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Micheloni G, Frattini A, Donini M, Dusi S, Leszl A, Di Meglio A, Pigazzi M, Musio A, Zecca M, Mina T, Rabusin M, Roccia P, Bernasconi P, Dambruoso I, Minelli A, Montalbano G, Acquati F, Porta G, Valli R, Pasquali F. Donor Cell Acute Myeloid Leukemia after Hematopoietic Stem Cell Transplantation for Chronic Granulomatous Disease: A Case Report and Literature Review. Genes (Basel) 2023; 14:2085. [PMID: 38003028 PMCID: PMC10671685 DOI: 10.3390/genes14112085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
The patient reported here underwent hematopoietic stem cell transplantation (HSCT) due to chronic granulomatous disease (CGD) caused by biallelic mutations of the NCF1 gene. Two years later, he developed AML, which was unexpected and was recognized via sex-mismatched chromosomes as deriving from the donor cells; the patient was male, and the donor was his sister. Donor cell leukemia (DCL) is very rare, and it had never been reported in patients with CGD after HSCT. In the subsequent ten years, the AML relapsed three times and the patient underwent chemotherapy and three further HSCTs; donors were the same sister from the first HSCT, an unrelated donor, and his mother. The patient died during the third relapse. The DCL was characterized since onset by an acquired translocation between chromosomes 9 and 11, with a molecular rearrangement between the MLL and MLLT3 genes-a quite frequent cause of AML. In all of the relapses, the malignant clone had XX sex chromosomes and this rearrangement, thus indicating that it was always the original clone derived from the transplanted sister's cells. It exhibited the ability to remain quiescent in the BM during repeated chemotherapy courses, remission periods and HSCT. The leukemic clone then acquired different additional anomalies during the ten years of follow-up, with cytogenetic results characterized both by anomalies frequent in AML and by different, non-recurrent changes. This type of cytogenetic course is uncommon in AML.
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Affiliation(s)
- Giovanni Micheloni
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
| | - Annalisa Frattini
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
- Istituto di Ricerca Genetica e Biomedica, CNR, 20090 Milano, Italy
| | - Marta Donini
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Stefano Dusi
- Section of General Pathology, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Anna Leszl
- Clinica Oncoematologica, Dipartimento di Salute della Donna e del Bambino, Università degli Studi di Padova, 35131 Padova, Italy
| | - Annamaria Di Meglio
- Clinica Oncoematologica, Dipartimento di Salute della Donna e del Bambino, Università degli Studi di Padova, 35131 Padova, Italy
| | - Martina Pigazzi
- Clinica Oncoematologica, Dipartimento di Salute della Donna e del Bambino, Università degli Studi di Padova, 35131 Padova, Italy
| | - Antonio Musio
- Istituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, 56124 Pisa, Italy
| | - Marco Zecca
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy
| | - Tommaso Mina
- Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, 27100 Pavia, Italy
| | - Marco Rabusin
- Emato-oncologia e Centro Trapianti, IRCCS Burlo Garofolo, 34137 Trieste, Italy
| | - Pamela Roccia
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
| | - Paolo Bernasconi
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
- Hematology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Irene Dambruoso
- Hematology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Antonella Minelli
- Department of Molecular Medicine, University of Pavia, 27100 Pavia, Italy
| | - Giuseppe Montalbano
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
| | - Francesco Acquati
- Dipartimento di Biotecnologie e Scienze della Vita, Università dell’Insubria, 21100 Varese, Italy
- Centro di Medicina Genomica, Università dell’Insubria, 21100 Varese, Italy
| | - Giovanni Porta
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
- Centro di Medicina Genomica, Università dell’Insubria, 21100 Varese, Italy
| | - Roberto Valli
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
- Centro di Medicina Genomica, Università dell’Insubria, 21100 Varese, Italy
| | - Francesco Pasquali
- Genetica Umana e Medica, Dipartimento di Medicina e Chirurgia, Università dell’Insubria, 21100 Varese, Italy
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Avanzini MA, Abbonante V, Catarsi P, Dambruoso I, Mantelli M, Poletto V, Lenta E, Guglielmelli P, Croce S, Cobianchi L, Jemos B, Campanelli R, Bonetti E, Di Buduo CA, Salmoiraghi S, Villani L, Massa M, Boni M, Zappatore R, Iurlo A, Rambaldi A, Vannucchi AM, Bernasconi P, Balduini A, Barosi G, Rosti V. The spleen of patients with myelofibrosis harbors defective mesenchymal stromal cells. Am J Hematol 2018; 93:615-622. [PMID: 29359451 DOI: 10.1002/ajh.25047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 11/07/2022]
Abstract
