1
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Affiliation(s)
- Claus-Henning Köhne
- Robert-Rössle-Klinik, Department of Hematology, Oncology and Tumorimmunology, Virchow-Klinikum, Humboldt Universität zu Berlin, Berlin, Germany
| | - P.T. Daniel
- Robert-Rössle-Klinik, Department of Hematology, Oncology and Tumorimmunology, Virchow-Klinikum, Humboldt Universität zu Berlin, Berlin, Germany
| | - B. Dörken
- Robert-Rössle-Klinik, Department of Hematology, Oncology and Tumorimmunology, Virchow-Klinikum, Humboldt Universität zu Berlin, Berlin, Germany
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2
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Sinn M, Sinn BV, Striefler JK, Lindner JL, Stieler JM, Lohneis P, Bischoff S, Bläker H, Pelzer U, Bahra M, Dietel M, Dörken B, Oettle H, Riess H, Denkert C. SPARC expression in resected pancreatic cancer patients treated with Gemcitabine: results from the CONKO-001 study. Ann Oncol 2017; 28:2900. [PMID: 27578776 DOI: 10.1093/annonc/mdw269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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3
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Schmitt C, Du J, Bittner A, Neuendorff N, Yu Y, von Kries J, Mathas S, Dörken B, Lee S. RESTORE & TARGET: a CONCEPTUALLY NOVEL TREATMENT APPROACH TO CLASSICAL HODGKIN'S LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_50] [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: 11/06/2022]
Affiliation(s)
- C. Schmitt
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - J. Du
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - A. Bittner
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - N. Neuendorff
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Y. Yu
- Molecular Medicine; Max-Delbrück-Centrum; Berlin Germany
| | - J. von Kries
- Screening Unit; Leibniz Institute für Molekulare Pharmakologie; Berlin Germany
| | - S. Mathas
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - B. Dörken
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Lee
- Medical Department of Hematology, Oncology and Tumor Immunology; Charité - Universitätsmedizin Berlin; Berlin Germany
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4
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Young E, Noerenberg D, Mansouri L, Ljungström V, Frick M, Sutton LA, Blakemore SJ, Galan-Sousa J, Plevova K, Baliakas P, Rossi D, Clifford R, Roos-Weil D, Navrkalova V, Dörken B, Schmitt CA, Smedby KE, Juliusson G, Giacopelli B, Blachly JS, Belessi C, Panagiotidis P, Chiorazzi N, Davi F, Langerak AW, Oscier D, Schuh A, Gaidano G, Ghia P, Xu W, Fan L, Bernard OA, Nguyen-Khac F, Rassenti L, Li J, Kipps TJ, Stamatopoulos K, Pospisilova S, Zenz T, Oakes CC, Strefford JC, Rosenquist R, Damm F. EGR2 mutations define a new clinically aggressive subgroup of chronic lymphocytic leukemia. Leukemia 2016; 31:1547-1554. [PMID: 27890934 DOI: 10.1038/leu.2016.359] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/04/2016] [Accepted: 11/09/2016] [Indexed: 12/11/2022]
Abstract
Recurrent mutations within EGR2 were recently reported in advanced-stage chronic lymphocytic leukemia (CLL) patients and associated with a worse outcome. To study their prognostic impact, 2403 CLL patients were examined for mutations in the EGR2 hotspot region including a screening (n=1283) and two validation cohorts (UK CLL4 trial patients, n=366; CLL Research Consortium (CRC) patients, n=490). Targeted deep-sequencing of 27 known/postulated CLL driver genes was also performed in 38 EGR2-mutated patients to assess concurrent mutations. EGR2 mutations were detected in 91/2403 (3.8%) investigated cases, and associated with younger age at diagnosis, advanced clinical stage, high CD38 expression and unmutated IGHV genes. EGR2-mutated patients frequently carried ATM lesions (42%), TP53 aberrations (18%) and NOTCH1/FBXW7 mutations (16%). EGR2 mutations independently predicted shorter time-to-first-treatment (TTFT) and overall survival (OS) in the screening cohort; they were confirmed associated with reduced TTFT and OS in the CRC cohort and independently predicted short OS from randomization in the UK CLL4 cohort. A particularly dismal outcome was observed among EGR2-mutated patients who also carried TP53 aberrations. In summary, EGR2 mutations were independently associated with an unfavorable prognosis, comparable to CLL patients carrying TP53 aberrations, suggesting that EGR2-mutated patients represent a new patient subgroup with very poor outcome.
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Affiliation(s)
- E Young
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - D Noerenberg
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - L Mansouri
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - V Ljungström
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - M Frick
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - L-A Sutton
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - S J Blakemore
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Galan-Sousa
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - K Plevova
- Central European Institute of Technology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - P Baliakas
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - D Rossi
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.,Hematology, Oncology Institute of Southern Switzerland and Institute of Oncology Research, Bellinzona, Switzerland
| | - R Clifford
- Oxford National Institute for Health Research Biomedical Research Centre and Department of Oncology, University of Oxford, Oxford, UK
| | - D Roos-Weil
- INSERM, U1170, Institut Gustave Roussy, Villejuif, France
| | - V Navrkalova
- Central European Institute of Technology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - B Dörken
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - C A Schmitt
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany
| | - K E Smedby
- Department of Medicine Solna, Clinical Epidemiology Unit, Karolinska Institutet, and Hematology Center, Karolinska University Hospital, Stockholm, Sweden
| | - G Juliusson
- Department of Laboratory Medicine, Stem Cell Center, Lund University, Lund, Sweden
| | - B Giacopelli
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - J S Blachly
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - C Belessi
- Hematology Department, General Hospital of Nikea, Piraeus, Greece
| | - P Panagiotidis
- First Department of Propaedeutic Medicine, School of Medicine, University of Athens, Athens, Greece
| | - N Chiorazzi
- Karches Center for Chronic Lymphocytic Leukemia Research, The Feinstein Institute for Medical Research, Manhasset, New York, USA
| | - F Davi
- Laboratory of Hematology and Universite Pierre et Marie Curie, Hopital Pitie-Salpetriere, Paris, France
| | - A W Langerak
- Department of Immunology, Laboratory for Medical Immunology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - D Oscier
- Department of Molecular Pathology, Royal Bournemouth Hospital, Bournemouth, UK
| | - A Schuh
- Oxford National Institute for Health Research Biomedical Research Centre and Department of Oncology, University of Oxford, Oxford, UK
| | - G Gaidano
- Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - P Ghia
- Università Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology and Department of Onco-Hematology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy
| | - W Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing, China
| | - L Fan
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing, China
| | - O A Bernard
- INSERM, U1170, Institut Gustave Roussy, Villejuif, France
| | - F Nguyen-Khac
- Laboratory of Hematology and Universite Pierre et Marie Curie, Hopital Pitie-Salpetriere, Paris, France
| | - L Rassenti
- Division of Hematology/Oncology, Department of Medicine, University of California at San Diego/Moores Cancer Center, La Jolla, CA, USA
| | - J Li
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Collaborative Innovation Center For Cancer Personalized Medicine, Nanjing, China
| | - T J Kipps
- Division of Hematology/Oncology, Department of Medicine, University of California at San Diego/Moores Cancer Center, La Jolla, CA, USA
| | - K Stamatopoulos
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden.,Institute of Applied Biosciences, Center for Research and Technology Hellas, Thessaloniki, Greece
| | - S Pospisilova
- Central European Institute of Technology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - T Zenz
- Department of Molecular Therapy in Haematology and Oncology (G250) and Department of Translational Oncology, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medicine V, University Hospital Heidelberg, Heidelberg, Germany.,German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - C C Oakes
- Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - J C Strefford
- Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - R Rosenquist
- Department of Immunology, Genetics, and Pathology, Science for Life Laboratory, Uppsala University, Sweden
| | - F Damm
- Department of Hematology, Oncology, and Tumor Immunology, Charité, University Medical Center, Berlin, Germany.,German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
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5
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Wurster KD, Hummel F, Richter J, Giefing M, Hartmann S, Hansmann ML, Kreher S, Köchert K, Krappmann D, Klapper W, Hummel M, Wenzel SS, Lenz G, Janz M, Dörken B, Siebert R, Mathas S. Inactivation of the putative ubiquitin-E3 ligase PDLIM2 in classical Hodgkin and anaplastic large cell lymphoma. Leukemia 2016; 31:602-613. [PMID: 27538486 PMCID: PMC5339435 DOI: 10.1038/leu.2016.238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 01/19/2016] [Revised: 08/02/2016] [Accepted: 08/09/2016] [Indexed: 12/12/2022]
Abstract
Apart from its unique histopathological appearance with rare tumor cells embedded in an inflammatory background of bystander cells, classical Hodgkin lymphoma (cHL) is characterized by an unusual activation of a broad range of signaling pathways involved in cellular activation. This includes constitutive high-level activity of nuclear factor-κB (NF-κB), Janus kinase/signal transducer and activator of transcription (JAK/STAT), activator protein-1 (AP-1) and interferon regulatory factor (IRF) transcription factors (TFs) that are physiologically only transiently activated. Here, we demonstrate that inactivation of the putative ubiquitin E3-ligase PDLIM2 contributes to this TF activation. PDLIM2 expression is lost at the mRNA and protein levels in the majority of cHL cell lines and Hodgkin and Reed–Sternberg (HRS) cells of nearly all cHL primary samples. This loss is associated with PDLIM2 genomic alterations, promoter methylation and altered splicing. Reconstitution of PDLIM2 in HRS cell lines inhibits proliferation, blocks NF-κB transcriptional activity and contributes to cHL-specific gene expression. In non-Hodgkin B-cell lines, small interfering RNA-mediated PDLIM2 knockdown results in superactivation of TFs NF-κB and AP-1 following phorbol 12-myristate 13-acetate (PMA) stimulation. Furthermore, expression of PDLIM2 is lost in anaplastic large cell lymphoma (ALCL) that shares key biological aspects with cHL. We conclude that inactivation of PDLIM2 is a recurrent finding in cHL and ALCL, promotes activation of inflammatory signaling pathways and thereby contributes to their pathogenesis.
