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Telomeric association (TA), i.e. fusion of chromosomes by their telomeres, predisposes a cell to genetic instability. Because of this we investigated the effect of X-rays exposure and cigarette smoking on the frequency of TA in peripheral blood lymphocytes of exposed individuals, in order to determine if TA can be a chromosomal marker in populations exposed to these carcinogens and if there is an synergistic effect between both agents. We found that the exposed groups show a greater percentage of TA when compared with the control group (P

Leukocyte-associated Ig-like receptor-1 (LAIR-1) is a surface molecule that functions as an inhibitory receptor on natural killer cells, T lymphocytes and monocytes. Here, we provide evidence that occupancy of LAIR-1 on human myelomonocytic leukemic cell lines inhibits proliferation and leads to programmed cell death (PCD), evaluated by propidium iodide staining and transmission electron microscopy. Interestingly, PCD elicited via LAIR-1 was not blocked by different caspase inhibitors, at variance with apoptosis induced via CD95/Fas, which was prevented by the caspase-1 and caspase-8 specific inhibitors. In addition, we show that the p65 subunit of the nuclear factor kappaB (NF-kappaB), constitutively expressed in the nucleus of these cell lines, was retained in the cytoplasm upon engagement of LAIR-1. This was evident already 8 h after LAIR-1 occupancy, when apoptosis was not yet detectable by fluorometric or ultrastructural analysis. Moreover, a reduction in inhibitor kappaBalpha phosphorylation was observed after LAIR-1 engagement. As blocking of NF-kappaB activation has been shown to rescue sensitivity to anti-cancer drugs in solid tumors, we suggest that LAIR-1 may represent a possible target for pharmacological approaches aimed to potentiate anti-leukemic therapy.

There are few reports about the incidence of the DeltaF508 mutation in Latin American countries. We show the study of the DeltaF508 mutation and the seven most common "European" mutations in 10 Ecuadorian CF affecteds. The incidence of DeltaF508 mutation found was 25% and none of the other seven was detected in our population, which indicates that at least 60% of the mutations in the studied population are different from most common in Europe. Similar data have been reported in other Amerindian populations, therefore it is suggested that Cystic Fibrosis in Ecuador-and other Amerindian countries in Latin America-have a different ethiology than that of Caucasian populations.

Grb10 has been described as a cellular partner of several receptor tyrosine kinases, including the insulin receptor (IR) and the insulin-like growth factor I (IGF-I) receptor (IGF-IR). Its cellular role is still unclear and a positive as well as an inhibitory role in mitogenesis depending on the cell context has been implicated. We have tested other mitogenic receptor tyrosine kinases as putative Grb10 partners and have identified the activated forms of platelet-derived growth factor (PDGF) receptor beta (PDGFRbeta), hepatocyte growth factor receptor (Met), and fibroblast growth factor receptor as candidates. We have mapped Y771 as a PDFGRbeta site that is involved in the association with Grb10 via its SH2 domain. We have further investigated the putative role of Grb10 in mitogenesis with four independent experimental strategies and found that all consistently suggested a role as a positive, stimulatory signaling adaptor in normal fibroblasts. (i) Complete Grb10 expression from cDNA with an ecdysone-regulated transient expression system stimulated PDGF-BB-, IGF-I, and insulin- but not epidermal growth factor (EGF)-induced DNA synthesis in an ecdysone dose-responsive fashion. (ii) Microinjection of the (dominant-negative) Grb10 SH2 domain interfered with PDGF-BB- and insulin-induced DNA synthesis. (iii) Alternative experiments were based on cell-permeable fusion peptides with the Drosophila antennapedia homeodomain which effectively traverse the plasma membrane of cultured cells. A cell-permeable Grb10 SH2 domain similarly interfered with PDGF-BB-, IGF-I-, and insulin-induced DNA synthesis. In contrast, a cell-permeable Grb10 Pro-rich putative SH3 domain binding region interfered with IGF-I- and insulin- but not with PDGF-BB- or EGF-induced DNA synthesis. (iv) Transient overexpression of complete Grb10 increased whereas cell-permeable Grb10 SH2 domain fusion peptides substantially decreased the cell proliferation rate (as measured by cell numbers) in normal fibroblasts. These experimental strategies independently suggest that Grb10 functions as a positive, stimulatory, mitogenic signaling adapter in PDGF-BB, IGF-I, and insulin action. This function appears to involve the Grb10 SH2 domain, a novel sequence termed BPS, and the Pro-rich putative SH3 domain binding region in IGF-I- and insulin-mediated mitogenesis. In contrast, PDGF-BB-mediated mitogenesis appears to depend on the SH2 but not on the Pro-rich region and may involve other, unidentified Grb10 domains. Distinct protein domains may help to define specific Grb10 functions in different signaling pathways.

In considering the influences of microsystems on adolescent substance use, familial and peer contexts have received the most extensive attention in the research literature. School and neighborhood settings, however, are other developmental contexts that may exert specific influences on adolescent substance use. In many instances, school settings are organized to provide educational services to students who share similar educational abilities and behavioral repertoires. The resulting segregation of students into these settings may result in different school norms for substance use. Similarly, neighborhood resources, including models for substance use and drug sales involvement, may play an important role in adolescent substance use. We briefly review literature examining contextual influences on adolescent substance use, and present results from two preliminary studies examining the contribution of school and neighborhood context to adolescent substance use. In the first investigation, we examine the impact of familial, peer, and school contexts on adolescent substance use. Respondents were 283 students (ages 13 to 18) from regular and special education classrooms in six schools. Although peer and parental contexts were important predictors of substance use, school norms for drug use accounted for variance in adolescent use beyond that explained by peer and parental norms. Data from a second study of 114 adolescents (mean age = 15) examines neighborhood contributions to adolescent substance use. In this sample, neighborhood indices did not contribute to our understanding of adolescent substance use. Implications for prevention are presented.

The hRAD54 gene is related to a family of genes involved in DNA recombination and repair and encodes a protein with DNA helicase activity. hRAD54 has been mapped to 1p32, a region frequently involved in deletions in a variety of tumor types, including atypical and anaplastic meningiomas. To determine whether alterations of hRAD54 are a common event in meningeal tumors, by means of polymerase chain reaction-single-stranded conformation analysis we examined 29 tumor samples characterized by 1p deletions for hRAD54 mutations. Although 18 tumors displayed allelic loss at the gene region (1p32) as determined by microsatellite marker analysis, the sole coding-sequence alteration detected corresponded to a T--C transition, with no amino-acid change. The genotype distribution was 10.34% TT, 44.8% TC, and 44.8% CC, whereas in the normal controls it was 3.77% TT, 13.2% TC, and 83.01% CC, and most meningiomas with 1 p32 deletion retained allele C. Another polymorphism due to a T--C change was evidenced at nt 3008, in the 3' untranslated region. This change was evidenced in all cases we sequenced. These results appear to exclude the involvement of the hRAD54 gene in the pathogenesis of the nontypical meningiomas, although a detrimental effect of the hRAD54 polymorphisms cannot be ruled out.

Background. The possibility of performing transplantation several days after explant seems to be a peculiarity of islet grafts, and the opportunity to cryo-preserve human islets may permit an indefinite period for modulating the recipient immune system. The aim of the present study was the evaluation of in vitro and in vivo functional properties of cryopreserved human islets. Methods. We used six consecutive human islet preparations not suitable for an immediate transplantation in diabetic patients because the limited islet mass separated. The in vitro function of cryo and fresh islets was studied by determination of insulin and glucagon secretion in response to such classical stimuli as glucose (16.7 mM), glucose (16.7 mM) + 3-isobutyl-1-methylxanthine (0.1 mM), arginine (10 mM), and tolbutamide (100 mu M). In vivo isfet function was assessed through intravenous glucose tolerance tests performed at 15, 30, 60, and 90 days after transplantation of 1000 hand-picked fresh or cryopreserved islets in nude mice. Results. Basal secretion of true insulin was significantly higher in cryopreserved islets than in fresh ones. The response of cryopreserved islets to arginine and glucose + isobutyl-l-methylxanthine seemed partially impaired. Proinsulin-like molecule secretion seemed higher in cryopreserved than in fresh islets in response to all secretagogues used, and the difference was statistically significant for arginine. The capacity of human cryopreserved islets to maintain a correct metabolic control in diabetic nude mice was progressively lost in 3 months. Conclusions. These findings showed that cryopreservation affects the function of isolated human islets, maintaining in vivo function for a limited period of time.

