1
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d'Amore F, Leppä S, Relander T, Larsen TS, Brown P, Jørgensen J, Mannisto S, Lugtenburg P, Leivonen S, Holte H, Fagerli UM, Lauritzsen GF, Meyer P, Minotti G, Menna P, Liestøl K, Toldbod H. FINAL ANALYSIS OF A NORDIC LYMPHOMA GROUP PHASE IB/IIA TRIAL OF PIXANTRONE, ETOPOSIDE, BENDAMUSTINE AND, IN CD20‐POSITIVE TUMORS, RITUXIMAB IN RELAPSED AGGRESSIVE B‐ OR T‐CELL LYMPHOMAS. Hematol Oncol 2021. [DOI: 10.1002/hon.151_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- F d'Amore
- Aarhus University Hospital, Hematology Aarhus N Denmark
| | - S Leppä
- Helsinki University Hospital Oncology Helsinki Finland
| | - T Relander
- Skane University Hospital Oncology Lund Sweden
| | - T. S Larsen
- Odense University Hospital Hematology Odense Denmark
| | - P Brown
- Copenhagen University Hospital Hematology Copenhagen Denmark
| | - J Jørgensen
- Aarhus University Hospital, Hematology Aarhus N Denmark
| | - S Mannisto
- Helsinki University Hospital Oncology Helsinki Finland
| | - P Lugtenburg
- University Medical Center, Erasmus MC Cancer Institute Rotterdam Netherlands
| | - S.‐K Leivonen
- Helsinki University Hospital Oncology Helsinki Finland
| | - H Holte
- Oslo University Hospital Oncology Oslo Norway
| | | | | | - P Meyer
- Stavanger University Hospital Oncology Stavanger Norway
| | - G Minotti
- University Hospital Campus Bio‐Medico Clinical Pharmaclogy Laboratory Rome Italy
| | - P Menna
- University Hospital Campus Bio‐Medico Clinical Pharmaclogy Laboratory Rome Italy
| | - K Liestøl
- University of Oslo Informatics Oslo Norway
| | - H Toldbod
- Aarhus University Hospital, Hematology Aarhus N Denmark
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2
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Leppä S, Jørgensen J, Karjalainen‐Lindsberg M, Beiske K, Nørgaard P, Drott K, Pasanen A, Karihtala K, Mannisto S, Wold B, Brodtkorb M, Fagerli U, Larsen TS, Munksgaard L, Fluge Ø, Jyrkkiö S, Brown PDN, Holte H. BIOMARKER‐DRIVEN TREATMENT STRATEGY IN HIGH RISK DIFFUSE LARGE B‐CELL LYMPHOMA: RESULTS OF A NORDIC PHASE 2 STUDY. Hematol Oncol 2021. [DOI: 10.1002/hon.27_2879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S Leppä
- University of Helsinki and Helsinki University Hospital Comprehensive Cancer Centre Department of Oncology Helsinki Finland
| | - J Jørgensen
- Aarhus University Hospital Department of Hematology Aarhus Denmark
| | | | - K Beiske
- Oslo University Hospital Department of Pathology Oslo Norway
| | - P Nørgaard
- Herlev and Gentofte Hospital Department of Pathology Herlev Denmark
| | - K Drott
- Skåne University Hospital Department of Oncology Lund Sweden
| | - A Pasanen
- University of Helsinki and Helsinki University Hospital Comprehensive Cancer Centre Department of Oncology Helsinki Finland
| | - K Karihtala
- University of Helsinki and Helsinki University Hospital Comprehensive Cancer Centre Department of Oncology Helsinki Finland
| | - S Mannisto
- University of Helsinki and Helsinki University Hospital Comprehensive Cancer Centre Department of Oncology Helsinki Finland
| | - B Wold
- Oslo University Hospital Department of Oncology Oslo Norway
| | - M Brodtkorb
- Oslo University Hospital Department of Oncology Oslo Norway
| | - Unn‐M Fagerli
- St. Olav's Hospital Department of Oncology Trondheim Norway
| | - T. S Larsen
- Odense University Hospital Department of Hematology Odense Denmark
| | - L Munksgaard
- Roskilde Hospital Department of Hematology Roskilde Denmark
| | - Ø Fluge
- Haukeland University Hospital Department of Oncology Bergen Norway
| | - S Jyrkkiö
- Turku University Hospital Department of Oncology Turku Finland
| | - P. d. N Brown
- Rigshospitalet Department of Hematology Copenhagen Denmark
| | - H Holte
- Oslo University Hospital Department of Oncology Oslo Norway
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3
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Laukka M, Mannisto S, Beule A, Kouri M, Blomqvist C. Comparison between CT and MRI in detection of metastasis of the retroperitoneum in testicular germ cell tumors: a prospective trial. Acta Oncol 2020; 59:660-665. [PMID: 32048533 DOI: 10.1080/0284186x.2020.1725243] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Introduction: To minimize the radiation exposure of mostly young testicular cancer patients, it is essential to find out whether CT could be replaced by magnetic resonance imaging (MRI) in the staging and follow-up of the patients. In this trial, we examined whether abdominal MRI is as effective as computed tomography (CT) in the detection of retroperitoneal metastases of testicular cancer.Material and methods: This prospective study included 50 patients, 46 cases of retroperitoneal metastases and 4 controls without abdominal metastases (mean age 33, 5 years, range 20-65 years). Imaging of the retroperitoneum was performed using CT and 1.5 T MRI with diffusion weighted imaging (DWI). One experienced radiologist re-analyzed all of the examinations without knowledge of clinical information. All metastatic or suspicious lymph nodes were noted and measured two-dimensionally from axial images. Nodal detection and the size of detected nodes on CT and MRI were compared.Results: There was no significant difference in the detection of retroperitoneal metastasis between CT and MRI. The sensitivity of MRI was 0.98. There was no statistically significant difference in the sizes of lymph nodes found in CT and MRI, and even very small lymph nodes could be detected in MRI as well as in CT.Conclusion: MRI with DWI is as good as CT in detection of retroperitoneal lymph node metastases regardless of lymph node size, and it can be used as part of follow-up of testicular cancer patients instead of ionizing radiation producing imaging methods.
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Affiliation(s)
- Marjut Laukka
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | | | - Annette Beule
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | - Mauri Kouri
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
| | - Carl Blomqvist
- Comprehensive Cancer Center, Helsinki University Hospital (HUH) and University of Helsinki, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
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4
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Jousilahti P, Laatikainen T, Harkanen T, Borodulin K, Harald K, Koskinen S, Mannisto S, Peltonen M, Sundvall J, Valsta L, Vartiainen E. P6222Changes in main CVD risk factors in Finland 1992–2017. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Systematic monitoring of cardiovascular disease (CVD) risk factors started in eastern Finland already in the 1970s as part of the North Karelia Project. Later on risk factor monitoring was extended to other parts of the country.
Purpose
In this study we report the trends of main CVD risk factors in Finland from 1992 to 2017.
Methods
Study population consists of a population-based random sample of 31 402 men and women aged 25–64 years who participated in the FINRISK Studies from 1992 to 2012, and in the FinHealth Study in 2017. Data collection was done every five years. Participation rate decreased from 76% in 1992 to 56% in 2017. Study protocol included self-reported questionnaire data on smoking and other health behavior, measurements of height, weight and blood pressure, and venous blood sample for laboratory analysis. Blood pressure was measured two times, and the average of the measurements was calculated, total serum cholesterol was analyzed using enzymatic method, and LDL cholesterol was calculated using Friedewald formula.
