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Pan X, Chang Y, Ruan G, Wei F, Jiang H, Jiang Q, Huang X, Zhao X. Prognostic impact of FLT3-ITD mutation on NPM1 + acute myeloid leukaemia patients and related molecular mechanisms. Br J Haematol 2023; 203:212-223. [PMID: 37621257 DOI: 10.1111/bjh.18973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 08/26/2023]
Abstract
The prognosis of acute myeloid leukaemia (AML) patients carrying NPM1 mutations is significantly worse when accompanied by FLT3-ITD mutations. However, accurate quantitative detection of FLT3-ITD mutations remains challenging. To identify a novel biomarker in NPM1+ FLT3-ITD+ AML patients for more accurate stratification, we analysed the differential gene expression between the NPM1+ FLT3-ITD+ and NPM1+ FLT3-ITD- groups in five public AML datasets and identified a biomarker by taking the intersection of differentially expressed genes. We validated this biomarker in bone marrow samples from NPM1+ AML patients at the Peking University Institute of Haematology and analysed its prognostic significance. BCAT1 expression was higher in the NPM1+ FLT3-ITD+ group than in the NPM1+ FLT3-ITD- group in all seven cohorts. BCAT1 was able to predict the prognosis of NPM1+ FLT3-ITD+ AML patients, and its predictive ability was superior to that of the FLT3-ITD allelic ratio (AR). FLT3-targeted inhibitor quizartinib reduced BCAT1 expression. BCAT1 knockdown using lentiviral vectors led to the downregulation of MYC expression. Thus, we identified BCAT1 as a novel biomarker for NPM1+ FLT3-ITD+ AML patients. The FLT3-ITD/BCAT1/MYC signalling pathway may play a biological role in promoting the occurrence and development of AML in FLT3-ITD+ cell lines.
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Affiliation(s)
- Xin'an Pan
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Yingjun Chang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Guorui Ruan
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Fangfang Wei
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Hao Jiang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Qian Jiang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
| | - Xiaojun Huang
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Beijing, China
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaosu Zhao
- National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, China
- Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, China
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Jaddaoui S, Bencharef H, Addakiri S, Dehbi H, Tazzite A, Lamchahab M, Oukkache B. [Prognostic value of residual disease detection in acute myeloid leukemia with normal karyotype and negative FLT3-ITD]. Ann Biol Clin (Paris) 2023; 81:136-144. [PMID: 37144777 DOI: 10.1684/abc.2023.1798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
INTRODUCTION Complete remission (CR) in patients with acute myeloid leukemia (AML) is still morphologicaly defined, thus corresponding to a wide range of tumor burden. OBJECTIVES we aimed to evaluate the residual disease (MRD) status in patients with AML, as well as perform a molecular analysis of the FLT3/ITD gene in patients with normal karyotype. MATERIAL AND METHODS adult patients with AML, diagnosed according to the WHO 2016 criteria, were included. MRD was detected using flow cytometric techniques after induction treatment resulting in CR. RESULTS thirty patients met our inclusion criteria. 83 % of them had an intermediate risk status, 67 % of which (20/30) having a normal karyotype. MRD and leukemic stem cell (LSC) positivity in this group was predominant with considerable decrease in benign progenitor count. The relapse-free survival (RFS) in the group of MRD negative patients with normal cytogenetics and non-mutated FLT3 gene was better than the RFS in all of our patients studied. CONCLUSION MRD and LSC are powerful prognostic factors for relapse. They should be routinely integrated to guide better management of AML.
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Affiliation(s)
- Samiha Jaddaoui
- Université Hassan II de la Faculté de Médecine et de Pharmacie, Laboratoire d'Hématologie du Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
| | - Hanaa Bencharef
- Université Hassan II de la Faculté de Médecine et de Pharmacie, Laboratoire d'Hématologie du Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
| | - Sara Addakiri
- Université Hassan II de la Faculté de Médecine et de Pharmacie, Laboratoire d'Hématologie du Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
| | - Hind Dehbi
- Laboratoire de génétique médicale de la Faculté de Médecine et de Pharmacie, université Hassan II, Casablanca, Maroc
| | - Amal Tazzite
- Laboratoire de génétique médicale de la Faculté de Médecine et de Pharmacie, université Hassan II, Casablanca, Maroc
| | - Mouna Lamchahab
- Service d'hématologie et onco-pédiatrie de l'hôpital 20 août, Casablanca, Maroc
| | - Bouchra Oukkache
- Université Hassan II de la Faculté de Médecine et de Pharmacie, Laboratoire d'Hématologie du Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc
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Li F, Liu YP, Zhu H, Hong M, Qian SX, Zhu Y, Shen WY, Chen LJ, He GS, Wu HX, Lu H, Li JY, Miao KR. [Clinical study of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation in the treatment of FLT3-ITD(+) acute myeloid leukemia with normal karyotype]. Zhonghua Xue Ye Xue Za Zhi 2023; 44:230-235. [PMID: 37356985 DOI: 10.3760/cma.j.issn.0253-2727.2023.03.009] [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] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To assess the efficacy of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of FLT3-ITD(+) acute myeloid leukemia (AML) with normal karyotype. Methods: The clinical data of FLT3-ITD(+) AML patients with normal karyotype in the First Affiliated Hospital of Nanjing Medical University from Jan 2018 to March 2021 were retrospectively analyzed. Results: The study included 49 patients with FLT3-ITD(+)AML, 31 males, and 18 females, with a median age of 46 (16-59) years old. All patients received induction chemotherapy, and 24 patients received sequential allo-HSCT (transplantation group) . The median follow-up time was 465 days, the one-year overall survival (OS) from diagnosis was (70.0 ± 7.4) %, and one-year disease-free survival (DFS) was (70.3±7.4) %. The one-year OS was significantly different between the transplantation group and the non-transplantation group [ (85.2 ± 7.9) % vs (52.6 ± 12.3) %, P=0.049]. but one-year DFS [ (84.7 ± 8.1) % vs (55.2 ± 11.9) %, P=0.061] was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD(+) (P>0.05) . There were 12 patients with high-frequency FLT3-ITD(+) in the transplantation and the non-transplantation groups, respectively. The one-year OS [ (68.8 ± 15.7) % in the transplantation group vs (26.2 ± 15.3) % in the non-transplantation group, P=0.027] and one-year DFS [ (45.5 ± 21.3) % in the transplantation group vs (27.8±15.8) % in the non-transplantation group, P=0.032] were significantly different between the two groups. Conclusion: Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD(+) patients, particularly those with FLT3-ITD high-frequency mutation.
