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Walma MS, Rombouts SJ, Brada LJH, Borel Rinkes IH, Bosscha K, Bruijnen RC, Busch OR, Creemers GJ, Daams F, van Dam RM, van Delden OM, Festen S, Ghorbani P, de Groot DJ, de Groot JWB, Haj Mohammad N, van Hillegersberg R, de Hingh IH, D'Hondt M, Kerver ED, van Leeuwen MS, Liem MS, van Lienden KP, Los M, de Meijer VE, Meijerink MR, Mekenkamp LJ, Nio CY, Oulad Abdennabi I, Pando E, Patijn GA, Polée MB, Pruijt JF, Roeyen G, Ropela JA, Stommel MWJ, de Vos-Geelen J, de Vries JJ, van der Waal EM, Wessels FJ, Wilmink JW, van Santvoort HC, Besselink MG, Molenaar IQ. Radiofrequency ablation and chemotherapy versus chemotherapy alone for locally advanced pancreatic cancer (PELICAN): study protocol for a randomized controlled trial. Trials 2021; 22:313. [PMID: 33926539 PMCID: PMC8082784 DOI: 10.1186/s13063-021-05248-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 04/03/2021] [Indexed: 12/18/2022] Open
Abstract
Background Approximately 80% of patients with locally advanced pancreatic cancer (LAPC) are treated with chemotherapy, of whom approximately 10% undergo a resection. Cohort studies investigating local tumor ablation with radiofrequency ablation (RFA) have reported a promising overall survival of 26–34 months when given in a multimodal setting. However, randomized controlled trials (RCTs) investigating the effect of RFA in combination with chemotherapy in patients with LAPC are lacking. Methods The “Pancreatic Locally Advanced Unresectable Cancer Ablation” (PELICAN) trial is an international multicenter superiority RCT, initiated by the Dutch Pancreatic Cancer Group (DPCG). All patients with LAPC according to DPCG criteria, who start with FOLFIRINOX or (nab-paclitaxel/)gemcitabine, are screened for eligibility. Restaging is performed after completion of four cycles of FOLFIRINOX or two cycles of (nab-paclitaxel/)gemcitabine (i.e., 2 months of treatment), and the results are assessed within a nationwide online expert panel. Eligible patients with RECIST stable disease or objective response, in whom resection is not feasible, are randomized to RFA followed by chemotherapy or chemotherapy alone. In total, 228 patients will be included in 16 centers in The Netherlands and four other European centers. The primary endpoint is overall survival. Secondary endpoints include progression-free survival, RECIST response, CA 19.9 and CEA response, toxicity, quality of life, pain, costs, and immunomodulatory effects of RFA. Discussion The PELICAN RCT aims to assess whether the combination of chemotherapy and RFA improves the overall survival when compared to chemotherapy alone, in patients with LAPC with no progression of disease following 2 months of systemic treatment. Trial registration Dutch Trial RegistryNL4997. Registered on December 29, 2015. ClinicalTrials.govNCT03690323. Retrospectively registered on October 1, 2018
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Affiliation(s)
- M S Walma
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. .,Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - S J Rombouts
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L J H Brada
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - I H Borel Rinkes
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - K Bosscha
- Departments of Surgery and Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - R C Bruijnen
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - O R Busch
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - G J Creemers
- Departments of Surgery and Medical Oncology, Catharina Hospital, Eindhoven, The Netherlands
| | - F Daams
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - R M van Dam
- Departments of Surgery and Medical Oncology GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, The Netherlands
| | - O M van Delden
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - S Festen
- Departments of Surgery and Medical Oncology, OLVG, Amsterdam, The Netherlands
| | - P Ghorbani
- Pancreatic Surgery Unit, Division of Surgery, CLINTEC, Karolinska Institute at Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - D J de Groot
- Departments of Surgery and Medical Oncology, UMC Groningen, Groningen, The Netherlands
| | - J W B de Groot
- Departments of Surgery and Medical Oncology, Isala, Zwolle, The Netherlands
| | - N Haj Mohammad
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - R van Hillegersberg
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - I H de Hingh
- Departments of Surgery and Medical Oncology, Catharina Hospital, Eindhoven, The Netherlands
| | - M D'Hondt
- Department of General and Digestive Surgery, Groeninge Hospital, Kortrijk, Belgium
| | - E D Kerver
- Departments of Surgery and Medical Oncology, OLVG, Amsterdam, The Netherlands
| | - M S van Leeuwen
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M S Liem
- Departments of Surgery and Medical Oncology, Medical Spectrum Twente, Enschede, The Netherlands
| | - K P van Lienden
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - M Los
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - V E de Meijer
- Departments of Surgery and Medical Oncology, UMC Groningen, Groningen, The Netherlands
| | - M R Meijerink
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L J Mekenkamp
- Departments of Surgery and Medical Oncology, Medical Spectrum Twente, Enschede, The Netherlands
| | - C Y Nio
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - I Oulad Abdennabi
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - E Pando
- HBP Surgery and Transplant Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - G A Patijn
- Departments of Surgery and Medical Oncology, Isala, Zwolle, The Netherlands
| | - M B Polée
- Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - J F Pruijt