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Affiliation(s)
- K D Wurster
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - F Hummel
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Richter
- Institute of Human Genetics, Christian-Albrechts University Kiel, Kiel, Germany
| | - M Giefing
- Institute of Human Genetics, Christian-Albrechts University Kiel, Kiel, Germany.,Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - S Hartmann
- Dr Senckenberg Institute of Pathology, University of Frankfurt, Medical School, Frankfurt, Germany
| | - M-L Hansmann
- Dr Senckenberg Institute of Pathology, University of Frankfurt, Medical School, Frankfurt, Germany
| | - S Kreher
- Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - K Köchert
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - D Krappmann
- Research Unit Cellular Signal Integration, Helmholtz Zentrum München für Gesundheit und Umwelt, Neuherberg, Germany
| | - W Klapper
- Department of Pathology, Haematopathology Section and Lymph Node Registry, Christian-Albrechts University Kiel, Kiel, Germany
| | - M Hummel
- Institute of Pathology, Charité-Universitätsmedzin Berlin, Berlin, Germany
| | - S-S Wenzel
- Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - G Lenz
- Division of Translational Oncology, Department of Medicine A, University Hospital Münster, and Cluster of Excellence EXC 1003, Cells in Motion, Münster, Germany
| | - M Janz
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - B Dörken
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R Siebert
- Institute of Human Genetics, Christian-Albrechts University Kiel, Kiel, Germany.,Institute of Human Genetics, University Hospital Ulm, Ulm, Germany
| | - S Mathas
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany.,Hematology, Oncology, and Tumor Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany.,German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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6
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Massenkeil G, Alexander T, Rosen O, Dörken B, Burmester G, Radbruch A, Hiepe F, Arnold R. Long-term follow-up of fertility and pregnancy in autoimmune diseases after autologous haematopoietic stem cell transplantation. Rheumatol Int 2016; 36:1563-1568. [PMID: 27522225 DOI: 10.1007/s00296-016-3531-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 01/04/2016] [Accepted: 07/08/2016] [Indexed: 12/29/2022]
Abstract
Issues of fertility and pregnancy require special attention in the long-term care of patients with autoimmune diseases (AD), who are candidates for haematopoietic stem cell transplantation (HSCT). In this single-centre observational study, we report fertility status and pregnancy outcomes in 15 patients (11 female and 4 male) after immunoablation with cyclophosphamide, antithymocyte globulin and autologous CD34+-selected HSCT for severe, refractory AD. The median follow-up after HSCT was 12 years (range 2-16 years). Impaired fertility was observed in six patients (five females and one male) before HSCT based on sexual hormone measurements. Higher age and cumulative cyclophosphamide dosage before HSCT correlated with fertility impairment. Median serum level of follicle-stimulating hormone (FSH) was significantly higher in female patients at 1 year after HSCT compared to baseline values, but premature ovarian failure developed in only one patient. Four women had five pregnancies and six healthy offsprings during follow-up, and no miscarriages were observed. The mothers were in treatment-free remissions during conception. No peripartal flare of their AD occurred. Although AD patients undergoing HSCT are at risk of developing infertility, pre-HSCT treatment and patients' age seem to have higher impact on long-term fertility status than HSCT itself. HSCT offers the opportunity to conceive during treatment-free remissions with favourable pregnancy outcomes.
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Affiliation(s)
- G Massenkeil
- Department of Haematology and Oncology, Charité University Medicine, Berlin, Germany. .,Department of Internal Medicine, Klinikum Guetersloh, Reckenberger Strasse 19, 33332, Guetersloh, Germany.
| | - T Alexander
- Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
| | - O Rosen
- Department of Haematology and Oncology, Charité University Medicine, Berlin, Germany
| | - B Dörken
- Department of Haematology and Oncology, Charité University Medicine, Berlin, Germany
| | - G Burmester
- Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
| | - A Radbruch
- German Rheumatism Research Centre, Berlin, Germany
| | - F Hiepe
- Department of Rheumatology and Clinical Immunology, Charité University Medicine, Berlin, Germany
| | - R Arnold
- Department of Haematology and Oncology, Charité University Medicine, Berlin, Germany
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7
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Massenkeil G, Zschieschang P, Thiel G, Hemmati PG, Budach V, Dörken B, Pross J, Arnold R. Frequent induction of chromosomal aberrations in in vivo skin fibroblasts after allogeneic stem cell transplantation: hints to chromosomal instability after irradiation. Radiat Oncol 2015; 10:266. [PMID: 26715553 PMCID: PMC4696175 DOI: 10.1186/s13014-015-0576-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 12/22/2014] [Accepted: 12/21/2015] [Indexed: 11/21/2022] Open
Abstract
Background Total body irradiation (TBI) has been part of standard conditioning regimens before allogeneic stem cell transplantation for many years. Its effect on normal tissue in these patients has not been studied extensively. Method We studied the in vivo cytogenetic effects of TBI and high-dose chemotherapy on skin fibroblasts from 35 allogeneic stem cell transplantation (SCT) patients. Biopsies were obtained prospectively (n = 18 patients) before, 3 and 12 months after allogeneic SCT and retrospectively (n = 17 patients) 23–65 months after SCT for G-banded chromosome analysis. Results Chromosomal aberrations were detected in 2/18 patients (11 %) before allogeneic SCT, in 12/13 patients (92 %) after 3 months, in all patients after 12 months and in all patients in the retrospective group after allogeneic SCT. The percentage of aberrant cells was significantly higher at all times after allogeneic SCT compared to baseline analysis. Reciprocal translocations were the most common aberrations, but all other types of stable, structural chromosomal aberrations were also observed. Clonal aberrations were observed, but only in three cases they were detected in independently cultured flasks. A tendency to non-random clustering throughout the genome was observed. The percentage of aberrant cells was not different between patients with and without secondary malignancies in this study group. Conclusion High-dose chemotherapy and TBI leads to severe chromosomal damage in skin fibroblasts of patients after SCT. Our long-term data suggest that this damage increases with time, possibly due to in vivo radiation-induced chromosomal instability.
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Affiliation(s)
- G Massenkeil
- Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany. .,Present address: Department of Internal Medicine, Clinic for Hematology and Oncology, Klinikum Guetersloh, Guetersloh, Germany.
| | - P Zschieschang
- Institute for Medical Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Present address: Medical practice for Human Genetics, Friedrichstrasse, Berlin, Germany
| | - G Thiel
- Institute for Medical Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany.,Present address: Medical practice for Human Genetics, Friedrichstrasse, Berlin, Germany
| | - P G Hemmati
- Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - V Budach
- Clinic for Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - B Dörken
- Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J Pross
- Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - R Arnold
- Department of Hematology, Oncology and Tumor Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
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8
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Pfeifer M, Zheng B, Erdmann T, Koeppen H, McCord R, Grau M, Staiger A, Chai A, Sandmann T, Madle H, Dörken B, Chu YW, Chen AI, Lebovic D, Salles GA, Czuczman MS, Palanca-Wessels MC, Press OW, Advani R, Morschhauser F, Cheson BD, Lenz P, Ott G, Polson AG, Mundt KE, Lenz G. Anti-CD22 and anti-CD79B antibody drug conjugates are active in different molecular diffuse large B-cell lymphoma subtypes. Leukemia 2015; 29:1578-86. [PMID: 25708834 DOI: 10.1038/leu.2015.48] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [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: 08/25/2014] [Revised: 01/08/2015] [Accepted: 02/13/2015] [Indexed: 12/16/2022]
Abstract
Antibody drug conjugates (ADCs), in which cytotoxic drugs are linked to antibodies targeting antigens on tumor cells, represent promising novel agents for the treatment of malignant lymphomas. Pinatuzumab vedotin is an anti-CD22 ADC and polatuzumab vedotin an anti-CD79B ADC that are both linked to the microtubule-disrupting agent monomethyl auristatin E (MMAE). In the present study, we analyzed the activity of these agents in different molecular subtypes of diffuse large B-cell lymphoma (DLBCL) both in vitro and in early clinical trials. Both anti-CD22-MMAE and anti-CD79B-MMAE were highly active and induced cell death in the vast majority of activated B-cell-like (ABC) and germinal center B-cell-like (GCB) DLBCL cell lines. Similarly, both agents induced cytotoxicity in models with and without mutations in the signaling molecule CD79B. In line with these observations, relapsed and refractory DLBCL patients of both subtypes responded to these agents. Importantly, a strong correlation between CD22 and CD79B expression in vitro and in vivo was not detectable, indicating that patients should not be excluded from anti-CD22-MMAE or anti-CD79B-MMAE treatment because of low target expression. In summary, these studies suggest that pinatuzumab vedotin and polatuzumab vedotin are active agents for the treatment of patients with different subtypes of DLBCL.