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Affiliation(s)
- F Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Y P Liu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - M Hong
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - S X Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Y Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - W Y Shen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - L J Chen
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - G S He
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H X Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - H Lu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - J Y Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - K R Miao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Martínez-Cuadrón D, Serrano J, Mariz J, Gil C, Tormo M, Martínez-Sánchez P, Rodríguez-Arbolí E, García-Boyero R, Rodríguez-Medina C, Martínez-Chamorro C, Polo M, Bergua J, Aguiar E, Amigo ML, Herrera P, Alonso-Domínguez JM, Bernal T, Espadana A, Sayas MJ, Algarra L, Vidriales MB, Vasconcelos G, Vives S, Pérez-Encinas MM, López A, Noriega V, García-Fortes M, Chillón MC, Rodríguez-Gutiérrez JI, Calasanz MJ, Labrador J, López JA, Boluda B, Rodríguez-Veiga R, Martínez-López J, Barragán E, Sanz MA, Montesinos P. Characteristics and Outcomes of Adult Patients in the PETHEMA Registry with Relapsed or Refractory FLT3-ITD Mutation-Positive Acute Myeloid Leukemia. Cancers (Basel) 2022; 14:cancers14112817. [PMID: 35681796 PMCID: PMC9179309 DOI: 10.3390/cancers14112817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/26/2022] [Accepted: 05/31/2022] [Indexed: 02/01/2023] Open
Abstract
This retrospective study investigated outcomes of 404 patients with relapsed/refractory (R/R) FMS-like tyrosine kinase 3 (FLT3)-internal tandem duplication (ITD) acute myeloid leukemia (AML) enrolled in the PETHEMA registry, pre-approval of tyrosine kinase inhibitors. Most patients (63%) had received first-line intensive therapy with 3 + 7. Subsequently, patients received salvage with intensive therapy (n = 261), non-intensive therapy (n = 63) or supportive care only (n = 80). Active salvage therapy (i.e., intensive or non-intensive therapy) resulted in a complete remission (CR) or CR without hematological recovery (CRi) rate of 42%. More patients achieved a CR/CRi with intensive (48%) compared with non-intensive (19%) salvage therapy (p < 0.001). In the overall population, median overall survival (OS) was 5.5 months; 1- and 5-year OS rates were 25% and 7%. OS was significantly (p < 0.001) prolonged with intensive or non-intensive salvage therapy compared with supportive therapy, and in those achieving CR/CRi versus no responders. Of 280 evaluable patients, 61 (22%) had an allogeneic stem-cell transplant after they had achieved CR/CRi. In conclusion, in this large cohort study, salvage treatment approaches for patients with FLT3-ITD mutated R/R AML were heterogeneous. Median OS was poor with both non-intensive and intensive salvage therapy, with best long-term outcomes obtained in patients who achieved CR/CRi and subsequently underwent allogeneic stem-cell transplant.
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Affiliation(s)
- David Martínez-Cuadrón
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
- Correspondence: ; Tel.: +34-96-1244925
| | - Josefina Serrano
- Hospital Universitario Reina Sofía and Instituto Maimónides de Investigación Biomédica Córdoba (IMIBIC), 14004 Córdoba, Spain;
| | - José Mariz
- IPO (Istituto Portugues Oncologia), 4200-072 Porto, Portugal;
| | - Cristina Gil
- Hospital General Universitario de Alicante, 03010 Alicante, Spain;
| | - Mar Tormo
- Hospital Clínico Universitario, INCLIVA Biomedical Research Institute, 46010 Valencia, Spain;
| | - Pilar Martínez-Sánchez
- Hospital Universitario 12 de Octubre, Complutense University, i+12, CNIO, 28041 Madrid, Spain; (P.M.-S.); (J.M.-L.)
| | | | | | | | | | - Marta Polo
- Hospital Clínico San Carlos, 28040 Madrid, Spain;
| | - Juan Bergua
- Hospital San Pedro Alcántara, 10003 Cáceres, Spain;
| | | | - María L. Amigo
- Hospital General Universitario Morales Meseguer, 30008 Murcia, Spain;
| | - Pilar Herrera
- Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain;
| | | | - Teresa Bernal
- Hospital Universitario Central de Asturias, 33011 Asturias, Spain;
| | - Ana Espadana
- Hospital de Coimbra, 3400-091 Coimbra, Portugal;
| | - María J. Sayas
- Hospital Universitario Doctor Peset, 46017 Valencia, Spain;
| | - Lorenzo Algarra
- Hospital General Universitario de Albacete, 02006 Albacete, Spain;
| | - María B. Vidriales
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain; (M.B.V.); (M.C.C.)
| | | | - Susana Vives
- ICO-Hospital Germans Trias i Pujol, Badalona, José Carreras Leukemia Research Institute, Universitat Autònoma de Barcelona, 08916 Barcelona, Spain;
| | | | | | - Víctor Noriega
- Complejo Hospitalario Universitario A Coruña, 15006 La Coruna, Spain;
| | | | - María C. Chillón
- Department of Hematology, University Hospital of Salamanca (HUS/IBSAL), CIBERONC and Cancer Research Institute of Salamanca-IBMCC (USAL-CSIC), 37007 Salamanca, Spain; (M.B.V.); (M.C.C.)
| | | | | | | | - Juan A. López
- Complejo Hospitalario Ciudad de Jaén, 23007 Jaén, Spain;
| | - Blanca Boluda
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Rebeca Rodríguez-Veiga
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Joaquín Martínez-López
- Hospital Universitario 12 de Octubre, Complutense University, i+12, CNIO, 28041 Madrid, Spain; (P.M.-S.); (J.M.-L.)
| | - Eva Barragán
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Miguel A. Sanz
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
| | - Pau Montesinos
- Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (B.B.); (R.R.-V.); (E.B.); (M.A.S.); (P.M.)
