Therapy-related myelodysplasia or acute myelogenous leukemia (t-MDS/AML) is a dreaded complication and the most common cause of non-relapse mortality in patients undergoing autologous hematopoietic cell transplantation (aHCT) for Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Previous studies indicate that t-MDS/AML results from damage to hematopoietic stem cells from genotoxic cancer treatment. However, the sequential cellular and molecular changes leading to development of t-MDS/AML are not known. We are conducting a prospective, longitudinal study of patients with HL and NHL undergoing aHCT, in order to gain insight into the pathogenesis and identify predictors of susceptibility to t-MDS/AML. Patients are being followed longitudinally from pre-aHCT to five years post-aHCT, with serial banking of peripheral blood (PB) and bone marrow (BM) samples at pre-determined time-points. The known timing and nature of genotoxic exposures for management of HL or NHL, together with banking of sequentially obtained samples, provides a unique opportunity to study sequential molecular and cellular changes In this liigh-risk population. We are exploring the hypothesis that defects in DNA repair, DNA damage response and increased proliferative demand on HSC that have already acquired DNA damage may contribute to genomic instability and emergence of a malignant clone. Studies conducted during the previous grant period have indicated a role for accelerated telomere shortening and abnormal regulation of hematopoietic stem cell proliferation in the pathogenesis of t-MDS/AML and support this hypothesis. Our previous studies have also resulted in development of methodologies to evaluate DNA repair and acquisition of chromosomal aberrations in primary hematopoietic cells. We propose to build upon our previous findings and systematically investigate the role of these mechanisms in the pathogenesis of t-MDS/AML, with an overarching goal of developing biomarkers of enhanced risk of t-MDS/AML.
We aim to understand the mechanisms and significance of DNA repair defects, altered telomere regulation and acquisition of cytogenetic lesions in the pathogenesis of t- MDS/AML;and to understand the interaction of these abnormalities, therapeutic exposures and demographic variables in determining risk of t-MDS/AML. Successful completion of these studies will provide insights into the pathogenesis of t-MDS/AML and allow accurate assessment of risk factors associated with the development of t-MDS/AML. Early identification of high-risk populations may aid in modification of treatment regimens to reduce risk of this complication.
Therapy-related myelodysplasia or acute myelogenous leukemia (t-MDS/AML) is a dreaded complication of treatment in patients undergoing autologous hematopoietic cell transplantation (aHCT) for lymphoma. The proposed studies will provide insights into the pathogenesis of t-MDS/AML and allow identification of risk factors and biomarkers for development of this complication. Early identification of high-risk populations may guide modification of treatments to reduce risk of t-MDS/AML or application of novel preventive strategies.
|Jonnalagadda, Mahesh; Mardiros, Armen; Urak, Ryan et al. (2015) Chimeric antigen receptors with mutated IgG4 Fc spacer avoid fc receptor binding and improve T cell persistence and antitumor efficacy. Mol Ther 23:757-68|
|Lacoste, Sandrine; Bhatia, Ravi; Bhatia, Smita et al. (2014) Granulocytes affect double-strand break repair assays in primary human lymphocytes. PLoS One 9:e93185|
|Herrmann, Andreas; Priceman, Saul J; Swiderski, Piotr et al. (2014) CTLA4 aptamer delivers STAT3 siRNA to tumor-associated and malignant T cells. J Clin Invest 124:2977-87|
|Chadalavada, Deepti; Adamson, Trinka W; Burnett, John C et al. (2014) Irradiated compared with nonirradiated NSG mice for the development of a human B-cell lymphoma model. Comp Med 64:179-85|
|Yang, Chunmei; Lee, Heehyoung; Pal, Sumanta et al. (2013) B cells promote tumor progression via STAT3 regulated-angiogenesis. PLoS One 8:e64159|
|Xin, Hong; Lu, Rongze; Lee, Heehyoung et al. (2013) G-protein-coupled receptor agonist BV8/prokineticin-2 and STAT3 protein form a feed-forward loop in both normal and malignant myeloid cells. J Biol Chem 288:13842-9|
|Zhou, Jiehua; Tiemann, Katrin; Chomchan, Pritsana et al. (2013) Dual functional BAFF receptor aptamers inhibit ligand-induced proliferation and deliver siRNAs to NHL cells. Nucleic Acids Res 41:4266-83|
|Ng, Thomas S C; Wert, David; Sohi, Hargun et al. (2013) Serial diffusion MRI to monitor and model treatment response of the targeted nanotherapy CRLX101. Clin Cancer Res 19:2518-27|
|Jonnalagadda, M; Brown, C E; Chang, W C et al. (2013) Efficient selection of genetically modified human T cells using methotrexate-resistant human dihydrofolate reductase. Gene Ther 20:853-60|
|Yang, Chunmei; Lee, Heehyoung; Jove, Veronica et al. (2013) Prognostic significance of B-cells and pSTAT3 in patients with ovarian cancer. PLoS One 8:e54029|
Showing the most recent 10 out of 59 publications