157 results on '"Josefina Serrano"'
Search Results
2. Comparison of the 2022 and 2017 European LeukemiaNet risk classifications in a real-life cohort of the PETHEMA group
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Claudia Sargas, Rosa Ayala, María J. Larráyoz, María C. Chillón, Eduardo Rodriguez-Arboli, Cristina Bilbao, Esther Prados de la Torre, David Martínez-Cuadrón, Rebeca Rodríguez-Veiga, Blanca Boluda, Cristina Gil, Teresa Bernal, Juan Bergua, Lorenzo Algarra, Mar Tormo, Pilar Martínez-Sánchez, Elena Soria, Josefina Serrano, Juan M. Alonso-Dominguez, Raimundo García, María Luz Amigo, Pilar Herrera-Puente, María J. Sayas, Esperanza Lavilla-Rubira, Joaquín Martínez-López, María J. Calasanz, Ramón García-Sanz, José A. Pérez-Simón, María T. Gómez Casares, Joaquín Sánchez-García, Eva Barragán, Pau Montesinos, and PETHEMA cooperative study group
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Next-Generation Sequencing is needed for the accurate genetic risk stratification of acute myeloid leukemia according to European LeukemiaNet (ELN) guidelines. We validated and compared the 2022 ELN risk classification in a real-life cohort of 546 intensively and 379 non-intensively treated patients. Among fit patients, those aged ≥65 years old showed worse OS than younger regardless risk classification. Compared with the 2017 classification, 14.5% of fit patients changed the risk with the 2022 classification, increasing the high-risk group from 44.3% to 51.8%. 3.7% and 0.9% FLT3-ITD mutated patients were removed from the favorable and adverse 2017 categories respectively to 2022 intermediate risk group. We suggest that midostaurin therapy could be a predictor for 3 years OS (85.2% with vs. 54.8% without midostaurin, P = 0.04). Forty-seven (8.6%) patients from the 2017 intermediate group were assigned to the 2022 adverse-risk group as they harbored myelodysplasia (MDS)-related mutations. Patients with one MDS-related mutation did not reach median OS, while patients with ≥2 mutations had 13.6 months median OS (P = 0.002). Patients with TP53 ± complex karyotype or inv(3) had a dismal prognosis (7.1 months median OS). We validate the prognostic utility of the 2022 ELN classification in a real-life setting providing supportive evidences to improve risk stratification guidelines.
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- 2023
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3. Feasibility and outcomes after dose reduction of immunochemotherapy in young adults with Burkitt lymphoma and leukemia: results of the BURKIMAB14 trial
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Josep-Maria Ribera, Mireia Morgades, Olga Garcia-Calduch, Maialen Sirvent, Buenaventura Buendia, Marta Cervera, Hugo Luzardo, Jesus-Maria Hernandez-Rivas, Marta Sitges, Irene Garcia-Cadenas, Pau Abrisqueta, Pau Montesinos, Mariana Bastos-Oreiro, Maria-Paz Queipo de Llano, Pilar Bravo, Anna Torrent, Pilar Herrera, Antoni Garcia-Guinon, Ferran Vall-llovera, Josefina Serrano, Maria-Jose Terol, Juan-Miguel Bergua, Ana Garcia-Noblejas, Cristina Barrenetxea, Laura Llorente, Daniel Garcia-Belmonte, Eva Gimeno, Antonia Cladera, Santiago Mercadal, and Juan-Manuel Sancho
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
High dose-intensive or infusional intermediate-dose immunochemotherapy is highly effective treatment for Burkitt lymphoma irrespective of human immunodeficiency virus (HIV) infection. However, toxicities of these regimens are relevant, especially in older adults and elderly patients. The prospective multicenter BURKIMAB14 trial included four to six blocks of immunochemotherapy according to stage (localized: 1 and 2 non-bulky; advanced: 2 bulky, 3, 4) and age, with dose reduction in patients >55 years old. Dose-intensity of chemotherapy was reduced in patients ≤55 years old after achieving complete metabolic response (CMR). Their outcomes were compared with those of similar patients included in the former BURKIMAB08 trial, in which there was no dose reduction. CMR was attained in 86 of 107 (80%) patients (17/19 in localized stages and 69/88 in advanced stages). Patients from the BURKIMAB14 trial ≤55 years old showed similar overall survival (OS), fewer infections and cytopenias than patients from the BURKIMAB08 trial. Patients >55 years old had a significantly higher treatment- related mortality despite dose reduction of chemotherapy. With a median follow-up of 3.61 years the 4-year OS probability was 73% (range, 63-81%). Age (≤55 vs. >55 years) and stage (localized vs. advanced) had prognostic significance. No significant differences in OS were observed in HIV-positive versus HIV-negative patients. The results of BURKIMAB14 are similar to those of other dose-intensive immunochemotherapy trials. Age >55 years and advanced stage, but not HIV infection, were associated with poor survival. Dose reduction of chemotherapy in young adults in CMR is safe and does not impact outcomes (clinicaltrials gov. Identifier: NCT05049473).
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- 2023
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4. S130: PRELIMINARY RESULTS OF QUIWI: A DOUBLE BLINDED, RANDOMIZED CLINICAL TRIAL COMPARING STANDARD CHEMOTHERAPY PLUS QUIZARTINIB VERSUS PLACEBO IN ADULT PATIENTS WITH NEWLY DIAGNOSED FLT3-ITD WILD-TYPE AML
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Pau Montesinos, Rebeca Rodríguez-Veiga, Juan Miguel Bergua Burgues, Lorenzo Algarra, Carmen Botella, Perez Simon Josè Antonio, Teresa Bernal, Mar Tormo, Maria Calbacho Robles, Olga Salamero, Josefina Serrano, Victor Noriega, Juan Antonio López-López, Susana Vives Polo, Mercedes Colorado, Jose Luis Lopez Lorenzo, María Belén Vidriales, Raimundo Garcia Boyero, Mayte Olave, Pilar Herrera-Puente, Olga Arce, Manuel Barrios Garcia, Maria Jose Sayas Lloris, Marta Polo, Maria Isabel Gomez Roncero, Eva Barragan, Rosa Ayala Diaz, Maria Carmen Chillon, Maria Jose Calasanz, Blanca Boluda, David Martinez-Cuadrón, and Jorge Labrador
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
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5. P531: MIDOSTAURIN PLUS 7 + 3 OR QUIZARTINIB PLUS 7 + 3 IN FLT3-ITD MUTATED AML
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Mar Tormo, Marina Diaz-Beya, Paola Beneit, Ainhoa Fernández Moreno, Montserrat Arnan, Ana Garrido Diaz, Susana Vives, Maria García Fortes, Antonia Sampol, Jorge Labrador, Antonio Garcia-Guiñon, Carmen Botella, Juan Miguel Bergua Burgues, Mayte Olave, Maria Luz Amigo, Xavier Ortín, Ferrand Ferran Vall-Llovera, Maria Pereiro, Josefina Serrano, Maria Jose Sayas Lloris, Almudena De Laiglesia Lorenzo, Juan Jose Bargay Lleonart, Maria Luisa Calabuig Muñoz, and Adolfo De La Fuente
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
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6. PB1779: FLT3-ITD MUTATION CHARACTERIZATION WITH CLASSICAL PCR METHODOLOGY VERSUS CAPTURE- AND AMPLICON-BASED NGS PLATFORMS: A PETHEMA NGS-AML PROJECT
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Cristina Bilbao, Ruth Stuckey, Claudia Sargas, María J Larráyoz, Maria Carmen Chillon, Rosa Ayala Diaz, Estrella Cruz Carrillo, Manuel Yébenes-Ramírez, David Martinez-Cuadron, Rebeca Rodriguez-Veiga, Cristina Gil, Teresa Bernal, Juan Miguel Bergua Burgues, Lorenzo Algarra, Mar Tormo, Maria Pilar Martinez Sanchez, Elena Soria Saldise, Josefina Serrano, Juan Manuel Alonso Dominguez, Raimundo Garcia Boyero, Maria Luz Amigo, Pilar Herrera-Puente, Maria J Sayas, Esperanza Lavilla Rubira, Carlos Rodriguez Medina, Santiago Sánchez Sosa, Jorge Rodríguez-Afonso, Paula Reyes-González-Casanova, Eduardo Rodríguez-Arbolí, Joaquin Sanchez Garcia, Joaquín Martinez-Lopez, Ramón García-Sanz, Maria Jose Calasanz, Eva Barragan, Maria Teresa Gomez Casares, and Pau Montesinos
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
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7. P1147: FEASIBILITY AND OUTCOME AFTER DOSE REDUCTION OF IMMUNOCHEMOTHERAPY IN YOUNG ADULTS WITH BURKITT LYMPHOMA AND LEUKEMIA. RESULTS OF THE BURKIMAB14 TRIAL
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Josep Maria Ribera, Mireia Morgades, Olga García-Calduch, Maialen Sirvent, Buenaventura Buendía Ureña, Marta Cervera, Hugo Luzardo, Jesus Hernández Rivas, Marta Sitges Arriaga, Irene Garcia Cadenas, Pablo Abrisquet Acosta, Pau Montesinos, Mariana Bastos Oreiro, María-Paz Queipo de Llano, Pilar Bravo, Anna Torrent, Maria Pilar Herrera Puente, Antonio Garcia-Guiñon, Ferran Vall-Llovera Calmet, Josefina Serrano, Maria J Terol, Juan Miguel Bergua Burgues, Ana García-Noblejas, Cristina Barrenetxea, Laura Llorente, Daniel García-Belmonte, Eva Gimeno, Antonia Cladera, Santiago Mercadal Vilchez, and Juan Manuel Sancho
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
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8. A scoring system for AML patients aged 70 years or older, eligible for intensive chemotherapy: a study based on a large European data set using the DATAML, SAL, and PETHEMA registries
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Emilie Bérard, Christoph Röllig, Sarah Bertoli, Arnaud Pigneux, Suzanne Tavitian, Michael Kramer, Hubert Serve, Martin Bornhäuser, Uwe Platzbecker, Carsten Müller-Tidow, Claudia D. Baldus, David Martínez-Cuadrón, Josefina Serrano, Pilar Martínez-Sánchez, Eduardo Rodríguez Arbolí, Cristina Gil, Juan Bergua, Teresa Bernal, Adolfo de la Fuente Burguera, Eric Delabesse, Audrey Bidet, Pierre-Yves Dumas, Pau Montesinos, and Christian Récher
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Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract In a context of therapeutic revolution in older adults with AML, it is becoming increasingly important to select patients for the various treatment options by taking account of short-term efficacy and toxicity as well as long-term survival. Here, the data from three European registries for 1,199 AML patients aged 70 years or older treated with intensive chemotherapy were used to develop a prognostic scoring system. The median follow-up was 50.8 months. In the training set of 636 patients, age, performance status, secondary AML, leukocytosis, and cytogenetics, as well as NPM1 mutations (without FLT3-ITD), were all significantly associated with overall survival, albeit not to the same degree. These factors were used to develop a score that predicts long-term overall survival. Three risk-groups were identified: a lower, intermediate and higher-risk score with predicted 5-year overall survival (OS) probabilities of ≥12% (n = 283, 51%; median OS = 18 months), 3–12% (n = 226, 41%; median OS = 9 months) and
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- 2022
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9. Outcomes after intensive chemotherapy for secondary and myeloid-related changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry
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David Martínez-Cuadrón, Juan E. Megías-Vericat, Cristina Gil, Teresa Bernal, Mar Tormo, Pilar Martínez-Sánchez, Carlos Rodríguez-Medina, Josefina Serrano, Pilar Herrera, José A. Pérez Simón, María J. Sayas, Juan Bergua, Esperanza Lavilla-Rubira, Maria Luz Amigo, Celina Benavente, Jose L. López Lorenzo, Manuel M. Pérez-Encinas, María B. Vidriales, Mercedes Colorado, Beatriz de Rueda, Raimundo García-Boyero, Sandra Marini, Julio García-Suárez, María López-Pavía, Maria I. Gómez-Roncero, Víctor Noriega, Aurelio López, Jorge Labrador, Ana Cabello, Claudia Sossa, Lorenzo Algarra, Mariana Stevenazzi, Antonio Solana-Altabella, Blanca Boluda, and Pau Montesinos
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Treatment options for patients with secondary acute myeloid leukemia (sAML) and AML with myeloid-related changes (AMLMRC) aged 60 to 75 years are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard "3+7" regimens. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60 to 75 years treated with intensive chemotherapy, reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS was 7.6 months (95% confidence interval [CI]: 6.7-8.5) and event-free survival (EFS) 2.7 months (95% CI: 2-3.3), without differences between intensive chemotherapy regimens and AML type. Multivariate analyses identified age ≥70 years, Eastern Cooperative Oncology Group performance status ≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), autologous HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.
