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  • 1
    In: Journal of Experimental Medicine, Rockefeller University Press, Vol. 209, No. 9 ( 2012-08-27), p. 1537-1551
    Abstract: Splenic marginal zone lymphoma (SMZL) is a B cell malignancy of unknown pathogenesis, and thus an orphan of targeted therapies. By integrating whole-exome sequencing and copy-number analysis, we show that the SMZL exome carries at least 30 nonsilent gene alterations. Mutations in NOTCH2, a gene required for marginal-zone (MZ) B cell development, represent the most frequent lesion in SMZL, accounting for ∼20% of cases. All NOTCH2 mutations are predicted to cause impaired degradation of the NOTCH2 protein by eliminating the C-terminal PEST domain, which is required for proteasomal recruitment. Among indolent B cell lymphoproliferative disorders, NOTCH2 mutations are restricted to SMZL, thus representing a potential diagnostic marker for this lymphoma type. In addition to NOTCH2, other modulators or members of the NOTCH pathway are recurrently targeted by genetic lesions in SMZL; these include NOTCH1, SPEN, and DTX1. We also noted mutations in other signaling pathways normally involved in MZ B cell development, suggesting that deregulation of MZ B cell development pathways plays a role in the pathogenesis of ∼60% SMZL. These findings have direct implications for the treatment of SMZL patients, given the availability of drugs that can target NOTCH, NF-κB, and other pathways deregulated in this disease.
    Type of Medium: Online Resource
    ISSN: 1540-9538 , 0022-1007
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    Language: English
    Publisher: Rockefeller University Press
    Publication Date: 2012
    detail.hit.zdb_id: 1477240-1
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  • 2
    In: Blood, American Society of Hematology, Vol. 136, No. Supplement 1 ( 2020-11-5), p. 31-32
    Abstract: Background. Approximately 70% of newly diagnosed chronic lymphocytic leukemia (CLL) patients present in early Binet or Rai stage, may never require treatment, and may have a life expectancy similar to that of the general population. Two independent and recent studies have identified the clinical and immunogenetic variables associated with shorter time to first treatment (TTFT) in Binet A and Rai 0 CLL (Condoluci et al., Blood 2020; Cohen et al., Haematologica 2020). However, the clinical impact of gene mutations in predicting TTFT is not completely understood. Purpose. Using a training/validation approach, we aimed at identifying new molecular biomarkers that may predict early treatment requirement and may help clinicians to better plan the watch and wait strategy in asymptomatic early stage CLL patients. Methods. The training cohort included 295 CLL in Binet A stage who did not require treatment for at least 3 months after diagnosis. The two validation multicenter cohorts included 402 treatment-naïve Binet A CLL patients (Binet A validation cohort) and 395 untreated Rai 0 CLL patients (Rai 0 validation cohort), respectively. In the training cohort, tumor genomic DNA was isolated from peripheral blood mononuclear cells at the time of diagnosis and was analyzed in the coding exons plus splice sites of the most frequently mutated genes in CLL with a next-generation-sequencing (NGS) approach using a variant allele frequency (VAF) threshold of 5%. In the validation series, the XPO1 gene (exons 15 and 16) was analyzed by NGS or by Sanger sequencing. The primary endpoint was TTFT defined as the time interval between the date of CLL diagnosis and the date of first CLL treatment. Results. In the training cohort, NGS mutational analysis showed that XPO1 was mutated in 7 (2.4%) patients. In univariate analysis, trisomy 12 (HR 2.42; 95% CI 1.43-4.15; p=0.001), unmutated IGHV genes (HR 4.51; 95% CI 2.83-7.05; p & lt;0.0001) and mutations of XPO1 (HR 8.88; 95% CI 3.77-20.95; p & lt;0.0001) (Fig. 1A), NOTCH1 (HR 3.02; 95% CI 1.66-5.51; p & lt;0.001) and SF3B1 (HR 2.65; 95% CI 1.15-6.10; p=0.022) were associated with a shorter TTFT. By multivariate analysis, XPO1 mutations (HR 4.24; 95% CI 1.72-10.44; p=0.002) and unmutated IGHV genes (HR 3.43; 95% CI 2.08-5.67; p & lt;0.0001) maintained an independent association with a shorter TTFT. XPO1 mutational analysis was