ABSTRACT
Many studies have reported that the impact of high temperatures affects physiology, welfare, health, and productivity of farm animals, and among these, the dairy cattle farming is one of the livestock sectors that suffers the greatest effects. The temperature-humidity index (THI) represents the state of the art in the evaluation of heat stress conditions in dairy cattle but often its measurement is not carried out in sheds. For this reason, the aim of this study was the monitoring of the THI in three dairy cattle farms in Mugello (Tuscany) to understand its influence on dairy cows. THI values were calculated using meteorological data from direct observation in sheds and outdoor environments. Data relating to the animal's behavior were collected using radio collars. The Pearson test and Mann-Kendall test were used for statistical analysis. The results highlighted a significant (P < 0.001) upward trend in THImax during the last 30 years both in Low Mugello (+ 1.1 every 10 years) and in High Mugello (+ 0.9 every 10 years). In Low Mugello sheds, during the period 2020-2022, more than 70% of daytime hours during the summer period were characterized by heat risk conditions (THI > 72) for livestock. On average the animals showed a significant (P < 0.001) decrease in time spent to feeding and rumination, both during the day and the night, with a significant (P < 0.001) increase in inactivity. This study fits into the growing demand for knowledge of the micro-climatic conditions within farms in order to support resilience actions for protecting both animal welfare and farm productivity from the effects of climate change. This could also be carried out thanks to estimation models which, based on the meteorological conditions forecast, could implement the thermal stress indicator (THI) directly from the high-resolution meteorological model, allowing to get a prediction of the farm's potential productivity loss based on the expected THI.
Subject(s)
Heat Stress Disorders , Hot Temperature , Animals , Female , Cattle , Humidity , Seasons , Temperature , Heat-Shock Response , Heat Stress Disorders/veterinary , Lactation , MilkABSTRACT
The taxonomic assemblage and functions of the plant bacterial community are strongly influenced by soil and host plant genotype. Crop breeding, especially after the massive use of nitrogen fertilizers which led to varieties responding better to nitrogen fertilization, has implicitly modified the ability of the plant root to recruit an effective bacterial community. Among the priorities for harnessing the plant bacterial community, plant genotype-by-microbiome interactions are stirring attention. Here, we analyzed the effect of plant variety and fertilization on the rhizosphere bacterial community. In particular, we clarified the presence in the bacterial community of a varietal effect of N and P fertilization treatment. 16S rRNA gene amplicon sequence analysis of rhizospheric soil, collected from four wheat varieties grown under four N-P fertilization regimes, and quantification of functional bacterial genes involved in the nitrogen cycle (nifH; amoA; nirK and nosZ) were performed. Results showed that variety played the most important role and that treatments did not affect either bacterial community diversity or bacterial phyla abundance. Variety-specific response of rhizosphere bacterial community was detected, both in relation to taxa (Nitrospira) and metabolic functions. In particular, the changes related to amino acid and aerobic metabolism and abundance of genes involved in the nitrogen cycle (amoA and nosZ), suggested that plant variety may lead to functional changes in the cycling of the plant-assimilable nitrogen.
Subject(s)
Rhizosphere , Triticum , Bacteria/metabolism , Fertilization , Nitrogen/metabolism , Plant Breeding , Plant Roots/metabolism , Plants/metabolism , RNA, Ribosomal, 16S/genetics , RNA, Ribosomal, 16S/metabolism , Soil/chemistry , Soil Microbiology , Triticum/geneticsABSTRACT
Although the use of pesticides has highlighted obvious advantages on agricultural yields, intensive and widespread pesticide use raises serious environmental and health concerns. In particular, organophosphate pesticides represent >40% of the totality used in the field of agriculture, and developing countries face the issue of agricultural poisoning, also due to scarce monitoring programs. In this work, a decentralized, miniaturized, sustainable, and portable paper-based electrochemical biosensor for the quantification of organophosphorus pesticides' level has been realized. The proposed approach highlights the use of a very common paper-based substrate, namely, office paper. Office paper offers several advantages due to its nature: it allows one to print conductive strips for electrochemical connection, loading bio-hybrid nanosized probes (Prussian blue, carbon black, and butyrylcholinesterase), evaluating pesticides and reducing waste disposal compared to plastic-based strips. The portable system has been characterized by a low detection limit of 1.3 ng/mL, and accordingly to total discovered pesticide contents in EU agricultural soils, up to ca. 3 µg/mL, it can offer a valuable tool for fast monitoring. To demonstrate its effectiveness, soil and fruit vegetables have been used to perform in situ quantification. Good recovery percentages between 90 and 110% have been achieved in different matrices, highlighting to be suitable for field measurements, and a good correlation has been obtained in comparison with LC-MS analysis.
