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Estrada N, Zamora L, Ferrer-Marín F, Palomo L, García O, Vélez P, De la Fuente I, Sagüés M, Cabezón M, Cortés M, Vallansot RO, Senín-Magán MA, Boqué C, Xicoy B. Association between Germline Single-Nucleotide Variants in ADME Genes and Major Molecular Response to Imatinib in Chronic Myeloid Leukemia Patients. J Clin Med 2022; 11:jcm11206217. [PMID: 36294538 PMCID: PMC9604607 DOI: 10.3390/jcm11206217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 12/02/2022] Open
Abstract
Imatinib is the most common first-line tyrosine kinase inhibitor (TKI) used to treat chronic-phase chronic myeloid leukemia (CP-CML). However, only a proportion of patients achieve major molecular response (MMR), so there is a need to find biological factors that aid the selection of the optimal therapeutic strategy (imatinib vs. more potent second-generation TKIs). The aim of this retrospective study was to understand the contribution of germline single-nucleotide variants (gSNVs) in the achievement of MMR with imatinib. In particular, a discovery cohort including 45 CP-CML patients was analyzed through the DMET array, which interrogates 1936 variants in 231 genes related to the absorption, distribution, metabolism and excretion (ADME) process. Variants statistically significant in the discovery cohort were then tested in an extended and independent cohort of 137 CP-CML patients. Finally, a total of 7 gSNVs (ABCG1-rs492338, ABCB11-rs496550, ABCB11-rs497692, CYP2D6-rs1135840, CYP11B1-rs7003319, MAT1A-rs4934027 and SLC22A1-rs628031) and one haplotype in the ABCB11 gene were significantly associated with the achievement of MMR with first-line imatinibtreatment. In conclusion, we identified a genetic signature of response to imatinib in CP-CML patients that could be useful in selecting those patients that may benefit from starting imatinib as first-line therapy, therefore avoiding the toxicity related to second-generation TKIs.
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Affiliation(s)
- Natalia Estrada
- Myeloid Neoplasms Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | - Lurdes Zamora
- Myeloid Neoplasms Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Correspondence:
| | - Francisca Ferrer-Marín
- Hospital General Universitario Morales Meseguer, CIBERER (CB15/00055), IMIB-Pascual Parrilla, UCAM, 30008 Murcia, Spain
| | - Laura Palomo
- MDS Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
- Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Olga García
- Myeloid Neoplasms Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | | | | | | | - Marta Cabezón
- Myeloid Neoplasms Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
| | | | | | | | | | - Blanca Xicoy
- Myeloid Neoplasms Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
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Acha P, Xandri M, Fuster‐Tormo F, Palomo L, Xicoy B, Cabezón M, Marcé S, Granada I, Vela D, Sagüés M, Boque C, Plensa E, Pineda A, Feliu E, Solé F, Zamora L. Diagnostic and prognostic contribution of targeted NGS in patients with triple-negative myeloproliferative neoplasms. Am J Hematol 2019; 94:E264-E267. [PMID: 31321810 DOI: 10.1002/ajh.25580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 07/12/2019] [Accepted: 07/13/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Pamela Acha
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia‐Hospital GermansTrias i PujolUniversitat Autònoma de Barcelona Badalona Spain
- Department of BiomedicineUniversitat de Barcelona Barcelona Spain
| | - Marisol Xandri
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
| | - Francisco Fuster‐Tormo
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia‐Hospital GermansTrias i PujolUniversitat Autònoma de Barcelona Badalona Spain
| | - Laura Palomo
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia‐Hospital GermansTrias i PujolUniversitat Autònoma de Barcelona Badalona Spain
| | - Blanca Xicoy
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
| | - Marta Cabezón
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
| | - Silvia Marcé
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
| | - Isabel Granada
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
| | | | | | | | | | | | - Evarist Feliu
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
| | - Francesc Solé
- MDS Research Group, Institut de Recerca Contra la Leucèmia Josep Carreras, Institut Català d'Oncologia‐Hospital GermansTrias i PujolUniversitat Autònoma de Barcelona Badalona Spain
| | - Lurdes Zamora
- Hematology Service, Institut Català d'Oncologia (ICO)‐Hospital Germans Trias i Pujol, Institut de Recerca Contra la Leucèmia Josep CarrerasUniversitat Autònoma de Barcelona Badalona Spain
