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  • American Society of Hematology  (2)
  • Hara, Takeshi  (2)
  • Mabuchi, Ryoko  (2)
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  • American Society of Hematology  (2)
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  • 1
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 4408-4408
    Abstract: Indoleamine 2,3-dioxygenase (IDO) catalyzes the rate-limiting step in the catabolism of tryptophan along the kynurenine pathway. In tumors, increased IDO activity inhibits T cell and natural killer cell proliferation and induces apoptosis. We have previously reported that IDO expression in lymphoma cells and serum concentration of kynurenine in diffuse large B-cell lymphoma are useful prognostic factors. Preclinical studies in rodents have demonstrated that IDO inhibitors, such as 1-methyl-D-tryptophan (D-1MT), are therapeutically beneficial, especially when combined with different types of cytotoxic chemotherapeutic agents. We investigated the therapeutic potential of IDO inhibitor D-1MT with cyclophosphamide (CY) by using an IDO-positive B-cell lymphoma model mouse. Materials and Methods To establish tumors, 1x106 A20 cells (BALB/c B-cell lymphoma cell line) were subcutaneously injected into the lower back of naïve syngeneic BALB/c mice. Seven days later, 20 BALB/c mice were treated with D-1MT (Sigma-Aldrich, Saint Louis, MO, USA) and/or CY. The mice were fed with D-1MT-supplemented water (5mg/mL), which was replaced every two to three days. CY was administered at 80 mg/kg i.p. on day 10. To examine the effect of D-1MT on A20 tumors and tumor-draining lymph nodes (TDLNs), mice were sacrificed on day 28. Serum concentration of kynurenine and tryptophan were measured by high-performance liquid chromatography. CD4+CD25+Foxp3+ regulatory T cells (Tregs) were counted by flow cytometry with a FACSCantoII flow cytometer (BD Biosciences, San Jose, CA, USA), and data were analyzed with FACSDiva 6.1 software (BD Biosciences). Quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) was performed with specific primer/probe sets that amplify IDO1, Foxp3, IFN-γ, cyclooxygenase-2 (COX-2), and GAPDH genes (TaqMan Gene Expression Assays; Applied Biosystems, Foster City, CA). Results The mean body and spleen weights of the mice did not differ significantly among the groups. The mean drinking water intakes (mL/day/mouse) of the D-1MT, CY, and D-1MT+CY groups were significantly less than that of the control group (p 〈 0.05). All mice implanted with A20 cells developed tumors that became palpable after day 7. On day 28, the tumor volume in the D-1MT+CY group was significantly less than that in the control group (p 〈 0.05), and there were no significant differences among the other treatment groups (Figure 1). There were no significant differences in the serum kynurenine-to-tryptophan ratio and the IDO1 expression level in the tumors among any treatment groups. The expression levels of IFN-γ and COX-2 mRNA in TDLNs were found to be significantly up-regulated in the CY and D-1MT+CY groups. By quantitative RT-PCR, the expression levels of IFN-γ and COX-2 mRNA in TDLNs were found to be significantly up-regulated in the CY and D-1MT+CY groups. The Foxp3 expression level and number of Tregs in TDLNs in the CY and D-1MT+CY groups were significantly higher than in the control group on day 28. The number of Tregs in TDLNs in the D-1MT+CY group was significantly lower than those in CY groups on day 17 (p 〈 0.05) (Figure 2). Conclusion Our results suggest that D-1MT in combination with CY is an effective treatment for IDO-positive lymphoma in a model mouse by reducing Tregs and breaking tumor tolerance. This antitumor effect might be induced by the suppression of Tregs by D-1MT. Our findings suggest that inhibition of IDO might offer a promising treatment strategy for lymphoma. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2013
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 2
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 4418-4418
    Abstract: BACKGROUND: The optimal management of relapsed or refractory aggressive B-cell lymphoma is not standardized. We previously reported the salvage chemotherapy with P-IMVP-16/CBDCA consisting of methylprednisolone (mPSL), carboplatin (CBDCA), etoposide (VP-16), ifosfamide (IFM), and methotrexate (MTX) for patients (pts) with aggressive non-Hodgkin's lymphoma who had previously received CHOP consisting of cyclophosphamide (CPA), doxorubicin (DOX), Vincristine (VCR) and prednisolone (PSL) (Sawada M; Eur J Haematol 2002). The purpose of this study is to determine the efficacy and safety of salvage chemotherapy with rituximab (R) combined with P-IMVP-16/CBDCA (R-P-IMVP-16/CBDCA) for relapsed or refractory aggressive B-cell lymphoma. PATIENTS AND METHODS: We retrospectively analyzed 66 pts with relapsed or refractory aggressive B-cell lymphoma who had received R-P-IMVP-16/CBDCA (R: 375mg/m2 on day1, mPSL: 1000mg/body on days 2-4, IFM: 1000mg/m2 on days 2-6, MTX: 30mg/m2 on day 4 and 11, VP-16: 80mg/m2 on days 2-4, and CBDCA 300mg/m2 on day 2, with granulocyte colony-stimulating factor every 21 days in 5 institutes of Gifu Hematology Study Group between July 2004 and January 2014. The pts who had responded to R-P-IMVP-16/CBDCA underwent autologous transplantation or received 3 additional R-P-IMVP-16/CBDCA cycles. Pts aged 70 or older were given 75% or less of the standard dose. All patients received R-CHOP or R-THP-COP regimen as a first-line chemotherapy. THP (pirarubicin), a derivative of DOX, is an anthracyclin with less cardiotoxicity than DOX. THP-COP has an equivalent efficacy to CHOP (Turumi H; JCRCO 2004). RESULTS: Enrolled 66 pts had a median age of 64.5 years [range 25-83] and were 65% male. The pathology of underlying lymphoma comprised diffuse large-B cell lymphoma (n=51), follicular lymphoma grade 3 (n=11), intravascular large B-cell lymphoma (n=1), primary mediastinal B cell lymphoma (n=1) and mantle cell lymphoma (n=2). The response rate [complete response (CR/CRu) plus partial response (PR)] was 60.6% (40/66), including 28 (42.4%) CR/CRu and 12 (18.2%) PR. Another 5 pts had stable disease and 21 pts progressed. Median overall survival (OS) and progression-free survival (PFS) were 47.1 months and 9.2 months, respectively. The OS rate for the 66 pts was 65.1% at 1 yr and 57.3% at 2 yr. The PFS rate for the 66 pts was 45.6% at 1 yr and 31.2% at 2 yr. The survival rate for the 40 responders was 97.4% at 1 yr and 88.1% at 2 yr, and the survival rate for the 26 non-responders was 15.0% at 1 yr (P 〈 0.001). Common toxicity criteria grade ≥ 3 drug-related adverse events included: neutropenia, anemia, thrombocytopenia and febrile neutropenia. Although the major toxicities were neutropenia and febrile neutropenia, only one DLBCL pt with common variable immunodeficiency died of sepsis related to neutropenia. Non-hematological adverse effects were predominantly mild and tolerable. CONCLUSIONS: The R-P-IMVP-16/CBDCA regimen displayed a significant activity in relapsed or refractory aggressive B-cell lymphoma, with acceptable toxicity and should be considered a candidate for combination chemotherapy. Futher clinical studies should be required. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
    Location Call Number Limitation Availability
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