- Departments of Surgery and Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands
| | - G Roeyen
- Department of Hepatobiliary, Endocrine and Transplantation Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - J A Ropela
- Department of Medical Oncology, St Jansdal Hospital, Harderwijk, The Netherlands
| | - M W J Stommel
- Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J de Vos-Geelen
- Departments of Surgery and Medical Oncology GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, The Netherlands
| | - J J de Vries
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - E M van der Waal
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - F J Wessels
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - J W Wilmink
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - H C van Santvoort
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - M G Besselink
- Departments of Surgery, Radiology and Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - I Q Molenaar
- Departments of Surgery, Radiology and Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
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Brada LJH, Walma MS, van Dam RM, de Vos-Geelen J, de Hingh IH, Creemers GJ, Liem MS, Mekenkamp LJ, de Meijer VE, de Groot DJA, Patijn GA, de Groot JWB, Festen S, Kerver ED, Stommel MWJ, Meijerink MR, Bosscha K, Pruijt JF, Polée MB, Ropela JA, Cirkel GA, Los M, Wilmink JW, Haj Mohammad N, van Santvoort HC, Besselink MG, Molenaar IQ. The treatment and survival of elderly patients with locally advanced pancreatic cancer: A post-hoc analysis of a multicenter registry. Pancreatology 2021; 21:163-169. [PMID: 33309624 DOI: 10.1016/j.pan.2020.11.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/03/2020] [Accepted: 11/22/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The treatment options for patients with locally advanced pancreatic cancer (LAPC) have improved in recent years and consequently survival has increased. It is unknown, however, if elderly patients benefit from these improvements in therapy. With the ongoing aging of the patient population and an increasing incidence of pancreatic cancer, this patient group becomes more relevant. This study aims to clarify the association between increasing age, treatment and overall survival in patients with LAPC. METHODS Post-hoc analysis of a multicenter registry including consecutive patients with LAPC, who were registered in 14 centers of the Dutch Pancreatic Cancer Group (April 2015-December 2017). Patients were divided in three groups according to age (<65, 65-74 and ≥75 years). Primary outcome was overall survival stratified by primary treatment strategy. Multivariable regression analyses were performed to adjust for possible confounders. RESULTS Overall, 422 patients with LAPC were included; 162 patients (38%) aged <65 years, 182 patients (43%) aged 65-74 and 78 patients (19%) aged ≥75 years. Chemotherapy was administered in 86%, 81% and 50% of the patients in the different age groups (p<0.01). Median overall survival was 12, 11 and 7 months for the different age groups (p<0.01).Patients treated with chemotherapy showed comparable median overall survival of 13, 14 and 10 months for the different age groups (p=0.11). When adjusted for confounders, age was not associated with overall survival. CONCLUSION Elderly patients are less likely to be treated with chemotherapy, but when treated with chemotherapy, their survival is comparable to younger patients.
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Affiliation(s)
- L J H Brada
- Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - M S Walma
- Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - R M van Dam
- Dept. of Surgery, Maastricht UMC, Maastricht, the Netherlands
| | - J de Vos-Geelen
- Dept. of Internal Medicine, Div. of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands
| | - I H de Hingh
- Dept. of Surgery, Catharina Hospital, Eindhoven, the Netherlands; Dept. of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, the Netherlands
| | - G J Creemers
- Dept. of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands
| | - M S Liem
- Dept. of Surgery, Medical Spectrum Twente, Enschede, the Netherlands
| | - L J Mekenkamp
- Dept. of Medical Oncology, Medical Spectrum Twente, Enschede, the Netherlands
| | - V E de Meijer
- Dept. of Surgery, UMC Groningen, Groningen, the Netherlands
| | - D J A de Groot
- Dept. of Medical Oncology, UMC Groningen, Groningen, the Netherlands
| | - G A Patijn
- Dept. of Surgery, Isala, Zwolle, the Netherlands
| | | | - S Festen
- Dept. of Surgery, OLVG, Amsterdam, the Netherlands
| | - E D Kerver
- Dept. of Medical Oncology, OLVG, Amsterdam, the Netherlands
| | - M W J Stommel
- Dept. of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - M R Meijerink
- Dept. of Radiology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - K Bosscha
- Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - J F Pruijt
- Dept. of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - M B Polée
- Dept. of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - J A Ropela
- Dept. of Medical Oncology, St Jansdal Hospital, Harderwijk, the Netherlands
| | - G A Cirkel
- Dept. of Medical Oncology, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - M Los
- Dept. of Medical Oncology, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - J W Wilmink
- Dept. of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - N Haj Mohammad
- Dept. of Medical Oncology, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - H C van Santvoort
- Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - M G Besselink
- Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - I Q Molenaar
- Dept. of Surgery, UMC Utrecht Cancer Center, St Antonius Hospital Nieuwegein and Meander Medical Center Amersfoort: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands.