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MESH Headings
- Antibodies, Monoclonal/pharmacology
- Apoptosis/drug effects
- Blotting, Western
- CD79 Antigens/genetics
- CD79 Antigens/immunology
- Cell Cycle/drug effects
- Cell Proliferation/drug effects
- Clinical Trials, Phase I as Topic
- Cohort Studies
- Flow Cytometry
- Follow-Up Studies
- Humans
- Immunoconjugates/pharmacology
- Immunoenzyme Techniques
- Lymphoma, Large B-Cell, Diffuse/classification
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/immunology
- Lymphoma, Large B-Cell, Diffuse/pathology
- Mutation/genetics
- Neoplasm Staging
- Prognosis
- Sialic Acid Binding Ig-like Lectin 2/genetics
- Sialic Acid Binding Ig-like Lectin 2/immunology
- Tumor Cells, Cultured
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Affiliation(s)
- M Pfeifer
- Department of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, Germany
| | - B Zheng
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - T Erdmann
- 1] Division of Translational Oncology, Department of Medicine A, University Hospital Münster, Münster, Germany [2] Cluster of Excellence EXC 1003, Cells in Motion Münster, Germany
| | - H Koeppen
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - R McCord
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - M Grau
- Department of Physics, Philipps-University, Marburg, Germany
| | - A Staiger
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus and Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
| | - A Chai
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - T Sandmann
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - H Madle
- 1] Division of Translational Oncology, Department of Medicine A, University Hospital Münster, Münster, Germany [2] Cluster of Excellence EXC 1003, Cells in Motion Münster, Germany
| | - B Dörken
- Department of Hematology, Oncology and Tumor Immunology, Charité-Universitätsmedizin Berlin, Germany
| | - Y-W Chu
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - A I Chen
- Department of Hematology-Oncology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - D Lebovic
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan, Ann Arbor, MI, USA
| | - G A Salles
- Hematology Department, Hospices Civils de Lyon - Université de Lyon, Pierre-Bénite, France
| | - M S Czuczman
- Department of Medicine and Immunology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - M C Palanca-Wessels
- 1] Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA [2] Seattle Genetics Inc, Bothell, WA, USA
| | - O W Press
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - R Advani
- Stanford University Medical Center, Stanford University, Stanford, CA, USA
| | - F Morschhauser
- Department of Hematology, Centre Hospitalier Régional Universitaire de Lille, Lille, France
| | - B D Cheson
- Lombardi Comprehensive Cancer Center, Georgetown University Hospital, Washington DC, USA
| | - P Lenz
- Department of Physics, Philipps-University, Marburg, Germany
| | - G Ott
- Department of Clinical Pathology, Robert-Bosch-Krankenhaus and Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany
| | - A G Polson
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - K E Mundt
- Genentech Inc., 1 DNA Way, South San Francisco, CA, USA
| | - G Lenz
- 1] Division of Translational Oncology, Department of Medicine A, University Hospital Münster, Münster, Germany [2] Cluster of Excellence EXC 1003, Cells in Motion Münster, Germany
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9
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Sinn M, Liersch T, Gellert K, Riess H, Stübs P, Waldschmidt D, Pelzer U, Stieler J, Striefler J, Bahra M, Dörken B, Oettle H. Conko-006: a Randomized Double-Blinded Phase Iib-Study of Adjuvant Therapy with Gemcitabine + Sorafenib/Placebo for Patients with R1-Resection of Pancreatic Cancer. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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10
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Meyer AH, Stroux A, Lerch K, Eucker J, Eitle J, Hohloch K, Andrzejak M, Possinger K, Dörken B, Pezzutto A, Scholz CW. Transformation and additional malignancies are leading risk factors for an adverse course of disease in marginal zone lymphoma. Ann Oncol 2014; 25:210-5. [PMID: 24356632 DOI: 10.1093/annonc/mdt507] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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: 11/14/2022] Open
Abstract
BACKGROUND Marginal zone lymphoma (MZL) is a non-Hodgkin lymphoma that occurs as extra nodal, nodal, or splenic. While MZL is generally considered an indolent disease, a substantial percentage of patients follow an unfavorable course. The objective of this retrospective analysis was to identify predictors for a reduced overall survival (OS), or conversely an increased OS. PATIENTS AND METHODS One hundred and ninety-seven MZL patients were analyzed. Apart from assessing previously published risk factors, concomitant morbidity at diagnosis, transformation into aggressive lymphoma, and occurrence of additional malignancies were evaluated. RESULTS Next to the known risk factors, i.e. above 60 years of age and elevated serum lactate dehydrogenase (LDH), we demonstrate that transformation into aggressive lymphoma, as well as additional malignancies, are important independent risk factors for a shortened OS in a multivariate analysis, irrespective of the MZL localization. Impressively, in the group of patients lacking LDH elevation, transformation, and/or additional malignancies, only 1 of 63 patients died during follow-up compared with 37 of 87 patients in the high-risk group (HR = 22.8; 95% confidence interval 3.1-167.0; P = 0.002). CONCLUSIONS Our analysis proposes novel risk factors and warrants for a continuous follow-up to detect the occurrence of transformation and additional malignancies early on.
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Affiliation(s)
- A H Meyer
- Department of Hematology, Oncology and Tumor Immunology
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11
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Schwarzer R, Nickel N, Godau J, Willie BM, Duda GN, Schwarzer R, Cirovic B, Leutz A, Manz R, Bogen B, Dörken B, Jundt F. Notch pathway inhibition controls myeloma bone disease in the murine MOPC315.BM model. Blood Cancer J 2014; 4:e217. [PMID: 24927406 PMCID: PMC4080208 DOI: 10.1038/bcj.2014.37] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [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: 04/23/2014] [Accepted: 04/30/2014] [Indexed: 01/16/2023] Open
Abstract
Despite evidence that deregulated Notch signalling is a master regulator of multiple myeloma (MM) pathogenesis, its contribution to myeloma bone disease remains to be resolved. Notch promotes survival of human MM cells and triggers human osteoclast activity in vitro. Here, we show that inhibition of Notch through the γ-secretase inhibitor XII (GSI XII) induces apoptosis of murine MOPC315.BM myeloma cells with high Notch activity. GSI XII impairs murine osteoclast differentiation of receptor activator of NF-κB ligand (RANKL)-stimulated RAW264.7 cells in vitro. In the murine MOPC315.BM myeloma model GSI XII has potent anti-MM activity and reduces osteolytic lesions as evidenced by diminished myeloma-specific monoclonal immunoglobulin (Ig)-A serum levels and quantitative assessment of bone structure changes via high-resolution microcomputed tomography scans. Thus, we suggest that Notch inhibition through GSI XII controls myeloma bone disease mainly by targeting Notch in MM cells and possibly in osteoclasts in their microenvironment. We conclude that Notch inhibition is a valid therapeutic strategy in MM.
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Affiliation(s)
- R Schwarzer
- Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - N Nickel
- Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - J Godau
- Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - B M Willie
- Julius Wolff Institute and Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - G N Duda
- Julius Wolff Institute and Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - R Schwarzer
- Institute of Biology and Molecular Biophysics, Humboldt University Berlin, Berlin, Germany
| | - B Cirovic
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - A Leutz
- Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - R Manz
- Institute for Systemic Inflammation Research (ISEF), University of Lübeck, Lübeck, Germany
| | - B Bogen
- 1] Centre for Immune Regulation, Institute of Immunology, Oslo University Hospital, Oslo, Norway [2] Jebsen Centre for Research on Influenza Vaccines, University of Oslo, Oslo, Norway
| | - B Dörken
- 1] Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany [2] Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - F Jundt
- 1] Department of Hematology, Oncology and Tumor Immunology, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Berlin, Germany [2] Department of Internal Medicine II, University Hospital Würzburg, University of Würzburg, Würzburg, Germany
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12
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Sinn M, Sinn BV, Striefler JK, Lindner JL, Stieler JM, Lohneis P, Bischoff S, Bläker H, Pelzer U, Bahra M, Dietel M, Dörken B, Oettle H, Riess H, Denkert C. SPARC expression in resected pancreatic cancer patients treated with gemcitabine: results from the CONKO-001 study. Ann Oncol 2014; 25:1025-32. [PMID: 24562449 DOI: 10.1093/annonc/mdu084] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [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: 12/30/2022] Open
Abstract
BACKGROUND Previous investigations in pancreatic cancer suggested a prognostic role for secreted protein acidic and rich in cysteine (SPARC) expression in the peritumoral stroma but not for cytoplasmic SPARC expression. The aim of this study was to evaluate the impact of SPARC expression in pancreatic cancer patients treated with gemcitabine compared with untreated patients. PATIENTS AND METHODS CONKO-001 was a prospective randomized phase III study investigating the role of adjuvant gemcitabine when compared with observation. Tissue samples of 160 patients were available for SPARC immunohistochemistry on tissue microarrays to evaluate its impact on patient outcome. RESULTS Strong stromal SPARC expression was associated with worse disease-free survival (DFS) and overall survival (OS) in the overall study population (DFS: P = 0.005, OS: P = 0.033). Its negative prognostic impact was restricted to patients treated with gemcitabine (DFS: P = 0.007, OS: P = 0.006). High cytoplasmic SPARC expression also was associated with worse patient outcome (DFS: P = 0.041, OS: P = 0.011). Again the effect was restricted to patients treated with gemcitabine (DFS: P = 0.002, OS: P = 0.003). In multivariable analysis, SPARC expression was independently predictive of patient outcome. CONCLUSIONS Our data confirm the prognostic significance of SPARC expression after curatively intended resection. The negative prognostic impact was restricted to patients who received adjuvant treatment with gemcitabine, suggesting SPARC as a predictive marker for response to gemcitabine.
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Affiliation(s)
- M Sinn
- Department of Medical Oncology and Haematology
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13
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Hay AE, Klimm B, Chen BE, Goergen H, Shepherd LE, Fuchs M, Gospodarowicz MK, Borchmann P, Connors JM, Markova J, Crump M, Lohri A, Winter JN, Dörken B, Pearcey RG, Diehl V, Horning SJ, Eich HT, Engert A, Meyer RM. An individual patient-data comparison of combined modality therapy and ABVD alone for patients with limited-stage Hodgkin lymphoma. Ann Oncol 2013; 24:3065-9. [PMID: 24121121 DOI: 10.1093/annonc/mdt389] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Treatment options for patients with nonbulky stage IA-IIA Hodgkin lymphoma include combined modality therapy (CMT) using doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) plus involved-field radiation therapy (IFRT), and chemotherapy with ABVD alone. There are no mature randomized data comparing ABVD with CMT using modern radiation techniques. PATIENTS AND METHODS Using German Hodgkin Study Group HD10/HD11 and NCIC Clinical Trials Group HD.6 databases, we identified 588 patients who met mutually inclusive eligibility criteria from the preferred arms of HD10 or 11 (n = 406) and HD.6 (n = 182). We evaluated time to progression (TTP), progression-free (PFS) and overall survival, including in three predefined exploratory subset analyses. RESULTS With median follow-up of 91 (HD10/11) and 134 (HD.6) months, respective 8-year outcomes were for TTP, 93% versus 87% [hazard ratio (HR) 0.44, 95% confidence interval (CI) 0.24-0.78]; for PFS, 89% versus 86% (HR 0.71, 95% CI 0.42-1.18) and for overall survival, 95% versus 95% (HR 1.09, 95% CI 0.49-2.40). In the exploratory subset analysis including HD10 eligible patients who achieved complete response (CR) or unconfirmed complete response (CRu) after two cycles of ABVD, 8-year PFS was 87% (HD10) versus 95% (HD.6) (HR 2.8; 95% CI 0.64-12.5) and overall survival 96% versus 100%. In contrast, among those without CR/CRu after two cycles of ABVD, 8-year PFS was 88% versus 74% (HR 0.35; 95% CI 0.16-0.79) and overall survival 95% versus 91%, respectively (HR 0.42; 95% CI 0.12-1.44). CONCLUSIONS In patients with nonbulky stage IA-IIA Hodgkin lymphoma, CMT provides better disease control than ABVD alone, especially among those not achieving complete response after two cycles of ABVD. Within the follow-up duration evaluated, overall survivals were similar. Longer follow-up is required to understand the implications of radiation and chemotherapy-related late effects. CLINICAL TRIALS The trials included in this analysis were registered at ClinicalTrials.gov: HD10 - NCT00265018, HD11 - NCT00264953, HD.6 - NCT00002561.
