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3. Expression profile of Bcl‐2 family proteins in newly diagnosed multiple myeloma patients.

Author

De Ramón, Cristina, Rojas, Elizabeta A., Misiewicz‐Krzeminska, Irena, Cardona‐Benavides, Ignacio J., Cuadrado, Myriam, Isidro, Isabel, Calasanz, María‐José, Fernandez, Manuela, García‐Sanz, Ramón, Puig, Noemi, Cedena, M. Teresa, Paiva, Bruno, Rosiñol, Laura, Martínez‐López, Joaquín, Bladé, Joan, Lahuerta, Juan J., San Miguel, Jesús F., Mateos, María V., Corchete, Luis A., and Gutiérrez, Norma C.

Published
2024
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4. Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification—an approach to classification of patients with t-MDS

Author

Kuendgen, A., Nomdedeu, M., Tuechler, H., Garcia-Manero, G., Komrokji, R. S., Sekeres, M. A., Della Porta, M. G., Cazzola, M., DeZern, A. E., Roboz, G. J., Steensma, D. P., Van de Loosdrecht, A. A., Schlenk, R. F., Grau, J., Calvo, X., Blum, S., Pereira, A., Valent, P., Costa, D., Giagounidis, A., Xicoy, B., Döhner, H., Platzbecker, U., Pedro, C., Lübbert, M., Oiartzabal, I., Díez-Campelo, M., Cedena, M. T., Machherndl-Spandl, S., López-Pavía, M., Baldus, C. D., Martinez-de-Sola, M., Stauder, R., Merchan, B., List, A., Ganster, C., Schroeder, T., Voso, M. T., Pfeilstöcker, M., Sill, H., Hildebrandt, B., Esteve, J., Nomdedeu, B., Cobo, F., Haas, R., Sole, F., Germing, U., Greenberg, P. L., Haase, D., and Sanz, G.

Published
2021
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5. Lenalidomide and dexamethasone with or without clarithromycin in patients with multiple myeloma ineligible for autologous transplant: a randomized trial

Author

Puig, Noemi, Hernández, Miguel T., Rosiñol, Laura, González, Esther, de Arriba, Felipe, Oriol, Albert, González-Calle, Verónica, Escalante, Fernando, de la Rubia, Javier, Gironella, Mercedes, Ríos, Rafael, García-Sánchez, Ricarda, Arguiñano, José M., Alegre, Adrián, Martín, Jesús, Gutiérrez, Norma. C., Calasanz, María J., Martín, María L., Couto, María del Carmen, Casanova, María, Arnao, Mario, Pérez-Persona, Ernesto, Garzón, Sebastián, González, Marta S., Martín-Sánchez, Guillermo, Ocio, Enrique M., Coleman, Morton, Encinas, Cristina, Vale, Ana M., Teruel, Ana I., Cortés-Rodríguez, María, Paiva, Bruno, Cedena, M. Teresa, San-Miguel, Jesús F., Lahuerta, Juan J., Bladé, Joan, Niesvizky, Ruben, and Mateos, María-Victoria

Published
2021
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6. P-473 Real-world evidence of statins and oral antidiabetics for multiple myeloma

Author

Lopez-Munoz, Nieves, primary, Hernandez-Ibarburu, Gema, additional, Sanchez, Jose Maria, additional, Alonso, Rafael, additional, Cuellar, Clara, additional, Calbacho, Maria, additional, Cedena, M Teresa, additional, Jimenez-Ubieto, Ana, additional, Ayala, Rosa, additional, Meloni, Laura, additional, Perez-Rey, David, additional, and Martinez-Lopez, Joaquín, additional

Published
2023
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7. P-062 Real-world evidence of bisphosphonates and denosumab for multiple myeloma

Author

Lopez-Munoz, Nieves, primary, Hernandez-Ibarburu, Gema, additional, Alonso, Rafael, additional, Sanchez, Jose Maria, additional, Cuellar, Clara, additional, Cedena, M Teresa, additional, Jimenez-Ubieto, Ana, additional, Calbacho, Maria, additional, Ayala, Rosa, additional, Meloni, Laura, additional, Perez-Rey, David, additional, and Martinez-Lopez, Joaquín, additional

Published
2023
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8. Large T cell clones expressing immune checkpoints increase during multiple myeloma evolution and predict treatment resistance

Author

Botta, C, Perez, C, Larrayoz, M, Puig, N, Cedena, M, Termini, R, Goicoechea, I, Rodriguez, S, Zabaleta, A, Lopez, A, Sarvide, S, Blanco, L, Papetti, D, Nobile, M, Besozzi, D, Gentile, M, Correale, P, Siragusa, S, Oriol, A, González-Garcia, M, Sureda, A, de Arriba, F, Rios Tamayo, R, Moraleda, J, Gironella, M, Hernandez, M, Bargay, J, Palomera, L, Pérez-Montaña, A, Goldschmidt, H, Avet-Loiseau, H, Roccaro, A, Orfao, A, Martinez-Lopez, J, Rosiñol, L, Lahuerta, J, Blade, J, Mateos, M, San-Miguel, J, Martinez Climent, J, Paiva, B, Botta, Cirino, Perez, Cristina, Larrayoz, Marta, Puig, Noemi, Cedena, Maria-Teresa, Termini, Rosalinda, Goicoechea, Ibai, Rodriguez, Sara, Zabaleta, Aintzane, Lopez, Aitziber, Sarvide, Sarai, Blanco, Laura, Papetti, Daniele M, Nobile, Marco S, Besozzi, Daniela, Gentile, Massimo, Correale, Pierpaolo, Siragusa, Sergio, Oriol, Albert, González-Garcia, Maria Esther, Sureda, Anna, de Arriba, Felipe, Rios Tamayo, Rafael, Moraleda, Jose-Maria, Gironella, Mercedes, Hernandez, Miguel T, Bargay, Joan, Palomera, Luis, Pérez-Montaña, Albert, Goldschmidt, Hartmut, Avet-Loiseau, Hervé, Roccaro, Aldo, Orfao, Alberto, Martinez-Lopez, Joaquin, Rosiñol, Laura, Lahuerta, Juan-José, Blade, Joan, Mateos, Maria-Victoria, San-Miguel, Jesús F, Martinez Climent, Jose-Angel, Paiva, Bruno, Botta, C, Perez, C, Larrayoz, M, Puig, N, Cedena, M, Termini, R, Goicoechea, I, Rodriguez, S, Zabaleta, A, Lopez, A, Sarvide, S, Blanco, L, Papetti, D, Nobile, M, Besozzi, D, Gentile, M, Correale, P, Siragusa, S, Oriol, A, González-Garcia, M, Sureda, A, de Arriba, F, Rios Tamayo, R, Moraleda, J, Gironella, M, Hernandez, M, Bargay, J, Palomera, L, Pérez-Montaña, A, Goldschmidt, H, Avet-Loiseau, H, Roccaro, A, Orfao, A, Martinez-Lopez, J, Rosiñol, L, Lahuerta, J, Blade, J, Mateos, M, San-Miguel, J, Martinez Climent, J, Paiva, B, Botta, Cirino, Perez, Cristina, Larrayoz, Marta, Puig, Noemi, Cedena, Maria-Teresa, Termini, Rosalinda, Goicoechea, Ibai, Rodriguez, Sara, Zabaleta, Aintzane, Lopez, Aitziber, Sarvide, Sarai, Blanco, Laura, Papetti, Daniele M, Nobile, Marco S, Besozzi, Daniela, Gentile, Massimo, Correale, Pierpaolo, Siragusa, Sergio, Oriol, Albert, González-Garcia, Maria Esther, Sureda, Anna, de Arriba, Felipe, Rios Tamayo, Rafael, Moraleda, Jose-Maria, Gironella, Mercedes, Hernandez, Miguel T, Bargay, Joan, Palomera, Luis, Pérez-Montaña, Albert, Goldschmidt, Hartmut, Avet-Loiseau, Hervé, Roccaro, Aldo, Orfao, Alberto, Martinez-Lopez, Joaquin, Rosiñol, Laura, Lahuerta, Juan-José, Blade, Joan, Mateos, Maria-Victoria, San-Miguel, Jesús F, Martinez Climent, Jose-Angel, and Paiva, Bruno