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- 2023
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10. Survival Outcomes and Health-Related Quality of Life in Older Adults Diagnosed with Acute Myeloid Leukemia Receiving Frontline Therapy in Daily Practice
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Fernando Ramos, María Lourdes Hermosín, Marta Fuertes-Núñez, Pilar Martínez, Carlos Rodriguez-Medina, Manuel Barrios, Francisco Ibáñez, Teresa Bernal, Maria Teresa Olave, Miguel Ángel Álvarez, María Vahí, Teresa Caballero-Velázquez, Bernardo González, Albert Altés, Lorena García, Pascual Fernández, María Antonia Durán, Rocío López, Montserrat Rafel, and Josefina Serrano
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acute myeloid leukemia ,elderly ,survival ,early death ,health-related quality of life ,life expectancy ,Medicine - Abstract
Acute myeloid leukemia has a poor prognosis in older adults, and its management is often unclear due to its underrepresentation in clinical trials. Both overall survival (OS) and health-related quality-of-life (HRQoL) are key outcomes in this population, and patient-reported outcomes may contribute to patient stratification and treatment assignment. This prospective study included 138 consecutive patients treated in daily practice with the currently available non-targeted therapies (intensive chemotherapy [IC], attenuated chemotherapy [AC], hypomethylating agents [HMA], or palliative care [PC]). We evaluated patients’ condition at diagnosis (Life expectancy [Lee Index for Older Adults], Geriatric Assessment in Hematology [GAH scale], HRQoL [EQ-5D-5L questionnaire], and fatigue [fatigue items of the QLQ-C30 scale]), OS, early death (ED), treatment tolerability (TT) and change in HRQoL over 12 months follow-up. The median OS was 7.1 months (IC not reached, AC 5.9, HMA 8.8, and PC 1.0). Poor risk AML category and receiving just palliative care, as well as a higher Lee index score in the patients receiving active therapy, independently predicted a shorter OS. The Lee Index and GAH scale were not useful for predicting TT. The white blood cell count was a valid predictor for ED. Patients’ HRQoL remained stable during follow-up.
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- 2023
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11. Impact of Center-related Characteristics and Macroeconomic Factors on the Outcome of Adult Patients With Acute Lymphoblastic Leukemia Treated With Pediatric-inspired Protocols
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Pere Barba, Mireia Morgades, Pau Montesinos, Jose Gonzalez-Campos, Anna Torrent, Cristina Gil, Teresa Bernal, Mar Tormo, Santiago Mercadal, Sandra Novoa, Irene García-Cadenas, M. Paz Queipo de Llano, Marta Cervera, Rosa Coll, Arancha Bermudez, M. Luz Amigo, Silvia Monsalvo, Jordi Esteve, Raimundo Garcia-Boyero, Andres Novo, Jesús Maria Hernandez Rivas, Antonia Cladera, Pilar Martinez-Sanchez, Josefina Serrano, Maria Teresa Artola, Beatriz Soria, Eugenia Abella, Ferran Vall-Llovera, Juan Bergua, Pilar Herrera, Daniel Barrios, Josep Maria Ribera, and on behalf of the Spanish PETHEMA Group
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2023
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12. Prognostic significance of FLT3-ITD length in AML patients treated with intensive regimens
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Tamara Castaño-Bonilla, Juan M. Alonso-Dominguez, Eva Barragán, Rebeca Rodríguez-Veiga, Claudia Sargas, Cristina Gil, Carmen Chillón, María B. Vidriales, Raimundo García, Joaquín Martínez-López, Rosa Ayala, María J. Larrayoz, Eduardo Anguita, Rebeca Cuello, Alberto Cantalapiedra, Estrella Carrillo, Elena Soria-Saldise, Jorge Labrador, Isabel Recio, Lorenzo Algarra, Carlos Rodríguez-Medina, Cristina Bilbao-Syeiro, Juan A. López-López, Josefina Serrano, Erik De Cabo, María J. Sayas, María T. Olave, Joaquín Sánchez-García, Mamen Mateos, Carlos Blas, Jose L. López-Lorenzo, Daniel Lainez-Gonzalez, Juana Serrano, David Martínez-Cuadrón, Miguel A. Sanz, and Pau Montesinos
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Medicine ,Science - Abstract
Abstract FLT3-ITD mutations are detected in approximately 25% of newly diagnosed adult acute myeloid leukemia (AML) patients and confer an adverse prognosis. The FLT3-ITD allelic ratio has clear prognostic value. Nevertheless, there are numerous manuscripts with contradictory results regarding the prognostic relevance of the length and insertion site (IS) of the FLT3-ITD fragment. We aimed to assess the prognostic impact of these variables on the complete remission (CR) rates, overall survival (OS) and relapse-free survival (RFS) of AML patients with FLT3-ITDmutations. We studied the FLT3-ITD length of 362 adult AML patients included in the PETHEMA AML registry. We tried to validate the thresholds of ITD length previously published (i.e., 39 bp and 70 bp) in intensively treated AML patients (n = 161). We also analyzed the mutational profile of 118 FLT3-ITD AML patients with an NGS panel of 39 genes and correlated mutational status with the length and IS of ITD. The AUC of the ROC curve of the ITD length for OS prediction was 0.504, and no differences were found when applying any of the thresholds for OS, RFS or CR rate. Only four out of 106 patients had ITD IS in the TKD1 domain. Our results, alongside previous publications, confirm that FLT3-ITD length lacks prognostic value and clinical applicability.
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- 2021
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13. The transcriptomic landscape of elderly acute myeloid leukemia identifies B7H3 and BANP as a favorable signature in high-risk patients
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Sara Villar, Beñat Ariceta, Xabier Agirre, Aura Daniela Urribarri, Rosa Ayala, David Martínez-Cuadrón, Juan Miguel Bergua, Susana Vives, Lorenzo Algarra, Mar Tormo, Pilar Martínez, Josefina Serrano, Catia Simoes, Pilar Herrera, Maria José Calasanz, Ana Alfonso-Piérola, Bruno Paiva, Joaquín Martínez-López, Jesús F. San Miguel, Felipe Prósper, and Pau Montesinos
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acute myeloid leukemia ,elderly ,transcriptomics ,biomarkers ,prognosis ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Acute myeloid leukemia (AML) in the elderly remains a clinical challenge, with a five-year overall survival rate below 10%. The current ELN 2017 genetic risk classification considers cytogenetic and mutational characteristics to stratify fit AML patients into different prognostic groups. However, this classification is not validated for elderly patients treated with a non-intensive approach, and its performance may be suboptimal in this context. Indeed, the transcriptomic landscape of AML in the elderly has been less explored and it might help stratify this group of patients. In the current study, we analyzed the transcriptome of 224 AML patients > 65 years-old at diagnosis treated in the Spanish PETHEMA-FLUGAZA clinical trial in order to identify new prognostic biomarkers in this population. We identified a specific transcriptomic signature for high-risk patients with mutated TP53 or complex karyotype, revealing that low expression of B7H3 gene with high expression of BANP gene identifies a subset of high-risk AML patients surviving more than 12 months. This result was further validated in the BEAT AML cohort. This unique signature highlights the potential of transcriptomics to identify prognostic biomarkers in in elderly AML.
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- 2022
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14. Evolving Risk Classifications in AML in a Real-Life Scenario: After Changes upon Changes, Is It More and More Adverse?
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Clara Aparicio-Pérez, Esther Prados de la Torre, Joaquin Sanchez-Garcia, Carmen Martín-Calvo, Carmen Martínez-Losada, Javier Casaño-Sanchez, Juana Serrano-López, and Josefina Serrano
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acute myeloid leukemia ,risk classifications ,European Leukemia Net ,TP53 mutations ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Acute myeloid leukemia (AML) is a heterogeneous disease classified into three risk categories (favorable, intermediate and adverse) with significant differences in outcomes. Definitions of risk categories evolve overtime, incorporating advances in molecular knowledge of AML. In this study, we analyzed the impacts of evolving risk classifications in 130 consecutive AML patients in a single-center real-life experience. Complete cytogenetic and molecular data were collected using conventional qPCR and targeted Next Generation Sequencing (NGS). Five-year OS probabilities were consistent among all classification models (roughly 50–72%, 26–32% and 16–20% for favorable, intermediate and adverse risk groups, respectively). In the same way, the medians of survival months and prediction power were similar in all models. In each update, around 20% of patients were re-classified. The adverse category consistently increased over time (31% in MRC, 34% in ELN2010, 50% in ELN2017), reaching up to 56% in the recent ELN2022. Noteworthily, in multivariate models, only age and the presence of TP53 mutations remained statistically significant. With updates in risk-classification models, the percentage of patients assigned to the adverse group is increasing, and so will the indications for allogeneic stem cell transplantation.