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Affiliation(s)
- A E Hay
- NCIC Clinical Trials Group and Queen's University, Kingston, Ontario, Canada
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14
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Pelzer U, Klein F, Bahra M, Sinn M, Dörken B, Neuhaus P, Meyer O, Riess H. Blood group determinates incidence for pancreatic cancer in Germany. Front Physiol 2013; 4:118. [PMID: 23745115 PMCID: PMC3662880 DOI: 10.3389/fphys.2013.00118] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 05/07/2013] [Indexed: 12/14/2022] Open
Abstract
Background: Genetic risk factors for sporadic pancreatic cancer are largely unknown but actually under high exposure. Findings of correlations between the AB0 blood group system (Chromosome 9q34,1—q34,2) and the risk of pancreatic cancer (PC) in patients from Asia, America and south Europe have already been published. So far it is unclear, whether this correlation between blood group an PC incidence can be found in German patients as well. Methods: One hundred and sixty-six patients who underwent a resection of PC were evaluated in a period between 2000 and 2010. Blood group reference distribution for the German population is given as: 0: 41%; A: 43%; B: 11%; AB: 5%; Rhesus positive: 85%; Rhesus negative: 15%. Analyses were done using the non-parametric Chi2-test (p-value two sided; SPSS 19.0). Results: Median age was 62 (34–82) years. Gender: female 73/44%; male: 93/56%. Observed blood group proportions: 0: 43 (25.9%)/A: 94 (56.6%)/B: 16 (9.6%)/AB: 13 (7.8%)/Rhesus positive: 131 (78.9%)/negative: 35 (21.1%). We detected a significant difference to the German reference distribution of the AB0 system (Chi2 19.34, df 3, p < 0.001). Rhesus factor has no impact on AB0-distribution (Chi2 4.13, df 3, p = 0.25), but differs significantly from reference distribution—probably due to initial AB0-variation (Chi2 4.82, df 1, p = 0.028). The odds ratio for blood group A is 2.01 and for blood group 0 is 0.5. Conclusions: The incidence of PC in the German cohort is highly associated with the AB0-system as well. More patients with blood group A suffer from PC (p < 0.001) whereas blood group 0 was less frequent in patients with PC (p < 0.001). Thus, our findings support the results from other non-German surveys. The causal trigger points of this carcinogenesis correlation are still not known.
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Affiliation(s)
- U Pelzer
- Department of Hematology/Oncology, Comprehensive Cancer Center, Charité - Universitätsmedizin Berlin Berlin, Germany
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15
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Terwey T, Le Duc T, Hemmati P, le Coutre P, Nagy M, Martus P, Dörken B, Arnold R. NIH-defined graft-versus-host disease and evidence for a potent graft-versus-leukemia effect in patients with acute lymphoblastic leukemia. Ann Oncol 2013; 24:1363-70. [DOI: 10.1093/annonc/mds615] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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16
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Nguyen-Hoai T, Hohn O, Vu MD, Baldenhofer G, Sayed Ahmed MS, Dörken B, Norley S, Lipp M, Pezzutto A, Westermann J. CCL19 as an adjuvant for intradermal gene gun immunization in a Her2/neu mouse tumor model: improved vaccine efficacy and a role for B cells as APC. Cancer Gene Ther 2012; 19:880-7. [DOI: 10.1038/cgt.2012.78] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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17
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Lamprecht B, Kreher S, Möbs M, Sterry W, Dörken B, Janz M, Assaf C, Mathas S. The tumour suppressor p53 is frequently nonfunctional in Sézary syndrome. Br J Dermatol 2012; 167:240-6. [PMID: 22384858 DOI: 10.1111/j.1365-2133.2012.10918.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Primary cutaneous T-cell lymphomas (CTCLs) are a heterogeneous group with Sézary syndrome (SS) as one of the most aggressive variants. Recently, we identified a loss of E2A as a recurrent event in SS, which enhanced proliferation via upregulation of the proto-oncogene MYC. MYC-induced transformation usually requires deleterious alterations of key apoptotic genes including p53; however, p53 functionality and mutation status in SS are unclear. OBJECTIVES We investigated functionality of p53 signalling by pharmacological treatment with the MDM2 antagonist nutlin-3, which might result in p53 activation. Furthermore, we analysed the TP53 mutation status in CTCL cell lines and highly purified tumour cells from patients with SS by mRNA and DNA sequencing. METHODS We analysed the apoptosis induction due to nutlin-3 treatment in various SS cell lines and primary patient samples by annexin V/propidium iodide staining. Induction of p53 target genes was analysed by immunoblotting, and TP53 was sequenced at the mRNA and DNA level. RESULTS We identified various TP53 mutations and an impaired p53 signalling in the vast majority of the investigated cell lines and primary SS cells. CONCLUSIONS In accordance with the importance of MYC deregulation in SS, p53 signalling is frequently nonfunctional in SS. However, although most likely ineffective as exclusive treatment in SS, it remains possible that pharmacological p53 activation could be beneficial in combination with other approaches including classical chemotherapeutics.
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Affiliation(s)
- B Lamprecht
- Department of Haematology, Oncology and Tumour Immunology, Charité- Universitätsmedizin Berlin, 13125 Berlin, Germany
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18
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Nguyen-Hoai T, Baldenhofer G, Sayed Ahmed MS, Pham-Duc M, Vu MD, Lipp M, Dörken B, Pezzutto A, Westermann J. CCL21 (SLC) improves tumor protection by a DNA vaccine in a Her2/neu mouse tumor model. Cancer Gene Ther 2011; 19:69-76. [PMID: 21997231 DOI: 10.1038/cgt.2011.69] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Secondary lymphoid-tissue chemokine (SLC/CCL21) is a CC chemokine that is constitutively expressed in various lymphoid tissues and binds to chemokine receptor CCR7 on mature dendritic cells (DCs) and distinct T-and B-cell sub-populations. In vivo, CCL21 regulates the encounters between DC and T cells and thus is a key regulator of adaptive immune responses. We asked whether CCL21 is able to augment immunogenicity of a DNA-based vaccine against Her2/neu in a Balb/c mouse model with syngeneic Her2/neu+ tumor cells (D2F2/E2). Mice were vaccinated intramuscularly with plasmid DNA (pDNA) on day 1 and boosted on day 15; tumor challenge was performed subcutaneously on day 25. Coexpression of CCL21 and Her-2/neu resulted in induction of a TH1-polarized immune response and substantial improvement of the protective effect of the DNA vaccine. Coexpression of tumor antigen pDNA(Her2/neu) with both pDNA(GM-CSF) and pDNA(CCL21) as adjuvants led to further improvement of protection by the vaccine (70% tumor-free mice on day 35 vs 40% with either adjuvant alone vs 5-10% with tumor antigen alone). Our results show that CCL21 is a potent adjuvant for DNA vaccination, particularly in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF). Clinical use of a pDNA(Her2/neu/CCL21/GM-CSF) vaccine might be particularly promising in minimal residual Her2/neu+ breast cancer.
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Affiliation(s)
- T Nguyen-Hoai
- Department of Hematology, Oncology and Tumor Immunology, Charité-University Medicine Berlin, Campus Berlin-Buch and Campus Virchow-Klinikum, Berlin, Germany
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Ringel F, Kaeda J, Schwarz M, Dörken B, le Coutre PD. In vitro effects of the novel JAK II inhibitor BSK805 in BCR-ABL and JAK II V617F-positive cell lines. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e13563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Terwey T, Hemmati P, Vuong L, le Coutre P, Massenkeil G, Dörken B, Arnold R. Reduced Intensity Versus Standard Myeloablative Conditioning in Patients With Acute Myeloid Leukemia in Second Complete Remission. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Köchert K, Ullrich K, Kreher S, Aster JC, Kitagawa M, Jöhrens K, Anagnostopoulos I, Jundt F, Lamprecht B, Zimber-Strobl U, Stein H, Janz M, Dörken B, Mathas S. High-level expression of Mastermind-like 2 contributes to aberrant activation of the NOTCH signaling pathway in human lymphomas. Oncogene 2010; 30:1831-40. [DOI: 10.1038/onc.2010.544] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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22
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Westermann J, Flörcken A, Willimsky G, van Lessen A, Kopp J, Takvorian A, Jöhrens K, Lukowsky A, Schönemann C, Sawitzki B, Pohla H, Frank R, Dörken B, Schendel DJ, Blankenstein T, Pezzutto A. Allogeneic gene-modified tumor cells (RCC-26/IL-7/CD80) as a vaccine in patients with metastatic renal cell cancer: a clinical phase-I study. Gene Ther 2010; 18:354-63. [DOI: 10.1038/gt.2010.143] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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23
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Vuong LG, Hemmati PG, Neuburger S, Terwey TH, Vulliamy T, Dokal I, le Coutre P, Dörken B, Arnold R. Reduced-intensity conditioning using fludarabine and antithymocyte globulin alone allows stable engraftment in a patient with dyskeratosis congenita. Acta Haematol 2010; 124:200-3. [PMID: 21042011 DOI: 10.1159/000318721] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [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: 03/01/2010] [Accepted: 07/01/2010] [Indexed: 11/19/2022]
Abstract
Dyskeratosis congenita (DC) is a rare inherited disorder characterized by the triad of nail dystrophy, mucosal leukoplakia, and reticular pigmentation. Bone marrow failure is the principal cause of early mortality, and stem cell transplantation is the only cure for these patients. However, the results of conventional hematopoietic stem cell transplantation (HSCT) for patients with DC are poor because of the high incidence of transplant-related complications. We describe the successful treatment of a 21-year-old male with DC by nonmyeloablative HSCT from a matched unrelated donor. The gene responsible for the X-linked form of DC was screened and hemizygosity for the mutation Gln31Lys was found, which is consistent with the diagnosis. The conditioning regimen consisted of only fludarabine and antithymocyte globulin. Additionally, a graft-versus-host disease (GVHD) prophylaxis was administered with cyclosporine A (CSA) and mycophenolate mofetil (MMF). The regimen was well tolerated, no severe posttransplantation complications were observed, and engraftment was rapid and complete (granulocytes on day +11 and platelets on day +13). Seven months after HSCT, the patient developed GVHD of the liver after tapering CSA which was successfully treated with prednisolone, CSA, and MMF. At the time of reporting, 3 years after HSCT, the patient remained in good clinical condition with minimal signs of chronic GVHD of the oral mucosa. Thus, we conclude that a low-intensity conditioning regimen might be sufficient to induce permanent engraftment by using matched unrelated donor HSCT in DC patients and may avoid severe organ toxicity. Although allogeneic HSCT in patients with DC will not cure the underlying genetic defect it may significantly prolong survival through effective therapy for hematologic complications.