Abstract

Tumor recognition by T cells is essential for antitumor immunity. A comprehensive characterization of T cell diversity may be key to understanding the success of immunomodulatory drugs and failure of PD-1 blockade in tumors such as multiple myeloma (MM). Here, we use single-cell RNA and T cell receptor sequencing to characterize bone marrow T cells from healthy adults (n = 4) and patients with precursor (n = 8) and full-blown MM (n = 10). Large T cell clones from patients with MM expressed multiple immune checkpoints, suggesting a potentially dysfunctional phenotype. Dual targeting of PD-1 + LAG3 or PD-1 + TIGIT partially restored their function in mice with MM. We identify phenotypic hallmarks of large intratumoral T cell clones, and demonstrate that the CD27− and CD27+ T cell ratio, measured by flow cytometry, may serve as a surrogate of clonal T cell expansions and an independent prognostic factor in 543 patients with MM treated with lenalidomide-based treatment combinations.

Published
2023

9. Immunogenomic identification and characterization of granulocytic myeloid-derived suppressor cells in multiple myeloma

Author

Perez C., Botta C., Zabaleta A., Puig N., Cedena M. -T., Goicoechea I., Alameda D., Jose-Eneriz E. S., Merino J., Rodriguez-Otero P., Maia C., Alignani D., Maiso P., Manrique I., Lara-Astiaso D., Vilas-Zornoza A., Sarvide S., Riillo C., Rossi M., Rosinol L., Oriol A., Blanchard M. -J., Rios R., Sureda A., Martin J., Martinez R., Bargay J., de la Rubia J., Hernandez M. -T., Martinez-Lopez J., Orfao A., Agirre X., Prosper F., Mateos M. -V., Lahuerta J. -J., Blade J., San-Miguel J. F., Paiva B., Espinosa M. C., Zamudio J. L. G., Herranz E. R., Tamayo R. R., Sanchez J. M., Bernal L. P., Rodriguez A. P. G., Garcia M. E. G., Mayol A. S., Lleonart J. B., Suarez A., Garcia M. T. H., Gaisan C. M., Ruiz B. H., Montero F. C., de Miguel Llorente D., Ramos F. S., Garcia A. I., Manteca M. M., Martin J. M. H., Barrigon F. E., Frade J. G., de Coca A. G., Franco C. A., Gomez J. L., Perez E. C., Creixenti J. B., Balari A. M. S., Montes Y. G., Teigell L. E., Guinon A. G., Monreal E. A., Campos J. A. S., Tutusaus J. M. M., Rocafiguera A. O., Gorrochategui M. G., Mesa M. G., Silva C. C., Perez M. S. G., Loureiro A. D., Sanchez J. A. M., Irazu M. J. N., Parraga F. J. P., Palacios J. J. L., Barahona P. B., Rodriguez C. E., Rivas J. A. H., de Oteyza J. P., del Barrio R. I., de la Guia A. L., Amor A. A., Pareja E. P., Castello I. K., Rodriguez M. J. B., Martinez R. M., Grau R. R., Mesa E. G., Sainz E. R., de Arriba F., Jimenez J. M. M., Romera M., Cardoso F. P., Perez J. M. A., Pomposo M. P., Persona E. P., Casasus A. I. T., Garcia P. R., Ramos I. J., Lor M. B. V., Garcia P. L. F., Chamorro C. M., Perez C., Botta C., Zabaleta A., Puig N., Cedena M.-T., Goicoechea I., Alameda D., Jose-Eneriz E.S., Merino J., Rodriguez-Otero P., Maia C., Alignani D., Maiso P., Manrique I., Lara-Astiaso D., Vilas-Zornoza A., Sarvide S., Riillo C., Rossi M., Rosinol L., Oriol A., Blanchard M.-J., Rios R., Sureda A., Martin J., Martinez R., Bargay J., de la Rubia J., Hernandez M.-T., Martinez-Lopez J., Orfao A., Agirre X., Prosper F., Mateos M.-V., Lahuerta J.-J., Blade J., San-Miguel J.F., Paiva B., Espinosa M.C., Zamudio J.L.G., Herranz E.R., Tamayo R.R., Sanchez J.M., Bernal L.P., Rodriguez A.P.G., Garcia M.E.G., Mayol A.S., Lleonart J.B., Suarez A., Garcia M.T.H., Gaisan C.M., Ruiz B.H., Montero F.C., de Miguel Llorente D., Ramos F.S., Garcia A.I., Manteca M.M., Martin J.M.H., Barrigon F.E., Frade J.G., de Coca A.G., Franco C.A., Gomez J.L., Perez E.C., Creixenti J.B., Balari A.M.S., Montes Y.G., Teigell L.E., Guinon A.G., Monreal E.A., Campos J.A.S., Tutusaus J.M.M., Rocafiguera A.O., Gorrochategui M.G., Mesa M.G., Silva C.C., Perez M.S.G., Loureiro A.D., Sanchez J.A.M., Irazu M.J.N., Parraga F.J.P., Palacios J.J.L., Barahona P.B., Rodriguez C.E., Rivas J.A.H., de Oteyza J.P., del Barrio R.I., de la Guia A.L., Amor A.A., Pareja E.P., Castello I.K., Rodriguez M.J.B., Martinez R.M., Grau R.R., Mesa E.G., Sainz E.R., de Arriba F., Jimenez J.M.M., Romera M., Cardoso F.P., Perez J.M.A., Pomposo M.P., Persona E.P., Casasus A.I.T., Garcia P.R., Ramos I.J., Lor M.B.V., Garcia P.L.F., and Chamorro C.M.