subsequently investigated in 2 independent multicenter cohorts of early stage CLL patients. In the Binet A validation cohort (N=402 patients), XPO1 was mutated in 15 (3.7%) patients and was associated with a shorter TTFT (HR 2.59; 95% CI 1.36-4.96; p=0.004) (Fig. 1B). Similarly, also in the Rai 0 validation cohort, (N=395 patients), XPO1was mutated in 8 (2.0%) patients and was associated with a shorter TTFT (HR 6.02; 95% CI 15.03-4.96; p & lt;0.001) (Fig. 1C). Moreover, in the Rai 0 validation cohort, XPO1 mutations maintained an independent association with a shorter TTFT when corrected in multivariate analysis by the IGHV mutational status (HR 3.31; 95% CI 1.30-8.44; p=0.012). By combining the training and the validation cohorts (N=1092 patients), a total of 30 somatically acquired XPO1 mutations were identified (2.7% of patients). More precisely, 27 (90.0%) mutations affected XPO1 codon E571 and 3 (10.0%) codon D624. This finding suggests that a target sequencing or an allele-specific polymerase chain reaction based method may be used to identify XPO1 mutations in a simple and time-effective manner. From a clinical perspective, patients carrying either XPO1 E571 or D624 mutations showed superimposable outcome in terms of TTFT (p=0.345) (Fig. 1D). Conclusions. Mutations of the XPO1 gene, encoding for exportin 1 which mediates the nuclear export of proteins and RNAs, are an independent predictor of shorter TTFT validated in independent series of early stage treatment-naïve CLL patients. XPO1 mutations are conceivably gain-of-function and may enhance cell proliferation by exporting out of the nucleus with a greater extent proteins that physiologically downregulate cell proliferation. Based on these results, XPO1 mutational analysis might be incorporated in other prognostic scores and help clinicians to refine the management of the watch and wait strategy for early stage CLL. In addition, XPO1 inhibitors are particularly active in XPO1E571 mutated cells (Taylor et al., Cancer Discov 2019) providing initial pre-clinical rational for their usage in XPO1 mutated CLL patients. Figure Disclosures Scarfo: AstraZeneca: Honoraria; Gilead: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Del Giudice:AstraZeneca: Membership on an entity's Board of Directors or advisory committees; Roche: Other: grant for meeting partecipation; Janssen: Other: grant for meeting participation; Tolero: Membership on an entity's Board of Directors or advisory committees. Sportoletti:Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Marasca:Shire: Honoraria; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees. Ghia:Acerta/AstraZeneca: Consultancy, Honoraria; ArQule: Consultancy, Honoraria; Gilead: Consultancy, Honoraria, Research Funding; AbbVie: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding; BeiGene: Consultancy, Honoraria; Janssen: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company), Research Funding; Novartis: Research Funding; Celgene/Juno: Consultancy, Honoraria; Lilly: Consultancy, Honoraria; MEI: Consultancy, Honoraria; Sunesis: Consultancy, Honoraria, Research Funding; Adaptive, Dynamo: Consultancy, Honoraria. Foà:Roche: Membership on an entity's Board of Directors or advisory committees; Incyte: Speakers Bureau; Roche: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Gaidano:Sunesys: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Astrazeneca: Membership on an entity's Board of Directors or advisory committees. Rossi:AstraZeneca: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Gilead: Honoraria, Research Funding; Abbvie: Honoraria, Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2020
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  • 3
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 118-118
