2020; 61:1850-1859. [DOI: 10.1080/10428194.2020.1747066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Katja Weisel
- University Medical Center of Hamburg-Eppendorf, Hamburg, Germany and University Hospital of Tuebingen, Tuebingen, Germany
| | | | | | - Munci Yagci
- Gazi Universitesi Tip Fakultesi Hastanesi, Besevler, Turkey
| | - Alessandra Larocca
- Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
| | - Abraham S. Kanate
- Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV, USA
| | | | - Nicola Cascavilla
- Fondazione IRCSS Casa Sollievo Della Sofferenza, San Giovanni Rotundo, Italy
| | - Supratik Basu
- New Cross Hospital, Wolverhampton, University Of Wolverhampton, United Kingdom
| | - Peter Johnson
- Department of Haematology, Western General Hospital, Edinburgh, United Kingdom
| | - Peter Byeff
- Cancer Center of Central Connecticut, Southington, CT, USA
| | - Marek Hus
- Samodzielny Publiczny Szpital Nr 1 W Lublinie, Lublin, Poland
| | | | | | - Pekka Anttila
- Division of Hematology, Helsinki University and Helsinki University Hospital Comprehensive Cancer Center, Helsinki, Finland
| | | | - Maria-Theresa Krauth
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Vienna, Austria
| | - Paulo Lucio
- Champalimaud Center for the Unknown, Lisbon, Portugal
| | | | - Larisa Mendeleeva
- National Research Center for Hematology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | | | - Xin Yu
- Bristol Myers Squibb, Summit, NJ, USA
| | | | - Tsvetan Biyukov
- Celgene International Sàrl, a Bristol Myers Squibb Company, Boudry, Switzerland
| | - Sujith Dhanasiri
- Celgene International Sàrl, a Bristol Myers Squibb Company, Boudry, Switzerland
| | - Paul Richardson
- Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
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Waszczuk-Gajda A, Drozd-Sokołowska J, Basak GW, Piekarska A, Mensah-Glanowska P, Sadowska-Klasa A, Wierzbowska A, Rzepecki P, Tomaszewska A, Mańko J, Hus M, Adamska M, Romejko-Jarosińska J, Dybko J, Biernat M, Kyrcz-Krzemień S, Sędzimirska M, Winciorek N, Jędrzejczak WW, Styczyński J, Giebel S, Gil L. Infectious Complications in Patients With Multiple Myeloma After High-Dose Chemotherapy Followed by Autologous Stem Cell Transplant: Nationwide Study of the Infectious Complications Study Group of the Polish Adult Leukemia Group. Transplant Proc 2020; 52:2178-2185. [PMID: 32217016 DOI: 10.1016/j.transproceed.2020.02.068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 02/13/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Multiple myeloma (MM) has become a chronic disease in majority of patients, and remission consolidation with autologous hematopoietic stem cell transplant (ASCT) remains the backbone of treatment in transplant-eligible patients. OBJECTIVE The aim of this multicenter cross-sectional nationwide retrospective study was to evaluate the epidemiology, etiology, and outcome of infections in patients with MM undergoing ASCT in 13 Polish transplant centers, carried out on behalf of the Infectious Complications Study Group of the Polish Adult Leukemia Group. METHODS A total number of consecutive 1374 patients with MM treated in Polish adult transplant centers from 2012 to 2014 were followed for infectious complications up to day +100 after ASCT in nationwide study. RESULTS Altogether 490 infection episodes in 336 patients (49% male, aged 21-72 years) were reported, including 145 episodes of neutropenic fever (103 patients) and 34 episodes of clinically documented infections (CDIs) (27 patients). Among microbiologically confirmed infections there were 251 episodes of bacterial infections (180 patients), 42 episodes of fungal infections (38 patients), and 18 episodes of viral infections (17 patients). The overall incidence of infections reached 13.1% for bacterial, 3.6% for fungal, and 1.3% for viral infections. There were 16 cases of infection-related deaths after ASCT (1.2%). The mortality risk factors included multidrug-resistant bacteria etiology (odds ratio [OR], 3.5; P = .033), coexistence of bacterial and fungal infection (OR, 6.3; P = .002), and CDI (OR, 5.5; P = .007). CONCLUSION ASCT in patients with MM was connected with low risk of life-threatening infections. However, multidrug-resistant bacteria bacterial etiology, mixed etiology, and CDI increased the risk of fatal outcome.