Subjects
Male, Transcription, Genetic, Neutrophils, T-Lymphocytes, Immunology, CD33, Biology, CD16, Biochemistry, Follow-Up Studie, Flow cytometry, Antigens, CD, medicine, Humans, Cytotoxic T cell, Lymphocyte Count, Tumor microenvironment, medicine.diagnostic_test, Myeloid-Derived Suppressor Cells, Cell Biology, Hematology, Middle Aged, Cell sorting, Neoplasm Proteins, medicine.anatomical_structure, T-Lymphocyte, Cancer research, Myeloid-derived Suppressor Cell, Female, Bone marrow, Multiple Myeloma, Human, Follow-Up Studies
Abstract

Granulocytic myeloid-derived suppressor cells (G-MDSCs) promote tumor growth and immunosuppression in multiple myeloma (MM). However, their phenotype is not well established for accurate monitoring or clinical translation. We aimed to provide the phenotypic profile of G-MDSCs based on their prognostic significance in MM, immunosuppressive potential, and molecular program. The preestablished phenotype of G-MDSCs was evaluated in bone marrow samples from controls and MM patients using multidimensional flow cytometry; surprisingly, we found that CD11b+CD14−CD15+CD33+HLADR− cells overlapped with common eosinophils and neutrophils, which were not expanded in MM patients. Therefore, we relied on automated clustering to unbiasedly identify all granulocytic subsets in the tumor microenvironment: basophils, eosinophils, and immature, intermediate, and mature neutrophils. In a series of 267 newly diagnosed MM patients (GEM2012MENOS65 trial), only the frequency of mature neutrophils at diagnosis was significantly associated with patient outcome, and a high mature neutrophil/T-cell ratio resulted in inferior progression-free survival (P < .001). Upon fluorescence-activated cell sorting of each neutrophil subset, T-cell proliferation decreased in the presence of mature neutrophils (0.5-fold; P = .016), and the cytotoxic potential of T cells engaged by a BCMA×CD3-bispecific antibody increased notably with the depletion of mature neutrophils (fourfold; P = .0007). Most interestingly, RNA sequencing of the 3 subsets revealed that G-MDSC–related genes were specifically upregulated in mature neutrophils from MM patients vs controls because of differential chromatin accessibility. Taken together, our results establish a correlation between the clinical significance, immunosuppressive potential, and transcriptional network of well-defined neutrophil subsets, providing for the first time a set of optimal markers (CD11b/CD13/CD16) for accurate monitoring of G-MDSCs in MM.

Published
2020
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10. Differentiation stage of myeloma plasma cells: biological and clinical significance

Author

Paiva, B, Puig, N, Cedena, M T, de Jong, B G, Ruiz, Y, Rapado, I, Martinez-Lopez, J, Cordon, L, Alignani, D, Delgado, J A, van Zelm, M C, Van Dongen, J J M, Pascual, M, Agirre, X, Prosper, F, Martín-Subero, J I, Vidriales, M-B, Gutierrez, N C, Hernandez, M T, Oriol, A, Echeveste, M A, Gonzalez, Y, Johnson, S K, Epstein, J, Barlogie, B, Morgan, G J, Orfao, A, Blade, J, Mateos, M V, Lahuerta, J J, and San-Miguel, J F

Published
2017
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11. Analysis of minimal residual disease in bone marrow by NGF and in peripheral blood by mass spectrometry in newly diagnosed multiple myeloma patients enrolled in the GEM2012MENOS65 clinical trial.

Author

Puig, Noemi, primary, Paiva, Bruno, additional, Contreras, Teresa, additional, Cedena, M. Teresa, additional, Rosiñol, Laura, additional, Martínez, Joaquín, additional, Oriol, Albert, additional, Blanchard, Maria Jesus, additional, Rios, Rafael, additional, Iñigo, María Belén, additional, Sureda Balari, Anna, additional, Miguel Teodoro, Hernández-Garcia, additional, de La Rubia, Javier, additional, Krsnik, Isabel, additional, José María, Moraleda, additional, Orfao, Alberto, additional, Blade, Joan, additional, F. San-Miguel, Jesús, additional, Lahuerta, Juan José, additional, and Mateos, Maria-Victoria, additional

Published
2021
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12. Therapy-related myelodysplastic syndromes deserve specific diagnostic sub-classification and risk-stratification—an approach to classification of patients with t-MDS

Author

Kuendgen, A., primary, Nomdedeu, M., additional, Tuechler, H., additional, Garcia-Manero, G., additional, Komrokji, R. S., additional, Sekeres, M. A., additional, Della Porta, M. G., additional, Cazzola, M., additional, DeZern, A. E., additional, Roboz, G. J., additional, Steensma, D. P., additional, Van de Loosdrecht, A. A., additional, Schlenk, R. F., additional, Grau, J., additional, Calvo, X., additional, Blum, S., additional, Pereira, A., additional, Valent, P., additional, Costa, D., additional, Giagounidis, A., additional, Xicoy, B., additional, Döhner, H., additional, Platzbecker, U., additional, Pedro, C., additional, Lübbert, M., additional, Oiartzabal, I., additional, Díez-Campelo, M., additional, Cedena, M. T., additional, Machherndl-Spandl, S., additional, López-Pavía, M., additional, Baldus, C. D., additional, Martinez-de-Sola, M., additional, Stauder, R., additional, Merchan, B., additional, List, A., additional, Ganster, C., additional, Schroeder, T., additional, Voso, M. T., additional, Pfeilstöcker, M., additional, Sill, H., additional, Hildebrandt, B., additional, Esteve, J., additional, Nomdedeu, B., additional, Cobo, F., additional, Haas, R., additional, Sole, F., additional, Germing, U., additional, Greenberg, P. L., additional, Haase, D., additional, and Sanz, G., additional

Published
2020
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13. Analysis of treatment efficacy in the GEM-CESAR trial for high-risk smoldering multiple myeloma patients: Comparison between the standard and IMWG MRD criteria and QIP-MS including FLC (QIP-FLC-MS).

