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Marcé S, Méndez A, Xicoy B, Estrada N, Cabezón M, Sturla AL, García MR, Angona A, Amat P, Escribano Serrat S, Scalzulli E, Morgades M, Senín A, Hernández-Boluda JC, Ferrer-Marín F, Anguita E, Cortés M, Plensa E, Breccia M, García-Gutierrez V, Zamora L. e14a2 Transcript Favors Treatment-Free Remission in Chronic Myeloid Leukemia When Associated with Longer Treatment with Tyrosine Kinase Inhibitors and Sustained Deep Molecular Response. J Clin Med 2024; 13:779. [PMID: 38337473 PMCID: PMC10856594 DOI: 10.3390/jcm13030779] [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: 12/13/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
e13a2 and e14a2 are the most frequent transcript types of the BCR::ABL1 fusion gene in chronic myeloid leukemia (CML). The current goal with tyrosine kinase inhibitors (TKI) is to achieve sustained deep molecular response (DMR) in order to discontinue TKI treatment and remain in the so-called treatment-free remission (TFR) phase, but biological factors associated with these goals are not well established. This study aimed to determine the effect of transcript type on TFR in patients receiving frontline treatment with imatinib (IM) or second-generation TKI (2G-TKI). Patients treated at least 119 months with IM presented less post-discontinuation relapse than those that discontinued IM before 119 months (p = 0.005). In addition, cases with the e14a2 transcript type treated at least 119 months with IM presented a better TFR (p = 0.024). On the other hand, the type of transcript did not affect the cytogenetic or molecular response in 2G-TKI treated patients; however, the use of 2G-TKI may be associated with higher and earlier DMR in patients with the e14a2 transcript.
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Affiliation(s)
- Sílvia Marcé
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Aleix Méndez
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Blanca Xicoy
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Natalia Estrada
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Marta Cabezón
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Antonella Luciana Sturla
- Hematology Department, ICO Hospitalet-Hospital Duran y Reynals, 08908 Barcelona, Spain; (A.L.S.); (M.R.G.); (A.S.)
| | - Miriam Ratia García
- Hematology Department, ICO Hospitalet-Hospital Duran y Reynals, 08908 Barcelona, Spain; (A.L.S.); (M.R.G.); (A.S.)
| | - Anna Angona
- Hematology Department, ICO Girona-Hospital Josep Trueta, 17007 Girona, Spain;
| | - Paula Amat
- Hematology Department, Hospital Clínico Universitario-INCLIVA de Valencia, 46010 Valencia, Spain; (P.A.); (J.C.H.-B.)
| | - Silvia Escribano Serrat
- Hematology Department, Hospital Clínico San Carlos, IML, IdISSC, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (S.E.S.); (E.A.)
| | - Emilia Scalzulli
- Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University, 00189 Rome, Italy; (E.S.); (M.B.)
| | - Mireia Morgades
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
| | - Alicia Senín
- Hematology Department, ICO Hospitalet-Hospital Duran y Reynals, 08908 Barcelona, Spain; (A.L.S.); (M.R.G.); (A.S.)
| | - Juan Carlos Hernández-Boluda
- Hematology Department, Hospital Clínico Universitario-INCLIVA de Valencia, 46010 Valencia, Spain; (P.A.); (J.C.H.-B.)
| | - Francisca Ferrer-Marín
- Hematology Department, Hospital General Universitario Morales Meseguer-CIBERER, IMIB, UCAM, 30008 Múrcia, Spain;
| | - Eduardo Anguita
- Hematology Department, Hospital Clínico San Carlos, IML, IdISSC, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain; (S.E.S.); (E.A.)
| | - Montserrat Cortés
- Hematology Department, Hospital General de Granollers, 08402 Granollers, Spain;
| | - Esther Plensa
- Hematology Department, Consorci Sanitari del Maresme, Hospital de Mataró, 08301 Mataró, Spain;
| | - Massimo Breccia
- Hematology, Department of Precision and Translational Medicine, Policlinico Umberto 1, Sapienza University, 00189 Rome, Italy; (E.S.); (M.B.)