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Walma MS, Brada LJ, Patuleia SIS, Blomjous JG, Bollen TL, Bosscha K, Bruijnen RC, Busch OR, Creemers GJ, Daams F, van Dam R, Festen S, Jan de Groot D, Willem de Groot J, Mohammad NH, Hermans JJ, de Hingh IH, Kerver ED, van Leeuwen MS, van der Leij C, Liem MS, van Lienden KP, Los M, de Meijer VE, Meijerink MR, Mekenkamp LJ, Nederend J, Nio CY, Patijn GA, Polée MB, Pruijt JF, Renken NS, Rombouts SJ, Schouten TJ, Stommel MWJ, Verweij ME, de Vos-Geelen J, de Vries JJJ, Vulink A, Wessels FJ, Wilmink JW, van Santvoort HC, Besselink MG, Molenaar IQ. Treatment strategies and clinical outcomes in consecutive patients with locally advanced pancreatic cancer: A multicenter prospective cohort. Eur J Surg Oncol 2020; 47:699-707. [PMID: 33280952 DOI: 10.1016/j.ejso.2020.11.137] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 08/30/2020] [Revised: 11/10/2020] [Accepted: 11/21/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Since current studies on locally advanced pancreatic cancer (LAPC) mainly report from single, high-volume centers, it is unclear if outcomes can be translated to daily clinical practice. This study provides treatment strategies and clinical outcomes within a multicenter cohort of unselected patients with LAPC. MATERIALS AND METHODS Consecutive patients with LAPC according to Dutch Pancreatic Cancer Group criteria, were prospectively included in 14 centers from April 2015 until December 2017. A centralized expert panel reviewed response according to RECIST v1.1 and potential surgical resectability. Primary outcome was median overall survival (mOS), stratified for primary treatment strategy. RESULTS Overall, 422 patients were included, of whom 77% (n = 326) received chemotherapy. The majority started with FOLFIRINOX (77%, 252/326) with a median of six cycles (IQR 4-10). Gemcitabine monotherapy was given to 13% (41/326) of patients and nab-paclitaxel/gemcitabine to 10% (33/326), with a median of two (IQR 3-5) and three (IQR 3-5) cycles respectively. The mOS of the entire cohort was 10 months (95%CI 9-11). In patients treated with FOLFIRINOX, gemcitabine monotherapy, or nab-paclitaxel/gemcitabine, mOS was 14 (95%CI 13-15), 9 (95%CI 8-10), and 9 months (95%CI 8-10), respectively. A resection was performed in 13% (32/252) of patients after FOLFIRINOX, resulting in a mOS of 23 months (95%CI 12-34). CONCLUSION This multicenter unselected cohort of patients with LAPC resulted in a 14 month mOS and a 13% resection rate after FOLFIRINOX. These data put previous results in perspective, enable us to inform patients with more accurate survival numbers and will support decision-making in clinical practice.
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Affiliation(s)
- Marieke S Walma
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Lilly J Brada
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Susana I S Patuleia
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | | | - Thomas L Bollen
- Dept. of Radiology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - Koop Bosscha
- Dept. of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Rutger C Bruijnen
- Dept. of Radiology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - Olivier R Busch
- Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Geert-Jan Creemers
- Dept. of Medical Oncology, Catharina Hospital, Eindhoven, the Netherlands
| | - Freek Daams
- Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ronald van Dam
- Dept. of Surgery, Maastricht UMC+, Maastricht, the Netherlands
| | | | - Derk Jan de Groot
- Dept. of Medical Oncology, UMC Groningen, Groningen, the Netherlands
| | | | - Nadia Haj Mohammad
- Dept. of Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - John J Hermans
- Dept. of Radiology, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Emile D Kerver
- Dept. of Medical Oncology, OLVG, Amsterdam, the Netherlands
| | - Maarten S van Leeuwen
- Dept. of Radiology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | | | - Mike S Liem
- Dept. of Surgery, Medical Spectrum Twente, Enschede, the Netherlands
| | - Krijn P van Lienden
- Dept. of Radiology Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amstrdam, the Netherlands
| | - Maartje Los
- Dept. of Medical Oncology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | | | - Martijn R Meijerink
- Dept. of Radiology Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amstrdam, the Netherlands
| | - Leonie J Mekenkamp
- Dept. of Medical Oncology, Medical Spectrum Twente, Enschede, the Netherlands
| | - Joost Nederend
- Dept. of Radiology, Catharina Hospital, Eindhoven, the Netherlands
| | - C Yung Nio
- Dept. of Radiology Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amstrdam, the Netherlands
| | - Gijs A Patijn
- Dept. of Surgery, Isala Clinics, Zwolle, the Netherlands
| | - Marco B Polée
- Dept. of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | - Johannes F Pruijt
- Dept. of Medical Oncology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Nomdo S Renken
- Dept. of Radiology, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Steffi J Rombouts