    Abstract: A fraction of Ph- CMPD is characterized by JAK2F617F mutation leading to constitutive JAK-STAT activation. The negative regulators of cytokine signaling SHP-1, SOCS-1 and SOCS-3 have a crucial function in the negative regulation of JAK2 activation/phosphorylation in response to EPO, G-CSF and a subset of cytokines. SHP-1, SOCS-1 and SOCS-3 may be silenced by aberrant DNA methylation in human malignancies. Here we tested chronic phase Ph- CMPD and acute myeloid leukaemia (AML) from Ph- CMPD for aberrant DNA methylation of SHP-1, SOCS-1 and SOCS-3. The study was based on: i) 85 Ph- CMPD, including 35 essential thrombocythemia (ET), 20 polycythemia vera (PV), 15 idiopathic myelofibrosis (IMF), 6 chronic myelomonocytic leukemia (CMML) and 9 Ph- chronic myeloid leukemia (Ph- CML); and on ii) 19 AML from Ph- CMPD, including 4 AML from PV, 10 AML from ET and 5 AML from IMF. Cases were analysed for SHP-1, SOCS-1 and SOCS-3 aberrant methylation by methylation-specific PCR and for JAK2V617F mutation by allele specific PCR. For comparison, 10 samples of normal bone marrow hematopoietic cells were also investigated. Among Ph- CMPD, methylation of SHP-1 occurred in 4/20 (20%) PV and 4/35 (11%) ET, while it was absent in IMF (0/15), CMML (0/6) and Ph- CML (0/9). Methylation of SOCS-1 occurred in 5/20 (25%) PV, 5/35 (14%) ET, 2/15 (13%) IMF and in 1/9 (11%) Ph- CML while it was absent in CMML (0/6). Methylation of SOCS-3 occurred in 11/20 (55%) PV, 13/35 (37%) ET, 4/15 (26%) IMF, 3/6 (50%) CMML and 3/9 (33%) Ph- CML. JAK2V617F mutation was detected in 47/85 (55%) Ph-CMPD, including 17/20 (85%) PV, 18/35 (51%) ET, 12/15 (80%) IMF, 0/6 CMML and 0/9 Ph- CML. SHP-1, SOCS-1 and SOCS-3 methylation was analysed according to JAK2 mutation status in PV, ET and IMF. In this group of patients, SHP-1, SOCS-1 and SOCS-3 methylation occurred in both JAK2 mutated cases (6/47, 13% for SHP-1; 10/47, 21% for SOCS-1 and 18/47, 38% for SOCS-3) and germline cases (2/38, 5% for SHP-1; 2/38, 5% for SOCS-1 and 10/38, 26% for SOCS-3). By combining the results of SHP-1, SOCS-1 and SOCS-3 methylation status, 21/47 (45%) JAK2 mutated cases carried SHP-1 and/or SOCS-1 and/or SOCS-3 methylation as opposed to 12/38 (31%) germline cases. This pattern of SHP-1 and SOCS-1 methylation was conserved also when the analysis was restricted to PV, ET and IMF each as a single group and after stratification for JAK2V617F mutation. Among AML from Ph- CMPD, methylation of SHP-1 occurred in 1/10 (10%) AML from ET, while it was absent in AML from PV and AML from IMF. Methylation of SOCS-1 occurred in 1/4 (25%) AML from PV and 1/10 (10%) AML from ET. One ET patient acquired SHP-1 methylation at transformation to AML. All normal bone marrow samples (n=10) scored negative for SHP-1, SOCS-1 and SOCS-3 methylation. The implications of these results are threefold. First, inactivation by aberrant methylation of SHP-1, SOCS-1 and SOCS-3 is involved in the pathogenesis of Ph- CMPD and is selectively associated with neoplastic hemopiesis. Second, among PV, ET and IMF, methylation of SHP-1, SOCS-1 and SOCS-3 may occur in both JAK2V617F positive and negative cases. Third, the low prevalence of SHP-1 and SOCS-1 methylation in AML from Ph- CMPD suggests that SHP-1 and SOCS-1 silencing is not involved in leukemic transformation.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
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  • 4
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 4169-4169
    Abstract: Abstract 4169 Splenic marginal zone lymphoma (SMZL) is an indolent B-cell neoplasm involving the spleen, bone marrow, and, in a fraction of cases, the peripheral blood. With the exception of TP53 disruption in a minority of cases, the molecular pathogenesis of SMZL is poorly understood. Although activation of the NF-kB pathway occurs frequently in SMZL, knowledge of the genetic mechanism driving NF-kB deregulation in this lymphoma is lacking. This study aims at providing a comprehensive molecular characterization of the NF-kB pathway in SMZL. The study included 99 SMZL, and followed a discovery-validation approach. Mutation analysis of 33 NF-kB pathway genes (BIRC2, BIRC3, BCL10, CARD11, CD40, CD79A, CD79B, CHUK, CSNK1A1, CYLD, IKBKB, IKBKG, MALT1, MAP3K14, MAP3K7, MAP3K7IP2, MAP3K7IP3, NFKB1, NFKBIA, NFKBIB, PRKCB1, REL, RIPK1, TNFAIP3, TNFRSF11A, TNFRSF13C, TNFSF13B, TRAF1, TRAF2, TRAF3, TRAF4, TRAF5, TRAF6) was applied to a discovery panel of 16 SMZL. The discovery panel allowed the identification of at least 1 mutated case (probability 〉 0.9) for mutations whose prevalence is ≥ 10% in the SMZL population. Genes found to be mutated in the discovery panel were further sequenced in a cohort of 83 SMZL in order to characterize the frequency and recurrency of the genetic lesion. Copy number changes of