| | - Valentín García-Gutierrez
- Hematology Department, Hospital Ramón y Cajal, IRYCIS, Universidad de Alcalalá Madrid, 28801 Madrid, Spain;
| | - Lurdes Zamora
- Hematology Department, Myeloid Neoplasms Group, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute (IJC), 08916 Badalona, Spain; (A.M.); (B.X.); (N.E.); (M.C.); (M.M.); (L.Z.)
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2
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Cabezón M, Malinverni R, Bargay J, Xicoy B, Marcé S, Garrido A, Tormo M, Arenillas L, Coll R, Borras J, Jiménez MJ, Hoyos M, Valcárcel D, Escoda L, Vall-Llovera F, Garcia A, Font LL, Rámila E, Buschbeck M, Zamora L. Different methylation signatures at diagnosis in patients with high-risk myelodysplastic syndromes and secondary acute myeloid leukemia predict azacitidine response and longer survival. Clin Epigenetics 2021; 13:9. [PMID: 33446256 PMCID: PMC7809812 DOI: 10.1186/s13148-021-01002-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/15/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Epigenetic therapy, using hypomethylating agents (HMA), is known to be effective in the treatment of high-risk myelodysplastic syndromes (MDS) and acute myeloid leukemia (AML) patients who are not suitable for intensive chemotherapy and/or allogeneic stem cell transplantation. However, response rates to HMA are low and there is an unmet need in finding prognostic and predictive biomarkers of treatment response and overall survival. We performed global methylation analysis of 75 patients with high-risk MDS and secondary AML who were included in CETLAM SMD-09 protocol, in which patients received HMA or intensive treatment according to age, comorbidities and cytogenetic. RESULTS Unsupervised analysis of global methylation pattern at diagnosis did not allow patients to be differentiated according to the cytological subtype, cytogenetic groups, treatment response or patient outcome. However, after a supervised analysis we found a methylation signature defined by 200 probes, which allowed differentiating between patients responding and non-responding to azacitidine (AZA) treatment and a different methylation pattern also defined by 200 probes that allowed to differentiate patients according to their survival. On studying follow-up samples, we confirmed that AZA decreases global DNA methylation, but in our cohort the degree of methylation decrease did not correlate with the type of response. The methylation signature detected at diagnosis was not useful in treated samples to distinguish patients who were going to relapse or progress. CONCLUSIONS Our findings suggest that in a subset of specific CpGs, altered DNA methylation patterns at diagnosis may be useful as a biomarker for predicting AZA response and survival.
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Affiliation(s)
- M Cabezón
- Hematology Laboratory Service, ICO Badalona-Hospital Germans Trias I Pujol, Myeloid Neoplasms Group, Josep Carreras Leukemia Research Institute (IJC), Badalona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Spain
| | - R Malinverni
- Cancer and Leukemia Epigenetics and Biology Program, Josep Carreras Leukemia Research Institute (IJC), Campus ICO-GTP-UAB, Badalona, Spain
| | - J Bargay
- Hematology Service, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - B Xicoy
- Hematology Laboratory Service, ICO Badalona-Hospital Germans Trias I Pujol, Myeloid Neoplasms Group, Josep Carreras Leukemia Research Institute (IJC), Badalona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Spain
| | - S Marcé