Author

Puíg, Noemí, primary, Contreras, Teresa, additional, Paiva, Bruno, additional, Cedena, M Teresa, additional, Martinez-Lopez, Joaquin, additional, Oriol, Albert, additional, Gutiérrez, Norma, additional, Ríos-Tamayo, Rafael, additional, Rosiñol, Laura, additional, Calasanz, María José, additional, Bargay, Joan, additional, de La Rubia, Javier, additional, Palomera, Luis, additional, Miguel Teodoro, Hernández-Garcia, additional, Garcia-Sanz, Ramón, additional, Blade, Joan, additional, Lahuerta, Juan José, additional, San Miguel, Jesus, additional, and Mateos, Maria-Victoria, additional

Published
2020
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14. Biological and clinical significance of dysplastic hematopoiesis in patients with newly-diagnosed multiple myeloma

Author

Maia C, Puig N, Cedena M, Goicoechea I, Valdes-Mas R, Vazquez I, Chillon M, Aguirre P, Sarvide S, Gracia-Aznarez F, Alkorta-Aranburu G, Calasanz M, Garcia-Sanz R, Gonzalez M, Gutierrez N, Martinez-Lopez J, Perez J, Merino J, Moreno C, Burgos L, Alignani D, Botta C, Prosper F, Matarraz S, Orfao A, Oriol A, Teruel A, de Paz R, de Arriba F, Hernandez Garcia M, Palomera L, Martinez R, Rosinol L, Mateos M, Lahuerta J, Blade J, San Miguel J, and Paiva B

Subjects
hemic and lymphatic diseases
Abstract

Risk of developing myelodysplastic syndromes (MDS) is significantly increased in both multiple myeloma (MM) and MGUS, suggesting that is therapy independent. However, the incidence and sequelae of dysplastic hematopoiesis at diagnosis are unknown. Here, we used multidimensional flow cytometry (MFC) to prospectively screen for presence of MDS-associated phenotypic alterations (MDS-PA) in the bone marrow of 285 MM patients enrolled in the PETHEMA/GEM2012MENOS65 trial (NCT01916252), and investigated the clinical significance of monocytic MDS-PA in a larger series of 1,252 patients enrolled in four PETHEMA/GEM protocols. At diagnosis, 33/285 (11.6%) cases displayed MDS-PA. Bulk- and single-cell targeted sequencing of MDS recurrently mutated genes in CD34+ progenitors (and dysplastic lineages) from 67 patients unveiled clonal hematopoiesis in 13/26 (50%) cases with MDS-PA versus 9/41 (22%) without MDS-PA; TET2 and NRAS were the most frequently mutated genes. Dynamics of MDS-PA at diagnosis and after autologous transplant were evaluated in 86/285 patients, and showed that in most cases (69/86, 80%) MDS-PA either persisted or remained absent in patients with or without MDS-PA at diagnosis, respectively. Noteworthy, MDS-associated mutations unfrequently emerged after high-dose therapy. Based on MFC profiling, we found that patients with MDS-PA have altered hematopoiesis and Treg distribution in the tumor microenvironment. Importantly, presence of monocytic MDS-PA at diagnosis anticipated greater risk of hematological toxicity and was independently associated with inferior progression-free (HR:1.5, P=.02) and overall survival (HR:1.7, P=.01). This study unveils the biological and clinical significance of dysplastic hematopoiesis in newly-diagnosed MM, which can be screened with moderate sensitivity using cost-effective MFC. Copyright © 2020 American Society of Hematology.

Published
2020

15. Early myeloma-related death in elderly patients: development of a clinical prognostic score and evaluation of response sustainability role (vol 32, pg 2427, 2018)

Author

Rodriguez-Otero P, Mateos M, Martinez-Lopez J, Martin-Calvo N, Hernandez M, Ocio E, Rosinol L, Martinez R, Teruel A, Gutierrez N, Bargay J, Bengoechea E, Gonzalez Y, de Oteyza J, Gironella M, Encinas C, Martin J, Cabrera C, Palomera L, de Arriba F, Cedena M, Paiva B, Puig N, Oriol A, Blade J, Lahuerta J, and San Miguel J

Published
2019

16. PS1352 DISSECTING THE BONE MARROW IMMUNE MICROENVIRONMENT IN THE COMPLETE SPECTRUM OF MONOCLONAL GAMMOPATHIES: POTENTIAL IMPLICATIONS IN DISEASE PATHOGENESIS

Author

Puig, N., primary, Paíno, T., additional, Pérez, J.J., additional, Rodero, E., additional, Paiva, B., additional, Cedena, M.-T., additional, Díaz-Tejedor, A., additional, Aires-Mejía, I., additional, Contreras, T., additional, Pessoa, R., additional, Garayoa, M., additional, García-Sanz, R., additional, Gutiérrez, N., additional, de la Calle, V. González, additional, Oriol, A., additional, Rosiñol, L., additional, Bargay, J., additional, Escalante, F., additional, de la Rubia, J., additional, de Arriba, F., additional, Hernández, M.-T., additional, Mateo, A. García, additional, Bladé, J., additional, Lahuerta, J.J., additional, Miguel, J. San, additional, Mateos, M.-V., additional, and Ocio, E.M., additional

Published
2019
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17. PF609 HEAVY&LIGHT CHAIN MONITORING IN HIGH RISK SMOLDERING MULTIPLE MYELOMA PATIENTS INCLUDED IN THE GEM-CESAR TRIAL: COMPARISON WITH CONVENTIONAL AND MINIMAL RESIDUAL DISEASE IMWG RESPONSE ASSESSMENT

Author

Puig, N., primary, Contreras, T., additional, Paiva, B., additional, Cedena, M.-T., additional, Pérez, J.J., additional, Aires, I., additional, Agullo, C., additional, Martínez-López, J., additional, Rodríguez-Otero, P., additional, González de la Calle, V., additional, González, M.-S., additional, Oriol, A., additional, Gutiérrez, N.-C., additional, Rios, R., additional, Rosiñol, L., additional, Alvarez, M.A., additional, Calasanz, M.J., additional, Bargay, J., additional, González, A.P., additional, Alegre, A., additional, Escalante, F., additional, Martínez, R., additional, de la Rubia, J., additional, Teruel, A.I., additional, de Arriba, F., additional, Palomera, L., additional, Hernández, M.T., additional, López, J., additional, Martín, J., additional, Mateo, A. García, additional, Ocio, E.M., additional, Bladé, J., additional, Lahuerta, J.J., additional, Miguel, J. San, additional, and Mateos, M.V., additional

Published
2019
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18. S871 CURATIVE STRATEGY (GEM-CESAR) FOR HIGH-RISK SMOLDERING MYELOMA: CARFILZOMIB, LENALIDOMIDE AND DEXAMETHASONE (KRD) AS INDUCTION FOLLOWED BY HDT-ASCT, CONSOLIDATION WITH KRD AND MAINTENANCE WITH RD

Author

Mateos, M.-V., primary, Martínez-López, J., additional, Rodríguez-Otero, P., additional, González de la Calle, V., additional, González, M.-S., additional, Oriol, A., additional, Gutiérrez, N.-C., additional, Paiva, B., additional, Rios, R., additional, Rosiñol, L., additional, Alvarez, M.-A., additional, Calasanz, M.-J., additional, Bargay, J., additional, González, A.-P., additional, Alegre, A., additional, Escalante, F., additional, Martínez, R., additional, Puig, N., additional, de la Rubia, J., additional, Teruel, A.-I., additional, Cedena, M.-T., additional, de Arriba, F., additional, Palomera, L., additional, Hernández, M.-T., additional, López, J., additional, Martín, J., additional, García-Mateo, A., additional, Ocio, E., additional, Bladé, J., additional, Lahuerta, J.-J., additional, and San Miguel, J., additional