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Affiliation(s)
- Anna Waszczuk-Gajda
- Department of Hematology, Oncology, and Internal Medicine, Medical University of Warsaw, Poland.
| | - Joanna Drozd-Sokołowska
- Department of Hematology, Oncology, and Internal Medicine, Medical University of Warsaw, Poland
| | | | | | | | | | | | - Piotr Rzepecki
- Military Institute of Medicine, Department of Hematology, Warsaw, Poland
| | - Agnieszka Tomaszewska
- Department of Hematology, Oncology, and Internal Medicine, Medical University of Warsaw, Poland; Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | | | - Marek Hus
- Medical University of Lublin, Lublin, Poland
| | | | - Joanna Romejko-Jarosińska
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw Branch, Department of Lymphoid Diseases, Warsaw, Poland
| | | | | | | | - Mariola Sędzimirska
- Lower Silesian Center for Cellular Transplantation and National Bone Marrow Donor Bank, Wroclaw, Poland
| | - Natalia Winciorek
- Lower Silesian Center for Cellular Transplantation and National Bone Marrow Donor Bank, Wroclaw, Poland
| | | | - Jan Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz
| | - Sebastian Giebel
- Maria Sklodowska-Curie Institute Cancer Center, Gliwice Branch, Gliwice, Poland
| | - Lidia Gil
- Poznan University of Medical Sciences, Poznan, Poland
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Wąsik-Szczepanek E, Szymczyk A, Szczepanek D, Grywalska E, Szumiło J, Trojanowski P, Czabak O, Hus M. Rare case of Richter's syndrome localization in liver and thyroid of a patient with a chronic lymphocytic leukemia (CLL) - Case report and literature. Ann Agric Environ Med 2020; 27:160-164. [PMID: 32208597 DOI: 10.26444/aaem/106041] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Richter's syndrome (RS) is a rare complication in which chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL) transforms into a more aggressive type of lymphoma - diffuse large B cell lymphoma (DLBCL), or Hodgkin's lymphoma (HL). The review describes the clinical case of a patient with CLL and RS diagnosis. A computed tomography (CT) scan of the abdominal cavity detected numerous normodense areas in the liver. Simultaneously, ultrasound examination (USG) of the thyroid revealed the presence of a solid hypoechogenic lump. The material sampled from closed biopsies of liver and thyroid in both cases allowed the diagnosis of diffuse large B cell lymphoma (DLBCL). The liver and the thyroid are particularly rare locations of RS. However, those cases allowed the conclusion that RS may occur even in a very unexpected and less probable location.
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MESH Headings
- Female
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Liver Neoplasms/diagnostic imaging
- Liver Neoplasms/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/pathology
- Middle Aged
- Thyroid Neoplasms/diagnostic imaging
- Thyroid Neoplasms/pathology
- Tomography, X-Ray Computed
- Ultrasonography
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Affiliation(s)
- Ewa Wąsik-Szczepanek
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Agnieszka Szymczyk
- Department of Clinical Transplantology, Medical University, Lublin, Poland
| | - Dariusz Szczepanek
- Chair and Department of Neurosurgery and Paediatric Neurosurgery, Medical University, Lublin, Poland
| | - Ewelina Grywalska
- Chair and Department of Clinical Immunology, Medical University, Lublin, Poland
| | - Justyna Szumiło
- Chair and Department of Clinical Pathomorphology, Medical University, Lublin, Poland
| | - Piotr Trojanowski
- Department of Otolaryngology and Laryngological Oncology, Medical University, Lublin, Poland
| | - Olga Czabak
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
| | - Marek Hus
- Chair and Department of Haematooncology and Bone Marrow Transplantation, Medical University, Lublin, Poland
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40
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Pluta A, Robak T, Brzozowski K, Stepka K, Wawrzyniak E, Krawczynska A, Czemerska M, Szmigielska-Kaplon A, Grzybowska-Izydorczyk O, Nowicki M, Stelmach P, Kuydowicz M, Gromek T, Hus M, Helbig G, Grosicki S, Bodzenta E, Razny M, Wojcik K, Bolkun L, Kloczko J, Knopinska-Posluszny W, Piekarska A, Hellman A, Sobas M, Wrobel T, Patkowska E, Lech-Maranda E, Warzocha K, Holowiecki J, Giebel S, Wierzbowska A. Early induction intensification with cladribine, cytarabine, and mitoxantrone (CLAM) in AML patients treated with the DAC induction regimen: a prospective, non-randomized, phase II study of the Polish Adult Leukemia Group (PALG). Leuk Lymphoma 2019; 61:588-603. [PMID: 31661339 DOI: 10.1080/10428194.2019.1678151] [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] [Indexed: 10/25/2022]
Abstract
We present the results of a prospective, non-randomized phase 2 trial in which 253 AML patients (pts) under 60 years old received DAC (Daunorubicin + AraC + Cladribine) as first induction followed by CLAM (Cladribine + AraC + Mitoxantrone) as early second induction on day 16 based on bone marrow (BM) blasts on day 14 (D14). The CR/CRi rate after a single course of DAC was 83% for pts with D14 BM blasts less than 10%. Forty-six pts had >10% BM blasts on D14, of whom 35 received CLAM with rates of CR/CRi 60% and early death (ED) 23%. The remaining 11 pts were not fit to receive CLAM, with rates of CR/CRi 28%, PR 18%, and ED 18%. Median OS was 7.2 versus 7.5 months, respectively. The overall CR/CRi rate was 77% after the first induction, with final CR/CRi rate 80% after DAC reinduction for pts who achieved PR with initial DAC course. CLAM used as early second induction might improve CR/CRi rates for younger AML pts with poor early response to DAC induction, but may be associated with higher mortality.
