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  • 1
    In: Cancer Biology & Therapy, Informa UK Limited, Vol. 16, No. 1 ( 2015-01-02), p. 60-65
    Type of Medium: Online Resource
    ISSN: 1538-4047 , 1555-8576
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2015
    detail.hit.zdb_id: 2088895-8
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  • 2
    In: British Journal of Haematology, Wiley, Vol. 171, No. 2 ( 2015-10), p. 290-292
    Type of Medium: Online Resource
    ISSN: 0007-1048 , 1365-2141
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 1475751-5
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  • 3
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 1921-1921
    Abstract: Multiple myeloma (MM) is a heterogeneous but incurable plasma cell malignancy which still requires new therapeutic approaches. Several molecular subsets of MM have been defined based on genetic and chromosomal aberrations. Briefly, t(4;14) or t(14;16) translocations and TP53 deletion are most frequent poor-risk genetic features of MM, while t(11;14) confers a neutral prognostic value. Because cancer cells have a high glycolytic metabolism, we investigated the efficiency of 2-deoxy-d-glucose (2-DG), a competitive inhibitor of hexokinase, to kill myeloma cells in these different molecular subsets. For this purpose we used 28 human myeloma cell lines (HMCL) representative of the molecular subsets carrying a t(11;14), t(4;14) or t(14;16) translocation, which respectively deregulate CCND1, MMSET and c-MAF. Apoptosis induced by 2DG was very heterogeneous among HMCLs, ranging from 5% to 96%. Of note, HMCLs carrying t(4;14) showed a trend to be more sensitive to 2DG (p=0.06, Mann–Whitney test) while HMCLs carrying t(11;14) appeared to be more resistant (p=0.08, Mann–Whitney test). Interestingly, 2DG sensitivity was not significantly related to the constitutive glycolytic activity of HMCLs (p=0.6). In fact, 2-DG not only strongly inhibited the glycolytic activity of HMCLs but also interfered with N-glycosylation. Indeed, addition of D-mannose, an N-linked glycosylation precursor, partly reversed 2-DG-induced cell death. However, the D-mannose efficiency was also heterogeneous among HMCLs, suggesting that the inhibition of N-glycosylation was not the only mechanism of 2-DG-induced cell death. An up-regulation of GRP78, CHOP and ATF-4 expression was induced by 2-DG in both sensitive and resistant HMCLs, suggesting that 2DG-induced cell death was independent from the UPR response. Finally, 2-DG uniformly induced Mcl-1 down-regulation in HMCLs, but only those dependent on Mcl-1 for survival (as confirmed by siRNA experiments) were killed by 2-DG. While the transcription of Mcl-1 is not affected by 2-DG, preliminary results indicate that proteosomal degradation could be involved as part of a more complex mechanism. Of note, most of t(11;14) HMCLs were resistant to cell death induced by Mcl-1 down-regulation but highly sensitive to ABT-199, which targets Bcl2 and efficiently kills t(11;14) HCMLs depending on this pathway for survival. Because 2-DG uniformly down-regulated Mcl-1, we combined it with ABT-199 in ABT-199-resistant HMCLs i.e., in HMCLs expressing a Bcl-2/Mcl-1 gene expression ratio lower to the threshold required for ABT-199 response. The combination of 2-DG and suboptimal ABT-199 dosage indeed strongly synergized in both t(4;14) and t(14;16) HMCLs. The efficiency of this combination was independent from the cells’ TP53 status. Finally, these results have been extended to primary myeloma cells. Finally our study highlights the fact that dual targeting of Mcl-1 by 2-DG and Bcl-2 by ABT-199, in MM cell lines or primary samples, is highly efficient to induce apoptosis whatever the molecular subtype, including those with the poorest prognostic value. ABT-199 is presently under evaluation in a phase I clinical trial in relapsed MM patients and the present study provides a biological rationale for evaluating 2-DG in combination with ABT-199 in MM patients. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
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  • 4
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 520-520