Published
2019
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19. Correction: Mutations in the DNA methylation pathway and number of driver mutations predict response to azacitidine in myelodysplastic syndromes

Author

Cedena, M. Teresa, primary, Rapado, Inmaculada, additional, Santos-Lozano, Alejandro, additional, Ayala, Rosa, additional, Onecha, Esther, additional, Abaigar, María, additional, Such, Esperanza, additional, Ramos, Fernando, additional, Cervera, José, additional, Díez-Campelo, María, additional, Sanz, Guillermo, additional, Rivas, Jesús Hernández, additional, Lucía, Alejandro, additional, and Martínez-López, Joaquin, additional

Published
2018
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20. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry : An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project

Author

Rawstron, Andy C., Kreuzer, Karl-Anton, Soosapilla, Asha, Spacek, Martin, Stehlikova, Olga, Gambell, Peter, McIver-Brown, Neil, Villamor, Neus, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, de la Serna, Javier, Teresa Cedena, M., Jaksic, Ozren, Nomdedeu, Josep, Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans E., Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David, Trneny, Marek, Mulligan, Stephen, Doubek, Michael, Pospisilova, Sarka, Hillmen, Peter, Oscier, David, Hallek, Michael, Ghia, Paolo, Montserrat, Emili, Rawstron, Andy C., Kreuzer, Karl-Anton, Soosapilla, Asha, Spacek, Martin, Stehlikova, Olga, Gambell, Peter, McIver-Brown, Neil, Villamor, Neus, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, de la Serna, Javier, Teresa Cedena, M., Jaksic, Ozren, Nomdedeu, Josep, Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans E., Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David, Trneny, Marek, Mulligan, Stephen, Doubek, Michael, Pospisilova, Sarka, Hillmen, Peter, Oscier, David, Hallek, Michael, Ghia, Paolo, and Montserrat, Emili

Abstract

The diagnostic criteria for CLL rely on morphology and immunophenotype. Current approaches have limitations affecting reproducibility and there is no consensus on the role of new markers. The aim of this project was to identify reproducible criteria and consensus on markers recommended for the diagnosis of CLL. ERIC/ESCCA members classified 14 of 35 potential markers as “required” or “recommended” for CLL diagnosis, consensus being defined as >75% and >50% agreement, respectively. An approach to validate “required” markers using normal peripheral blood was developed. Responses were received from 150 participants with a diagnostic workload >20 CLL cases per week in 23/150 (15%), 5–20 in 82/150 (55%), and <5 cases per week in 45/150 (30%). The consensus for “required” diagnostic markers included: CD19, CD5, CD20, CD23, Kappa, and Lambda. “Recommended” markers potentially useful for differential diagnosis were: CD43, CD79b, CD81, CD200, CD10, and ROR1. Reproducible criteria for component reagents were assessed retrospectively in 14,643 cases from 13 different centers and showed >97% concordance with current approaches. A pilot study to validate staining quality was completed in 11 centers. Markers considered as “required” for the diagnosis of CLL by the participants in this study (CD19, CD5, CD20, CD23, Kappa, and Lambda) are consistent with current diagnostic criteria and practice. Importantly, a reproducible approach to validate and apply these markers in individual laboratories has been identified. Finally, a consensus “recommended” panel of markers to refine diagnosis in borderline cases (CD43, CD79b, CD81, CD200, CD10, and ROR1) has been defined and will be prospectively evaluated.

Published
2018
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21. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry: An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project

Author

Rawstron, AC, Kreuzer, K-A, Soosapilla, A, Spacek, M, Stehlikova, O, Gambell, P, McIver-Brown, N, Villamor, N, Psarra, K, Arroz, M, Milani, R, de la Serna, J, Teresa Cedena, M, Jaksic, O, Nomdedeu, J, Moreno, C, Rigolin, GM, Cuneo, A, Johansen, P, Johnsen, HE, Rosenquist, R, Niemann, CU, Kern, W, Westerman, D, Trneny, M, Mulligan, S, Doubek, M, Pospisilova, S, Hillmen, P, Oscier, D, Hallek, M, Ghia, P, Montserrat, E, Rawstron, AC, Kreuzer, K-A, Soosapilla, A, Spacek, M, Stehlikova, O, Gambell, P, McIver-Brown, N, Villamor, N, Psarra, K, Arroz, M, Milani, R, de la Serna, J, Teresa Cedena, M, Jaksic, O, Nomdedeu, J, Moreno, C, Rigolin, GM, Cuneo, A, Johansen, P, Johnsen, HE, Rosenquist, R, Niemann, CU, Kern, W, Westerman, D, Trneny, M, Mulligan, S, Doubek, M, Pospisilova, S, Hillmen, P, Oscier, D, Hallek, M, Ghia, P, and Montserrat, E

Published
2018

22. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry:An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project

Author

Rawstron, Andy C., Kreuzer, Karl-anton, Soosapilla, Asha, Spacek, Martin, Stehlikova, Olga, Gambell, Peter, Mciver-brown, Neil, Villamor, Neus, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, De La Serna, Javier, Cedena, M. Teresa, Jaksic, Ozren, Nomdedeu, Josep, Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans E., Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David, Trneny, Marek, Mulligan, Stephen, Doubek, Michael, Pospisilova, Sarka, Hillmen, Peter, Oscier, David, Hallek, Michael, Ghia, Paolo, Montserrat, Emili, Rawstron, Andy C., Kreuzer, Karl-anton, Soosapilla, Asha, Spacek, Martin, Stehlikova, Olga, Gambell, Peter, Mciver-brown, Neil, Villamor, Neus, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, De La Serna, Javier, Cedena, M. Teresa, Jaksic, Ozren, Nomdedeu, Josep, Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans E., Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David, Trneny, Marek, Mulligan, Stephen, Doubek, Michael, Pospisilova, Sarka, Hillmen, Peter, Oscier, David, Hallek, Michael, Ghia, Paolo, and Montserrat, Emili

Published
2018

23. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry: An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project

Author

Rawstron, Andy C., primary, Kreuzer, Karl-Anton, additional, Soosapilla, Asha, additional, Spacek, Martin, additional, Stehlikova, Olga, additional, Gambell, Peter, additional, McIver-Brown, Neil, additional, Villamor, Neus, additional, Psarra, Katherina, additional, Arroz, Maria, additional, Milani, Raffaella, additional, de la Serna, Javier, additional, Cedena, M. Teresa, additional, Jaksic, Ozren, additional, Nomdedeu, Josep, additional, Moreno, Carol, additional, Rigolin, Gian Matteo, additional, Cuneo, Antonio, additional, Johansen, Preben, additional, Johnsen, Hans E., additional, Rosenquist, Richard, additional, Niemann, Carsten Utoft, additional, Kern, Wolfgang, additional, Westerman, David, additional, Trneny, Marek, additional, Mulligan, Stephen, additional, Doubek, Michael, additional, Pospisilova, Sarka, additional, Hillmen, Peter, additional, Oscier, David, additional, Hallek, Michael, additional, Ghia, Paolo, additional, and Montserrat, Emili, additional