- Hematology Laboratory Service, ICO Badalona-Hospital Germans Trias I Pujol, Myeloid Neoplasms Group, Josep Carreras Leukemia Research Institute (IJC), Badalona, Spain
| | - A Garrido
- Hematology Service, Hospital de Sant Pau, Barcelona, Spain
| | - M Tormo
- Hematology Service, Hospital Clínico de Valencia, Valencia, Spain
| | - L Arenillas
- Hematology Service, Hospital del Mar, Barcelona, Spain
| | - R Coll
- Hematology Service, ICO Girona - Hospital Josep Trueta, Girona, Spain
| | - J Borras
- Hematology Service, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - M J Jiménez
- Hematology Laboratory Service, ICO Badalona-Hospital Germans Trias I Pujol, Myeloid Neoplasms Group, Josep Carreras Leukemia Research Institute (IJC), Badalona, Spain
| | - M Hoyos
- Hematology Service, Hospital de Sant Pau, Barcelona, Spain
| | - D Valcárcel
- Hematology Service, Hospital Vall D'Hebron, Barcelona, Spain
| | - L Escoda
- Hematology Service, Hospital Joan XXIII, Tarragona, Spain
| | - F Vall-Llovera
- Hematology Service, Hospital Mútua de Terrassa, Terrassa, Spain
| | - A Garcia
- Hematology Service, Hospital Arnau de Vilanova, Lleida, Spain
| | - L L Font
- Hematology Service, Hospital Verge de La Cinta, Tortosa, Spain
| | - E Rámila
- Hematology Service, Hospital Parc Taulí, Sabadell, Spain
| | - M Buschbeck
- Cancer and Leukemia Epigenetics and Biology Program, Josep Carreras Leukemia Research Institute (IJC), Campus ICO-GTP-UAB, Badalona, Spain.,Program for Predictive and Personalized Medicine of Cancer, Germans Trias I Pujol Research Institute (PMPPC-IGTP), Badalona, Spain
| | - L Zamora
- Hematology Laboratory Service, ICO Badalona-Hospital Germans Trias I Pujol, Myeloid Neoplasms Group, Josep Carreras Leukemia Research Institute (IJC), Badalona, Spain.
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Cabezón M, Bargay J, Xicoy B, García O, Borrás J, Tormo M, Marcé S, Pedro C, Valcárcel D, Jiménez MJ, Guàrdia R, Palomo L, Brunet S, Vall-Llovera F, Garcia A, Feliu E, Zamora L. Impact of mutational studies on the diagnosis and the outcome of high-risk myelodysplastic syndromes and secondary acute myeloid leukemia patients treated with 5-azacytidine. Oncotarget 2018; 9:19342-19355. [PMID: 29721207 PMCID: PMC5922401 DOI: 10.18632/oncotarget.25046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 12/06/2017] [Accepted: 03/05/2018] [Indexed: 12/22/2022] Open
Abstract
Myelodysplastic syndromes (MDS) are stem cell disorders caused by various gene abnormalities. We performed targeted deep sequencing in 39 patients with high-risk MDS and secondary acute myeloid leukemia (sAML) at diagnosis and follow-up (response and/or relapse), with the aim to define their mutational status, to establish if specific mutations are biomarkers of response to 5-azacytidine (AZA) and/or may have impact on survival. Overall, 95% of patients harbored at least one mutation. TP53, DNMT3A and SRSF2 were the most frequently altered genes. Mutations in TP53 correlated with higher risk features and shorter overall survival (OS) and progression free survival (PFS) in univariate analysis. Patients with SRSF2 mutations were associated with better OS and PFS. Response rate was 55%; but we could not correlate the presence of TET2 and TP53 mutations with AZA response. Patients with sAML presented more variations than patients with high-risk MDS, and usually at relapse the number of mutations increased, supporting the idea that in advanced stages of the disease there is a greater genomic complexity. These results confirm that mutation analysis can add prognostic value to high-risk MDS and sAML patients, not only at diagnosis but also at follow-up.