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- 2023
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15. Molecular Landscape and Validation of New Genomic Classification in 2668 Adult AML Patients: Real Life Data from the PETHEMA Registry
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Claudia Sargas, Rosa Ayala, María José Larráyoz, María Carmen Chillón, Estrella Carrillo-Cruz, Cristina Bilbao-Sieyro, Esther Prados de la Torre, David Martínez-Cuadrón, Rebeca Rodríguez-Veiga, Blanca Boluda, Cristina Gil, Teresa Bernal, Juan Miguel Bergua, Lorenzo Algarra, Mar Tormo, Pilar Martínez-Sánchez, Elena Soria, Josefina Serrano, Juan Manuel Alonso-Domínguez, Raimundo García-Boyero, María Luz Amigo, Pilar Herrera-Puente, María José Sayas, Esperanza Lavilla-Rubira, Joaquín Martínez-López, María José Calasanz, Ramón García-Sanz, José Antonio Pérez-Simón, María Teresa Gómez-Casares, Joaquín Sánchez-García, Eva Barragán, Pau Montesinos, and on behalf of PETHEMA group
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acute myeloid leukemia ,Next–Generation Sequencing ,cross–validations ,mutational profile ,genomic classification ,clinical validation ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Next–Generation Sequencing (NGS) implementation to perform accurate diagnosis in acute myeloid leukemia (AML) represents a major challenge for molecular laboratories in terms of specialization, standardization, costs and logistical support. In this context, the PETHEMA cooperative group has established the first nationwide diagnostic network of seven reference laboratories to provide standardized NGS studies for AML patients. Cross–validation (CV) rounds are regularly performed to ensure the quality of NGS studies and to keep updated clinically relevant genes recommended for NGS study. The molecular characterization of 2856 samples (1631 derived from the NGS–AML project; NCT03311815) with standardized NGS of consensus genes (ABL1, ASXL1, BRAF, CALR, CBL, CEBPA, CSF3R, DNMT3A, ETV6, EZH2, FLT3, GATA2, HRAS, IDH1, IDH2, JAK2, KIT, KRAS, MPL, NPM1, NRAS, PTPN11, RUNX1, SETBP1, SF3B1, SRSF2, TET2, TP53, U2AF1 and WT1) showed 97% of patients having at least one mutation. The mutational profile was highly variable according to moment of disease, age and sex, and several co–occurring and exclusion relations were detected. Molecular testing based on NGS allowed accurate diagnosis and reliable prognosis stratification of 954 AML patients according to new genomic classification proposed by Tazi et al. Novel molecular subgroups, such as mutated WT1 and mutations in at least two myelodysplasia–related genes, have been associated with an adverse prognosis in our cohort. In this way, the PETHEMA cooperative group efficiently provides an extensive molecular characterization for AML diagnosis and risk stratification, ensuring technical quality and equity in access to NGS studies.
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- 2023
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16. Impact of FLT3–ITD Mutation Status and Its Ratio in a Cohort of 2901 Patients Undergoing Upfront Intensive Chemotherapy: A PETHEMA Registry Study
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Rosa Ayala, Gonzalo Carreño-Tarragona, Eva Barragán, Blanca Boluda, María J. Larráyoz, María Carmen Chillón, Estrella Carrillo-Cruz, Cristina Bilbao, Joaquín Sánchez-García, Teresa Bernal, David Martinez-Cuadron, Cristina Gil, Josefina Serrano, Carlos Rodriguez-Medina, Juan Bergua, José A. Pérez-Simón, María Calbacho, Juan M. Alonso-Domínguez, Jorge Labrador, Mar Tormo, Maria Luz Amigo, Pilar Herrera-Puente, Inmaculada Rapado, Claudia Sargas, Iria Vazquez, María J. Calasanz, Teresa Gomez-Casares, Ramón García-Sanz, Miguel A. Sanz, Joaquín Martínez-López, and Pau Montesinos
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FLT3–ITD mutation and ratio ,real-world outcomes ,acute myeloid leukemia (AML) ,prognosis ,outcome ,death ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
FLT3–ITD results in a poor prognosis in terms of overall survival (OS) and relapse-free survival (RFS) in acute myeloid leukemia (AML). However, the prognostic usefulness of the allelic ratio (AR) to select post-remission therapy remains controversial. Our study focuses on the prognostic impact of FLT3–ITD and its ratio in a series of 2901 adult patients treated intensively in the pre-FLT3 inhibitor era and reported in the PETHEMA registry. A total of 579 of these patients (20%) harbored FLT3–ITD mutations. In multivariate analyses, patients with an FLT3–ITD allele ratio (AR) of >0.5 showed a lower complete remission (CR rate) and OS (HR 1.47, p = 0.009), while AR > 0.8 was associated with poorer RFS (HR 2.1; p < 0.001). Among NPM1/FLT3–ITD-mutated patients, median OS gradually decreased according to FLT3–ITD status and ratio (34.3 months FLT3–ITD-negative, 25.3 months up to 0.25, 14.5 months up to 0.5, and 10 months ≥ 0.5, p < 0.001). Post-remission allogeneic transplant (allo-HSCT) resulted in better OS and RFS as compared to auto-HSCT in NPM1/FLT3–ITD-mutated AML regardless of pre-established AR cutoff (≤0.5 vs. >0.5). Using the maximally selected log-rank statistics, we established an optimal cutoff of FLT3–ITD AR of 0.44 for OS, and 0.8 for RFS. We analyzed the OS and RFS according to FLT3–ITD status in all patients, and we found that the group of FLT3–ITD-positive patients with AR < 0.44 had similar 5-year OS after allo-HSCT or auto-HSCT (52% and 41%, respectively, p = 0.86), but worse RFS after auto-HSCT (p = 0.01). Among patients with FLT3–ITD AR > 0.44, allo-HSCT was superior to auto-HSCT in terms of OS and RFS. This study provides more evidence for a better characterization of patients with AML harboring FLT3–ITD mutations.
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- 2022
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17. Inflammation rapidly recruits mammalian GMP and MDP from bone marrow into regional lymphatics
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Juana Serrano-Lopez, Shailaja Hegde, Sachin Kumar, Josefina Serrano, Jing Fang, Ashley M Wellendorf, Paul A Roche, Yamileth Rangel, Leolene J Carrington, Hartmut Geiger, H Leighton Grimes, Sanjiv Luther, Ivan Maillard, Joaquin Sanchez-Garcia, Daniel T Starczynowski, and Jose A Cancelas
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endotoxemia ,inflammation ,myeloid progenitors ,circulation ,lymphatics ,bone marrow ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Innate immune cellular effectors are actively consumed during systemic inflammation, but the systemic traffic and the mechanisms that support their replenishment remain unknown. Here, we demonstrate that acute systemic inflammation induces the emergent activation of a previously unrecognized system of rapid migration of granulocyte-macrophage progenitors and committed macrophage-dendritic progenitors, but not other progenitors or stem cells, from bone marrow (BM) to regional lymphatic capillaries. The progenitor traffic to the systemic lymphatic circulation is mediated by Ccl19/Ccr7 and is NF-κB independent, Traf6/IκB-kinase/SNAP23 activation dependent, and is responsible for the secretion of pre-stored Ccl19 by a subpopulation of CD205+/CD172a+ conventional dendritic cells type 2 and upregulation of BM myeloid progenitor Ccr7 signaling. Mature myeloid Traf6 signaling is anti-inflammatory and necessary for lymph node myeloid cell development. This report unveils the existence and the mechanistic basis of a very early direct traffic of myeloid progenitors from BM to lymphatics during inflammation.
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- 2021
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18. Characteristics and Outcomes of Adult Patients in the PETHEMA Registry with Relapsed or Refractory FLT3-ITD Mutation-Positive Acute Myeloid Leukemia
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David Martínez-Cuadrón, Josefina Serrano, José Mariz, Cristina Gil, Mar Tormo, Pilar Martínez-Sánchez, Eduardo Rodríguez-Arbolí, Raimundo García-Boyero, Carlos Rodríguez-Medina, Carmen Martínez-Chamorro, Marta Polo, Juan Bergua, Eliana Aguiar, María L. Amigo, Pilar Herrera, Juan M. Alonso-Domínguez, Teresa Bernal, Ana Espadana, María J. Sayas, Lorenzo Algarra, María B. Vidriales, Graça Vasconcelos, Susana Vives, Manuel M. Pérez-Encinas, Aurelio López, Víctor Noriega, María García-Fortes, María C. Chillón, Juan I. Rodríguez-Gutiérrez, María J. Calasanz, Jorge Labrador, Juan A. López, Blanca Boluda, Rebeca Rodríguez-Veiga, Joaquín Martínez-López, Eva Barragán, Miguel A. Sanz, Pau Montesinos, and on behalf of the PETHEMA Group
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acute myeloid leukemia ,FLT3-ITD mutation ,real-world outcomes ,relapsed/refractory disease ,salvage therapy ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
This retrospective study investigated outcomes of 404 patients with relapsed/refractory (R/R) FMS-like tyrosine kinase 3 (FLT3)-internal tandem duplication (ITD) acute myeloid leukemia (AML) enrolled in the PETHEMA registry, pre-approval of tyrosine kinase inhibitors. Most patients (63%) had received first-line intensive therapy with 3 + 7. Subsequently, patients received salvage with intensive therapy (n = 261), non-intensive therapy (n = 63) or supportive care only (n = 80). Active salvage therapy (i.e., intensive or non-intensive therapy) resulted in a complete remission (CR) or CR without hematological recovery (CRi) rate of 42%. More patients achieved a CR/CRi with intensive (48%) compared with non-intensive (19%) salvage therapy (p < 0.001). In the overall population, median overall survival (OS) was 5.5 months; 1- and 5-year OS rates were 25% and 7%. OS was significantly (p < 0.001) prolonged with intensive or non-intensive salvage therapy compared with supportive therapy, and in those achieving CR/CRi versus no responders. Of 280 evaluable patients, 61 (22%) had an allogeneic stem-cell transplant after they had achieved CR/CRi. In conclusion, in this large cohort study, salvage treatment approaches for patients with FLT3-ITD mutated R/R AML were heterogeneous. Median OS was poor with both non-intensive and intensive salvage therapy, with best long-term outcomes obtained in patients who achieved CR/CRi and subsequently underwent allogeneic stem-cell transplant.