Published
2018
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24. Mutations in the DNA methylation pathway and number of driver mutations predict response to azacitidine in myelodysplastic syndromes

Author

Cedena, M. Teresa, primary, Rapado, Inmaculada, additional, Santos-Lozano, Alejandro, additional, Ayala, Rosa, additional, Onecha, Esther, additional, Abaigar, María, additional, Such, Esperanza, additional, Ramos, Fernando, additional, Cervera, José, additional, Díez-Campelo, María, additional, Sanz, Guillermo, additional, Rivas, Jesús Hernández, additional, Lucía, Alejandro, additional, and Martínez-López, Joaquin, additional

Published
2017
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25. Analytical and clinical validation of a novel in-house deep-sequencing method for minimal residual disease monitoring in a phase II trial for multiple myeloma

Author

Martinez-Lopez, J, primary, Sanchez-Vega, B, additional, Barrio, S, additional, Cuenca, I, additional, Ruiz-Heredia, Y, additional, Alonso, R, additional, Rapado, I, additional, Marin, C, additional, Cedena, M-T, additional, Paiva, B, additional, Puig, N, additional, Mateos, M-V, additional, Ayala, R, additional, Hernández, M-T, additional, Jimenez, C, additional, Rosiñol, L, additional, Martínez, R, additional, Teruel, A-I, additional, Gutiérrez, N, additional, Martin-Ramos, M-L, additional, Oriol, A, additional, Bargay, J, additional, Bladé, J, additional, San-Miguel, J, additional, Garcia-Sanz, R, additional, and Lahuerta, J-J, additional

Published
2017
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26. Reproducible Diagnosis of Chronic Lymphocytic Leukemia (CLL) By Flow Cytometry : An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation Project

Author

Rawstron, Andy C., Kreuzer, Karl-Anton, Soosapilla, Asha, Spacek, Martin, Gambell, Peter, McIver-brown, Neil, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, de la Serna, Javier, Teresa Cedena, M., Jaksic, Ozren, Nomdedeu, Josep F., Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans Erik, Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David A., Trneny, Marek, Mulligan, Stephen P., Hillmen, Peter, Oscier, David G., Hallek, Michael, Ghia, Paolo, Montserrat, Emili, Rawstron, Andy C., Kreuzer, Karl-Anton, Soosapilla, Asha, Spacek, Martin, Gambell, Peter, McIver-brown, Neil, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, de la Serna, Javier, Teresa Cedena, M., Jaksic, Ozren, Nomdedeu, Josep F., Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans Erik, Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David A., Trneny, Marek, Mulligan, Stephen P., Hillmen, Peter, Oscier, David G., Hallek, Michael, Ghia, Paolo, and Montserrat, Emili

Published
2015

27. Reproducible Diagnosis of Chronic Lymphocytic Leukemia (CLL) By Flow Cytometry: An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation Project

Author

Rawstron, Andy C, primary, Kreuzer, Karl-Anton, additional, Soosapilla, Asha, additional, Spacek, Martin, additional, Gambell, Peter, additional, McIver-brown, Neil, additional, Psarra, Katherina, additional, Arroz, Maria, additional, Milani, Raffaella, additional, de la Serna, Javier, additional, Cedena, M. Teresa, additional, Jaksic, Ozren, additional, Nomdedeu, Josep F., additional, Moreno, Carol, additional, Rigolin, Gian Matteo, additional, Cuneo, Antonio, additional, Johansen, Preben, additional, Johnsen, Hans Erik, additional, Rosenquist, Richard, additional, Niemann, Carsten Utoft, additional, Kern, Wolfgang, additional, Westerman, David A, additional, Trneny, Marek, additional, Mulligan, Stephen P., additional, Hillmen, Peter, additional, Oscier, David G, additional, Hallek, Michael, additional, Ghia, Paolo, additional, and Montserrat, Emili, additional

Published
2015
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28. Prognostic value of antigen expression in multiple myeloma: a PETHEMA/GEM study on 1265 patients enrolled in four consecutive clinical trials

Author

Arana, P, Paiva, B, Cedena, M-T, Puig, N, Cordon, L, Vidriales, M-B, Gutierrez, N C, Chiodi, F, Burgos, L, Anglada, L-L, Martinez-Lopez, J, Hernandez, M-T, Teruel, A-I, Gironella, M, Echeveste, M-A, Rosiñol, L, Martinez, R, Oriol, A, De la Rubia, J, Orfao, A, Blade, J, Lahuerta, J-J, Mateos, M-V, and San Miguel, J-F

Abstract

Persistence of minimal residual disease (MRD) after treatment for myeloma predicts inferior outcomes, but within MRD-positive patients there is great heterogeneity with both early and very late relapses. Among different MRD techniques, flow cytometry provides additional information about antigen expression on tumor cells, which could potentially contribute to stratify MRD-positive patients. We investigated the prognostic value of those antigens required to monitor MRD in 1265 newly diagnosed patients enrolled in the GEM2000, GEM2005MENOS65, GEM2005MAS65 and GEM2010MAS65 protocols. Overall, CD19pos, CD27neg, CD38lo, CD45pos, CD81pos, CD117negand CD138loexpression predicted inferior outcomes. Through principal component analysis, we found that simultaneous CD38lowCD81posCD117negexpression emerged as the most powerful combination with independent prognostic value for progression-free survival (HR:1.69; P=0.002). This unique phenotypic profile retained prognostic value among MRD-positive patients. We then used next-generation flow to determine antigen stability throughout the course of the disease, and found that the expression of antigens required to monitor MRD is mostly stable from diagnosis to MRD stages, except for CD81 whose expression progressively increased from baseline to chemoresistant tumor cells (14 vs 28%). Altogether, we showed that the phenotypic profile of tumor cells provides additional prognostic information, and could be used to further predict risk of relapse among MRD-positive patients.