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands; Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Thijs J Schouten
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - Martijn W J Stommel
- Dept. of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Maaike E Verweij
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - Judith de Vos-Geelen
- Dept. of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht UMC+, Maastricht, the Netherlands
| | - Jan J J de Vries
- Dept. of Radiology Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amstrdam, the Netherlands
| | - Annelie Vulink
- Dept. of Medical Oncology, Reinier de Graaf Hospital, Delft, the Netherlands
| | - Frank J Wessels
- Dept. of Radiology, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - Johanna W Wilmink
- Dept. of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam; the Netherlands
| | - Hjalmar C van Santvoort
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
| | - Marc G Besselink
- Dept. of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - I Quintus Molenaar
- Dept. of Surgery, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein: Regional Academic Cancer Center Utrecht, Utrecht, the Netherlands
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Lugtenburg PJ, de Nully Brown P, van der Holt B, D'Amore FA, Koene HR, de Jongh E, Fijnheer R, van Esser JW, Böhmer LH, Pruijt JF, Verhoef GE, Hoogendoorn M, Bilgin MY, Nijland M, van der Burg-de Graauw NC, Oosterveld M, Jie KSG, Larsen TS, van der Poel MW, Leijs MB, Silbermann MH, van Marwijk Kooy M, Beeker A, Kersten MJ, Doorduijn JK, Tick LW, Brouwer RE, Lam KH, Burggraaff CN, de Keizer B, Arens AI, de Jong D, Hoekstra OS, Zijlstra-Baalbergen JM. Rituximab-CHOP With Early Rituximab Intensification for Diffuse Large B-Cell Lymphoma: A Randomized Phase III Trial of the HOVON and the Nordic Lymphoma Group (HOVON-84). J Clin Oncol 2020; 38:3377-3387. [PMID: 32730183 DOI: 10.1200/jco.19.03418] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Immunochemotherapy with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) has become standard of care for patients with diffuse large B-cell lymphoma (DLBCL). This randomized trial assessed whether rituximab intensification during the first 4 cycles of R-CHOP could improve the outcome of these patients compared with standard R-CHOP. PATIENTS AND METHODS A total of 574 patients with DLBCL age 18 to 80 years were randomly assigned to induction therapy with 6 or 8 cycles of R-CHOP-14 with (RR-CHOP-14) or without (R-CHOP-14) intensification of rituximab in the first 4 cycles. The primary end point was complete remission (CR) on induction. Analyses were performed by intention to treat. RESULTS CR was achieved in 254 (89%) of 286 patients in the R-CHOP-14 arm and 249 (86%) of 288 patients in the RR-CHOP-14 arm (hazard ratio [HR], 0.82; 95% CI, 0.50 to 1.36; P = .44). After a median follow-up of 92 months (range, 1-131 months), 3-year failure-free survival was 74% (95% CI, 68% to 78%) in the R-CHOP-14 arm versus 69% (95% CI, 63% to 74%) in the RR-CHOP-14 arm (HR, 1.26; 95% CI, 0.98 to 1.61; P = .07). Progression-free survival at 3 years was 74% (95% CI, 69% to 79%) in the R-CHOP-14 arm versus 71% (95% CI, 66% to 76%) in the RR-CHOP-14 arm (HR, 1.20; 95% CI, 0.94 to 1.55; P = .15). Overall survival at 3 years was 81% (95% CI, 76% to 85%) in the R-CHOP-14 arm versus 76% (95% CI, 70% to 80%) in the RR-CHOP-14 arm (HR, 1.27; 95% CI, 0.97 to 1.67; P = .09). Patients between ages 66 and 80 years experienced significantly more toxicity during the first 4 cycles in the RR-CHOP-14 arm, especially neutropenia and infections. CONCLUSION Early rituximab intensification during R-CHOP-14 does not improve outcome in patients with untreated DLBCL.
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Affiliation(s)
| | | | - Bronno van der Holt
- Haemato Oncology Foundation for Adults in the Netherlands (HOVON) Data Center, Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | | | | | - Eva de Jongh
- Albert Schweitzer Hospital, Dordrecht, the Netherlands
| | | | | | | | | | | | | | | | - Marcel Nijland
- University Medical Center Groningen, Groningen, the Netherlands
| | | | | | | | | | | | | | | | | | - Aart Beeker
- Spaarne Gasthuis, Hoofddorp, the Netherlands
| | | | | | | | | | - King H Lam
- Erasmus MC Cancer Institute, Rotterdam, the Netherlands
| | | | | | | | - Daphne de Jong
- HOVON Pathology Facility and Biobank, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Otto S Hoekstra
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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5
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Duerloo EE, Peterse JL, Pruijt JF, Kool LJ. Quiz case. Mesenteric panniculitis (sclerosing mesenteritis, mesenteric lipodystrophy, retractile or liposclerotic mesenteritis. Eur J Radiol 2001; 38:160-2. [PMID: 11411455 DOI: 10.1016/s0720-048x(00)00248-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- E E Duerloo
- Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam.
