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  • 1
    In: Leukemia & Lymphoma, Informa UK Limited, Vol. 49, No. 10 ( 2008-01), p. 2015-2017
    Type of Medium: Online Resource
    ISSN: 1042-8194 , 1029-2403
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2008
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  • 2
    In: EMJ Oncology, European Medical Group
    Abstract: Myelodysplastic syndrome (MDS) is a heterogeneous group of myeloid disorders. Allogeneic stem cell transplantation (alloSCT) is the therapeutic approach with a known curative potential for patients with MDS, which allows long-term disease control to be achieved. Despite advances in transplantation technology, there is still a considerable morbidity and mortality associated with this approach. Moreover, numerous controversies still exist regarding alloSCT in MDS. There is significant variability in the management of patients with MDS, especially of the intermediate-risk category and specifically in regards to the timing and use of transplantation. Modern genetic analysis has identified a variety of new mutations, which are associated with clinical phenotype and prognosis. Whether somatic mutations are important prognostic markers of response to alloSCT is little known. It is not clear whether somatic mutations can help to identify groups that are most likely to benefit from alloSCT. In this article, we review the current status of somatic mutations in MDS and focus on the prognostic impact of mutations in the context of alloSCT.
    Type of Medium: Online Resource
    ISSN: 2054-619X
    Language: English
    Publisher: European Medical Group
    Publication Date: 2016
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  • 3
    In: Zeitschrift für Gastroenterologie, Georg Thieme Verlag KG, Vol. 59, No. 11 ( 2021-11), p. 1189-1196
    Abstract: Einleitung Der Einfluss einer SARS-CoV-2-Infektion auf chronisch entzündliche Darmerkrankungen (CED) ist bislang nicht gut charakterisiert, und es ist unklar, ob diese eine Anpassung der immunsuppressiven Therapie erfordert. Methodik Für die retrospektive Dokumentation klinischer Parameter und Veränderungen einer immunsuppressiven Therapie von mit SARS-CoV-2 infizierten CED-Patienten wurde ein nationales Melderegister etabliert. Ergebnisse Insgesamt wurden nur 3 von 185 CED-Patienten (1,6 %) wegen abdomineller Symptome auf eine SARS-CoV-2-Infektion getestet. Im COVID-19-Krankheitsverlauf entwickelten 43,5 % Durchfall, abdominelle Schmerzen oder Hämatochezie (Hospitalisierungsrisiko mit vs. ohne abdominelle Symptome: 20,0 % vs. 10,6 %, p  〈  0,01). Bei aktiver CED zum Zeitpunkt des SARS-CoV-2-Nachweises bestand ein erhöhtes Hospitalisierungsrisiko (Remission 11,2 %, aktive CED 23,3 % p  〈  0,05). Die CED-spezifische Therapie blieb bei 115 Patienten (71,4 %) unverändert; die häufigste Änderung bestand in einer Unterbrechung der systemischen Therapie (16,2 %). Diskussion Bei mit SARS-CoV-2 infizierten CED-Patienten traten häufig neue abdominelle Symptome bei Infektion auf. Diese führten aber nur selten zur SARS-CoV-2-Testung. Eine hohe CED-Aktivität zum Zeitpunkt des SARS-CoV-2-Nachweises war mit einem erhöhten Hospitalisierungsrisiko assoziiert.
    Type of Medium: Online Resource
    ISSN: 0044-2771 , 1439-7803
    RVK:
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2021
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  • 4
    In: Blood, American Society of Hematology, Vol. 118, No. 21 ( 2011-11-18), p. 4868-4868
    Abstract: Abstract 4868 FLT3-ITD occurs with a frequency of 35%–45% in normal karyotype AML and has an adverse impact on prognosis. FLT3-ITD mutations are very variable in length and position of the tandem duplication. We have analyzed 211 AML patients with a median age of 54 years (range, 17–75). For all patients, intensive double-induction and consolidation therapy were intended. Patients with a matched related (MRD) or unrelated donor (MUD) were allocated to allogeneic stem cell transplantation (alloSCT). To investigate ITD insertion site and length, as well as their clinical impact in AML patients, we have performed sequencing analysis in diagnostic samples from 46 FT3- ITD–mutated patients. In 39 (87%) patients a single sequence was found, 6 patients displayed 2 and more different mutations. The median size of the inserted sequences was 63 nucleotides (range, 21–203 nucleotides). ITD integration sites were categorized according to functional regions of the FLT3 receptor: juxtamembrane domain (JMD), n =29 (JMD switch motif, n=3; JMD zipper motif, n=20; and JMD hinge region, n=6) and beta1-sheet of the tyrosine kinase domain-1 (TKD1), n=17. In the majority of the cases insertion sites were localized in JMD between amino acid (AA) 593 and 609 (n=20; 43%) and in TKD1 between AAs 610 and 615 (n=17; 37%). Integration site was strongly correlated with the ITD size (p=0.001) and with white blood cells (WBC) count (p=0.05). The prognostic significance of FLT3-ITD size is discussed