Schwannomas are common benign tumours of schwann cell origin, frequently found in patients with neurofibromatosis type 2 (NF2). Inactivation of the NF2 tumour suppressor gene appears to be a molecular event responsible for the development of up to 60% of cases, but no data are available on other superimposed secondary or alternative molecular abnormalities in those schwannomas lacking NF2 gene inactivation. We analysed 23 sporadic schwannomas for mutations in the NF2 gene and for the allelic status at 1p, 14q and 22q, as alterations of these genomic regions appear to be related to tumour progression in meningiomas, another NF2-associated neoplasm. Nine samples displayed allelic losses for markers on chromosome 22, and deletions at 1p were detected in two. No case showed losses for 14q. Three tumours displayed NF2 gene mutations, at exons 2, 7 and 12. Our results confirm that inactivation of the NF2 gene is a primary event in schwannoma development, and provide data suggesting that allelic loss at 1p may contribute to the pathogenesis of a small subgroup of this histological tumour type.

Six novel mutations were identified in the NF2 tumor suppressor gene in a panel of meningiomas and neurinomas. Screening was performed using a combination of single-strand conformation polymorphism and heteroduplex analyses on polymerase chain reaction-amplified DNA from tumors and matched peripheral blood lymphocytes. Mutations involved exons 2, 7, 11 and 12, and corresponded to three frameshift, one nonsense, one missense and one polymorphism.

This study compares the frequency of telomeric associations in the peripheral blood of women suffering breast and cervix uterine cancer with a healthy control group. Two kinds of cultures were developed for each individual: with and without aphidicolin. In the normal cultures, the number of telomeric associations observed was 95.5 times higher in individuals affected by breast cancer and 41.3 times higher in those affected by cervix uterine cancer when compared to the control group (p < 0.001). In the cultures with aphidicolin, higher numbers of altered metaphases were observed in both groups as compared to the control groups (p < 0.001). Statistically significant differences (p < 0.001) could also be observed when comparing telomeric associations between the two types of cancer in both cultures. When we compared individuals affected by breast cancer in both types of cultures statistical differences were found (p < 0.05), and similar results were found in individuals affected by uterine cervix cancer (p < 0.001). The findings suggest that telomeric associations may be reflecting chromosome instability observed in cancer and that this instability behaves differently for various types of cancer.

A 38-year-old man with a recent history of travel in India and unprotected sexual intercourse with Indian women, was admitted with painful enlarged lymphnodes predominantly in the right inguinal area. Diagnosis of lymphogranuloma venereum was made by means of a positive immunofluorescence test (Total Ig titer of 1:512) and a positive detection of chlamydial antigens by ELISA in a semen sample. He was successfully treated with ciprofloxacin. This observation emphasizes the relevance of infection due to C. trachomatis serotypes L1-L3 that may be acquired during travel in developing countries.

To identify prognostic subgroups among non-functioning (nonsyndromic) pancreatic endocrine tumours, a series of 61 tumours were analysed systematically for macroscopic, histopathological and immunohistochemical variables potentially predictive of malignancy. High-grade nuclear atypia, elevated mitotic rate and multifocal necrosis allowed us to separate 5 poorly differentiated carcinomas from 56 well differentiated tumours. Among the latter, 29 well-differentiated carcinomas showing gross local invasion or metastases were identified. Vascular or perineural microinvasion, Ki67 proliferative index2%, mitotic rateor = 2, sizeor = 4 cm, capsular penetration, nuclear atypia, lack of progesterone receptors and presence of calcitonin were among the variables correlated with malignancy. The first two were the most sensitive and specific. Their presence or absence was used in the 27 tumours lacking evidence of malignancy at the time of surgery to separate 11 cases with increased risk of malignancy (in 2 of which metastases developed during follow-up) from 16 cases with limited risk. The resulting four prognostic groups of non-functioning pancreatic endocrine tumours (limited- and increased-risk tumours, well-differentiated carcinomas and poorly differentiated carcinomas) showed distinct survival curves, which were significantly affected by vascular microinvasion, Ki67 proliferative index and metastases.

A case of Primary Malignant Lymphoma of the Spleen (PMLS) with exclusive red pulp involvement is described and discussed. Although the unusual topographic presentation the authors emphasize the physiologic arrangement of lymphoid cell in splenic red pulp cords that can give origin to the neoplasia. They moreover discuss problems of differential diagnosis with Malignant Histiocytosis (MH), Hairy Cell Leukemia (HCL) and Myeloid Process, both by morphology and immunohistochemistry.

Of 91 adult patients with respiratory tract infections, 13 (14%) had serological evidence of recent infection with Chlamydia pneumoniae. The clinical picture was consistent with asthmatic bronchitis in three patients, whilst exacerbations of chronic obstructive pulmonary disease were present in five subjects and, pneumonia was diagnosed in the remaining five. Our findings provide evidence of an aetiological association between C. pneumoniae and respiratory infections in our region (Bari, South Italy).

By using five highly polymorphic markers, the allelic status of chromosome 1 was established in a series of 236 tumors of the nervous system, including all major histologic subtypes: gliomas, meningiomas, neurinomas, neuroblastomas, medulloblastomas, etc. Loss of alleles at 1p was observed at significant frequencies in neuroblastomas (26% of cases), meningiomas (32%) and malignant gliomas (37%) (primarily oligodendrogliomas [94%]). This anomaly was also detected in two of 23 neurinomas, two of three neurofibrosarcomas, one primary lymphoma, and two metastatic tumors of the brain. The analysis of tumors displaying partial 1p deletions suggests the existence of two distinct regions, 1p36 and 1p35-p32, in which loci nonrandomly involved in the development of neurogenic neoplasms might be located., This work was supported by funds from grant C367/92 from the Comunidad Autónoma de Madrid, grant SAF-92-0182 from the Ministerio de Educación y Ciencia, FISS grant 92/0783, and a grant from Fundación Científica de la Asociación Española contra el Cáncer.

The role of BCR/ABL isoforms and their relationships to leukemia phenotype are discussed continuously because of the variety of information reported. Here we describe a man with CML an atypical b3/a3 rearrangement, who had a good response to INF α treatment. This may be due to a deletion of the ABL exon 2 sequences, which are an essential part of the ABL SH3 domain inducing STAT5 expression, which is indeed crucial for the BCR/ABL leukemogenesis; because of its role in anti-apoptotic activity and cell cycle progress.

We studied K-ras and p53 gene mutations in a panel of 57 primary pancreatic cancers including ductal and nonductal tumors. DNAs were obtained from formalin-fixed, paraffin-embedded material. Target sequences were amplified by polymerase chain reaction and analyzed by denaturing gradient gel electrophoresis and sequencing. Both K-ras and p53 genes were frequently mutated in ductal cancers (25 of 35, 71.4%; 18 of 35, 51.4%, respectively). K-ras mutations were confined to the second position of codon 12 where base transitions and transversions were equally observed. p53 changes were mainly missense mutations. Transitions and transversions were found equally with a prevalence of G:C--A:T changes among transitions. No gene alterations were present in the 6 exocrine nonductal tumors and (with one exception) in the 12 endocrine tumors analyzed. Our results indicate that mutated K-ras and p53 genes can cooperate in the establishment of ductal pancreatic cancers, whereas other genetic events have to be present in nonductal tumors. Moreover, K-ras alterations may represent an early event in ductal tumorigenesis, as suggested both by the high gene mutation frequency and by the presence of mutations in low-grade tumors. On the contrary, p53 gene changes seem to represent an event required for the malignancy progression of ductal tumors from lower to higher grades.