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Affiliation(s)
- Agnieszka Pluta
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Kamil Brzozowski
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Konrad Stepka
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Ewa Wawrzyniak
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Anna Krawczynska
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | | | | | | | - Mateusz Nowicki
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Piotr Stelmach
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Marta Kuydowicz
- Department of Hematology, Medical University of Lodz, Lodz, Poland
| | - Tomasz Gromek
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Grzegorz Helbig
- Department of Hematology and BMT, Medical School of Silesia, Katowice, Poland
| | - Sebastian Grosicki
- Department of Cancer Prevention, School of Public Health, Medical University of Silesia, Katowice, Poland
| | - Ewa Bodzenta
- Department of Hematology, Municipal Hospital, Chorzow, Poland
| | - Małgorzata Razny
- Hematology Department, Rydygier Memorial Hospital, Krakow, Poland
| | - Karol Wojcik
- Hematology Department, Rydygier Memorial Hospital, Krakow, Poland
| | - Lukasz Bolkun
- Department of Hematology, Medical University Hospital, Bialystok, Poland
| | - Janusz Kloczko
- Department of Hematology, Medical University Hospital, Bialystok, Poland
| | | | - Agnieszka Piekarska
- Department of Hematology, Transplantation Medical University of Gdansk, Gdansk, Poland
| | - Andrzej Hellman
- Department of Hematology, Transplantation Medical University of Gdansk, Gdansk, Poland
| | - Marta Sobas
- Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Wroclaw, Poland
| | - Tomasz Wrobel
- Department of Hematology, Blood Neoplasm and Bone Marrow Transplantation, Wroclaw, Poland
| | - Elzbieta Patkowska
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.,Department of Hematology and Transfusion Medicine, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland.,Department of Hematology and Transfusion Medicine, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Krzysztof Warzocha
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Jerzy Holowiecki
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Cancer Center, Gliwice Branch, Gliwice, Poland
| | - Sebastian Giebel
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie Institute - Cancer Center, Gliwice Branch, Gliwice, Poland
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Zmorzyński S, Popek-Marciniec S, Szudy-Szczyrek A, Wojcierowska-Litwin M, Korszeń-Pilecka I, Chocholska S, Styk W, Hus M, Filip AA. The Association of GSTT1, GSTM1, and TNF-α Polymorphisms With the Risk and Outcome in Multiple Myeloma. Front Oncol 2019; 9:1056. [PMID: 31681592 PMCID: PMC6798955 DOI: 10.3389/fonc.2019.01056] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 04/03/2019] [Accepted: 09/27/2019] [Indexed: 01/30/2023] Open
Abstract
Oxidative stress and systemic inflammation are closely linked with increased risk of cancer development. Tumor necrosis factor alpha (TNF-α) is one of the pro-inflammatory cytokines. Glutathione S-transferases (GSTs) are enzymes involved in oxidative stress handling. Polymorphisms of genes encoding mentioned molecules may potentially influence the risk and the outcome in neoplastic diseases. Multiple myeloma (MM) is a hematological malignancy characterized by clonal, atypical plasma cell proliferation. In the present study we investigated the association of deletion polymorphisms in GSTT1/GSTM1 genes and single nucleotide polymorphisms (SNPs) in the TNF-α gene at positions −308/−238 with the risk and outcome in MM and sensitivity to bortezomib under in vitro conditions. One hundred newly diagnosed MM patients and 100 healthy blood donors were genotyped by means of multiplex PCR (for GSTs) and PCR-RFLP (for TNF-α). In a subgroup of 50 MM patients, bone marrow cells were treated with bortezomib in vitro. Patients with −238GA+AA or GSTT1-null genotypes had 2.0 (p = 0.002) or 2.29 (p = 0.013) fold increased risk of MM. The interaction effects and risk of MM were observed in GSTT1/GSTM1-null (OR = 2.82, p = 0.018), −308/−238GA+AA (OR = 5.63, p < 0.001), as well as in all combinations of −308 with GSTs. The −308/−238GA+AA genotypes in comparison to GG were associated with earlier MM onset−61.14 vs. 66.86 years (p = 0.009) and 61.72 vs. 66.52 years (p = 0.035), respectively. Patients with GSTM1-present had shorter progression-free-survival (15.17 vs. 26.81 months, p = 0.003) and overall-survival (22.79 vs. 34.81 months, p = 0.039) compared with GSTM1-null. We did not observe relationship between response rate and studied polymorphisms. The in vitro study revealed significantly higher number of apoptotic cells at 12 nM of bortezomib in GSTT1-present, GSTM1-null/present, −308GG and −238GG/GA+AA genotypes. Our findings comprise large analysis of studied polymorphisms in MM.