Subject(s)
Biosensing Techniques , Pesticides , Agriculture , Organophosphorus Compounds , Pesticides/analysis , SoilABSTRACT
We report the realization of a Hanbury Brown and Twiss (HBT)-like experiment with a gas of interacting bosons at low temperatures. The low-temperature regime is reached in a three-dimensional optical lattice and atom-atom correlations are extracted from the detection of individual metastable helium atoms after a long free fall. We observe, in the noncondensed fraction of the gas, a HBT bunching whose properties strongly deviate from the HBT signals expected for noninteracting bosons. In addition, we show that the measured correlations reflect the peculiar quantum statistics of atoms belonging to the quantum depletion and of the Bogoliubov phonons, i.e., of collective excitations of the many-body quantum state. Our results demonstrate that atom-atom correlations provide information about the quantum state of interacting particles, extending the interest of HBT-like experiments beyond the case of noninteracting particles.
ABSTRACT
Pulmonary infections (PIs) are a major complication of patients with myelodysplastic syndromes (MDS). We retrospectively evaluated 234 MDS patients treated with azacytidine (AZA). The total number of AZA cycles was 2886 (median 8 cycles per patient). There were 111 episodes of PI (3.8% of AZA cycles) in 81 patients (34.6%). PIs were considered of fungal origin in 27 cases (24.3%), associated to bacteremia in 11 cases (9.9%), to influenza infection in two cases (1.8%) and of unknown origin in the remaining 71 cases (64.0%). Forty-five PI episodes were documented in cycles 1 to 4 of AZA (5.1% of 875 cycles) and the remaining 66 episodes beyond the fourth cycle (3.2% of 2011 cycles) (P = .017). Overall, a fungal PI was documented in 13/875 (1.5%) cycles 1 to 4 and in 13/2011 (0.6%) cycles beyond the fourth cycle (P = .001). A baseline chronic pulmonary disease was significantly associated to a higher risk of severe PIs. In the survival analysis, cases of PI in patients who progressed to acute leukemia (PAL) were excluded, in view of the predominant influence of PAL on the outcome of the patients. A PI unrelated to PAL documented during the first 4 AZA cycles was an independent factor predicting lower survival (OR, 2.13; 95% CI, 1.37-3.33; P = .001). In conclusion, PIs are common in MDS patients receiving AZA, in particular during the first cycles of treatment and are associated with an unfavorable outcome. The results of our study raise the issue of the need of a tailored infection prevention strategy.