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Lopez-Millan B, Costales P, Gutiérrez-Agüera F, Díaz de la Guardia R, Roca-Ho H, Vinyoles M, Rubio-Gayarre A, Safi R, Castaño J, Romecín PA, Ramírez-Orellana M, Anguita E, Jeremias I, Zamora L, Rodríguez-Manzaneque JC, Bueno C, Morís F, Menendez P. The Multi-Kinase Inhibitor EC-70124 Is a Promising Candidate for the Treatment of FLT3-ITD-Positive Acute Myeloid Leukemia. Cancers (Basel) 2022; 14:cancers14061593. [PMID: 35326743 PMCID: PMC8946166 DOI: 10.3390/cancers14061593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 12/17/2022] Open
Abstract
Simple Summary Patients with AML harboring constitutively active mutations in the FLT3 receptor generally have a poor prognosis (FLT3-ITDMUT). Despite the fact that several FLT3 inhibitors have been developed, clinical responses are commonly partial or not durable, highlighting the need for new molecules targeting FLT3-ITDMUT. Here, we tested EC-70124, a hybrid indolocarbazole analog from the same chemical space as midostaurin (a well-known FLT3 inhibitor). Our in vitro and in vivo experiments showed that EC-70124 exerts a robust and specific antileukemia activity against FLT3-ITDMUT AML cells while sparing healthy hematopoietic cells. Collectively, EC-70124 is a promising and safe agent for the treatment of this aggressive type of AML. Abstract Acute myeloid leukemia (AML) is the most common acute leukemia in adults. Patients with AML harboring a constitutively active internal tandem duplication mutation (ITDMUT) in the FMS-like kinase tyrosine kinase (FLT3) receptor generally have a poor prognosis. Several tyrosine kinase/FLT3 inhibitors have been developed and tested clinically, but very few (midostaurin and gilteritinib) have thus far been FDA/EMA-approved for patients with newly diagnosed or relapse/refractory FLT3-ITDMUT AML. Disappointingly, clinical responses are commonly partial or not durable, highlighting the need for new molecules targeting FLT3-ITDMUT AML. Here, we tested EC-70124, a hybrid indolocarbazole analog from the same chemical space as midostaurin with a potent and selective inhibitory effect on FLT3. In vitro, EC-70124 exerted a robust and specific antileukemia activity against FLT3-ITDMUT AML primary cells and cell lines with respect to cytotoxicity, CFU capacity, apoptosis and cell cycle while sparing healthy hematopoietic (stem/progenitor) cells. We also analyzed its efficacy in vivo as monotherapy using two different xenograft models: an aggressive and systemic model based on MOLM-13 cells and a patient-derived xenograft model. Orally disposable EC-70124 exerted a potent inhibitory effect on the growth of FLT3-ITDMUT AML cells, delaying disease progression and debulking the leukemia. Collectively, our findings show that EC-70124 is a promising and safe agent for the treatment of AML with FLT3-ITDMUT.
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Affiliation(s)
- Belen Lopez-Millan
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- GENYO, Centre for Genomics and Oncological Research, Pfizer, Universidad de Granada, Junta de Andalucía, 18016 Granada, Spain;
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Correspondence: (B.L.-M.); (P.M.)
| | | | - Francisco Gutiérrez-Agüera
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
| | - Rafael Díaz de la Guardia
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- GENYO, Centre for Genomics and Oncological Research, Pfizer, Universidad de Granada, Junta de Andalucía, 18016 Granada, Spain;
| | - Heleia Roca-Ho
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
| | - Meritxell Vinyoles
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
| | - Alba Rubio-Gayarre
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- GENYO, Centre for Genomics and Oncological Research, Pfizer, Universidad de Granada, Junta de Andalucía, 18016 Granada, Spain;
| | - Rémi Safi
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
| | - Julio Castaño
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
| | - Paola Alejandra Romecín
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
| | - Manuel Ramírez-Orellana
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Department of Pediatric Hematology and Oncology, Hospital Infantil Universitario Niño Jesús, Instituto de Investigación Sanitaria La Princesa, 28006 Madrid, Spain
| | - Eduardo Anguita
- Servicio de Hematología, Hospital Clínico San Carlos, IdISSC, School of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Irmela Jeremias
- Research Unit Apoptosis in Hematopoietic Stem Cells, Helmholtz Zentrum München, 85764 Munich, Germany;
| | - Lurdes Zamora
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- Hematology Department, ICO-Hospital Germans Trias i Pujol, 08916 Barcelona, Spain
| | | | - Clara Bueno
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Centro de Investigación Biomédica en Red–Oncología (CIBERONC), 28029 Madrid, Spain
| | | | - Pablo Menendez
- Department of Biomedicine, Josep Carreras Leukemia Research Institute, School of Medicine, University of Barcelona, 08036 Barcelona, Spain; (F.G.-A.); (R.D.d.l.G.); (H.R.-H.); (M.V.); (A.R.-G.); (R.S.); (J.C.); (P.A.R.); (L.Z.); (C.B.)
- Red Española de Terapias Avanzadas (TERAV), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain;
- Centro de Investigación Biomédica en Red–Oncología (CIBERONC), 28029 Madrid, Spain
- Instituciò Catalana de Recerca i Estudis Avançats (ICREA), 08010 Barcelona, Spain
- Correspondence: (B.L.-M.); (P.M.)
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Ebian HF, Elshorbagy S, Mohamed H, Embaby A, Khamis T, Sameh R, Sabbah NA, Hussein S. Clinical implication and prognostic significance of FLT3-ITD and ASXL1 mutations in Egyptian AML patients: A single-center study. Cancer Biomark 2021; 32:379-389. [PMID: 34487021 DOI: 10.3233/cbm-210024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Both Fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) and Additional Sex Comb-like 1 (ASXL1) mutations are frequent and early genetic alteration events in acute myeloid leukemia (AML) patients. These genetic alterations may be associated with an unfavorable prognosis. OBJECTIVE Up to our knowledge, this is the first study performed to evaluate the clinical implication and prognostic significance of FLT3-ITD and ASXL1 mutations and their coexistence on the outcome of Egyptian AML patients. METHODS Our study included 83 patients with AML who were subjected to immunophenotyping and detection of FLT3-ITD and ASXL1 gene mutation by polymerase chain reaction (PCR) and real-time PCR, respectively. RESULTS FLT3-ITD and ASXL1 mutations were detected in 20.5% and 18.1% of AML patients respectively. Seven patients (8.4%) had co-expression of both genes' mutations. FLT3-ITD mutation was significantly higher in younger age, higher WBCs count and poor cytogenetic risk patients (P= 0.01, < 0.001 and 0.008 respectively). ASXL1 mutation was significantly higher in intermediate cytogenetic risk patients (P= 0.2). The mean period of survival and relapse-free survival (RFS) were significantly reduced in FLT3-ITD and ASXL1 mutations compared with their non-mutant types (P= 0.01 and 0.03 respectively). Both mutations were independent risk factors for overall survival (OS) and (RFS) in univariate and multivariate analysis in AML patients. CONCLUSION FLT3-ITD and ASXL1 gene mutations or their coexistence can predict a poor prognosis in AML patients.
