GTPase regulator associated with the focal adhesion kinase (GRAF) transcript was down-regulated in patients with myeloid malignancies

<p>Abstract</p> <p>Background</p> <p>GTPase regulator associated with the focal adhesion kinase (<it>GRAF</it>), a putative tumor suppressor gene, is found inactivated in hematopoietic malignancies by either genetic or epigenetic abnormalities. However, the expression level of <it>GRAF </it>gene has not yet been studied in leukemia. The aim of this study was to investigate the expression level of <it>GRAF </it>gene in those patients with myeloid malignancies including acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) and chronic myeloid leukemia (CML).</p> <p>Methods</p> <p>The expression levels of <it>GRAF </it>transcript were determined in 94 patients using real-time quantitative PCR (RQ-PCR). Clinical and laboratory data of these patients were collected and analyzed.</p> <p>Results</p> <p>The significantly decreased level of <it>GRAF </it>transcript was observed in three myeloid malignancies compared to controls. Within AML, there was no difference in the level of <it>GRAF </it>transcript among different FAB subtypes (<it>P </it>> 0.05). Difference was not observed in the amount of <it>GRAF </it>mRNA between CML at chronic phase and controls. As CML progressed, <it>GRAF </it>transcript significantly decreased. In MDS, three cases with 5q deletion had lower <it>GRAF </it>transcript than four without 5q deletion (median 0.76 vs 2.99) (<it>P </it>> 0.05).</p> <p>Conclusion</p> <p>our results demonstrate that the <it>GRAF </it>transcript is decreased in myeloid malignancies.</p

Rare predicted loss-of-function variants of type I IFN immunity genes are associated with life-threatening COVID-19

Background: We previously reported that impaired type I IFN activity, due to inborn errors of TLR3- and TLR7-dependent type I interferon (IFN) immunity or to autoantibodies against type I IFN, account for 15–20% of cases of life-threatening COVID-19 in unvaccinated patients. Therefore, the determinants of life-threatening COVID-19 remain to be identified in ~ 80% of cases. Methods: We report here a genome-wide rare variant burden association analysis in 3269 unvaccinated patients with life-threatening COVID-19, and 1373 unvaccinated SARS-CoV-2-infected individuals without pneumonia. Among the 928 patients tested for autoantibodies against type I IFN, a quarter (234) were positive and were excluded. Results: No gene reached genome-wide significance. Under a recessive model, the most significant gene with at-risk variants was TLR7, with an OR of 27.68 (95%CI 1.5–528.7, P = 1.1 × 10−4) for biochemically loss-of-function (bLOF) variants. We replicated the enrichment in rare predicted LOF (pLOF) variants at 13 influenza susceptibility loci involved in TLR3-dependent type I IFN immunity (OR = 3.70[95%CI 1.3–8.2], P = 2.1 × 10−4). This enrichment was further strengthened by (1) adding the recently reported TYK2 and TLR7 COVID-19 loci, particularly under a recessive model (OR = 19.65[95%CI 2.1–2635.4], P = 3.4 × 10−3), and (2) considering as pLOF branchpoint variants with potentially strong impacts on splicing among the 15 loci (OR = 4.40[9%CI 2.3–8.4], P = 7.7 × 10−8). Finally, the patients with pLOF/bLOF variants at these 15 loci were significantly younger (mean age [SD] = 43.3 [20.3] years) than the other patients (56.0 [17.3] years; P = 1.68 × 10−5). Conclusions: Rare variants of TLR3- and TLR7-dependent type I IFN immunity genes can underlie life-threatening COVID-19, particularly with recessive inheritance, in patients under 60&nbsp;years old

CXCR4 : a new therapeutic target of the leukaemic cell ? : role of the SDF-1/CXCR4 axis in acute leukaemia