Subject(s)
Antimetabolites, Antineoplastic/adverse effects , Azacitidine/adverse effects , Lung/microbiology , Myelodysplastic Syndromes/drug therapy , Respiratory Tract Infections/etiology , Aged , Female , Follow-Up Studies , Humans , Lung/drug effects , Male , Middle Aged , Myelodysplastic Syndromes/pathology , Prognosis , Respiratory Tract Infections/chemically induced , Retrospective Studies , Survival RateABSTRACT
Predictive factors of response to hypomethylating agents (HMA) in elderly acute myeloid leukemia (AML) patients remain unclear in the real-life setting and no direct comparison between azacitidine (AZA) and decitabine (DEC) has been carried out. We retrospectively evaluated 110 AML patients treated with HMA (78 AZA, 32 DEC) as first-line therapy outside of clinical trials. Median age was 75 years (range 58-87). The median overall survival (OS) of the entire cohort was 8.0 months (95% CI 6.1-10), without significant differences among the subgroups: AZA 8.8 months vs DEC 6.3 months (p = 0.291). HMA treatment yielded an overall response rate (ORR) of 40% (AZA 37% vs DEC 47%, p = 0.237). A stable disease (SD) after 4 HMA cycles was not associated with a worse survival outcome compared with an early optimal response. Factors independently associated with a better OS were transfusion independence during treatment (p = 0.049), achievement of an optimal response to treatment (p < 0.001), and a baseline hemoglobin level ≥ 9.25 (p = 0.018). A bone marrow (BM) blast count ≥ 30% (p < 0.001) and a therapy-related AML (p = 0.008) remain poor survival predictors. Of the available biologic features, an adverse risk category according to the ELN classification was significantly associated with a shorter survival over the intermediate risk category (p = 0.034). Disease progression remains the primary cause of death. Infectious complications were more severe (p = 0.036) and occurred earlier (p = 0.006) in the DEC group compared with that of the AZA group. In conclusion, clinical prognostic factors associated to response and survival have been identified without significant associations concerning overall outcomes between the two HMAs.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Azacitidine/therapeutic use , DNA Methylation/drug effects , DNA, Neoplasm/drug effects , Decitabine/therapeutic use , Leukemia, Myeloid, Acute/drug therapy , Aged , Aged, 80 and over , Bone Marrow/pathology , Cause of Death , Cell Count , DNA, Neoplasm/chemistry , Disease Progression , Disease-Free Survival , Female , Hemoglobins/analysis , Humans , Infections/etiology , Infections/mortality , Kaplan-Meier Estimate , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Neoplastic Stem Cells , Proportional Hazards Models , Retrospective Studies , Treatment OutcomeABSTRACT
Monosomal karyotype confers a poor prognosis in patients with acute myeloid leukemia. Here, we determined the impact of the type of remission-induction chemotherapy and the impact of having a donor in younger acute myeloid leukemia patients with a monosomal karyotype included in two phase III trials. In the first trial patients were randomized to receive either daunorubicin, mitoxantrone, or idarubicin in addition to standard-dose cytarabine and etoposide for induction chemotherapy. In the second trial patients were randomized to standard-dose cytarabine or high-dose cytarabine induction, both with daunorubicin and etoposide. In both trials, patients who achieved a complete remission with or without complete hematologic recovery underwent allogeneic hematopoietic stem cell transplantation if they had a donor; otherwise, they underwent autologous transplantation. In comparison to patients with intermediate-risk cytogenetics without a monosomal karyotype (n=1,584) and with adverse cytogenetics without a monosomal karyotype (n=218), patients with a monosomal karyotype (n=188) were more likely not to achieve a complete remission with or without count recovery [odds ratio=2.85, 95% confidence interval (95%, CI): 2.10-3.88] and had shorter overall survival [hazard ratio, (HR)=2.44, 95% CI: 2.08-2.88]. There was no impact of the type of anthracycline or of the dose of cytarabine on outcomes in patients with a monosomal karyotype. Among monosomal karyo type patients who achieved a complete remission with or without count recovery, HLA-identical related donor availability was associated with longer survival from complete remission with or without count recovery (HR=0.59, 95% CI: 0.37-0.95). ClinicalTrials.gov identifiers: AML-10: NCT00002549; AML-12: NCT00004128.
Subject(s)
Abnormal Karyotype , Hematopoietic Stem Cell Transplantation , Leukemia, Myeloid, Acute/genetics , Leukemia, Myeloid, Acute/therapy , Monosomy/genetics , Adolescent , Adult , Age Factors , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Female , Hematopoietic Stem Cell Transplantation/adverse effects , Hematopoietic Stem Cell Transplantation/methods , Humans , Induction Chemotherapy , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/mortality , Male , Middle Aged , Odds Ratio , Prognosis , Survival Analysis , Transplantation, Homologous , Treatment Outcome , Young AdultABSTRACT
The outcome of high-risk myelodysplastic syndrome (MDS) patients treated with 5-azacitidine (5-AZA) in the real-life setting remains largely unknown. We evaluated 110 MDS patients (IPSS intermediate 2/high) treated outside of clinical trials at a single institution between September 2003 and January 2017. Median duration of therapy was 9.5 cycles. The overall survival (OS) of the whole cohort was 66.1% at 1 year and 38.3% at 2 years. No differences in terms of OS were observed with regard to gender (p = 0.622) and age at baseline (< 65 years, 65-75, and > 75 years, p = 0.075). According to the IPSS-R, the very high-risk group had an inferior 2-year OS (17%) compared with intermediate-group patients (64%, p < 0.001). Transfusion independency at baseline was identified as a favorable prognostic factor on 1-year (66.8%) and 2-year OS (43.4%) (p < 0.001). After four cycles, the persistence of bone marrow blasts > 10% identified patients with a worse outcome, with a 2-year OS of 9.4% (p = 0.002). The occurrence of an infection during the first four cycles impacted on the 2-year OS (31.6% vs 58.3% in patients without infections, p = 0.032). Patients receiving at least 24 cycles of the drug have a 5-year OS of 38.2%. This analysis allowed to identify features at baseline or during treatment with 5-AZA associated with a different 2-year OS.