Factor Analysis can extract salient features from EEG data and reduce redundancy of multi-channel computerized EEG data. A 16-channel computerized frequency analysis of background brain electrical activity during 3 functional conditions (eyes closed, eyes open and hyperventilation) was carried out in two groups, fifty healthy subjects and twenty-three schizophrenics. The power log-transformed relative values of normal subjects and schizophrenic patients were submitted to Factor Analysis and the resulting factor scores were compared. Schizophrenics showed EEG abnormalities in delta 2, theta 1 and alpha 2 bands for the first factor, accounting for the eyes closed condition, and in theta 2 and beta 2 bands for the second factor, accounting for the eyes open condition. This preliminary study demonstrates the utility of Factor Analysis in managing and comparing computerized EEG data.

The porous (Wolinski) balloon was designed to allow local delivery of compounds targeted to inhibit postintervention restenosis; however, successful use of the device has been hampered by arterial trauma caused by the balloon itself. This study utilized several experimental systems to assess the functional characteristics of the porous balloon catheter. This information was utilized to design and test a new microporous infusion catheter for local intra-arterial drug delivery.Flow characteristics in fluid and semisolid media as well as arterial trauma by light and electron microscopy were documented for the porous and microporous balloons. In addition, the efficacy of methylene blue delivery in situ and in vitro was documented and quantified for the microporous design.The porous balloon exhibits flow characteristics consistent with orifice-related streaming that produces arterial trauma. By maximizing external balloon-pore density and minimizing pore size, the microporous design minimizes streaming in test systems. This is manifested by minimal arterial trauma when applied to intact arteries. The microporous catheter is effective for dye delivery both in situ and in vivo.The microporous catheter design offers improved functional characteristics when compared with the porous balloon for local intra-arterial drug delivery.

Abstract 4050 The role of the telomeres in the mechanisms of ageing and carcinogenesis has generated a considerable interest as a novel approach to the treatment of many cancers. Telomeres are nucleoproteins structures that protect the ends of eukaryotic chromosomes, which are particularly vulnerable due to progressive shortening in almost all dividing cells. The telomere length was observed as a critical factor in the initiation and progression of human cancers, and it is associated to chromosomal instability. Most immortal cells possess enzymatic activity of telomerase. This suggests that telomerase activity and telomere length maintenance may be required for unlimited cell proliferation, tumorigenesis, and protection, allowing the evasion of apoptosis in cancer development. The telomerase activity could also be regulated positively or negatively by post-trancriptional and/or post-translational modification of the enzyme without transcriptional up-regulation of human telomerase reverse transcriptase (hTERT) mRNA. In this work, we analyze the expression data of all genes involved in telomerase activity. Patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM), multiple myeloma (MM) and plasma cell leukemia (PLC) were studied through gene expression profiling analysis (Human Genome U133 Plus 2.0 arrays, Affymetrix). We identify 21 deregulated genes, implicated directly in telomere length maintenance activity in clonal plasma cells compared with normal cells (20 up-regulated and 1 down-regulated). These genes are MYC, KRAS, HSPA9, RB1 and members of the families: Small nucleolar ribonucleoproteins (H/ACA snoRNPs), A/B subfamily of ubiquitously expressed heterogeneous nuclear ribonucleoproteins (hnRNPs), and 14-3 -3 family. In conclusion, the myeloma cells acquire the telomere maintenance capability without deregulation of the human telomerase RNA gene (hTERC) and hTERT gene expression. It is an alternative lengthening of telomeres mechanism that has effect in the regulation of the BAD activity in apoptosis. The mechanism is based on preventing the partially-denatured proteins from aggregating, telomere maintenance through the correct processing and intranuclear trafficking of hTERC, telomerase reactivation and telomere stabilization, and efficient accumulation of hTERT in the nucleus. Thus, the findings of this study may help to improve telomerase-based therapy for multiple myeloma. Disclosures: No relevant conflicts of interest to declare.

The present research sought to develop and validate a novel instrument for the assessment of body image dissatisfaction and negative health behaviors in adolescent males. Additionally, this research was focused on providing a useful tool for the strength and conditioning professional to use when assessing clinical adolescent populations who may be at risk for body image disorders related to their sport performance. A comprehensive search of relevant medical and socio-behavioral databases was conducted for years 1990-2005 yielding 293 useable studies (244 empirical and 49 theoretical) for inclusion in a content analysis. Search terms included'body image,'‘adolescence,’‘satisfaction,’and ‘males.’ Statistically relevant interpersonal, intrapersonal, and social factors were coded and classified. The most statistically relevant factors were formulated into questions and subscales to form the overall pilot instrument. The instrument was piloted with a sample of 27 adolescent boys and was adjusted and revised based on feedback. The initial instrument was reviewed by a panel of five content area experts. Each of the 28 scale questions were evaluated for relevance and readability. Four out of five experts (80%) had to approve the question for it to be included in the scale. Content, face, discrepant, and convergent validity was established using the objective measures evaluated by the expert panel. Each of the final 28 questions was determined to be appropriate and valid to be included in the scale. Nine questions were omitted based on the evaluation and inclusion criteria. Initial pilot reliability was judge to be somewhat acceptable for the body image scale with a Cronbach's α = .66. Final reliability of the Adolescent Body Image Satisfaction Scale [ABISS] after the modification of 9 items was judged to be acceptable with a Cronbach's α = .82. Following the adjustments made to the ABISS during the pilot study, the instrument was used to study 330 adolescent males. Based on subjective as well as objective feed back, the ABISS appears to be a valid and reliable instrument that can be used to measure the psychobehavioral attributes of adolescent males pertaining to body image satisfaction. Strength and conditioning professionals should be aware of the psychological attributes of their athletes and clients as much as their physiologic attributes. Having an understanding of how adolescents view their bodies and the image of it will assist professionals in designing appropriate, health-promotive strength programs, while at the same time monitoring for signs of body image dissatisfaction, which can lead to negative health practices (e.g., performance-enhancing drug use, exercise addictions, disordered eating). The ABISS appears to be a valid and reliable instrument to assess for the aforementioned features, but should be further validated with other populations.

A culturally readapted scale of the classical Rokeach scale was applied to a 200-subject sample. Subjects were male and female workers on the one hand, and university men and women, on the other hand. The results of the different subsamples were compared by means of statistical techniques. Later, the same comparison was carried out with data from a similar study performed in Venezuela.

We describe five cases of extragonadal germ cell tumor (EGCT) diagnosed by the electron microscope (EM) on cytological material. The clinical diagnosis was incorrect in all cases and EGCT was suspected in two cases; cytological diagnosis by light microscopy confirmed the presence of malignant tumor cells, but did not identify the cytotype/s correctly except in one case. Ultrasonography, laparoscopy. and autopsy (in case 3) excluded a primitive germ cell tumor (GCT). Histology confirmed the EM diagnosis in all cases. EM, even of scanty or necrotic cytological material, is particularly useful for mediastinal and retroperitoneal masses. In case of EGCT, EM can identify the different cytotypes and the different ultrastructural subcellular cytotypes and demonstrates a close relation between seminomatous and nonseminomatous GCT, which could influence their classification and prognosis. © 1992 Wiley-Liss, Inc.

