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  • SURVIVAL  (5)
  • 1
    Keywords: RECEPTOR ; ANGIOGENESIS ; CANCER ; CELLS ; EXPRESSION ; IN-VITRO ; proliferation ; SURVIVAL ; CELL ; Germany ; VITRO ; DIAGNOSIS ; SUPPORT ; SYSTEM ; microarray ; PROTEIN ; PROTEINS ; SAMPLE ; SAMPLES ; cell line ; LINES ; TIME ; PATIENT ; DNA ; CELL-LINES ; STAGE ; microarrays ; PLASMA ; affymetrix ; CELL-LINE ; chemotherapy ; PATHOGENESIS ; PROGNOSTIC-FACTORS ; CANCER-PATIENTS ; PROGNOSTIC FACTORS ; RECEPTORS ; CANCER PATIENTS ; cell lines ; MULTIPLE-MYELOMA ; beta(2)-microglobulin ; HIGH-DOSE CHEMOTHERAPY ; multiple myeloma ; PROGNOSTIC-FACTOR ; LONG ; STAGING SYSTEM ; BONE ; RELEVANCE ; CANDIDATES ; PLASMA-CELLS ; Plasma cells ; A
    Abstract: Pathogenesis of multiple myeloma is associated with an aberrant expression of pro-proliferative, pro-angiogenic and bone-metabolism-modifying factors by malignant plasma cells. Given the frequently long time span from diagnosis of early-stage plasma cell dyscrasias to overt myeloma and the mostly low proliferation rate of malignant plasma cells, we hypothesize these to similarly express a novel class of inhibitory factors of potential prognostic relevance. Bone morphogenic proteins (BMPs) represent possible candidates as they inhibit proliferation, stimulate bone formation and have an effect on the survival of cancer patients. We assessed the expression of BMPs and their receptors by Affymetrix DNA microarrays (n=779) including CD138-purified primary myeloma cell samples (n=635) of previously untreated patients. BMP6 is the only BMP expressed by malignant and normal plasma cells. Its expression is significantly lower in proliferating myeloma cells, myeloma cell lines or plasmablasts. BMP6 significantly inhibits the proliferation of myeloma cell lines, survival of primary myeloma cells and in vitro angiogenesis. A high BMP6 expression in primary myeloma cell samples delineates significantly superior overall survival for patients undergoing high-dose chemotherapy independent of conventional prognostic factors (International Staging System (ISS) stage, beta(2) microglobulin)
    Type of Publication: Journal article published
    PubMed ID: 19718049
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  • 2
    Keywords: PROGNOSTIC-FACTORS ; chemotherapy ; HIGH-RISK ; PLASMA ; gene expression ; CHROMOSOMAL-ABERRATIONS ; treatment ; BONE-MARROW ; STAGE ; score ; TARGET ; DELETION ; multiple myeloma ; HIGH-DOSE CHEMOTHERAPY ; PROGNOSTIC FACTORS ; TRANSLOCATION ; MULTIPLE-MYELOMA ; CELL ; SURVIVAL ; proliferation ; EXPRESSION ; CELLS ; PATIENT ; COHORT ; RISK ; SAMPLE ; SAMPLES ; GENE-EXPRESSION ; GENE ; BONE ; PROGNOSTIC-FACTOR ; methods ; DISEASE PROGRESSION ; MARROW ; PLASMA-CELLS ; chromosomal aberration ; A ; D ; Plasma cells
    Abstract: Introduction: Proliferation of malignant plasma cells - currently rarely measured - has been described as strong adverse prognostic factors in multiple myeloma. Methods. We assessed proliferation using gene expression based indices in 757 samples including two independent cohorts of 298 and 345 CD138-purified myeloma cells from previously untreated patients undergoing high-dose chemotherapy, together with clinical prognostic factors, chromosomal aberrations, and gene expression based high-risk scores. Results. In the two cohorts, 43.3 % and 39.4 % of all myeloma cell samples show a proliferation-index above the median plus three standard deviations of normal bone marrow plasma cells. Within myeloma cell samples, malignant plasma cells of patients in advanced stages or those harboring a disease-progression associated gain of 1q21 or deletion of 13q14.3 show a significantly higher, those with gain of chromosome 9, 15 or 19 (hyperdiploid samples) a significantly lower proliferation-index. Proliferation correlates with presence of chromosomal aberrations in metaphase cytogenetics. It is significantly predictive for event-free and overall survival in both cohorts of patients, largely independent of clinical prognostic factors, e.g. serum-ß2-microglobulin, ISS stage,high-risk associated chromosomal aberrations, e.g. translocation t(4;14), and gene expression based high-risk scores. Conclusion. Proliferation is a central prognostic factor in multiple myeloma. Using gene expression based assessment anti-proliferative treatment could be personalizedand risk-adaptedly administered.Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaften für Hämatologie und Onkologie, 2.-6. Oktober 2009, Heidelberg/Mannheim
    Type of Publication: Meeting abstract published
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  • 3
    Keywords: GENE ; GENE-EXPRESSION ; EXPRESSION ; SURVIVAL ; CLASSIFICATION ; gene expression profiling ; FLUORESCENCE ; expression profiling ; MULTIPLE-MYELOMA ; ONCOLOGY ; multiple myeloma ; Jun ; gene expression ; IN-SITU ; fluorescence in situ hybridisation ; PROGNOSTIC-FACTOR ; MOLECULAR CLASSIFICATION ; FREE SURVIVAL
    Type of Publication: Meeting abstract published
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  • 4