Subject(s)
Antimetabolites, Antineoplastic/therapeutic use , Azacitidine/therapeutic use , Myelodysplastic Syndromes/drug therapy , Opportunistic Infections/drug therapy , Adult , Aged , Aged, 80 and over , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Myelodysplastic Syndromes/mortality , Myelodysplastic Syndromes/pathology , Opportunistic Infections/mortality , Opportunistic Infections/pathology , Prognosis , Retrospective Studies , Risk Factors , Survival Analysis , Treatment OutcomeABSTRACT
The presence of cytogenetic clonal heterogeneity has been associated with poor prognosis in patients with acute myeloid leukemia (AML). Here, we reassessed this association. The study cohort consisted of all patients with an abnormal karyotype randomized in the EORTC/GIMEMA AML-10 and AML-12 trials. Abnormal karyotypes were classified as no subclones present (cytogenetic abnormality in a single clone), defined subclones present (presence of one to three subclones), and composite karyotypes (CP) (clonal heterogeneity not allowing enumeration of individual subclones). The main endpoints were overall survival (OS) and disease-free survival (DFS). Among 1291 patients with an abnormal karyotype, 1026 had no subclones, 226 at least 1 subclone, and 39 a CP. Patients with defined subclones had an OS similar to those with no subclones (hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.88-1.26), but CP patients had a shorter OS (HR = 1.58, 95% CI 1.11-2.26). However, in a multivariate Cox model stratified by protocol and adjusted for age, cytogenetic risk group, secondary versus primary AML, and performance status, clonal heterogeneity lost its prognostic importance (HR = 1.10, 95% CI 0.91-1.32 for defined subclones versus no subclones; HR = 0.96, 95% CI 0.67-1.38 for CP versus no subclones). Also, the impact of having a donor on DFS was similar in the three clonal subgroups. In summary, in patients with cytogenetic abnormality, presence of subclones had no impact on OS. The dismal outcome in patients with a CP was explained by the known predictors of poor prognosis. TRIAL REGISTRATION: AML-10: ClinicalTrials.gov identifier: NCT00002549, retrospectively registered July 19, 2004; AML12: ClinicalTrials.gov identifier: NCT00004128, registered January 27, 2003.
Subject(s)
Chromosome Aberrations , Leukemia, Myeloid, Acute/diagnosis , Leukemia, Myeloid, Acute/genetics , Leukemia, Myeloid, Acute/mortality , Abnormal Karyotype , Adolescent , Adult , Clonal Evolution/genetics , Cytogenetic Analysis , Female , Genetic Heterogeneity , Humans , Male , Middle Aged , Prognosis , Randomized Controlled Trials as Topic , Retrospective Studies , Survival Analysis , Young AdultABSTRACT
OBJECTIVES: To evaluate differences in clinical results according to age among patients with chronic myeloid leukemia (CML). METHODS: 207 consecutive CML patients treated with imatinib frontline were revised, dividing them in young adults (>20 < 45 years) (YA), middle-aged adults (≥45 < 65 years) (MA) and elderly (≥65 years) (EL). RESULTS: Cumulative incidence of complete cytogenetic response (CCyR) and major molecular response (MMolR) were significantly higher in MA compared with YA and EL (P < .001 for CCyR and P = .001 for MMolR). Number of total events was lower in MA (8 [11.1%] vs 21 [34.4%] in YA and 28 [37.8%] in EL, P = .001): no difference was observed for blastic evolution (P = .478). Number of deaths was higher in the EL (12 [16.2%] vs 2 [3.2%] in YA and 0 in MA, P < .001): however, 11/12 deaths in EL were not related to CML. The PFS curve in MA was significantly longer than in YA and in EL (P = .02). The OS curve in EL was significantly shorter than in YA and in MA (P < .001). CONCLUSIONS: Age at diagnosis influences significantly the course of CML patients treated with imatinib: a possible explanation of the counterintuitive worse course in YA is the delayed diagnosis compared to elderly.