CXCR4, récepteur de la chimiokine SDF-1 (stromal cell-derived factor 1) joue un rôle capital dans l’hématopoïèse normale mais aussi dans la biologie de la cellule leucémique. Ce récepteur est exprimé à la surface des blastes et participe à « l’ancrage » de la cellule souche leucémique (CSL) au sein de la niche médullaire. Les interactions de la CSL avec le micro-environnement sont source de signaux de survie et de résistance à l’apoptose. La première partie de ce travail correspond à deux analyses en cytométrie en flux de l’expression de CXCR4 et de molécules d’adhérence sur des échantillons diagnostiques de LAM (leucémie aiguë myéloïde). Ce travail confirme la valeur pronostique péjorative de l’expression de CXCR4 et propose un modèle de stratification pronostique des patients, en fonction de leur phénotype d’adhérence. La deuxième partie s’intéresse à l’identification de potentielles cibles thérapeutiques dans un modèle de LAL à chromosome Philadelphie, pathologie au pronostic sombre malgré les progrès thérapeutiques liés aux ITK (inhibiteurs de tyrosine kinase). L’inhibition de CXCR4 par l’AMD3100 permet de potentialiser l’efficacité de l’aracytine et du dasatinib dans un modèle de co-culture stromale avec la lignée SUPB15. Une deuxième piste de ciblage thérapeutique de la LAL Phi+ est l’inhibition de la protéine chaperone HSP90. Une expression forte de HSP90 (dans les LAL Phi+ par rapport aux LAL Phi-) s’associe à une plus grande cytotoxicité du 17-AAG. En conclusion, CXCR4 est un récepteur clé de la cellule leucémique. L’étude de son niveau d’expression permet des stratifications pronostiques des patients et son blocage en fait une cible thérapeutique prometteuseCXCR4, receptor of the chemokine SDF-1 (stromal cell-derived factor 1) plays a major role in the normal hematopoiesis but also in the biology of the leukaemic cell. This receptor is expressed on the surface of blasts and is a key molecule in "the anchoring" of the leukaemic stem cell (LSC) within the bone marrow niche. The interactions of the LSC with the bone marrow microenvironment promote survival signals and drug resistance. The first part of this work consists of two flow cytometry analyses of CXCR4 and adhesion molecules expression in patients with AML (acute myeloid leukaemia) at diagnosis. The results confirm that CXCR4 expression is associated with poor prognosis and this work proposes to stratify patients, according to their adhesive phenotype, in order to establish risk-adapted strategies. The second part deals with the identification of potential therapeutic targets in a model of ALL with chromosome Philadelphia. Despite therapeutic improvements with the ITK (tyrosine kinase inhibitors) era, long term survival remains poor. The inhibition of CXCR4 by the AMD3100 enhances the sensitivity of SUPB15 cell line to cytarabine and dasatinib therapy in a model of stromal co-culture. A second way of therapeutic targeting of the ALL Phi + is the inhibition of the heat-shock protein HSP90. High percentage of HSP90-positive cells (in Ph+ ALL samples) is associated with high sensitivity to 17-AAG. In conclusion, CXCR4 appears as a key receptor of the leukaemic cell. The analysis of its level of expression allows prognostic stratifications and its blockade represents a promising therapeutic targe

Emotional experiences one year after a traffic accident: An exploratory study of verbatim accounts of the ESPARR cohort

International audienceThe aim of this study was to characterize different possible profiles of emotional experiences of victims of traffic accident based on verbatim accounts collected one year after the accident, and to relate these profiles to various socio-demographic and health data. A hierarchical cluster analysis of the emotional lexicon was made by categorizing and quantifying the EMOTAIX© lexicon using Tropes© text analysis software. Out of the 751 selected subjects, 328 expressed one or more emotional experiences. A link appeared between quality of life (QoL), post-traumatic stress disorder (PTSD) and the valence of expressed emotions. Injury severity and history distinguished two sets expressing negative-valence emotional experience. Paradoxically, a group also emerged with a large proportion of severely injured persons, associated with the expression of positive-valence emotional experiences and with domains of QoL and PTSD. The analysis of subjective data sheds light on the experience of traffic accident victims and shows a way forward for research and clinical intervention

A phase 1/2 trial of lenalidomide and dexamethasone in adult patients with refractory/relapsed acute lymphoblastic leukemia