    Abstract: Landscape analyses of mutational patterns have shown that virtually all myelodysplastic syndromes (MDS) harbor somatic mutations in 〉 80% of cases. These molecular alterations provide useful clonality markers with a potential for early diagnosis of MDS when only cytopenia without marked dysplasia is observed. These markers have been proposed as future prognostic tools to guide therapeutic strategies (Bejar et al., 2011; Itzykson et al, 2013; Mufti et al 2013). Mutational analysis is finally a good way to track disease complexity by deciphering oligoclonality in MDS and better understand clonal evolution. Alterations in the TP53 gene are the most common cause of tumor escape from apoptosis. The aim of this study was to identify TP53 mutations in consecutive samples of lower-risk MDS (IPSS ≤1) with del(5q)obtained at follow-up or progression after sequential classical treatments. Next-generation sequencing (NGS) was used to backtrack the mutant clone(s) identified in late samples. The study was performed both by conventional Sanger sequencing and NGS on a GS Junior Instrument (Roche Applied Science, Mannheim, Germany). For each sample, eight exons (4-11) were amplified from 320 ng of DNA with preconfigured primer plates provided within the IRON II study network. PCR reactions were performed using the FastStart High Fidelity PCR System kit (Roche Applied Science). After double purification with Agencourt AMPure XP beads (Beckman Coulter, Miami, FL), exon-specific amplicon pools were generated and quantified using the Quant-iT™ Broad-Range PicoGreen DNA Assay Kit (Invitrogen, Carlsbad, CA). Emulsion PCR was performed with GS Junior emPCR Reagents (Lib-A) (Roche Applied Science) using 5 x 106 beads at a copy per bead ratio of 0.6. Finally, a fraction of 5-7% enriched beads was loaded on GS Junior Titanium sequencing PicoTiterPlate kit (Roche Applied Science). Data were analyzed for sequence alignment and variant detection using the GS Junior Sequencer and GS Amplicon Variant Analyzer softwares, versions 2.7 and 2.9 (Roche Applied Science). The results were further processed using the Sequence Pilot software version 4.0.1 (JSI Medical Systems, Kippenheim, Germany). The sensitivity of variant detection was set to a lower limit of 〉 1% for bidirectional reads. This threshold was chosen according to a recent study investigating the assay's lower limit of detection (Grossmann et al., 2013), thus underlining the strength of NGS to identify subclones at a low frequency, not detectable by conventional Sanger analysis. A total of 89 DNA samples were extracted from the cytogenetics pellets of a cohort of 40 MDS with del(5q). TP53 mutation analysis was performed on 40 initial and 49 follow-up or progression samples including serial samples for 23 subjects. The depth of coverage was at least 500X and up to 8,444X per amplicon. Of those samples obtained and analysed at time of last follow-up or progression, 14 (61%) had TP53 mutations, mostly in the DNA-binding domain. Performing backtracking on previously collected serial samples, TP53 mutations were retrieved by NGS in 43% of initial samples (n=6), which is different from what was previously described by Jädersten et al (2011). A complete scenario of clonal evolution was retrieved in 11 cases, evidenced by TP53 mutations and/or cytogenetics. These were always consecutive to treatment with lenalidomide, yet 6 of the 12 cases without clonal evolution were also consecutive lenalidomide. Figure 1 provides the example of a complete follow-up including nine time points. More correlation with treatment will be provided. Although lenalidomide remains the treatment of choice for MDS with del(5q), resistant subclones may survive and culminate even following therapy initiation. This theory was recently suggested by Landau et al. in CLL (2013) and our test results support this. Early detection of emerging subclones could lead to initiation of alternative treatment, and we thus propose that a monitoring of TP53 alleles is performed annually after the onset of therapy for MDS using NGS. Figure 1. Figure 1. Disclosures: Kohlmann: MLL Munich Leukemia Laboratory: Employment. Moreau:CELGENE: Honoraria, Speakers Bureau; JANSSEN: Honoraria, Speakers Bureau.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
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    detail.hit.zdb_id: 80069-7
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  • 5
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 12, No. 11_Supplement ( 2013-11-01), p. C48-C48
    Abstract: Multiple myeloma (MM) is a heterogeneous but incurable plasma cell malignancy which still requires new therapeutic approaches. Several molecular subsets of MM have been defined based on genetic and chromosomal aberrations. Briefly, t(4;14) or t(14;16) translocations and TP53 deletion are most frequent poor-risk genetic features of MM, while t(11;14) confers a neutral prognostic value. Because cancer cells have a high glycolytic metabolism, we investigated the efficiency of 2-deoxy-d-glucose (2-DG), a competitive inhibitor of hexokinase, to kill myeloma cells. For this purpose we used 28 human myeloma cell lines (HMCL) representative of these different molecular subsets. Cell death induced by 2-DG was assessed by Apo-2.7 staining. Investigation of the underlying apoptotic mechanisms was evaluated by analyzing, by western blotting, modulation