Published
2018
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29. Biological and clinical significance of dysplastic hematopoiesis in patients with newly diagnosed multiple myeloma

Author

Norma C. Gutiérrez, Felipe Prosper, Gorka Alkorta, Rafael Martínez, Felipe de Arriba, José de Jesús Pérez, Francisco Javier Gracia-Aznárez, Ibai Goicoechea, Diego Alignani, Leire Burgos, Noemi Puig, Maria-Teresa Cedena, Juan José Lahuerta, Bruno Paiva, Marcos González, Albert Oriol, Maria-Jose Calasanz, Maria-Victoria Mateos, Raquel de Paz, Alberto Orfao, Rafael Valdés-Mas, Catarina Maia, Jesús F. San Miguel, Juana Merino, Joan Bladé, Joaquin Martinez-Lopez, Sergio Matarraz, Cirino Botta, Laura Rosiñol, M C Chillón, Ana-Isabel Teruel, Miguel T. Hernandez, Luis Palomera, Iria Vázquez, Ramón García-Sanz, Sarai Sarvide, Cristina Moreno, Paula Martínez de Aguirre, Maia C., Puig N., Cedena M.-T., Goicoechea I., Valdes-Mas R., Vazquez I., Chillon M.-C., Aguirre P., Sarvide S., Gracia-Aznarez F.J., Alkorta G., Calasanz M.-J., Garcia-Sanz R., Gonzalez M., Gutierrez N.C., Martinez-Lopez J., Perez J.J., Merino J., Moreno C., Burgos L., Alignani D., Botta C., Prosper F., Matarraz S., Orfao A., Oriol A., Teruel A.-I., de Paz R., de Arriba F., Hernandez M.T., Palomera L., Martinez R., Rosinol L., Mateos M.-V., Lahuerta J.-J., Blade J., San Miguel J.F., and Paiva B.

Subjects
Male, Oncology, Physics::Instrumentation and Detectors, medicine.medical_treatment, Kaplan-Meier Estimate, Hematopoietic stem cell transplantation, Biochemistry, hemic and lymphatic diseases, Antineoplastic Combined Chemotherapy Protocols, Tumor Microenvironment, Prospective Studies, Computer Science::Operating Systems, In Situ Hybridization, Fluorescence, Multiple myeloma, Randomized Controlled Trials as Topic, Computer Science::Cryptography and Security, Hazard ratio, Hematopoietic Stem Cell Transplantation, High-Throughput Nucleotide Sequencing, Hematology, Middle Aged, Flow Cytometry, Prognosis, Combined Modality Therapy, Progression-Free Survival, medicine.anatomical_structure, Female, Clonal Hematopoiesis, Multiple Myeloma, medicine.medical_specialty, Immunology, Transplantation, Autologous, Internal medicine, medicine, Humans, Clinical significance, Progression-free survival, Computer Science::Distributed, Parallel, and Cluster Computing, Aged, Antineoplastic Combined Chemotherapy Protocol, business.industry, Cell Biology, medicine.disease, Transplantation, Clinical Trials, Phase III as Topic, Myelodysplastic Syndromes, Mutation, Bone marrow, business, Monoclonal gammopathy of undetermined significance
Abstract

On behalf of the PETHEMA/GEM Cooperative Group., Risk of developing myelodysplastic syndrome (MDS) is significantly increased in both multiple myeloma (MM) and monoclonal gammopathy of undetermined significance, suggesting that it is therapy independent. However, the incidence and sequelae of dysplastic hematopoiesis at diagnosis are unknown. Here, we used multidimensional flow cytometry (MFC) to prospectively screen for the presence of MDS-associated phenotypic alterations (MDS-PA) in the bone marrow of 285 patients with MM enrolled in the PETHEMA/GEM2012MENOS65 trial (#NCT01916252). We investigated the clinical significance of monocytic MDS-PA in a larger series of 1252 patients enrolled in 4 PETHEMA/GEM protocols. At diagnosis, 33 (11.6%) of 285 cases displayed MDS-PA. Bulk and single-cell–targeted sequencing of MDS recurrently mutated genes in CD34+ progenitors (and dysplastic lineages) from 67 patients revealed clonal hematopoiesis in 13 (50%) of 26 cases with MDS-PA vs 9 (22%) of 41 without MDS-PA; TET2 and NRAS were the most frequently mutated genes. Dynamics of MDS-PA at diagnosis and after autologous transplant were evaluated in 86 of 285 patients and showed that in most cases (69 of 86 [80%]), MDS-PA either persisted or remained absent in patients with or without MDS-PA at diagnosis, respectively. Noteworthy, MDS-associated mutations infrequently emerged after high-dose therapy. Based on MFC profiling, patients with MDS-PA have altered hematopoiesis and T regulatory cell distribution in the tumor microenvironment. Importantly, the presence of monocytic MDS-PA at diagnosis anticipated greater risk of hematologic toxicity and was independently associated with inferior progression-free survival (hazard ratio, 1.5; P = .02) and overall survival (hazard ratio, 1.7; P = .01). This study reveals the biological and clinical significance of dysplastic hematopoiesis in newly diagnosed MM, which can be screened with moderate sensitivity using cost-effective MFC.

Published
2020

30. Reproducible diagnosis of chronic lymphocytic leukemia by flow cytometry:An European Research Initiative on CLL (ERIC) & European Society for Clinical Cell Analysis (ESCCA) Harmonisation project

Author

Rawstron, AC, Kreuzer, K-A, Soosapilla, A, Spacek, M, Stehlikova, O, Gambell, P, McIver-Brown, N, Villamor, N, Psarra, K, Arroz, M, Milani, R, de la Serna, J, Cedena, MT, Jaksic, O, Nomdedeu, J, Moreno, C, Rigolin, GM, Cuneo, A, Johansen, P, Johnsen, HE, Rosenquist, R, Niemann, CU, Kern, W, Westerman, D, Trneny, M, Mulligan, S, Doubek, M, Pospisilova, S, Hillmen, P, Oscier, D, Hallek, M, Ghia, P, Montserrat, E, Rawstron, Andy C., Kreuzer, Karl-Anton, Soosapilla, Asha, Spacek, Martin, Stehlikova, Olga, Gambell, Peter, McIver-Brown, Neil, Villamor, Neu, Psarra, Katherina, Arroz, Maria, Milani, Raffaella, de la Serna, Javier, Cedena, M. Teresa, Jaksic, Ozren, Nomdedeu, Josep, Moreno, Carol, Rigolin, Gian Matteo, Cuneo, Antonio, Johansen, Preben, Johnsen, Hans E., Rosenquist, Richard, Niemann, Carsten Utoft, Kern, Wolfgang, Westerman, David, Trneny, Marek, Mulligan, Stephen, Doubek, Michael, Pospisilova, Sarka, Hillmen, Peter, Oscier, David, Hallek, Michael, Ghia, Paolo, and Montserrat, Emili

Subjects
chronic lymphocytic leukemia, diagnosis, flow cytometry, 2734, Histology, Cell Biology, Clinical Laboratory Medicine, Reproducibility of Results, Pilot Projects, Original Articles, Leukemia, Lymphocytic, Chronic, B-Cell, NO, Immunophenotyping, diagnosi, Klinisk laboratoriemedicin, immune system diseases, hemic and lymphatic diseases, Biomarkers, Tumor, Humans, Original Article, Retrospective Studies
Abstract