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- 2022
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19. Azacitidine vs. Decitabine in Unfit Newly Diagnosed Acute Myeloid Leukemia Patients: Results from the PETHEMA Registry
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Jorge Labrador, David Martínez-Cuadrón, Adolfo de la Fuente, Rebeca Rodríguez-Veiga, Josefina Serrano, Mar Tormo, Eduardo Rodriguez-Arboli, Fernando Ramos, Teresa Bernal, María López-Pavía, Fernanda Trigo, María Pilar Martínez-Sánchez, Juan-Ignacio Rodríguez-Gutiérrez, Carlos Rodríguez-Medina, Cristina Gil, Daniel García Belmonte, Susana Vives, María-Ángeles Foncillas, Manuel Pérez-Encinas, Andrés Novo, Isabel Recio, Gabriela Rodríguez-Macías, Juan Miguel Bergua, Víctor Noriega, Esperanza Lavilla, Alicia Roldán-Pérez, Miguel A. Sanz, Pau Montesinos, and on behalf of PETHEMA Group
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acute myeloid leukemia ,elderly ,treatment ,azacitidine ,decitabine ,hypomethylating agents ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
The hypomethylating agents, decitabine (DEC) and azacitidine (AZA), allowed more elderly acute myeloid leukemia (AML) patients to be treated. However, there are little direct comparative data on AZA and DEC. This multicenter retrospective study compared the outcomes of AZA and DEC in terms of response and overall survival (OS). Potential predictors associated with response and OS were also evaluated. A total of 626 AML patients were included (487 treated with AZA and 139 with DEC). Response rates were similar in both groups: CR was 18% with AZA vs. 23% with DEC (p = 0.20), CR/CRi was 20.5% vs. 25% (p = 0.27) and ORR was 32% vs. 39.5% (p = 0.12), respectively. Patients with leukocytes < 10 × 109/L, bone marrow blasts < 50% and ECOG ≥ 2 had higher ORR with DEC than with AZA. OS was similar in both groups: 10.4 months (95% CI: 9.2–11.7) vs. 8.8 months (95% CI: 6.7–11.0, p = 0.455), for AZA and DEC, respectively. Age (≥80 years), leukocytes (≥ 10 × 109/L), platelet count (9/L) and eGFR (≥45 mL/min/1.73 m2) were associated with higher OS with AZA compared to DEC. In conclusion, we found no differences in response and OS rates in AML patients treated with AZA or DEC.
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- 2022
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20. Networking for advanced molecular diagnosis in acute myeloid leukemia patients is possible: the PETHEMA NGS-AML project
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Claudia Sargas, Rosa Ayala, María Carmen Chillón, María J. Larráyoz, Estrella Carrillo-Cruz, Cristina Bilbao, Manuel Yébenes-Ramírez, Marta Llop, Inmaculada Rapado, Ramón García-Sanz, Iria Vázquez, Elena Soria, Yanira Florido-Ortega, Kamila Janusz, Carmen Botella, Josefina Serrano, David Martínez-Cuadrón, Juan Bergua, Mari Luz Amigo, Pilar Martínez-Sánchez, Mar Tormo, Teresa Bernal, Pilar Herrera-Puente, Raimundo García, Lorenzo Algarra, María J. Sayas, Lisette Costilla-Barriga, Esther Pérez-Santolalla, Inmaculada Marchante, Esperanza Lavilla-Rubira, Víctor Noriega, Juan M. Alonso-Domínguez, Miguel Á. Sanz, Joaquín Sánchez-Garcia, María T. Gómez-Casares, José A. Pérez-Simón, María J. Calasanz, Marcos González-Díaz, Joaquín Martínez-López, Eva Barragán, and Pau Montesinos
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Next-generation sequencing (NGS) has recently been introduced to efficiently and simultaneously detect genetic variations in acute myeloid leukemia (AML). However, its implementation in the clinical routine raises new challenges focused on the diversity of assays and variant reporting criteria. In order to overcome this challenge, the PETHEMA group established a nationwide network of reference laboratories aimed to deliver molecular results in the clinics. We report the technical cross-validation results for NGS panel genes during the standardization process and the clinical validation in 823 samples of 751 patients with newly diagnosed or refractory/relapse AML. Two cross-validation rounds were performed in seven nationwide reference laboratories in order to reach a consensus regarding quality metrics criteria and variant reporting. In the pre-standardization cross-validation round, an overall concordance of 60.98% was obtained with a great variability in selected genes and conditions across laboratories. After consensus of relevant genes and optimization of quality parameters the overall concordance rose to 85.57% in the second cross-validation round. We show that a diagnostic network with harmonized NGS analysis and reporting in seven experienced laboratories is feasible in the context of a scientific group. This cooperative nationwide strategy provides advanced molecular diagnostic for AML patients of the PETHEMA group (clinicaltrials gov. Identifier: NCT03311815).
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- 2020
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21. Hypomethylating agents in relapsed and refractory AML: outcomes and their predictors in a large international patient cohort
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Maximilian Stahl, Michelle DeVeaux, Pau Montesinos, Raphael Itzykson, Ellen K. Ritchie, Mikkael A. Sekeres, John D. Barnard, Nikolai A. Podoltsev, Andrew M. Brunner, Rami S. Komrokji, Vijaya R. Bhatt, Aref Al-Kali, Thomas Cluzeau, Valeria Santini, Amir T. Fathi, Gail J. Roboz, Pierre Fenaux, Mark R. Litzow, Sarah Perreault, Tae Kon Kim, Thomas Prebet, Norbert Vey, Vivek Verma, Ulrich Germing, Juan Miguel Bergua, Josefina Serrano, Steven D. Gore, and Amer M. Zeidan
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Specialties of internal medicine ,RC581-951 - Abstract
Abstract: Although hypomethylating agents (HMAs) are frequently used in the frontline treatment of older acute myeloid leukemia (AML) patients, little is known about their effectiveness in relapsed or primary treatment–refractory (RR)-AML. Using an international multicenter retrospective database, we studied the effectiveness of HMAs in RR-AML and evaluated for predictors of response and overall survival (OS). A total of 655 patients from 12 centers received azacitidine (57%) or decitabine (43%), including 290 refractory (44%) and 365 relapsed (56%) patients. Median age at diagnosis was 65 years. Best response to HMAs was complete remission (CR; 11%) or CR with incomplete count recovery (CRi; 5.3%). Additionally, 8.5% experienced hematologic improvement. Median OS was 6.7 months (95% confidence interval, 6.1-7.3). As expected, OS differed significantly by best response, with patients achieving CR and CRi having a median OS of 25.3 and 14.6 months, respectively. In multivariate analysis, the presence of ≤5% circulating blasts and a 10-day schedule of decitabine were associated with improved response rates, whereas the presence of >5% circulating blasts and >20% bone marrow blasts were associated with decreased OS. A significant subset of RR-AML patients (16%) achieved CR/CRi with HMAs and experienced a median OS of 21 months. Outside of a clinical trial, HMAs represent a reasonable therapeutic option for some patients with RR-AML.
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- 2018
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22. The Mutational Landscape of Acute Myeloid Leukaemia Predicts Responses and Outcomes in Elderly Patients from the PETHEMA-FLUGAZA Phase 3 Clinical Trial
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Rosa Ayala, Inmaculada Rapado, Esther Onecha, David Martínez-Cuadrón, Gonzalo Carreño-Tarragona, Juan Miguel Bergua, Susana Vives, Jesus Lorenzo Algarra, Mar Tormo, Pilar Martinez, Josefina Serrano, Pilar Herrera, Fernando Ramos, Olga Salamero, Esperanza Lavilla, Cristina Gil, Jose Luis López Lorenzo, María Belén Vidriales, Jorge Labrador, José Francisco Falantes, María José Sayas, Bruno Paiva, Eva Barragán, Felipe Prosper, Miguel Ángel Sanz, Joaquín Martínez-López, Pau Montesinos, and on behalf of the Programa para el Estudio de la Terapeutica en Hemopatias Malignas (PETHEMA) Cooperative Study Group
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clinical trials and observations ,myeloid neoplasia ,NGS ,variants ,leukemia ,myelocytic ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
We sought to predict treatment responses and outcomes in older patients with newly diagnosed acute myeloid leukemia (AML) from our FLUGAZA phase III clinical trial (PETHEMA group) based on mutational status, comparing azacytidine (AZA) with fludarabine plus low-dose cytarabine (FLUGA). Mutational profiling using a custom 43-gene next-generation sequencing panel revealed differences in profiles between older and younger patients, and several prognostic markers that were useful in young patients were ineffective in older patients. We examined the associations between variables and overall responses at the end of the third cycle. Patients with mutated DNMT3A or EZH2 were shown to benefit from azacytidine in the treatment-adjusted subgroup analysis. An analysis of the associations with tumor burden using variant allele frequency (VAF) quantification showed that a higher overall response was associated with an increase in TET2 VAF (odds ratio (OR), 1.014; p = 0.030) and lower TP53 VAF (OR, 0.981; p = 0.003). In the treatment-adjusted multivariate survival analyses, only the NRAS (hazard ratio (HR), 1.9, p = 0.005) and TP53 (HR, 2.6, p = 9.8 × 10−7) variants were associated with shorter overall survival (OS), whereas only mutated BCOR (HR, 3.6, p = 0.0003) was associated with a shorter relapse-free survival (RFS). Subgroup analyses of OS according to biological and genomic characteristics showed that patients with low–intermediate cytogenetic risk (HR, 1.51, p = 0.045) and mutated NRAS (HR, 3.66, p = 0.047) benefited from azacytidine therapy. In the subgroup analyses, patients with mutated TP53 (HR, 4.71, p = 0.009) showed a better RFS in the azacytidine arm. In conclusion, differential mutational profiling might anticipate the outcomes of first-line treatment choices (AZA or FLUGA) in older patients with AML. The study is registered at ClinicalTrials.gov as NCT02319135.
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- 2021
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23. DIFFERENCES IN EX-VIVO CHEMOSENSITIVITY TO ANTHRACYCLINES IN FIRST LINE ACUTE MYELOID LEUKEMIA
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Juan Eduardo Megias-Vericat, David Martínez-Cuadrón, Joaquin Martínez López, Juan Miguel Bergua, Mar Tormo, Josefina Serrano, Ataulfo González, Jaime Pérez de Oteyza, Susana Vives, Belen Vidriales, Pilar Herrera, Juan Antonio Vera, Aurelio López Martínez, Adolfo De la Fuente, María Lourdes Amador, José Ángel Hernández-Rivas, María Ángeles Fernández, Carlos Javier Cerveró, Daniel Morillo, Pilar Hernández Campo, Julián Gorrochategui, Daniel Primo, José Luis Rojas, Margarita Guenova, Joan Ballesteros, Miguel Ángel Sanz, and Pau Montesinos
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anthracycline ,ex-vivo test ,idarubicin ,daunorubicin ,mitoxantrone ,acute myeloid leukemia ,personalized medicine ,Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
BACKGROUND: Induction schedules in acute myeloid leukemia (AML) are based on combinations of cytarabine and anthracyclines. The choice of the anthracycline employed has been widely studied in multiple clinical trials showing similar complete remission rates. MATERIALS AND METHODS: Using an ex vivo test we have analyzed if a subset of AML patients may respond differently to cytarabine combined with idarubicin, daunorubicin or mitoxantrone. Bone marrow (BM) samples of 198 AML patients were incubated for 48 hours in 96 well plates, each well containing different drugs or drug combinations at different concentrations. Ex vivo drug sensitivity analysis was made using the PharmaFlow platform maintaining the BM microenvironment. Drug response was evaluated as depletion of AML blast cells in each well after incubation. Annexin V-FITC was used to quantify the ability of the drugs to induce apoptosis, and pharmacological responses were calculated using pharmacokinetic population models. RESULTS: Similar dose-respond graphs were generated for the three anthracyclines, with a slight decrease in EC50 with idarubicin (p=1.462E-06), whereas the interpatient variability of either drug was large. To identify those cases of selective sensitivity to anthracyclines, potency was compared, in terms of area under the curve. Differences in anthracycline monotherapy potency greater than 30% from 3 pairwise comparisons were identified in 28.3% of samples. Furthermore, different sensitivity was detected in 8.2% of patients comparing combinations of cytarabine and anthracyclines. DISCUSSION: A third of the patients could benefit of the use of this test in the first line induction therapy selection, although it should be confirmed in a clinical trial specifically designed.