Abstract 1798 Poster Board I-824 Histone modifications are known to mediate transcriptional regulation through changes in chromatin condensation and as such can lead to aberrant transcriptional patterns resulting in malignant transformation. Modulation of chromatin structure via histone modification is becoming recognised as an important pathogenic mechanism in myeloma and has been suggested by the over-expression of MMSET, a histone methyltransferase, by the t(4;14) chromosomal rearrangement. More recently inactivation of UTX, a histone demethylase, has also been suggested to have a role in myeloma pathogenesis and both UTX and MMSET are mediators of transcriptional repression. UTX is inactivated in a number of different cancer cell lines but importantly, mutations and deletions have been detected in myeloma cell lines and we wished to follow up on this observation in uniformly treated clinical cases. UTX is a large gene found on the X chromosome covering 240 kb of genomic DNA and consists of 29 exons encoding a protein with both JmjC-domains and tricopeptide repeats responsible for histone demethylation and polycomb protein interactions. Inactivation of UTX occurs through deletions of individual exons through to large whole gene deletions as well as by mutations scattered throughout the 29 exons. A further mechanism of UTX inactivation which has not been looked for to date is via DNA methylation of the CpG island upstream of the transcriptional start site. We set out to determine the status of UTX in our dataset which includes expression, mapping, and methylation array data from presenting myeloma samples entered into the MRC Myeloma IX clinical trial. The gene expression of UTX was measured on 272 samples using Affymetrix U133 Plus 2.0 arrays and showed that 80% of samples do not express UTX transcripts but using expression quartile analysis we could not detect an effect on overall survival. The mechanism underlying the abrogation of expression was investigated further using the Affymetrix 500K SNP mapping array on a subset of 114 samples to detect copy number alterations. UTX was hemizygously deleted in 21 (42%) female samples and was completely deleted in 1 male sample, at the resolution of the arrays. In order to determine if individual exons were deleted, at a resolution below that detectable by mapping arrays, we performed quantitative PCR coupled with high resolution melting (HRM) analysis using the Rotor-gene Q real-time cycler (Qiagen). Exons were amplified, over 40 cycles, to obtain products of ∼200 bp using LC Green Plus mastermix (Idaho Technologies) in a 10 μl reaction on the Rotor-gene Q with a final HRM step from 72-95 °C with increments of 0.1 °C. Amplification plots combined with the HRM step allows us to identify both homozygous deletions and mutations within the exons. We screened all 114 samples for micro-deletions and mutations and found homozygous deletions in ∼7% of samples and identified a significant proportion of mutations using the HRM method which accounted for a total of ∼10% of gene inactivation. In order to determine if methylation could be responsible for inactivation of the remaining allele we used the Illumina Infinium humanmethylation27 array to study the methylation status at the UTX locus. This array interrogates 27,578 highly informative CpG sites per sample at the single-nucleotide resolution using bisulfite converted DNA. The results of this analysis are presented as an average beta-score where 1.0 is fully methylated and 0 is fully unmethylated. Samples were analyzed using Illumina GenomeStudio and the custom differential methylation algorithm. In samples with a diploid copy number of UTX the methylation signals covered 2 ranges: hemi-methylated (0.35-0.55, n=7) and hyper-methylated (0.73-0.89, n=14). In samples with 1 copy of UTX, which includes all males, there were 3 ranges: hypomethylated (0.08-0.21, n=5), hemi-methylated (0.35-0.51, n=3), and hypermethylated (0.66-0.88, n=48). All of the hypomethylated samples with a single copy of UTX were male, and at least 1 of these samples contained an inactivating exonic deletion resulting in complete loss of function. These data indicate that methylation of the residual allele contributes significantly to the inactivation of UTX along with interstitial deletions and mutations. We will go on to present data on the interaction of UTX with variation at the UTY locus and how this modulates behaviour of the myeloma clone. Disclosures No relevant conflicts of interest to declare.

To obtain a comprehensive genomic profile of presenting multiple myeloma cases we performed high resolution single nucleotide polymorphism (SNP) mapping array analysis to examine changes in DNA copy number and loss of heterozygosity in 115 cases with matched peripheral blood controls. Identification

Hairy-cell leukaemia (HCL) is a rare B-cell disorder, with a variant form (HCL-v), which differs from the former in morphology, immunophenotype, clinical behaviour and response to treatment. Whilst HCL is highly sensitive to purine analogues, HCL-v patients do not respond to these treatments and have a median survival of only 7 years compared to over 20 years in HCL. The relationship between these two disorders is yet to be determined and the molecular mechanisms underlying them are still largely unknown. Genomic studies are limited due to the rarity of the disease and have mainly been performed at the cytogenetic level. We have used single nucleotide polymorphism (SNP) arrays to examine DNA copy number changes and loss of heterozygosity (LOH) in 14 HCL and 15 HCL-v cases with the aim of finding genetic markers that may distinguish both disease types and can explain their different clinical outcome. DNA extracted from PBMC samples enriched for tumour cells (HC >84%) was interrogated using the Affymetrix Human Mapping 500K Array Set. Data were analysed using CNAG 2.0 and dCHIP 2006 to identify regions of genomic imbalance and LOH by comparison to a set of 25 normal controls. DNA copy number abnormalities (excluding the IGH and IGL heterogeneic loci) were identified in 11/14 (78%) HCL and 13/15 (87%) HCL-v cases. The median number of lesions per patient in HCL (2.5, range=0–14) was half that observed for HCL-v (5, range=0–34) (p=0.1, not significant) with 3/15 cases of HCL-v exhibiting more than 20 aberrations. The most significant difference between HCL and HCL-v was the occurrence of deletions on 17p, involving monoallelic loss of TP53. Such losses were evident in 33% (5/15) of HCL-v cases compared to 0% of HCL cases (p=0.02). Sequencing analysis detected mutations in the non-deleted allele in 3/5 of these cases, suggesting biallelic loss of TP53 function. Other frequent events were present in both HCL and HCL-v and included gains on chromosome 5 (1/14 HCL and 5/15 HCL-v) and deletions on 7q (3/14 HCL and 3/15 HCL-v) and 14q (2/14 HCL and 1/15 HCL-v). Similar aberrations have been detected in previous cytogenetic studies of typical HCL but the high resolution of the SNP arrays has allowed us to further define these regions of imbalance in both disorders. Chromosome 5 abnormalities included trisomy 5 in two cases and a minimal region of gain, 18.9 Mb in size (5q34–q35.3), was present in 4/6 cases. The cases exhibiting 7q deletions allowed the minimal region to be further defined to 4.1 Mb (7q31.31–q31.33), a region containing approximately 25 known genes. Deletion of 14q24.1–q32.13 was seen in two HCL cases, therefore further minimising the 14q22–q32 region identified previously. One HCL-v case exhibited an interesting region of deletion at 14q32.32, consisting of a focal homozygous deletion flanked by hemizygous loss, containing candidate tumour suppressor genes that may be involved in HCL-v pathogenesis. In addition to these larger lesions, focal gains, harbouring only a single gene, were identified in both disorders at 19p13.2 (3/14 HCL, 3/15 HCL-v), 20p13 (4/14 HCL, 3/15 HCL-v) and 17q21.2 (4/16 HCL and 5/15 HCL-v). High-resolution copy number analyses allow the identification of novel genetic lesions in HCL and HCL-v and further define known cytogenetic aberrations. Our data show that HCL and HCL-v are generally similar at the genomic level but can be distinguished based on 17p deletions, suggesting that biallelic loss of TP53 may contribute to the greater genomic instability and to the aggressiveness of HCL-v. Other HCL-v cases may carry aberrations of other genes involved in DNA damage/repair pathways aside from TP53 and will be investigated.