the 33 NF-kB genes investigated were obtained by SNP array (GeneChip Human Mapping 250K NspI, Affimetrix). SMZL was characterized by an array of lesions affecting genes at different levels of the NF-kB pathway. Overall, 15/99 SMZL (15.0%) carried somatic mutations in genes regulating the NF-kB pathway, including TNFAIP3, TRAF3, BIRC3 and CD79A. Mutations of TNFAIP3, TRAF3, BIRC3 and CD79A were mutually exclusive among SMZL cases. Mutations of TNFAIP3 were most frequent and occurred in 6/99 (6.0%) SMZL. All mutations were represented by small insertions/deletions leading to frameshift. By SNP array, deletions encompassing TNFAIP3 were observed in 9/99 (9.0%) SMZL. By combining SNP array and mutation analysis, 13/99 (13.0%) SMZL harbored TNFAIP3 disruption by mutation and/or deletion. Mutations of TRAF3 occurred in 4/99 (4.0%) SMZL. Mutations were small insertions/deletions leading to frameshift (n=2), non-sense mutations (n=1), and missense mutations (n=1). By SNP array, deletions encompassing TRAF3 were observed in 7/99 (7.7%) SMZL. By combining SNP array and mutation analysis, 10/99 (10.0%) SMZL harbored TRAF3 disruption by mutation and/or deletion. Mutations of BIRC3 occurred in 4/99 (4.0%) SMZL. Mutations were non-sense mutations (n=1) or insertions/deletions leading to frameshift (n=3). By SNP array, deletions encompassing BIRC3 were observed in 5/99 (5.0%) SMZL. By combining SNP array and mutation analysis, 9/99 (9.0%) SMZL harbored BIRC3 disruption by mutation and/or deletion. Mutations and deletion of BIRC3 were mutually exclusive, suggesting a haploinsufficiency effect of BIRC3 genetic lesions. One mutation of the CD79A gene was observed out of 99 SMZL, and was represented by a single bp insertion leading to frameshift of the entire ITAM domain. Overall, by combining mutation analysis with SNP array data of the TNFAIP3, TRAF3, BIRC3 and CD79A genes, 28/99 (28.2%) SMZL harbored at least one genetic lesion affecting the NF-kB pathway. The prevalence of genetic lesions affecting the NF-kB pathway did not differ between HCV- (20/77, 26.0%) and HCV+ (4/15, 26.7%) SMZL (p=1.000). Also, the prevalence of NF-kB pathway genetic lesions did not differ among SMZL subgroups defined by TP53 disruption, immunoglobulin gene mutation status, or stereotyped B cell receptor. These observations document that genetic lesions targeting the NF-kB pathway by mutation and/or deletion are frequently involved in the pathogenesis of SMZL and might provide novel therapeutic targets for this lymphoma. The novel finding of BIRC3 inactivating mutations in SMZL points to a more general role of BIRC3 (also known as cIAP2) in marginal zone lymphoma, since BIRC3/cIAP2 is also involved in the t(11;18) translocation of MALT lymphoma. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
    detail.hit.zdb_id: 1468538-3
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  • 5
    In: Blood, American Society of Hematology, Vol. 117, No. 8 ( 2011-02-24), p. 2405-2413
    Abstract: Several drugs used for diffuse large B-cell lymphoma (DLBCL) treatment rely on DNA damage for tumor cell killing. We verified the prognostic impact of the host DNA repair genotype in 2 independent cohorts of DLBCL treated with R-CHOP21 (training cohort, 163 cases; validation cohort, 145 cases). Among 35 single nucleotide polymorphisms analyzed in the training series, MLH1 rs1799977 was the sole predicting overall survival. DLBCL carrying the MLH1 AG/GG genotype displayed an increased death risk (hazard ratio [HR] = 3.23; P 〈 .001; q =0 .009) compared with patients carrying the AA genotype. Multivariate analysis adjusted for International Prognostic Index identified MLH1 AG/GG as an independent OS predictor (P 〈 .001). The poor prognosis of MLH1 AG/GG was the result of an increased risk of failing both R-CHOP21 (HR = 2.02; P = .007) and platinum-based second-line (HR = 2.26; P = .044) treatment. Survival analysis in the validation series confirmed all outcomes predicted by MLH1 rs1799977. The effect on OS of MLH1, a component of the DNA mismatch repair system, is consistent with its role in regulating the genotoxic effects of doxorubicin and platinum compounds, which are a mainstay of DLBCL first- and second-line treatment.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 6
