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12th Congress of the European Hematology ... - Haematologica

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12 th <strong>Congress</strong> <strong>of</strong> <strong>the</strong> <strong>European</strong> <strong>Hematology</strong> Association<br />

Acute myeloid leukemia - Biology II<br />

0466<br />

ROLE OF MONOCYTE CHEMOATTRACTANT PROTEIN-1 IN THE CHEMOTACTIC MIGRATION<br />

OF ALL-TRANS RETINOIC ACID-TREATED PROMYELOCYTIC LEUKEMIC CELLS TOWARD<br />

ALVEOLAR EPITHELIAL CELLS<br />

H.Ch. Hsu, 1 W.H. Tsai, 2 C.C. Lin, 1 C.H. Shih, 3 C.K. Ho, 1 Y.R. Kou2 1 Taipei-Veterans General Hospital, TAIPEI; 2 National Yang-Ming University,<br />

TAIPEI; 3 Taipei Medical University, TAIPEI, Taiwan<br />

Background. Although all-trans retinoic acid (ATRA) can treat acute<br />

promyelocytic leukemia (APL), it also causes retinoic acid syndrome<br />

with presentations similar to acute respiratory distress syndrome. Our<br />

previous study has demonstrated that IL-8 and GRO-α secreted from<br />

alveolar epi<strong>the</strong>lial cells play an important role in <strong>the</strong> cell-cell interaction<br />

involved in <strong>the</strong> chemotactic transmigration <strong>of</strong> ATRA-treated APL cells<br />

toward alveolar epi<strong>the</strong>lial cells.(Critical Care Medicine-<br />

10.1097/01.CCM.0000256844.38259.27). Aims. In this study, we fur<strong>the</strong>r<br />

investigated <strong>the</strong> role <strong>of</strong> monocyte chemoattractant protein-1 (MCP-1;<br />

CCL2) involved in <strong>the</strong> chemotactic transmigration <strong>of</strong> ATRA-treated NB4<br />

(ATRA-NB4) APL cells toward A549 alveolar epi<strong>the</strong>lial cells. Methods.<br />

Co-culture and transmigration assay were used in this study. NB4 and<br />

A549 cells were separately cultured with ATRA and/or dexamethasone<br />

for 1-3 days. NB4 or ATRA-NB4 cells were <strong>the</strong>n placed in an upper insert<br />

and co-incubated with A549 cells or <strong>the</strong>ir conditioned medium (CM)<br />

located in a lower plate. Results. We firstly determined <strong>the</strong> MCP-1 level<br />

in <strong>the</strong> CM by ELISA. Only A549 cells constitutively secreted MCP-1.<br />

However, ATRA treatment markedly enhanced <strong>the</strong> secretion <strong>of</strong> MCP-1<br />

in both A549 and NB4 cells. Exogenous administration <strong>of</strong> MCP-1 also<br />

promoted <strong>the</strong> ATRA-NB4 transmigration. Neutralization <strong>of</strong> MCP-1 in<br />

CM <strong>of</strong> A549 cells with its specific antibodies reduced ATRA-NB4 transmigration<br />

by about 38%. Pretreatment <strong>of</strong> ATRA-treated NB4 cells with<br />

antibody directed against MCP-1 receptor (CCR2) significantly reduce<br />

<strong>the</strong> transmigration <strong>of</strong> ATRA-treated NB4 cells by about 45%. Dexamethasone<br />

did not affect <strong>the</strong> secretion <strong>of</strong> MCP-1 in untreated- or ATRAtreated<br />

NB4 cells. However, when dexamethasone was applied to A549<br />

cells, MCP-1 secretion was suppressed in both untreated- or ATRAtreated<br />

A549 cells, and <strong>the</strong>re was attenuation <strong>of</strong> ATRA-NB4 transmigration.<br />

Conclusions. MCP-1 secreted from alveolar epi<strong>the</strong>lial cells also play<br />

an important role in <strong>the</strong> cell-cell interaction involved in <strong>the</strong> chemotactic<br />

transmigration <strong>of</strong> ATRA-treated APL cells toward alveolar epi<strong>the</strong>lial<br />

cells.<br />

0467<br />

REPORT OF 38 PATIENTS WITH HYPERDIPLOID KARYOTYPE IN ACUTE MYELOID<br />

LEUKEMIA: A GROUPE FRANCAIS DE CYTOGENETIQUE HEMATOLOGIQUE STUDY<br />

C. Terré, 1 I. Luquet, 2 J.L. Laï, 3 C. Barin, 4 L. Baranger, 5<br />

C. Bilhou-Nabera, 6 E. Lippert, 7 C. Gervais, 8 P. Talmant, 9<br />

P. Cornillet-Lefebvre, 2 C. Perot, 10 N. Nadal, 11 M.J. Mozziconacci, 12<br />

M. Lafage-Pochital<strong>of</strong>f, 12 V. Eclache, 13 F. Mugneret, 14 C. Lefebvre, 15<br />

C. Herens, 16 F. Speleman, 17 H. Poirel, 18 I. Tigaud, 19 C. Cabrol, 20<br />

P. Rousselot, 1 S. Castaigne, 1 R. Berger21 1 Versailles Hospital, LE CHESNAY, France; 2 Reims Hospital, REIMS, France;<br />