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Affiliation(s)
- L G Vuong
- Medizinische Klinik m.S. Hämatologie und Onkologie, Universitätsmedizin Berlin, Germany.
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Haugstetter AM, Loddenkemper C, Lenze D, Gröne J, Standfuß C, Petersen I, Dörken B, Schmitt CA. Cellular senescence predicts treatment outcome in metastasised colorectal cancer. Br J Cancer 2010; 103:505-9. [PMID: 20628375 PMCID: PMC2939783 DOI: 10.1038/sj.bjc.6605784] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 06/10/2010] [Accepted: 06/16/2010] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cellular senescence is a terminal cell-cycle arrest that occurs in response to activated oncogenes and DNA-damaging chemotherapy. Whether cancer cell senescence at diagnosis might be predictive for treatment outcome is unknown. METHODS A senescence index (SI) was developed and used to retrospectively correlate the treatment outcome of 30 UICC stage IV colorectal cancer (CRC) patients with their SI at diagnosis. RESULTS 5-Fluorouracil/leucovorin-treated CRC patients achieved a significantly longer progression-free survival when presenting with SI-positive tumours before therapy (median 12.0 vs 6.0 months; P=0.044). CONCLUSION Cancer cell senescence predicts treatment outcome in metastasised CRC. Prospective analyses of larger patient cohorts are needed.
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Affiliation(s)
- A M Haugstetter
- Medical Department of Hematology, Oncology and Tumor Immunology, Molekulares Krebsforschungszentrum der Charité – MKFZ, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
| | - C Loddenkemper
- Institute of Pathology, Technische Universität München, Munich, Germany
- Department of Pathology, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - D Lenze
- Institute of Pathology, Technische Universität München, Munich, Germany
| | - J Gröne
- Department of General, Vascular and Thoracic Surgery, Campus Benjamin Franklin, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - C Standfuß
- Department of Bioinformatics, Free University, Berlin, Germany
| | - I Petersen
- Department of Pathology, Friedrich Schiller University, Jena, Germany
| | - B Dörken
- Medical Department of Hematology, Oncology and Tumor Immunology, Molekulares Krebsforschungszentrum der Charité – MKFZ, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - C A Schmitt
- Medical Department of Hematology, Oncology and Tumor Immunology, Molekulares Krebsforschungszentrum der Charité – MKFZ, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
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Stieler J, Pelzer U, Sinn M, Dörken B, Oettle H, Riess H. CONKO-008: Oxaliplatin (O)/folinic acid (FA)/5-fluorouracil (5-FU) (24 h) in combination with lapatinib as a second-line therapy in pancreatic cancer after gemcitabine failure: A phase I/II trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Nicolaou A, Sinn M, Hildebrandt B, Gebauer B, Ricke J, Dörken B, Riess H. A phase II study in patients with advanced biliary tract carcinoma (BTC) treated with hepatic arterial infusion chemotherapy (HAI) with oxaliplatin (O), 5-fluorouracil (5FU), and folinic acid (FA). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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27
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Bichev D, Breithaupt K, Dogan Y, Grieser C, Pfiffer TE, Daum S, Treese C, Schumacher G, Dörken B, Thuss-Patience PC. Perioperative chemotherapy with epirubicin, cisplatin, and 5-FU (ECF) for gastroesophageal cancer: A retrospective analysis. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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28
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Riess H, Pelzer U, Opitz B, Stauch M, Reitzig P, Hahnfeld S, Müller L, Stieler J, Dörken B, Oettle H. A prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy: Final results of the CONKO-004 trial. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.4033] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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29
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Yürek S, Riess H, Kreher S, Dörken B, Salama A. Fatal immune haemolysis due to antibodies to individual metabolites of 5-fluorouracil. Transfus Med 2010; 20:265-8. [DOI: 10.1111/j.1365-3148.2010.01009.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Despite the fact that classical Hodgkin lymphoma (HL) has been described more than 170 years ago, only over the last 15 years significant advances regarding its molecular pathogenesis have been achieved. The lack of a specific lineage profile in combination with the low number of the malignant mononuclear Hodgkin- and multinucleated Reed-Sternberg- (HRS-) cells in the affected lymph nodes prevented for a long time both the identification of its cell of origin and of genomic and molecular defects. The development of methods for the analysis of micromanipulated single cells made it possible to demonstrate a B cell origin of HRS cells. However, it has become clear that the normal B cell-specific gene expression program in HRS cells is disrupted by various molecular lesions. Furthermore, molecular and genomic defects of various signaling pathways could be identified in HRS cells, including the NF-kappaB, JAK/STAT and MAPK-AP-1 signaling pathways, which protect HRS cells from apoptotic cell death. Despite significant advances in the treatment of HL, the considerable long term toxicity of conventional therapies requires the development of new non-genotoxic therapeutic strategies. Therefore, it will be a central aim to develop new treatment strategies based on these insights into HL pathogenesis.
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Affiliation(s)
- S Mathas
- Hämatologie, Onkologie und Tumorimmunologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin
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31
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Pelzer U, Deutschinoff G, Opitz B, Stauch M, Reitzig P, Hahnfeld S, Knigge O, Riess H, Dörken B, Oettle H. 6513 Successful prevention of symptomatic thromboembolic events by the low molecular weight heparin enoxaparin in patients with advanced pancreatic cancer – results of the CONKO 004 trial. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71235-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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32
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Floercken A, Takvorian A, Singh A, Hopfenmüller W, Pezzutto A, Dörken B, Westermann J. Modulation of regulatory T cells and myeloid-derived suppressor cells by sorafenib and sunitinib in renal cell carcinoma patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16002 Background: Induction of regulatory T (Treg) and myeloid-derived suppressor cells (MDSC) is a major mechanism for the escape of tumors from immunological control. Increased levels of Treg cells have been described in renal cell cancer (RCC) patients and seem to correlate with an adverse outcome. Furthermore, reduction of Treg has been reported for RCC patients under sunitinib therapy. The aim of our study was to analyse the influence of sorafenib and sunitinib on the frequency of Treg and MDSC in patients with metastatic RCC (mRCC). Methods: The number of T reg, MDSC and lymphocyte subpopulations was analysed by flowcytometry in peripheral blood (pb) of patients (n=19) with histologically confirmed mRCC under treatment with either sunitinib (50 mg/d, n=11) or sorafenib (800 mg/d, n=8). After informed consent blood samples were taken before and during the 1st, 2nd, and 3rd month of therapy. Flowcytometric analysis was performed using fluorochrome labeled antibodies against CD3, CD4, CD8, CD25, CD127, FOXp3, CD33, C14, CD11b and HLA-DR. Results: The baseline level of Treg did not differ from healthy controls. However, there was a significant increase of CD3+CD4+CD25+FOXp3+Treg (13,5% vs. 36,3% of gated cells, p= 0.02) and the ratio FOXp3+/FOXp3- CD3+CD4+ T cells (0,16% vs. 0,56% of gated cells, p= 0.02) in the group of sorafenib-treated patients compared to sunitinib-treated patients during the 1st month of therapy and thereafter. This effect was confirmed in an intragroup analysis. There was no influence of Sunitinib on the frequency of Treg. Analysis of CD33+/HLA-DR-/11b+ MDSC did not reveal any change under treatment with sorafenib or sunitinib. Conclusions: Sorafenib, but not sunitinib, leads to an early and sustained increase of Treg in pb of mRCC patients. A negative influence of sorafenib on primary immune responses has been described and has mainly been attributed to functional impairment of dendritic cells (DC). Whether altered DC function under sorafenib is responsible for the induction of Treg in RCC patients will have to be addressed in future studies. In immunoresponsive tumors such as RCC, immunological effects of kinase inhibitors are particularly relevant for the design of combination trials with immunotherapeutic agents. No significant financial relationships to disclose.