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Affiliation(s)
- Huda F Ebian
- Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sherin Elshorbagy
- Oncology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Haitham Mohamed
- Hematology Oncology Unit/Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmad Embaby
- Hematology Oncology Unit/Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Tarek Khamis
- Pharmacology Department, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Reham Sameh
- Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Norhan A Sabbah
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Samia Hussein
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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7
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Luo Y, Lu Y, Long B, Lin Y, Yang Y, Xu Y, Zhang X, Zhang J. Blocking DNA Damage Repair May Be Involved in Stattic (STAT3 Inhibitor)-Induced FLT3-ITD AML Cell Apoptosis. Front Cell Dev Biol 2021; 9:637064. [PMID: 33796529 PMCID: PMC8007876 DOI: 10.3389/fcell.2021.637064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/23/2021] [Indexed: 12/13/2022] Open
Abstract
The FMS-like tyrosine kinase 3 (FLT3)- internal tandem duplication (ITD) mutation can be found in approximately 25% of all acute myeloid leukemia (AML) cases and is associated with a poor prognosis. The main treatment for FLT3-ITD-positive AML patients includes genotoxic therapy and FLT3 inhibitors, which are rarely curative. Inhibiting STAT3 activity can improve the sensitivity of solid tumor cells to radiotherapy and chemotherapy. This study aimed to explore whether Stattic (a STAT3 inhibitor) affects FLT3-ITD AML cells and the underlying mechanism. Stattic can inhibit the proliferation, promote apoptosis, arrest cell cycle at G0/G1, and suppress DNA damage repair in MV4-11cells. During the process, through mRNA sequencing, we found that DNA damage repair-related mRNA are also altered during the process. In summary, the mechanism by which Stattic induces apoptosis in MV4-11cells may involve blocking DNA damage repair machineries.
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Affiliation(s)
- Yuxuan Luo
- Department of Pediatric, Guangzhou Women and Children's Medical Center, Guangzhou, China.,Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Lu
- Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Department of Blood Transfusion, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Bing Long
- Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Sen Yat-sen Institute of Hematology, Guangzhou, China
| | - Yansi Lin
- Department of General Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanling Yang
- Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yichuang Xu
- Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Xiangzhong Zhang
- Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Sen Yat-sen Institute of Hematology, Guangzhou, China
| | - Jingwen Zhang
- Department of Hematology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,Sen Yat-sen Institute of Hematology, Guangzhou, China
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8
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Dumas PY, Bertoli S, Bérard E, Largeaud L, Bidet A, Delabesse E, Leguay T, Leroy H, Gadaud N, Rieu JB, Vial JP, Vergez F, Lechevalier N, Luquet I, Klein E, Sarry A, de Grande AC, Pigneux A, Récher C. Real-World Outcomes of Patients with Refractory or Relapsed FLT3-ITD Acute Myeloid Leukemia: A Toulouse-Bordeaux DATAML Registry Study. Cancers (Basel) 2020; 12:cancers12082044. [PMID: 32722211 PMCID: PMC7465142 DOI: 10.3390/cancers12082044] [Citation(s) in RCA: 8] [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: 06/08/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 12/15/2022] Open
Abstract
Two recent phase 3 trials showed that outcomes for relapsed/refractory (R/R) FLT3-mutated acute myeloid leukemia (AML) patients may be improved by a single-agent tyrosine kinase inhibitor (TKI) (i.e., quizartinib or gilteritinib). In the current study, we retrospectively investigated the characteristics and real-world outcomes of R/R FLT3-internal tandem duplication (ITD) acute myeloid leukemia (AML) patients in the Toulouse-Bordeaux DATAML registry. In the study, we included 316 patients with FLT3-ITD AML that received intensive chemotherapy as a first-line treatment. The rate of complete remission (CR) or CR without hematological recovery (CRi) was 75.2%, and 160 patients were R/R after a first-line TKI-free treatment (n = 294). Within the subgroup of R/R patients that fulfilled the main criteria of the QUANTUM-R study, 48.9% received an intensive salvage regimen; none received hypomethylating agents or low-dose cytarabine. Among the R/R FLT3-ITD AML patients with CR1 durations < 6 months who received intensive TKI-free treatment, the rate of CR or CRi after salvage chemotherapy was 52.8%, and these results allowed a bridge to be transplanted in 39.6% of cases. Finally, in this QUANTUM-R standard arm-matched cohort, the median overall survival (OS) was 7.0 months and 1-, 3- and 5-year OS were 30.2%, 23.7% and 21.4%, respectively. To conclude, these real-world data show that the intensity of the second-line treatment likely affects response and transplantation rates. Furthermore, the results indicate that including patients with low-intensity regimens, such as low-dose cytarabine or hypomethylating agents, in the control arm of a phase 3 trial may be counterproductive and could compromise the results of the study.
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Affiliation(s)
- Pierre-Yves Dumas
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
- Université de Bordeaux, 33076 Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1035, 33000 Bordeaux, France
- Correspondence: ; Tel.: +33-557-656-511; Fax: +33-557-656-514
| | - Sarah Bertoli
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
| | - Emilie Bérard
- Service d’Epidémiologie, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France;
- INSERM-Université de Toulouse III, UMR 1027, 31000 Toulouse, France
| | - Laetitia Largeaud
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Audrey Bidet
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Eric Delabesse
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Thibaut Leguay
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Harmony Leroy
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Noémie Gadaud
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
| | - Jean Baptiste Rieu
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Jean-Philippe Vial
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - François Vergez
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Nicolas Lechevalier
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Isabelle Luquet
- Laboratoire d’Hématologie Biologique, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (J.B.R.); (I.L.)
| | - Emilie Klein
- Laboratoire d’Hématologie Biologique, CHU Bordeaux, F-33000 Bordeaux, France; (A.B.); (J.-P.V.); (N.L.); (E.K.)
| | - Audrey Sarry
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
| | - Anne-Charlotte de Grande
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
| | - Arnaud Pigneux
- Service d’Hématologie Clinique et de Thérapie Cellulaire, CHU Bordeaux, F-33000 Bordeaux, France; (T.L.); (H.L.); (A.-C.d.G.); (A.P.)
- Université de Bordeaux, 33076 Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale, U1035, 33000 Bordeaux, France
| | - Christian Récher
- Service d’Hématologie, Institut Universitaire du Cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Toulouse, 31000 Toulouse, France; (S.B.); (L.L.); (N.G.); (A.S.); (C.R.)