Results
Smoking prevalence, mean blood pressure and total and LDL cholesterol levels declined markedly during the 25 year follow up but BMI, waist circumference and prevalence of obesity increased (table).
CVD risk factor change from 1992 to 2017 Risk factor Men 1992 Men 2017 p value Women 1992 Women 2017 p value Smoking (%) 36.7 20.6 <0.001 25.9 16.5 <0.001 SBP (mmHg) 136.6 131.2 <0.001 130.3 124.5 <0.001 DBP (mmHg) 82.7 81.6 <0.001 78.6 77.8 <0.001 Chol (mmol/L) 5.66 5.17 <0.001 5.42 5.18 <0.001 LDL chol (mmol/L) 3.54 3.16 <0.001 3.26 3.03 <0.001 BMI (kg/m2) 26.2 27.2 <0.001 25.1 26.4 <0.001 WC (cm) 92.8 96.1 <0.001 79.2 86.2 <0.001 Obesity (%) 15.7 23.2 <0.001 14.8 22.7 <0.001
Conclusions
The levels of main traditional CVD risk factors have markedly decreased among the Finnish population during the last 25 years but in the same time, obesity has become a major public health challenge.
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Affiliation(s)
- P Jousilahti
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - T Laatikainen
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - T Harkanen
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - K Borodulin
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - K Harald
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - S Koskinen
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - S Mannisto
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - M Peltonen
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - J Sundvall
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - L Valsta
- National Institute for Health and Welfare-THL, Helsinki, Finland
| | - E Vartiainen
- National Institute for Health and Welfare-THL, Helsinki, Finland
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5
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Leppä S, Jørgensen J, Tierens A, Meriranta L, Østlie I, Brown P, Fagerli U, Larsen T, Mannisto S, Munksgaard L, Maisenhølder M, Vasala K, Meyer P, Jerkeman M, Björkholm M, Fluge Ø, Jyrkkiö S, Ralfkiaer E, Spetalen S, Karjalainen-Lindsberg M, Holte H. YOUNG HIGH RISK PATIENTS WITH DIFFUSE LARGE B-CELL LYMPHOMA INCLUDING BCL-2/MYC
DOUBLE HIT LYMPHOMAS BENEFIT FROM DOSE-DENSE IMMUNOCHEMOTHERAPY WITH EARLY CNS PROPHYLAXIS. Hematol Oncol 2019. [DOI: 10.1002/hon.92_2629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- S. Leppä
- Department of Oncology; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - J. Jørgensen
- Department of Hematology; Aarhus University Hospital; Aarhus Denmark
| | - A. Tierens
- Department of Pathology; University Health Network; Toronto Canada
| | - L. Meriranta
- Department of Oncology; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - I. Østlie
- Department of Pathology; Oslo University Hospital; Oslo Norway
| | - P. Brown
- Department of Hematology; Rigshospitalet; Copengahen Denmark
| | - U. Fagerli
- Department of Oncology; St. Olavs Hospital; Trondheim Norway
| | - T.S. Larsen
- Department of Hematology; Odense University Hospital; Odense Denmark
| | - S. Mannisto
- Department of Oncology; Helsinki University Hospital Comprehensive Cancer Centre; Helsinki Finland
| | - L. Munksgaard
- Department of Hematology; Roskilde Hospital; Roskilde Denmark
| | - M. Maisenhølder
- Department of Oncology; University Hospital of North Norway; Tromsø Norway
| | - K. Vasala
- Department of Oncology; Central Finland Central Hospital; Jyväskylä Finland
| | - P. Meyer
- Department of Oncology; Stavanger University Hospital; Stavanger Norway
| | - M. Jerkeman
- Department of Oncology; Skåne University Hospital; Lund Sweden
| | - M. Björkholm
- Department of Hematology; Karolinska University Hospital; Stockholm Sweden
| | - Ø. Fluge
- Department of Oncology; Haukeland University Hospital; Bergen Norway
| | - S. Jyrkkiö
- Department of Oncology; Turku University Hospital; Turku Finland
| | - E. Ralfkiaer
- Department of Pathology; Rigshospitalet; Copenhagen Denmark
| | - S. Spetalen
- Department of Pathology; Oslo University Hospital; Oslo Norway
| | | | - H. Holte
- Department of Oncology; Oslo University Hospital; Oslo Norway
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6
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Mannisto S, Vähämurto P, Pollari M, Clausen MR, Jyrkkiö S, Kellokumpu-Lehtinen PL, Kovanen P, Karjalainen-Lindsberg ML, d'Amore F, Leppä S. Intravenous but not intrathecal central nervous system-directed chemotherapy improves survival in patients with testicular diffuse large B-cell lymphoma. Eur J Cancer 2019; 115:27-36. [PMID: 31082690 DOI: 10.1016/j.ejca.2019.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/23/2019] [Accepted: 04/02/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Testicular lymphoma is a rare malignancy affecting mainly elderly men, the majority representing diffuse large B-cell lymphoma (DLBCL). Its relapse rate is higher than that of nodal DLBCL, often affecting the central nervous system (CNS) with dismal prognosis. PATIENTS AND METHODS We searched for patients with testicular DLBCL (T-DLBCL) involvement from the pathology databases of Southern Finland University Hospitals and the Danish Lymphoma Registry. Clinical information was collected, and outcomes between treatment modalities were evaluated. Progression-free survival (PFS), disease-specific survival (DSS) and overall survival (OS) were assessed using Kaplan-Meier and Cox proportional hazards methods. RESULTS We identified 235 patients; of whom, 192 were treated with curative anthracycline-based chemotherapy. Full survival data were available for 189 patients. In univariate analysis, intravenous CNS-directed chemotherapy, and irradiation or orchiectomy of the contralateral testis translated into favourable PFS, DSS and OS, particularly among the elderly patients (each p ≤ 0.023). Intrathecal chemotherapy had no impact outcome. In multivariate analyses, the advantage of intravenous CNS-directed chemotherapy (hazard ration [HR] for OS, 0.419; 95% confidence interval [CI], 0.256-0.686; p = 0.001) and prophylactic treatment of contralateral testis (HR for OS, 0.514; 95% CI, 0.338-0.782; p = 0.002) was maintained. Rituximab improved survival only among high-risk patients (International Prognostic Index≥3, p = 0.019). The cumulative risk of CNS progression was 8.4% and did not differ between treatment modalities. CONCLUSION The results support the use of CNS-directed chemotherapy and prophylactic treatment of the contralateral testis in patients with T-DLBCL involvement. Survival benefit appears resulting from better control of systemic disease rather than prevention of CNS progression.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Central Nervous System Neoplasms/mortality
- Central Nervous System Neoplasms/prevention & control
- Central Nervous System Neoplasms/secondary
- Databases, Factual
- Denmark
- Disease Progression
- Finland
- Humans
- Infusions, Intravenous
- Infusions, Spinal
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/mortality
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Large B-Cell, Diffuse/radiotherapy
- Male
- Middle Aged
- Orchiectomy
- Progression-Free Survival
- Registries
- Risk Assessment
- Risk Factors
- Testicular Neoplasms/drug therapy
- Testicular Neoplasms/mortality
- Testicular Neoplasms/pathology
- Testicular Neoplasms/radiotherapy
- Time Factors
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Affiliation(s)
- S Mannisto
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland
| | - P Vähämurto
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - M Pollari
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Oncology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - M R Clausen
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - S Jyrkkiö
- Department of Oncology and Radiotherapy, Turku University Central Hospital, Turku, Finland
| | - P-L Kellokumpu-Lehtinen
- Department of Oncology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - P Kovanen
- Department of Pathology, Helsinki University Hospital, Helsinki, Finland
| | | | - F d'Amore
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - S Leppä
- Research Program Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
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7