controversial. Several studies reported conflicting results. We have found that CR durations was significant better (p=0.05) in patients with bigger ITD size, and there were no statistical differences in OS and DFS. There was no significant association between the number of mutations and OS or DFS. Presence of the any type of mutations was more common in M5 (16 of 54, 29%, P 0.01). It was associated with normal karyotype (72% vs 43%), p=0,0001; higher white blood cells (WBC) count (98×109/l vs 21×109/l), p=0,0001; higher BM blasts (85% vs 71%, p=0,0001), de novo AML (91% vs 69%), p=0,0001); and inferior OS (p=0,008) and DFS (p=0,01), when we excluded AML M3 patients. The prevalence of ITD allele on the DNA level was heterogeneous. Based on quantitative analysis, the mutant/wild-type (wt) ratio ranged from 0,1 to 11,5. Patients with a mutant/wt ratio above 0,3 had significantly shorter CR duration (p=0,02), OS (p=0,03), and DFS (p=0,01). Taken together, our data confirm that FLT3 mutation represent a common aberration in adult AML and associated with inferior outcome. A high mutant/wt ratio appears to have a major impact on the prognostic relevance. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
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  • 5
    In: Blood, American Society of Hematology, Vol. 128, No. 22 ( 2016-12-02), p. 2891-2891
    Abstract: DNA (cytosine-5)-methyltransferase 3 alpha (DNMT3A) mutations is one of the most frequent somatic mutations in acute myeloid leukemia (AML). Although DNMT3A mutations have been studied extensively, influence of mutations on AML prognosis and their role on the pathogenesis of AML remains not completely clear. Little is known about the significance of mutations burden in the time of diagnosis on the clinical and prognostic features of AML. Recently discovered persistence of DNMT3A mutations in complete remission after standard therapy indicates the presence of mutation in early pre-leukemic stem cells. In this aspect, it would be essential to analyze the existence of DNMT3A-positive cells after allogeneic stem cell transplantation (alloSCT). Using quantitative PCR, we analyzed mutations burden in diagnostic samples obtained from 65 AML patients with DNMT3A mutation. Then follow up samples were analyzed repeatedly, after induction, consolidation therapy, and after alloSCT with a mean follow-up of 33 months. Using well-established markers of minimal residual disease and donor engraftment, we monitored DNMT3A stability during complete molecular remission (CMR). In addition, we analyzed the combination of DNMT3A mutation with others mutations, such as FLT3, NPM1, IDH1, IDH,and others, at the time of diagnosis, as well as in relapse of AML. Finally, we analyzed the prognostic impact of DNMT3A mutations depending on the distinct combination of mutations with other genetic markers. For this, 150 matched-pairs AML patients without DNMT3A mutation were analyzed. We have found considerable variation of mutations burden (from 1% till 90%) in diagnostic samples. Although, the prognostic impact of mutations burden in diagnostic samples have not been verify, we have found a significant associations of higher mutations burden with M4/M5 FAB variant of AML (p=0,04) and presence of NPM1 mutation (p=0,023). Persistence of DNMT3A mutations in CMR after standard chemotherapy was found in all patients. The loss of correlation between DNMT3A and others could be explained by sub-clone architecture and clonal evolution of AML. After alloSCT, DNMT3A mutations were not discovered in patients with CMR and complete donor chimerism. This data suggests the removal of leukemic stem cells after alloSCT and indicate the importance of alloSCT for high risk AML patients. In relapse of leukemia, all samples showed an increasing of DNMT3A mutated alleles. In addition, matched-pairs analysis suggests that DNMT3A, particularly when accompanied by FLT3-ITD, is a significant prognostic factor for inferior outcome, even after alloSCT. We conclude that long-term quantitative monitoring of DNMT3A mutations could provide additional prognostic information and could explain the role of mutations in development and progression of AML. Disclosures Pezzutto: Cellgene, Novartis, Roche, Gilead: Membership on an entity's Board of Directors or advisory committees.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2016
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  • 6
    In: Blood, American Society of Hematology, Vol. 126, No. 23 ( 2015-12-03), p. 5325-5325
