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Faramand RG, Lee SB, Jain MD, Cao B, Wang X, Rejeski K, Subklewe M, Fahrmann JF, Saini NY, Hanash SM, Kang YP, Chang D, Rodriguez PC, Dean EA, Nishihori T, Shah BD, Lazaryan A, Chavez J, Khimani F, Pinilla-Ibarz JA, Dam M, Reid KM, Corallo SA, Menges M, Hidalgo Vargas M, Mandula JK, Holliday BA, Bachmeier CA, Speth K, Song Q, Mattie M, Locke FL, Davila ML. Baseline Serum Inflammatory Proteins Predict Poor CAR T Outcomes in Diffuse Large B-cell Lymphoma. Blood Cancer Discov 2024; 5:106-113. [PMID: 38194367 PMCID: PMC10905320 DOI: 10.1158/2643-3230.bcd-23-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/28/2023] [Accepted: 01/05/2024] [Indexed: 01/10/2024] Open
Abstract
A subset of patients with diffuse large B-cell lymphoma (DLBCL) treated with CD19 chimeric antigen receptor (CAR) T-cell therapy have poor clinical outcomes. We report serum proteins associated with severe immune-mediated toxicities and inferior clinical responses in 146 patients with DLBCL treated with axicabtagene ciloleucel. We develop a simple stratification based on pre-lymphodepletion C reactive protein (CRP) and ferritin to classify patients into low-, intermediate-, and high-risk groups. We observe that patients in the high-risk category were more likely to develop grade ≥3 toxicities and had inferior overall and progression-free survival. We sought to validate our findings with two independent international cohorts demonstrating that patients classified as low-risk have excellent efficacy and safety outcomes. Based on routine and readily available laboratory tests that can be obtained prior to lymphodepleting chemotherapy, this simple risk stratification can inform patient selection for CAR T-cell therapy. SIGNIFICANCE CAR T-cell therapy has changed the treatment paradigm for patients with relapsed/refractory hematologic malignancies. Despite encouraging efficacy, a subset of patients have poor clinical outcomes. We show that a simple clinically applicable model using pre-lymphodepletion CRP and ferritin can identify patients at high risk of poor outcomes. This article is featured in Selected Articles from This Issue, p. 80.
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Affiliation(s)
- Rawan G. Faramand
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Sae Bom Lee
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Michael D. Jain
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Biwei Cao
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Xuefeng Wang
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kai Rejeski
- Department of Medicine III, University Hospital, Ludwig Maximilian University (LMU) Munich, Germany
| | - Marion Subklewe
- Department of Medicine III, University Hospital, Ludwig Maximilian University (LMU) Munich, Germany
| | - Johannes F. Fahrmann
- Department of Clinical Cancer Prevention, Division of Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, Texas
| | - Neeraj Y. Saini
- Department of Clinical Cancer Prevention, Division of Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, Texas
| | - Samir M. Hanash
- Department of Clinical Cancer Prevention, Division of Cancer Prevention and Population Sciences, MD Anderson Cancer Center, Houston, Texas
| | - Yun Pyo Kang
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Darwin Chang
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Paolo C. Rodriguez
- Department of Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Erin A. Dean
- Division of Hematology and Oncology, University of Florida, Gainesville, Florida
| | - Taiga Nishihori
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Bijal D. Shah
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Aleksandr Lazaryan
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Julio Chavez
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Farhad Khimani
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Javier A. Pinilla-Ibarz
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Marian Dam
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kayla M. Reid
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Salvatore A. Corallo
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Meghan Menges
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Melanie Hidalgo Vargas
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Jay K. Mandula
- Pelotonia Institute for Immuno-Oncology, The Ohio State University Comprehensive Cancer Center - Arthur G James Cancer Hospital and Richard J Solove Research Institute, The Ohio State University, Columbus, Ohio
| | | | - Christina A. Bachmeier
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Kelly Speth
- Kite, a Gilead Company, Santa Monica, California
| | - Qinghua Song
- Kite, a Gilead Company, Santa Monica, California
| | - Mike Mattie
- Kite, a Gilead Company, Santa Monica, California
| | - Frederick L. Locke
- Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Marco L. Davila
- Department of Medical Oncology, Roswell Park Cancer Center, Buffalo, New York
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Joseph J, Srour SA, Milton DR, Ramdial JL, Saini NY, Olson AL, Bashir Q, Oran B, Alousi AM, Hosing C, Qazilbash MH, Kebriaei P, Shpall EJ, Champlin RE, Popat UR. Transplantation Outcomes of Myelofibrosis with Busulfan and Fludarabine Myeloablative Conditioning. Transplant Cell Ther 2023; 29:770.e1-770.e6. [PMID: 37742746 DOI: 10.1016/j.jtct.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/13/2023] [Accepted: 09/18/2023] [Indexed: 09/26/2023]
Abstract