ABSTRACT
Both Dasision and ENESTnd trials had many exclusion criteria, with a possible selection bias compared with the real-life. To address the impact of this bias on the first-line treatment in the current clinical practice, we revised 207 unselected newly diagnosed chronic phase chronic myeloid leukaemia (CML) patients [M/F 108/99, median age 58.8 years, interquartile range 42.3-70.2] treated with front-line imatinib from June 2002 to June 2013 at our Institution, and evaluated how many of them would have been excluded from enrolment in the two trials. Twenty-eight patients (13.5%) should have been excluded by both trials because of polycomorbidities (12), severe cardiomyopathy (five), age > 80 with frailty (three), drug abuse (two) or other severe concomitant diseases (six). In addition, eight patients should have been excluded by Dasision due to isolated chronic obstructive broncopulmonar disease, and 19 patients should have been excluded by ENESTnd due to isolated diabetes (10), arrhythmia (four), acute myocardial infarction > 6 months before CML diagnosis (two), chronic pancreatic disease (two) and peripheral arterial obstructive disease (one). On the whole, 36 patients (17.4%) would have been excluded by Dasision trial and 47 (22.7%) by ENESTnd trial. The patients potentially not eligible for both trials were significantly older and with imatinib had a worse outcome compared with patients potentially eligible. Our data highlight that an automatic transposition of results available in clinical controlled trials into the frontline real-life management of CML patients should be regarded with caution. Copyright © 2015 John Wiley & Sons, Ltd.
Subject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Adult , Aged , Controlled Clinical Trials as Topic , Female , Humans , Imatinib Mesylate/adverse effects , Imatinib Mesylate/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality , Male , Middle AgedABSTRACT
The prognostic role of CD15 in acute myeloid leukemia (AML) has been tested in different studies with conflicting results. To address this issue, we retrospectively evaluated a cohort of 460 AML patients of all ages with the exclusion of acute promyelocytic leukemia (M/F 243/217, median age 50.6 years [range 0.9-81.2]) intensively treated at our institute between January 1999 and December 2010. CD15 positivity was found in 171 of 406 evaluable patients (42.1%). Complete remission (CR) was achieved by 334 patients (72.6%), while 82 (17.8%) were resistant and 44 (9.6%) died during induction: the median CR duration was 15.5 months (range 0.6-176.0), with 2-year disease-free survival rate of 45.1% (95% confidence interval 39.6-50.6). The median overall survival was 14.4 months (range 0.3-177.0), with 2-year overall survival rate of 42.2% (95% confidence interval 37.5-46.9). At univariate analysis for CR achievement, age < 60 years (P < .001), World Health Organization classification (P = .045), low-risk karyotype (P < .001), no high-risk karyotype (P = .006), positivity for AML-ETO (P = .004)/CBFß-MYH11 (P = .003)/CD15 (P = .006)/CD11b (P = .013), negativity for FLT3-ITD (P = .001), Hb > 8 g/dL (P = .020), and white blood cell < 50 × 109 /L (P = .034) had a favorable impact. At a multivariate logistic regression model, CD15 positivity (P = .002), age < 60 years (P = .008), white blood cell < 50 × 109 /L (P = .017), and low-risk/no high-risk karyotype (P = .026/P = .025) retained an independent prognostic role on CR achievement. The baseline assessment of CD15 positivity appears to have a role in the risk evaluation for CR achievement in AML patients undergoing intensive chemotherapy and should be assessed in prospective studies together with other clinical and biologic features already reported.