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Affiliation(s)
- Szymon Zmorzyński
- Department of Cancer Genetics With Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Sylwia Popek-Marciniec
- Department of Cancer Genetics With Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Aneta Szudy-Szczyrek
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | | | - Iwona Korszeń-Pilecka
- Department of Cancer Genetics With Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Wojciech Styk
- Department of Cancer Genetics With Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Agata A Filip
- Department of Cancer Genetics With Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
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Czyżewski K, Styczyński J, Giebel S, Frączkiewicz J, Salamonowicz M, Zając-Spychala O, Zaucha-Prażmo A, Drozd-Sokołowska J, Waszczuk-Gajda A, Dybko J, Mańko J, Zalas-Więcek P, Gałązka P, Wysocki M, Kowalczyk J, Wachowiak J, Goździk J, Basak GW, Kałwak K, Adamska M, Hus M, Piekarska A, Sadowska-Klasa A, Mensah-Glanowska P, Kyrcz-Krzemień S, Biernat M, Wierzbowska A, Rzepecki P, Tomaszewska A, Hałaburda K, Gil L. Age-dependent determinants of infectious complications profile in children and adults after hematopoietic cell transplantation: lesson from the nationwide study. Ann Hematol 2019; 98:2197-2211. [PMID: 31321454 PMCID: PMC6700048 DOI: 10.1007/s00277-019-03755-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 04/06/2019] [Accepted: 07/02/2019] [Indexed: 12/16/2022]
Abstract
Incidence and outcome of microbiologically documented bacterial/viral infections and invasive fungal disease (IFD) in children and adults after hematopoietic cell transplantation (HCT) were compared in 650 children and 3200 adults in multicenter cross-sectional nationwide study. Infections were diagnosed in 60.8% children and 35.0% adults, including respectively 69.1% and 63.5% allo-HCT, and 33.1% and 20.8% auto-HCT patients. The incidence of bacterial infections was higher in children (36.0% vs 27.6%; p < 0.0001). Infections with Gram-negative bacteria were more frequent than Gram-positives in adults (64.6% vs 44.8%; p < 0.0001). Outcome of bacterial infections was better in children (95.5% vs 91.4%; p = 0.0011). The IFD incidence (25.3% vs 6.3%; p < 0.0001) and outcome (88.0% vs 74.9%; p < 0.0001) were higher in children. The incidence of viral infections was higher in children after allo-HCT (56.3% vs 29.3%; p < 0.0001), and auto-HCT (6.6% vs 0.8%; p < 0.0001). Outcome of viral infections was better in children (98.6% vs 92.3%; p = 0.0096). Infection-related mortality was 7.8% in children and 18.4% in adults (p < 0.0001). No child after auto-HCT died of infection. Adult age, mismatched transplants, acute leukemia, chronic GVHD, CMV reactivation, infection with Gram-negatives, and duration of infection > 21 days were risk factors for death from infection. In conclusion, pediatric patients have 2.9-fold higher incidence and 2.5-fold better outcome of infections than adults after HCT.
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Affiliation(s)
- Krzysztof Czyżewski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Jan Styczyński
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland.
| | - Sebastian Giebel
- Department of Hematology, Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Jowita Frączkiewicz
- Department of Pediatric Transplantology, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - Małgorzata Salamonowicz
- Department of Pediatric Transplantology, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - Olga Zając-Spychala
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Poznan, Poland
| | - Agnieszka Zaucha-Prażmo
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Lublin, Poland
| | | | | | - Jarosław Dybko
- Department of Hematology, Medical University, Wroclaw, Poland
- Department and Clinic of Internal and Occupational Diseases, Hypertension and Clinical Oncology, Medical University, Wroclaw, Poland
| | - Joanna Mańko
- Department of Hematology, Medical University, Lublin, Poland
| | - Patrycja Zalas-Więcek
- Department of Microbiology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Przemysław Gałązka
- Department of Pediatric Surgery, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - Mariusz Wysocki
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, ul. Sklodowskiej-Curie 9, 85-094, Bydgoszcz, Poland
| | - Jerzy Kowalczyk
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Lublin, Poland
| | - Jacek Wachowiak
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University, Poznan, Poland
| | - Jolanta Goździk
- Department of Pediatric Transplantology, Clinical Immunology and Transplantology, Collegium Medicum, Jagiellonian University, Krakow, Poland
| | | | - Krzysztof Kałwak
- Department of Pediatric Transplantology, Hematology and Oncology, Medical University, Wroclaw, Poland
| | - Monika Adamska
- Department of Hematology, Poznan University of Medical Sciences, Poznan, Poland
| | - Marek Hus
- Department of Hematology, Medical University, Lublin, Poland
| | | | | | | | | | - Monika Biernat
- Department of Hematology, Medical University, Wroclaw, Poland
| | | | - Piotr Rzepecki
- Department of Hematology, Military Institute of Medicine, Warsaw, Poland
| | - Agnieszka Tomaszewska
- Department of Hematology, Medical University, Warsaw, Poland
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Kazimierz Hałaburda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Lidia Gil
- Department of Hematology, Poznan University of Medical Sciences, Poznan, Poland