- Université Toulouse III Paul Sabatier, 31000 Toulouse, France; (E.D.); (F.V.)
- Cancer Research Center of Toulouse, UMR1037 INSERM, ERL5294 CNRS, 31000 Toulouse, France
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9
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Nie L, Ma R, Yuan X, Jiang L, Yang S, Xu H, Liu X, Liu Y, Zhang L, Zhu Z. The prognostic value of CD2, CD4, and HLA-DR expression and FLT3-ITD mutation in adult acute promyelocytic leukemia. Leuk Lymphoma 2020; 61:2482-2487. [PMID: 32476519 DOI: 10.1080/10428194.2020.1768386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In order to explore the prognostic value of CD2, CD4, and human leucocyte antigen-DR (HLA-DR) expression and Fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD) mutation in leukemia cells in the bone marrow of patients with acute promyelocytic leukemia (APL), we retrospectively collected and analyzed the immunophenotype, molecular features and clinical characteristics of 219 newly diagnosed adult patients with APL in Henan Provincial People's Hospital from January 2010 to December 2019. It turned out that the relapse rates of patients with CD2, CD4, or HLA-DR expression and the early mortality rates of patients with CD2 expression, HLA-DR expression, or FLT3-ITD mutation were higher than those of their counterparts. Moreover, reduced overall survival was found for patients who showed CD2 expression, HLA-DR expression or FLT3-ITD mutation. Therefore, CD2 expression, HLA-DR expression and FLT3-ITD mutation were adverse prognostic factors in adults with APL.
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Affiliation(s)
- Lu Nie
- Zhengzhou University, Zhengzhou, China.,Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China.,Institute of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Rongjun Ma
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaoli Yuan
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Li Jiang
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Shiwei Yang
- Institute of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Hui Xu
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaoyin Liu
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Yuanbo Liu
- Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Lin Zhang
- Institute of Hematology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Zunmin Zhu
- Zhengzhou University, Zhengzhou, China.,Department of Hematology, Henan Provincial People's Hospital, Zhengzhou, China.,Institute of Hematology, Henan Provincial People's Hospital, Zhengzhou, China.,Henan Key Laboratory of Stem Cell Differentiation and Modification, Zhengzhou, China
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10
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Hwang DY, Eom JI, Jang JE, Jeung HK, Chung H, Kim JS, Cheong JW, Min YH. ULK1 inhibition as a targeted therapeutic strategy for FLT3-ITD-mutated acute myeloid leukemia. J Exp Clin Cancer Res 2020; 39:85. [PMID: 32393312 PMCID: PMC7212592 DOI: 10.1186/s13046-020-01580-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/22/2020] [Indexed: 12/19/2022]
Abstract
Background In acute myeloid leukemia (AML), internal tandem duplication mutations in the FLT3 tyrosine kinase receptor (FLT3-ITD) are associated with a dismal outcome. Although uncoordinated 51-like kinase 1 (ULK1), which plays a central role in the autophagy pathway, has emerged as a novel therapeutic target for various cancers, its role in FLT3-ITD AML remains elusive. In this study, we evaluated the effects of ULK1 inhibition on leukemia cell death in FLT3-ITD AML. Method We evaluated ULK1 expression and the levels of apoptosis and autophagy following ULK1 inhibition in FLT3-ITD AML cell lines and investigated the mechanism underlying apoptosis induced by ULK1 inhibition. Statistical analysis was performed using GraphPad Prism 4.0 (GraphPad Software Inc). Results FLT3-ITD AML cells showed significantly higher ULK1 expression than FLT3-wild-type (WT) AML cells. Two ULK1 inhibitors, MRT 68921 and SBI-0206965, induced apoptosis in FLT3-ITD AML cells, with relatively minimal effects on FLT3-WT AML cells and normal CD34-positive cells. Apoptosis induction by ULK1 inhibition was associated with caspase pathway activation. Interestingly, ULK1 inhibition paradoxically also induced autophagy, showing synergistic interaction with autophagy inhibitors. Hence, autophagy may act as a prosurvival mechanism in FLT3-ITD AML cells. FLT3-ITD protein degradation and inhibition of the ERK, AKT, and STAT5 pathways were also observed in FLT3-ITD AML cells following treatment with ULK1 inhibitors. Conclusion ULK1 is a viable drug target and ULK1 inhibition may represent a promising therapeutic strategy against FLT3-ITD AML.
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Affiliation(s)
- Doh Yu Hwang
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Ju-In Eom
- Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Ji Eun Jang
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Hoi-Kyung Jeung
- Avison Biomedical Research Center, Yonsei University College of Medicine, Seoul, 03722, South Korea
| | - Haerim Chung
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jin Seok Kim
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - June-Won Cheong
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Yoo Hong Min
- Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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11
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Bertoli S, Dumas PY, Bérard E, Largeaud L, Bidet A, Delabesse E, Tavitian S, Gadaud N, Leguay T, Leroy H, Rieu JB, Vial JP, Vergez F, Lechevalier N, Luquet I, Klein E, Sarry A, Grande AC, Récher C, Pigneux A. Outcome of Relapsed or Refractory FLT3-Mutated Acute Myeloid Leukemia Before Second-Generation FLT3 Tyrosine Kinase Inhibitors: A Toulouse-Bordeaux DATAML Registry Study. Cancers (Basel) 2020; 12:E773. [PMID: 32218221 DOI: 10.3390/cancers12040773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/21/2020] [Accepted: 03/22/2020] [Indexed: 12/11/2022] Open
Abstract
A recent phase 3 trial showed that the outcome of patients with relapsed/refractory (R/R) FLT3-mutated acute myeloid leukemia (AML) improved with gilteritinib, a single-agent second-generation FLT3 tyrosine kinase inhibitor (TKI), compared with standard of care. In this trial, the response rate with standard therapy was particularly low. We retrospectively assessed the characteristics and outcome of patients with R/R FLT3-mutated AML included in the Toulouse–Bordeaux DATAML registry. Among 347 patients who received FLT3 TKI-free intensive chemotherapy as first-line treatment, 174 patients were refractory (n = 48, 27.6%) or relapsed (n = 126, 72.4%). Salvage treatments consisted of intensive chemotherapy (n = 99, 56.9%), azacitidine or low-dose cytarabine (n = 9, 5.1%), other low-intensity treatments (n = 17, 9.8%), immediate allogeneic stem cell transplantation (n = 4, 2.3%) or best supportive care only (n = 45, 25.9%). Among the 114 patients who previously received FLT3 TKI-free intensive chemotherapy as first-line treatment (refractory, n = 32, 28.1%; relapsed, n = 82, 71.9%), the rate of CR (complete remission) or CRi (complete remission with incomplete hematologic recovery) after high- or low-intensity salvage treatment was 50.0%, with a bridge to transplant in 34.2% (n = 39) of cases. The median overall survival (OS) was 8.2 months (interquartile range, 3.0–32); 1-, 3- and 5-year OS rates were 36.0% (95%CI: 27–45), 24.7% (95%CI: 1–33) and 19.7% (95%CI: 1–28), respectively. In this real-word study, although response rate appeared higher than the controlled arm of the ADMIRAL trial, the outcome of patients with R/R FLT3-mutated AML remains very poor with standard salvage therapy.