The diagnostic criteria for CLL rely on morphology and immunophenotype. Current approaches have limitations affecting reproducibility and there is no consensus on the role of new markers. The aim of this project was to identify reproducible criteria and consensus on markers recommended for the diagnosis of CLL. ERIC/ESCCA members classified 14 of 35 potential markers as “required” or “recommended” for CLL diagnosis, consensus being defined as >75% and >50% agreement, respectively. An approach to validate “required” markers using normal peripheral blood was developed. Responses were received from 150 participants with a diagnostic workload >20 CLL cases per week in 23/150 (15%), 5–20 in 82/150 (55%), and 97% concordance with current approaches. A pilot study to validate staining quality was completed in 11 centers. Markers considered as “required” for the diagnosis of CLL by the participants in this study (CD19, CD5, CD20, CD23, Kappa, and Lambda) are consistent with current diagnostic criteria and practice. Importantly, a reproducible approach to validate and apply these markers in individual laboratories has been identified. Finally, a consensus “recommended” panel of markers to refine diagnosis in borderline cases (CD43, CD79b, CD81, CD200, CD10, and ROR1) has been defined and will be prospectively evaluated. © 2017 International Clinical Cytometry Society.

Published
2018
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31. Curative Strategy for High-Risk Smoldering Myeloma: Carfilzomib, Lenalidomide, and Dexamethasone (KRd) Followed by Transplant, KRd Consolidation, and Rd Maintenance.

Author

Mateos MV, Martínez-López J, Rodriguez Otero P, González-Calle V, Gonzalez MS, Oriol A, Gutiérrez NC, Ríos-Tamayo R, Rosiñol L, Alvarez Rivas MA, Bargay J, Gonzalez-Rodriguez AP, Alegre A, Escalante F, Iñigo Rodríguez MB, De La Rubia J, Teruel AI, de Arriba F, Palomera L, Hernández MT, Lopez Jiménez J, Reinoso-Segura M, García Mateo A, Ocio EM, Paiva B, Puig N, Cedena MT, Bladé J, Lahuerta JJ, and San-Miguel JF

Subjects
Humans, Male, Female, Middle Aged, Aged, Adult, Hematopoietic Stem Cell Transplantation methods, Transplantation, Autologous, Melphalan administration & dosage, Melphalan therapeutic use, Consolidation Chemotherapy, Maintenance Chemotherapy, Multiple Myeloma drug therapy, Multiple Myeloma therapy, Disease Progression, Lenalidomide administration & dosage, Lenalidomide therapeutic use, Lenalidomide adverse effects, Dexamethasone administration & dosage, Dexamethasone therapeutic use, Oligopeptides therapeutic use, Oligopeptides administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Antineoplastic Combined Chemotherapy Protocols adverse effects, Smoldering Multiple Myeloma drug therapy
Abstract

Purpose: Early treatment of high-risk smoldering myeloma has been shown to delay progression to multiple myeloma (MM). We conducted this trial with curative intention using a treatment approach employed for newly diagnosed patients with MM., Methods: Patients with high-risk smoldering myeloma (>50% progression risk at 2 years) and transplant candidates were included and received induction therapy with carfilzomib, lenalidomide, and dexamethasone (KRd), six cycles, followed by high-dose melphalan (200 mg/m 2 ) autologous stem-cell transplantation (HDM-ASCT), two KRd consolidation cycles, and Rd maintenance for 2 years. The primary end point was undetectable measurable residual disease (uMRD) rate by next-generation flow after ASCT. Sustained uMRD 4 years after ASCT was the secondary end point., Results: Between June 2015 and June 2017, 90 patients were included, and 31% met at least one SixtyLightchain MRI (SLiM)-hypercalcemia, renal impairment, anemia, bone disease (CRAB) criterion. After a median follow-up of 70.1 months, 3 months after ASCT, in the intention-to-treat population, 56 (62%) of 90 patients had uMRD, and 4 years later, it was sustained in 29 patients (31%). Five patients progressed to MM, and the 70-month progression rate was 94% (95% CI, 84 to 89). The presence of any SLiM CRAB criteria predicted progression to MM (four of the five patients; hazard ratio, 0.12; 95% CI, 0.14 to 1.13; P = .03). Thirty-six patients showed biochemical progression, and failure to achieve uMRD at the end of treatment predicted it. The 70-month overall survival was 92% (95% CI, 82 to 89). Neutropenia and infections were the most frequent adverse events during treatment, resulting in one treatment-related death. Three second primary malignancies have been reported., Conclusion: Although a longer follow-up is needed, this curative approach is encouraging and more effective than active MM, with 31% of the patients maintaining the uMRD 4 years after HDM-ASCT.

Published
2024
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32. Response to azacitidine in patients with chronic myelomonocytic leukemia according to overlap myelodysplastic/myeloproliferative neoplasms criteria.

Author

Triguero A, Xicoy B, Zamora L, Jiménez MJ, García O, Calabuig M, Díaz-Beyá M, Arzuaga J, Ramos F, Medina A, Bernal T, Talarn C, Coll R, Collado R, Chen TH, Borrás J, Brunet S, Marchante I, Marco V, López-Cadenas F, Calbacho M, Simiele A, Cortés M, Cedena MT, Pedreño M, Aguilar C, Pedró C, Fernández M, Stoica C, Ribera JM, and Sanz G

Subjects
Humans, Myelodysplastic Syndromes diagnosis, Myelodysplastic Syndromes drug therapy, Myelodysplastic-Myeloproliferative Diseases drug therapy, Retrospective Studies, Azacitidine adverse effects, Azacitidine therapeutic use, Leukemia, Myelomonocytic, Chronic drug therapy
Abstract

Background: Azacitidine (AZA) is approved for the treatment of high-risk chronic myelomonocytic leukemia (CMML) of myelodysplastic (MD) subtype. Data of response rates using the specific response criteria for this disease are scarce. The aim of this study was to evaluate the response to AZA in patients diagnosed with CMML from the Spanish Registry of Myelodysplastic Syndromes (MDS) applying the overlap myelodysplastic/myeloproliferative neoplasms (MDS/MPN) response criteria., Methods: We retrospectively studied 91 patients with CMML treated with at least one cycle of AZA from the Spanish Registry of MDS. As it was a real-world study, the response rate was evaluated between cycle 4 and 6, applying the MDS/MPN response criteria FINDINGS: The overall response rate at cycle 4-6 was 58%. Almost half of the patients achieved transfusion independence and one quarter showed clinical benefit, regardless of the CMML French-American-British (FAB) and World Health Organization (WHO) subtypes and CMML Specific Prognosis Scoring (CPSS) risk groups. Toxicity was higher in the MD-CMML subtype., Interpretation: In our series, most CMML patients achieved an overall response rate with AZA according to the overlap-MDS/MPN response criteria regardless of the CMML FAB and WHO subtypes and CPSS risk groups. Thus, AZA may also be a treatment option for patients with the myeloproliferative CMML subtype and those with a lower-risk CPSS, but symptomatic., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Published
2022
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