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Vähämurto P, Mannisto S, Pollari M, Karjalainen-Lindsberg ML, Mäkitie AA, Leppä S. Clinical features and outcome of the patients with sinonasal tract diffuse large B-cell lymphoma in the pre-rituximab and rituximab eras. Eur J Haematol 2019; 102:457-464. [PMID: 30834564 DOI: 10.1111/ejh.13225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/10/2019] [Accepted: 02/11/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Sinonasal tract diffuse large B-cell lymphoma (SNT-DLBCL), a rare extranodal lymphoma, is not well characterized. We performed a population-based study to determine cell-of-origin, clinical presentation and impact of rituximab (R) and central nervous system (CNS) directed chemotherapy on survival. PATIENTS AND METHODS Patients with SNT-DLBCL were identified from pathology databases. Clinical information was collected and outcomes between different treatment modalities evaluated. RESULTS Thirty-two percent of the patients had germinal centre B-cell phenotype. Forty-six patients were treated with curative intent using CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or CHOP-like chemotherapy, 21 (46%) before and 25 (54%) in the R-era. Additionally, 24 (52%) received CNS-directed chemotherapy. Addition of R to chemotherapy reduced the risk of progression (RR = 0.368, 95% CI 0.138-0.976, P = 0.045) and death (RR = 0.245, 95% CI 0.068-0.883, P = 0.032), and translated into better survival (5-year PFS, 67% vs 38%, P = 0.037; 5-year OS, 81% vs 48%, P = 0.020). CNS-directed chemotherapy reduced the risk of progression (RR = 0.404, 95% CI 0.159-1.029, P = 0.057) and death (RR = 0.298, 95% CI 0.093-0.950, P = 0.041), and translated into favorable survival (5-year PFS, 67% vs 32%, P = 0.050; 5-year OS 82% vs 43%, P = 0.030). CONCLUSION Patients with SNT-DLBCL benefit from rituximab and CNS-directed chemotherapy.
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Affiliation(s)
- Pauli Vähämurto
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and Research Program in Applied Tumor Genomics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Otorhinolaryngology - Head and Neck Surgery and Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Susanna Mannisto
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and Research Program in Applied Tumor Genomics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjukka Pollari
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and Research Program in Applied Tumor Genomics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Oncology, University of Tampere and Tampere University Hospital, Tampere, Finland
| | | | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery and Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden
| | - Sirpa Leppä
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Center and Research Program in Applied Tumor Genomics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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8
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Leivonen SK, Pollari M, Brück O, Pellinen T, Autio M, Karjalainen-Lindsberg ML, Mannisto S, Kellokumpu-Lehtinen PL, Kallioniemi O, Mustjoki S, Leppä S. T-cell inflamed tumor microenvironment predicts favorable prognosis in primary testicular lymphoma. Haematologica 2018; 104:338-346. [PMID: 30237271 PMCID: PMC6355505 DOI: 10.3324/haematol.2018.200105] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 09/19/2018] [Indexed: 12/18/2022] Open
Abstract
Primary testicular lymphoma is a rare lymphoid malignancy, most often, histologically, representing diffuse large B-cell lymphoma. The tumor microenvironment and limited immune surveillance have a major impact on diffuse large B-cell lymphoma pathogenesis and survival, but the impact on primary testicular lymphoma is unknown. Here, the purpose of the study was to characterize the tumor microenvironment in primary testicular lymphoma, and associate the findings with outcome. We profiled the expression of 730 immune response genes in 60 primary testicular lymphomas utilizing the Nanostring platform, and used multiplex immunohistochemistry to characterize the immune cell phenotypes in the tumor tissue. We identified a gene signature enriched for T-lymphocyte markers differentially expressed between the patients. Low expression of the signature predicted poor outcome independently of the International Prognostic Index (progression-free survival: HR=2.810, 95%CI: 1.228-6.431, P=0.014; overall survival: HR=3.267, 95%CI: 1.406-7.590, P=0.006). The T-lymphocyte signature was associated with outcome also in an independent diffuse large B-cell lymphoma cohort (n=96). Multiplex immunohistochemistry revealed that poor survival of primary testicular lymphoma patients correlated with low percentage of CD3+CD4+ and CD3+CD8+ tumor-infiltrating lymphocytes (P<0.001). Importantly, patients with a high T-cell inflamed tumor microenvironment had a better response to rituximab-based immunochemotherapy, as compared to other patients. Furthermore, loss of membrane-associated human-leukocyte antigen complexes was frequent and correlated with low T-cell infiltration. Our results demonstrate that a T-cell inflamed tumor microenvironment associates with favorable survival in primary testicular lymphoma. This further highlights the importance of immune escape as a mechanism of treatment failure.
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Affiliation(s)
- Suvi-Katri Leivonen
- Research Program Unit, Medical Faculty, University of Helsinki, Finland.,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | - Marjukka Pollari
- Research Program Unit, Medical Faculty, University of Helsinki, Finland.,Department of Oncology, Tampere University Hospital, Finland
| | - Oscar Brück
- Hematology Research Unit Helsinki, Department of Clinical Chemistry and Hematology, University of Helsinki, Finland
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Matias Autio
- Research Program Unit, Medical Faculty, University of Helsinki, Finland.,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | | | - Susanna Mannisto
- Research Program Unit, Medical Faculty, University of Helsinki, Finland.,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Department of Oncology, Tampere University Hospital, Finland.,University of Tampere, Faculty of Medicine and Life Sciences, Finland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland.,Science for Life Laboratory, Karolinska Institutet, Department of Oncology and Pathology, Solna, Sweden
| | - Satu Mustjoki
- Hematology Research Unit Helsinki, Department of Clinical Chemistry and Hematology, University of Helsinki, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | - Sirpa Leppä
- Research Program Unit, Medical Faculty, University of Helsinki, Finland .,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
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9
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Pollari M, Brück O, Pellinen T, Vähämurto P, Karjalainen-Lindsberg ML, Mannisto S, Kallioniemi O, Kellokumpu-Lehtinen PL, Mustjoki S, Leivonen SK, Leppä S. PD-L1 + tumor-associated macrophages and PD-1 + tumor-infiltrating lymphocytes predict survival in primary testicular lymphoma. Haematologica 2018; 103:1908-1914. [PMID: 30026337 PMCID: PMC6278972 DOI: 10.3324/haematol.2018.197194] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 07/16/2018] [Indexed: 12/18/2022] Open
Abstract
Primary testicular lymphoma is a rare and aggressive lymphoid malignancy, most often representing diffuse large B-cell lymphoma histologically. Tumor-associated macrophages and tumor-infiltrating lymphocytes have been associated with survival in diffuse large B-cell lymphoma, but their prognostic impact in primary testicular lymphoma is unknown. Here, we aimed to identify macrophages, their immunophenotypes and association with lymphocytes, and translate the findings into survival of patients with primary testicular lymphoma. We collected clinical data and tumor tissue from 74 primary testicular lymphoma patients, and used multiplex immunohistochemistry and digital image analysis to examine macrophage markers (CD68, CD163, and c-Maf), T-cell markers (CD3, CD4, and CD8), B-cell marker (CD20), and three checkpoint molecules (PD-L1, PD-L2, and PD-1). We demonstrate that a large proportion of macrophages (median 41%, range 0.08–99%) and lymphoma cells (median 34%, range 0.1–100%) express PD-L1. The quantity of PD-L1+ CD68+ macrophages correlates positively with the amount of PD-1+ lymphocytes, and a high proportion of either PD-L1+ CD68+ macrophages or PD-1+ CD4+ and PD-1+ CD8+ T cells translates into favorable survival. In contrast, the number of PD-L1+lymphoma cells or PD-L1− macrophages do not associate with outcome. In multivariate analyses with IPI, PD-L1+ CD68+ macrophage and PD-1+ lymphocyte contents remain as independent prognostic factors for survival. In conclusion, high PD-L1+ CD68+ macrophage and PD-1+ lymphocyte contents predict favorable survival in patients with primary testicular lymphoma. The findings implicate that the tumor microenvironment and PD-1 – PD-L1 pathway have a significant role in regulating treatment outcome. They also bring new insights to the targeted thera py of primary testicular lymphoma.