Splenic hematopoiesis is a major feature in the course of myelofibrosis (MF). In fact, the spleen of patients with MF contains malignant hematopoietic stem cells retaining a complete differentiation program, suggesting both a pivotal role of the spleen in maintaining the disease and a tight regulation of hematopoiesis by the splenic microenvironment, in particular by mesenchymal stromal cells (MSCs). Little is known about splenic MSCs (Sp-MSCs), both in normal and in pathological context. In this work, we have in vitro expanded and characterized Sp-MSCs from 25 patients with MF and 13 healthy subjects (HS). They shared similar phenotype, growth kinetics, and differentiation capacity. However, MF Sp-MSCs expressed significant lower levels of nestin, and favored megakaryocyte (Mk) differentiation in vitro at a larger extent than their normal counterpart. Moreover, they showed a significant upregulation of matrix metalloprotease 2 (MMP2) and fibronectin 1 (FN1) genes both at mRNA expression and at protein level, and, finally, developed genetic abnormalities which were never detected in HS-derived Sp-MSCs. Our data point toward the existence of a defective splenic niche in patients with MF that could be responsible of some pathological features of the disease, including the increased trafficking of CD34+ cells and the expansion of the megakaryocytic lineage.
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Affiliation(s)
| | - Vittorio Abbonante
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Paolo Catarsi
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Irene Dambruoso
- Department of Hematology-Oncology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Melissa Mantelli
- Pediatric Onco-Hematology/Cell Factory, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Valentina Poletto
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Elisa Lenta
- Pediatric Onco-Hematology/Cell Factory, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Paola Guglielmelli
- Department of Clinical and Experimental Medicine, Research and Innovation Center for Myeloproliferative Diseases, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Stefania Croce
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Lorenzo Cobianchi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Basilio Jemos
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Rita Campanelli
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Elisa Bonetti
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Christian Andrea Di Buduo
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Silvia Salmoiraghi
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Villani
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Margherita Massa
- Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Marina Boni
- Department of Hematology-Oncology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Rita Zappatore
- Department of Hematology-Oncology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessandra Iurlo
- Hematology Division, IRCCS Ca' Granda-Maggiore Policlinico Hospital Foundation, Milan, Italy
| | - Alessandro Rambaldi
- Hematology and Bone Marrow Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy
| | - Alessandro Maria Vannucchi
- Department of Clinical and Experimental Medicine, Research and Innovation Center for Myeloproliferative Diseases, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Paolo Bernasconi
- Department of Hematology-Oncology, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Alessandra Balduini
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Giovanni Barosi
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
| | - Vittorio Rosti
- Center for the Study of Myelofibrosis, Laboratory of Biochemistry, Biotechnology and Advanced Diagnosis, IRCCS Policlinico San Matteo Foundation, Pavia, Italy
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Pelizzo G, Avanzini MA, Folini M, Bussani R, Mantelli M, Croce S, Acquafredda G, Travaglino P, Cimino-Reale G, Boni M, Dambruoso I, Calcaterra V. CPAM type 2-derived mesenchymal stem cells: Malignancy risk study in a 14-month-old boy. Pediatr Pulmonol 2017; 52:990-999. [PMID: 28493304 DOI: 10.1002/ppul.23734] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/20/2017] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The association between congenital pulmonary airway malformations (CPAM) and malignancy is reported in the literature. Interactions between the tumor, immune, and mesenchymal stromal/stem cells (MSCs) have been recognized as crucial for understanding tumorigenesis. We characterized MSCs isolated from CPAM lesions in order to define potential malignancy risks. METHODS CPAM II pulmonary tissue was used for MSC expansion; a "healthy" lung section from the same child was used as a comparator. Morphology, immunophenotype, differentiation and immunological capacity, proliferative growth, gene signature telomerase activity, and in vivo tumorigenicity in nude mice were evaluated. RESULTS MSCs were successfully isolated and propagated from CPAM tissue. CPAM-MSCs presented the typical MSC morphology and phenotype, while exhibiting high proliferative capacity, reaching confluence at a median time of 5 days as well as differentiation capabilities. CPAM-MSCs at early passages were not neoplastic and chromosomally normal, even though unbalanced chromosomal rearrangements were noted by molecular karyotype. CONCLUSIONS CPAM-MSCs exhibited specific features similar to tumor derived MSCs. Whilst there was no evidence of malignant transformation in the cystic tissue, our results provide evidence that this abnormal tissue has malignant potential. MSCs are considered important players in the tumor microenvironment and they have been closely linked to regulation of tumor survival, growth, and progression. Thus, early lesion resection also in asymptomatic patients might be indicated to exclude that the microenvironment may be potentially permissive to cancer development.