Subject(s)
Leukemia, Myeloid, Acute/genetics , Lewis X Antigen/genetics , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Karyotype , Male , Middle Aged , Prognosis , Survival Rate , Young AdultABSTRACT
The Food and Agricultural Organization (FAO) method for potential evapotranspiration assessment is based on the crop coefficient, which allows one to relate the reference evapotranspiration of well irrigated grass to the potential evapotranspiration of specific crops. The method was originally developed for cultivated species based on lysimeter measurements of potential evapotranspiration. Not many applications to natural vegetated areas exist due to the lack of available data for these species. In this paper we investigate the potential of using evapotranspiration measurements acquired by micrometeorological stations for the definition of crop coefficient functions of natural vegetated areas and extrapolation to ungauged sites through remotely sensed data. Pastures, deciduous and evergreen forests have been considered and lower crop coefficient values are found with respect to FAO data.
ABSTRACT
The triangle method has been applied to derive a weekly indicator of evaporative fraction on vegetated areas in a temperate region in Northern Italy. Daily MODIS Aqua Land Surface Temperature (MYD11A1) data has been combined with air temperature maps and 8-day composite MODIS NDVI (MOD13Q1/MYD13Q1) data to estimate the Evaporative Fraction (EF) at 1 km resolution, on a daily basis. Measurements at two eddy covariance towers located within the study area have been exploited to assess the reliability of satellite based EF estimations as well as the robustness of input data. Weekly syntheses of the daily EF indicator (EFw) were then derived at regional scale for the years 2010, 2011 and 2012 as a proxy of overall surface moisture condition. EFw showed a temporal behavior consistent with growing cycles and agro-practices of the main crops cultivated in the study area (rice, forages and corn). Comparison with official regional corn yield data showed that variations in EFw cumulated over summer are related with crop production shortages induced by water scarcity. These results suggest that weekly-averaged EF estimated from MODIS data is sensible to water stress conditions and can be used as an indicator of crops' moisture conditions at agronomical district level. Advantages and disadvantages of the proposed approach to provide information useful to issue operational near real time bulletins on crop conditions at regional scale are discussed.
ABSTRACT
Global Positioning System (GPS) dissemination of frequency standards is ubiquitous at present, providing the most widespread time and frequency reference for the majority of industrial and research applications worldwide. On the other hand, the ultimate limits of the GPS presently curb further advances in high-precision, scientific and industrial applications relying on this dissemination scheme. Here, we demonstrate that these limits can be reliably overcome even in laboratories without a local atomic clock by replacing the GPS with a 642-km-long optical fiber link to a remote primary caesium frequency standard. Through this configuration we stably address the 1S0-3P0 clock transition in an ultracold gas of 173Yb, with a precision that exceeds the possibilities of a GPS-based measurement, dismissing the need for a local clock infrastructure to perform beyond-GPS high-precision tasks. We also report an improvement of two orders of magnitude in the accuracy on the transition frequency reported in literature.
ABSTRACT
Despite therapeutic improvements, a sizable number of patients with T-cell acute lymphoblastic leukemia still have a poor outcome. To unravel the genomic background associated with refractoriness, we evaluated the transcriptome of 19 cases of refractory/early relapsed T-cell acute lymphoblastic leukemia (discovery cohort) by performing RNA-sequencing on diagnostic material. The incidence and prognostic impact of the most frequently mutated pathways were validated by Sanger sequencing on genomic DNA from diagnostic samples of an independent cohort of 49 cases (validation cohort), including refractory, relapsed and responsive cases. Combined gene expression and fusion transcript analyses in the discovery cohort revealed the presence of known oncogenes and identified novel rearrangements inducing overexpression, as well as inactivation of tumor suppressor genes. Mutation analysis identified JAK/STAT and RAS/PTEN as the most commonly disrupted pathways in patients with chemorefractory disease or early relapse, frequently in association with NOTCH1/FBXW7 mutations. The analysis on the validation cohort documented a significantly higher risk of relapse, inferior overall survival, disease-free survival and event-free survival in patients with JAK/STAT or RAS/PTEN alterations. Conversely, a significantly better survival was observed in patients harboring only NOTCH1/FBXW7 mutations: this favorable prognostic effect was abrogated by the presence of concomitant mutations. Preliminary in vitro assays on primary cells demonstrated sensitivity to specific inhibitors. These data document the negative prognostic impact of JAK/STAT and RAS/PTEN mutations in T-cell acute lymphoblastic leukemia and suggest the potential clinical application of JAK and PI3K/mTOR inhibitors in patients harboring mutations in these pathways.