of the UPR response and implication of the Bcl-2 protein family. Finally, the possibly synergistic effect of the combination of 2-DG and ABT-199 was investigated. Cell death induced by 2DG was very heterogeneous among HMCLs, ranging from 5% to 96%. Of note, HMCLs carrying t(4;14) showed a trend to be more sensitive to 2DG (p=0.06) while HMCLs carrying t(11;14) appeared to be more resistant (p=0.08). Interestingly, 2-DG not only strongly inhibited the glycolytic activity of HMCLs but also interfered with N-glycosylation. Indeed, addition of D-mannose, an N-linked glycosylation precursor, partly reversed 2-DG-induced cell death. However, the D-mannose efficiency was also heterogeneous among HMCLs, suggesting that the inhibition of N-glycosylation was not the only mechanism of 2-DG-induced cell death. An up-regulation of GRP78, CHOP and ATF-4 expression was induced by 2-DG in both sensitive and resistant HMCLs, suggesting that 2DG-induced cell death was independent from the UPR response. Finally, 2-DG uniformly induced Mcl-1 down-regulation in HMCLs, but only those dependent on Mcl-1 for survival were killed by 2-DG. Preliminary results indicate that proteosomal degradation could be involved as part of a more complex mechanism. Of note, most of t(11;14) HMCLs were resistant to Mcl-1 down-regulation but highly sensitive to ABT-199, which targets Bcl-2 and efficiently kills t(11;14) HCMLs depending on this pathway for survival. Because 2-DG uniformly down-regulated Mcl-1, we combined it with ABT-199 in ABT-199-resistant HMCLs i.e., in HMCLs expressing a Bcl-2/Mcl-1 gene expression ratio lower to the threshold required for ABT-199 response. The combination of 2-DG and suboptimal ABT-199 dosage indeed strongly synergized in both t(4;14) and t(14;16) HMCLs. This study highlights the fact that dual targeting of Mcl-1 by 2-DG and Bcl-2 by ABT-199, in MM cell lines or primary samples, is highly efficient to induce apoptosis whatever the molecular subtype, including those with the poorest prognostic value. ABT-199 is presently under evaluation in a phase I clinical trial in relapsed MM patients and the present study provides a biological rationale for evaluating 2-DG in combination with ABT-199 in MM patients. Citation Information: Mol Cancer Ther 2013;12(11 Suppl):C48. Citation Format: Maxime Halliez, Sophie Maïga, Cyrille Touzeau, Patricia Gomez-Bougie, Steven Le Gouill, Catherine Pellat-Deceunynck, Martine Amiot. Dual targeting of myeloma cells by 2-deoxy-D-glucose and ABT-199 combination respectively through the down-regulation of Mcl-1 and binding to Bcl-2. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr C48.
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2013
    detail.hit.zdb_id: 2062135-8
    SSG: 12
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  • 6
    In: American Journal of Hematology, Wiley, Vol. 89, No. 2 ( 2014-02), p. 156-161
    Abstract: The aim of this study is to investigate long‐term outcome of symptomatic type 1 cryoglobulinemia (CG) and its determinants. Retrospective cohort study was conducted in two French University Hospitals. Patients with type 1 CG were identified using laboratory databases. Inclusion criterion was the presence of persistent symptoms of CG. Among 227 screened patients, 36 were included. Skin or vasomotor symptoms were the most frequent features (75%). Nephropathy and neuropathy occurred in 30% and 47% of cases, respectively. The underlying B cell disease (BCD) was a nonmalignant monoclonal gammopathy (NMMG) in 13 (36%) and a hematologic malignancy (HM) in 23 (64%; Waldenstrom macroglobulinemia (WM) in 12, low‐grade non‐Hodgkin lymphoma (NHL) in 6, multiple myeloma (MM) in 4, and chronic lymphocytic leukemia in 1 patient. Severe manifestations affected half the patients and were more frequent with IgG (82 vs. 30% ( P  = 0.006)). At last follow‐up, 64% of patients had suffered no hematologic manifestation. Potent chemotherapeutic regimens were mainly used in HM. For patients with NMMG, WM, or NHL, fludarabine or rituximab‐based regimens appeared to yield better responses. Five‐year survival rate was 82%. In multivariate analysis, mortality was significantly higher in older patients (HR: 1.17 per year [95% CI: 1.06–1.28], P  = 0.001) and those with nephropathy (HR: 8.9 [95% CI: 1.9–43], P  = 0.006). Kidney disease, infections, Richter's transformation, and second malignancies were important sources of morbi‐mortality. Despite its limitations, this series provide novel information regarding type 1 CG. Further studies are needed to improve its management. To date, therapeutic strategy should be tailored according to patient's characteristics (age, comorbidities, underlying BCD), and therapeutic target.Am. J. Hematol. 89:156–161, 2014. © 2013 Wiley Periodicals, Inc.