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- 2019
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24. Characterization of the DNAM-1, TIGIT and TACTILE Axis on Circulating NK, NKT-Like and T Cell Subsets in Patients with Acute Myeloid Leukemia
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Isabel Valhondo, Fakhri Hassouneh, Nelson Lopez-Sejas, Alejandra Pera, Beatriz Sanchez-Correa, Beatriz Guerrero, Juan M. Bergua, Maria Jose Arcos, Helena Bañas, Ignacio Casas-Avilés, Joaquin Sanchez-Garcia, Josefina Serrano, Carmen Martin, Esther Duran, Corona Alonso, Rafael Solana, and Raquel Tarazona
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acute myeloid leukemia ,DNAM-1 ,NK cells ,NKT-like cells ,TACTILE ,T cells ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background: Acute myeloid leukemia (AML) remains a major clinical challenge due to poor overall survival, which is even more dramatic in elderly patients. TIGIT, an inhibitory receptor that interacts with CD155 and CD112 molecules, is considered as a checkpoint in T and NK cell activation. This receptor shares ligands with the co-stimulatory receptor DNAM-1 and with TACTILE. The aim of this work was to analyze the expression of DNAM-1, TIGIT and TACTILE in NK cells and T cell subsets in AML patients. Methods: We have studied 36 patients at the time of diagnosis of AML and 20 healthy volunteers. The expression of DNAM-1, TIGIT and TACTILE in NK cells and T cells, according to the expression of CD3 and CD56, was performed by flow cytometry. Results: NK cells, CD56− T cells and CD56+ T (NKT-like) cells from AML patients presented a reduced expression of DNAM-1 compared with healthy volunteers. An increased expression of TIGIT was observed in mainstream CD56− T cells. No differences were observed in the expression of TACTILE. Simplified presentation of incredibly complex evaluations (SPICE) analysis of the co-expression of DNAM-1, TIGIT and TACTILE showed an increase in NK and T cells lacking DNAM-1 and co-expressing TIGIT and TACTILE. Low percentages of DNAM-1−TIGIT+TACTILE+ NK cells and DNAM-1− TIGIT+TACTILE+ CD56− T cells were associated with a better survival of AML patients. Conclusions: The expression of DNAM-1 is reduced in NK cells and in CD4+ and CD8+ T cells from AML patients compared with those from healthy volunteers. An increased percentage of NK and T cells lacking DNAM-1 and co-expressing TIGIT and TACTILE is associated with patient survival, supporting the role of TIGIT as a novel candidate for checkpoint blockade.
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- 2020
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25. Clonal genetic evolution at relapse of favorable-risk acute myeloid leukemia with NPM1 mutation is associated with phenotypic changes and worse outcomes
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Carmen Martínez-Losada, Juana Serrano-López, Josefina Serrano-López, Nelida I. Noguera, Eduardo Garza, Liliana Piredda, Serena Lavorgna, María Antonietta Irno Consalvo, Tiziana Ottone, Valentina Alfonso, Juan Ramón Peinado, María Victoria Garcia-Ortiz, Teresa Morales-Ruiz, Andrés Jérez, Ana María Hurtado, Pau Montesinos, José Cervera, Esperanza Such, Marian Ibañez, Amparo Sempere, Miguel Ángel Sanz, Francesco Lo-Coco, and Joaquín Sánchez-García
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Published
- 2018
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26. Cytoplasmic localization of wild-type survivin is associated with constitutive activation of the PI3K/Akt signaling pathway and represents a favorable prognostic factor in patients with acute myeloid leukemia
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Juana Serrano-López, Josefina Serrano, Vianihuini Figueroa, Antonio Torres-Gomez, Salvador Tabares, Javier Casaño, Noemi Fernandez-Escalada, and Joaquín Sánchez-Garcia
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Diseases of the blood and blood-forming organs ,RC633-647.5 - Abstract
Survivin is over-expressed in most hematologic malignancies but the prognostic significance of the subcompartmental distribution of wild-type or splicing variants in acute myeloid leukemia has not been addressed yet. Using western blotting, we assessed the expression of wild-type survivin and survivin splice variants 2B and Delta-Ex3 in nuclear and cytoplasmic protein extracts in samples taken from 105 patients at the time of their diagnosis of acute myeloid leukemia. Given that survivin is a downstream effector of the PI3K/Akt signaling pathway, survivin expression was also correlated with pSer473-Akt. Wild-type survivin and the 2B splice variant were positive in 76.3% and 78.0% of samples in the nucleus, cytoplasm or both, whereas the Delta-Ex3 isoform was only positive in the nucleus in 37.7% of samples. Cytoplasmic localization of wild-type survivin was significantly associated with the presence of high levels of pSer473-Akt (P
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- 2013
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27. BURNOUT SYNDROME IN NURSING STAFF ATTACHED TO THE OPERATING ROOM AREA OF A HEALTH INSTITUTION.
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Alma Delia, Reyes Sánchez, primary, Yahaira Marlen, Espinosa Elizondo, primary, Carmen Josefina, Serrano Favela, primary, and Ma. Cristina, Ochoa Estrada, primary
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- 2024
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28. Identifying prognostic gene panels in acute myeloid leukemia
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Joaquin Sanchez-Garcia, Josefina Serrano, Esther Prados de La Torre, Juana Serrano-López, Clara Aparicio-Perez, E Barragán, and Pau Montesinos
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Hematology - Published
- 2023
29. Outcomes after intensive chemotherapy for secondary and myeloidrelated changes acute myeloid leukemia patients aged 60 to 75 years old: a retrospective analysis from the PETHEMA registry
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David Martínez-Cuadrón, Juan E. Megías-Vericat, Cristina Gil, Teresa Bernal, Mar Tormo, Pilar Martínez-Sánchez, Carlos Rodríguez-Medina, Josefina Serrano, Pilar Herrera, José A. Pérez Simón, María J. Sayas, Juan Bergua, Esperanza Lavilla-Rubira, Maria Luz Amigo, Celina Benavente, Jose L. López Lorenzo, Manuel M. Pérez-Encinas, María B. Vidriales, Mercedes Colorado, Beatriz De Rueda, Raimundo García-Boyero, Sandra Marini, Julio García-Suárez, María López-Pavía, Maria I. Gómez-Roncero, Víctor Noriega, Aurelio López, Jorge Labrador, Ana Cabello, Claudia Sossa, Lorenzo Algarra, Mariana Stevenazzi, Antonio Solana-Altabella, Blanca Boluda, and Pau Montesinos
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Hematology - Abstract
Treatment options for patients with secondary and myeloid related changes acute myeloid leukemia (sAML and AML-MRC) aged 60-75 years old are scarce and unsuitable. A pivotal trial showed that CPX-351 improved complete remission with/without incomplete recovery (CR/CRi) and overall survival (OS) as compared with standard 3+7. We retrospectively analyze outcomes of 765 patients with sAML and AML-MRC aged 60-75 years treated with intensive chemotherapy (IC), reported to the PETHEMA registry before CPX-351 became available. The CR/CRi rate was 48%, median OS 7.6 months (CI95%, 6.7-8.5) and event-free survival (EFS) 2.7 months (CI95%, 2-3.3), without differences between IC regimens and AML type. Multivariate analyses identified age ≥70 years, ECOG≥1 as independent adverse prognostic factors for CR/CRi and OS, while favorable/intermediate cytogenetic risk and NPM1 were favorable prognostic factors. Patients receiving allogeneic stem cell transplant (HSCT), auto-HSCT, and those who completed more consolidation cycles showed improved OS. This large study suggests that classical intensive chemotherapy could lead to similar CR/CRi rates with slightly shorter median OS than CPX-351.