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Affiliation(s)
- A. Floercken
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - A. Takvorian
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - A. Singh
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - W. Hopfenmüller
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - A. Pezzutto
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - B. Dörken
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
| | - J. Westermann
- Charité, Campus Virchow Klinikum, Berlin, Germany; Charité University Hospital, Campus Benjamin Franklin, Berlin, Germany
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33
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Lentzsch S, Reichardt P, Gürtler R, Dörken B. Intrapericardial Application of Mitoxantrone for Treatment of Malignant Pericardial Effusion. Oncol Res Treat 2009. [DOI: 10.1159/000218465] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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34
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le Coutre P, Meisel H, Hofmann J, Röcken C, Vuong GL, Neuburger S, Hemmati PG, Dörken B, Arnold R. Reactivation of hepatitis E infection in a patient with acute lymphoblastic leukaemia after allogeneic stem cell transplantation. Gut 2009; 58:699-702. [PMID: 19359434 DOI: 10.1136/gut.2008.165571] [Citation(s) in RCA: 110] [Impact Index Per Article: 7.3] [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: 12/20/2022]
Abstract
Hepatitis E virus (HEV) is the major cause of several outbreaks of waterborne hepatitis in tropical and subtropical countries and of sporadic cases of viral hepatitis in endemic and industrialised countries. Generally, HEV causes an acute self-limiting hepatitis. The clinical course is characterised by transient viraemia and transaminasaemia followed by a full hepatic recovery. Recent studies describe prolonged and chronic HEV infections in some immunosuppressed patients after solid organ transplantation. Here, an indigenous acute limited hepatitis E in a patient with Philadelphia chromosome-positive acute lymphoblastic leukaemia prior to allogeneic stem cell transplantation is reported. Fourteen weeks after stem cell transplantation, reappearance of HEV viraemia was observed, with increasing viral load and modestly elevated serum transaminases. Sequence analysis of the viral RNAs revealed a reactivation of endogenous HEV genotype 3, indicating viral persistence after recovery from acute hepatitis E.
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Affiliation(s)
- P le Coutre
- Campus Virchow-Klinikum, Charité, Medizinische Klinik m.S. Hämatologie und Onkologie, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
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35
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Terwey TH, Massenkeil G, Tamm I, Hemmati PG, Neuburger S, Martus P, Dörken B, Hoelzer D, Arnold R. Allogeneic SCT in refractory or relapsed adult ALL is effective without prior reinduction chemotherapy. Bone Marrow Transplant 2008; 42:791-8. [PMID: 18711350 DOI: 10.1038/bmt.2008.258] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We present 60 patients with refractory (n=8) or relapsed (n=52) adult ALL who received allogeneic hematopoietic SCT (HSCT) with (n=41) or without (n=19) prior reinduction chemotherapy. In our center, omission of reinduction is recommended if a suitable donor is promptly available, tumor burden is moderate and disease features suggest a highly aggressive course. Overall survival (OS) of the whole cohort at 1, 2 and 5 years was 42, 33 and 28%, respectively. Leukemia-free survival at 1, 2 and 5 years was 37, 33 and 24%. Deaths were due to relapse (n=25), acute or chronic GVHD (n=7), infections (n=8) or toxicity (n=4). Interestingly, patients who did not receive reinduction before HSCT had better outcomes than patients who received reinduction with OS at 1, 2 and 5 years being 58 vs 34%, 47 vs 25% and 47 vs 18%, respectively (P=0.039). Importantly, even achievement of a second CR after reinduction was not associated with improved survival compared to patients directly proceeding to HSCT. We conclude that patients who undergo HSCT for refractory or relapsed ALL can achieve long-term survival. In selected patients, reinduction chemotherapy can be omitted if immediate HSCT is feasible.
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Affiliation(s)
- T H Terwey
- Department of Hematology and Oncology, Charité-University Medicine Berlin, Campus Virchow-Klinikum, Berlin, Germany.
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36
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Nicolaou A, Goerke A, Sinn M, Hildebrandt B, Ricke J, Pech M, Podrabsky P, Neumann UP, Dörken B, Riess H. Hepatic arterial infusion chemotherapy (HAI) with oxaliplatin (O), 5-fluorouracil (5FU), and folinic acid (FA) in patients with advanced hepatocellular carcinoma (HCC) or biliary tract carcinoma (BTC): A phase II study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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37
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Pohlank K, Hilbig A, Pelzer U, Stieler J, Roll L, Goerke A, Sinn M, Dörken B, Riess H, Oettle H. Decrease of CA 19–9 in patients with advanced pancreatic cancer (APC) undergoing chemotherapy predicts survival time. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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38
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Pelzer U, Kubica K, Stieler J, Schwaner I, Heil G, Görner M, Mölle M, Hilbig A, Dörken B, Riess H, Oettle H. A randomized trial in patients with gemcitabine refractory pancreatic cancer. Final results of the CONKO 003 study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4508] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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39
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Thuss-Patience PC, Kretzschmar A, Dogan Y, Rothmann F, Blau I, Schwaner I, Lebedinzew B, Grothoff M, Dörken B, Reichardt P. Docetaxel and capecitabine for advanced gastric cancer: Phase II study investigating dose dependent efficacy in two patient cohorts. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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Lutz C, Massenkeil G, Nagy M, Neuburger S, Tamm I, Rosen O, Dörken B, Arnold R. A pilot study of prophylactic donor lymphocyte infusions to prevent relapse in adult acute lymphoblastic leukemias after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 2008; 41:805-12. [DOI: 10.1038/sj.bmt.1705981] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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41
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Hildebrandt B, Müller C, Pezzutto A, Daniel PT, Dörken B, Scholz C. Assessment of free light chains in the cerebrospinal fluid of patients with lymphomatous meningitis - a pilot study. BMC Cancer 2007; 7:185. [PMID: 17915026 PMCID: PMC2194780 DOI: 10.1186/1471-2407-7-185] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2007] [Accepted: 10/03/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lymphomatous meningitis (LM) represents a severe complication of malignant lymphomas. While clinical suspicion is raised by symptoms ranging from mild disturbances of sensation to severe pain or impaired consciousness, the definite diagnosis of LM is often difficult to obtain. Since B-cell lymphomas are clonally restricted to express either kappa or lambda immunoglobulin light chain, we hypothesised that analysis of free light chain (FLC) ratios might facilitate the diagnosis of LM. METHODS Kappa and lambda FLC were measured using a novel nephelometric assay in cerebrospinal fluid (CSF) and serum from 17 patients. 5/17 suffered from LM as demonstrated by cytology, immunocytology, and/or imaging procedures. RESULTS Measurement of FLC concentrations in CSF was achieved for all 17 patients. FLC levels in CSF were lower than serum FLC levels in samples for the same patient obtained at the same time (p < 0.01). CSF and serum FLC concentrations correlated weakly in all patients irrespective of LM status. Significantly more patients with cytopathologically and immunohistochemically proven LM displayed abnormal kappa/lambda FLC ratios in CSF compared to individuals with no LM (p < 0.01). CONCLUSION This is the first report demonstrating that a significant proportion of LM patients display an abnormal kappa/lambda FLC ratio in the CSF.
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Affiliation(s)
- B Hildebrandt
- Charité-Centrum für Tumormedizin, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité- Universitätsmedizin Berlin, Augustenburger Platz 1, D-13344 Berlin, Germany
| | - C Müller
- Zentrum für Diagnostische und Präventive Labormedizin, Zentralinstitut für Laboratoriumsmedizin und Pathobiochemie, Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13344 Berlin, Germany
| | - A Pezzutto
- Charité-Centrum für Tumormedizin, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité- Universitätsmedizin Berlin, Augustenburger Platz 1, D-13344 Berlin, Germany
| | - PT Daniel
- Charité-Centrum für Tumormedizin, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité- Universitätsmedizin Berlin, Augustenburger Platz 1, D-13344 Berlin, Germany
| | - B Dörken
- Charité-Centrum für Tumormedizin, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité- Universitätsmedizin Berlin, Augustenburger Platz 1, D-13344 Berlin, Germany
| | - C Scholz
- Charité-Centrum für Tumormedizin, Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Campus Virchow-Klinikum, Charité- Universitätsmedizin Berlin, Augustenburger Platz 1, D-13344 Berlin, Germany
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42
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Cayeux S, Bukarica B, Buschow C, Charo J, Bunse M, Dörken B, Blankenstein T. In vivo splenic CD11c cells downregulate CD4 T-cell response thereby decreasing systemic immunity to gene-modified tumour cell vaccine. Gene Ther 2007; 14:1481-91. [PMID: 17700709 DOI: 10.1038/sj.gt.3303003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
One of the factors influencing the efficacy of tumour cell vaccines is the site of immunization. We have shown previously that gene-modified vaccines delivered directly inside the spleen induced antigen cross-presentation by splenic antigen-presenting cells (not B cells). Here, we examined the interaction between splenic CD11c(+) cells and antigen-specific CD4(+) T cells. We used tumour cells expressing ovalbumin (OVA), a situation where CD4(+) T-cell help is required for the generation of a cytotoxic T lymphocyte response. Using in vivo bioluminescence imaging of luciferase-expressing EL4-OVA cells, we could demonstrate that tumour cells were located exclusively inside the spleen following intrasplenic injection. We showed that after intrasplenic immunization with T/SA-OVA cells, splenic class I(+) class II(+) CD11c(+) cells engulfed and presented in vivo the OVA class I-restricted peptide SIINFEKL. However, in vivo previously adoptively transferred 5,6-carboxy-succinimidyl-fluorescein-ester-labelled transgenic CD4(+)KJI-26(+) cells specific for the class II OVA(323-339) peptide underwent abortive proliferation in the spleen. These CD4(+)KJI-26(+) cells were only transiently activated and produced IL-10 and IL-4 and not IFN-gamma. It appears that splenic CD11c(+) cells can downregulate splenic specific CD4(+) T-cell response thereby leading to a decrease in antitumour systemic immunity.
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Affiliation(s)
- S Cayeux
- Charité-am-MDC, Campus Buch, Berlin, Germany.
