12th Congress of the European Hematology ... - Haematologica
12th Congress of the European Hematology ... - Haematologica
12th Congress of the European Hematology ... - Haematologica
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0933<br />
CLINICAL FEATURES OF ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION-<br />
ASSOCIATED ORGANIZING PNEUMONIA<br />
K. Ohashi, 1 M. Jinta, 2 H. Akiyama, 1 H. Sakamaki1 1 Tokyo Metropolitan Komagome Hospital, TOKYO, Japan; 2 Tokyo Medical<br />
and Dental University, TOKYO, Japan<br />
In this study, we describe <strong>the</strong> clinical course and outcomes <strong>of</strong> allogeneic<br />
hematopoietic stem cell transplantation-associated organizing pneumonia<br />
(HOP) observed in our institution over <strong>the</strong> past 20 years. Charts and<br />
chest radiographs <strong>of</strong> 603 allogeneic transplant recipients were retrospectively<br />
reviewed for HOP. Total 12 cases <strong>of</strong> HOP were observed (2.0%) at<br />
a median interval <strong>of</strong> 148 days after transplantation (range, 53-475 days).<br />
They presented low-grade fever, non-productive cough and dyspnea at <strong>the</strong><br />
onset <strong>of</strong> HOP. The initial antibiotics treatment did not ameliorate <strong>the</strong>se<br />
symptoms, but most patients well responded to 0.5-1 mg/kg <strong>of</strong> prednisolone.<br />
However, in 9 out <strong>of</strong> 12 patients, HOP flared-up after discontinuing<br />
treatment or while decreasing <strong>the</strong> doses, but responded to <strong>the</strong> retreatment<br />
with <strong>the</strong> initial dose <strong>of</strong> steroids. Although 3 patients died, <strong>the</strong>re<br />
was no death due to pulmonary failure. In remaining 9 patients, <strong>the</strong>re was<br />
no relapse <strong>of</strong> primary disease and 5-year survival was 74.1%. The clinical<br />
features <strong>of</strong> 12 patients were similar in that <strong>the</strong>y all received an irradiation<br />
containing conditioning and most patients had a prior history <strong>of</strong> acute<br />
graft-versus-host disease (GVHD) and cytomegalovirus (CMV) infection.<br />
Fur<strong>the</strong>rmore, 8 patients had active chronic GVHD at <strong>the</strong> onset <strong>of</strong> HOP.<br />
These suggest that several factor such as irradiation containing regimen,<br />
previous CMV infection and allogeneic immune reaction may contribute<br />
to <strong>the</strong> occurrence <strong>of</strong> HOP. Moreover, <strong>the</strong> patients with HOP might enjoy<br />
a relatively good prognosis due to low rate <strong>of</strong> relapse <strong>of</strong> primary disease<br />
possibly through graft-versus-leukemia reaction, even though facing multiple<br />
episodes <strong>of</strong> disease exacerbation <strong>of</strong> HOP.<br />
Table 1. Clinical features <strong>of</strong> HOP.<br />
1 Day 105 + + - - 88 68 71/68 N M No No + - - 0.20 98.6 87.6 ND ND<br />
2 Day 53 + + - - 96 33 33/531 A+I M No No + - - 0.38 130.3 78.0 68.2 73.2<br />
3 Day 173 + + + - 91 14.3 35/541 A F No Yes + - + 0.06 133.9 72.1 85.7 88.7<br />
4 Day 203 - - + - 96 2.3 ND/ND N M No No + - + ND 109.2 79.3 81.7 87.3<br />
5 Day 140 + + - - ND 2.2 ND/ND A F No Yes - - + ND 109.2 77.6 ND ND<br />
6 Day 259 - + - - 97 1.9 ND/ND N M No No - - + 0.14 103.9 88.4 94.2 93.7<br />
7 Day 475 + - + - 81 35.1 6/134 A+I D No Yes + - + ND 122.0 83.5 ND ND<br />
8 Day 124 + + - - 92 0.4 31/551 A+I D No Yes + - + 0.36 96.0 86.1 57.1 87.4<br />