Outcomes of myelofibrosis (MF) with allogeneic stem cell transplantation (allo-SCT) have improved over the past decade, related in part to advances in supportive treatments and conditioning regimens. Several factors are known to predict transplantation outcomes. However, most studies lack homogeneity in conditioning regimens used, limiting their ability to assess prognostic factors on transplantation outcomes. We aimed to identify the risk factors that predict transplantation outcomes in patients with MF who underwent matched or mismatched allo-SCT using a uniform myeloablative conditioning regimen consisting of busulfan and fludarabine with tacrolimus and methotrexate-based graft-versus-host disease prophylaxis. This single-center study included patients with MF who underwent allo-SCT with a matched unrelated donor (MUD), matched related donor (MRD), or mismatched unrelated donor (MMUD) and received busulfan and fludarabine conditioning with methotrexate/tacrolimus-based GVHD prophylaxis. Sixty-five patients with MF met the study criteria and were included in our analysis. At a median follow-up of 35.6 months, the 3-year cumulative incidence of relapse (CIR), nonrelapse mortality (NRM), and overall survival (OS) for all study patients were 27%, 20%, and 65%, respectively. In a multivariable analysis for CIR, prior use of JAK inhibitors was significantly associated with a decreased risk of relapse (hazard ratio [HR], .33; 95% confidence interval [CI], .11 to .99; P = .048). For NRM, Hematopoietic Cell Transplantation Comorbidity Index (≥3 versus <3; HR, 10.09; 95% CI, 2.09 to 48.76; P = .004) and donor type (MUD versus MRD: HR, 5.38; 95% CI, 1.14 to 25.30; P = .033; MMUD versus MRD: HR, 10.73; 95% CI, 1.05 to 109.4; P = .045) were associated with an increased risk of mortality. Likewise for OS, HCT-CI (≥3 versus <3; HR, 3.31; 95% CI, 1.22 to 8.99; P = .019) and donor type (MMUD versus MRD: HR, 5.20; 95% CI, 1.35 to 19.98; P = .016) were significantly associated with inferior survival. Longer time from diagnosis to allo-SCT seemed to confer worse survival, but the difference did not reach statistical significance (>12 months versus ≤12 months: NRM: HR, 7.20; 95% CI, .96 to 53.94; P = .055; OS: HR, 2.60; 95% CI, .95 to 7.14; P = .06). In a homogenous cohort of MF patients uniformly treated with busulfan/fludarabine myeloablative conditioning and methotrexate-based GVHD prophylaxis, we show that donor choice and HCT-CI are the 2 strongest predictors for improved survival after allo-SCT.
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Affiliation(s)
- Jacinth Joseph
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Samer A Srour
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Denái R Milton
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeremy L Ramdial
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Neeraj Y Saini
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amanda L Olson
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amin M Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Muzaffar H Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Uday R Popat
- Department of Stem Cell Transplantation and Cellular Therapy, University of Texas MD Anderson Cancer Center, Houston, Texas.
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Stein-Thoeringer CK, Saini NY, Zamir E, Blumenberg V, Schubert ML, Mor U, Fante MA, Schmidt S, Hayase E, Hayase T, Rohrbach R, Chang CC, McDaniel L, Flores I, Gaiser R, Edinger M, Wolff D, Heidenreich M, Strati P, Nair R, Chihara D, Fayad LE, Ahmed S, Iyer SP, Steiner RE, Jain P, Nastoupil LJ, Westin J, Arora R, Wang ML, Turner J, Menges M, Hidalgo-Vargas M, Reid K, Dreger P, Schmitt A, Müller-Tidow C, Locke FL, Davila ML, Champlin RE, Flowers CR, Shpall EJ, Poeck H, Neelapu SS, Schmitt M, Subklewe M, Jain MD, Jenq RR, Elinav E. A non-antibiotic-disrupted gut microbiome is associated with clinical responses to CD19-CAR-T cell cancer immunotherapy. Nat Med 2023; 29:906-916. [PMID: 36914893 PMCID: PMC10121864 DOI: 10.1038/s41591-023-02234-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/25/2023] [Indexed: 03/14/2023]
Abstract
Increasing evidence suggests that the gut microbiome may modulate the efficacy of cancer immunotherapy. In a B cell lymphoma patient cohort from five centers in Germany and the United States (Germany, n = 66; United States, n = 106; total, n = 172), we demonstrate that wide-spectrum antibiotics treatment ('high-risk antibiotics') prior to CD19-targeted chimeric antigen receptor (CAR)-T cell therapy is associated with adverse outcomes, but this effect is likely to be confounded by an increased pretreatment tumor burden and systemic inflammation in patients pretreated with high-risk antibiotics. To resolve this confounding effect and gain insights into antibiotics-masked microbiome signals impacting CAR-T efficacy, we focused on the high-risk antibiotics non-exposed patient population. Indeed, in these patients, significant correlations were noted between pre-CAR-T infusion Bifidobacterium longum and microbiome-encoded peptidoglycan biosynthesis, and CAR-T treatment-associated 6-month survival or lymphoma progression. Furthermore, predictive pre-CAR-T treatment microbiome-based machine learning algorithms trained on the high-risk antibiotics non-exposed German cohort and validated by the respective US cohort robustly segregated long-term responders from non-responders. Bacteroides, Ruminococcus, Eubacterium and Akkermansia were most important in determining CAR-T responsiveness, with Akkermansia also being associated with pre-infusion peripheral T cell levels in these patients. Collectively, we identify conserved microbiome features across clinical and geographical variations, which may enable cross-cohort microbiome-based predictions of outcomes in CAR-T cell immunotherapy.
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Affiliation(s)
- Christoph K Stein-Thoeringer
- Division of Microbiome and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Internal Medicine I, University Clinic Tuebingen, Tuebingen, Germany
| | - Neeraj Y Saini
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, USA.