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12
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Takahashi T, Usuki K, Matsue K, Ohno H, Sakura T, Imanaka R, Murakami M, Ohwada S, Takagi T, Sakajiri S. Efficacy and safety of quizartinib in Japanese patients with FLT3-ITD positive relapsed or refractory acute myeloid leukemia in an open-label, phase 2 study. Int J Hematol 2019; 110:665-74. [PMID: 31473943 DOI: 10.1007/s12185-019-02727-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/13/2019] [Accepted: 08/19/2019] [Indexed: 10/26/2022]
Abstract
FMS-like tyrosine kinase 3 (FLT3) internal tandem duplication (ITD) mutations in patients with acute myeloid leukemia (AML) are associated with early relapse and poor survival. This multicenter, single-arm, two-stage phase 2 study (NCT02984995) was conducted to evaluate the efficacy and safety of quizartinib hydrochloride (initial dose 20/30 mg/day), an oral, highly potent, selective FLT3 inhibitor in Japanese patients (median age 65 years) with FLT3-ITD positive relapsed/refractory (R/R) AML. The composite complete remission (CRc) rate (primary endpoint) was 53.8% (90% confidence interval 36.2-70.8%) for evaluable patients in the efficacy analysis set. The median duration of CRc and overall survival was 16.1 weeks and 34.1 weeks, respectively. The most frequent treatment-emergent adverse events (TEAEs) were febrile neutropenia (43.2%), platelet count decreased (37.8%), and QT prolonged (35.1%). Two (5.4%) patients experienced TEAEs associated with treatment discontinuation. All serious TEAEs (45.9%), except febrile neutropenia (16.2%), were reported in ≤ 2 patients. The incidence of QTcF 451-480 ms and 481-500 ms was 37.8% and 2.7%, respectively. No QTcF > 500 ms, events of torsade de pointes or arrhythmia with clinical symptoms were reported. Quizartinib monotherapy was well tolerated and resulted in clinically meaningful reductions in blast count in Japanese patients with FLT3-ITD R/R AML.
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13
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Balzhanova YB, Parovichnikova EN, Sokolov AN, Ryzhko VV, Samtsova MA, Gribanova EO. [Sorafenib - induced thyroiditis in patient with a relapse of acute myelomonocytic leukemia with FLT3-ITD mutation]. TERAPEVT ARKH 2019; 91:93-97. [PMID: 32598759 DOI: 10.26442/00403660.2019.08.000381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Indexed: 11/22/2022]
Abstract
Sorafenib has been used in acute myeloid leukemias with FLT3-ITD mutation improving the outcomes. However the high incidence of treatment - emergent adverse event may be associated with treatment using sorafenib with cytotoxic chemotherapy. We have reported a case of severe thyroiditis in patient with a relapse of acute myelomonocytic leukemia.
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14
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Zhou F, Ge Z, Chen B. Quizartinib (AC220): a promising option for acute myeloid leukemia. Drug Des Devel Ther 2019; 13:1117-1125. [PMID: 31114157 PMCID: PMC6497874 DOI: 10.2147/dddt.s198950] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/04/2019] [Indexed: 12/27/2022]
Abstract
Quizartinib is an effective therapy for patients with FLT3-ITD acute myeloid leukemia (AML) by continuing to inhibit the activity of FLT3 gene, leading to apoptosis of tumor cells. Multiple clinical trials have proved that it is effective in relapsed or refractory AML with an FLT3-ITD mutation. In this review, we focus on the characteristics of FLT3/ITD mutations, the mechanism and pharmacokinetics of quizartinib, and the mechanisms of resistance to quizartinib. We also summarize clinical experiences and adverse effects with quizartinib and recommend crucial approaches of quizartinib in the therapy of patients with newly diagnosed AML and patients with relapsed/refractory AML, particularly those with FLT3-ITD mutation. Quizartinib presents its advantages as a very promising agent in the treatment of AML, especially in patients with FLT3-ITD mutations. FLT3/ITD mutation can lead to constitutive autophosphorylation of FLT3 and activation of its downstream effectors including RAS/RAF/MEK, MAPK/ERK, PI3K/AKT/mTOR and JAK/STAT5 signal pathways, while Quizartinib can inhibit these downstream pathways through specific FLT3 inhibition. Quizartinib has received US Food and Drug Administration breakthrough therapy designation in patients with relapsed/refractory FLT3-ITD AML based on clinical trials. A larger sample of clinical trials are needed to verify its safety and efficacy, and the efficacy of quizartinib combined with chemotherapy or allogeneic hematopoietic cell transplantation should also be estimated in clinical trials. Meanwhile, for the side effects of quizartinib, further studies are needed to find a way to reduce its toxicity.