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- 2023
30. Pethema NGS-AML Project. Final Analysis and Clinical Validation of New Genomic Classifications
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Claudia Sargas, Rosa Ayala, Maria Jose Larrayoz, Carmen Chillon, Estrella Carrillo, Cristina Bilbao, Esther Prados de La Torre, David Martinez-Cuadron, Rebeca Rodríguez-Veiga, Cristina Gil, Teresa Bernal, Juan Miguel Bergua Burgués, Lorenzo Algarra, Mar Tormo, Pilar Martínez Sánchez, Elena Soria, Josefina Serrano, Juan Manuel Alonso Dominguez, Raimundo García-Boyero, Maria Luz Amigo, Pilar Herrera, María J. Sayas, Esperanza Lavilla, Joaquín Martínez-López, María José Calasanz, Ramón García-Sanz, Jose A. Perez-Simon, María Teresa Gómez-Casares, Joaquín Sánchez-Garcia, Eva Barragán, and Pau Montesinos
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Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
31. Transcriptional and Genomic Characterization of Measurable Residual Disease (MRD) Cells in Acute Myeloid Leukemia (AML)
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Catia Patricia Simoes, Sara Villar, Beñat Ariceta, Juan-José Garcés, Leire Burgos, Diego Alignani, Sarvide Sarai, David Martinez-Cuadron, Juan Miguel Bergua Burgués, Susana Vives, Lorenzo Algarra, Mar Tormo, Pilar Martinez Sanchez, Josefina Serrano, Pilar Herrera, Fernando Ramos, Olga Salamero, Esperanza Lavilla, Cristina Gil, Jose Luiz Lopez Lorenzo, María Belén Vidriales, María Carmen Chillón Santos, Jorge Labrador, José F. Falantes, Maria Jose Sayas, Rosa Ayala, Joaquín Martínez-López, Ana Alfonso-Pierola, María José Calasanz, Felipe Prosper, Jesús San-Miguel, Miguel A. Sanz, Pau Montesinos, and Bruno Paiva
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Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
32. Conventional PCR Versus Next Generation Sequencing for Diagnosis of FLT3, IDH and NPM1 Mutations in Acute Myeloid Leukemia: Interim Analysis of the PCR-LMA Protocol of the Pethema Group
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Blanca Boluda, Claudia Sargas, Rosa Ayala, Maria Jose Larrayoz, María Carmen Chillón Santos, Estrella Carrillo-Cruz, Cristina Bilbao, Esther Prados de La Torre, Irene Navarro-Vicente, David Martinez-Cuadron, Rebeca Rodríguez-Veiga, Cristina Gil, Teresa Bernal del Castillo, Juan Miguel Bergua Burgués, Lorenzo Algarra, Mar Tormo, Pilar Martinez Sanchez, Elena Soria, Josefina Serrano, Juan Manuel Alonso Dominguez, Raimundo García-Boyero, Maria Luz Amigo, Pilar Herrera, Maria Jose Sayas, Esperanza Lavilla, Joaquín Martínez-López, María José Calasanz, Ramón García-Sanz, Jose A. Perez-Simon, María Teresa Gómez-Casares, Joaquín Sánchez-Garcia, Eva Barragán, and Pau Montesinos
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Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
33. Evolution of the Genetic and Biological Studies Performed at Diagnosis in Patients with Acute Myeloid Leukemia Included in the Pethema Epidemiological Registry (REALMOL Study)
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Jorge Labrador, David Martinez-Cuadron, Blanca Boluda, Josefina Serrano, Cristina Gil, Jose A. Perez-Simon, Teresa Bernal del Castillo, Juan Miguel Bergua Burgués, Joaquín Martínez-López, Carlos Rodriguez, María Belén Vidriales, Raimundo García-Boyero, Jesús Lorenzo Algarra, Marta Polo, Maria Jose Sayas, Mar Tormo, Pilar Herrera, Esperanza Lavilla, Fernando Ramos, Maria Luz Amigo, Susana Vives, Joaquín Sánchez-Garcia, Cristina Bilbao, María Carmen Chillón Santos, Maria Jose Larrayoz, Rosa Ayala, Eva Barragán, Miguel A. Sanz, Pau Montesinos, and Juan Manuel Alonso-Dominguez
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Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
34. Prognostic Impact of NPM1 and FLT3-ITD Mutations in Patients Treated with Non-Intensive Regimens: A Pethema Registry Study
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Edwin Uriel Suárez, Juan Manuel Alonso, Blanca Boluda, Esperanza Lavilla, Mar Tormo, Carmen Botella, Susana Vives, Carlos Rodriguez, Josefina Serrano, María José Sayas, Pilar Martínez Sánchez, Fernando Ramos, Teresa Bernal del Castillo, Lorenzo Algarra, Juan Miguel Bergua Burgués, José Pérez-Simón, Pilar Herrera, Manuel Barrios-García, Víctor Noriega-Concepción, Jóse Ángel Raposo-Puglia, Rosa Ayala, Eva Barragán, David Martinez-Cuadron, and Pau Montesinos
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Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
35. High-throughput RNA sequencing transcriptome analysis of ABC-DLBCL reveals several tumor evasion strategies
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Juana Serrano López, Carla Jiménez-Jiménez, Somchai Chutipongtanate, Josefina Serrano, Marta Rodríguez-Moreno, Álvaro Jiménez, Yesenia Jiménez, Sara G. Pedrero, Daniel Laínez, Juan Manuel Alonso-Domínguez, Pilar Llamas Sillero, Miguel Ángel Piris, and Joaquín Sánchez-García
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Gene Expression Regulation, Neoplastic ,Cancer Research ,Oncology ,Gene Expression Profiling ,High-Throughput Nucleotide Sequencing ,Humans ,Lymphoma, Large B-Cell, Diffuse ,Oncogenes ,Hematology ,Transcriptome - Abstract
Activated B-cell (ABC) lymphoma, a distinct molecular entity within diffuse large B-cell lymphoma (DLBCL), remains highly incurable, showing a worse response to standard immunochemotherapy. The discouraging results obtained in several clinical trials using proteasome inhibitors, tyrosine kinase inhibitors, or immunomodulators, lead to an intense search for new, potentially druggable biomarkers in DLBCL. In this study, we designed an experimental strategy for DLBCL to discover high- and low-abundance RNA-seq-derived transcripts involved in the oncogenic phenotype in patients diagnosed with ABC-DLBCL. Based on the results of a comparative analysis, 79 DE genes and two enriched gene sets related to metabolism and immunity were selected. Genes related to drug resistance, anti-inflammatory response, and tumor-cell dissemination were found to be up-regulated, while tumor suppressor genes were down-regulated. Then, we searched for the perturbagens most suitable for gene expression profiling (GEP) by iLINCS-CMap. Herein, we present a novel experimental approach that connects the omics signature of DLBCL with potential drugs for more accurate treatments.
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- 2022
36. Ergonomía en el quirófano
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Abilene Cirenia Escamilla-Ortiz and Josefina Serrano Pérez
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General Earth and Planetary Sciences ,General Environmental Science - Published
- 2023
37. No Evidence that CD33 rs12459419 Polymorphism Predicts Gemtuzumab Ozogamicin Response in Consolidation Treatment of Acute Myeloid Leukemia Patients: Experience of the PETHEMA Group
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Tamara Castaño-Bonilla, Eva Barragán, Claudia Sargas, Alejandro Sanz, Lorenzo Algarra, Pilar Herrera-Puente, Raimundo García-Boyero, Manuel Barrios, David Martinez-Cuadron, Rebeca Rodriguez-Veiga, Blanca Boluda, Cristina Gil, Josefina Serrano-López, Joaquín Martínez-López, María José Sayas-Lloris, María Teresa Olave, Rosalía Riaza-Grau, Teresa Bernal-Del Castillo, María José Larrayoz, Raquel Amigo, Antonio Jiménez-Velasco, Joaquín Sánchez, Rosa Ayala, Carlos Blas, Daniel Lainez, Juana Serrano-López, Miguel A. Sanz, Juan M. Alonso-Domínguez, and Pau Montesinos
- Subjects
Leukemia, Myeloid, Acute ,Aminoglycosides ,Article Subject ,Biochemistry (medical) ,Clinical Biochemistry ,Sialic Acid Binding Ig-like Lectin 3 ,Genetics ,Humans ,General Medicine ,Antibodies, Monoclonal, Humanized ,Molecular Biology ,Gemtuzumab ,Polymorphism, Single Nucleotide - Abstract
Gemtuzumab ozogamicin (GO) is a conjugate of a monoclonal antibody and calicheamicin, which has been reapproved for the treatment of acute myeloid leukemia (AML). AML patients with the CD33 rs12459419 CC genotype might benefit from the addition of GO to intensive treatment in contrast to patients with CT/TT genotypes. Nevertheless, contradictory results have been reported. We sought to shed light on the prediction of GO response in AML patients with rs12459419 polymorphism who were treated with GO in the consolidation ( n = 70 ) or reinduction ( n = 20 ) phase. The frequency distribution of the rs12459419 polymorphism in the complete cohort of patients was 44.4% ( n = 40 ), 50% ( n = 45 ), and 5.6% ( n = 5 ) for CC, CT, and TT genotypes, respectively. Regarding the patients treated with GO for consolidation, we performed a Kaplan-Meier analysis of overall survival and relapse-free survival according to the rs12459419 polymorphism (CC vs. CT/TT patients) and genetic risk using the European Leukemia Net (ELN) 2010 risk score. We also carried out a Cox regression analysis for the prediction of overall survival, with age and ELN 2010 as covariates. We found no statistical significance in the univariate or multivariate analysis. Additionally, we performed a global Kaplan-Meier analysis for the patients treated with GO for reinduction and did not find significant differences; however, our cohort was too small to draw any conclusion from this analysis. The use of GO in consolidation treatment is included in the approval of the compound; however, evidence regarding its efficacy in this setting is lacking. Rs12459419 polymorphism could help in the selection of patients who might benefit from GO. Regrettably, in our cohort, the rs12459419 polymorphism does not seem to be an adequate tool for the selection of patients who might benefit from the addition of GO in consolidation cycles.
- Published
- 2022
38. Real-Life Comparative Analysis of Prognostic Risk Classification According to ELN 2010, 2017 and 2022 in AML Patients
- Author