Multiple Myeloma (MM) is a malignancy depicted by clonal expansion of plasma cells in the bone marrow. There are two broad genetic subtypes of multiple myeloma as defined as hyperdiploid multiple myeloma (H-MM), characterized by trisomies of chromosomes 3, 5, 7, 9, 11, 15, 19, and 21, and nonhyperdiploid multiple myeloma (NH-MM) associated with primary translocations involving the immunoglobulin heavy chain (IgH). These two subtypes of multiple myeloma have two different molecular pathogenesis given that characteristic changes of each have been already observed. In order to contribute to the understanding of this malignancy and to unveil the different molecular pathogenesis, our interest is focused on Human Multiple Myeloma Cell lines (HMCLs), as a model, and a broad but specific group of enzymatic proteins: the Kinases. Kinase hyperactivity or lack of it often results in disregulation of cellular pathways involved in proliferation and survival. In our study, we describe the patterns of genetic lesions and molecular pathogenesis of 11 HMCLs with Single Nucleotide Polymorphism (SNP)-based mapping arrays from Affymetrix Human Mapping 500K array set. This technique allows the examination and identification of copy number changes, bi-allelic deletions and the identification of loss of heterozygosity (LOH) due to loss and uniparental disomy, as well as gene localization and identification. The 11 HMCLs utilized are characterized for their structural alterations and not by hyperdiploidy. In addition, so as to fulfill the selection criteria, a minimum of 3 cell lines must present the alterations cited below. The most frequently identified alterations were located as follows: Previously described gains were observed in 1q, 7q, 8, 11q, 18, 19, and 20q; but also found at 4q. The bi-allelic deletions were ascertained on 3p. Similarly, we identified the regions of hemizygotic deletions on 1, 2q, 6q, 8q, 9p, 11q, 12, 13q, 14q, 17p, and 20p. In addition, described regions of homozygotic deletions were detected on 1p, 6q, 8p, 13q, 16q, and 22q, and furthermore located on 2q, 3, 4q, 9, 10q, 12p, and 20p. Finally, the uniparental disomies (UPDs) obtained were traced on 1q, 4q, 8q, 10q, and 22q. These identified alterations are affecting a series of enzymatic genes belonging to targeted pathways. Within the chromosomes 1, 10, 11, 14, and 16 we have localized kinases that are part of the PI3K/AKT pathway, which affect to a number of intracellular and extracellular myeloma growth cytokines. In the chromosomes 1, 6, 12, and 19 we identified a series of Cyclin-Dependent Kinases that are critical regulators of cell cycle progression and RNA transcription, since they regulate and control the cyclins, cell cycle regulatory proteins, which can provoke dysregulation and abnormally accelerated cell cycle progression. And finally on chromosomes 1, 2, 14, 21, and 22 we observed certain Aurora and related kinases, as another family of the cell cycle regulators and often aberrantly activated in human tumor cells, they facilitate transit from G2 through cytokinesis. These mutated kinases may be potential targets for therapeutics. Our data demonstrates the genomic complexity of multiple myeloma enhancing our understanding of the molecular pathogenesis of the disease and the importance of the HMCLs as a model.

Single nucleotide polymorphisms (SNPs) have been long regarded as being important in determining variation and disease predisposition. Recently, chromosomal structural variation in the form of deletions, insertions and duplifications have been identified frequently in the genome of the general population. Such copy number variations (CNVs) have been shown to contribute to a range of human diseases. In recent studies we have utilized Affymetrix 50K and 500K arrays to identify acquired copy number change in myeloma tumor samples. In those studies we had access to paired constitutional DNA and in the present study have been able to report for the first time a CNV map of the constitutional genome of myeloma patients. Affymetrix 500K mapping arrays were used to identify copy number changes in 63 paired samples using DNA from peripheral blood and CD138 selected plasma cells. Tumor samples were analyzed in CNAG using both a paired and unpaired analysis to distinguish between inherited and acquired copy number change. Constitutional DNA was analyzed by both CNAG and GEMCA using 90 Caucasian samples from the Hapmap database as a reference set. For maximum calling accuracy, only those regions identified by both algorithms were called as CNVs. As with similar studies, overlapping CNVs identified using this approach were merged to generate a list of CNV regions (CNVRs) characteristic of the constitutional DNA of these myeloma cases. Using this approach, we identified 292 CNVs across 63 cases, with a median of 4 regions per sample. There were 155 discrete CNVRs, of which 46 were recurrent. The recurrent CNVRs were found most frequently in the pericentric regions of chromosome 14 and 15 in keeping with other studies. We then compared these recurrent CNVRs with a comparable dataset of normal individuals generated using Affymetrix 500K arrays. In this analysis, 25/46 recurrent CNVRs in the myeloma cases were novel. The two most frequent novel CNVRs in the myeloma cases were gains on chromosome 21 and 15. We also compared the characteristics of the constitutional CNVs with the acquired copy number changes in the corresponding tumor samples and identified that the constitutional CNVs were generally considerably smaller. However, using unpaired analysis it was possible to determine the presence of the constitutional CNV in the tumor sample, providing validation of the CNVs. We were also able to demonstrate that acquired copy number change in the tumor cells can either exaggerate or ameliorate the effect of the inherited CNV in the tumor genome, such as cases with acquired trisomy 15 and deletion or gain of regions of 15q in the constitutional DNA. These findings also reinforce the need for paired non-tumor DNA when undertaking copy number analysis of tumor DNA using SNP arrays. In this study we have been able to identify for the first time the presence of CNVs in the constitutional genome of individuals with myeloma. We have been able to systematically catalogue these CNVRs. These results provide the basis for future studies aimed at identifying how this type of genomic variation may influence the development of and outcome of myeloma and a broad range of other hematological conditions.

Chronic lymphocytic leukaemia (CLL) is a heterogenous disease with a highly variable clinical course. A number of recurrent genetic abnormalities associated with CLL have been identified (e.g. 11q-, trisomy 12, 13q-, 17p-), some of which have been shown to be important prognostic markers. Whilst the clinical effects of 17p and 11q deletions are known to be associated with loss of the tumour suppressors TP53 and ATM, respectively, the genes underlying the effects of other genomic aberrations are still yet to be determined. In order to identify additional events that may be crucial to CLL pathogenesis and prognosis we selected 28 cases from the CLL4 study lacking 17p- and 11q- and used high density single nucleotide polymorphism (SNP) arrays to detect novel genomic copy number abnormalities including copy-number-neutral loss of heterozygosity (LOH). DNA was extracted from PBMC samples enriched for CLL cells (CLL>80%) and interrogated using the Affymetrix Human Mapping 500K Array Set. Data were analysed using CNAG 2.0 and dCHIP 2006 to identify regions of genomic imbalance and LOH by comparison to a set of 25 normal controls. In this set of CLL cases without 17p- and 11q-, DNA copy number abnormalities (excluding the IGH and IGL heterogeneic loci) were identified in all 28 cases with a median number of lesions per patient of 7 (range=1–20). Genomic losses were more frequent than gains with a median of 5 deletions/patient compared to a median of 2 gains/patient (p=< 0.0001). The deletions were detected in 96% of cases whereas gains were detected in 79% of cases. As expected, one of the most frequent events identified on the arrays were deletions incorporating 13q14, confirming 12 of 14 cases identified by FISH as having 13q loss. The two deletions not detected by the arrays were shown to be present in less than 20% of CLL cells by FISH. The arrays revealed the minimal deleted region (MDR) to be 13q14.2–14.3 (0.7 Mb) containing the genes DLEU1, DLEU2 and DLEU7. This region also contains the micro-RNAs miR15a and miR16, previously shown to be down-regulated in CLL, further supporting a role for these non-coding RNAs in CLL pathogenesis. Also consistent with FISH data, three cases exhibited trisomy 12. In addition to these known CLL abnormalities, the high resolution of the SNP arrays allowed the identification of novel focal regions of loss containing candidate genes linked to CLL pathogenesis. Interesting focal deletions were observed at 3p13 (15/28 cases), 3q27.3 (9/28 cases), 7q32.3 (20/28 cases), 14q11.2 (10/28 cases), 15q13.3 (3/28 cases) and 18q21.2 (15/28), most of which harboured only a single candidate tumour suppressor gene. Large telomeric regions of LOH without corresponding copy number change, indicative of uniparental disomy (UPD), were present in 4/28 cases of CLL. One case had copy-neutral LOH involving the complete long arm of chromosome 11, which may be an alternative mechanism of loss of ATM, undetectable by FISH. High-resolution copy number analysis has allowed the identification of novel recurrent genetic lesions in CLL, containing tumour suppressor genes that have been implicated in the pathogenesis of other cancers. Further investigation, including gene expression analysis and functional studies of the genes identified, will provide valuable insight into the pathogenesis of CLL and will be presented in the meeting.

Defining biologically relevant prognostic indices in myeloma is a challenge. The International Staging System (ISS) is important but based on simple clinical data. Cytogenetics, in particular switch translocations and 17p-, are more important biologically, being based on underlying genetic changes. However, these changes do not capture all of the important biological data and so signatures based on global expression analysis have been developed to address these shortcomings. Most signatures to date have been based on expression features correlated with outcome rather than using structural genetic change to define biologically relevant expression features and, as such, although predictive, they may be acting as “bystander” markers rather than being pathologically important themselves. We have used homozygous deletions (HD) to define relevant genes and gene signatures predictive of outcome in a large homogeneously treated set of myeloma patients.