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA.
| | - Eli Zamir
- Division of Microbiome and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Viktoria Blumenberg
- Medizinische Klinik III, LMU Klinikum, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center of the LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| | - Maria-Luisa Schubert
- Department of Hematology, Oncology and Rheumatology, University Clinic Heidelberg, Heidelberg, Germany
| | - Uria Mor
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel
| | - Matthias A Fante
- Department of Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
| | - Sabine Schmidt
- Division of Microbiome and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Eiko Hayase
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Tomo Hayase
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Roman Rohrbach
- Division of Microbiome and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Chia-Chi Chang
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Lauren McDaniel
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Ivonne Flores
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA
| | - Rogier Gaiser
- Division of Microbiome and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias Edinger
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
- Department of Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
- Leibnitz Institut für Immuntherapie (LIT), Regensburg, Germany
| | - Daniel Wolff
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
- Department of Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
- Leibnitz Institut für Immuntherapie (LIT), Regensburg, Germany
| | - Martin Heidenreich
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
- Leibnitz Institut für Immuntherapie (LIT), Regensburg, Germany
| | - Paolo Strati
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Ranjit Nair
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Dai Chihara
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Luis E Fayad
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Swaminathan P Iyer
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Raphael E Steiner
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Preetesh Jain
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Loretta J Nastoupil
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Jason Westin
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Reetakshi Arora
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael L Wang
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Joel Turner
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL, USA
| | - Meghan Menges
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Kayla Reid
- Department of Clinical Science, Moffitt Cancer Center, Tampa, FL, USA
| | - Peter Dreger
- Department of Hematology, Oncology and Rheumatology, University Clinic Heidelberg, Heidelberg, Germany
| | - Anita Schmitt
- Department of Hematology, Oncology and Rheumatology, University Clinic Heidelberg, Heidelberg, Germany
| | - Carsten Müller-Tidow
- Department of Hematology, Oncology and Rheumatology, University Clinic Heidelberg, Heidelberg, Germany
| | - Frederick L Locke
- Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center and Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Marco L Davila
- Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center and Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, USA
| | | | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, USA
| | - Hendrik Poeck
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
- Department of Internal Medicine III, University Clinic Regensburg, Regensburg, Germany
- Leibnitz Institut für Immuntherapie (LIT), Regensburg, Germany
| | - Sattva S Neelapu
- Department of Lymphoma and Myeloma, MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Schmitt
- Department of Hematology, Oncology and Rheumatology, University Clinic Heidelberg, Heidelberg, Germany
| | - Marion Subklewe
- Medizinische Klinik III, LMU Klinikum, Munich, Germany
- Laboratory for Translational Cancer Immunology, Gene Center of the LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK) and Bavarian Center for Cancer Research (BZKF), partner site Munich, Munich, Germany
| | - Michael D Jain
- Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center and Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
| | - Robert R Jenq
- Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, TX, USA.
- Department of Genomic Medicine, MD Anderson Cancer Center, Houston, TX, USA.
- CPRIT Scholar in Cancer Research, University of Texas, Houston, USA.
| | - Eran Elinav
- Division of Microbiome and Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Systems Immunology Department, Weizmann Institute of Science, Rehovot, Israel.
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Shi D, Hosing C, Khouri IF, Saengboon S, Saini NY, Ramdial JL, Akin S, Bashir Q, Steiner R, Dabaja B, Pinnix C, Ahmed S, Alousi AM, Anderlini P, Kebriaei P, Qazilbash MH, Popat UR, Shpall EJ, Champlin RE, Nieto Y, Srour SA. Long-Term Outcomes after Autologous Stem Cell Transplant (ASCT) for Primary Central Nervous System Lymphoma (PCNSL). Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00580-8] [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: 02/07/2023]
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Kawedia JD, Liu X, Ramdial J, Srour SA, Mehta RS, Popat UR, Nieto Y, Saini NY, Kebriaei P, Knape C, Gulbis AM, Champlin RE, Shpall EJ, Qazilbash MH, Bashir Q. Creatinine Clearance Is Associated with Propylene Glycol-Free Melphalan (Evomela) Pharmacokinetics and Gastrointestinal Toxicities in Newly Diagnosed Multiple Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00660-7] [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: 02/07/2023]
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Pasvolsky O, Milton DR, Masood A, Sami SS, Tanner MR, Bashir Q, Srour SA, Saini NY, Ramdial JL, Nieto Y, Lee HC, Patel KK, Kebriaei P, Thomas SK, Weber DM, Orlowski RZ, Shpall EJ, Champlin RE, Qazilbash MH. Single-Agent Lenalidomide Maintenance after Upfront Autologous Stem Cell Transplant for Newly Diagnosed Multiple Myeloma: The MD Anderson Cancer Center Experience. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00600-0] [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: 02/07/2023]