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Affiliation(s)
- Marta Cabezón
- Hematology Service, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain.,Departament de Medicina, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Joan Bargay
- Hematology Service, Hospital Son Llàtzer, Mallorca, Spain
| | - Blanca Xicoy
- Hematology Service, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Olga García
- Josep Carreras Leukemia Research Institute, Campus Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep Borrás
- Hematology Service, Hospital Son Llàtzer, Mallorca, Spain
| | - Mar Tormo
- Hematology Service, Hospital Clínic de Valencia, Valencia, Spain
| | - Sílvia Marcé
- Hematology Service, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Carme Pedro
- Hematology Service, Hospital del Mar, Barcelona, Spain
| | - David Valcárcel
- Hematology Service, Hospital Vall d'Hebron, Barcelona, Spain
| | - Maria-José Jiménez
- Hematology Service, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Ramón Guàrdia
- Hematology Service, ICO Girona-Hospital Josep Trueta, Girona, Spain
| | - Laura Palomo
- Josep Carreras Leukemia Research Institute, Campus Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Salut Brunet
- Hematology Service, Hospital de Sant Pau, Barcelona, Spain
| | | | - Antoni Garcia
- Hematology Service, Hospital Arnau de Vilanova, Lleida, Spain
| | - Evarist Feliu
- Hematology Service, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lurdes Zamora
- Hematology Service, ICO Badalona-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
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4
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Palomo L, Garcia O, Arnan M, Xicoy B, Fuster F, Cabezón M, Coll R, Ademà V, Grau J, Jiménez MJ, Pomares H, Marcé S, Mallo M, Millá F, Alonso E, Sureda A, Gallardo D, Feliu E, Ribera JM, Solé F, Zamora L. Targeted deep sequencing improves outcome stratification in chronic myelomonocytic leukemia with low risk cytogenetic features. Oncotarget 2018; 7:57021-57035. [PMID: 27486981 PMCID: PMC5302970 DOI: 10.18632/oncotarget.10937] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 05/20/2016] [Accepted: 07/01/2016] [Indexed: 11/25/2022] Open
Abstract
Clonal cytogenetic abnormalities are found in 20-30% of patients with chronic myelomonocytic leukemia (CMML), while gene mutations are present in >90% of cases. Patients with low risk cytogenetic features account for 80% of CMML cases and often fall into the low risk categories of CMML prognostic scoring systems, but the outcome differs considerably among them. We performed targeted deep sequencing of 83 myeloid-related genes in 56 CMML patients with low risk cytogenetic features or uninformative conventional cytogenetics (CC) at diagnosis, with the aim to identify the genetic characteristics of patients with a more aggressive disease. Targeted sequencing was also performed in a subset of these patients at time of acute myeloid leukemia (AML) transformation. Overall, 98% of patients harbored at least one mutation. Mutations in cell signaling genes were acquired at time of AML progression. Mutations in ASXL1, EZH2 and NRAS correlated with higher risk features and shorter overall survival (OS) and progression free survival (PFS). Patients with SRSF2 mutations associated with poorer OS, while absence of TET2 mutations (TET2wt) was predictive of shorter PFS. A decrease in OS and PFS was observed as the number of adverse risk gene mutations (ASXL1, EZH2, NRAS and SRSF2) increased. On multivariate analyses, CMML-specific scoring system (CPSS) and presence of adverse risk gene mutations remained significant for OS, while CPSS and TET2wt were predictive of PFS. These results confirm that mutation analysis can add prognostic value to patients with CMML and low risk cytogenetic features or uninformative CC.