The ultrastructural localization of chromogranin A (Chr A) was studied in eleven neoplasias of the diffuse neuroendocrine system (3 pancreatic islet-cell tumours, 1 medullary carcinoma of the thyroid, 1 large bowel and 1 small bowel carcinoid tumours, 2 carcinoid tumours of the lung, 1 adenoma of the parathyroid gland, 2 pheochromocytomas of the adrenal gland). On account of the great influence of the technical treatment of the samples on the immunolocalization of Chr A, the effect of the following variables was studied in a case of pheochromocytoma: fixation in glutaraldehyde versus paraformaldehyde, postfixation in osmium tetroxide versus omission, embedding in epoxy resin versus acrylic resin. The method of choice for the better preservation of the antigenic character of the tissue was found to be fixation in 4% paraformaldehyde, omission of osmium postfixation and embedding in LRWhite acrylic resin; by this procedure we were able to find Chr A in the neurosecretory granules of all the studied cases, using three commercially available antibodies directed against Chr A. These findings further confirm that Chr A is a reliable marker for the study of neuroendocrine neoplasias by electron microscopy.

Previous data sets have defined deregulation of the RAS, RAF and MAPK pathway as being critical in Myeloma pathogenesis. More recently, the NFκB pathway has been identified as commonly deregulated. Combined with cytogenetic data these findings suggest that multiple events affecting common pathways lead to the initiation and progression of Myeloma. We employed a novel strategy to identify other deregulated pathways contributing to Myeloma progression. We hypothesize that gain of chromosome segments correlates with over-expression of genes contained within and losses result in a corresponding decrease in expression. For copy number (CN) 0, i.e. homozygous deletions, expression should be lost. Expression may not always be altered by other CN changes, e.g. hemizygous deletions (CN1) where a single copy of the gene may be sufficient to maintain the level of expression. Furthermore, the relationship between CN and expression is not expected to be linear, e.g. CN4 having twice the expression of the normal CN2, as steric interactions and feedback mechanisms play important roles in the expression of multiple copies. Our aim was to identify CN changes in Myeloma plasma cells and identify networks of gene expression altered as a consequence of CN changes. Dysregulation of one gene within a pathway can perturb the overall balance of the system, causing changes in the entire network that could contribute to tumour pathogenesis. Expression changes correlating with genes with CN changes should reflect the interactions of those genes and identify more genes that are co-regulated or directly influenced within the same networks. The CN0 and CN4 plus genes should have the largest downstream effects, i.e. complete ablation or large over-expression of a gene would perturb its networks the most. We analysed DNA and RNA from CD138+ plasma cells from 84 patients with Myeloma. The DNA was analysed using the Affymetrix 500k SNP GeneChip arrays and CN changes were assessed using DNA from paired samples of peripheral blood and inferred using dChip (2007 build). Gene expression was measured using RNA and Affymetrix HG-U133 +2 GeneChips with dChip to generate expression values. Correlation of expression was measured using the Pearson correlation coefficient and significance was assessed using permutation tests and a corrected p

Homozygous deletions (HD) are important in cancer cell lines and have a non-random distribution in the genome. We have determined the frequency and distribution of HD, along with the genes affected, in 84 presenting multiple myeloma cases using the Affymetrix 500K SNP GeneChip mapping arrays. Initially we took a highly sensitive approach identifying regions with a copy number (CN)

We have previously shown that integration of gene expression and SNP based mapping arrays can identify genes dysregulated as a result of copy number loss and gain in multiple myeloma. Using FISH, it has been possible to identify that gain and loss frequently occurs in association with primary IgH translocations, such as loss of FGFR3 and gain of CCND1 in a proportion of t(4;14) and t(11;14) cases. The aim of this study was to determine the frequency and size of such copy number change associated with IgH translocations and to identify the genes dysregulated as a consequence of these. FISH was performed on CD138 selected plasma cells from 80 newly diagnosed myeloma cases to identify cases with primary IgH translocations. Affymetrix 500K mapping arrays were used to determine copy number change using paired tumor and constitutional DNA and Affymetrix U133 plus 2.0 expression arrays were used to determine global gene expression. Samples were analyzed in dChip and CNAG. Thirty eight of 80 cases (47.5%) had primary IgH translocations: 7 t(4;14), 1 t(6;14), 16 t(11;14), 3 t(14;16), 2 t(14;20) and 9 with an unknown translocation partner. Of 29 cases with a known translocation partner, 11 had gain or loss of all or part of the derivative chromosome. Three of 7 t(4;14) cases had loss of FGFR3 by FISH, confirmed by mapping array as being due to deletion of the derivative 14, with loss of 4p16.3-pter and the remainder of chromosome 14 excluding IgH. The region on 4p commenced at FGFR3 and extended to the telomere. Gene expression analysis showed that there was underexpression of FGFR3 and 4 other genes in the deleted region in the 4p16 deleted cases. In 6 of 16 t(11;14) cases, the translocation was associated with an additional copy of CCND1 by FISH. Mapping arrays revealed in all cases the gain commenced at the presumed translocation breakpoint: in 4 cases there was gain of 11q13.3-qter and in 2 there was gain of a small region of 11q13 only. In most cases there was isolated gain of a variable sized region of 14q32 suggesting a sequence whereby translocation was followed by gain then by deletion of a portion of the derivative chromosome. Gene expression analysis identified 4 genes overexpressed on 11q in t(11;14) cases with 11q gain. In a single t(6;14) case there was a complex rearrangement involving gain of 6p21.1-pter and IgH with loss of the derivative 6, again suggesting translocation followed by gain then loss. In one t(14;16) case there was UPD of 16q except for 16q23-qter with associated gain of IgH alone. This complex pattern suggests a sequence whereby deletion is followed by IgH translocation then by duplication of the untranslocated 16q. This study has shown that loss and gain of translocated regions is a frequent occurrence, present in 11/29 cases with known IgH translocations. Using mapping arrays it is possible to demonstrate that in the majority of cases, the translocation is the initial event, followed by subsequent gain or loss as a later event. We have shown the variable size of these regions and have identified genes dysregulated as a result of the deletions of 4p in t(4;14) cases and gains of 11q in t(11;14) cases. These findings provide evidence of collaborating mechanisms that may be responsible for disease progression in these cases.

We have shown that loss of heterozygosity (LOH) at 16q is an adverse prognostic marker when it occurs in combination with either t(4;14) translocation or del(17p). Using 500K Affymetrix mapping arrays we found that 16q was involved in translocations with the IgH locus, deleted, or had uniparental disomy (UPD). The deletion patterns led us to 2 regions at 16q12.1 and 16q21-q24.1, which contains 5 genes and is the location of the t(14;16) translocation. By integrating mapping and expression profiling data from presenting myeloma cases we were able to identify WWOX and CYLD as key genes deregulated in these regions. Both WWOX and CYLD are known tumor suppressor genes. WWOX is known to have a pro-apoptotic effect by participating in the TNF apoptotic pathway and via the direct physical interaction with p53 and p73. CYLD functions as a negative regulator of the NF-κB pathway as well as blocking the activation of cyclin D. WWOX is found to be methylated in other cancer tissues, whereas CYLD is frequently mutated. To determine mode of action of these genes in samples with LOH we performed mutation and methylation analysis on myeloma cell lines and pre-treatment patient samples. Variant transcripts of WWOX, which may act as dominant negatives to block the function of WWOX have been reported so we also determined the nature of these in the samples. Exons from WWOX and CYLD were PCR amplified from samples with LOH, as well as from samples with retention of heterozygosity, and sequenced directly. All differences to the consensus were checked against databases for known SNPs and mutations. Mutations in the tumor sample were confirmed by a repeat PCR, and mutations were also checked against peripheral blood DNA from the same patient to determine if these were acquired in the tumor. LOH of 16q was found in 2 out of 9 myeloma cell lines and additionally homozygous deletion of WWOX exons 5-8 in KMS11 cells was observed. cDNA analysis from these cell lines showed that KMS11 cells expressed variant 3, as could be expected, whereas the dominant transcript in other cell lines is variant 1. However, 2 cell lines also expressed an additional transcript (variant 4), which has previously been shown to act as a dominant-negative transcript. All pretreatment samples expressed the variant 1 transcript. 16 pretreatment samples with LOH were screened for mutations revealing 2 mutations in exon 9, one of which was non-synonymous. Methylation analysis of the WWOX locus is underway. Analysis of CYLD showed frequent mutation in cell lines with many synonymous and non-synonymous mutations, including several frame-shifts resulting in truncated products. Screening of 14 pretreatment samples with LOH at the CYLD locus revealed 2 mutations including a C>TT mutation in exon 11, which results in a frameshift and premature termination of translation. Alternative transcripts of CYLD are formed through splicing of exons 3 and 7. Both exon 3 variants were present but only the variant lacking exon 7 was present in myeloma cell lines. These data suggest that dysregulation of both WWOX and CYLD may be important in the pathogenesis of myeloma and contribute to the effect of del(16q) on patient survival.