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Hernández-Boluda JC, Pereira A, Pastor-Galán I, Alvarez-Larrán A, Savchuk A, Puerta JM, Sánchez-Pina JM, Collado R, Díaz-González A, Angona A, Sagüés M, García-Gutiérrez V, Boqué C, Osorio S, Vallansot R, Palomera L, Mendizábal A, Casado LF, Pérez-Encinas M, Pérez-López R, Ferrer-Marín F, Sánchez-Guijo F, García C, Heras NDL, López-Lorenzo JL, Cervantes F, Steegmann JL. Feasibility of treatment discontinuation in chronic myeloid leukemia in clinical practice: results from a nationwide series of 236 patients. Blood Cancer J 2018; 8:91. [PMID: 30504932 PMCID: PMC6275158 DOI: 10.1038/s41408-018-0125-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 07/17/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 12/11/2022] Open
Abstract
Over half of chronic myeloid leukemia (CML) patients in deep molecular response do not lose the major molecular response (MMR) after stopping treatment with tyrosine kinase inhibitors (TKI). This strategy is safe in clinical trials, but its applicability in the real-life setting remains unsettled. We describe the outcomes after TKI discontinuation in a nationwide series of 236 CML patients. Median follow-up from treatment discontinuation was 21.5 months and 5 patients died from CML-unrelated causes. TKI therapy was reinitiated due to MMR loss (n = 52), increase ≥ 1 log in BCR-ABL transcript level without losing MMR (n = 12), patient preference (n = 2), and withdrawal syndrome (n = 1). Treatment-free remission rate at 4 years was 64% (95% confidence interval, CI: 55%–72%). Cumulative incidence of molecular recurrence at 3 years was 33% (95% CI: 26%–38%). TKI treatment for < 5 years and MR4.5 duration shorter than 4 years were both associated with higher incidence of molecular recurrence. No patient had disease progression. Response status at last control was: MR4.5 (n = 196), MR4 (n = 15), MMR (n = 14), complete cytogenetic response (n = 10), and other (n = 1). A significant increase in Hb and cholesterol levels was observed after imatinib withdrawal. Our results demonstrate that TKI treatment discontinuation is feasible in real-life clinical practice.
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Affiliation(s)
| | - Arturo Pereira
- Hemotherapy and Hemostasis Department, Hospital Clínic-IDIBAPS, Barcelona, Spain
| | - Irene Pastor-Galán
- Hematology Department, Hospital Clínico Universitario-INCLIVA, Valencia, Spain
| | - Alberto Alvarez-Larrán
- Hematology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Alisa Savchuk
- Hematology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - José Manuel Puerta
- Hematology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Rosa Collado
- Hematology Department, Hospital General Universitario, Valencia, Spain
| | | | - Anna Angona
- Hematology Department, Hospital del Mar-IMIM, Barcelona, Spain
| | - Miguel Sagüés
- Hematology Department, Hospital Universitario de Girona, Doctor Josep Trueta, Girona, Spain
| | | | - Concepción Boqué
- Hematology Department, Institut Català d'Oncologia, Hospital Duran i Reynals, Hospitalet de Llobregat, Spain
| | - Santiago Osorio
- Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Rolando Vallansot
- Hematology Department, Hospital Universitario Joan XXIII, Tarragona, Spain
| | - Luis Palomera
- Hematology Department, Hospital Clínico Universitario Lozano Blesa, IIS Aragón, Zaragoza, Spain
| | | | | | - Manuel Pérez-Encinas
- Hematology Department, Hospital Clínico Universitario, Santiago de Compostela, Spain
| | - Raúl Pérez-López
- Hematology Department, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Francisca Ferrer-Marín
- Hematology and Medical Oncology Department, Hospital Morales Meseguer-CIBERER, IMIB-Arrixaca, UCAM, Murcia, Spain
| | - Fermín Sánchez-Guijo
- Hematology Department, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain
| | - Carmen García
- Hematology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | | | | | - Francisco Cervantes
- Hematology Department, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain
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Cruz D, Costa P, Sagüés M. Meningeal cryptococcosis in a patient with angioimmunoblastic lymphoma treated with alemtuzumab. Med Clin (Barc) 2018; 152:e19-e20. [PMID: 30001898 DOI: 10.1016/j.medcli.2018.05.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 05/26/2018] [Accepted: 05/30/2018] [Indexed: 10/28/2022]
Affiliation(s)
- David Cruz
- Servicio de Hematología Clínica, ICO-Girona, Hospital Universitario Dr. Josep Trueta, Girona, España.