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Affiliation(s)
- Laura Palomo
- MDS Research Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Olga Garcia
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Montse Arnan
- Hematology Service, ICO-Hospital Duran i Reynals, Barcelona, Spain
| | - Blanca Xicoy
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Francisco Fuster
- MDS Research Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Marta Cabezón
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Rosa Coll
- Hematology Service, ICO-Hospital Josep Trueta, Girona, Spain
| | - Vera Ademà
- MDS Research Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Javier Grau
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Maria-José Jiménez
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Helena Pomares
- Hematology Service, ICO-Hospital Duran i Reynals, Barcelona, Spain
| | - Sílvia Marcé
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Mar Mallo
- MDS Research Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Fuensanta Millá
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Esther Alonso
- Hematology Service, ICO-Hospital Duran i Reynals, Barcelona, Spain
| | - Anna Sureda
- Hematology Service, ICO-Hospital Duran i Reynals, Barcelona, Spain
| | - David Gallardo
- Hematology Service, ICO-Hospital Josep Trueta, Girona, Spain
| | - Evarist Feliu
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Josep-Maria Ribera
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Francesc Solé
- MDS Research Group, Josep Carreras Leukaemia Research Institute, ICO-Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - Lurdes Zamora
- Hematology Service, ICO-Hospital Germans Trias i Pujol, Josep Carreras Leukaemia Research Institute, Universitat Autònoma de Barcelona, Badalona, Spain
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Palomo L, Mallo M, Xicoy B, Ademà V, Garcia O, Marcé S, Grau J, Jiménez M, Alonso E, Pomares H, Arnan M, Arenillas L, Florensa L, Ayats J, Lemes A, Millá F, Feliu E, Solé F, Zamora L. P-069 Contribution of SNP-arrays and mutational studies to diagnosis and prognosis of CMML with low-risk cytogenetic features or no metaphases. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70118-8] [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: 11/30/2022]
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Molina-Arcas M, Marcé S, Villamor N, Huber-Ruano I, Casado FJ, Bellosillo B, Montserrat E, Gil J, Colomer D, Pastor-Anglada M. Equilibrative nucleoside transporter-2 (hENT2) protein expression correlates with ex vivo sensitivity to fludarabine in chronic lymphocytic leukemia (CLL) cells. Leukemia 2004; 19:64-8. [PMID: 15510196 DOI: 10.1038/sj.leu.2403582] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Fludarabine is considered the treatment of choice for most patients with chronic lymphocytic leukemia (CLL). We have analyzed the role of plasma membrane transporters in nucleoside-derived drug bioavailability and action in CLL cells. Among the known plasma membrane transporters, we have previously observed a significant correlation between fludarabine uptake via ENT carriers and ex vivo sensitivity of CLL cells to fludarabine, although mRNA amounts of the equilibrative nucleoside transporters hENT1 and hENT2 do not show any predictive response to treatment. In this study, using polyclonal monospecific antibodies we have observed a significant correlation between the expression of hENT2 by Western blot and fludarabine uptake via hENT carriers and also with ex vivo sensitivity of CLL cells to fludarabine. These results suggest that the equilibrative nucleoside transporter hENT2 plays a role in fludarabine responsiveness in CLL patients.
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Affiliation(s)
- M Molina-Arcas
- Departament de Bioquímica i Biologia Molecular, Universitat de Barcelona, E-08028 Barcelona, Spain
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7
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Bellosillo B, Villamor N, López-Guillermo A, Marcé S, Esteve J, Campo E, Colomer D, Montserrat E. Complement-mediated cell death induced by rituximab in B-cell lymphoproliferative disorders is mediated in vitro by a caspase-independent mechanism involving the generation of reactive oxygen species. Blood 2001; 98:2771-7. [PMID: 11675350 DOI: 10.1182/blood.v98.9.2771] [Citation(s) in RCA: 159] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mechanisms involving the in vitro effect of rituximab in cells from 55 patients with B-cell lymphoproliferative disorders were investigated. No cytotoxic effect was observed when cells were incubated with rituximab alone, but in the presence of human AB serum rituximab induced complement-dependent cell death (R-CDC). A cytotoxic effect was observed in cells from 9 of 33 patients with B-cell chronic lymphocytic leukemia, 16 of 16 patients with mantle-cell lymphoma, 4 of 4 patients with follicular lymphoma, and 2 of 2 patients with hairy-cell leukemia. R-CDC was observed in cells from patients expressing more than 50 x 10(3) CD20 molecules per cell, and directly correlated with the number of CD20 molecules per cell. Preincubation with anti-CD59 increased the cytotoxic effect of rituximab and sensitized cells from nonsensitive cases. Neither cleavage of poly-ADP ribose polymerase (PARP) nor activation of caspase-3 was observed in R-CDC. In addition, no cells with a hypodiploid DNA content were detected and R-CDC was not prevented by a broad-spectrum caspase inhibitor, suggesting a caspase-independent mechanism. Incubation with rituximab in the presence of AB serum induced a rapid and intense production of reactive oxygen species (ROS). R-CDC was blocked by the incubation of cells with N-acetyl-L-cysteine (NAC) or Tiron, 2 ROS scavengers, indicating that the cytotoxic effect was due to the generation of superoxide (O) radicals. In conclusion, the results of the present study suggest that CD20, CD59, and complement have a role in the in vitro cytotoxic effect of rituximab, which is mediated by a caspase-independent process that involves ROS generation.