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Affiliation(s)
- Marjukka Pollari
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Oncology, Tampere University Hospital, Finland
| | - Oscar Brück
- Hematology Research Unit Helsinki, Department of Clinical Chemistry and Hematology, University of Helsinki, Finland
| | - Teijo Pellinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
| | - Pauli Vähämurto
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | | | - Susanna Mannisto
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland.,Science for Life Laboratory, Karolinska Institutet, Department of Oncology and Pathology, Solna, Sweden
| | - Pirkko-Liisa Kellokumpu-Lehtinen
- Department of Oncology, Tampere University Hospital, Finland.,Faculty of Medicine and Life Sciences, University of Tampere, Finland
| | - Satu Mustjoki
- Hematology Research Unit Helsinki, Department of Clinical Chemistry and Hematology, University of Helsinki, Finland.,Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | - Suvi-Katri Leivonen
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland.,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
| | - Sirpa Leppä
- Research Program Unit, Faculty of Medicine, University of Helsinki, Finland .,Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
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10
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Vento SI, Vähämurto P, Silventoinen K, Karjalainen-Lindsberg ML, Mannisto S, Leppä S, Mäkitie AA. Clinical findings in 25 patients with sinonasal or nasopharyngeal extramedullary plasmacytoma in a four-decade single-centre series. Acta Otolaryngol 2017; 137:975-980. [PMID: 28537101 DOI: 10.1080/00016489.2017.1325514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/19/2022]
Abstract
OBJECTIVES Extramedullary plasmacytoma in the sinonasal tract or nasopharynx is rare. The aim of the study was to review data on symptoms, clinical findings, treatment and follow-up of plasmacytomas in the sinonasal and nasopharyngeal regions in order to delineate the main clinical characteristics and the optimal management. METHOD Twenty-five patients with sinonasal or nasopharyngeal plasmacytoma, diagnosed and treated at the Helsinki University Hospital during a 39-year period from 1975 to 2013 were retrospectively reviewed. RESULTS There were 18 males and 7 females with a median age of 66 years (range, 36-80). Sixty-eight percent received only radiotherapy or (chemo)radiotherapy. Forty-seven percent of them had a complete response to primary radiotherapy and one patient had a complete response after receiving additional brachytherapy. Four patients were treated primarily with surgery only. Two of them had a local recurrence, but were then successfully treated with radiotherapy. Altogether, four patients received a combination of surgery and (chemo)radiotherapy. Forty-four percent were alive with no evidence of disease after a median follow-up time of 78 months. Forty percent died of their disease and 16% died of other causes. CONCLUSIONS Our study supports radiotherapy as a treatment of choice, but for small tumours surgery alone or in combination with radiotherapy may also be considered.
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Affiliation(s)
- Seija Inkeri Vento
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Pauli Vähämurto
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Oncology and Research Program Unit, Medical Faculty, University of Helsinki and Helsinki University Hospital Cancer Center, Helsinki, Finland
| | - Kaija Silventoinen
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Susanna Mannisto
- Department of Oncology and Research Program Unit, Medical Faculty, University of Helsinki and Helsinki University Hospital Cancer Center, Helsinki, Finland
| | - Sirpa Leppä
- Department of Oncology and Research Program Unit, Medical Faculty, University of Helsinki and Helsinki University Hospital Cancer Center, Helsinki, Finland
| | - Antti Aarni Mäkitie
- Department of Otorhinolaryngology – Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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11
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Jousilahti P, Harald K, Jula A, Laatikainen T, Mannisto S, Peltonen M, Perola M, Puska P, Salomaa V, Tuomilehto J, Valsta L, Vartiainen E. 1192Salt intake and the risk of heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.1192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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d'Amore F, Leppä S, Larsen T, Brown P, Relander T, Mannisto S, Jørgensen J, Holte H, Lauritzsen G, Enblad G, Toldbod H. A PHASE 1/2 STUDY OF PIXANTRONE, ETOPOSIDE, BENDAMUSTINE AND, IN CD20+ TUMORS, RITUXIMAB IN PATIENTS WITH RELAPSED AGGRESSIVE B- OR T-CELL LYMPHOMAS-THE P[R]EBEN STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2440_7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- F. d'Amore
- Hematology; Aarhus University Hospital; Aarhus C Denmark
| | - S. Leppä
- Oncology; Helsinki University Hospital; Helsinki Finland
| | - T.S. Larsen
- Hematology; Odense University Hospital; Odense Denmark
| | - P. Brown
- Hematology; Copenhagen University Hospital; Copenhagen Denmark
| | - T. Relander
- Oncology; Skåne University Hospital; Lund Sweden
| | - S. Mannisto
- Oncology; Helsinki University Hospital; Helsinki Finland
| | - J.M. Jørgensen
- Hematology; Aarhus University Hospital; Aarhus C Denmark
| | - H. Holte
- Oncology; Oslo University Hospital; Oslo Norway
| | | | - G. Enblad
- Oncology; Uppsala Academic Hospital; Uppsala Sweden
| | - H. Toldbod
- Hematology; Aarhus University Hospital; Aarhus C Denmark
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13
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Leppä S, Joergensen J, de Nully Brown P, Fagerli U, Larsen T, Janes R, Mannisto S, Munksgaard L, Maisenhölder M, Vasala K, Meyer P, Jerkeman M, Björkholm M, Fluge Ø, Jyrkkiö S, Pedersen L, Eriksson M, Holte H. DOSE-DENSE CHEMOIMMUNOTHERAPY AND CNS PROPHYLAXIS IN PATIENTS WITH HIGH-RISK DLBCL: A COMPARISON OF NORDIC CRY-04 AND CHIC STUDIES. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Leppä
- Department of Oncology; Helsinki University Hospital Cancer Center; Helsinki Finland
| | - J. Joergensen
- Department of Haematology; Aarhus University Hospital; Aarhus Denmark
| | | | - U. Fagerli
- Department of Oncology; St. Olavs Hospital HF; Trondheim Norway
| | - T.S. Larsen
- Department of Haematology; Odense University Hospital; Odense Denmark
| | - R. Janes
- Department of Oncology; Helsinki University Hospital Cancer Center; Helsinki Finland
| | - S. Mannisto
- Department of Oncology; Helsinki University Hospital Cancer Center; Helsinki Finland
| | - L. Munksgaard
- Department of Haematology; Roskilde Hospital; Roskilde Denmark
| | - M. Maisenhölder
- Department of Oncology; University Hospital of North Norway; Tromsö Norway
| | - K. Vasala
- Department of Oncology, Central Finland Central Hospital; Jyväskylä Finland
| | - P. Meyer
- Department of Hematology and Oncology; Stavanger University Hospital; Stavanger Norway
| | - M. Jerkeman
- Department of Oncology; Skane University Hospital; Lund Sweden
| | - M. Björkholm
- Department of Medicine; Karolinska University Hospital; Stockholm Sweden
| | - Ø. Fluge
- Department of Oncology; Haukeland University Hospital; Bergen Norway
| | - S. Jyrkkiö
- Department of Oncology; Turku University Hospital; Turku Finland
| | - L.M. Pedersen
- Department of Haematology; Herlev Hospital; Herlev Denmark
| | - M. Eriksson
- Department of Oncology; Skane University Hospital; Lund Sweden
| | - H. Holte
- Department of Oncology; Oslo University Hospital; Oslo Norway
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14