9 Day 156 - - + - 96 0.0 6/372 A+I M No No - + + 0.51 118.9 83.9 107.0 86.5<br />
10 Day 118 - + + - 94 4.7 19/525 A+I M No Yes - + + ND 120.7 83.9 ND ND<br />
11 Day 266 + + - - 92 1.1 90/765 I D No Yes - + - 0.10 104.9 81.3 51.0 76.0<br />
12 Day 122 + + - - 91 14.4 ND/230 A+I M No Yes - + - ND 89.5 87.6 83.1 93.9<br />
0934<br />
B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA-DERIVED DENDRITIC CELLS STIMULATE<br />
ALLOGENEIC T-CELL RESPONSE AND EXPRESS CHEMOKINES INVOLVED IN T-CELL<br />
MIGRATION<br />
W. Luczynski, A. Stasiak-Barmuta, J. Piszcz, E. Ilendo, O. Kowalczuk,<br />
M. Krawczuk-Rybak<br />
Medical University, BIALYSTOK, Poland<br />
Background. Despite discovery <strong>of</strong> new <strong>the</strong>rapeutic agents, including<br />
nucleoside analogs and monoclonal antibodies, <strong>the</strong> B-cell chronic lymphocytic<br />
leukemia (B-CLL) remains incurable. In recent years, some effort has<br />
been made in developing T-cell specific immunity against neoplasmatic<br />
cells. Reconstitution <strong>of</strong> effective costimulation and immunological<br />
response <strong>of</strong> host T-cells against CLL cells could be a potential approach<br />
in immuno<strong>the</strong>rapeutic trials. CD40/CD40L system is involved in <strong>the</strong> survival<br />
and proliferation <strong>of</strong> normal and neoplasmatic B-cells. Some preclinical<br />
studies have shown that CD40 stimulation can differentiate leukemic<br />
cells into dendritic cells (DCs) and result in host response. Aims. In this<br />
study, we sought to determine whe<strong>the</strong>r B-CLL cells could be turned into<br />
efficient and functional antigen presenting cells, as well as to assess <strong>the</strong><br />
type <strong>of</strong> allogeneic T-cell response against B-CLL - derived DCs. Methods.<br />
B-CLL cells from 25 patients were stimulated or not with CD40L and IL-<br />
4 for 96 hours and <strong>the</strong>n cultured in mixed lymphocyte reaction (MLR)<br />
with allogeneic T-cells. The expression <strong>of</strong> costimulatory and adhesion<br />
molecules at mRNA (real-time RT PCR) and protein level (flow cytometry)<br />
was assessed before and after <strong>the</strong> culture <strong>of</strong> B-CLL cells with or<br />
without CD40L/IL-4. The expression <strong>of</strong> activation molecules on <strong>the</strong> surface<br />
<strong>of</strong> T-cells before and after MLR was assessed with flow cytometry.<br />
The mRNA levels for chosen chemokines was determined by real-time<br />
12 th <strong>Congress</strong> <strong>of</strong> <strong>the</strong> <strong>European</strong> <strong>Hematology</strong> Association<br />
RT-PCR. Results. 1) after CD40 stimulation B-CLL cells achieved phenotypical<br />
and functional characterization <strong>of</strong> DCs (i.e. upregulated co-stimulatory<br />
and adhesion molecules at mRNA and protein level) 2) leukemiaderived<br />
DCs expressed higher amount <strong>of</strong> mRNA for chemokines<br />
involved in T-cell migration (MDC, TARC and CCR7) 3) <strong>the</strong> proliferating<br />
response <strong>of</strong> T-cells against leukemia-derived DCs consisted <strong>of</strong> CD4<br />
and CD8 cells (upregulation <strong>of</strong> HLA-DR and OX40). Conclusion. Our<br />
experiment confirm that B-CLL cells can be turned into dendritic-like<br />
cells, additionally, <strong>the</strong>se cells express chemokines involved in T-cell<br />
migration and stimulate allogeneic response.<br />