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Affiliation(s)
- Gloria Pelizzo
- Pediatric Surgery Unit, Children's Hospital, Istituto Mediterraneo di Eccellenza Pediatrica, Palermo, Italy
| | - Maria A Avanzini
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Marco Folini
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Rossana Bussani
- Institute of Pathologic Anatomy, University of Trieste, Trieste, Italy
| | - Melissa Mantelli
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Stefania Croce
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Gloria Acquafredda
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Paola Travaglino
- Immunology and Transplantation Laboratory/Cell Factory/Pediatric Hematology/Oncology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Graziella Cimino-Reale
- Molecular Pharmacology Unit, Department of Experimental Oncology and Molecular Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy
| | - Marina Boni
- Hematology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Irene Dambruoso
- Hematology Department, Fondazione IRCCS Policlinico S. Matteo, Pavia, Italy
| | - Valeria Calcaterra
- Pediatric Unit, Department of Internal Medicine, University of Pavia and Department of Maternal and Children's Health, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Calvello C, Rocca B, Klersy C, Zappatore R, Giardini I, Dambruoso I, Pasi F, Caresana M, Zappasodi P, Nano R, Boni M, Bernasconi P. Alternative splicing of hTERT: a further mechanism for the control of active hTERT in acute myeloid leukemia. Leuk Lymphoma 2017; 59:702-709. [PMID: 28679326 DOI: 10.1080/10428194.2017.1346252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
hTERT component is the key regulator of telomerase. Alternatively spliced variants of hTERT generate different telomerase activity. The goal of the study was to determine the role of different hTERT isoforms in the regulation of telomerase expression in AML patients. Among the 97 studied patients, 45 had a complex karyotype and 52 a normal karyotype. hTERT isoforms expression was determined in bone marrow samples by q-RT-PCR, using SYBR Green I. hTERT expression was lower in AML patients than controls (median 2.5 vs. 10.1, p = .003), though no difference was observed between the complex and normal karyotype (median 3.2 vs. 2.3, p = .37). High trans-dominant negative isoform expression increased the response rate by two. High expression of inactive product (-α - β) was shown to increase the risk of relapse by about three times. In conclusion, our data suggest an intriguing link between the control of hTERT isoforms expression and AML outcome.
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Affiliation(s)
- Celeste Calvello
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Barbara Rocca
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Catherine Klersy
- b Service of Biometry and Clinical Epidemiology , Fondazione IRCCS Policlinico San Matteo , Pavia , Italy
| | - Rita Zappatore
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Ilaria Giardini
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Irene Dambruoso
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Francesca Pasi
- c Division of Radiotherapy , Fondazione IRCCS Policlinico San Matteo , Pavia , Italy.,d Department of Biology and Biotechnology, Laboratory of Neuro Radio Experimental Biology , University of Pavia , Pavia , Italy
| | - Marilena Caresana
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Patrizia Zappasodi
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Rosanna Nano
- d Department of Biology and Biotechnology, Laboratory of Neuro Radio Experimental Biology , University of Pavia , Pavia , Italy
| | - Marina Boni
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
| | - Paolo Bernasconi
- a Division of Hematology , Fondazione IRCCS Policlinico San Matteo University of Pavia , Pavia , Italy
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Dambruoso I, Invernizzi R, Boni M, Zappatore R, Giardini I, Cavigliano MP, Rocca B, Calvello C, Bastia R, Caresana M, Pasi F, Nano R, Bernasconi P. MDS/AML del(11)(q14) Share Common Morphological Features Despite Different Chromosomal Breakpoints. Anticancer Res 2017; 37:645-649. [PMID: 28179312 DOI: 10.21873/anticanres.11359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 12/23/2016] [Accepted: 01/09/2017] [Indexed: 11/10/2022]
Abstract
In myelodysplatic syndromes and acute myeloid leukemia (MDS/AML) deletion of the 11q14 region is a rare chromosomal defect (incidence: 0.6-1.0%), included within the intermediate risk criteria by the International Prognostic Scoring System. No fluorescence in situ hybridization (FISH) study has yet been performed to identify a common breakpoint region (CBR). In our study through FISH with bacterial artificial chromosomes and commercial probes, we analyzed seven patients with MDS/AML harboring 11q14 deletion on conventional cytogenetic analysis. FISH revealed deletions in five patients and amplifications in two. Three patients with deletion carried a CBR, two had a deletion involving a more centromeric breakpoint. These five patients exhibited multilineage dysplasia, blast cells with large round nuclei, loose chromatin, small and abundant nucleoli, and vacuolated cytoplasm with very thin Auer bodies. In conclusion, the morphological features which occur independently of the extent of the deletion are of multilineage dysplasia in MDS and leukemic blasts strongly reactive to peroxidase in AML; despite the variable size of the deleted area, some patients harbor a CBR.