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Iskierka-Jażdżewska E, Puła B, Szeremet A, Hus M, Gołos A, Hołojda J, Piszczek W, Steckiewicz P, Wojciechowska M, Zaucha JM, Warzocha K, Jamroziak K. Ibrutinib discontinuation in patients with relapsed or refractory chronic lymphocytic leukemia treated in a compassionate use program: A report from the Polish Adult Leukemia Study Group (PALG). ADV CLIN EXP MED 2019; 28:1051-1057. [PMID: 31199879 DOI: 10.17219/acem/99911] [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] [Indexed: 11/24/2022]
Abstract
BACKGROUND Development of a novel class of drugs, the B-cell receptor-signaling inhibitors, including ibrutinib, has been a major achievement in the therapy of refractory or relapsed chronic lymphocytic leukemia (CLL). However, the CLL patients who have discontinued the ibrutinib treatment in clinical trials have been reported to have poor prognosis. OBJECTIVES In this retrospective study by the Polish Adult Leukemia Group (PALG), we analyzed the reasons for ibrutinib cessation and outcomes after discontinuing ibrutinib in refractory or relapsed CLL patients treated in a compassionate use program in Poland. MATERIAL AND METHODS Polish CLL patients were included if they discontinued ibrutinib for any reason. The clinical data on the course of ibrutinib treatment was collected anonymously using electronic Case Report Forms (CRFs). The causes of discontinuation of ibrutinib as reported by the treating physicians were analyzed. RESULTS Thirty-seven patients who discontinued ibrutinib were identified. The median duration of ibrutinib treatment in this group was 4.4 months (range: 0.2-25.2). The main reason for discontinuing ibrutinib was adverse events (n = 20, 54%), while 14 (38%) patients discontinued therapy due to disease progression and 3 (8%) due to other causes. The most common treatment complications that led to ibrutinib cessation were severe respiratory tract infections (9 patients, 24%). In the group discontinuing ibrutinib for progressive disease, 11 patients progressed with untransformed CLL, while in 3 patients, a rare type of Richter transformation to Hodgkin's lymphoma was diagnosed. Twenty-nine patients (78%) died during the follow-up period, and median overall survival (OS) reached 2.0 months (95% CI = 0.8-5.5 months). Importantly, no significant survival difference was detected between patients who discontinued ibrutinib due to disease progression and due to adverse events. CONCLUSIONS The results of this analysis indicate that ibrutinib discontinuation in relapsed or refractory CLL is associated with poor prognosis regardless of the reason for ibrutinib cessation.
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Affiliation(s)
| | - Bartosz Puła
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Agnieszka Szeremet
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Wroclaw Medical University, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Aleksandra Gołos
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Jadwiga Hołojda
- Department of Hematology, Specialist District Hospital, Legnica, Poland
| | | | | | | | - Jan Maciej Zaucha
- Department of Oncological Propaedeutics, Medical University of Gdańsk, Poland
- Gdynia Oncology Center, Poland
| | - Krzysztof Warzocha
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
| | - Krzysztof Jamroziak
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warszawa, Poland
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Szymczyk A, Chocholska S, Macheta A, Szczepanek D, Hus M, Podhorecka M. Assessment of microRNA expression in leukemic cells as predictors of sensitivity to purine nucleoside analogs, fludarabine and cladribine, in chronic lymphocytic leukemia patients. Cancer Manag Res 2019; 11:5021-5031. [PMID: 31239767 PMCID: PMC6551592 DOI: 10.2147/cmar.s191311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 10/18/2018] [Accepted: 03/18/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Great progress has been achieved lately in the therapy for chronic lymphocytic leukemia (CLL), one of the most frequently diagnosed adult leukemias. New classes of drugs, such as kinase inhibitors and BCL-2 protein antagonists, have been approved for treatment of CLL patients. Despite the abovementioned therapies the disease can still be effectively treated with purine nucleoside analogs (PNA). However, some patients, for example, those with TP53 gene abnormalities, become resistant, and the other factors involved in the therapy resistance are still being investigated. This study was aimed at analyzing the possible role of microRNAs as markers predicting the outcome of chemotherapy based on PNA – fludarabine and cladribine in CLL patients. Methods: The expression of miR-21, miR-34a, miR-181a and miR-221 in previously separated leukemic cells was assessed with the use of qRQ-PCR technique at the moment of diagnosis in 40 CLL patients. In turn, apoptosis induced by fludarabine and cladribine in 24-hour cell culture was evaluated by determining the increase in the percentage of apoptotic cells of CD5+/CD19+/Cas3+ phenotype, using a flow cytometry method. Nine of the 40 studied subjects were treated with fludarabine-based regimens and were analyzed with regards to in vivo response to PNA. Results: We detected a significantly higher PNA-induced apoptosis rate in patients with high miR-34a expression in comparison to low expression ones. Interestingly, such differences were detected particularly in standard cytogenetic patients. Conclusions: These results may prove an important role of miR-34a expression as a predictor of apoptosis, even in cases when other risk factors like cytogenetic abnormalities are absent. An assessment of microRNAs expression seems to be useful as an indicator of sensitivity to PNA and may help to predict PNA-based therapy outcome.