    In: Blood, American Society of Hematology, Vol. 118, No. 18 ( 2011-11-03), p. 4930-4934
    Abstract: Splenic marginal zone lymphoma (SMZL) is one of the few B-cell lymphoma types that remain orphan of molecular lesions in cancer-related genes. Detection of active NF-κB signaling in 14 (58%) of 24 SMZLs prompted the investigation of NF-κB molecular alterations in 101 SMZLs. Mutations and copy number abnormalities of NF-κB genes occurred in 36 (36%) of 101 SMZLs and targeted both canonical (TNFAIP3 and IKBKB) and noncanonical (BIRC3, TRAF3, MAP3K14) NF-κB pathways. Most alterations were mutually exclusive, documenting the existence of multiple independent mechanisms affecting NF-κB in SMZL. BIRC3 inactivation in SMZL recurred because of somatic mutations that disrupted the same RING domain that in extranodal marginal zone lymphoma is removed by the t(11;18) translocation, which points to BIRC3 disruption as a common mechanism across marginal zone B-cell lymphomagenesis. Genetic lesions of NF-κB provide a molecular basis for the pathogenesis of more than 30% of SMZLs and offer a suitable target for NF-κB therapeutic approaches in this lymphoma.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 7
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 480-480
    Abstract: Scant information is available on the impact of the host genetic background as a predictor of outcome and toxicity in diffuse large B cell lymphoma (DLBCL) treated with R-CHOP. We verified whether relevant single nucleotide polymorphisms (SNPs) of the host may further refine prognostic stratification and toxicity prediction in DLBCL treated with R-CHOP21. The study was based on 106 consecutive DLBCL provided with a prospectively collected dataset. Candidate SNPs belonged to genes known to be involved in the pharmacogenetics of cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab, and included SNPs affecting: drug metabolism (cytochrome-P450: CYP2B6- 25504C & gt;T, CYP2B6-15630G & gt;T, CYP2C19-19153G & gt;A, CYP3A4--392A & gt;G, CYP3A4- 14365T & gt;G, CYP3A5-6980G & gt;A); drug detoxification: (gluthatione-S-transferase: GSTA1--4621T & gt;C, GSTM1-null, GSTP1-1374A & gt;G, GSTP1-2264C & gt;T); drug transport (multidrug-resistance-related proteins: ABCC1-129623G & gt;T, ABCC2-53394T & gt;A, ABCC2-68692G & gt;A, ABCB1-90855C & gt;T, ABCB1-49691G & gt;A, ABCG2-8824C & gt;A, ABCG2-33G & gt;A; and drug pharmacodynamics (NADPH-subunits: NCF4--368A & gt;G, RAC2-7418T & gt;A, CYBA-4185C & gt;T; TP53: p53-440G & gt;C; Fcγ receptor: FCGR2A- 4487A & gt;G, FCGR3A-5092T & gt;G, FCGR3A-1301T & gt;G/A; glucocorticoid receptor: GR- 1087A & gt;G, GR-67G & gt;A, GR-1829C & gt;G). Genotyping of candidate SNPs was performed on PBMC collected at DLBCL diagnosis by SNP-minisequencing. Primary end points were event free survival (EFS) and toxicity. Associations of SNPs with primary endpoints were controlled for multiple testing by false discovery rate (FDR) analysis. Univariate log-rank analysis controlled for multiple comparisons by FDR testing identified GSTA1-- 4621C & gt;T, CYBA-4185C & gt;T, and ABCC2-53394T & gt;A as predictors of EFS. GSTA1 encodes a glutathione S-transferase facilititating solubility and excretion of cyclophosphamide and its derivatives. Patients carrying the GSTA1--4621 CT/TT genotypes displayed a better EFS (3-year EFS: 68.4%; SE: 5.9%) compared to GSTA1--4621 CC carriers (3-year EFS: 39.2%; SE: 9.2%) (p=.025; q=.200). CYBA encodes a NAD(P)H oxidase subunit. Patients carrying the CYBA-4185 TT genotype displayed a poorer EFS (3-year EFS: 41.7%; SE: 12.4%) compared to CYBA-4185 CT/CC carriers (3-year EFS: 61.2%; SE: 5.8%) (p=.008; q=.156). ABCC2 encodes an ATP-binding cassette transporter (MRP2) acting as an efflux system for doxorubicin and vincristine. Patients carrying the ABCC2-53394 AT/AA genotypes displayed a poorer EFS (3-year EFS: 34.1%; SE: 11.5%) compared to ABCC2- 53394 TT carriers (3-year EFS: 64.0%; SE: 5.8%) (p=.013; q=.156). Multivariate analysis identified GSTA1--4621 CT/TT (HR: 0.39; 95% CI 0.21–0.73; p=.004) and CYBA-4185 TT (HR: 2.01; 95% CI 1.01–3.97; p=.045) as independent predictors of EFS in DLBCL treated with R-CHOP21, along with IPI 3–5 (HR: 4.88; 95% CI 2.24–8.55; p= 1.5 × 10−4). CYBA- 4185C & gt;T and GSTA1--4621C & gt;T also predicted outcome in