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Affiliation(s)
- Irene Dambruoso
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rosangela Invernizzi
- Division of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marina Boni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Rita Zappatore
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ilaria Giardini
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Barbara Rocca
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Celeste Calvello
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Raffaella Bastia
- Division of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marilena Caresana
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Pasi
- Division of Radiotherapy, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.,Laboratory of Neuro Radio Experimental Biology, Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Rosanna Nano
- Laboratory of Neuro Radio Experimental Biology, Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Paolo Bernasconi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Bernasconi P, Farina M, Boni M, Dambruoso I, Calvello C. Therapeutically targeting SELF-reinforcing leukemic niches in acute myeloid leukemia: A worthy endeavor? Am J Hematol 2016; 91:507-17. [PMID: 26822317 DOI: 10.1002/ajh.24312] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/21/2015] [Accepted: 01/16/2016] [Indexed: 12/17/2022]
Abstract
A tight relationship between the acute myeloid leukemia (AML) population and the bone marrow (BM) microenvironment has been convincingly established. The AML clone contains leukemic stem cells (LSCs) that compete with normal hematopoietic stem cells (HSCs) for niche occupancy and remodel the niche; whereas, the BM microenvironment might promote AML development and progression not only through hypoxia and homing/adhesion molecules, but also through genetic defects. Although it is still unknown whether the niche influences treatment results or contains any potential target for treatment, this dynamic AML-niche interaction might be a promising therapeutic objective to significantly improve the AML cure rate.
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Affiliation(s)
- Paolo Bernasconi
- Division of Hematology; Fondazione IRCCS Policlinico San Matteo, University of Pavia; Pavia Italy
| | - Mirko Farina
- Division of Hematology; Fondazione IRCCS Policlinico San Matteo, University of Pavia; Pavia Italy
| | - Marina Boni
- Division of Hematology; Fondazione IRCCS Policlinico San Matteo, University of Pavia; Pavia Italy
| | - Irene Dambruoso
- Division of Hematology; Fondazione IRCCS Policlinico San Matteo, University of Pavia; Pavia Italy
| | - Celeste Calvello
- Division of Hematology; Fondazione IRCCS Policlinico San Matteo, University of Pavia; Pavia Italy
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7
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Rumi E, Milosevic JD, Casetti I, Dambruoso I, Pietra D, Boveri E, Boni M, Bernasconi P, Passamonti F, Kralovics R, Cazzola M. Efficacy of Ruxolitinib in Chronic Eosinophilic Leukemia Associated With a PCM1-JAK2 Fusion Gene. J Clin Oncol 2013; 31:e269-71. [DOI: 10.1200/jco.2012.46.4370] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Elisa Rumi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Jelena D. Milosevic
- Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Ilaria Casetti
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Irene Dambruoso
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Daniela Pietra
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Emanuela Boveri
- Institute of Anatomic Pathology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Marina Boni
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy
| | - Paolo Bernasconi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo; and University of Pavia, Pavia, Italy
| | | | - Robert Kralovics
- Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria
| | - Mario Cazzola
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo; and University of Pavia, Pavia, Italy
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8
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Bernasconi P, Klersy C, Boni M, Cavigliano PM, Dambruoso I, Zappatore R. Validation of the new comprehensive cytogenetic scoring system (NCCSS) on 630 consecutive de novo MDS patients from a single institution. Am J Hematol 2013; 88:120-9. [PMID: 23349006 DOI: 10.1002/ajh.23369] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 11/15/2012] [Accepted: 11/18/2012] [Indexed: 11/05/2022]
Abstract
This study evaluated whether the NCCSS truly improves the prognostic stratification of 630 consecutive de novo MDS patients and established which cytogenetic grouping [NCCSS or International Prognostic Scoring System (IPSS)], when combined with the WHO classification, best predicted the clinical outcome of myelodysplastic syndromes (MDS). The frequency of chromosomal defects was 53.8%. Clinical parameters, including number of cytopenias, WHO classification, IPSS cytogenetic categories and scores, NCCSS were all relevant for overall survival (OS) and leukemia-free survival (LFS) and were included in six distinct multivariate models compared by the Akaike Information Criterion (AIC). The most effective model to predict OS included the number of cytopenias, the WHO classification and the NCCSS, whereas the model including the number of cytopenias, blast cell percentage and the NCCSS and the model including the number of cytopenias the WHO classification and the NCCSS were almost equally effective to predict LFS. In conclusion, the NCCS (i) improves the prognostic stratification of the good and poor IPSS cytogenetic categories by introducing the very good and the very poor categories; (ii) is still incomplete in establishing the prognostic relevance of rare/double defects, (ii) applied to patients who receive supportive treatment only identifies five different prognostic subgroups, but applied to patients treated with specific therapies reveals only a trend toward a significantly different OS and LFS when patients of the poor and intermediate cytogenetic categories are compared, (iii) combined with the WHO classification is much more effective than the IPSS in predicting MDS clinical outcome.