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Affiliation(s)
- Agnieszka Szymczyk
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland.,Department of Clinical Transplantology, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Arkadiusz Macheta
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Dariusz Szczepanek
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Monika Podhorecka
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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Mlak R, Szudy‐Szczyrek A, Mazurek M, Szczyrek M, Homa‐Mlak I, Mielnik M, Chocholska S, Jankowska‐Łęcka O, Małecka‐Massalska T, Hus M. Polymorphisms in the promotor region of theCRBNgene as a predictive factor for peripheral neuropathy in the course of thalidomide‐based chemotherapy in multiple myeloma patients. Br J Haematol 2019; 186:695-705. [DOI: 10.1111/bjh.15972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/19/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Radosław Mlak
- Department of Human Physiology Medical University of Lublin Lublin Poland
| | - Aneta Szudy‐Szczyrek
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | - Marcin Mazurek
- Department of Human Physiology Medical University of Lublin Lublin Poland
| | - Michał Szczyrek
- Department of Pneumonology, Oncology and Allergology Medical University of Lublin Lublin Poland
| | - Iwona Homa‐Mlak
- Department of Human Physiology Medical University of Lublin Lublin Poland
| | - Michał Mielnik
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | - Sylwia Chocholska
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | - Olga Jankowska‐Łęcka
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
| | | | - Marek Hus
- Department of Haemato‐oncology and Bone Marrow Transplantation Medical University of Lublin Lublin Poland
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Gisslinger H, Buxhofer-Ausch V, Hodisch J, Radinoff A, Karyagina E, Kyrcz-Krzemień S, Abdulkadyrov K, Gerbutavicius R, Melikyan A, Burgstaller S, Hus M, Kłoczko J, Yablokova V, Tzvetkov N, Całbecka M, Shneyder T, Warzocha K, Jurgutis M, Kaplanov K, Jilma B, Schoergenhofer C, Klade C. A phase III randomized, multicentre, double blind, active controlled trial to compare the efficacy and safety of two different anagrelide formulations in patients with essential thrombocythaemia - the TEAM-ET 2·0 trial. Br J Haematol 2019; 185:691-700. [PMID: 30919941 PMCID: PMC6594023 DOI: 10.1111/bjh.15824] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 12/18/2018] [Indexed: 01/02/2023]
Abstract
Anagrelide is an established treatment option for essential thrombocythaemia (ET). A prolonged release formulation was developed with the aim of reducing dosing frequency and improving tolerability, without diminishing efficacy. This multicentre, randomized, double blind, active‐controlled, non‐inferiority trial investigated the efficacy, safety and tolerability of anagrelide prolonged release (A‐PR) over a reference product in high‐risk ET patients, either anagrelide‐naïve or ‐experienced. In a 6 to 12‐week titration period the individual dose for the consecutive 4‐week maintenance period was identified. The primary endpoint was the mean platelet count during the maintenance period (3 consecutive measurements, day 0, 14, 28). Of 112 included patients 106 were randomized. The mean screening platelet counts were 822 × 109/l (95% confidence interval (CI) 707–936 × 109/l) and 797 × 109/l (95% CI 708–883 × 109/l) for A‐PR and the reference product, respectively. Both treatments effectively reduced platelet counts, to mean 281 × 109/l for A‐PR (95% CI 254–311) and 305 × 109/l (95% CI 276–337) for the reference product (P < 0·0001, for non‐inferiority). Safety and tolerability were comparable between both drugs. The novel prolonged‐release formulation was equally effective and well tolerated compared to the reference product. A‐PR provides a more convenient dosing schedule and will offer an alternative to licensed immediate‐release anagrelide formulations.
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Affiliation(s)
- Heinz Gisslinger
- Department of Haematology and Blood Coagulation, Medical University of Vienna, Vienna, Austria
| | | | | | - Atanas Radinoff
- Clinic of Oncology and Haematology, Tokuda Hospital Sofia, Sofia, Bulgaria
| | | | - Slawomira Kyrcz-Krzemień
- Samodzielny Publiczny Szpital Kliniczny im, Andrzeja Mielęckiego Śląskiego Uniwersytetu Medycznego w Katowicach, Katowice, Poland
| | - Kudrat Abdulkadyrov
- Russian Scientific-Research Institute for Haematology and Transfusiology, St. Petersburg, Russian Federation
| | | | | | - Sonja Burgstaller
- Abteilung für Innere Medizin IV, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Marek Hus
- Klinika Hematoonkologii i Transplantacji Szpiku, Lublin, Poland
| | - Janusz Kłoczko
- Klinika Hematologii z Pododziałem Chorób Naczyń, Uniwersytecki Szpital Kliniczny w Białymstoku, Białystok, Poland
| | - Vera Yablokova
- Yaroslavl Regional Clinical Hospital, Yaroslavl, Russian Federation
| | - Nikolay Tzvetkov
- MHAT Dr. Georgi Stranski, Clinic of Haematology, Pleven, Bulgaria
| | - Malgorzata Całbecka
- Oddział Hematologii, Specjalistyczny Szpital Miejski im. M. Kopernika w Toruniu, Torun, Poland
| | - Tatyana Shneyder
- Leningrad Regional Clinical Hospital, St. Petersburg, Russian Federation
| | | | | | - Kamil Kaplanov
- Volgograd Regional Clinical Oncology Dispensary, Volgograd, Russian Federation
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria
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Surdacki G, Szudy-Szczyrek A, Gorący A, Chyl-Surdacka K, Hus M. The role of immune checkpoint inhibitors in prostate cancer. Ann Agric Environ Med 2019; 26:120-124. [PMID: 30922041 DOI: 10.26444/aaem/96331] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Prostate cancer (PC) is the most commonly diagnosed malignant tumour and the third cause of cancer deaths among men in Europe. The treatment of early-stage PC is very effective and in many cases allows achievement of a complete cure, whereas the treatment of metastatic prostate cancer (mPC) is still a huge challenge for clinicians. New therapeutic strategies for mPC are urgently needded. One of the most promising methods of treatment is anticancer immunotherapy including the monoclonal antibodies against immune checkpoint inhibitors. OBJECTIVES To present the potential possibilities of using checkpoint inhibitors blockage in the treatment of mPC, and to overview the results of recent research on immune checkpoint inhibitors in patients with PC. STATE OF KNOWLEDGE Recent studies suggest that monoclonal antibodies directed against immune checkpoint inhibitors in combination with traditional therapy may become a breakthrough in the treatment of mPC in the near future. CONCLUSIONS The immunotherapy using monoclonal antibodies against immune checkpoint inhibitors seems to be a new opportunity for patients with advanced PC. The key to achieve the maximum anti-tumour response is to choose the best candidates for this therapy and determine the optimal sequence and combination of drugs. The introduction of immunotherapy as the standard treatment of patients with advanced PC requires further studies.