DLBCL subgroups by IPI. The impact of SNPs was also evaluated for toxicity in 658 R-CHOP21 courses by logistic regression analysis adjusted for age, sex, ECOG PS, IPI, comorbidities, organ function, and doses of cyclophosphamide, doxorubicin and vincristine. Generalized estimating equations (GEE) were used to build a multivariate model for toxicity, which adjusts for the clustering of treatment courses within a patient. NCF4--368AG/GG was an independent predictor of low risk of hematologic toxicity G3-4 (HR:0.45; p=.018), infection (HR:0.46; p=.003), and cardiac toxicity (HR:0.37; p=.023). The implications of these results are twofold. First, host SNPs affecting doxorubicin and/or cyclophosphamide pharmacodynamics (CYBA-4185C & gt;T) and detoxification (GSTA1--4621C & gt;T) are independent predictors of outcome in DLBCL treated with R-CHOP21. Poor EFS heralded by CYBA-4185C & gt;T, a nonsynonimous SNP of NADPH-oxidase p22phox, may be due to reduced production of reactive oxygen species (ROS) that mediate doxorubicin cytotoxicity. Favorable EFS associated with GSTA1--4621C & gt;T may be related to reduced expression of glutathione- S-transferase A1, a phase II enzyme involved in cyclophosphamide and doxorubicin detoxification. Second, NCF4--368AG/GG, a SNP belonging to NADPH-oxidase p40phox and regulating ROS generation, has an independent protective role against both hematologic and non-hematologic toxicity.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
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  • 8
    In: British Journal of Haematology, Wiley, Vol. 142, No. 2 ( 2008-07), p. 202-215
    Type of Medium: Online Resource
    ISSN: 0007-1048 , 1365-2141
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2008
    detail.hit.zdb_id: 1475751-5
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  • 9
    In: Annals of the New York Academy of Sciences, Wiley, Vol. 1112, No. 1 ( 2007-09), p. 326-338
    Abstract: Abstract :  Thymosin α1 (Tα1), first described and characterized by Allan Goldstein in 1972, is used worldwide for the treatment of some immunodeficiencies, malignancies, and infections. Although Tα1 has shown a variety of effects on cells and pathways of the immune system, its central role in modulating dendritic cell (DC) function has only recently been appreciated. As DCs have the ability to sense infection and tissue stress and to translate collectively this information into an appropriate immune response, an action on DCs would predict a central role for Tα1 in inducing different forms of immunity and tolerance. Recent results have shown that Tα1: ( a ) primed DCs for antifungal Th1 resistance through Toll‐like receptor (TLR)/MyD88‐dependent signaling and this translated in vivo in protection against aspergillosis; ( b ) activated plasmacytoid DCs (pDC) via the TLR9/MyD88‐dependent viral recognition, thus leading to the activation of interferon regulatory factor 7 and the promotion of the IFN‐α/IFN‐γ−dependent effector pathway, which resulted in vivo in protection against primary murine cytomegalovirus infection; ( c ) induced indoleamine 2,3‐dioxygenase activity in DCs, thus affecting tolerization toward self as well as microbial non‐self‐antigens, and this resulted in vivo in transplantation tolerance and protection from inflammatory allergy .  Tα1 is produced in vivo by cleavage of prothymosin α in diverse mammalian tissues. Our data qualify Tα1 as an endogenous regulator of immune homeostasis and suggest that instructive immunotherapy with Tα1, via DCs and tryptophan catabolism, could be at work to control inflammation, immunity, and tolerance in a variety of clinical settings .
    Type of Medium: Online Resource
    ISSN: 0077-8923 , 1749-6632
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    Language: English
    Publisher: Wiley
    Publication Date: 2007
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    SSG: 11
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  • 10
    In: British Journal of Haematology, Wiley, Vol. 152, No. 3 ( 2011-02), p. 284-294
    Type of Medium: Online Resource
    ISSN: 0007-1048
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 1475751-5
    Library Location Call Number Volume/Issue/Year Availability
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