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Popat UR, Saliba RM, Mehta RS, Alousi AM, Al-Atrash G, Bashir Q, Hosing CM, Gulbis AM, Im JS, Kebriaei P, Khouri IF, Kawedia JD, Marin D, Nieto Y, Olson A, Oran B, Ramdial J, Saini NY, Shigle TL, Srour SA, Rezvani K, Qazilbash MH, Andersson BS, Shpall EJ, Champlin RE. Myeloablative Fractionated Busulfan Fludarabine and Thiotepa Regimen for Haploidentical Donor Transplantation. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00284-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Saengboon S, Khouri IF, Hosing C, Ramdial JL, Saini NY, Akin S, Shi D, Steiner R, Malpica L, Ahmed S, Westin JR, Dabaja B, Wu SY, Alousi AM, Kebriaei P, Qazilbash MH, Popat UR, Champlin RE, Shpall EJ, Nieto Y, Srour SA. Timing of Autologous Stem Cell Transplantation (ASCT) in Patients with Primary Central Nervous System Lymphoma (PCNSL). Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00583-3] [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: 02/07/2023]
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Popat UR, Saliba RM, Mehta RS, Alousi AM, Al-Atrash G, Bashir Q, Chen J, Gulbis AM, Hosing CM, Im JS, Kebriaei P, Khouri IF, Kawedia JD, Marin D, Nieto Y, Olson A, Oran B, Ramdial J, Saini NY, Srour SA, Rezvani K, Qazilbash MH, Kantarjian H, Andersson BS, Champlin RE, Shpall EJ. Myeloablative Fractionated Busulfan Regimens in Matched Donor Transplantation. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00281-6] [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: 02/07/2023]
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Fahrmann JF, Saini NY, Chia-Chi C, Irajizad E, Strati P, Nair R, Fayad LE, Ahmed S, Lee HJ, Iyer S, Steiner R, Vykoukal J, Wu R, Dennison JB, Nastoupil L, Jain P, Wang M, Green M, Westin J, Blumenberg V, Davila M, Champlin R, Shpall EJ, Kebriaei P, Flowers CR, Jain M, Jenq R, Stein-Thoeringer CK, Subklewe M, Neelapu SS, Hanash S. A polyamine-centric, blood-based metabolite panel predictive of poor response to CAR-T cell therapy in large B cell lymphoma. Cell Rep Med 2022; 3:100720. [PMID: 36384092 PMCID: PMC9729795 DOI: 10.1016/j.xcrm.2022.100720] [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: 11/23/2021] [Revised: 06/06/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022]
Abstract
Anti-CD19 chimeric antigen receptor (CAR) T cell therapy for relapsed or refractory (r/r) large B cell lymphoma (LBCL) results in durable response in only a subset of patients. MYC overexpression in LBCL tumors is associated with poor response to treatment. We tested whether an MYC-driven polyamine signature, as a liquid biopsy, is predictive of response to anti-CD19 CAR-T therapy in patients with r/r LBCL. Elevated plasma acetylated polyamines were associated with non-durable response. Concordantly, increased expression of spermidine synthase, a key enzyme that regulates levels of acetylated spermidine, was prognostic for survival in r/r LBCL. A broad metabolite screen identified additional markers that resulted in a 6-marker panel (6MetP) consisting of acetylspermidine, diacetylspermidine, and lysophospholipids, which was validated in an independent set from another institution as predictive of non-durable response to CAR-T therapy. A polyamine centric metabolomics liquid biopsy panel has predictive value for response to CAR-T therapy in r/r LBCL.
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Affiliation(s)
- Johannes F. Fahrmann
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA
| | - Neeraj Y. Saini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA,Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Chang Chia-Chi
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Ehsan Irajizad
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA,Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA
| | - Paolo Strati
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Ranjit Nair
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Luis E. Fayad
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Hun Ju Lee
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Swaminathan Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Raphael Steiner
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Jody Vykoukal
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA
| | - Ranran Wu
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA
| | - Jennifer B. Dennison
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA
| | - Loretta Nastoupil
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Preetesh Jain
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Michael Wang
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Michael Green
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Jason Westin
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Viktoria Blumenberg
- Department of Medicine III, University Hospital, LMU Munich, 81377 Munich, Germany,National Center for Tumor Diseases (NCT), Neuenheimer Feld 460, 69120 Heidelberg, Germany
| | - Marco Davila
- Department of Blood and Marrow Transplant and Cellular Therapy, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Richard Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Elizabeth J. Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Christopher R. Flowers
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Michael Jain
- Department of Blood and Marrow Transplant and Cellular Therapy, Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
| | - Robert Jenq
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA
| | - Christoph K. Stein-Thoeringer
- National Center for Tumor Diseases (NCT), Neuenheimer Feld 460, 69120 Heidelberg, Germany,German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), Heidelberg, Germany
| | - Marion Subklewe
- Department of Medicine III, University Hospital, LMU Munich, 81377 Munich, Germany,German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), Heidelberg, Germany,Laboratory for Translational Cancer Immunology, Gene Center of the LMU Munich, Munich, Germany,Corresponding author
| | - Sattva S. Neelapu
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA,Corresponding author
| | - Sam Hanash
- Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, 6767 Bertner Avenue, Houston, TX 77030, USA,Corresponding author
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11