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Affiliation(s)
- Gabriel Surdacki
- Department of Urology and Urological Onkology, The name of John of the God Hospital, Lublin, Poland.
| | - Aneta Szudy-Szczyrek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland.
| | - Aneta Gorący
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland.
| | - Katarzyna Chyl-Surdacka
- Department of Dermatology, Venerology and Paediatric Dermatology, Medical University of Lublin, Poland.
| | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland.
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Zmorzynski S, Szudy-Szczyrek A, Popek-Marciniec S, Korszen-Pilecka I, Wojcierowska-Litwin M, Luterek M, Chocholska S, Styk W, Swiderska-Kołacz G, Januszewska J, Mielnik M, Hus M, Filip AA. ACE Insertion/Deletion Polymorphism (rs4646994) Is Associated With the Increased Risk of Multiple Myeloma. Front Oncol 2019; 9:44. [PMID: 30788288 PMCID: PMC6372536 DOI: 10.3389/fonc.2019.00044] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 09/25/2018] [Accepted: 01/16/2019] [Indexed: 12/31/2022] Open
Abstract
Introduction: The insertion (I allele) deletion (D allele) polymorphism of ACE gene (rs4646994) may influence the etiopathogenesis of multiple myeloma (MM). ACE gene is expressed in bone marrow cells and encodes angiotensin converting enzyme (ACE). It converts angiotensin I to active peptide angiotensin II, which stimulates proliferation of hematopoietic stem cells. This suggests possible association of ACE I/D gene polymorphism with MM. The aim of our study was to check possible impact of this polymorphism on risk of development and outcome of MM, as well as, sensitivity to bortezomib in cell cultures derived from MM patients. Objects and Methods: Genomic DNA from 98 newly diagnosed MM patients and 100 healthy blood donors were analyzed by PCR method. Chromosomal aberrations were detected by use of cIg-FISH. In a subgroup of 40 MM patients nucleated bone marrow cells were treated with bortezomib in vitro. Results: The Hardy-Weinberg equilibrium test showed that genotypic frequencies diverged significantly from the equilibrium. The differences between I and D allele frequencies in control and study population were significant (p = 0.046). We observed the association between DD genotype and more than 2-fold risk of MM - OR = 2.69; p < 0.0001. We did not detect any significant differences among studied genotypes regarding clinical and laboratory parameters. Moreover, we did not observe the association between survival of MM patients and I/D genotypes. Bortezomib increased number of apoptotic and necrotic cells, but the only statistically significant differences were observed in the number of viable cells at 1 nM between ID and DD genotypes (p = 0.026). Conclusion: Presented results confirmed the significant relationship between ACE (I/D) polymorphism and risk of MM development. We did not observe the association of ACE I/D polymorphism with disease outcome and bortezomib in vitro sensitivity.