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6
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Fibbe WE, Pruijt JF, van Kooyk Y, Figdor CG, Opdenakker G, Willemze R. The role of metalloproteinases and adhesion molecules in interleukin-8-induced stem-cell mobilization. Semin Hematol 2000; 37:19-24. [PMID: 10718155 DOI: 10.1016/s0037-1963(00)90085-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The chemokine interleukin-8 (IL-8) is a potent chemoattractant and activator of neutrophils. Upon systemic injection, IL-8 induces an immediate neutropenia followed by a rebound granulocytosis. In this report, we discuss the effects of IL-8 on the mobilization of hematopoietic stem cells. Within 20 minutes following a single intraperitoneal injection in mice, IL-8 induces the mobilization of hematopoietic progenitor cells (HPC) with colony-forming, radioprotective, and long-term lymphomyeloid resubpopulating ability. Mobilization can be specifically prevented by pretreatment with antibodies against the beta2 integrin LFA-1 (CD11a). In monkeys, IL-8 Induces the rapid release of the metalloproteinase gelatinase-B concurrent with the mobilization of HPC. The latter effect can be prevented by blocking gelatinase-B activity using specific monoclonal antibodies, suggesting the involvement of gelatinase-B as a mediator of HPC mobilization. These results are consistent with the hypothesis that neutrophils are major regulators of stem-cell mobilization through the release of metalloproteinases (MMPs) that cleave extracellular matrix molecules to which HPC are attached.
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Affiliation(s)
- W E Fibbe
- Department of Hematology, Leiden University Medical Center, The Netherlands
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7
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Pruijt JF, Fibbe WE, Laterveer L, Pieters RA, Lindley IJ, Paemen L, Masure S, Willemze R, Opdenakker G. Prevention of interleukin-8-induced mobilization of hematopoietic progenitor cells in rhesus monkeys by inhibitory antibodies against the metalloproteinase gelatinase B (MMP-9). Proc Natl Acad Sci U S A 1999; 96:10863-8. [PMID: 10485917 PMCID: PMC17974 DOI: 10.1073/pnas.96.19.10863] [Citation(s) in RCA: 188] [Impact Index Per Article: 7.5] [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: 11/18/2022] Open
Abstract
Previously, we demonstrated that IL-8 induces rapid mobilization of hematopoietic progenitor cells (HPC) from the bone marrow of rhesus monkeys. Because activation of neutrophils by IL-8 induces the release of gelatinase B (MMP-9), which is involved in the degradation of extracellular matrix molecules, we hypothesized that MMP-9 release might induce stem cell mobilization by cleaving matrix molecules to which stem cells are attached. Rhesus monkeys were treated with a single i.v. injection of 0.1 mg/kg human IL-8, which resulted in a 10- to 100-fold increase in HPC within 30 min after injection. Zymographic analysis revealed a dramatic instantaneous increase in the plasma levels of MMP-9, followed by the increase in circulating HPC. Enzyme levels decreased at 2 h after injection of IL-8, simultaneously with the decrease in the numbers of circulating HPC. To test the hypothesis that MMP-9 induction was involved in HPC mobilization, rhesus monkeys were treated with a highly specific inhibitory monoclonal anti-gelatinase B antibody. Anti-gelatinase B at a dose of 1-2 mg/kg completely prevented the IL-8-induced mobilization of HPC, whereas a dose of 0.1 mg/kg had only a limited effect. Preinjection of inhibitory antibodies did not preclude the IL-8-induced production and secretion of MMP-9. Pretreatment with an irrelevant control antibody did not affect IL-8-induced mobilization, showing that the inhibition by the anti-gelatinase B antibody was specific. In summary, IL-8 induces the rapid systemic release of MMP-9 with concurrent mobilization of HPC that is prevented by pretreatment with an inhibitory anti-gelatinase B antibody, indicating that MMP-9 is involved as a mediator of the IL-8-induced mobilization of HPC.
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Affiliation(s)
- J F Pruijt
- Laboratory of Experimental Hematology, Department of Hematology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
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8
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Abstract
The CXC chemokine interleukin-8 induces rapid mobilization of hematopoietic progenitor cells in mice and monkeys. Antibodies against the beta 2-integrin leukocyte function-associated antigen-1 completely blocked interleukin-8-induced mobilization. This was not due to a direct effect on the hematopoietic progenitor cells, as leukocyte function-associated antigen-1 was found not to be expressed on hematopoietic progenitor cells. Additional experiments showed that interleukin-8 induces the rapid release of the metalloproteinase gelatinase B, concurrent with the mobilization of hematopoietic progenitor cells. Mobilization could be completely prevented by anti-gelatinase B antibodies. Because neutrophils express leukocyte function-associated antigen-1 and high affinity interleukin-8 receptors, and release gelatinase B upon stimulation with interleukin-8, we hypothesized that neutrophils are key mediators in interleukin-8-induced stem cell mobilization. Further studies showed that mobilization by interleukin-8 was completely absent in mice rendered neutropenic with anti-granulocytic antibodies. Taken together, these data are consistent with an essential role for neutrophils in interleukin-8-induced stem cell mobilization.