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Saini NY, Swoboda DM, Greenbaum U, Ma J, Patel RD, Devashish K, Das K, Tanner MR, Strati P, Nair R, Fayad L, Ahmed S, Lee HJ, Iyer SP, Steiner R, Jain N, Nastoupil L, Loghavi S, Tang G, Bassett RL, Jain P, Wang M, Westin JR, Green MR, Sallman DA, Padron E, Davila ML, Locke FL, Champlin RE, Garcia-Manero G, Shpall EJ, Kebriaei P, Flowers CR, Jain MD, Wang F, Futreal AP, Gillis N, Neelapu SS, Takahashi K. Clonal Hematopoiesis Is Associated with Increased Risk of Severe Neurotoxicity in Axicabtagene Ciloleucel Therapy of Large B-Cell Lymphoma. Blood Cancer Discov 2022; 3:385-393. [PMID: 35533245 PMCID: PMC9445749 DOI: 10.1158/2643-3230.bcd-21-0177] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/10/2022] [Accepted: 05/05/2022] [Indexed: 11/16/2022] Open
Abstract
To explore the role of clonal hematopoiesis (CH) in chimeric antigen receptor (CAR) T-cell therapy outcomes, we performed targeted deep sequencing on buffy coats collected during the 21 days before lymphodepleting chemotherapy from 114 large B-cell lymphoma patients treated with anti-CD19 CAR T cells. We detected CH in 42 (36.8%) pretreatment samples, most frequently in PPM1D (19/114) and TP53 (13/114) genes. Grade ≥3 immune effector cell-associated neurotoxicity syndrome (ICANS) incidence was higher in CH-positive patients than CH-negative patients (45.2% vs. 25.0%, P = 0.038). Higher toxicities with CH were primarily associated with DNMT3A, TET2, and ASXL1 genes (DTA mutations). Grade ≥3 ICANS (58.9% vs. 25%, P = 0.02) and ≥3 cytokine release syndrome (17.7% vs. 4.2%, P = 0.08) incidences were higher in DTA-positive than in CH-negative patients. The estimated 24-month cumulative incidence of therapy-related myeloid neoplasms after CAR T-cell therapy was higher in CH-positive than CH-negative patients [19% (95% CI, 5.5-38.7) vs. 4.2% (95% CI, 0.3-18.4), P = 0.028]. SIGNIFICANCE Our study reveals that CH mutations, especially those associated with inflammation (DNMT3A, TET2, and ASXL1), are associated with severe-grade neurotoxicities in lymphoma patients receiving anti-CD19 CAR T-cell therapy. Further studies to investigate the mechanisms and interventions to improve toxicities in the context of CH are warranted. See related content by Uslu and June, p. 382. This article is highlighted in the In This Issue feature, p. 369.
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Affiliation(s)
- Neeraj Y. Saini
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - David M. Swoboda
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa,
Florida
| | - Uri Greenbaum
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
| | - Junsheng Ma
- Department of Biostatistics, The University of Texas MD Anderson Cancer
Center, Houston, Texas
| | - Romil D. Patel
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kartik Devashish
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Kaberi Das
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Mark R. Tanner
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paolo Strati
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Ranjit Nair
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Luis Fayad
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Hun Ju Lee
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Swaminathan P. Iyer
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Raphael Steiner
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Nitin Jain
- Department of Leukemia, The University of Texas MD Anderson Cancer Center,
Houston, Texas
| | - Loretta Nastoupil
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Sanam Loghavi
- Department of Hematopathology, The University of Texas MD Anderson Cancer
Center, Houston, Texas
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer
Center, Houston, Texas
| | - Roland L. Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer
Center, Houston, Texas
| | - Preetesh Jain
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Michael Wang
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Jason R. Westin
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Michael R. Green
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - David A. Sallman
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa,
Florida
| | - Eric Padron
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa,
Florida
| | - Marco L. Davila
- Department of Blood and Marrow Transplant and Cellular Immunotherapy,
Moffitt Cancer Center, Tampa, Florida
| | - Frederick L. Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy,
Moffitt Cancer Center, Tampa, Florida
| | - Richard E. Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Elizabeth J. Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University
of Texas MD Anderson Cancer Center, Houston, Texas
| | - Christopher R. Flowers
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Michael D. Jain
- Department of Blood and Marrow Transplant and Cellular Immunotherapy,
Moffitt Cancer Center, Tampa, Florida
| | - Feng Wang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer
Center, Houston, Texas
| | - Andrew P. Futreal
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer
Center, Houston, Texas
| | - Nancy Gillis
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa,
Florida
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa,
Florida
| | - Sattva S. Neelapu
- Department of Lymphoma and Myeloma, The University of Texas MD Anderson
Cancer Center, Houston, Texas
| | - Koichi Takahashi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center,
Houston, Texas
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer
Center, Houston, Texas
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12
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Srour SA, Saengboon S, Nelson BE, Ramdial J, Bashir Q, Vickers MR, Saini NY, Hosing C, Popat UR, Delgado R, Lee HC, Kaufman G, Orlowski RZ, Champlin RE, Qazilbash MH. Melphalan Dose Intensity for Autologous Stem Cell Transplantation (ASCT) in AL Amyloidosis. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00707-2] [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: 10/18/2022]
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13
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Popat UR, Mehta RS, Bassett R, Alousi AM, Al-Atrash G, Bashir Q, Hosing C, Im JS, Kebriaei P, Kawedia JD, Khouri IF, Marin D, Nieto Y, Olson A, Oran B, Ramdial J, Saini NY, Srour SA, Rezvani K, Qazilbash MH, Shpall EJ, Andersson BS, Champlin RE. Optimizing Myeloablative Fractionated Busulfan, Fludarabine and Thiotepa Regimen: Results of Two Parallel Cohorts in a Phase 2 Prospective Clinical Trial. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00257-3] [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: 11/28/2022]