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Clara Aparicio Pérez, Ana Camila Gonzalez Teomiro, Maria Carmen Martinez Losada, Manuel Yébenes Ramírez, Carmen Martin Calvo, Esther Prados de La Torre, Joaquín Sánchez-Garcia, and Josefina Serrano
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
39. Indolent Acute Myeloid Leukemia with Long Survival in Patients Treated with Best Supportive Care Only: A Pethema Registry Study
- Author
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Jorge Labrador, Josefina Serrano, Laura Torres, Evelyn Acuña-Cruz, Jose A. Perez-Simon, Maria Lopez-Pavia, Gabriela Rodriguez Macias, Carmen Botella, Carlos Rodriguez, Pilar Martinez Sanchez, Maria Luz Amigo, Maria Victoria Cuevas, Teresa Bernal del Castillo, María Carmen Montes, Celina Benavente, Juan Ignacio Rodriguez-Gutierrez, Mar Tormo, Raimundo García-Boyero, Aurelio Lopez Martínez, Rafael Lluch Garcia, Jesús Lorenzo Algarra, Esperanza Lavilla, David Martinez-Cuadron, Miguel A. Sanz, and Pau Montesinos
- Subjects
Immunology ,Cell Biology ,Hematology ,Biochemistry - Published
- 2022
40. No Evidence that
- Author
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Tamara, Castaño-Bonilla, Eva, Barragán, Claudia, Sargas, Alejandro, Sanz, Lorenzo, Algarra, Pilar, Herrera-Puente, Raimundo, García-Boyero, Manuel, Barrios, David, Martinez-Cuadron, Rebeca, Rodriguez-Veiga, Blanca, Boluda, Cristina, Gil, Josefina, Serrano-López, Joaquín, Martínez-López, María José, Sayas-Lloris, María Teresa, Olave, Rosalía, Riaza-Grau, Teresa Bernal-Del, Castillo, María José, Larrayoz, Raquel, Amigo, Antonio, Jiménez-Velasco, Joaquín, Sánchez, Rosa, Ayala, Carlos, Blas, Daniel, Lainez, Juana, Serrano-López, Miguel A, Sanz, Juan M, Alonso-Domínguez, and Pau, Montesinos
- Subjects
Leukemia, Myeloid, Acute ,Aminoglycosides ,Sialic Acid Binding Ig-like Lectin 3 ,Humans ,Antibodies, Monoclonal, Humanized ,Gemtuzumab ,Polymorphism, Single Nucleotide - Abstract
Gemtuzumab ozogamicin (GO) is a conjugate of a monoclonal antibody and calicheamicin, which has been reapproved for the treatment of acute myeloid leukemia (AML). AML patients with the
- Published
- 2022
41. Measurable residual disease in elderly acute myeloid leukemia: results from the PETHEMA-FLUGAZA phase 3 clinical trial
- Author
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Miguel A. Sanz, Catia Simoes, Maria-Jose Calasanz, Lorenzo Algarra, Mar Tormo, María-José Sayas, Jesús F. San-Miguel, David Martínez-Cuadrón, Esperanza Lavilla, Fernando Ramos, Josefina Serrano, Juan-Miguel Bergua, J. Falantes, Joaquin Martinez-Lopez, Jorge Labrador, María-Belén Vidriales, Rosa Ayala, Cristina Gil, Susana Vives, J. López, Pilar Rodríguez Martínez, Sara Villar, Pilar Herrera, Olga Salamero, Bruno Paiva, Felipe Prosper, and Pau Montesinos
- Subjects
Oncology ,medicine.medical_specialty ,Neoplasm, Residual ,Myeloid ,PREDICTION ,Phases of clinical research ,law.invention ,HEMATOPOIETIC-CELL TRANSPLANTATION ,AGE ,AML ,Randomized controlled trial ,law ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Aged ,RISK ,Myeloid Neoplasia ,OLDER PATIENTS ,MUTATIONS ,business.industry ,Remission Induction ,Cytarabine ,Myeloid leukemia ,Hematology ,Prognosis ,medicine.disease ,INTENSIVE CHEMOTHERAPY ,GENE ,Fludarabine ,PROGNOSTIC VALUE ,body regions ,Clinical trial ,Leukemia, Myeloid, Acute ,Leukemia ,medicine.anatomical_structure ,business ,medicine.drug - Abstract
The value of measurable residual disease (MRD) in elderly patients with acute myeloid leukemia (AML) is inconsistent between those treated with intensive vs hypomethylating drugs, and unknown after semi-intensive therapy. We investigated the role of MRD in refining complete remission (CR) and treatment duration in the phase 3 FLUGAZA clinical trial, which randomized 283 elderly AML patients to induction and consolidation with fludarabine plus cytarabine (FLUGA) vs 5-azacitidine. After consolidation, patients continued treatment if MRD was =0.01% or stopped if MRD was
- Published
- 2021
42. Impact of Center-related Characteristics and Macroeconomic Factors on the Outcome of Adult Patients With Acute Lymphoblastic Leukemia Treated With Pediatric-inspired Protocols
- Author
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Pere, Barba, Mireia, Morgades, Pau, Montesinos, Jose, Gonzalez-Campos, Anna, Torrent, Cristina, Gil, Teresa, Bernal, Mar, Tormo, Santiago, Mercadal, Sandra, Novoa, Irene, García-Cadenas, M Paz Queipo, de Llano, Marta, Cervera, Rosa, Coll, Arancha, Bermudez, M Luz, Amigo, Silvia, Monsalvo, Jordi, Esteve, Raimundo, Garcia-Boyero, Andres, Novo, Jesús Maria, Hernandez Rivas, Antonia, Cladera, Pilar, Martinez-Sanchez, Josefina, Serrano, Maria Teresa, Artola, Beatriz, Soria, Eugenia, Abella, Ferran, Vall-Llovera, Juan, Bergua, Pilar, Herrera, Daniel, Barrios, and Josep Maria, Ribera
- Abstract
Altres ajuts: Asociación Española contra el Cáncer (GC16173697BIGA)
- Published
- 2022
43. Long-term survival after intensive chemotherapy or hypomethylating agents in AML patients aged 70 years and older: a large patient data set study from European registries
- Author
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Audrey Bidet, Hubert Serve, Pierre-Yves Dumas, Carsten Müller-Tidow, Josefina Serrano, Teresa Bernal, Sarah Bertoli, Juan Bergua, Eduardo Rodriguez Arbolí, Uwe Platzbecker, Pilar Martínez-Sánchez, Martin Bornhäuser, Eric Delabesse, Adolfo de la Fuente Burguera, Christian Recher, Arnaud Pigneux, Michael Kramer, Claudia D. Baldus, David Martínez-Cuadrón, Pau Montesinos, Emilie Bérard, Cristina Gil, Christoph Röllig, and Suzanne Tavitian
- Subjects
Cancer Research ,medicine.medical_specialty ,medicine.medical_treatment ,EARLY DEATH ,NEWLY-DIAGNOSED AML ,Intensive chemotherapy ,ACUTE MYELOID-LEUKEMIA ,REGIMENS ,Lower risk ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Long term survival ,MANAGEMENT ,Humans ,Medicine ,In patient ,VENETOCLAX ,Registries ,ELDERLY-PATIENTS ,AZACITIDINE ,Aged ,Aged, 80 and over ,Chemotherapy ,EPIGENETIC THERAPY ,business.industry ,Significant difference ,Myeloid leukemia ,Hematology ,Patient data ,CARE ,Leukemia, Myeloid, Acute ,Treatment Outcome ,Oncology ,Azacitidine ,business - Abstract
The outcome of acute myeloid leukemia patients aged 70 years or older is poor. Defining the best treatment option remains controversial especially when choosing between intensive chemotherapy and hypomethylating agents. We set up a multicentric European database collecting data of 3 700 newly diagnosed acute myeloid leukemia patients ≥70 years. The primary objective was to compare overall survival in patients selected for intensive chemotherapy (n = 1199) or hypomethylating agents (n = 1073). With a median follow-up of 49.5 months, the median overall survival was 10.9 (95% CI: 9.7–11.6) and 9.2 months (95% CI: 8.3–10.2) with chemotherapy and hypomethylating agents, respectively. Complete remission or complete remission with incomplete hematologic recovery was 56.1% and 19.7% with chemotherapy and hypomethylating agents, respectively (P
- Published
- 2022
44. Prognostic significance of FLT3-ITD length in AML patients treated with intensive regimens
- Author
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Elena Soria-Saldise, Isabel Recio, Estrella Carrillo, David Martínez-Cuadrón, Jorge Labrador, Juan A. López-López, Erik de Cabo, Carlos Blas, Carmen Chillón, Cristina Gil, Miguel A. Sanz, Rebeca Rodríguez-Veiga, María Teresa Olave, María José Larrayoz, J. A. Serrano, José Luis López-Lorenzo, Lorenzo Algarra, Eva Barragán, Carlos Rodríguez-Medina, María Belén Vidriales, Josefina Serrano, Daniel Lainez-González, Raimundo García, Rebeca Cuello, Joaquin Sanchez-Garcia, Joaquin Martinez-Lopez, Rosa Ayala, Tamara Castaño-Bonilla, Pau Montesinos, Eduardo Anguita, Juan M. Alonso-Domínguez, Maria Jose Sayas, Alberto Cantalapiedra, Mamen Mateos, Claudia Sargas, and Cristina Bilbao-Syeiro
- Subjects
Male ,Oncology ,FLT3/ITD ,IMPACT ,Insertion site ,Allelic ratio ,RECOMMENDATIONS ,Prognostic markers ,hemic and lymphatic diseases ,Mutational status ,Aged, 80 and over ,Multidisciplinary ,Molecular medicine ,Remission Induction ,Middle Aged ,Prognosis ,Leukemia, Myeloid, Acute ,Medicine ,Female ,psychological phenomena and processes ,Flt3 itd ,Adult ,medicine.medical_specialty ,Adolescent ,Science ,ACUTE MYELOID-LEUKEMIA ,Newly diagnosed ,DIAGNOSIS ,Disease-Free Survival ,Article ,Acute myeloid leukaemia ,Young Adult ,MUTANT LEVEL ,Internal medicine ,MANAGEMENT ,medicine ,Overall survival ,Humans ,Oncogenesis ,Aged ,Retrospective Studies ,MUTATIONS ,business.industry ,Complete remission ,Adult Acute Myeloid Leukemia ,INTERNAL TANDEM DUPLICATION ,body regions ,SIZE ,fms-Like Tyrosine Kinase 3 ,Mutation ,business - Abstract
FLT3-ITD mutations are detected in approximately 25% of newly diagnosed adult acute myeloid leukemia (AML) patients and confer an adverse prognosis. The FLT3-ITD allelic ratio has clear prognostic value. Nevertheless, there are numerous manuscripts with contradictory results regarding the prognostic relevance of the length and insertion site (IS) of the FLT3-ITD fragment. We aimed to assess the prognostic impact of these variables on the complete remission (CR) rates, overall survival (OS) and relapse-free survival (RFS) of AML patients with FLT3-ITDmutations. We studied the FLT3-ITD length of 362 adult AML patients included in the PETHEMA AML registry. We tried to validate the thresholds of ITD length previously published (i.e., 39 bp and 70 bp) in intensively treated AML patients (n = 161). We also analyzed the mutational profile of 118 FLT3-ITD AML patients with an NGS panel of 39 genes and correlated mutational status with the length and IS of ITD. The AUC of the ROC curve of the ITD length for OS prediction was 0.504, and no differences were found when applying any of the thresholds for OS, RFS or CR rate. Only four out of 106 patients had ITD IS in the TKD1 domain. Our results, alongside previous publications, confirm that FLT3-ITD length lacks prognostic value and clinical applicability.