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Floercken A, Kopp J, Schabath R, Joehrens-Leder K, Pohla H, Schendel D, Blankenstein T, Dörken B, Westermann J, Pezzutto A. HLA-A0201-positive, IL-7/B7.1-cotransfected allogeneic tumor cells as a vaccine in metastatic renal cell cancer—A clinical phase-I trial. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.3072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
3072 Background: Tumor vaccination remains a promising experimental approach in RCC. HLA-A0201-restricted T cell immunity against RCC is well established. RCC26 is an allogeneic HLA-A0201+ human RCC cell line, a T cell clone specifically recognising RCC26 and other RCC in the context of HLA-A0201 has previously been generated, the TCR of this T cell clone was characterised. Furthermore, IL-7/B7.1 cotransfected tumor cells are a potent vaccine in animal models. Methods: RCC26 was transfected with pKEx-IL-7-IR-B7 coding for human IL-7 and B7.1 (CD80). 10 HLA-A0201+ patients with metastatic RCC and disease progression under cytokine therapy were included. 10 vaccinations with 2.5–40x106 gene-modified irradiated tumor cells which had been produced under GMP conditions were performed s.c. over 22 weeks. Primary endpoints of the study were feasibility, safety and immunological response, secondary endpoint was clinical response. The protocol was approved by the ethics committee, all patients gave informed consent. Results: Gene-modified RCC26 cells produced IL-7 (3.4 ng/106 cells/24h), more than 90% of the cells were CD80+. Vaccination was feasible and safe with no severe toxicity. Local DTH-reactions were observed in 4 patients. Skin biopsies of the vaccination site showed lymphocytic infiltrates dominated by CD4+T cells. In 8 patients vaccination induced HLA- and /or antinuclear antibodies without clinical signs of autoimmunity. Analysis of the T cell response against RCC-associated antigens is under way. No partial or complete responses could be documented. However, 50% of the patients had stable disease with the longest TTP being 69 weeks. Mean TTP in our cohort was 25 weeks (range 4 to 69 weeks). Conclusion: Our results show that vaccination with an allogeneic gene-modified tumor cell line is feasible and safe. Stable disease lasting up to 69 weeks in a substantial proportion of patients suggests immunological activity of the vaccine. Vaccination of patients with a low tumor burden is a promising strategy for the future, i.e. after surgery or treatment with novel multi-kinase inhibitors. No significant financial relationships to disclose.
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Affiliation(s)
- A. Floercken
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - J. Kopp
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - R. Schabath
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - K. Joehrens-Leder
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - H. Pohla
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - D. Schendel
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - T. Blankenstein
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - B. Dörken
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - J. Westermann
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
| | - A. Pezzutto
- Charite University Medicine Berlin, Berlin, Germany; GSF, Munich, Germany; Max-Delbrück-Center for Molecular Medicine, Berlin, Germany
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Riess H, Pelzer U, Stieler J, Schwaner I, Heil G, Görner M, Mölle M, Hilbig A, Dörken B, Oettle H. A randomized second line trial in patients with gemcitabine refractory advanced pancreatic cancer - CONKO 003. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4517] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4517 Objective: For nearly ten years gemcitabine (G) was standard first line therapy for patients (pts) with advanced pancreatic cancer (APC). There is no consensus about second line therapy after disease progression while receiving G, but 5-FU-based regimens are considered. Results about randomized second line studies in APC are very rare. Our phase II study (ASCO 2002) showed activity of the OFF (oxaliplatin/folinic Acid (FA)/5-fluorouracil (FU) [24h] ) regimen in 23 pts. To examine the impact and the side effects of oxaliplatin we initiated a multicenter phase III study to compare OFF and FF in pts with G refractory APC. Methods: Pts with CT/ MRT confirmed failure with G in first line therapy, Karnofsky Performance Status (KPS) >60%, controlled pain, adequate hematological, renal and liver functions were eligible. Pts were stratified according to duration of first line therapy, KPS and tumor stage. We randomized pts to outpatient treatment with FF (FU 2g/m2 (24h)/ FA 200 mg/m2 (30min) on d1, d8, d15 and d22) or OFF (FF+Oxaliplatin 85mg/m2, d8, d22). In both arms the next cycle started on day 43. Pts were followed with regular staging every 3 months or at any signs of disease progression. Results: Until now we randomized 161 of 165 (planned) pts between 02/2004 and 01/2007. So we expect to present first results (side effects, progression free survival, overall survival) at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- H. Riess
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - U. Pelzer
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - J. Stieler
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - I. Schwaner
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - G. Heil
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - M. Görner
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - M. Mölle
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - A. Hilbig
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - B. Dörken
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
| | - H. Oettle
- Universitätsmedizin Berlin - Charité, Berlin, Germany; Outpatient Department, Berlin, Germany; Klinikum, Lüdenscheid, Germany; Klinikum, Bielefeld, Germany; Outpatient Department, Dresden, Germany
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45
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Westermann J, Nguyen-Hoai T, Baldenhofer G, Höpken UE, Lipp M, Dörken B, Pezzutto A. CCL19 (ELC) as an adjuvant for DNA vaccination: induction of a TH1-type T-cell response and enhancement of antitumor immunity. Cancer Gene Ther 2007; 14:523-32. [PMID: 17384577 DOI: 10.1038/sj.cgt.7701042] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [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: 11/08/2022]
Abstract
Coexpression of tumor antigens together with immunomodulatory molecules is a strategy in DNA vaccination aiming at an amplification of the antitumor immune response. Epstein-Barr virus-induced-molecule-1-ligand-chemokine (ELC/CCL19) is a CC chemokine that binds to the chemokine receptor CCR7. CCR7 is expressed on mature dendritic cells (DC) and distinct T- and B-cell subpopulations. CCL19 (ELC) is mainly expressed in secondary lymphoid organs and plays a central role in regulating the encounters between DC and T cells. We asked whether CCL19 is able to augment immunogenicity of a DNA vaccine in a C57BL/6 mouse model with syngeneic MCA205 (beta-gal) tumor cells. Mice were vaccinated twice intramuscularly on days 1 and 15 and tumor challenge was performed subcutaneously on day 25. Coadministration of plasmid DNA (pDNA) (beta-gal) plus pDNA (CCL19) was compared with pDNA (beta-gal), pDNA (CCL19), mock vector and phosphate-buffered saline (PBS) alone. Coexpression of CCL19 resulted in enhancement of a Th1-polarized immune response with substantial improvement of the protective effect of the DNA vaccine. Immunohistochemical staining revealed an increased CD8+ T-cell infiltration in the tumor tissue of mice that had been immunized with pDNA (beta-gal) plus pDNA (CCL19). We conclude that CCL19 is an attractive adjuvant for DNA vaccination able to augment antitumor immunity and that this effect is partially caused by enhanced CD8+ T-cell recruitment.
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Affiliation(s)
- J Westermann
- Department of Hematology, Charité - University Medicine Berlin, Campus Berlin-Buch, Berlin, Germany.
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46
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Nickenig C, Dreyling M, Hoster E, Ludwig WD, Dörken B, Freund M, Huber C, Ganser A, Trümper L, Forstpointner R, Unterhalt M, Hiddemann W. Initial chemotherapy with mitoxantrone, chlorambucil, prednisone impairs the collection of stem cells in patients with indolent lymphomas—results of a randomized comparison by the German Low-Grade Lymphoma Study Group. Ann Oncol 2007; 18:136-142. [PMID: 17071931 DOI: 10.1093/annonc/mdl348] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 11/12/2022] Open
Abstract
Myeloablative radio-chemotherapy with subsequent autologous stem cell transplantation (ASCT) significantly prolongs progression free and probably overall survival in follicular lymphoma (FL) in first remission. The current trial explored prospectively the rate of successful stem cell mobilization in patients with advanced stage FL after initial therapy with either Mitoxantrone, Chlorambucil, Prednisone (MCP) or Cyclophosphamide, Doxorubicin, Vincristine, Prednisone (CHOP) as part of a prospective randomized comparison of both regimens. ASCT patients received Dexa-BEAM (Dexamethasone, BCNU, Melphalan, Etoposide, Cytarabine) for mobilization of stem cells. Stem cells were collected and a minimum of 2x2.0x106/kg bw CD34+ was required for ASCT. Of 79 evaluable patients, 58 (73%) had follicular lymphoma, 13 (16%) mantle cell lymphoma and 8 (10%) lymphoplasmacytic lymphoma. In the 45 patients assigned to CHOP, stem cell collection was successful in 42 cases (93%, 95% CI 82% to 99%). This high mobilization rate after CHOP could be confirmed in 61 subsequent patients (87%). In contrast, after MCP therapy stem cell collection was successful in only 15 of 34 patients (44%, 95% CI 27% to 62%; P=0.0003). In conclusion, initial therapy with MCP significantly impairs the ability to collect stem cells and should be avoided for first line therapy of younger patients potentially qualifying for high dose consolidation and ASCT in first remission.
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Affiliation(s)
- C Nickenig
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - M Dreyling
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - E Hoster
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern; Institute of Medical Informatics, Biometry and Epidemiology, University of Munich
| | - W-D Ludwig
- Department of Hematology and Oncology, Charité Campus Berlin-Buch
| | - B Dörken
- Department of Hematology and Oncology, Charité Berlin Campus Virchow-Klinikum
| | - M Freund
- Division of Hematology and Oncology, University Rostock
| | - C Huber
- Department of Internal Medicine III, University of Mainz
| | - A Ganser
- Department of Hematology, Hemostasis and Oncology, Hannover Medical School
| | - L Trümper
- Department of Hematology and Oncology, Georg-August University, Göttingen, Germany
| | - R Forstpointner
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - M Unterhalt
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern
| | - W Hiddemann
- Department of Internal Medicine III, Ludwig-Maximilians University, Munich Grosshadern.