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14
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Popat UR, Mehta RS, Bassett R, Alousi AM, Al-Atrash G, Bashir Q, Hosing C, Im JS, Kebriaei P, Kawedia JD, Khouri IF, Marin D, Nieto Y, Olson A, Oran B, Ramdial J, Saini NY, Srour SA, Valdez BC, Rezvani K, Qazilbash MH, Kadia TM, Kantarjian H, Shpall EJ, Champlin RE, Andersson BS. Post-Transplant Cyclophosphamide Versus Tacrolimus and Methotrexate to Prevent Graft-Versus-Host Disease in Recipients of Matched Donor Transplantation: Comparison of Sequential Cohorts in a Prospective Trial. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00539-5] [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: 11/29/2022]
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15
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Gaballa M, Ma J, Tanner MR, Rauf M, Bashir Q, Srour SA, Saini NY, Ramdial J, Nieto Y, Murphy R, Rezvani K, Tang G, Lin P, Lee HC, Patel KK, Ullah MR, Kaufman G, Manasanch E, Kebriaei P, Thomas S, Weber D, Orlowski RZ, Shpall EJ, Champlin RE, Qazilbash MH. KRD vs. VRD as Induction before Autologous Hematopoietic Progenitor Cell Transplantation for High-Risk Newly Diagnosed Multiple Myeloma. Transplant Cell Ther 2022. [DOI: 10.1016/s2666-6367(22)00680-7] [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: 10/18/2022]
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16
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Gaballa MR, Ma J, Tanner MR, Al-Juhaishi T, Bashir Q, Srour SA, Saini NY, Ramdial JL, Nieto Y, Murphy R, Rezvani K, Tang G, Lee HC, Patel KK, Kaufman GP, Manasanch EE, Ullah MR, Kebriaei P, Thomas SK, Weber DM, Orlowski RZ, Shpall EJ, Champlin RE, Qazilbash MH. Real-world long-term outcomes in multiple myeloma with VRD induction, Mel200-conditioned auto-HCT, and lenalidomide maintenance. Leuk Lymphoma 2021; 63:710-721. [PMID: 34686083 DOI: 10.1080/10428194.2021.1992763] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Standard-of-care for newly-diagnosed, autologous hematopoietic stem cell transplantation (auto-HCT)-eligible, multiple myeloma (MM) patients includes bortezomib, lenalidomide, and dexamethasone (VRD) induction followed by melphalan 200 mg/m2 (Mel200)-conditioned auto-HCT and lenalidomide maintenance. We completed a retrospective case series assessing outcomes of 187 MM patients who received this regimen at our institution. The 100-day non-relapse mortality incidence was zero. Before auto-HCT, 9.6 and 52.9% of patients achieved a complete response (CR) or ≥ very good partial response (VGPR), respectively. At day-100 post-transplant, 29.4 and 74.9% had achieved a CR/stringent-CR (sCR) or ≥ VGPR, respectively. At the last evaluation, 57.2% of patients had CR/sCR and 87.1% had ≥ VGPR. Median follow-up, progression-free survival (PFS), and overall survival (OS) were 63.2, 50, and 101.7 months, respectively. The 5-year PFS and OS were 43.1 and 79%. High-risk cytogenetics was associated with worse outcomes. This study illustrates that VRD induction, Mel200-conditioned auto-HCT, and lenalidomide maintenance are associated with good outcomes in MM.
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Affiliation(s)
- Mahmoud R Gaballa
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA.,Bone Marrow Transplant and Cellular Immunotherapy Program, Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - Junsheng Ma
- Department of Biostatistics, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Mark R Tanner
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Taha Al-Juhaishi
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Qaiser Bashir
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Samer A Srour
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Neeraj Y Saini
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Jeremy L Ramdial
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Yago Nieto
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Regan Murphy
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Katayoun Rezvani
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Guilin Tang
- Division of Pathology and Laboratory Medicine, Department of Hematopathology, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Hans C Lee
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Krina K Patel
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Gregory P Kaufman
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Elisabet E Manasanch
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Muhammad R Ullah
- Ameer-ud-Din Medical College, Lahore General Hospital, Lahore, Pakistan
| | - Partow Kebriaei
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Sheeba K Thomas
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Donna M Weber
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Robert Z Orlowski
- Department of Lymphoma/Myeloma, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Richard E Champlin
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Muzaffar H Qazilbash
- Department of Stem Cell Transplantation & Cellular Therapy, MD Anderson Cancer Center, University of Texas, Houston, TX, USA
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17
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Greenbaum U, Mahadeo KM, Kebriaei P, Shpall EJ, Saini NY. Chimeric Antigen Receptor T-Cells in B-Acute Lymphoblastic Leukemia: State of the Art and Future Directions. Front Oncol 2020; 10:1594. [PMID: 32984022 PMCID: PMC7480185 DOI: 10.3389/fonc.2020.01594] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/23/2020] [Indexed: 12/24/2022] Open
Abstract
Use of adoptive T-cell therapy modified with chimeric antigen receptor (CAR-T) has revolutionized treatment of patients with relapsed/refractory (r/r) B-cell acute lymphoblastic leukemia (B-ALL). CAR-T cells directed against CD19 antigen have produced response rates as high as 90% in clinical trials for r/r B-ALL. Despite high rates of complete remissions, the durability of responses has been sub-optimal with frequent relapses, especially in adult B-ALL population. Systemic toxicities from CAR-T therapy and standardization of toxicities grading and management is another major hurdle in the development of CAR-T field. In this review, we discuss the latest evidence of CAR-T therapy in B-ALL, potential mechanisms of relapse and barriers to CAR-T cell therapy in B-ALL. We also debate the role of allogeneic hematopoietic stem cell transplant (allo-HCT) post CAR-T therapy.