- Published
- 2021
45. AML-122 Midostaurin Maintenance versus Allo SCT versus W&W in FLT3-Mutated AML: A 'Real-Life' Multicenter Study
- Author
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Adolfo de la Fuente, Marina Diaz Beya, Paola Beneit, Ainhoa Fernandez Moreno, Montserrat Arnan Sangerman, Ana Garrido, Susana Vives Polo, Maria Garcia Fortes, Antonia Sampol Mayol, Jorge Labrador, Antoni Garcia Guinon, Cristina Gil Cortes, Juan Bergua, Mayte Olave, Maria Luz Amigo, Xavi Ortin, Ferran Vall-LLovera, Monica Estevez, Antonio Diaz-Lopez, Josefina Serrano, and Mar Tormo
- Subjects
Cancer Research ,Oncology ,Hematology - Published
- 2022
46. Poster: AML-122 Midostaurin Maintenance versus Allo SCT versus W&W in FLT3-Mutated AML: A 'Real-Life' Multicenter Study
- Author
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Adolfo de la Fuente, Marina Diaz Beya, Paola Beneit, Ainhoa Fernandez Moreno, Montserrat Arnan Sangerman, Ana Garrido, Susana Vives Polo, Maria Garcia Fortes, Antonia Sampol Mayol, Jorge Labrador, Antoni Garcia Guinon, Cristina Gil Cortes, Juan Bergua, Mayte Olave, Maria Luz Amigo, Xavi Ortin, Ferran V Poster, Monica Estevez, Antonio Diaz-Lopez, Josefina Serrano, and Mar Tormo
- Subjects
Cancer Research ,Oncology ,Hematology - Published
- 2022
47. Impact of Measurable Residual Disease (MRD) By Multiparameter Flow Cytometry (MFC): A Real-World Study in 1,076 Patients with Acute Myeloid Leukemia (AML)
- Author
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Joaquin Martinez-Lopez, Sofía Grille, Josefina Serrano, Pau Montesinos, Jesús F. San-Miguel, Bruno Paiva, C. Rodriguez, Maria Luz Amigo, Fabián Tarín, Joaquin Sanchez, Teresa Bernal del Castillo, María Belén Vidriales, Enrique Colado, Miguel A. Sanz, Juan Manuel Alonso Dominguez, Marcos González, Teresa Caballero-Velázquez, Mercedes Colorado, Maria Desamparados Sampere Talens, Raimundo García-Boyero, Jaime Pérez de Oteyza, Lourdes Cordón, Maria Jose Sayas, Manuel Perez Encinas, Olga Pérez-López, Lissette Del Pilar Costilla, Celina Benavente, Alberto Orfao, Claudia Sossa, David Martínez-Cuadrón, José A. Pérez-Simón, María Teresa Cedena, Manuel Barrios Garcia, Jesús Lorenzo Algarra, and Carmen Botella
- Subjects
business.industry ,hemic and lymphatic diseases ,Immunology ,Cancer research ,Medicine ,Myeloid leukemia ,Cell Biology ,Hematology ,Disease ,Multiparameter flow cytometry ,business ,Residual ,Biochemistry - Abstract
Background: Evaluation of MRD is standard in patients with AML. However, the role of decentralized MRD assessment for risk stratification in AML remains largely unknown, and so it does which methodological aspects are critical to empower the evaluation of MRD with prognostic significance, particularly if using MFC. Aim: To evaluate the role of decentralized MRD assessment using MFC for risk stratification and putative treatment individualization of patients with AML. Methods: This study was performed on 1,076 AML patients in complete remission (CR) after 7+3 induction chemotherapy, in whom MRD was evaluated by MFC in local laboratories over a period of 20 years in the PETHEMA group. We conducted a survey of technical aspects of MFC based MRD testing in the laboratories of the 60 participating Hospitals, to determine the impact of methodological heterogeneity in the prognostic value of MFC. Results: We first investigated the most effective MRD cutoff to stratify patients' risk at first remission. Patients were segmented into progressively higher cutoffs, starting at 0.01% followed by 0.05%, 0.1%, 0.5% and 1%. Our results showed that 0.1% reached higher statistical significance to discriminate patients with different relapse-free survival (RFS, HR: 0.77; P = .001) and overall survival (OS, HR: 0.73; P = .001). In multivariate analyses together with patients' age, WBC, genetic risk and post-consolidation therapy, MRD status was selected as an independent prognostic factor for OS. To further define the utility of "real-world" MRD assessment using MFC in risk stratification of AML, recursive partitioning was performed using the prognostic and treatment related factors selected in the multivariate Cox model for OS. Of the four variables evaluated, hematopoietic stem cell transplantation (HSCT, regardless of autologous or allogeneic source) vs no transplant emerged as the best single discriminator for OS, followed by genetic risk, age and MRD status. There were two branching points defined by MRD status; the first in patients ≤60 years with intermediate genetic risk who were not transplanted and the second in patients with adverse genetics who were not transplanted, in whom Forty-nine of the 60 hospitals (82%) responded to the survey on questions regarding the measurement of MRD using MFC in the PETHEMA LMA 1999, 2007 and 2010 protocols, providing information corresponding to 966 of the 1,076 (90%) patients regarding the number of markers, preparation of samples, instruments, approach (ie, LAIP, DfN or LAIP+DfN), number of cells to define a cluster, etc. The survey revealed significant heterogeneity intra- and inter-protocols that reflected improvement in MFC assessment of MRD over time, in the absence of harmonization nor standardization at the national level. Accordingly, we investigated if the heterogeneity in methodological, interpretation and reporting aspects of MFC based MRD testing were hampering its ability to predict outcome independently of other patient and treatment related factors. Strikingly, our results showed that except for the denominator used to calculate MRD burden (ie, total nucleated cells vs leukocytes), lack of standardization in all other parameters had an impact on the ability of MFC to predict outcomes in AML (Figure). Namely, panels with ≤4 markers or ≤2 combinations failed to identify patients with significantly different RFS according to MRD status, and MFC-based MRD monitoring was prognostic only when >500,000 cells were measured. Only MRD assessment using patient-specific panels was predictive of outcome. Conclusions: We report here one of the largest studies investigating the role of MRD monitoring using MFC. Our results confirmed that detection of MRD identifies patients in CR/CRi with inferior survival, but uncovered that decentralized MRD testing lacks significance when compared to other baseline risk factors and in the context of risk-adapted post-consolidation strategies. Thus, while this study demonstrated that "real-world" decentralized assessment of MRD using MFC does provide prognostic information in AML patients at first remission, our results question its readiness for risk stratification towards clinical decisions outside trials, at least until adequate standardization of this technique is achieved. Figure Disclosures Paiva: SkylineDx: Consultancy; Takeda: Consultancy, Honoraria, Research Funding; Roche: Research Funding; Adaptive: Honoraria; Amgen: Honoraria; Janssen: Consultancy, Honoraria; Karyopharm: Consultancy, Honoraria; Kite: Consultancy; Celgene: Consultancy, Honoraria, Research Funding, Speakers Bureau; Sanofi: Consultancy, Honoraria, Research Funding. Alonso Dominguez:Celgene: Research Funding; Incyte: Research Funding; Pfizer: Research Funding. Martinez-Lopez:Janssen: Speakers Bureau; Altum: Membership on an entity's Board of Directors or advisory committees, Patents & Royalties; Hosea: Membership on an entity's Board of Directors or advisory committees, Patents & Royalties; Roche: Speakers Bureau; Amgen: Speakers Bureau; Takeda: Speakers Bureau; Vivia Biotech: Honoraria; Novartis: Research Funding; BMS: Research Funding, Speakers Bureau; Incyte: Research Funding, Speakers Bureau. Sossa:Astellas: Honoraria; Roche: Honoraria; Takeda: Honoraria; Novo: Honoraria. San-Miguel:Roche, AbbVie, GlaxoSmithKline, and Karyopharm: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb, Celgene, Novartis, Takeda, Amgen, MSD, Janssen, and Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees.
- Published
- 2020
48. La simulación en cirugía abierta
- Author
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Abilene Cirenia Escamilla-Ortiz and Josefina Serrano Pérez
- Subjects
General Earth and Planetary Sciences ,General Environmental Science - Published
- 2022
49. Inflammation rapidly recruits mammalian GMP and MDP from bone marrow into regional lymphatics
- Author
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H. Leighton Grimes, Juana Serrano-Lopez, Jose A. Cancelas, Hartmut Geiger, Paul A. Roche, Sanjiv A. Luther, Sachin Kumar, Shailaja Hegde, Daniel T. Starczynowski, Jing Fang, Josefina Serrano, Leolene J Carrington, Ivan Maillard, Joaquin Sanchez-Garcia, Ashley M Wellendorf, and Yamileth Rangel
- Subjects
0301 basic medicine ,Male ,medicine ,Time Factors ,Mouse ,Lymphadenopathy ,immunology ,0302 clinical medicine ,Immunology and Inflammation ,Cell Movement ,Granulocyte-Macrophage Progenitor Cells ,Biology (General) ,Child ,Cells, Cultured ,Aged, 80 and over ,Mice, Knockout ,endotoxemia ,General Neuroscience ,General Medicine ,myeloid progenitors ,Middle Aged ,Lymphatic system ,medicine.anatomical_structure ,Phenotype ,Child, Preschool ,Medicine ,circulation ,lymphatics ,Female ,Lymph ,Stem cell ,medicine.symptom ,Inflammation Mediators ,Research Article ,Human ,Signal Transduction ,Adult ,bone marrow ,Adolescent ,QH301-705.5 ,Science ,Inflammation ,Biology ,General Biochemistry, Genetics and Molecular Biology ,Lymphatic System ,03 medical and health sciences ,Young Adult ,Immune system ,Animals ,Humans ,Cell Lineage ,human ,Progenitor cell ,mouse ,Myeloid Progenitor Cells ,Aged ,General Immunology and Microbiology ,Dendritic cell ,Mice, Inbred C57BL ,Disease Models, Animal ,030104 developmental biology ,inflammation ,Immunology ,Bone marrow ,030215 immunology - Abstract
Innate immune cellular effectors are actively consumed during systemic inflammation, but the systemic traffic and the mechanisms that support their replenishment remain unknown. Here, we demonstrate that acute systemic inflammation induces the emergent activation of a previously unrecognized system of rapid migration of granulocyte-macrophage progenitors and committed macrophage-dendritic progenitors, but not other progenitors or stem cells, from bone marrow (BM) to regional lymphatic capillaries. The progenitor traffic to the systemic lymphatic circulation is mediated by Ccl19/Ccr7 and is NF-κB independent, Traf6/IκB-kinase/SNAP23 activation dependent, and is responsible for the secretion of pre-stored Ccl19 by a subpopulation of CD205+/CD172a+ conventional dendritic cells type 2 and upregulation of BM myeloid progenitor Ccr7 signaling. Mature myeloid Traf6 signaling is anti-inflammatory and necessary for lymph node myeloid cell development. This report unveils the existence and the mechanistic basis of a very early direct traffic of myeloid progenitors from BM to lymphatics during inflammation., eLife digest When the body becomes infected with disease-causing pathogens, such as bacteria, the immune system activates various mechanisms which help to fight off the infection. One of the immune system’s first lines of defense is to launch an inflammatory response that helps remove the pathogen and recruit other immune cells. However, this response can become overactivated, leading to severe inflammatory conditions that damage healthy cells and tissues. A second group of cells counteract this over inflammation and are different to the ones involved in the early inflammatory response. Both types of cells – inflammatory and anti-inflammatory – develop from committed progenitors, which, unlike stem cells, are already destined to become a certain type of cell. These committed progenitors reside in the bone marrow and then rapidly travel to secondary lymphoid organs, such as the lymph nodes, where they mature into functioning immune cells. During this journey, committed progenitors pass from the bone marrow to the lymphatic vessels that connect up the different secondary lymphoid organs, and then spread to all tissues in the body. Yet, it is not fully understood what exact route these cells take and what guides them towards these lymphatic tissues during inflammation. To investigate this, Serrano-Lopez, Hegde et al. used a combination of techniques to examine the migration of progenitor cells in mice that had been treated with lethal doses of a bacterial product that triggers inflammation. This revealed that as early as one to three hours after the onset of infection, progenitor cells were already starting to travel from the bone marrow towards lymphatic vessels. Serrano-Lopez, Hegde et al. found that a chemical released by an “alarm” immune cell already residing in secondary lymphoid organs attracted these progenitor cells towards the lymphatic tissue. Further experiments showed that the progenitor cells travelling to secondary lymphoid organs were already activated by bacterial products. They then follow the chemical released by alarm immune cells ready to respond to the immune challenge and suppress inflammation. These committed progenitors were also found in the inflamed lymph nodes of patients. These findings suggest this rapid circulation of progenitors is a mechanism of defense that contributes to the fight against severe inflammation. Altering how these cells migrate from the bone marrow to secondary lymphoid organs could provide a more effective treatment for inflammatory conditions and severe infections. However, these approaches would need to be tested further in the laboratory and in clinical trials.
- Published
- 2021
50. Author response: Inflammation rapidly recruits mammalian GMP and MDP from bone marrow into regional lymphatics
- Author
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Ashley M Wellendorf, H. Leighton Grimes, Hartmut Geiger, Paul A. Roche, Sanjiv A. Luther, Josefina Serrano, Shailaja Hegde, Daniel T. Starczynowski, Ivan Maillard, Leolene J Carrington, Jose A. Cancelas, Sachin Kumar, Jing Fang, Yamileth Rangel, Joaquin Sanchez-Garcia, and Juana Serrano-Lopez
- Subjects
Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,Lymphatic system ,business.industry ,medicine ,Inflammation ,Bone marrow ,medicine.symptom ,business - Published
- 2021
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