Leone, J.E., and J.V. Fetro. Perceptions and attitudes toward androgenic-anabolic steroid use among 2 age categories: A qualitative inquiry. J. Strength Cond. Res. 21(2):532- 537. 2007.-We attempted to qualitatively investigate why men of 2 age categories have chosen not to use androgenic-anabolic steroids (AASs). Twelve men (22.28 ± 1.38 years [group I] and 53.00 ± 13.28 years [group II]) were selected on the basis of specific inclusion criteria, including age and fitness levels (i.e., "do you weight train?"). Subjects were classified in 1 of 2 categories-younger or older precluders-and were asked to complete 2 survey instruments before their participation. The Drive for Muscularity Scale (reliability 0.85) and Body Image Questionnaire were used to gain a better understanding of perceptions and motivations regarding health, fitness, and body image. A series of semistructured questions were used to enhance focus group discussion regarding attitudes. Questions were validated by a panel of experts in qualitative methods. Member checks were conducted to enhance trustworthiness of the data. Data were transcribed verbatim and analyzed with thematic open-coding techniques. Various behaviors were reported regarding body image. Emerging themes showed a clear demarcation between age categories. Younger subjects cited power, control, body image, and narcissism, whereas older subjects viewed AAS use as more of an athletic-based phenomenon, such as with performance enhancement, when asked about steroids. Groups were in agreement that media trends and perceptions of the ideal male body are becoming "superhuman" and unattainable without chemical means. Understanding attitudinal perspectives might help complement national data on AAS trends. Future investigations could help coaches and allied health professionals collaborate with each other, as well as with national groups and foundations, to devise more appropriate strategies in addressing this growing athletic and public health concern

The translocation/cyclin classification system in myeloma does not neatly define subgroups of hyperdiploidy (HRD) and we sought a more definitive sub-classification. Using 131 pre-treatment samples (49 HRD with no split IgH locus by FISH) we defined subgroups using both supervised and unsupervised hierarchical clustering of gene expression profiles. RNA was purified from CD138+ cells, amplified using a 2-cycle IVT and hybridised onto U133 Plus 2 GeneChips. On 30 of the 49 HRD samples we also performed 500K SNP mapping arrays to define the true extent of the genomic change in HRD. The most common trisomic chromosomes were 15 (97%), 9 (86%), 19 (80%), 5 (77%), 11 (74%), 3 (64%), 21 (54%) and 7 (54%). There was no association between HRD and any of the major genetic abnormalities (1p, 1q, 6q, 8p, 13, 16q and 17p) compared to the non-HRD (NHRD) group. Many interstitial deletions were seen in all HRD samples, on both odd and even numbered chromosomes. However, using gene mapping alone it was not possible to globally sub-classify HRD myeloma. We compared NHRD and HRD sample gene expression profiles, removing differences between t(4;14) and t(11;14) cases in the NHRD group. This analysis showed that HRD samples segregate into 2 groups; one with a pattern distinct to NHRD samples and another containing genes that are up-regulated in both HRD and NHRD samples. In this analysis 176 genes were up-regulated in the HRD samples and were predominantly located on the trisomic chromosomes, especially 19, 11, 9 and 5. These genes showed a predominant upregulation of HGF and TRAIL, and down-regulation of TRAIL-R2 compared to NHRD samples. Unsupervised hierarchical clustering split the HRD samples into 5 distinct groups suggesting that there are distinct pathological entities. Group 1 overexpressed 90 genes including BCL2, CCNL1 (cyclin L1) and CDK6, consistent with a proliferation signature. Group 2 overexpressed interferon inducible genes including IFI6, IFI27, IFIT1 as well as TRAIL. Group 3 upregulated genes included IL8, MMP9 and TIMP2. Group 4 upregulated transcripts include neurexophilin 3. Group 5 was less well defined but contained transcripts for CCND2, WNT5A and CXCR4. To define clinically relevant subgroups the HRD samples were clustered comparing response or no response to induction chemotherapy. Analysis showed that Group 1 cases cluster together and were either non or minimal responders. This is consistent with the Group 1 cases over-expressing cell-cycle and proliferation related genes. Group 5 clustered together and were either complete or partial responders, and had a low expression of the genes over expressed by Group 1. The non-responder group overexpressed 58 genes and include MMSET-like 1 (in a region on 8p paralogous to 4p containing FGFR1), DVL3 (dishevelled homolog 3) and CCNL1. 23 genes were over expressed in the complete response group including caspase 1 and manic fringe homolog. The unsupervised HRD cluster and the supervised response cluster shared 10 genes, including CCNL1 and ASS. We have used both genetic and expression data to further define the HRD sub-group in terms of gene expression signatures and response to therapy and have identified 5 groups, of which Group 1 has a proliferation signature and poor response to induction therapy.

Abnormalities of 16q are important recurrent events in multiple myeloma (MM). We performed FISH on CD138 selected plasma cells from 701 newly diagnosed MM patients from the LRF UKMF cytogenetics database. Gene mapping, including paired normal controls, and gene expression analysis was performed on 55 cases using the Affymetrix Human Mapping 500K Array Set and U133 Plus 2.0 Arrays respectively. 16q deletion (del16q) was identified by FISH using probes for cMAF (Abbott Diagnostics) in 131/701 cases (18.7%) and was significantly associated with deletion 17p (16.5% vs. 8.9%, p=0.006), deletion 13 (60.8% vs. 48.5%, p=0.009), deletion of IgH (22.1% vs. 11.1%, p=0.0003) and non-hyperdiploid status (58.3% vs. 42.7%, p=0.006). Del16q showed a trend to poor overall survival, mean survival 43 vs. 61 months (p=0.09), and was associated with significantly worse survival in combination with t(4;14) compared with either t(4;14) or del16q alone, mean survival 15 vs. 26 vs. 45 months respectively (p=0.006). t(14;16) was identified by FISH in 31/701 cases (4.4%) and was associated with poor prognosis, mean survival 29 vs. 54 months (p=0.005). Mapping arrays revealed loss of heterozygosity (LOH) involving all or part of 16q in 20 of 55 cases (36%) in 3 distinct patterns: uniparental disomy (UPD) of chromosome 16 or 16q in 4/55 cases (7%); deletion of chromosome 16 or the whole of 16q in 11/55 cases (20%); and interstitial deletion of small regions of 16q in 5/55 cases (10%), focused on 16q12, the location of CYLD, and 16q23, the location of WWOX. 16q LOH was distributed across translocation groups but was identified in all 4 mapping cases containing 17p deletion, supporting the association identified by FISH. As WWOX is the site of the common fragile site FRA16D and deletions at common fragile sites have been associated with DNA instability in human cancers, we assessed this using gene mapping in these 55 MM cases. Although deletions spanning other common fragile sites were identified, they were not restricted to those with 16q LOH. However, in 2 t(14;16) cases, hemizygous deletions of approximately 100kb could be identified within WWOX at the presumed translocation breakpoint. One of the t(14;16) cases had a similar hemizygous deletion within FHIT, another tumor suppressor gene located within common fragile site FRA3B, consistent with findings in other cancer types. Cases with 16q LOH or t(14;16) all had significantly reduced WWOX expression relative to cases without 16q abnormalities, confirming gene inactivation by either LOH or translocation. Cases with 16q LOH also had significantly reduced expression of two other potential tumor suppressor genes located on 16q, CYLD and RBL2. In summary, our data confirms the adverse prognosis associated with 16q translocation or deletion. Array data reveals 16q LOH occurs due to deletion or UPD with two regions involved, one defined by CYLD and the other by WWOX. WWOX is also inactivated by translocation and is associated with interstitial deletions at this and other common fragile sites. WWOX is a likely candidate gene in MM pathogenesis because of its interaction with TP53 and CYLD via its effects on NF-κB.