0935<br />
TRANSCRIPTIONAL SILENCING AND FREQUENT ABERRANT DNA METHYLATION OF<br />
ADAMTS-1, AN ANTIANGIOGENIC FACTOR WITH DIRECT INHIBITORY EFFECTS ON<br />
LEUKEMIC CELL GROWTH IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA<br />
K.-M. Lau, 1,3 L. Li1 , S.-H. Cheng1 , A.P.L. Cheung, 1 K.C.K. Cheng, 1<br />
M.M.K. Shing, 2 C.-K. Li, 2 M.H.L. Ng1,3 1 Department <strong>of</strong> Anatomical and Cellular Pathology, 2 Department <strong>of</strong> Pediatrics,<br />
Prince <strong>of</strong> Wales Hospital, The Chinese University <strong>of</strong> Hong Kong and 3 State Key<br />
Laboratory in Oncology in South China, The Chinese University <strong>of</strong> Hong Kong<br />
Background. Angiogenesis plays an increasingly important role in carcinogenesis<br />
and is a prominent feature in <strong>the</strong> bone marrow (BM) in childhood<br />
acute lymphoblastic leukemia (ALL). ADAMTS-1 (A Disintegrin<br />
And Metalloproteinase with ThromboSpondin-like motifs-1) is a potent<br />
endogenous angiogenic inhibitor and its expression is down-regulated in<br />
certain human solid cancers. Aims. To examine <strong>the</strong> involvement <strong>of</strong><br />
ADAMTS-1 in <strong>the</strong> pathogenesis <strong>of</strong> childhood ALL by expression and DNA<br />
methylation studies. Methods. Semi-quantitative RT-PCR was used for<br />
examining ADAMTS-1 expression. Bisulfite DNA sequencing and combined<br />
bisulfite restriction analysis for determining ADAMTS-1 methylation.<br />
Nucle<strong>of</strong>ection, annexin V and propidium iodide staining for studying<br />
<strong>the</strong> effects <strong>of</strong> exogenic ADAMTS-1 expression on apoptosis and cell<br />
cycle regulation. Results. We first demonstrated aberrant DNA methylation<br />
associated loss <strong>of</strong> expression <strong>of</strong> ADAMTS-1 in 2/3 B-lineage ALL cell lines<br />
(Reh and RS4:11) and in 4/7 BM samples from pediatric patients with Blineage<br />
ALL, and reactivation <strong>of</strong> this gene expression by DNA demethylation<br />
in <strong>the</strong> Reh cells. We also first revealed aberrant DNA methylation<br />
<strong>of</strong> ADAMTS-1 in 31 out <strong>of</strong> 42 (74%) childhood patients with B-lineage<br />
ALL. Exogenic ADAMTS-1 expression significantly induced G2/M cell<br />
cycle arrest and apoptosis in <strong>the</strong> Reh leukemic cells. Conclusions. Our findings<br />
indicated that aberrant ADAMTS-1 DNA methylation associated<br />
transcriptional silencing <strong>of</strong> <strong>the</strong> gene might be involved in <strong>the</strong> leukemogenesis<br />
<strong>of</strong> childhood ALL. More importantly, in addition to <strong>the</strong> antiangiogenic<br />
effect, for <strong>the</strong> first time, we demonstrated <strong>the</strong> direct inhibitory effects<br />
<strong>of</strong> ADAMTS-1 on leukemic cell growth, which represents an endo<strong>the</strong>lial<br />
cell-independent action <strong>of</strong> this molecule in cancer growth control. These<br />
findings may have critical impacts in molecular targeting strategy in <strong>the</strong><br />
management <strong>of</strong> B-lineage childhood ALL.<br />
*The work described in this paper was partially supported by a grant from <strong>the</strong><br />
Research Council <strong>of</strong> <strong>the</strong> Hong Kong Special Administrative Region, China (Project<br />
No. CUHK 4415/05M).<br />
haematologica/<strong>the</strong> hematology journal | 2007; 92(s1) | 349