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Affiliation(s)
- Paolo Bernasconi
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo; University of Pavia; Italy
| | - Catherine Klersy
- Scientific Direction, Clinical Epidemiology and Biometry Unit; Fondazione IRCCS Policlinico San Matteo; Italy
| | - Marina Boni
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo; University of Pavia; Italy
| | - Paola Maria Cavigliano
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo; University of Pavia; Italy
| | - Irene Dambruoso
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo; University of Pavia; Italy
| | - Rita Zappatore
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo; University of Pavia; Italy
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9
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Dambruoso I, Boni M, Rossi M, Zappasodi P, Calvello C, Zappatore R, Cavigliano PM, Giardini I, Rocca B, Caresana M, Astori C, Cazzola M, Castagnola C, Bernasconi P. Detection of TET2 abnormalities by fluorescence in situ hybridization in 41 patients with myelodysplastic syndrome. Cancer Genet 2012; 205:285-94. [PMID: 22749034 DOI: 10.1016/j.cancergen.2012.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 03/29/2012] [Accepted: 03/29/2012] [Indexed: 10/28/2022]
Abstract
TET2 haplo-insufficiency occurs through different molecular mechanisms and is promptly revealed by array comparative genomic hybridization, single nucleotide polymorphism (SNP) array, and next-generation sequencing (NGS). Fluorescence in situ hybridization (FISH) can effectively demonstrate TET2 deletions and is often used to validate molecular results. In the present study 41 MDS patients with and without 4q abnormalities were analyzed with a series of bacterial artificial chromosome (BAC) probes spanning the 4q22.3-q25 region. On conventional cytogenetic (CC) studies, a structural defect of the long arm of chromosome 4 (4q) was observed in seven patients. In three, one each with a t(1;4)(p21;q24), an ins(5;4)(q23;q24qter), and a t(4;17)(q31;p13) as the sole chromosomal abnormality, FISH with the RP11-356L5 and RP11-16G16 probes, which cover the TET2 locus, produced one signal only. Unexpectedly, this same result was achieved in 3 of the remaining 34 patients. Thus, a TET2 deletion was observed in a total of six patients (14.6%). TET2 deletion was not correlated with any particular clinical findings or outcome. These findings demonstrate that 1) FISH is an effective and economical method to reveal cryptic abnormalities of band 4q22-q24 resulting in TET2 deletions; 2) in these patients, TET2 deletion is the unifying genetic event; and 3) the different breakpoints within the 4q22-q25 region suggest that deletions are not mediated by repetitive sequences.
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Affiliation(s)
- Irene Dambruoso
- Division of Hematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Italy.