    Type of Medium: Online Resource
    ISSN: 0361-8609 , 1096-8652
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 1492749-4
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  • 7
    In: Cancer Letters, Elsevier BV, Vol. 383, No. 2 ( 2016-12), p. 204-211
    Type of Medium: Online Resource
    ISSN: 0304-3835
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2016
    detail.hit.zdb_id: 195674-7
    detail.hit.zdb_id: 2004212-7
    SSG: 12
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  • 8
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 3107-3107
    Abstract: Cereblon (CRBN) was recently identified as a protein binding immunomodulatory drugs (IMiDs) (Ito et al., 2010, Lopez-Girona et al., 2011) essential for the activity of thalidomide, lenalidomide and pomalidomide in patients suffering from multiple myeloma (MM) (Zhu et al., 2011 & 2012). It is known that some patients develop resistance to these drugs, raising the question of a possible role of CRBN alterations (mutations, deletions, loss of transcription...) in the development of such treatment escapes (Broyl et al., 2012, Heintel et al, 2013). Ito et al (2010) showed that loss of the C-ter fragment of CRBN or missense mutations (Y384A and W386A) in the thalidomide binding domain (TBD) indeed impair the efficacy of this drug. We investigated whether the loss of CRBN expression, particularly of full length isoforms including exons 10 and 11 encoding TBD, or missense mutations could be detected by polymerase chain reaction (PCR) followed by fragment-length analysis or Sanger bidirectional sequencing. This method was applied to a cohort of 19 patients issued from a consecutive cohort of 45 elderly patients treated with lenalidomide and dexamethasone for relapsed or refractory MM (Touzeau et al., 2012). RNA was extracted from plasma cells purified by CD138 immunomagnetic sorting (STEM CELLS® beads) at the time of diagnosis. Sanger sequencing performed on RT-PCR products revealed no missense mutations but disclosed a high frequency of alternative splicing of CRBN in samples from MM patients (Lodé et al 2013). We thus developed a new PCR strategy to detect and semi-quantify alternative spliced isoforms of CRBN involving or not a loss of CRBN specific domains, focusing on exons 10 and 11. Two PCR were performed with custom-made primers: PCR-1 was designed to encompass the whole coding sequence of CRBN and PCR-2 was specifically designed to cover TBD. Fragment-length analysis of fluorescent PCR-2 products was obtained by capillary electrophoresis on an Applied Biosystems 3130xl Genetic Analyser (Applied Biosystems, Foster City, CA) allowing for precise sizing and semi-quantification by assessing the height of peaks. This PCR strategy was highly efficient to detect both unspliced CRBN transcripts (PCR-1 and PCR-2 fragments detected at 1562 nucleotides (nt) and 568nt, respectively) and CRBN alternatively spliced variants. The sizing strategy chosen allowed to identify exon skipping. For instance, PCR-2 fragments without exon 10 were visualized as peaks of 234nt, 319nt and 436nt depending on the presence or not of exons 7, 8 and 9. Alternative CRBN splicing in TBD was seen in nearly all patients of this cohort. Examples of representative splicing patterns are shown in figure 1. Semi-quantification of CRBN spliced transcripts showed that 58% of patients had lost more than 50% of CRBN full-length isoform and that 37% had lost more than 50% of exon10. Of note, two patients with a very short duration of response to lenalidomide and dexamethasone (16 days and 58 days respectively) had lost more than 95% of full-length CRBN and more than 90% of exon 10 (see MM6179 in figure1) in initial samples in spite of proper detection of an actin fragment of 858nt.Figure1Figure1. The fragment-length PCR analysis presented here demonstrates that CRBN splicing profiles in MM patients are very heterogeneous. A correlation with response to treatment was not established in this rather small cohort of patients, but this could be due to the fact that diagnosis samples were collected too early in relation to the time of initiating lenalidomide treatment. Indeed, CRBN splicing could be therapy-induced. A prospective study is needed to determine whether the semi-quantification of CRBN alternatively spliced variants would indeed correlate with, or even predict, clinical response to IMiDs. Moreover, further mutation studies are needed to elucidate the heterogeneity of splicing profiles which could reflect the presence of subclonal mutations in genes encoding the splicing machinery. Disclosures: Moreau: CELGENE: Honoraria, Speakers Bureau; JANSSEN: Honoraria, Speakers Bureau.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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