Deletions on chromosome 1p and gains on chromosome 1q are common alterations in Myeloma (MM). We analyzed 78 cases using Affymetrix 500K SNP and U133 Plus 2 expression arrays to characterize abnormalities of this chromosome. Copy number, loss of heterozygosity (LOH) analysis and supervised hierarchical clustering (HC) were performed using dChipSNP. LOH and deletion of 1p were found in 22/78 cases (28%). Of these 6 had deletion of the whole of 1p, 9 cases had an interstitial deletion (1p12–p21.3), median size 47.2 Mb (0.2–50.5), and 7 cases had more than one interstitial deletion, median size 5.3 Mb (0.5–55.6). Supervised HC of expression data identified 324 differentially expressed genes comparing deletions of 1p with normal cases. Of these 12 genes were located at 1p12–p21.3, all of which were underexpressed in the samples with deletion. We found one small homozygous microdeletion located at 1p32.3 containing only one transcript CDKN2C. Homozygous deletions by definition contain genes which are completely inactivated and as such are likely to be relevant to the MM pathogenesis. We extended this analysis looking for other alterations at this region and homozygous deletions, mean 0.41 Mb (0.03–1.74), were seen in 4 samples at 1p32.3 (5%). These cases together with another 6 (13%) with deletion at 1p32.3 define a minimally altered region within which CDKN2C is located and in all cases is underexpressed. This data suggests that inactivation of the INK4a/ARF pathway may be important. We looked at other genes in this pathway but did not find homozygous deletions in any of them, however, we did identify another 5 cases with hemizygous deletion. The TC classification utilises data on cyclin D expression and as CDKN2C directly regulates these complexes we looked at how these changes were distributed relative to expression of cyclin Ds. We did not find a consistent pattern as alterations were found in both the elevated D1 and D2 groups. Further analysis of the expression patterns in this pathway and how they relate to genomic changes detected with the SNP array is ongoing. Gains of 1q were identified in 25/78 cases (32%), with gain of the whole of 1q being responsible for the majority. Supervised HC between samples with and without 1q gains identified 659 differentially expressed genes. Of these, 83 genes were located in 1q21–q43, all of which were overexpressed in 1q+. We identified a single case with a small defined region of gain (up to 4 copies) covering 17.5 Mb at 1q21.1–q23.3. Looking within this region following HC we found 42 genes overexpressed (1.3–32.4 fold), including MCL1 and NTRK1, compared to other 1q+ cases. We analyzed our dataset for previously described genes altered in 1q. While we found upregulation of CKS1B, BCL9 and PDZK1 we could not distinguish these from other genes located within this amplicon. Gain of 1q has been associated with poor outcome and we sought other regions co-segregating with 1q+; del13 was the most frequently associated change and all cases with both alterations had an IGH translocation, which may contribute to the poor prognosis of this subgroup. We confirm the importance of changes on chromosome 1 in the MM pathogenesis and provide data supporting the critical deregulation of the G1S cell cycle transition as being important and frequently affected by deletions of 1p affecting CDKN2C.

We have utilised aCGH (Breakthrough Breast Cancer Research Centre 5.8K array) and mutational analysis of the TP53 gene (exons 4–10) on 74 cases of CLL to define the extent of deletion at 17p, TP53 mutational status, additional genomic changes, and how this affects clinical outcome. 17p- cases were selected by FISH (n=37, Vysis LSI P53 probe) and 37 cases were selected as being representative of the survival curve of CLL patients without 17p-. FISH identified 22 cases with TP53- in ≥ 50% of cells, 4 cases with TP53- 20–50% and 11 cases with TP53- ≤ 20%. aCGH can detect abnormalities present in >50% of cells and all of the TP53- cases greater than 50% by FISH were detected with deletion ranging between 6-20Mb in length, the majority encompassing the entire p-arm. In addition aCGH detected deletion of 17p in 5/15 cases with TP53- 20% have a poor clinical outcome (median survival 11 months, median progression free survival 3 months), the majority of these (85%) also have a mutation of TP53 whereas in cases with ≤ 20% 17p- only 10% were mutated. The 17p- group was characterised by additional recurrent deletions involving 18p, 20p and 22q, which tended to occur as single additional events. Understanding the order in which these events occur is important, 18p- was found in 6 cases, 2 of which had Recurrent abnormalities were also found on other chromosomes, but did not differ between the two groups. These included regions with previously identified abnormalities; trisomy 12 (n=11), loss of 6q14.1–24.3 (n=11), loss of 11q12.1–25 (n=17) and loss of 13q12.1–21.1 (n=6) as well as detection of novel abnormalities; gain of 4p16.3–16.1 (n=23), gain of 11p15.5–15.3 (n=22), gain of 22q11.21–13.33 (n=22) and deletions on chromosome 9 (n=9). These results show that deletion of TP53 and mutation of the other allele are critical adverse prognostic factors. We have also defined a genetic background (18p-, 20p- and 22q-) on which these changes arise.

Immunoglobulin heavy chain translocations are an initiating genetic event in the pathogenesis of 50% of multiple myeloma cases. The t(4;14) and t(11;14) translocations each occur in approximately 15% of cases but have distinct clinical outcomes with t(4;14) being associated with a poor prognosis. This may reflect the patterns of genes deregulated by the translocation but also by additional genetic events acquired later in the disease natural history collaborating with the initial translocation. Previous analysis has shown that the t(4;14) results in overexpression of both FGFR3 and MMSET, whereas the t(11;14) results in dysregulation of cyclin D1. In order to identify collaborating genes important in disease progression, we have used the Affyemtrix 50K SNP mapping array to determine chromosomal copy number and loss of heterozygosity (LOH), and the Affymetrix U133 plus 2 array to determine gene expression levels, in t(4;14) and t(11;14) cases. CD138 plasma cells were selected from 22 newly diagnosed myeloma cases, and the presence of the translocation and hyperdiploid status were determined by FISH (9 t(4;14) cases, 13 t(11;14) cases, all cases non-hyperdiploid using the FISH ploidy index). In keeping with our previous studies both t(4;14) and t(11;14) had distinct gene expression profiles characterized by overexpression of FGFR3, MMSET, cyclin D1 and cyclin D2 using hierarchical clustering programmes. A significant percentage of cases lacking a t(4;14) also appeared to have dysregulation of MMSET and its splice variants, as using the array specific hybridization patterns and RT-PCR there was overexpression of the C terminal exons of MMSET but a lack of IgH-MMSET fusions. There was a good correlation between the hyperdiploid status of the cells using FISH and SNP arrays, although some chromosomes that were not tested by FISH showed the presence of chromosomal trisomies in the SNP array. All of the t(4;14) cases had numerous large regions of chromosomal amplification and deletion, some of which were associated with LOH whereas a number of the t(11;14) cases showed diploid SNP calls with no regions of LOH, suggesting greater genomic instability in t(4;14). There was 90% correlation between the presence of a t(4;14) and deletion of chromosome 13q. Chromosome 1 has been suggested to be the site of important collaborating genes previously and in keeping with this we identified 1p amplifications in 12/22 cases, 1q amplifications in 7/22 cases and 1p deletions in 2/22 cases. These abnormalities were equally distributed across both translocation groups suggesting that they are common events in myeloma which are not associated with any particular translocation. In contrast, deletion of regions 16q appear to be specific to a subgroup of t(11;14) cases, with loss in 5 of 13 t(11;14) cases and none being seen in the t(4;14) cases. Current studies comparing the abnormalities detected with high resolution SNP array to gene expression profiles will help to determine how the expression of genes within these key regions of gain and loss are altered and how they may contribute to myeloma pathogenesis.