International audienceOBJECTIVES: Adult patients with refractory/relapsed ALL have poor survival outcomes with current chemotherapies. We aimed to determine safety and efficacy of lenalidomide, an oral immunomodulator, in these patients. METHODS: This phase 1/2 trial (EUDRACT # 2009-009372-13) included 10 patients who received 28-day cycles of oral lenalidomide 25 mg/day, days 1 through 21, in combination with oral dexamethasone 40 mg/day on days 1, 8, 15, 22. Primary endpoints were tolerance and the overall response rate (ORR). Secondary endpoints included overall survival (OS) and quality of life. RESULTS: The most common grade 3 or 4 adverse events were myelosuppression. The ORR among the participants who could be evaluated was 28.6% (95% confidence interval [CI], 0-62.2%). The median OS was 92 days (range, 43-133 days). All patients have died because of progressive disease. Quality of life remains stable during treatment cycles. DISCUSSION AND CONCLUSION: The safety of combination therapy consisting of lenalidomide plus dexamethasone is consistent with ambulatory administration. Efficacy should be reevaluated in a larger series including patients less intensively previously treate

Impact of fluconazole versus posaconazole prophylaxis on the incidence of fungal infections in patients receiving induction chemotherapy for acute myeloid leukemia

Background: Invasive fungal infections (IFIs) remain one of the worrying complications in patients with acute myeloid leukemia (AML) due to their incidence and high level of attributable mortality. In light of these risks, antifungal prophylaxis has always been debated. We conducted a single-center retrospective study of two prophylactic antifungal agents (fluconazole/posaconazole) in 91 consecutive patients receiving induction chemotherapy for AML between 2005 and 2009, in order to evaluate the impact on the incidence of IFI and on the mycological flora of the patients. Methods: In total, 39 patients received prophylactic fluconazole versus 52 who received posaconazole. The baseline characteristics of the two groups were comparable. Results: Overall, 17 patients developed an IFI, with no difference in frequency between the two groups. Utilization of empirical or pre-emptive therapy was similar irrespective of the type of prophylaxis used. Mycological examination of stools revealed an increase in non-albicans Candida colonization in the fluconazole group during hospitalization and the appearance of Saccharomyces cerevisiae colonization in patients receiving posaconazole. Conclusion: The present study does not distinguish between fluconazole and posaconazole as a primary effective prevention against fungal infections. More prospective studies and meta-analyses are warranted

Evaluation by Flow Cytometry of Mature Monocyte Subpopulations for the Diagnosis and Follow-Up of Chronic Myelomonocytic Leukemia

Chronic myelomonocytic leukemia (CMML) is a myelodysplastic/myeloproliferative neoplasm, characterized by persistent monocytosis and dysplasia in at least one myeloid cell lineage. This persistent monocytosis should be distinguished from the reactive monocytosis which is sometimes observed in a context of infections or solid tumors. In 2015, Selimoglu-Buet et al. observed an increased percentage of classical monocytes (CD14+/CD16− &gt;94%) in the peripheral blood (PB) of CMML patients. In this study, using multiparametric flow cytometry (MFC), we assessed the monocytic distribution in PB samples and in bone marrow aspirates from 63 patients with monocytosis or CMML suspicion, and in seven follow-up blood samples from CMML patients treated with hypomethylating agents (HMA). A control group of 12 healthy age-matched donors was evaluated in parallel in order to validate the analysis template. The CMML diagnosis was established in 15 cases in correlation with other clinical manifestations and biological tests. The MFC test for the evaluation of the repartition of monocyte subsets, as previously described by Selimoglu-Buet et al. showed a specificity of 97% in blood and 100% in marrow samples. Additional information regarding the expression of intermediate MO2 monocytes percentage improved the specificity to 100% in blood samples allowing the screening of abnormal monocytosis. The indicative thresholds of CMML monocytosis were different in PB compared to BM samples (classical monocytes &gt;95% for PB and &gt;93% for BM). A decrease of monocyte levels in PB and BM, along with a normalization of monocytes distribution, was observed after treatment in 4/7 CMML patients with favorable evolution. No significant changes were observed in 3/7 patients who did not respond to HMA therapy and also presented unfavorable molecular prognostic factors at diagnosis (ASXL1, TET2, and IDH2 mutations). Considering its simplicity and robustness, the monocyte subsets evaluation by MFC provides relevant information for CMML diagnosis