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Affiliation(s)
- J F Pruijt
- Department of Hematology, Leiden University Medical Center, The Netherlands
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9
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Abstract
The CXC chemokine interleukin-8 (IL-8) has profound hematopoietic activities following systemic administration. It induces the rapid mobilization of cells with lymphomyeloid repopulating ability in mice and of hematopoietic progenitor cells in monkeys. In this paper, evidence is presented that stem cell mobilization in mice requires the functional expression on the beta 2-integrin leukocyte function-associated antigen-1 (LFA-1). In monkeys, systemic injection of IL-8 is followed by a significant increase in the circulating levels of the matrix metallo proteinase gelatinase-B (MMP-9). Based on these findings, the hypothesis is discussed that mature neutrophils serve as intermediate cells in IL-8-induced stem cell mobilization by the release of proteinases.
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Affiliation(s)
- W E Fibbe
- Department of Hematology, Leiden University Medical Center, The Netherlands.
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10
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Pruijt JF, van Kooyk Y, Figdor CG, Willemze R, Fibbe WE. Murine hematopoietic progenitor cells with colony-forming or radioprotective capacity lack expression of the beta 2-integrin LFA-1. Blood 1999; 93:107-12. [PMID: 9864152] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
Recently, we have demonstrated that antibodies that block the function of the beta2-integrin leukocyte function-associated antigen-1 (LFA-1) completely abrogate the rapid mobilization of hematopoietic progenitor cells (HPC) with colony-forming and radioprotective capacity induced by interleukin-8 (IL-8) in mice. These findings suggested a direct inhibitory effect of these antibodies on LFA-1-mediated transmigration of stem cells through the bone marrow endothelium. Therefore, we studied the expression and functional role of LFA-1 on murine HPC in vitro and in vivo. In steady state bone marrow +/- 50% of the mononuclear cells (MNC) were LFA-1(neg). Cultures of sorted cells, supplemented with granulocyte colony-stimulating factor (G-CSF)/granulocyte-macrophage colony-stimulating factor (GM-CSF)/IL-1/IL-3/IL-6/stem cell factor (SCF) and erythropoietin (EPO) indicated that the LFA-1(neg) fraction contained the majority of the colony-forming cells (CFCs) (LFA-1(neg) 183 +/- 62/7,500 cells v LFA-1(pos) 29 +/- 17/7,500 cells, P <.001). We found that the radioprotective capacity resided almost exclusively in the LFA-1(neg) cell fraction, the radioprotection rate after transplantation of 10(3), 3 x 10(3), 10(4), and 3 x 10(4) cells being 63%, 90%, 100%, and 100% respectively. Hardly any radioprotection was obtained from LFA-1(pos) cells. Similarly, in cytokine (IL-8 and G-CSF)-mobilized blood, the LFA-1(neg) fraction, which comprised 5% to 10% of the MNC, contained the majority of the colony-forming cells, as well as almost all cells with radioprotective capacity. Subsequently, primitive bone marrow-derived HPC, represented by Wheat-germ-agglutinin (WGA)+/Lineage (Lin)-/Rhodamine (Rho)- sorted cells, were examined. More than 95% of the Rho- cells were LFA-1(neg). Cultures of sorted cells showed that the LFA-1(neg) fraction contained all CFU. Transplantation of 150 Rho- LFA-1(neg) or up to 600 Rho-LFA-1(pos) cells protected 100% and 0% of lethally irradiated recipient mice, respectively. These results show that primitive murine HPC in steady-state bone marrow and of cytokine-mobilized blood do not express LFA-1.
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Affiliation(s)
- J F Pruijt
- Laboratory of Experimental Hematology, Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
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11
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Pruijt JF, van Kooyk Y, Figdor CG, Lindley IJ, Willemze R, Fibbe WE. Anti-LFA-1 blocking antibodies prevent mobilization of hematopoietic progenitor cells induced by interleukin-8. Blood 1998; 91:4099-105. [PMID: 9596655] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Previously, we have shown that interleukin (IL)-8 induces the rapid (15 to 30 minutes) mobilization of hematopoietic progenitor cells (HPC) in mice. Because integrins are essential for adhesion and transendothelial migration of HPC, we studied the involvement of the beta2-integrin leukocyte function-associated antigen-1 (LFA-1) in IL-8-induced mobilization. After a single injection of blocking anti-LFA-1 antibodies, no mobilization of colony-forming cells was observed. In addition, when mice were pretreated with anti-LFA-1 or saline and subsequently injected with 30 microg of IL-8, mobilization of HPC was completely blocked. We showed that this was not due to anti-LFA-1 antibodies affecting colony formation, as addition of anti-LFA-1 antibodies to colony cultures in semisolid medium had no inhibitory activity. Also, anti-intercellular adhesion molecule (ICAM)-1 antibodies, directed to the main ligand of LFA-1 significantly inhibited the IL-8-induced mobilization. Furthermore, IL-1-induced mobilization was significantly inhibited by anti-LFA-1 antibodies. Because LFA-1 is reported to be expressed on more differentiated HPC, it was considered that the IL-8-induced mobilization of more primitive HPC would not be blocked by anti-LFA-1 antibodies. Transplantation of blood-derived mononuclear cells (MNC) from IL-8-mobilized animals pretreated with anti-LFA-1 antibodies protected only 25% of lethally irradiated recipient mice, whereas the radioprotection rate of control mice transplanted with MNC derived from IL-8-mobilized animals was 86% (P < .01). Anti-LFA-1 antibodies did not interfere with stem cell homing, as transplantation of IL-8-mobilized blood MNC, incubated in vitro with these antibodies resulted in 100% radioprotection. We conclude that anti-LFA-1 antibodies completely prevent the rapid mobilization of colony-forming cells and of cells with radioprotective capacity induced by IL-8. These results indicate a major role for the beta2-integrin LFA-1 in the IL-8-induced mobilization of hematopoietic stem cells.