3Lille Hospital, LILLE, France; 4 Tours Hospital, TOURS, France, 5Angers Hospital,<br />

ANGERS, France; 6 Kremlin-Bicêtre Hospital, KREMLIN-BICÊTRE,<br />

France; 7 Bordeaux Hospital, BORDEAUX, France; 8 Strasbourg Hospital,<br />

STRASBOURG, France; 9 Nantes Hospital, NANTES, France; 10 Saint-Antoine<br />

Hospital, PARIS, France; 11 Saint-Etienne Hospital, SAINT-ETIENNE, France;<br />

12 Paoli-Calmettes Institut, MARSEILLE, France; 13 Avicenne Hospital, AVI-<br />

CENNE, France; 14 Dijon Hospital, DIJON, France; 15 Grenoble Hospital,<br />

GRENOBLE, France; 16 Liège Hospital, LIÈGE, Belgium; 17 Ghent Hospital,<br />

GHENT, Belgium; 18 Cliniques Universitaires St-Luc, BRUXELLES, Belgium;<br />

19 Lyon Hospital, LYON, France; 20 Genève Hospital, GENÈVE, Switzerland;<br />

21 Necker Hospital, PARIS, France<br />

Background. Large hyperdiploidy (49 or more chromosomes) is a rare<br />

abnormality in AML and no large series describing <strong>the</strong> feature <strong>of</strong> such<br />

population <strong>of</strong> patients are available. Applying <strong>the</strong> definition <strong>of</strong> complexe<br />

caryotypes, all patients with hyperdiploid AML fall in <strong>the</strong> high risk<br />

cytogenetic cohort. Aims. We report here <strong>the</strong> first large cohort <strong>of</strong> 38<br />

patients with more than 48 chromosomes and without karyotypic structural<br />

abnormality to better define <strong>the</strong> incidence, <strong>the</strong> clinical and morphological<br />

characteristics, and <strong>the</strong> prognosis <strong>of</strong> this rare group <strong>of</strong> patients.<br />

174 | haematologica/<strong>the</strong> hematology journal | 2007; 92(s1)<br />

Methods. 4884 cytogenetic studies performed in laboratories members <strong>of</strong><br />

<strong>the</strong> GFCH were screened. This corresponds to AML patients (adults and<br />

pediatrics) diagnosed in 19 French and Belgium institutions during A<br />

retrospective and one year prospective survey (February 2005-February<br />

2006). We were able to select 38 AML patients with hyperdiploid karyotypes<br />

without structural abnormality under conventional cytogenetic.<br />

Results. Large hyperdiploidy is rare in AML with an incidence inferior to<br />

1% (0.78%). Sex ratio F/M was 2.2 and median age 65 years (ranging<br />

from 1 to 91 years). All AML FAB subtype was represented. Although<br />

all chromosomes are involved, some seems to prevail: gains <strong>of</strong> chromosome<br />

8 (68%), 21 (47%) and 19 (39%) are <strong>the</strong> most frequent followed<br />

by gains <strong>of</strong> chromosome 14 (34%), chromosomes 10 and 13 (29% each)<br />

and chromosomes 4 and 11 (26% each). Interestingly, some chromosomes<br />

involved in hyperdiploid ALL (4, 6, 8 , 10, 14, 18, 21 and X) are<br />

also found in our hyperdiploid AML patients, suggesting that <strong>the</strong>se gains<br />

are not lineage restricted. Monosomie was uncommon and we report<br />

only two X chromosome losses in women. A cryptic rearrangement <strong>of</strong><br />