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Hemmati PG, Güner D, Gillissen B, Wendt J, von Haefen C, Chinnadurai G, Dörken B, Daniel PT. Bak functionally complements for loss of Bax during p14ARF-induced mitochondrial apoptosis in human cancer cells. Oncogene 2006; 25:6582-94. [PMID: 16847458 DOI: 10.1038/sj.onc.1209668] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [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: 11/09/2022]
Abstract
In contrast to the initial notion that the biological activity of p14(ARF) strictly depends on a functional mdm-2/p53 signaling axis, we recently demonstrated that p14(ARF) mediates apoptosis in a p53/Bax-independent manner. Here, we show that p14(ARF) induces breakdown of the mitochondrial membrane potential and cytochrome c release before triggering caspase-9- and caspase-3/7-like activities in p53/Bax-deficient DU145 prostate cancer cells expressing wild-type Bak. Re-expression of Bax in these cells failed to further enhance p14(ARF)-induced apoptosis, suggesting that p14(ARF)-induced apoptosis primarily depends on Bak but not Bax in these cells. To further define the role of Bak and Bax in p14(ARF)-induced mitochondrial apoptosis, we employed short interference RNA for the knockdown of bak in isogeneic, p53 wild-type HCT116 colon cancer cells either proficient or deficient for Bax. There, combined loss of Bax and Bak attenuated p14(ARF)-induced apoptosis whereas single loss of Bax or Bak was only marginally effective, as in the case of DU145. Notably, HCT116 cells deficient for Bax and Bak failed to release cytochrome c and showed attenuated activation of caspase-9 (LEHDase) and caspase-3/caspase-7 (DEVDase) upon p14(ARF) expression. These data indicate that p14(ARF) triggers apoptosis via a Bax/Bak-dependent pathway in p53-proficient HCT116, whereas Bax is dispensable in p53-deficient DU145 cells. Nevertheless, a substantial proportion of p14(ARF)-induced cell death proceeds in a Bax/Bak-independent manner. This is also the case for inhibition of clonogenic growth that occurs, at least in part, through an entirely Bax/Bak-independent mechanism.
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Affiliation(s)
- P G Hemmati
- Department of Hematology, Oncology and Tumor Immunology, University Medical Center Charité, Berlin-Buch, Germany
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48
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Thuss-Patience PC, Kretzschmar A, Dogan Y, Blau I, Pink D, Lebedinzew B, Micheel S, Dörken B, Reichardt P. Capecitabine and docetaxel for advanced gastric cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4068 Background: Docetaxel is increasingly integrated into chemotherapy combination regimens against gastric cancer. Docetaxel and 5-FU were compared to ECF and appeared to be very active and well tolerated (Thuss-Patience et. al. JCO 2005). In the current study the dual combination capecitabine and docetaxel (CapDoc) is evaluated to develop a convenient out-patient regimen with minimal toxicity. Methods: Prospective multicenter phase II trial. Eligibility: Metastatic or locally advanced gastro-esophageal junction or gastric adenocarcinoma, ECOG PS 0–2, no prior palliative chemotherapy. Chemotherapy: Docetaxel 75 mg/m2 d1, capecitabine 2000 mg/m2 d1–14, q3w. For part I of the study (presented here) accrual is completed (40 pts). In part II we reduced the starting dose of docetaxel to 60 mg/m2 and capecitabine to 1600 mg/m2 to further improve tolerability (accrual ongoing, 8 pts included so far, presented at meeting). Results: 40 pts are included in this trial (part I). Age: 32–79 years (median 61), M/F 29/11, ECOG PS 0: 7 pts, 1: 27 pts, 2: 6 pts. Number of organs involved by metastases: 1: 9 pts, 2: 11 pts, 3: 16 pts, more than 3: 4 pts. Measurable disease (RECIST): 40 pts. 233 cycles of chemotherapy are administered so far. Toxicity: 40 pts are evaluable for toxicity (worst grade per patient; % of pts): Grade 1/2/3/4: Nausea: 53/10/3/- %, vomiting: 18/13/-/3 %, diarrhea: 23/20/13/- %, asthenia: 38/40/10/- %, stomatitis: 23/15/10/- %, alopecia: 25/53/-/- %, fever not neutropenic: 10/20/3/- %, neutropenic fever: -/-/10/3 %, nail changes: 33/28/-/- %, paresthesia: 18/18/5/- %, dizziness: 15/8/5/- %, hand-foot-syndrome: 25/18/18/- %, leuko-neutropenia: 8/13/25/28 %, thrombocytopenia: 18/-/-/- %, anemia: 40/15/5/- %, fluid retention: 13/5/-/-, pulmonary embolism or thrombosis: 3/5/3/5. Dose adjustments of docetaxel had to be made in 45% and of capecitabine in 55% of pts. Response: 26 of 37 pts with tumor related symptoms showed a subjective improvement of symptoms (70.3%). 38 pts are evaluable for objective response: CR 1 pt (2.6%), PR 20 pts (52.6%), NC 14 pts (36.8%), PD 3 pts (7.9%), (objective response rate: 55.3%). Median time to tumor progression 5.5 months, median survival 9.5 months. Conclusion: These data suggest that CapDoc is a well tolerated convenient out-patient combination with very promising efficacy. [Table: see text]
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Affiliation(s)
- P. C. Thuss-Patience
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - A. Kretzschmar
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - Y. Dogan
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - I. Blau
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - D. Pink
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - B. Lebedinzew
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - S. Micheel
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - B. Dörken
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
| | - P. Reichardt
- Charité Campus Virchow, Berlin, Germany; Charité Campus Buch, Berlin, Germany; Praxis für Hämatologie und Onkologie, Berlin, Germany
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Stieler JM, Hilbig A, Pelzer U, Roll L, Dörken B, Riess H, Oettle H. CONKO-101: Results of a multicenter phase II study of an outpatient regimen consisting out of gemcitabine, 5-FU (24h CI), folinic acid and cisplatin for patients with inoperable esophageal cancer. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4066 Background: Standard therapy for inoperable esophageal cancer is a combination of cisplatin and 5-FU combined with radiation for locally advanced stages. As gemcitabine shows synergy with cisplatin and 5-FU, we evaluated the combination of cisplatin 30 mg/m2 (90 min), Gemcitabine 1000 mg/m2 (30 min), FS 200 mg/m2 (30 min) and 5-FU 750 mg/m2 24h CI) d1,8 q d22 for patients with inoperable esophageal cancer. For locally advanced stages, patients received sequential radiochemotherapy with 5-FU CI. Methods: 89 (75 m/14 w) pts. were included into this multicentrical phase 2 study. 58 had SCC, 30 AC, 1 pt. had undifferentiated carcinoma. Median age was 61 (22–86), Median KI 90 (60–100). 2 pts. had stage IIa, 4 stage IIb, 30 stage III, 16 stage IVa and 37 stage IVb. Results: 71 pts. are so far evaluable for response and 84 for toxicity. 2 pts. (2.8%) had CR (1 pathologically confirmed), 27 pts. had PR (38.1%), 33 pts. had SD (46.5%) and 9 pts. had PD (12.6%) as best response. MS was 10.7 months (13.1 for stage II/III and 9.1 for stage IV). Median TTP was 6 months, and PFS was 6 months. Observed toxicity was low and predominantly hematologic with Leukopenia Grade III/IV in 10% of cycles, Hb Grade III/IV in 5.3% of cycles and Thrombopenia Grade III/IV in 2.4% of cycles. Conclusion: This regimen is well tolerable and can easily be applied on an outpatient base. The remission rates and survival data are within the range previously reported in other phase II studies. No significant financial relationships to disclose.
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Affiliation(s)
| | - A. Hilbig
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - U. Pelzer
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - L. Roll
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - B. Dörken
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H. Riess
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H. Oettle
- Charité Universitätsmedizin Berlin, Berlin, Germany
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50
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Pelzer U, Hilbig A, Stieler J, Roll L, Stauch M, Opitz B, Scholten T, Hahnfeld S, Dörken B, Riess H, Oettle H. A prospective, randomized trial of simultaneous pancreatic cancer treatment with enoxaparin and chemotherapy (PROSPECT - CONKO 004). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.4110] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4110 Background: Approximately 20% of patients (pts) diagnosed with pancreatic adenocarcinoma (PA) develop venous thromboembolism, which may contribute to the dismal prognosis of PA. A small phase II trial suggested an improved survival by the addition of low molecular weight heparin (LMWH) to chemotherapy (Icli et al., ASCO 2003). We conducted a small pilot study which indicated that the addition of enoxaparin to chemotherapy GFFC chemotherapy (see below) is safe and feasible in pts with advanced PA. Furthermore, results of several phase III studies suggest that pts in good performance status may benefit from more intensive chemotherapy regimen (Riess et al; Heinemann et al; ASCO 2005). Based on these considerations we started the multicenter phase III study CONKO 004. Methods: 540 patients are to be recruited into this study. Primary stratification takes place according to Karnowsky performance status and kidney function. Patients with KPS > 80% and normal kidney function receive GFFC ± LMWH (gemcitabine 1 g/m2 (30 min), cisplatin 30 mg/m2 (90 min), 5-fluorouracil 750 mg/m2 (24 h), folinic acid 200 mg/m2 (30 min), d1, 8; q3w ± Enoxaparin 1mg/kg daily s.c.). Pts with KPS < 80 % and increased creatinin plasma levels (>1.3 mg/dl) receive the current standard therapy (gemcitabine 1 g/m2 (30 min), d1, 8, 15; q4w) ± LMWM ± Enoxaparin 1mg/kg daily s.c. After 12 weeks of initial chemotherapy all patients who have not progressed received the standard therapy (gemcitabine 1 g/m2 (30 min), d1, 8, 15; q4w) ± Enoxaparin 40mg daily s.c. Results: From April 2004 to Dezember 2005 140 pts have been recruited in this study. Until now no unexpected serious adverse events concerning severe bleedings were observed in the enoxaparin treatment group. No heparin induced thrombocytopenia (HIT II) was documented. The first interim analysis per protocol is planned after 12 pts. with deep vein thrombosis or thromboembolic events. This interim analysis is expected to be completed in May 2006. Conclusions: Our observations indicate that the addition of enoxaparin—given the dosage mentioned above—to GEM/GFFC is safe, does not change toxicity and maintains activity of chemotherapy in pts with advanced PA. This study is open to recruitment. No significant financial relationships to disclose.
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Affiliation(s)
- U. Pelzer
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - A. Hilbig
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J. Stieler
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - L. Roll
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M. Stauch
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - B. Opitz
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - T. Scholten
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - S. Hahnfeld
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - B. Dörken
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H. Riess
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H. Oettle
- Universitätsmedizin, Berlin, Germany; Outpatient Department, Kronach, Germany; Hospital St. Elisabeth/St. Barbara, Halle, Germany; Hospital, Hagen, Germany; Outpatient Department, Jena, Germany; Charité Universitätsmedizin Berlin, Berlin, Germany
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