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Affiliation(s)
- J F Pruijt
- Laboratory of Experimental Hematology, the Department of Hematology, Leiden University Medical Center, Leiden, The Netherlands
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12
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Pruijt JF, Lindley IJ, Heemskerk DP, Willemze R, Fibbe WE. Leukemia inhibitory factor induces in vivo expansion of bone marrow progenitor cells that accelerate hematopoietic reconstitution but do not enhance radioprotection in lethally irradiated mice. Stem Cells 1997; 15:50-5. [PMID: 9007222 DOI: 10.1002/stem.150050] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Leukemia inhibitory factor (LIF) is a pleiotropic cytokine with distinct hematopoietic activities. In vivo treatment of mice with recombinant murine LIF induces thrombocytosis and increases the number of hematopoietic progenitor cells (HPCs) in spleen and bone marrow (BM). In this study, we applied LIF to expand HPCs in vivo prior to syngeneic BM transplantation. BALB/c donor mice were treated with recombinant human LIF at a dose of 2.5 microg/day s.c. for seven days. This resulted in a 1.6-fold increment in platelet counts from 941 to 1,470 x 10(9)/l (mean, n = 20). Mean spleen weight increased from 120 mg to 160 mg (n = 5). The total numbers of HPCs in the spleen as well as in the BM, as assessed in a CFU-GM (colony forming unit-granulocyte-macrophage) assay, were significantly higher in LIF-treated donors than in saline-treated controls (30.1 +/- 14.5 versus 7.4 +/- 5.3 x 10(3) per spleen; mean +/- SD, n = 22,p < 0.001 and 74.4 +/- 17.1 versus 55.3 +/- 16.1 x 10(3) per femur, p < 0.001). Recipient mice were lethally (8.5 Gy) irradiated and transplanted with 3 x 10(5) BM cells derived from LIF- or saline-treated donors. Hematopoietic reconstitution was monitored by tail bleeding at three-day intervals. Platelet and WBC nadir counts in control animals were reached at day 9 (31 +/- 25 x 10(9)/l for platelets and 0.40 +/- 0.10 x 10(9)/l for WBC; mean +/- SD, n = 29 per treatment group); in animals transplanted with LIF-treated BM cells, these counts were 44 +/- 25 x 10(9)/l for platelets, p < 0.05 and 0.60 +/- 0.38 x 10(9)/l for WBC, p < 0.01. In addition, platelet reconstitution was faster in recipients of LIF-treated BM cells (226 +/- 118 versus 126 +/- 62 x 10(9)/l at day 12 and 633 +/- 174 versus 434 +/- 180 x 10(9)/l at day 15, p < 0.001). Similarly, the reconstitution of WBC was also significantly enhanced. The radioprotection rate of lethally irradiated recipients with increasing cell doses of BM cells derived from LIF-treated donors was higher at all cell doses tested then of control animals, but did not reach statistical significance. These results show that in vivo treatment with LIF expands the number of committed progenitor cells and BM repopulating cells that accelerate short-term hematopoietic reconstitution without increasing radioprotection. Our data do not support a major role for LIF as a single factor inducing expansion of hematopoietic stem cells in vivo.
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Affiliation(s)
- J F Pruijt
- Department of Hematology, Leiden University Hospital, The Netherlands
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13
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Beverstock GC, de Meijer PH, ten Bokkel Huinink D, Pruijt JF, den Ottolander GJ, Wessels HW, Mollevanger P. A case of isodicentric 7p as sole abnormality in a patient with acute myeloid leukemia. Cancer Genet Cytogenet 1996; 89:132-5. [PMID: 8697419 DOI: 10.1016/0165-4608(95)00316-9] [Citation(s) in RCA: 13] [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] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The detection of isochromosomes in the leukemias and in solid tumors has been well described in the literature, the most common being the i(17q), which is found in the blast crisis of CML and terminal stages of acute myeloid leukemia. Reports of isochromosome 7 have, however, been less well represented, particularly isochromosomes of the short arm of chromosome 7, which represent approximately 1% of all reported isochromosomes in neoplasia. We present here a case report of an elderly female patient with AML-M2 who manifested an idic(7p) in the majority of her bone marrow cells. Fluorescence in situ hybridization (FISH) studies with both centromere-7--and chromosome-7--specific DNA probes verified the diagnosis of idic(7p). To the best of our knowledge, this is the first report of this type of leukemia with an acquired idic(7p) as the sole cytogenetic abnormality.