MLL was found in 15% <strong>of</strong> <strong>the</strong>se patients leading <strong>the</strong>m in a subcategory<br />

in <strong>the</strong> WHO classification with an unfavorable prognosis. Therefore<br />

detection <strong>of</strong> MLL rearrangement should be systematically search in AML<br />

without a well cytogenetically established prognosis. When we applied<br />

<strong>the</strong> most frequent definition <strong>of</strong> complexe karyotypes (3 or more abnormalities),<br />

all patients with large hyperdiploid AML fall in <strong>the</strong> unfavorable<br />

category. Among <strong>the</strong> 18 patients without ML rearrangement receiving<br />

an induction <strong>the</strong>rapy, 16 (89%) reached CR and 6 (33%) were still<br />

alive after a 26 months median follow-up (10-56 months). The median<br />

time to relapse is 658 days for <strong>the</strong> 16 patients in CR including 3 patients<br />

censored at <strong>the</strong> time <strong>of</strong> bone marrow transplantation. Conclusions.<br />

Although this study was retrospective <strong>the</strong>se results suggest that hyperdiploid<br />

AML may be better classified in <strong>the</strong> intermediate prognostic<br />

group when hyperdiploidy is <strong>the</strong> only cytogenetic abnormality.<br />

0468<br />

CTLA-4 EXPRESSED BY CHEMORESISTANT, AS WELL AS UNTREATED, MYELOID<br />

LEUKEMIA CELLS CAN BE TARGETED WITH LIGANDS TO INDUCE APOPTOSIS<br />

S. Laurent, 1 G.L. Palmisano, 2 A. Martelli, 3 K. Tomohiro, 4 P.L. Tazzari, 5 I.<br />

Pierri, 6 M. Clavio, 6 B. Dozin, 1 G. Balbi, 7 M. Megna, 1 A. Morabito, 1<br />

T. Lamparelli, 6 A. Bacigalupo, 6 M. Gobbi, 6 M.P. Pistillo1<br />

1 2 National Cancer Research Inst., GENOVA, Italy; Dept <strong>of</strong> Biology, GENO-<br />

VA, Italy; 3Dept Human Anatom. Sciences, BOLOGNA, Italy; 4S. Marianna<br />

Univ. School <strong>of</strong> Medic., KANAGAWA, Japan; 5S. Orsola Malpighi Hospital,<br />

BOLOGNA, Italy; 6Dept. <strong>Hematology</strong> S. Martino H., GENOVA, Italy;<br />

7DOBIG University <strong>of</strong> Genoa, GENOVA, Italy<br />

Background and Aims. We previously reported that about 80% <strong>of</strong> acute<br />

myeloid leukemia (AML) samples tested at diagnosis constitutively<br />

expressed CTLA-4. In this study, we compared CTLA-4 expression and<br />

function <strong>of</strong> leukemic cells from AML patients at diagnosis with those<br />

from AML patients resistant to conventional chemo<strong>the</strong>rapy. We also<br />

explored <strong>the</strong> possibility <strong>of</strong> targeting CTLA-4 for apoptosis induction in<br />

chemoresistant AML cells. Results. AML cells ei<strong>the</strong>r from untreated<br />

patients (n=15) or in chemoresistant phase (n=10) were analysed for<br />

CTLA-4 protein and transcript expression by flow cytometry and RT-<br />

PCR, respectively. CTLA-4 expression was similar in untreated and in<br />

chemoresistant samples and not associated with patients’ clinical features.<br />

CTLA-4 expressed by chemoresistant AML cells was able to transduce<br />

an apoptotic signal on engagement with its recombinant ligands r-<br />

CD80/r-CD86 which induced an average <strong>of</strong> 71% and 62% apoptotic<br />

cells respectively, at highest concentration. Apoptosis was equally<br />

induced in untreated leukemic cells accompanied by cleavage <strong>of</strong> procaspase-8<br />

and -3. Conclusions. this study provides <strong>the</strong> first evidence that<br />

killing <strong>of</strong> leukemic cells from AML patients may be obtained upon<br />

engagement <strong>of</strong> CTLA-4 with its ligands opening <strong>the</strong> way to a novel<br />

potential <strong>the</strong>rapeutic approach based on triggering <strong>the</strong> CTLA-4 molecule<br />

to circumvent chemoresistance in AML.<br />

0469<br />

PROTEOMICS ANALYSIS TO IDENTIFY BIOMARKERS AND PHARMACOLOGICAL TARGETS<br />

IN ACUTE MYELOID LEUKEMIAS WITH FLT3/ITD MUTATIONS<br />

N. Barbarroja, 1 L.A. Torres, 1 V. Hernandez, 1 E. Siendones, 2<br />

J.M. Villalba, 3 A. Torres, 1 F. Velasco, 1 Ch. López-Pedrera1 1 Hospital Reina S<strong>of</strong>ia, CÓRDOBA; 2 Centro Andaluz Biologia del Desarrollo,<br />

SEVILLA; 3 Universidad de Córdoba, CÓRDOBA, Spain<br />

The Flt3 receptor tyrosine kinase is a critical mediator in <strong>the</strong> patho-

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