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Affiliation(s)
- Fang Zhou
- Department of Hematology and Oncology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, People's Republic of China
| | - Zheng Ge
- Department of Hematology and Oncology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, People's Republic of China
| | - Baoan Chen
- Department of Hematology and Oncology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu Province, People's Republic of China
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Tang SH, Lu Y, Zhang PS, Liu XH, Du XH, Chen D, Sha KY, Li SY, Cao JJ, Chen LG, Zhuang XX, Pei RZ, Tang XW. [Effect of FLT3-ITD with DNMT3A R882 double-mutation on the prognosis of acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation]. Zhonghua Xue Ye Xue Za Zhi 2019; 39:552-557. [PMID: 30122013 PMCID: PMC7342207 DOI: 10.3760/cma.j.issn.0253-2727.2018.07.005] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
目的 探讨FLT3-ITD和DNMT3A R882双突变对急性髓系白血病(AML)患者allo-HSCT预后的影响。 方法 使用直接测序法检测206例接受allo-HSCT的AML患者(M3和使用分子靶向药物索拉菲尼的病例除外)初诊时骨髓中常见的基因突变组套(包括FLT3-ITD、DNMT3A、c-kit、CEBPA、FLT3-TKD、NPM1),回顾性分析患者的临床资料,比较各基因突变组的移植预后。 结果 ①206例AML患者中男104例,女102例,中位年龄38(3~63)岁。FAB分型:M0 6例,M1 24例,M2 56例,M4 39例,M5 63例,M6 6例,不能分类12例。②全部206例患者根据初诊时的突变基因情况分为4组:FLT3-ITD+ DNMT3A R882+组(A组)19例,FLT3-ITD+ DNMT3A R882−组(B组)38例,FLT3-ITD−DNMT3A R882+组(C组)21例,FLT3-ITD−DNMT3A R882−组(D组)128例。四组间性别、年龄、初诊时白细胞计数、FAB分型、移植前疾病状态、染色体核型、供者类型、预处理方案及GVHD发生率比较,差异无统计学意义(P>0.05)。③A组和B、C、D组比较,2年累积复发率较高[分别为(72.2±2.6)%、(38.6±0.6)%、(36.8±1.6)%、(27.8±0.1)%,P值均<0.05],总生存率较低[分别为(30.9±13.3)%、(67.5±7.8)%、(61.4±12.4)%、(80.1±3.7)%,P值均<0.05],无白血病生存率较低[分别为(11.3±10.2)%、(47.9±8.4)%、(56.8±12.5)%、(79.7±3.6)%,P值均<0.05]。 结论 伴有FLT3-ITD与DNMT3A R882双突变的AML患者移植后累积复发率较高,总生存率和无白血病生存率较差。
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Affiliation(s)
- S H Tang
- Department of Hematology, Yinzhou People Hospital, Ningbo 315040, China
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Ma RJ, Zhu ZM, Yuan XL, Jiang L, Yang SW, Yang J, Guo JM, Shi J, Lei PC, Zhang L, Shang BJ, Sun K, Zhai YP, Li W, Zhang Y. [The analysis of prognosis-associated factors in adults with acute promyelocytic leukemia]. Zhonghua Xue Ye Xue Za Zhi 2019; 38:592-596. [PMID: 28810326 PMCID: PMC7342290 DOI: 10.3760/cma.j.issn.0253-2727.2017.07.007] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
目的 探讨CD34、CD2、CD56表达和FLT3-ITD突变在成人急性早幼粒细胞白血病(APL)中的预后价值。 方法 分析2010年1月至2016年3月确诊的137例成人APL患者的免疫表型及分子学特点,探讨CD34、CD2、CD56表达及FLT3-ITD突变与初诊WBC、完全缓解率、早期死亡率、复发率、总生存(OS)率及无病生存(DFS)率的关系。 结果 ①137例APL患者中,伴CD34表达者占26.3%,伴CD2表达者占25.5%,伴CD56表达者占10.2%,FLT3-ITD突变率为17.5%。CD34、CD2、CD56表达和FLT3-ITD突变在高危组患者中的发生率分别为43.2%、47.7%、18.2%和27.3%;在中/低危组患者中的发生率分别为18.3%、15.1%、6.5%和12.9%,差异均有统计学意义(χ2值分别为9.561、16.764、4.480、4.268,P值分别为0.002、<0.001、0.034、0.039)。②中位随访41个月,完全缓解率为96.9%,早期死亡率为6.6%,复发率为7.3%。与阴性者比较,伴CD34或CD2表达者的复发率增加(18.8%对3.3%,χ2=8.462,P=0.004;16.1%对4.3%,χ2=4.382,P=0.028);伴CD56表达或FLT3-ITD突变者早期死亡率增加(21.4%对4.9%,χ2=5.610,P=0.018;16.7%对4.4%,χ2=4.833,P=0.028)。③137例患者的OS率为88.3%,DFS率为84.7%;CD34、CD56表达或FLT3-ITD突变者的OS及DFS较阴性者差(P值均<0.05)。 结论 在成人APL患者中,CD34、CD2、CD56表达及FLT3-ITD突变是一种不良预后因素。
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Affiliation(s)
- R J Ma
- Department of Hematology, Henan Provincial People's Hospital, Henan University, Zhengzhou 450003, China
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Abstract
Acute myeloid leukemia (AML) is a highly heterogeneous disease. Mutation with internal tandem duplication of fms-like tyrosine kinase-3 (FLT3-ITD) is one of the two most common driver mutations and the presence of FLT3-ITD delivers poor prognosis. A number of ongoing clinical efforts are focused on FLT3 inhibitor use to improve the outcomes of this otherwise difficult leukemia. Midostaurin has been shown to improve outcomes in FLT3-mutated AML in the frontline setting. Several FLT3 inhibitors, especially second-generation agents, have shown clinically meaningful activity in relapsed or refractory AML and in patients not amenable to intensive therapy. In this article, we briefly review the biology of FLT3 in the physiological state and its role in leukemogenesis. We present a detailed review of current clinical evidence of FLT3 inhibitors and their use in the induction, treatment of relapsed or refractory disease, and maintenance setting.
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Affiliation(s)
- Grerk Sutamtewagul
- Division of Hematology, Oncology and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA,
| | - Carlos E Vigil
- Division of Hematology, Oncology and Blood and Marrow Transplantation, University of Iowa Hospitals and Clinics, Iowa City, IA, USA,
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18
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Zhang QY, Wei XD, Yin QS, Mi RH, Yuan FF, Chen L. [Sorafenib in combination with chemotherapy as first-line therapy for FLT3-ITD positive acute myeloid leukemia]. Zhonghua Xue Ye Xue Za Zhi 2017; 38:415-420. [PMID: 28565742 PMCID: PMC7354192 DOI: 10.3760/cma.j.issn.0253-2727.2017.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Indexed: 11/26/2022]
Abstract
Objective: To analyze the clinical features of acute myeloid leukemia patients with Fms-like tyrosine kinase 3 internal tandem duplication (FLT3-ITD) mutation and the therapeutic effect of sorafenib in combination with chemotherapy as first-line therapy for these patients. Methods: Clinical features and therapeutic effect were retrospectively analyzed in 53 AML patients with FLT3-ITD mutation diagnosed in Henan Cancer Hospital from January 2013 to August 2016. The biological characteristics and clinical efficacy of chemotherapy in combination with or without Sorafeinb were analyzed. Results: FLT3-ITD mutation was identified in 53 AML patients, 22 cases (41.5%) were M(5) subtype. The median of the peripheral WBC was 61.00 (0.98-920.00) ×10(9)/L, and there were 50 (94.3%) patients with WBC>10×10(9)/L. The median of blast cell in bone marrow was 0.730 (0.234-0.966) . The total remission rate of all these 53 patients was 56.6% (30/53) . The complete remission (CR) rates in patients treated with chemotherapy in combination with sorafenib and patients with chemotherapy alone were 86.4% (19/22) and 35.5% (11/31) , respectively. The 1-year overall survival rates of the two groups were 78.3%% and 50.0% (P=0.041) , and 1-year progression free survival rates were 75.9% and 42.4% (P=0.044) , respectively. Conclusion: AML patients with FLT3-ITD mutation have the characteristics of high peripheral WBC, high blast cells in bone marrow and accompanying with M(5) subtype. Sorafeinb combined with chemotherapy can significantly improve CR rate and short term survival.