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Affiliation(s)
- G C Beverstock
- Department of Clinical Cytogenetics, University Hospital Leiden, The Netherlands
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14
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Pruijt JF, Haanen JB, Hollander AA, den Ottolander GJ. Azathioprine-induced pure red-cell aplasia. Nephrol Dial Transplant 1996; 11:1371-3. [PMID: 8672045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Affiliation(s)
- J F Pruijt
- Department of Hematology, University Hospital Leiden, Leiden, The Netherlands
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15
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Fibbe WE, Heemskerk DP, Laterveer L, Pruijt JF, Foster D, Kaushansky K, Willemze R. Accelerated reconstitution of platelets and erythrocytes after syngeneic transplantation of bone marrow cells derived from thrombopoietin pretreated donor mice. Blood 1995; 86:3308-13. [PMID: 7579432] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The recent cloning of the ligand of the c-Mpl hematopoietin receptor has indicated a major role for this cytokine in the development of megakaryocytes. In this study we have applied c-Mpl ligand (thrombopoietin [TPO]) in the setting of syngeneic transplantation in an attempt to accelerate the reconstitution of platelets. Donor mice were treated with 20 kilounits (kU)/d TPO intraperitoneally (ip) for 5 days. This resulted in a 2.5-fold increment in platelet counts from 1,119 x 10(9)/L to 2,582 x 10(9)/L (mean, n = 7). Total numbers of hematopoietic progenitor cells in bone marrow (BM) and spleen, as assessed in a colony-forming unit-granulocyte erythroid monocyte macrophage (CFU-GEMM) colony assay (55.3 v 38.6 x 10(3) CFU/femur; 27.3 v 16.3 x 10(3) CFU/spleen, mean, n = 7) as well as total numbers of burst-forming unit-erythroid (BFU-E) (24.0 v 16.4 x 10(3)/femur; 10.2 v 1.9 x 10(3)/spleen, mean, n = 7), were significantly higher in TPO-treated donors than in saline-treated controls. Female Balb-C mice were lethally (8.5 Gy) irradiated and transplanted with 10(5) BM cells. After transplantation, groups of mice were treated with recombinant murine TPO at a dose of 20 to 30 kU/d ip or subcutaneously (SC) for 5 to 14 days. Using this dose and schedule, TPO did not stimulate the recovery of platelets in comparison with control animals transplanted with equal cell numbers but given vehicle alone. In other experiments, 10(5) BM cells were procured from TPO-treated donor mice and transplanted into lethally irradiated recipient mice. In comparison with animals transplanted with an equal number of BM cells derived from saline-treated controls, recipients of TPO-treated BM cells had significantly faster platelet recovery and higher platelet nadir counts (88 v 30 x 10(9)/L, mean, n = 20). Transplantation of TPO-treated BM cells also resulted in an accelerated recovery of erythrocytes and increased erythrocyte nadir counts (7.2 v 5.0 x 10(12)/L, mean, n = 20). At the day of platelet nadir (day 12 after transplantation) these animals had higher numbers of BFU-Es (770 v 422, mean, n = 5) in the marrow and also had higher reticulocyte counts (44 / 1000 v 8 / 1000 mean, n = 5) in the blood. Therefore, the accelerated recovery of erythrocytes may be a direct effect of TPO on erythropoiesis.(ABSTRACT TRUNCATED AT 400 WORDS)
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Affiliation(s)
- W E Fibbe
- Department of Hematology, University Medical Center Leiden, The Netherlands
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16
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Pruijt JF, Roldaan AC. [An unusual form of recurring pneumothorax]. Ned Tijdschr Geneeskd 1991; 135:570-2. [PMID: 2027407] [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] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Two cases of catamenial pneumothorax are described. This syndrome is characterized by recurring right-sided pneumothorax associated with menstruation. In one of our patients endometriosis of the diaphragm could be diagnosed in a biopsy, taken during thoracoscopy. Some clinical, etiologic and therapeutic implications are discussed.
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Affiliation(s)
- J F Pruijt
- Bronovo Ziekenhuis, afd. Longziekten, 's-Gravenhage
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17
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Abstract
In this study the applicability of the conical cuff in the measurement of arterial blood pressure in the general population was investigated. A wide range of arm circumferences was used for non-invasive comparative measurements of brachial artery pressures, using the standard rectangular sphygmomanometer cuffs and a recently developed conical cuff. In previous studies the conical cuff proved to reflect arterial blood pressure more accurately in obese patients than the standard rectangular cuffs. With the conical cuff lower systolic and diastolic pressure readings were obtained than with the rectangular cuffs and this proved to be independent of arm circumference. The lower pressure results in obese individuals were probably related to the fact that the conical cuff generally was found to fit better on larger upper arms than the large rectangular cuff. We conclude that in all likelihood blood pressure is more accurately measured in obese people with the use of a conical cuff and therefore warrants further investigation.
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