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Mannisto S, Vähämurto P, Clausen M, Marjukka P, Jyrkkiö S, Karjalainen-Lindsberg M, Kellokumpu-Lehtinen P, d'Amore F, Leppä S. CNS TARGETING CHEMOTHERAPY IS ASSOCIATED WITH SUPERIOR SURVIVAL IN PATIENTS WITH TESTICULAR LYMPHOMA - RESULTS FROM FINNISH-DANISH RETROSPECTIVE STUDY. Hematol Oncol 2017. [DOI: 10.1002/hon.2439_139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S. Mannisto
- Department of Oncology; Helsinki University Hospital Cancer Center; Helsinki Finland
| | - P. Vähämurto
- Department of Oncology; Helsinki University Hospital Cancer Center; Helsinki Finland
| | - M.R. Clausen
- Department of Hematology; Aarhus University Hospital; Aarhus Denmark
| | - P. Marjukka
- Department of Oncology; Tampere University Hospital; Tampere Finland
| | - S. Jyrkkiö
- Department of Oncology and Radiotherapy; Turku University Hospital; Turku Finland
| | | | | | - F. d'Amore
- Department of Hematology; Aarhus University Hospital; Aarhus Denmark
| | - S. Leppä
- Department of Oncology; Helsinki University Hospital Cancer Center; Helsinki Finland
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15
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Moffitt AB, Ondrejka SL, McKinney M, Rempel RE, Goodlad JR, Teh CH, Leppa S, Mannisto S, Kovanen PE, Tse E, Au-Yeung RKH, Kwong YL, Srivastava G, Iqbal J, Yu J, Naresh K, Villa D, Gascoyne RD, Said J, Czader MB, Chadburn A, Richards KL, Rajagopalan D, Davis NS, Smith EC, Palus BC, Tzeng TJ, Healy JA, Lugar PL, Datta J, Love C, Levy S, Dunson DB, Zhuang Y, Hsi ED, Dave SS. Enteropathy-associated T cell lymphoma subtypes are characterized by loss of function of SETD2. J Exp Med 2017; 214:1371-1386. [PMID: 28424246 PMCID: PMC5413324 DOI: 10.1084/jem.20160894] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 02/06/2017] [Accepted: 03/02/2017] [Indexed: 12/17/2022] Open
Abstract
Enteropathy-associated T cell lymphoma (EATL) is the most common oncologic complication of celiac disease. Moffitt and colleagues identify novel EATL-defining mutations in SETD2, as well as clinically relevant mutations in the JAK-STAT pathway. Enteropathy-associated T cell lymphoma (EATL) is a lethal, and the most common, neoplastic complication of celiac disease. Here, we defined the genetic landscape of EATL through whole-exome sequencing of 69 EATL tumors. SETD2 was the most frequently silenced gene in EATL (32% of cases). The JAK-STAT pathway was the most frequently mutated pathway, with frequent mutations in STAT5B as well as JAK1, JAK3, STAT3, and SOCS1. We also identified mutations in KRAS, TP53, and TERT. Type I EATL and type II EATL (monomorphic epitheliotropic intestinal T cell lymphoma) had highly overlapping genetic alterations indicating shared mechanisms underlying their pathogenesis. We modeled the effects of SETD2 loss in vivo by developing a T cell–specific knockout mouse. These mice manifested an expansion of γδ T cells, indicating novel roles for SETD2 in T cell development and lymphomagenesis. Our data render the most comprehensive genetic portrait yet of this uncommon but lethal disease and may inform future classification schemes.
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Affiliation(s)
- Andrea B Moffitt
- Duke Center for Genomics and Computational Biology, Duke University, Durham, NC 27708.,Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Sarah L Ondrejka
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH 44195
| | - Matthew McKinney
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Rachel E Rempel
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - John R Goodlad
- Haematological Malignancy Diagnostic Service, St. James's University Hospital, Leeds LS9 7TF, England, UK
| | - Chun Huat Teh
- Haematology Department, Western General Hospital, Edinburgh EH14 1TY, Scotland, UK
| | - Sirpa Leppa
- Department of Oncology and Research Program Unit, Faculty of Medicine, Helsinki University Hospital Cancer Center and University of Helsinki, 00014 Helsinki, Finland
| | - Susanna Mannisto
- Department of Oncology and Research Program Unit, Faculty of Medicine, Helsinki University Hospital Cancer Center and University of Helsinki, 00014 Helsinki, Finland
| | - Panu E Kovanen
- HUSLAB and Medicum, Helsinki University Hospital Cancer Center and University of Helsinki, 00014 Helsinki, Finland
| | - Eric Tse
- University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | | | - Yok-Lam Kwong
- University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | | | - Javeed Iqbal
- University of Nebraska Medical Center, Omaha, NE 68198
| | - Jiayu Yu
- University of Nebraska Medical Center, Omaha, NE 68198
| | | | - Diego Villa
- British Columbia Cancer Agency, University of British Columbia, Vancouver, BC V6R 1ZE, Canada
| | - Randy D Gascoyne
- British Columbia Cancer Agency, University of British Columbia, Vancouver, BC V6R 1ZE, Canada
| | - Jonathan Said
- University of California, Los Angeles, Los Angeles, CA 90095
| | | | - Amy Chadburn
- Presbyterian Hospital, Pathology and Cell Biology, Cornell University, New York, NY 10065
| | | | | | - Nicholas S Davis
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Eileen C Smith
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Brooke C Palus
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Tiffany J Tzeng
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Jane A Healy
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Patricia L Lugar
- Department of Medicine, Duke University School of Medicine, Durham, NC 27710
| | - Jyotishka Datta
- Department of Statistical Science, Duke University, Durham, NC 27708
| | - Cassandra Love
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
| | - Shawn Levy
- Hudson Alpha Institute for Biotechnology, Huntsville, AL 35806
| | - David B Dunson
- Department of Statistical Science, Duke University, Durham, NC 27708
| | - Yuan Zhuang
- Department of Immunology, Duke University School of Medicine, Durham, NC 27710
| | - Eric D Hsi
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH 44195
| | - Sandeep S Dave
- Duke Center for Genomics and Computational Biology, Duke University, Durham, NC 27708.,Duke Cancer Institute, Duke University School of Medicine, Durham, NC 27710
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16
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Harjama L, Kuitunen H, Turpeenniemi-Hujanen T, Haapasaari KM, Leppä S, Mannisto S, Karjalainen-Lindsberg ML, Lehtinen T, Eray M, Vornanen M, Haapasalo H, Soini Y, Jantunen E, Nousiainen T, Vasala K, Kuittinen O. Constant pattern of relapse in primary central nervous lymphoma patients treated with high-dose methotrexate combinations. A Finnish retrospective study. Acta Oncol 2015; 54:939-43. [PMID: 25761092 DOI: 10.3109/0284186x.2014.990110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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: 11/13/2022]
Abstract
BACKGROUND Primary central nervous system lymphoma (PCNSL) is a rare brain tumour with a dismal prognosis. Several phase II studies with high-dose methotrexate-based regimens have shown promising early results, but in all hospital-based data published so far, the disease outcome is poor. MATERIAL AND METHODS We performed a hospital-based retrospective analysis to evaluate the long-term results of the Nordic type of Bonn chemotherapy regimen in PCNSL patients. The study included 54 patients with newly diagnosed PCNSL who received chemotherapy with curative intent as their first-line treatment. RESULTS We found promising response rates, 76% of the patients achieving CR and 22% patients achieving PR, with corresponding two-year EFS 53% and OS 76%. However, with longer follow-up a constant pattern of relapses was observed with only one patient remaining in primary remission after 60 months. DISCUSSION The finding suggests that basic biological differences exist between PCNSL and systemic diffuse large B-cell lymphoma and there is a need for consolidation or maintenance therapy after achieving a remission in patients with PCNSL.