| | - Paula Costa
- Servicio de Laboratorio Clínico Territorial ICS Girona, Parque Sanitario Martí Julià, Girona, España
| | - Miguel Sagüés
- Servicio de Hematología Clínica, ICO-Girona, Hospital Universitario Dr. Josep Trueta, Girona, España
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Sagüés M, Paredes V, Altés J, Fernández de Sevilla A. [Ictus cerebellopontine as first manifestation of an intravascular diffuse large B cell lymphoma involving at the kidney]. Med Clin (Barc) 2015; 144:48-9. [PMID: 24698716 DOI: 10.1016/j.medcli.2014.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 02/07/2014] [Accepted: 02/13/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Miguel Sagüés
- Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospital Duran i Reynals, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; Servei de Medicina Interna, Consorci Sanitari Integral-Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España.
| | - Viviana Paredes
- Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospital Duran i Reynals, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España; Servei de Medicina Interna, Consorci Sanitari Integral-Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - Jordi Altés
- Servei de Medicina Interna, Consorci Sanitari Integral-Hospital Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
| | - Alberto Fernández de Sevilla
- Servei d'Hematologia Clínica, Institut Català d'Oncologia-Hospital Duran i Reynals, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España
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Sagüés M, Sancho JM, Serrano D, Balsalobre P, Gayoso J, Morgades M, Conde E, Iriondo A, Varela R, Escoda L, Xicoy B, Espigado I, Fernández-Abellán P, Díez JL, Ribera JM. [Comparison of two initial mobilizing strategies of peripheral blood stem cells for autologous transplantation in patients with lymphoma and human immunodeficiency virus infection]. Med Clin (Barc) 2012; 139:192-6. [PMID: 21807388 DOI: 10.1016/j.medcli.2011.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/05/2011] [Accepted: 05/10/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Several studies have demonstrated the feasibility of autologous stem cell transplantation (ASCT) in patients with lymphoma and human immunodeficiency virus (HIV) infection. HIV infection has been described as a risk factor for poor mobilization. The aim of this study was to compare the results of two mobilization strategies of peripheral blood stem cells (PBSC) in patients with lymphoma and HIV infection in seven Spanish hospitals. PATIENTS AND METHODS The following variables were collected: demographic, clinical and biological features, previous chemotherapies and outcomes, as well as mobilization's strategies (classified in two groups: 1) G-CSF, and 2) G-CSF + chemotherapy). RESULTS Between January 2000 and May 2010, 42 patients with lymphoma and HIV infection were referred for ASCT. The rate of successful mobilization (collection >1.60 × 10(6) CD34 cells/kg) with the first regimen was 67%, with no differences between those patients mobilized with G-CSF or with G-CSF + chemotherapy (16 [72%] and 12 [60%], respectively; p=0.382). The status of the lymphoma at the time of mobilization was the only factor for successful mobilization (20/22 patients [91%] in complete remission [CR] mobilized adequately versus 5/12 [58%] in partial remission [PR]; p=0.038). CONCLUSIONS In patients with lymphoma and HIV infection, mobilization with G-CSF was as effective as mobilization with chemotherapy followed by G-CSF. The stage of disease prior to the mobilization was the main risk factor for the success of mobilization, with better results in patients mobilized in remission of the lymphoma.
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Affiliation(s)
- Miguel Sagüés
- ICO-Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Institut de Recerca contra la Leucèmia Josep Carreras, Badalona, Barcelona, Spain
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Sagüés M, Navarro JT, Ribera JM, Millá F. Linfoma plasmablástico de localización testicular como primera manifestación de infección por el VIH. Med Clin (Barc) 2012; 139:89-90. [DOI: 10.1016/j.medcli.2011.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2011] [Accepted: 11/17/2011] [Indexed: 11/29/2022]
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