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Affiliation(s)
- Szymon Zmorzynski
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Aneta Szudy-Szczyrek
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Sylwia Popek-Marciniec
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Iwona Korszen-Pilecka
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | | | - Małgorzata Luterek
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Wojciech Styk
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | | | | | - Michal Mielnik
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Marek Hus
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Agata A Filip
- Department of Cancer Genetics with Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
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Wąsik-Szczepanek E, Szymczyk A, Szczepanek D, Wszoła-Kleinrok J, Chocholska S, Pluta A, Hus M. Richter syndrome: A rare complication of chronic lymphocytic leukemia or small lymphocytic lymphoma. ADV CLIN EXP MED 2018; 27:1683-1689. [PMID: 30156387 DOI: 10.17219/acem/75903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Richter's syndrome (RS) is a rare complication with an unfavorable prognosis, in which chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) transform into a more aggressive type of lymphoma, most commonly into diffuse large B cell lymphoma (DLBCL) or less often into Hodgkin's lymphoma (HL). OBJECTIVES The objective of this research paper was to present a retrospective analysis of patients with CLL/SLL whose disease transformed into RS. MATERIAL AND METHODS The study included 217 patients (100 women and 107 men) with CLL/SLL diagnosed in the years 2006-2015 at the Department of Hematooncology and Bone Marrow Transplantation of the Medical University of Lublin, which transformed into RS. We analyzed clinical, laboratory, immunophenotypic (ZAP-70 and CD38 expression), histopathological, and genetic data (del(17p), del(11q)), which was collected at the time of CLL/SLL diagnosis, and some which was collected at the time of transformation. RESULTS Richter's syndrome was diagnosed in 4.6% of all CLL and SLL patients. The group of patients with RS consisted of 9 patients with primary CLL and 1 patient with a diagnosis of SLL (8 patients with transformation into DLBCL and 2 patients with transformation into HL). Leukemic lymphocytes showed evidence of peripheral blood lymphocyte membrane expression of ZAP70+/CD38+ (1 patient), of ZAP-70+/CD38- (3 patients), of ZAP-70-/CD38- (1 patient), and of ZAP-70-/CD38+ (5 patients). The deletion of 11q (del(11q)) was documented in 2 patients. In 4 cases, the location of RS was extremely rare (the thyroid gland, liver, skin, bladder, and central nervous system). CONCLUSIONS Richter's syndrome is a rare, but probable complication of CLL/SLL with an unfavorable prognosis, and it should be taken into account at every stage of the disease, particularly when the course of the disease is aggressive.
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MESH Headings
- Adult
- Cell Transformation, Neoplastic
- Child
- Disease Progression
- Female
- Hodgkin Disease/diagnosis
- Hodgkin Disease/genetics
- Hodgkin Disease/pathology
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/genetics
- Lymphoma, Large B-Cell, Diffuse/pathology
- Male
- Prognosis
- Retrospective Studies
- ZAP-70 Protein-Tyrosine Kinase/genetics
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Affiliation(s)
- Ewa Wąsik-Szczepanek
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Agnieszka Szymczyk
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
- Independent Clinical Transplantology Unit, Medical University of Lublin, Poland
| | - Dariusz Szczepanek
- Chair and Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, Poland
| | - Joanna Wszoła-Kleinrok
- Department of Nephrology, Endocrinology, Hypertension and Internal Diseases of Independent Public Hospital in Zamość, Poland
| | - Sylwia Chocholska
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
| | - Andrzej Pluta
- Department of Hematooncology , Oncology Centre, Brzozów, Poland
| | - Marek Hus
- Chair and Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Poland
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Szudy-Szczyrek A, Mlak R, Szczyrek M, Chocholska S, Sompor J, Nogalski A, Małecka-Massalska T, Hus M. Polymorphisms in the promoter region of the CRBN gene as a predictive factor for the first-line CTD therapy in multiple myeloma patients. Oncotarget 2018; 9:24054-24068. [PMID: 29844872 PMCID: PMC5963627 DOI: 10.18632/oncotarget.25307] [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: 02/21/2018] [Accepted: 04/16/2018] [Indexed: 11/25/2022] Open
Abstract
Cereblon is a primary molecular target for immunomodulatory drugs. The aim of this study was to evaluate the influence of selected clinical and molecular factors including single nucleotide polymorphisms (SNPs) in CRBN gene on the efficacy of first line CTD (cyclophosphamide, thalidomide, dexamethasone) chemotherapy in patients with multiple myeloma. Study group consisted of 68 patients. Analysis of CRBN gene SNPs (rs6768972, rs1672753) was performed using Real-Time PCR genotyping technique. Median progression free survival (PFS) was 15 months and overall survival (OS) 79 months. Factors associated with significantly shorter OS included ISS 3, kidney disease, weight loss, anemia, thrombocytopenia, hypoalbuminemia, elevated β2-microglobuline and CRP. The presence of t(4;14) was associated with significantly shorter PFS and OS. Both examined SNPs proved to be statistically significant, independent predictive factors of efficacy of the CTD chemotherapy. The presence of AA genotype (rs6768972) correlated with longer median PFS (18 vs 9 months; HR=0.49,95% CI: 0.26-0.91, p=0.0062). Conversely, in the carriers of CC genotype (rs1672753) significantly shorter median PFS was observed (4 vs 16 months; HR=3.93, 95% CI: 0.26-59.64, p=0.0321). In conclusion, SNPs of the CRBN gene may be useful in qualifying patients for treatment with regimens containing thalidomide.
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Affiliation(s)
- Aneta Szudy-Szczyrek
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
| | - Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, 20-080 Lublin, Poland
| | - Michał Szczyrek
- Department of Internal Medicine in Nursing, Medical University of Lublin, 20-090 Lublin, Poland.,Department of Pneumology, Oncology and Allergology, Medical University of Lublin, 20-950 Lublin, Poland
| | - Sylwia Chocholska
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
| | - Jacek Sompor
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland
| | - Adam Nogalski
- Department of Trauma Surgery and Emergency Medicine, Medical University of Lublin, 20-081 Lublin, Poland
| | | | - Marek Hus
- Department of Haematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland
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