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Affiliation(s)
- Uri Greenbaum
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kris Michael Mahadeo
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Neeraj Y Saini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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18
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Saini NY, Patel R, Varma A, Bashir Q, Delgado R, Rondon G, Popat U, Hosing C, Nieto Y, Kebriaei P, Weber DM, Thomas SK, Lee HC, Manasanch EE, Orlowski RZ, Champlin RE, Qazilbash MH, Patel KK. Long-term durable efficacy of autologous stem cell transplantation in POEMS syndrome. Am J Hematol 2019; 94:E72-E74. [PMID: 30548467 DOI: 10.1002/ajh.25375] [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: 11/12/2018] [Revised: 11/26/2018] [Accepted: 12/05/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Neeraj Y Saini
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Romil Patel
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Ankur Varma
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Ruby Delgado
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Chitra Hosing
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Donna M. Weber
- Department of Lymphoma and MyelomaMD Anderson Cancer Houston TX 77030
| | - Sheeba K. Thomas
- Department of Lymphoma and MyelomaMD Anderson Cancer Houston TX 77030
| | - Hans C. Lee
- Department of Lymphoma and MyelomaMD Anderson Cancer Houston TX 77030
| | | | | | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Muzaffar H. Qazilbash
- Department of Stem Cell Transplantation and Cellular TherapyMD Anderson Cancer Center Houston TX 77030
| | - Krina K. Patel
- Department of Lymphoma and MyelomaMD Anderson Cancer Houston TX 77030
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19
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Saini NY, Saliba RM, Rondon G, Maadani F, Popat U, Hosing CM, Oran B, Bashir Q, Olson A, Nieto Y, Alousi A, Kebriaei P, Srour S, Mehta R, Anderlini P, Shpall EJ, Qazilbash MH, Khouri IF, Fayad L, Lee H, Fowler N, Parmar S, Westin J, Hagemeister F, Champlin RE, Ciurea SO. Impact of Donor Type and Melphalan Dose on Allogeneic Transplantation Outcomes for Patients with Lymphoma. Biol Blood Marrow Transplant 2019; 25:1340-1346. [PMID: 30763728 DOI: 10.1016/j.bbmt.2019.02.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/04/2019] [Indexed: 12/11/2022]
Abstract
We analyzed 186 patients with lymphoma who underwent allogeneic stem cell transplantation (ASCT) with fludarabine-melphalan (FM) conditioning and different types of donors (25 haploidentical [HD], 98 matched unrelated [MUD], and 63 matched related [MRD]) at our institution between September 2009 and January 2018. Patients received fludarabine 160 mg/m2 (40 mg/m2/day for 4 days) in combination with 1 dose of melphalan 140 mg/m2 (FM140) or 100 mg/m2 (FM100). Engraftment was similar among the 3 groups (92%, 89%, and 98%, respectively; P = .7). The 6-month cumulative incidence of grade III-IV acute graft-versus-host disease (GVHD) was 4% in the HD group, 14% in the MUD group, and 8% in the MRD group (P not significant), and the respective 3-year cumulative incidence of chronic GVHD was 5%, 16%, and 26% (P not significant). The respective 3-year nonrelapse mortality and relapse rates were 31%, 32%, and 10% (HD versus MUD, P = .9; HD versus MRD, P = .02) and 15%, 21%, and 39% (HD versus MUD, P = .4; HD versus MRD, P = .04). At 3 years, progression-free survival (PFS) was 59%, 44%, and 46% (P not significant); overall survival (OS) was 52%, 54%, and 67% (P not significant); and GVHD-free, relapse-free survival was 39%, 31%, and 24% (P not significant). No differences in the 3-year PFS (57% versus 43%; P = .3) and OS (64% versus 58%; P = .7) were seen between patients receiving FM100 and those receiving FM140. Our data demonstrate that in patients with lymphoma, ASCT with HD transplants have similar outcomes as ASCT with HLA-matched transplants, and the FM100 conditioning regimen appears to be at least as effective as the FM140 regimen.
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Affiliation(s)
- Neeraj Y Saini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Rima M Saliba
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Farzaneh Maadani
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Uday Popat
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Chitra M Hosing
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Betul Oran
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amanda Olson
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Amin Alousi
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Samer Srour
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Rohtesh Mehta
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Paolo Anderlini
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Muzaffar H Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Issa F Khouri
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Luis Fayad
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Hun Lee
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Nathan Fowler
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Simrit Parmar
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Jason Westin
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Fredrick Hagemeister
- Department of Lymphoma and Myeloma, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Stefan O Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
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20
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Saini NY, Cerny J, Furtado VF, Desmond A, Zhou Z, Raffel G, Puthawala I, Bednarik J, Shanahan L, Miron PM, Woda B, Ramanathan M, Nath R. Elderly do benefit from induction chemotherapy: High dose mitoxantrone-based ("5 + 1") induction chemotherapy regimen in newly diagnosed acute myeloid leukemia. Am J Hematol 2019; 94:209-215. [PMID: 30417942 DOI: 10.1002/ajh.25347] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/05/2018] [Accepted: 11/06/2018] [Indexed: 01/18/2023]
Abstract
An intensive "5 + 1" regimen, which included bolus high dose cytarabine (HiDAC) at 3 g/m2 once daily over 3 hours on days 1-5 and high dose mitoxantrone (HDM) 80 mg/m2 on day 2, was evaluated in 101 consecutively treated newly diagnosed acute myeloid leukemia (AML) patients at a single center since 2009. The median age was 65 (range 18-90) years. The 4 and 8-week mortality in our cohort was 3/101 (2.9%) and 7/99 (7%), respectively. The overall response (complete remission [CR] + CRi) was 76.2% (77/101). The median overall survival (OS) stratified by age group <60, 60-69 and ≥70 years were 56, 31 and 9 months respectively (log-rank, P = 0.02). 51.7% (45/84) of patients with intermediate/adverse risk category proceeded to allogeneic stem cell transplants. Among these 84 patients, the percentage of patients able to proceed to transplant in age groups <60, 60-69, and ≥ 70 years were 75% (18/24), 60.7% (17/28), and 31.2% (10/32), respectively. In conclusion, HDM-based chemotherapy regimen produces high CR rates, is well tolerated and more patients can undergo curative postremission therapy including stem cell transplant.