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Affiliation(s)
- B Bellosillo
- Hematopathology Unit, Department of Hematology, Institute of Hematology and Oncology, Postgraduate School of Hematology Farreras-Valentí, Barcelona, Spain
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Schaeverbeke T, Fatout E, Marcé S, Vernhes JP, Hallé O, Antoine JF, Lequen L, Bannwarth B, Dehais J. Remitting seronegative symmetrical synovitis with pitting oedema: disease or syndrome? Ann Rheum Dis 1995; 54:681-4. [PMID: 7677447 PMCID: PMC1009968 DOI: 10.1136/ard.54.8.681] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate the outcome of patients with remitting seronegative symmetrical synovitis with pitting oedema (RS3PE). METHODS In a retrospective chart review study, we identified all the patients presenting with polyarthritis and pitting oedema in the past 20 years. We tried to recall the 24 patients with characteristics of RS3PE according to McCarty et al. Two patients had died and four could not be traced. Five could not be seen after the initial period of follow up; relevant data were obtained from their practitioner. For the remaining 13 patients, clinical, radiological, and biological evaluation was performed in our department, with the last assessment in 1993. RESULTS The follow up period was from one to 18 years (mean 4.6 (SD 4.5) years). Eleven patients developed one or several recurrences of articular manifestations consisting of mild oligoarthritis (n = 8), definite spondyloarthropathy (n = 2), and rheumatoid arthritis (n = 1). The delay of the first recurrence was 18 months to 12 years after the first attack. Thirteen patients had no recurrence, but three of them developed remarkable features: rheumatoid factor, antinuclear antibodies (1/2000), Sjögren's syndrome. HLA B typing was performed in nine patients and revealed B7 (n = 2), B27 (n = 2) and B22 (n = 2). Isolated HLA B27 typing was performed in two other patients and was positive in one. CONCLUSION The long term outcome of RS3PE can lead to different rheumatic diseases. RS3PE appears to be a syndrome related to the elderly onset of the rheumatic diseases, including spondyloarthropathy and rheumatoid arthritis, rather than a specific entity.
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Affiliation(s)
- T Schaeverbeke
- Department of Rheumatology, University Hospital of Bordeaux, University of Bordeaux II, France
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Marcé S, Bannwarth B, Schaeverbeke T, Dehais J. [Neutropenia after the first administration of methotrexate in rheumatoid arthritis]. Rev Rhum Ed Fr 1993; 60:843-4. [PMID: 8054935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Marcé S, Bannwarth B, Schaeverbeke T, Dehais J. Is low dose methotrexate nephrotoxic? J Rheumatol 1993; 20:1806-7. [PMID: 8295203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Marcé S, Schaeverbeke T, Vital JM, Morrier P, Jacq F, Sénégas J, Dehais J. [Sciatica caused by an intraspinal synovial cyst with erosion of the posterior arch]. Rev Rhum Ed Fr 1993; 60:176-7. [PMID: 8136813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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