    Keywords: PATHOGENESIS ; PROGNOSTIC-FACTORS ; PLASMA ; affymetrix ; CELL-LINE ; chemotherapy ; CELL-LINES ; multiple myeloma ; HIGH-DOSE CHEMOTHERAPY ; CANCER PATIENTS ; RECEPTORS ; PROGNOSTIC FACTORS ; CANCER-PATIENTS ; cell lines ; MULTIPLE-MYELOMA ; CELL ; human ; VITRO ; DIAGNOSIS ; INHIBITION ; IN-VITRO ; proliferation ; SURVIVAL ; CANCER ; CELLS ; EXPRESSION ; RECEPTOR ; ANGIOGENESIS ; APOPTOSIS ; PATIENT ; LINES ; TRANSPLANTATION ; INDUCTION ; IMPACT ; PROTEINS ; PROTEIN ; SAMPLE ; SAMPLES ; cell line ; BONE ; RELEVANCE ; STEM-CELL ; methods ; PROGNOSTIC-FACTOR ; PLASMA-CELLS ; CANDIDATES ; A ; D ; Plasma cells ; autologous ; WELL
    Abstract: Introduction:Pathogenesis of multiple myeloma is associated with an aberrant expression of pro-proliferative-, pro-angiogenic and bone-metabolism modifying factors by malignant plasma cells. Given the timespan from diagnosis of early-stage plasma cell dyscrasias to overt myeloma and the low proliferation rate of malignant plasma cells, we hypothesize these likewise to express a novel class of inhibitory factors of potential prognostic relevance. Bone morphogenic proteins (BMPs) represent possible candidates as they inhibit proliferation, stimulate bone formation, and have impact on the survival of cancer patients.Methods.We assessed expression of BMPs and their receptors by Affymetrix DNA-microarrays (n=434) including CD138-purified primary myeloma cell samples (n=233) of previously untreated patients treated with high-dose chemotherapy and autologous stem cell transplantation. Inhibition of proliferation of human myeloma cell lines (n=10) and apoptosis induction in primary myeloma cell samples (n=5) is assessed. The inhibition of vitro tubule formation by BMP6 is investigated using the AngioKit-assay.Results.BMP6 is the only BMP expressed by malignant or normal plasma cells. Its expression is significantly lower in proliferating myeloma cells, myeloma cell lines, or plasmablasts. BMP6 significantly inhibits proliferation of myeloma cell lines, survival of primary myeloma cells, and in vitro angiogenesis. High BMP6-expression in primary myeloma cell samples delineates significantly superior overall survival for patients undergoing high-dose chemotherapy independent of conventional prognostic factors (ISS-stage, serum-ß2-microglobulin).Conclusion.BMP6 exemplifies a novel class of factors independently prognostic for overall survival expressed by normal as well as malignant plasma cells that inhibits proliferation of myeloma cells and induction of angiogenesis.Gemeinsame Jahrestagung der Deutschen, Österreichischen und Schweizerischen Gesellschaften für Hämatologie und Onkologie, 2.-6. Oktober 2009, Heidelberg/Mannheim
    Type of Publication: Meeting abstract published
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  • 5
    Keywords: EXPRESSION ; proliferation ; SURVIVAL ; KINASE ; SYSTEM ; RISK ; GENE-EXPRESSION ; IN-SITU HYBRIDIZATION ; gene expression profiling ; multiple myeloma ; STAGING SYSTEM ; MOLECULAR CLASSIFICATION ; INTERGROUPE FRANCOPHONE ; CELL LABELING INDEX ; CYCLIN-D DYSREGULATION ; EVENT-FREE SURVIVAL ; MALIGNANT PLASMA-CELLS ; MONOCLONAL GAMMOPATHIES ; risk score ; risk-adapted treatment
    Abstract: Background. Proliferation of malignant plasma cells is a strong adverse prognostic factor in multiple myeloma and simultaneously targetable by available (e.g. tubulin-polymerase inhibitors) and upcoming (e.g. aurora-kinase inhibitors) compounds. Design and Methods. We assessed proliferation using gene-expression based indices in 757 samples including independent cohorts of 298 and 345 CD138-purified myeloma cells from previously untreated patients undergoing high-dose chemotherapy, together with clinical prognostic factors, chromosomal aberrations, and gene-expression based high-risk scores. Results. In the two cohorts, 43.3% and 39.4% of myeloma cell samples show a proliferation-index above the median plus three standard-deviations of normal bone-marrow plasma cells. Thereby, malignant plasma cells of patients in advanced stages or those harboring disease-progression associated gain of 1q21 or deletion of 13q14.3 show significantly higher, patients with gain of chromosome 9, 15 or 19 (hyperdiploid samples) significantly lower proliferation-indices. Proliferation correlates with presence of chromosomal aberrations in metaphase cytogenetics. It is significantly predictive for event-free and overall survival in both cohorts, allows highly predictive risk stratification (e.g. event-free survival 12.7 vs. 26.2 vs. 40.6 months, P〈.001) of patients, and is largely independent of clinical prognostic factors, e.g. serum-beta2-microglobulin, ISS-stage, high-risk associated chromosomal aberrations, e.g. translocation t(4;14), and gene-expression based high-risk scores. Conclusions. Proliferation assessed by gene-expression-profiling, being independent of serum-beta2-microglobulin, ISS-stage, t(4;14), and gene-expression-based risk-scores, is thus a central prognostic factor in multiple myeloma. Surrogating a biological targetable variable, gene-expression-based assessment of proliferation allows selection of patients for risk-adapted anti-proliferative treatment in the background of conventional and gene expression based risk factors.
    Type of Publication: Journal article published
    PubMed ID: 20884712
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