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Affiliation(s)
- Q Y Zhang
- Department of Hematology, the Affiliated Cancer Hospital of Zhengzhou University; Henan Cancer Hospital, Zhengzhou 450008, China
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Oran B, Cortes J, Beitinjaneh A, Chen HC, de Lima M, Patel K, Ravandi F, Wang X, Brandt M, Andersson BS, Ciurea S, Santos FP, de Padua Silva L, Shpall EJ, Champlin RE, Kantarjian H, Borthakur G. Allogeneic Transplantation in First Remission Improves Outcomes Irrespective of FLT3-ITD Allelic Ratio in FLT3-ITD-Positive Acute Myelogenous Leukemia. Biol Blood Marrow Transplant 2016; 22:1218-1226. [PMID: 27058617 PMCID: PMC6201699 DOI: 10.1016/j.bbmt.2016.03.027] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [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: 01/08/2016] [Accepted: 03/25/2016] [Indexed: 11/22/2022]
Abstract
The adverse prognosis of internal tandem duplication in the FMS-like tyrosine kinase 3 gene(s) (FLT3-ITD) in patients with acute myelogenous leukemia (AML) may depend on allelic burden. We compared postremission treatment with chemotherapy and hematopoietic stem cell transplantation (HSCT) in 169 FLT3-ITDmut intermediate cytogenetic risk AML patients with allelic ratio evaluable at diagnosis who achieved first complete remission (CR1) with induction therapy. To minimize selection bias, the analysis was limited to patients who remained in CR1 for at least 4 months (median time to HSCT) after achieving CR1, and propensity score matching was implemented. Sensitivity analysis including patients who remained in CR1 for at least 3 months was applied as well. HSCT in CR1 was associated with longer relapse-free survival (RFS) and overall survival (OS), with 3-year estimated rates of 18% and 24%, respectively (P < .001), for patients receiving chemotherapy and 46% and 54%, respectively (P < .001), for those undergoing HSCT. Multivariate regression models showed that HSCT remained statistically significant with improved RFS and OS independent of FLT3-ITD allelic ratio and NPM1 status. Irrespective of postremission therapy, relapse remains the main reason for treatment failure, with a 3-year incidence of 68% in chemotherapy recipients versus 41% in HSCT recipients. Allogeneic HSCT improved disease outcomes compared with chemotherapy after propensity score matching was applied. The improvement observed for RFS (hazard ratio [HR], 0.55; P = .09) and OS (HR, 0.58; P = .10) with HSCT as postremission therapy in patients who remained in CR1 for at least 4 months did not reach statistical significance; however, the sensitivity analyses including patients who remained in CR1 for at least 3 months showed significant improvement in both RFS (HR, 0.31; P = .002) and OS (HR, 0.27; P = .02) after propensity score matching. Our results indicate that HSCT in CR1 for AML FLT3-ITDmut patients is associated with longer RFS and OS. Innovative transplantation strategies to improve relapse incidence are urgently needed.
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Affiliation(s)
- Betül Oran
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas.
| | - Jorge Cortes
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Amer Beitinjaneh
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Hsiang-Chun Chen
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Marcos de Lima
- Department of Medicine-Hematology and Oncology, University Hospitals and Case Western Reserve University, Cleveland, Ohio
| | - Keyur Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Farhad Ravandi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Xuemei Wang
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mark Brandt
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Borje S Andersson
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stefan Ciurea
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Fabio P Santos
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Leandro de Padua Silva
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elizabeth J Shpall
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Richard E Champlin
- Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hagop Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Gautam Borthakur
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Affiliation(s)
- George Deeb
- Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Eunice Wang
- Department of Medicine, Roswell Park Cancer Institute, Buffalo, New York
| | - Paul Wallace
- Department of Pathology and Laboratory Medicine, Roswell Park Cancer Institute, Buffalo, New York
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Park JE, Yuen HF, Zhou JB, Al-Aidaroos AQO, Guo K, Valk PJ, Zhang SD, Chng WJ, Hong CW, Mills K, Zeng Q. Oncogenic roles of PRL-3 in FLT3-ITD induced acute myeloid leukaemia. EMBO Mol Med 2013; 5:1351-66. [PMID: 23929599 PMCID: PMC3799491 DOI: 10.1002/emmm.201202183] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 06/18/2013] [Accepted: 06/20/2013] [Indexed: 02/06/2023] Open
Abstract
FLT3-ITD mutations are prevalent mutations in acute myeloid leukaemia (AML). PRL-3, a metastasis-associated phosphatase, is a downstream target of FLT3-ITD. This study investigates the regulation and function of PRL-3 in leukaemia cell lines and AML patients associated with FLT3-ITD mutations. PRL-3 expression is upregulated by the FLT3-STAT5 signalling pathway in leukaemia cells, leading an activation of AP-1 transcription factors via ERK and JNK pathways. PRL-3-depleted AML cells showed a significant decrease in cell growth. Clinically, high PRL-3 mRNA expression was associated with FLT3-ITD mutations in four independent AML datasets with 1158 patients. Multivariable Cox-regression analysis on our Cohort 1 with 221 patients identified PRL-3 as a novel prognostic marker independent of other clinical parameters. Kaplan–Meier analysis showed high PRL-3 mRNA expression was significantly associated with poorer survival among 491 patients with normal karyotype. Targeting PRL-3 reversed the oncogenic effects in FLT3-ITD AML models in vitro and in vivo. Herein, we suggest that PRL-3 could serve as a prognostic marker to predict poorer survival and as a promising novel therapeutic target for AML patients.
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Affiliation(s)
- Jung Eun Park
- Institute of Molecular and Cell Biology, A*STAR (Agency for Science, Technology and Research), Singapore
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