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Affiliation(s)
- Liisa Harjama
- Oulu University Hospital, Department of Oncology and Radiotherapy, Oulu University , Oulu , Finland
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17
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Suominen MH, Jyvakorpi SK, Pitkala KH, Finne-Soveri H, Hakala P, Mannisto S, Soini H, Sarlio-Lahteenkorva S. Nutritional guidelines for older people in Finland. J Nutr Health Aging 2014; 18:861-7. [PMID: 25470800 DOI: 10.1007/s12603-014-0509-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [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: 01/03/2023]
Abstract
BACKGROUND Ageing is associated with an increased risk of malnutrition, decreased nutrient intake, unintentional weight loss and sarcopenia, which lead to frailty, functional disabilities and increased mortality. Nutrition combined with exercise is important in supporting older people's health, functional capacity and quality of life. OBJECTIVE To identify nutritional needs in various groups of older individuals and to present the nutritional guidelines for older people in Finland. DESIGN A review of the existing literature on older people's nutritional needs and problems. The draft guidelines were written by a multidisciplinary expert panel; they were then revised, based on comments by expert organisations. The guidelines were approved by the National Nutritional Council in Finland. RESULTS The heterogeneity of the older population is highlighted. The five key guidelines are: 1. The nutritional needs in different age and disability groups should be considered. 2. The nutritional status and food intake of older individuals should be assessed regularly. 3. An adequate intake of energy, protein, fiber, other nutrients and fluids should be guaranteed. 4. The use of a vitamin D supplement (20 μg per day) recommended. 5. The importance of physical activity is highlighted. In addition, weight changes, oral health, constipation, obesity, implementing nutritional care are highlighted. CONCLUSIONS Owing to the impact that good nutrition has on health and well-being in later life, nutrition among older people should be given more attention. These nutritional guidelines are intended to improve the nutrition and nutritional care of the older population.
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Affiliation(s)
- M H Suominen
- MH Suominen, Unit of General Practice, Helsinki University Central Hospital and Department of General Practice and Primary Health Care, University of Helsinki, Finland,
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18
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Borodulin K, Vartiainen E, Peltonen M, Jousilahti P, Juolevi A, Laatikainen T, Mannisto S, Salomaa V, Sundvall J, Puska P. Forty-year trends in cardiovascular risk factors in Finland. Eur J Public Health 2014; 25:539-46. [DOI: 10.1093/eurpub/cku174] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Salonen J, Rajpert-De Meyts E, Mannisto S, Nielsen JE, Graem N, Toppari J, Heikinheimo M. Differential developmental expression of transcription factors GATA-4 and GATA-6, their cofactor FOG-2 and downstream target genes in testicular carcinoma in situ and germ cell tumors. Eur J Endocrinol 2010; 162:625-31. [PMID: 19969558 DOI: 10.1530/eje-09-0734] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Testicular germ cell cancer is the most common malignancy among young males. The pre-invasive precursor, carcinoma in situ testis (CIS), presumably originates from arrested and transformed fetal gonocytes. Given that GATA transcription factors have essential roles in embryonic and testicular development, we explored the expression of GATA-4, GATA-6, cofactor friend of GATA (FOG)-2, and downstream target genes during human testis development and addressed the question whether changes in this pathway may contribute to germ cell neoplasms. METHODS Fetal testis, testicular CIS, and overt tumor samples were analyzed by immunohistochemistry for GATA-4, GATA-6, FOG-2, steroidogenic factor 1 (NR5A1/SF1), anti-Müllerian hormone/Müllerian-inhibiting substance (AMH), and inhibin-alpha (INHalpha). RESULTS GATA-4 was not expressed in normal germ cells, except for a subset of gonocytes at the 15th gestational week. The CIS cells expressed GATA-4 and GATA-6 heterogeneously, whereas most of the CIS cells expressed GATA-4 cofactor FOG-2. GATA target gene SF-1 was expressed heterogeneously in CIS cells, whereas INHalpha and AMH were mostly negative. Seminomas and yolk sac tumors were positive for GATA-4 and GATA-6, but mostly negative for FOG-2 and the GATA target genes. In contrast, pluripotent embryonal carcinomas and choriocarcinomas were GATA-4 and GATA-6 negative. CONCLUSIONS Differential expression of the GATA-4 target genes suggested cell-specific functions of GATA-4 in the germ and somatic cells. The GATA-4 expression in early fetal gonocytes, CIS, and seminoma cells but the absence in more mature germ cells is consistent with the early fetal origin of CIS cells and suggests that GATA-4 is involved in early germ cell differentiation.
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Affiliation(s)
- Jonna Salonen
- Institute of Biomedicine, Paediatric Research Center, Children's Hospital, University of Helsinki, Biomedicum Helsinki, PO Box 20, SF-00014 Helsinki, Finland
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20
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Jay PY, Bielinska M, Erlich JM, Mannisto S, Pu WT, Heikinheimo M, Wilson DB. Impaired mesenchymal cell function in Gata4 mutant mice leads to diaphragmatic hernias and primary lung defects. Dev Biol 2007; 301:602-14. [PMID: 17069789 PMCID: PMC1808541 DOI: 10.1016/j.ydbio.2006.09.050] [Citation(s) in RCA: 133] [Impact Index Per Article: 7.8] [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: 05/21/2006] [Revised: 09/08/2006] [Accepted: 09/29/2006] [Indexed: 01/13/2023]
Abstract
Congenital diaphragmatic hernia (CDH) is an often fatal birth defect that is commonly associated with pulmonary hypoplasia and cardiac malformations. Some investigators hypothesize that this constellation of defects results from genetic or environmental triggers that disrupt mesenchymal cell function in not only the primordial diaphragm but also the thoracic organs. The alternative hypothesis is that the displacement of the abdominal viscera in the chest secondarily perturbs the development of the heart and lungs. Recently, loss-of-function mutations in the gene encoding FOG-2, a transcriptional co-regulator, have been linked to CDH and pulmonary hypoplasia in humans and mice. Here we show that mutagenesis of the gene for GATA-4, a transcription factor known to functionally interact with FOG-2, predisposes inbred mice to a similar set of birth defects. Analysis of wild-type mouse embryos demonstrated co-expression of Gata4 and Fog2 in mesenchymal cells of the developing diaphragm, lungs, and heart. A significant fraction of C57Bl/6 mice heterozygous for a Gata4 deletion mutation died within 1 day of birth. Developmental defects in the heterozygotes included midline diaphragmatic hernias, dilated distal airways, and cardiac malformations. Heterozygotes had any combination of these defects or none. In chimeric mice, Gata4(-/-) cells retained the capacity to contribute to cells in the diaphragmatic central tendon and lung mesenchyme, indicating that GATA-4 is not required for differentiation of these lineages. We conclude that GATA-4, like its co-regulator FOG-2, is required for proper mesenchymal cell function in the developing diaphragm, lungs, and heart.