    Abstract: Introduction: Multiple myeloma (MM) cells strongly rely on the interaction with bone marrow mesenchymal stromal cells (BMMSCs) for proliferation and survival. We previously reported that MM cells influence the mitochondrial function and senescence of surrounding BMMSCs amongst others via NAD-dependent deacetylase sirtuin-3 (SIRT3) (Blood, 2014; BMC Cancer, 2015). In the further course we examined the function of SIRT3 in BMMSCs and possible underlying mechanisms of SIRT3 activation. Methods: In this study we transfected 2 healthy donor BMMSCs (HD-BMMSCs) for transient knock-down of SIRT3 using 4 different siRNAs (GeneSolution, Qiagen). We analysed mitochondrial membrane potential (ΔΨM) and reactive oxygen species (ROS) by FACS. Cell cycle analysis was performed using "cell cycle assay kit" (Abcam). Senescence was examined using FACS and senescence-associated β-galactosidase activity. Apoptosis was analysed using Annexin V-FITC Kit (Miltenyi) and protein expression was examined by western blot. In addition we analysed the influence of MCT transporter interaction on SIRT3 expression in 6 BMMSCs of myeloma patients (MM-BMMSCs) using α-cyano-4-hydroxycinnamic acid (α-CN). Results: SIRT3 knock-down in HD-BMMSCs induced 1.4- to 1.9-fold increase in ROS levels (p 〈 0.05). This was associated with dissipation of ΔΨM between 1.4- to 1.8-fold depending on the siRNA that was used for transient knock-down of SIRT3 (p 〈 0.04). Furthermore inhibition of SIRT3 mimicked cell cycle arrest in S phase previously reported in BMMSCs of myeloma patients. Percentage of BMMSCs in S phase increased upon SIRT3 knock-down between 6.7%-9.6% (p 〈 0.039). In addition, reduction of SIRT3 led to 1.5-fold increased senescence-associated β-galactosidase activity in transfected HD-BMMSCs indicating that this protein amongst others could be responsible for premature senescence of BMMSCs of myeloma patients (p 〈 0.03). We further supposed that interaction of BMMSCs with MM cells via MCT transporters could influence SIRT3 levels in BMMSCs of myeloma patients. Inhibition of MCT interaction induced apoptosis in MM cells but not BMMSCs (p 〈 0.04). Furthermore, suppression of MCT interaction between MM cells and MM-BMMSCs reduced activation of SIRT3 around 1.7-fold in MM-BMMSCs. Conclusion: SIRT3 seems to be a major regulator of mitochondrial functions in BMMSCs. Thus, reduced expression of SIRT3 that was previously reported in MM-BMMSCs could be the reason for increased ROS levels, cell cycle arrest in S phase and premature senescence-like state of MM-BMMSCs. In addition, our data show that inhibition of MCT transporters in MM cells and MM-BMMSCs induces apoptosis in MM cells and inhibits increased expression of SIRT3 in MM-BMMSCs. Disabling of MCT transporter interaction could possibly inhibit sustained induction of mitochondrial stress response in MM-BMMSCs and circumvent induction of the premature senescence-like state. Disclosures Blau: MSD: Honoraria; JAZZ Pharma: Honoraria; Shire: Honoraria; Celgene: Honoraria, Research Funding; AMGEN: Honoraria; Janssen: Honoraria, Research Funding; Baxalta: Honoraria; BMS: Honoraria.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
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  • 7
    In: Blood, American Society of Hematology, Vol. 122, No. 21 ( 2013-11-15), p. 3149-3149
    Abstract: Multiple myeloma (MM) is a B-cell malignancy characterized by accumulation of malignant plasma cells (PC) within the bone marrow. The bone marrow microenvironment such as bone marrow stroma cells (BMSC) supports MM disease progression, resistance to chemotherapy, protects the tumor cells against apoptosis and causes osteolytic bone disease and angiogenesis. The aim of this study was to identify constitutive genetic alterations in BMSC derived from patients with MM (MM-BMSC) in comparison to BMSC from healthy donors. For BMSC selection, mononuclear cells were isolated from fresh bone marrow aspirates and were further expanded in cell culture. We studied 25 MM patients and 5 healthy donors. Senescence status was determined in passage 1 of cell cultures. MM-BSMC displayed a considerably higher percentage of senescence cells (p 〈 0,05). We investigated the expression of cell cycle and adhesion-associated genes (CCNE1, CCND1, CDKN1B, VCAM, ICAM, IKK-alpha) in BMSC (passage 4) using SYBR-Green Real-Time PCR and relative quantification by linear regression. A downregulation of CCNE1 (p=0,05), CDKN1B (p=0,29), and an upregulation of CCND1 (p=0,05), VCAM-1 (p=0,33), ICAM-1 (p=0,33), and IKK-alpha (p=0,05) was demonstrated. Furthermore, the expression profile of miRNAs, targeting the analyzed mRNA genes or correlating with senescence, was studied (miR-16, miR-221, miR-126, miR-223, miR-485-5p and miR-519d). For miRNA detection treatment with Poly(A)-Polymerase and cDNA-Synthesis with a Poly(T)VN-Adaptor primer were carried out following an amplification with an universal reverse primer corresponding to the adaptor sequence and a miRNA-specific primer. miR-16, miR-223, miR-485-5p and miR-519d were significantly upregulated, (p=0,02; p=0,004; p=0,02; and p=0,002, respectively), whereas miR-221 and miR-126 showed no considerable differences to BMSC obtained from healthy donors. Next we investigated incubation of immunmodulatory drug Lenalidomid in BMSC cultures. Cells were treated with 10 µM Lenalidomid over 72 hours and expression was normalized to a 0,01 % DMSO control. Significant difference in gene expression were visible for ICAM-1 (p=0,01). For CDKN1B (p=0,16) and VCAM-1 (p=0,12) we demonstrated changes in gene expression. Our results indicate aberrant expression of cell cycle and adhesion-related genes, such as CCNE1, CCND1 and CDKN1B VCAM-1, ICAM-1 and IKK-alpha in MM-BMSC as compared with healthy donors. Furthermore, we found significant upregulation of miR-16, miR-223, miR-485-5p and miR-519d. Further investigation are needed to determine molecular mechanisms in MM-BMSC and PC interaction that lead to constitutive changes in BMSC characteristics and gene expression patterns. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    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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  • 8
    In: Blood, American Society of Hematology, Vol. 126, No. 22 ( 2015-11-26), p. 2491-2501
    Abstract: MLL3 acts as tumor suppressor in FLT3-ITD AML. The existence of DNMT3A mutations in remission samples implies that the DNMT3A mutant clone can survive induction chemotherapy.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2015
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 9
    Online Resource
    Online Resource
    American Society of Hematology ; 2018
    In:  Blood Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5263-5263
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5263-5263
    Abstract: Introduction Genetic mutations play an important role in the development and progression of acute myeloid leukemia (AML). One of the common aberration in AML is mutation in the epigenetic modifying gene, DNA methyltransferase 3α (DNMT3A). Despite the active investigations, the exact impact of mutation on the development of AML is not completely known. The occurrence of mutation in pre-leukemic cells explains a particular attention to DNMT3A. The most common mutation is located in codon R882 (DNMT3AR882mut). The objective of this study is to compare clinical and prognostic characteristics of AML patients in relation to presence of DNMT3AR882mut. The quantification of the mutation burden in follow up samples was performed both after standard therapy and after allogeneic stem cell transplantation (alloSCT). In addition, it was investigated whether the quantification of the mutational burden of DNMT3AR882mut is significant to the progression of disease. Methods Samples of 580 AML were retrospective analyzed using HRM-PCR, capillare electrophorese, and Sanger Sequencing. The median observation period was 495 days. Of 580, 69 have DNMT3AR882mut. Mutation burden was evaluated in follow-up samples by quantitative PCR. The statistical methods were selected according to sample distribution and evaluated with SPSS (significance level p 〈 0.05). Results DNMT3A R882mut were associated with a higher level of leukocytes and blasts at diagnosis, with M4-M5 variant of AML, and with normal karyotype. It was found that NPM1 and FLT3-ITD are more frequent co-mutations that have a significant effect on the prognosis of disease. Analysis of mutation burden of DNMT3AR882mut at diagnosis showed a large spread (0.02 - 66.9 %). At the time of diagnosis, DNMT3AR882mut transcript levels did not correlate with clinical and prognostic characteristics. The mutation burden decreased after therapy, but was always visible in CR after standard therapy. In CR after allogeneic stem cell transplantation (alloSCT) with complete donor chimerism mutation was not detected. In relapse of AML, an increasing of the mutation burden were found in all patients, both after therapy, and after alloSCT. In relapse samples, the same mutant clone was found. Conclusion The DNMT3A mutation is a common genetic aberration in AML patients, which is associated with specific clinical and prognostic data. The presence of co-mutations, especially NPM1 and FLT3-ITD, has a significant effect on the prognosis of patients. Quantitative detection of DNMT3AR882mut at different time points of disease revealed the persistence of mutated clone after standard therapy and disappearance of DNMT3AR882mut after alloSCT. It is suggest that alloSCT is the optimal treatment option for the eradication of DNMT3AR882mut in AML patients. Disclosures Bullinger: Sanofi: Research Funding, Speakers Bureau; Janssen: Speakers Bureau; Amgen: Honoraria, Speakers Bureau; Pfizer: Speakers Bureau; Jazz Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Bristol-Myers Squibb: Speakers Bureau; Bayer Oncology: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 10
    Online Resource
    Online Resource
    Informa UK Limited ; 2013
    In:  Leukemia & Lymphoma Vol. 54, No. 1 ( 2013-01), p. 145-152
    In: Leukemia & Lymphoma, Informa UK Limited, Vol. 54, No. 1 ( 2013-01), p. 145-152
    Type of Medium: Online Resource
    ISSN: 1042-8194 , 1029-2403
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2013
    detail.hit.zdb_id: 2030637-4
    detail.hit.zdb_id: 1042374-6
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