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10
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Bernasconi P, Dambruoso I, Cavigliano PM, Boni M, Travaglino E, Benatti C, Invernizzi R. A complex chromosome 3 rearrangement not affecting RPN1, EVI1/MDS1 genes in a patient with an atypical refractory cytopenia with multilineage dysplasia. Ann Hematol 2007; 87:147-50. [PMID: 17960379 DOI: 10.1007/s00277-007-0398-z] [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] [Received: 07/11/2007] [Accepted: 09/28/2007] [Indexed: 10/22/2022]
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11
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Bernasconi P, Klersy C, Boni M, Cavigliano P, Calatroni S, Giardini I, Rocca B, Zappatore R, Caresana M, Dambruoso I, Lazzarino M, Bernasconi C. P109 Revised IPSS cytogenetic categories and WHO classification allow a better prognostic definition of patients with de novo myelodysplastic syndromes (MDS). Leuk Res 2007. [DOI: 10.1016/s0145-2126(07)70179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Bernasconi P, Klersy C, Boni M, Cavigliano PM, Calatroni S, Giardini I, Rocca B, Zappatore R, Caresana M, Dambruoso I, Lazzarino M, Bernasconi C. World Health Organization classification in combination with cytogenetic markers improves the prognostic stratification of patients with de novo primary myelodysplastic syndromes. Br J Haematol 2007; 137:193-205. [PMID: 17408458 DOI: 10.1111/j.1365-2141.2007.06537.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [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: 11/26/2022]
Abstract
This study correlated chromosomal defects with French-American-British (FAB)/World Health Organization (WHO) classification subtypes, proposed a revised International Prognostic Scoring System (IPSS) cytogenetic grouping; and established which classification, when used with the IPSS cytogenetic categories, best predicted clinical outcome in the myelodysplastic syndromes (MDS). A higher prevalence of chromosomal defects and distinct defects were observed in patients with multi-lineage dysplasia and a blast cell percentage >10%. Abnormalities of the long arm of chromosome 3, del(7)(q31q35), trisomy 8, del(11)(q14q23), del(12p) and 20q- could be segregated from their respective IPSS cytogenetic categories and used to develop new cytogenetic subgroups. Clinical parameters, FAB/WHO classification, IPSS score and standard or revised cytogenetic categories were statistically relevant for overall survival (OS) and progression-free intervals (PFI) and were included within five distinct multivariate models compared by the Akaike Information Criterion. To predict OS, the best models included age, WHO classification and standard or revised IPSS cytogenetic categories; to predict PFI, the best model included the same variables and revised cytogenetic categories. In conclusion, (i) the WHO classification was associated with a more homogeneous cytogenetic pattern than the FAB classification, (ii) WHO classification and standard/revised IPSS cytogenetic categories were much more effective than IPSS for predicting MDS clinical outcome, (iii) revised cytogenetic subgroups predicted PFI more effectively than standard categories.
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MESH Headings
- Adult
- Aged
- Chromosome Aberrations
- Chromosome Deletion
- Chromosomes, Human/genetics
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 20/genetics
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 7/genetics
- Chromosomes, Human, Pair 8/genetics
- Cytogenetic Analysis/methods
- Disease Progression
- Female
- Humans
- Karyotyping/methods
- Male
- Middle Aged
- Myelodysplastic Syndromes/classification
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/therapy
- Prognosis
- Trisomy/genetics
- World Health Organization
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Affiliation(s)
- Paolo Bernasconi
- Division of Haematology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
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Bernasconi P, Boni M, Cavigliano PM, Calatroni S, Giardini I, Rocca B, Zappatore R, Dambruoso I, Caresana M. Clinical Relevance of Cytogenetics in Myelodysplastic Syndromes. Ann N Y Acad Sci 2006; 1089:395-410. [PMID: 17261783 DOI: 10.1196/annals.1386.034] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [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]
Abstract
Myelodysplastic syndromes (MDS) are a group of heterogeneous stem cell disorders with different clinical behaviors and outcomes. Conventional cytogenetics (CC) studies have demonstrated that the majority of MDS patients harbor clonal chromosome defects. The probability of discovering a chromosomal abnormality has been increased by fluorescence in situ hybridization (FISH), which has revealed that about 15% of patients with a normal chromosome pattern on CC may instead present cryptic defects. Cytogenetic abnormalities, except for the interstitial long-arm deletion of chromosome 5 (5q-), are not specific for any French-American-British (FAB)/World Health Organization (WHO) MDS subtypes, demonstrate the clonality of the disease, and identify peculiar morphological entities, thus confirming clinical diagnosis. In addition, chromosome abnormalities are independent prognostic factors predicting overall survival and the likelihood of progression in acute myeloid leukemia.
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Affiliation(s)
- Paolo Bernasconi
- Department of Blood, Heart and Lung Medical Sciences of the University of Pavia and Division of Hematology, Fondazione Policlinico San Matteo IRCCS, Pavia, Italy.
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