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Affiliation(s)
- Patrick Y. Jay
- Department of Pediatrics, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
- Department of Genetics, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
| | - Malgorzata Bielinska
- Department of Pediatrics, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
| | - Jonathan M. Erlich
- Department of Pediatrics, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
| | - Susanna Mannisto
- Program for Developmental & Reproductive Biology, Biomedicum Helsinki and Children’s Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - William T. Pu
- Departments of Cardiology, Pediatrics, & Genetics, Children’s Hospital Boston and Harvard Medical School, Boston, MA 02115
| | - Markku Heikinheimo
- Department of Pediatrics, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
- Program for Developmental & Reproductive Biology, Biomedicum Helsinki and Children’s Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - David B. Wilson
- Department of Pediatrics, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
- Departments of Molecular Biology & Pharmacology, Washington University and St. Louis Children’s Hospital, St. Louis, MO 63110
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Abstract
Congenital diaphragmatic hernia (CDH) is a severe birth defect that is accompanied by malformations of the lung, heart, testis, and other organs. Patients with CDH may have any combination of these extradiaphragmatic defects, suggesting that CDH is often a manifestation of a global embryopathy. This review highlights recent advances in human and mouse genetics that have led to the identification of genes involved in CDH. These include genes for transcription factors, molecules involved in cell migration, and extracellular matrix components. The expression patterns of these genes in the developing embryo suggest that mesenchymal cell function is compromised in the diaphragm and other affected organs in patients with CDH. We discuss potential mechanisms underlying the seemingly random combination of diaphragmatic, pulmonary, cardiovascular, and gonadal defects in these patients.
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Affiliation(s)
- Malgorzata Bielinska
- Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
| | - Patrick Y. Jay
- Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
- Department of Genetics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
| | - Jonathan M. Erlich
- Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
| | - Susanna Mannisto
- Program for Developmental & Reproductive Biology, Biomedicum Helsinki and Children's Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - Zsolt Urban
- Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
- Department of Genetics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
| | - Markku Heikinheimo
- Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
- Program for Developmental & Reproductive Biology, Biomedicum Helsinki and Children's Hospital, University of Helsinki, 00290 Helsinki, Finland
| | - David B. Wilson
- Department of Pediatrics, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
- Department of Molecular Biology & Pharmacology, Washington University and St. Louis Children's Hospital, St. Louis, MO 63110 USA
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22
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Kotarsky H, Tabasum I, Mannisto S, Heikinheimo M, Hansson S, Fellman V. BCS1L is expressed in critical regions for neural development during ontogenesis in mice. Gene Expr Patterns 2007; 7:266-73. [PMID: 17049929 DOI: 10.1016/j.modgep.2006.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2006] [Revised: 09/07/2006] [Accepted: 09/08/2006] [Indexed: 11/24/2022]
Abstract
BCS1L is a chaperone necessary for the incorporation of Rieske FeS and Qcr10p into complex III (CIII) of the respiratory chain. Mutations in the BCS1L gene cause early fetal growth restriction and a lethal neonatal disease in humans, however, the pathogenesis remains unclear. Here, we analysed the expression of BCS1L during mouse embryonic development and compared its expression with that of the mitochondrial markers Porin, GRIM19, Core I, and Rieske FeS. BCS1L was strongly expressed in embryonic tissues already at embryonic days 7 (E7) and 9 whereas the expression of Porin and Rieske FeS was not as evident at this time point. At E11, BCS1L, Porin, and Rieske FeS had overlapping expression patterns in organs known to contain high numbers of mitochondria such as heart, liver and somites. In contrast, BCS1L was differently distributed compared to the mitochondrial proteins Porin, Rieske FeS, Core I and Grim 19 in the floor plate of the E11, E12 and E13 neural tube. These results show that the expression pattern of BCS1L only partially overlaps with the expression of Porin and Rieske FeS. Thus, BCS1L alone or in cooperation with Rieske FES may during development have previously unknown functions beside its role in assembly of complex III. The floor plate of the neural tube is essential for dorsal ventral patterning and the guidance of the developing neurons to their targets. The predominant expression of BCS1L in this region, together with its presence in peripheral ganglia from E13 onwards, indicates a role for BCS1L in the development of neural structures.
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Affiliation(s)
- Heike Kotarsky
- Department of Pediatrics, Clinical Sciences, Lund University, Lund, Sweden.
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Bielinska M, Kiiveri S, Parviainen H, Mannisto S, Heikinheimo M, Wilson DB. Gonadectomy-induced adrenocortical neoplasia in the domestic ferret (Mustela putorius furo) and laboratory mouse. Vet Pathol 2006; 43:97-117. [PMID: 16537928 DOI: 10.1354/vp.43-2-97] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [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] [Indexed: 11/19/2022]
Abstract
Sex steroid-producing adrenocortical adenomas and carcinomas occur frequently in neutered ferrets, but the molecular events underlying tumor development are not well understood. Prepubertal gonadectomy elicits similar tumors in certain inbred or genetically engineered strains of mice, and these mouse models shed light on tumorigenesis in ferrets. In mice and ferrets, the neoplastic adrenocortical cells, which functionally resemble gonadal steroidogenic cells, arise from progenitors in the subcapsular or juxtamedullary region. Tumorigenesis in mice is influenced by the inherent susceptibility of adrenal tissue to gonadectomy-induced hormonal changes. The chronic elevation in circulating luteinizing hormone that follows ovariectomy or orchiectomy is a prerequisite for neoplastic transformation. Gonadectomy alters the plasma or local concentrations of steroid hormones and other factors that affect adrenocortical tumor development, including inhibins, activins, and Müllerian inhibiting substance. GATA-4 immunoreactivity is a hallmark of neoplastic transformation, and this transcription factor might serve to integrate intracellular signals evoked by different hormones. Synergistic interactions among GATA-4, steroidogenic factor-1, and other transcription factors enhance expression of inhibin-alpha and genes critical for ectopic sex steroid production, such as cytochrome P450 17alpha-hydroxylase/17,20 lyase and aromatase. Cases of human adrenocortical neoplasia have been linked to precocious expression of hormone receptors and to mutations that alter the activity of G-proteins or downstream effectors. Whether such genetic changes contribute to tissue susceptibility to neoplasia in neutered ferrets and mice awaits further study.
