Analysis of t(15;17) chromosomal breakpoint sequences in therapy-related versus de novo acute promyelocytic leukemia: Association of DNA breaks with specific DNA motifs at PML and RARA loci

2010 ◽  
Vol 49 (8) ◽  
pp. 726-732 ◽  
Author(s):  
Syed Khizer Hasan ◽  
Tiziana Ottone ◽  
Richard F. Schlenk ◽  
Yuanyuan Xiao ◽  
Joseph L. Wiemels ◽  
...  
Haematologica ◽  
2019 ◽  
Vol 105 (9) ◽  
pp. 2286-2297 ◽  
Author(s):  
Jianbiao Zhou ◽  
Jessie Yiying Quah ◽  
Yvonne Ng ◽  
Jing-Yuan Chooi ◽  
Sabrina Hui-Min Toh ◽  
...  

Differentiation therapies achieve remarkable success in acute promyelocytic leukemia, a subtype of acute myeloid leukemia. However, excluding acute promyelocytic leukemia, clinical benefits of differentiation therapies are negligible in acute myeloid leukemia except for mutant isocitrate dehydrogenase 1/2. Dihydroorotate dehydrogenase catalyses the fourth step of the de novo pyrimidine synthesis pathway. ASLAN003 is a highly potent dihydroorotate dehydrogenase inhibitor that induces differentiation, as well as reduces cell proliferation and viability, of acute myeloid leukemia cell lines and primary acute myeloid leukemia blasts including in chemo-resistant cells. Apoptotic pathways are triggered by ASLAN003, and it also significantly inhibits protein synthesis and activates AP-1 transcription, contributing to its differentiation promoting capacity. Finally, ASLAN003 substantially reduces leukemic burden and prolongs survival in acute myeloid leukemia xenograft mice and acute myeloid leukemia patient-derived xenograft models. Notably, the drug has no evident effect on normal hematopoietic cells and exhibits excellent safety profiles in mice, even after a prolonged period of administration. Our results, therefore, suggest that ASLAN003 is an agent targeting dihydroorotate dehydrogenase with potential in the treatment of acute myeloid leukemia. ASLAN003 is currently being evaluated in phase 2a clinical trial in acute myeloid leukemia patients.


2020 ◽  
Vol 61 (8) ◽  
pp. 1989-1995 ◽  
Author(s):  
Ping Cai ◽  
Qian Wu ◽  
Yemin Wang ◽  
Xiaofei Yang ◽  
Xinyou Zhang ◽  
...  

Blood ◽  
1998 ◽  
Vol 92 (2) ◽  
pp. 374-382 ◽  
Author(s):  
Masue Imaizumi ◽  
Hoshiro Suzuki ◽  
Miyako Yoshinari ◽  
Atsushi Sato ◽  
Toshiaki Saito ◽  
...  

Abstract The binding of all-trans retinoic acid (ATRA) to the ligand-binding region in the E-domain of retinoic acid receptor-α (RARα) modifies the transcriptional activity of RARα protein. ATRA probably induces differentiation of acute promyelocytic leukemia (APL) cells by binding to the E-domain of the RARα portion (RARα/E-domain) of PML/RARα chimeric protein. Therefore, molecular alteration in the RARα/E-domain of the chimeric gene is one mechanism by which patients with APL may acquire resistance to ATRA therapy. In this study using reverse transcription-polymerase chain reaction and single-strand conformation polymorphism, DNA segments amplified from the RARα/E-domain in fresh APL cells of 23 APL patients (8 males and 15 females from 4 to 76 years of age) were screened for mutations. Of those patients, 3 patients (1 with de novo and 2 with relapse) had clinical resistance to ATRA therapy. We found mutations in the RARα/E-domain of PML/RARα chimeric gene exclusively in the 2 patients who exhibited ATRA-resistance at relapse, whereas the mutations were not detected at their initial onset. Interestingly, these patients received a prolonged or intermittent administration of ATRA before relapse with ATRA-resistance. The mutations lead to the change of amino acid in the ligand-binding region of RARα/E-domain, Arg272Gln, or Met297Leu according to the amino acid sequence of RARα, respectively. Further study demonstrated that the in vitro ligand-dependent transcriptional activity of the mutant PML/RARα protein was significantly decreased as compared with that of wild-type PML/RARα. These findings suggest that mutations in the RARα/E-domain of the PML/RARα chimeric gene may confer clinical resistance to ATRA therapy in patients with APL.


Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 4284-4284
Author(s):  
Zhang Jie ◽  
Xiaojian Meng ◽  
Zhen Cai ◽  
Xiujin Ye ◽  
He Huang

Abstract Abstract 4284 Background: Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) with distinctive biologic and clinical features that is now highly curable. However, there are complicated issues in treatment strategies for induction, consolidation and maintenance that remain to be studied. The optimal regimen and the duration of consolidation is one of the above controversies. Patients and methods: Six patients (4 males, 2 females) were enrolled in this observation with a median age of 28 years (18–36). All were diagnosed de novo APL with demonstration of the abnormal increased promyelocytes of 53–90% accompanied with detection of t(15;17) or PML/RARα rearrangements. At diagnosis, WBC counts were 0.9–4.6×109/L and platelet counts were 13–84×109/L. Induction therapy was composed of all-trans retinoic acid (ATRA) with or without anthracycline or homoharritonine. After achieving complete remission (CR) following the above regimens, consolidation therapy was given monthly consisting single anthracycline agent of idarubincin (8–10 mg/m2/d, day 1–3) or aclarubicin (8–12 mg/m2/d, day 1–7) and alternative ATRA (25 mg/m2/d, day 1–15). After 12–18 months of consolidation, patients received maintenance therapy including methotrexate (12 mg/m2/d, per week) plus 6 mercaptopurine (30 mg/m2/d, qod ×12 days) and alternative ATRA (25 mg/m2/d, day 1–15) for one year. Results and conclusions: At present, all of the six patients are in continuous CR status, four of whom ceased treatment and are undergoing regular monitoring. Preliminary results from our experience demonstrates that single anthracycline and alternative ATRA can act as a valid option with limited toxicity for APL and might be used as a consolidation strategy, particularly for low and intermediate-risk patients. Disclosures: No relevant conflicts of interest to declare.


2017 ◽  
Vol 97 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Hongli Zhao ◽  
Yanqiu Zhao ◽  
Yingmei Zhang ◽  
Jinxiao Hou ◽  
Huiyuan Yang ◽  
...  

2020 ◽  
Vol 06 (03) ◽  
pp. 147-148
Author(s):  
Balendu Prakash ◽  
Shikha Prakash ◽  
Sneha Tiwari

AbstractAcute promyelocytic leukemia (APML) is a subtype of acute myeloid leukemia. The condition is clinically marked by anemia, fatigue, weakness, frequent infections, and fever associated with easy bleeding and coagulopathy. The diagnosis is made through bone marrow aspiration exhibiting increased promyelocytes and test for PML-RARα fusion gene. There has been remarkable progress in the treatment of APML in the past few decades with the induction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO). This has also brought down mortality and relapse rates considerably. Similarly, nearly 90% patients are able to live disease free for about 10 years. However, there are certain hindrances to these treatments majorly due to side effects, relapses, and limited periods of remission associated with ATRA and ATO. Here, a freshly diagnosed case of APML is being reported. The patient was diagnosed in leading medical centers of Aligarh and New Delhi and only treated with blood transfusions in the absence of an established line of treatment in 1982. The patient has completed 37 years long survival without any sign of the disease and any adverse effect. This approach could be considered as an add-on medical therapy for APML.


1979 ◽  
Vol 1 (1) ◽  
pp. 69-78 ◽  
Author(s):  
Harvey M. Golomb ◽  
Joseph R. Testa ◽  
James W. Vardiman ◽  
Ann E. Butler ◽  
Janet D. Rowley

Vestnik ◽  
2021 ◽  
pp. 8-12
Author(s):  
Р.М. Рамазанова ◽  
А.К. Косанова ◽  
Ж.С. Шерияздан ◽  
Г.А. Сабырбаева ◽  
Г.М. Жандыбаева ◽  
...  

Описан клинический случай впервые выявленного острого промиелоцитарного лейкоза у 36-летней беременной женщины при сроке 16-17 нед. До родов ей проведены 2 курса химиотерапии по схеме AIDA: индукция ремиссии даунорубицин из расчета 60 мг/м - 2, 4, 6, 8 дни, АТRA 45мг/м с 1 по 15 дни, дексаметазон 2,5 мг/м х 2 р в день с 1- по 15 дни. Ремиссия достигнута после 1-го курса индукционной терапии. После завершения 2-го курса ХТ в периоде полной ремиссии острого промиелоцитарного лейкоза на сроке беременности 25 недель проведено кесарево сечение в условиях городского родильного дома. Через 2 нед после родоразрешения в условиях гематологического отделения проведены еще два курса консолидации ремиссии. Далее пациентка переведена на поддерживающую терапию согласно протоколу AIDA: АТRA 45мг/м с 1 по 15 дни каждые 3 месяца, Метотрексат 15 мг/м/сут еженедельно, 6-Меркаптопурин 50 мг/м/сут. В контрольных анализах миелограммы констатируется полная ремиссия - 2.5% бластных клеток при нормальном соотношении всех ростков кроветворения. The case of de novo acute promyelocyte leukemia in a 36 year old pregnant woman (gestation age 16-17 weeks) is described. Two courses of “AIDA” chemotherapy were performed. Remission was achieved after the first induction chemotherapy. A month after the second consolidation chemotherapy at gestation age 25 weeks a living premature fetus was delivered by means of Cesarean delivery. After the delivery two more consolidation courses and supportive chemotherapy were performed. The woman now has been on remission.


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