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Affiliation(s)
- Neeraj Y. Saini
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
- Department of Stem Cell Transplant and Cellular Therapy, MD Anderson Cancer Center; Houston Texas
| | - Jan Cerny
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
| | - Vanessa F. Furtado
- Department of Internal Medicine, UMass Memorial Medical Center; Worcester Massachusetts
| | | | - Zheng Zhou
- Lahey Cancer Center and Clinic; Massachusetts
| | - Glen Raffel
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
| | - Imran Puthawala
- Department of Internal Medicine, UMass Memorial Medical Center; Worcester Massachusetts
| | - Jayde Bednarik
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
| | - Lindsey Shanahan
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
| | - Patricia M. Miron
- UMass Memorial Medical Center Cytogenetics Director; Quest Diagnostics
| | - Bruce Woda
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
| | - Muthalagu Ramanathan
- Division of Bone Marrow Transplantation, UMass Memorial Medical Center; Worcester Massachusetts
| | - Rajneesh Nath
- Banner MD Anderson Cancer Center; Phoenix, Gilbert Arizona
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21
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Saini NY, Patel R, Varma A, Bashir Q, Delgado R, Rondon G, Popat UR, Hosing CM, Nieto Y, Kebriaei P, Alousi AM, Ahmed S, Weber DM, Thomas SK, Lee HC, Manasanch EE, Patel KK, Orlowski RZ, Champlin RE, Qazilbash MH. Melphalan-based autologous transplant in octogenarian multiple myeloma patients. Am J Hematol 2019; 94:E2-E5. [PMID: 30300461 DOI: 10.1002/ajh.25310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 09/30/2018] [Accepted: 10/03/2018] [Indexed: 11/07/2022]
Affiliation(s)
- Neeraj Y. Saini
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Romil Patel
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Ankur Varma
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Qaiser Bashir
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Ruby Delgado
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Gabriela Rondon
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Uday R. Popat
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Chitra M. Hosing
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Yago Nieto
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Partow Kebriaei
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Amin M. Alousi
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Sairah Ahmed
- Department of Lymphoma and Myeloma; MD Anderson Cancer Center; Houston Texas
| | - Donna M. Weber
- Department of Lymphoma and Myeloma; MD Anderson Cancer Center; Houston Texas
| | - Sheeba K. Thomas
- Department of Lymphoma and Myeloma; MD Anderson Cancer Center; Houston Texas
| | - Hans C. Lee
- Department of Lymphoma and Myeloma; MD Anderson Cancer Center; Houston Texas
| | | | - Krina K. Patel
- Department of Lymphoma and Myeloma; MD Anderson Cancer Center; Houston Texas
| | - Robert Z. Orlowski
- Department of Lymphoma and Myeloma; MD Anderson Cancer Center; Houston Texas
| | - Richard E. Champlin
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
| | - Muzaffar H. Qazilbash
- Department of Stem Cell Transplantation and Cellular Therapy; MD Anderson Cancer Center; Houston Texas
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22
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Furtado VF, Saini NY, Walsh W, Bathini V, Miron PM. Rare gene fusion rearrangement SPTNB1-PDGFRB in an atypical myeloproliferative neoplasm. Mol Cytogenet 2018; 11:56. [PMID: 30377450 PMCID: PMC6195751 DOI: 10.1186/s13039-018-0405-1] [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: 07/03/2018] [Accepted: 10/10/2018] [Indexed: 12/03/2022] Open
Abstract
The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia recognizes a distinct class of myeloid and lymphoid tumors with eosinophilia-related proliferations associated with specific gene rearrangements, one of which involves rearrangements of platelet-derived growth factor receptor B (PDGFRB) gene. We report a case of a rare PDGFRB rearrangement with SPTNB1 (spectrin beta, nonerythrocytic 1) that presented as atypical myeloproliferative neoplasm.
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Affiliation(s)
- Vanessa Fiorini Furtado
- 1Department of Internal Medicine, University of Massachusetts Medical School, 55 Lake Avenue N, Worcester, MA 01655 USA
| | - Neeraj Y Saini
- 2Division of Hematology/Oncology, University of Massachusetts Medical School, Worcester, MA USA
| | - William Walsh
- 2Division of Hematology/Oncology, University of Massachusetts Medical School, Worcester, MA USA
| | - Venu Bathini
- 2Division of Hematology/Oncology, University of Massachusetts Medical School, Worcester, MA USA
| | - Patricia M Miron
- Department of Pathology, UmassMemorial Medical Center, Worcester, MA USA
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