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Affiliation(s)
- M Bielinska
- Department of Pediatrics, Box 8208, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA
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Kallio H, Pastorekova S, Pastorek J, Waheed A, Sly WS, Mannisto S, Heikinheimo M, Parkkila S. Expression of carbonic anhydrases IX and XII during mouse embryonic development. BMC Dev Biol 2006; 6:22. [PMID: 16719910 PMCID: PMC1526727 DOI: 10.1186/1471-213x-6-22] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 05/23/2006] [Indexed: 12/24/2022]
Abstract
BACKGROUND Of the thirteen active carbonic anhydrase (CA) isozymes, CA IX and XII have been linked to carcinogenesis. It has been suggested that these membrane-bound CAs participate in cancer cell invasion, which is facilitated by an acidic tumor cell environment. Since active cell migration is a characteristic feature of embryonic development, we set out to explore whether these isozymes are expressed in mouse embryos of different ages. The studies were focused on organogenesis stage. RESULTS Immunohistochemistry demonstrated that both CA IX and XII are present in several tissues of the developing mouse embryo during organogenesis. Staining for CA IX revealed a relatively wide distribution pattern with moderate signals in the brain, lung, pancreas and liver and weak signals in the kidney and stomach. The expression pattern of CA XII in the embryonic tissues was also relatively broad, although the intensity of immunostaining was weak in most tissues. The CA XII-positive tissues included the brain, where the most prominent staining was seen in the choroid plexus, and the stomach, pancreas, liver and kidney. CONCLUSION Membrane-bound CA isozymes IX and XII are expressed in various tissues during mouse organogenesis. These enzymes may regulate ion and pH homeostasis within the developing embryo.
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Affiliation(s)
- Heini Kallio
- Institute of Medical Technology, University of Tampere and Tampere University Hospital, Biokatu 8, FIN-33520 Tampere, Finland
| | - Silvia Pastorekova
- Center of Molecular Medicine, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Jaromir Pastorek
- Center of Molecular Medicine, Institute of Virology, Slovak Academy of Sciences, Bratislava, Slovak Republic
| | - Abdul Waheed
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - William S Sly
- Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, St. Louis, Missouri, USA
| | - Susanna Mannisto
- Children's Hospital and Program for Developmental and Reproductive Biology, University of Helsinki, Helsinki, Finland
| | - Markku Heikinheimo
- Children's Hospital and Program for Developmental and Reproductive Biology, University of Helsinki, Helsinki, Finland
- Department of Pediatrics, Washington University, St. Louis, Missouri, USA
| | - Seppo Parkkila
- Institute of Medical Technology, University of Tampere and Tampere University Hospital, Biokatu 8, FIN-33520 Tampere, Finland
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
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Jacobsen CM, Mannisto S, Porter-Tinge S, Genova E, Parviainen H, Heikinheimo M, Adameyko II, Tevosian SG, Wilson DB. GATA-4:FOG interactions regulate gastric epithelial development in the mouse. Dev Dyn 2006; 234:355-62. [PMID: 16127717 DOI: 10.1002/dvdy.20552] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [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] [Indexed: 12/12/2022] Open
Abstract
Transcription factor GATA-4 is a key participant in cytodifferentiation of the mouse hindstomach. Here we show that GATA-4 cooperates with a Friend-of-GATA (FOG) cofactor to direct gene expression in this segment of gut. Immunohistochemical staining revealed that GATA-4 and FOG-1 are co-expressed in hindstomach epithelial cells from embryonic days (E) 11.5 to 18.5. The other member of the mammalian FOG family, FOG-2, was not detected in gastric epithelium. To show that GATA-4:FOG interactions influence stomach development, we analyzed Gata4(ki/ki) mice, which express a mutant GATA-4 that cannot bind FOG cofactors. Sonic Hedgehog, an endoderm-derived signaling molecule normally down-regulated in the distal stomach, was over-expressed in hindstomach epithelium of E11.5 Gata4(ki/ki) mice, and there was a concomitant decrease in fibroblast growth factor-10 in adjacent mesenchyme. We conclude that functional interaction between GATA-4 and a member of the FOG family, presumably FOG-1, is required for proper epithelial-mesenchymal signaling in the developing stomach.
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Affiliation(s)
- Christina M Jacobsen
- Department of Pediatrics, Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, MO 63110, USA
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Mannisto S, Butzow R, Salonen J, Leminen A, Heikinheimo O, Heikinheimo M. Transcription factors GATA-4 and GATA-6, and their potential downstream effectors in ovarian germ cell tumors. Tumour Biol 2005; 26:265-73. [PMID: 16110260 DOI: 10.1159/000087565] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Accepted: 05/10/2005] [Indexed: 11/19/2022] Open
Abstract
Ovarian germ cell tumors (GCTs) are histologically heterogeneous neoplasms originating from activated germ cells, the oocyte stem cells. These rare tumors often contain many different tissues mixed together, and malignant components are occasionally hidden within benign tissues thus complicating the diagnosis. The reasons for the variable differentiation of germ cells are still largely unknown. As transcription factors GATA-4 and GATA-6 as well as their downstream factors (e.g. HNF-4, BMP-2 and Ihh) are essential for normal yolk sac development, we studied their expression in 19 ovarian GCTs. Endodermal markers were expressed distinctively in different GCT types. The malignant endoderm in yolk sac tumors expressed all factors of endodermal development included in the study. Dysgerminomas, on the contrary, expressed only GATA-4 and, in a minority of cases, Ihh and BMP-2. The results suggest that GATA-4 and GATA-6 detected in the ovarian GCTs have retained their normal function. The fact that GATA-6 and HNF-4 are expressed exclusively in endodermal tissues indicates that these transcription factors play a role in the differentiation of germ cells towards the endodermal phenotype. Analysis of the nuclear transcription factors in tumor tissue could serve as a new informative diagnostic tool for ovarian GCTs.
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Affiliation(s)
- Susanna Mannisto
- Program for Developmental and Reproductive Biology, Biomedicum, University of Helsinki, Helsinki, Finland
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Secchiero P, Melloni E, Heikinheimo M, Mannisto S, Di Pietro R, Iacone A, Zauli G. TRAIL regulates normal erythroid maturation through an ERK-dependent pathway. Blood 2004; 103:517-22. [PMID: 12969966 DOI: 10.1182/blood-2003-06-2137] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [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: 02/08/2023] Open
Abstract
In order to investigate the biologic activity of tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on human erythropoiesis, glycophorin A (GPA)+ erythroid cells were generated in serum-free liquid phase from human cord blood (CB) CD34+ progenitor cells. The surface expression of TRAIL-R1 was weakly detectable in the early-intermediate phase of erythroid differentiation (days 4-6; dim-intermediate GPA expression), whereas a clear-cut expression of TRAIL-R2 was observed through the entire course of erythroid differentiation (up to days 12-14; bright GPA expression). On the other hand, surface TRAIL-R3 and -R4 were not detected at any culture time. Besides inducing a rapid but small increase of apoptotic cell death, which was abrogated by the pan-caspase inhibitor z-VAD-fmk, the addition of recombinant TRAIL at day 6 of culture inhibited the generation of morphologically mature erythroblasts. Among the intracellular pathways investigated, TRAIL significantly stimulated the extracellular signal-regulated kinase 1/2 (ERK1/2) but not the p38/mitogen-activated protein kinase (MAPK) or the c-Jun NH2-terminal kinase (JNK) pathway. Consistently with a key role of ERK1/2 in mediating the negative effects of TRAIL on erythroid maturation, PD98059, a pharmacologic inhibitor of the ERK pathway, but not z-VAD-fmk or SB203580, a pharmacologic inhibitor of p38/MAPK, reverted the antidifferentiative effect of TRAIL on CB-derived erythroblasts.
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Affiliation(s)
- Paola Secchiero
- Dept of Morphology and Embryology, Human Anatomy Section, University of Ferrara, Via Fossato di Mortara 66, 44100 Ferrara, Italy.
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