Subject(s)
Genetic Variation , High-Throughput Nucleotide Sequencing , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/genetics , Sequence Analysis, RNA , Adolescent , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cell Cycle Proteins/metabolism , Child , Cluster Analysis , Cohort Studies , Drug Resistance, Neoplasm , F-Box Proteins/metabolism , F-Box-WD Repeat-Containing Protein 7 , Female , Gene Expression Profiling , Humans , Janus Kinases/metabolism , Male , Middle Aged , Mutation , Oncogene Proteins, Fusion/genetics , PTEN Phosphohydrolase/metabolism , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/metabolism , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/mortality , Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/therapy , Prognosis , Receptor, Notch1/genetics , Receptor, Notch1/metabolism , Recurrence , STAT Transcription Factors/metabolism , Signal Transduction , Survival Analysis , Treatment Outcome , Ubiquitin-Protein Ligases/metabolism , Young Adult , ras Proteins/metabolismSubject(s)
DNA-Binding Proteins/genetics , Fusion Proteins, bcr-abl/genetics , Histone-Lysine N-Methyltransferase/genetics , Myeloid-Lymphoid Leukemia Protein/genetics , Oncogene Proteins, Fusion/genetics , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/genetics , Transcriptional Elongation Factors/genetics , Adult , Female , Humans , Male , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/epidemiology , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/therapy , Prognosis , Survival AnalysisABSTRACT
Lenalidomide induces in patients with myelodysplastic syndrome (MDS) and del(5q) erythroid and cytogenetic response rates as high as 75% and 50%, respectively. It is still unclear, however, how long lenalidomide treatment should be continued and whether or not the drug could be interrupted. To assess the feasibility of lenalidomide discontinuation, we revised a cohort of 16 low-risk MDS patients with del(5q) treated at our institute in a phase II multicentric Italian study. Among the 12 responding patients, four discontinued lenalidomide while in complete response. All four patients needed during treatment a permanent lenalidomide reduction from 10 to 5 mg/day because of haematological toxicity (three patients) or grade 3 muscular and bone pain (one patient). At lenalidomide discontinuation after 16, 20, 27 and 20 months from the start, respectively, all four patients were in complete hematologic response and three forth in complete cytogenetic response. Three patients are still in response after 36, 30 and 20 months from lenalidomide discontinuation, respectively: The remaining patient relapsed after 20 months, and she is now receiving a new course of lenalidomide. In conclusion, long-lasting remissions are achievable in MDS patients with del(5q) in complete response after lenalidomide discontinuation.
Subject(s)
Chromosome Deletion , Chromosomes, Human, Pair 5/genetics , Myelodysplastic Syndromes/drug therapy , Thalidomide/analogs & derivatives , Aged , Angiogenesis Inhibitors/adverse effects , Angiogenesis Inhibitors/therapeutic use , Female , Hematologic Diseases/chemically induced , Humans , Lenalidomide , Middle Aged , Myelodysplastic Syndromes/genetics , Pain/chemically induced , Remission Induction , Thalidomide/adverse effects , Thalidomide/therapeutic use , Time Factors , Treatment OutcomeABSTRACT
Hematopoietic transcription factors are involved in chromosomal translocations, which generate fusion proteins contributing to leukemia pathogenesis. Analysis of patient's primary leukemia blasts revealed that those carrying the t(8;21) generating AML1/ETO, the most common acute myeloid leukemia-associated fusion protein, display low levels of a microRNA-223 (miR-223), a regulator of myelopoiesis. Here, we show that miR-223 is a direct transcriptional target of AML1/ETO. By recruiting chromatin remodeling enzymes at an AML1-binding site on the pre-miR-223 gene, AML1/ETO induces heterochromatic silencing of miR-223. Ectopic miR-223 expression, RNAi against AML1/ETO, or demethylating treatment enhances miR-223 levels and restores cell differentiation. Here, we identify an additional action for a leukemia fusion protein linking the epigenetic silencing of a microRNA locus to the differentiation block of leukemia.