1  3530 133 IMATINIB (ST1571) PROVIDES ONLY LIMITED SELECTIVITY FOR CML CELLS AND TREATMENT MIGHT BE COMPLICATED BY SILENT BCR-ABL GENES. VERY PROMISING RESULTS HAVE BEEN OBTAINED IN CLINICAL TRIALS ON CHRONIC-PHASE CHRONIC MYELOID LEUKEMIA (CP-CML) PATIENTS TREATED WITH IMATINIB MESYLATE (IM; GLEEVECR, STI571), A BCR-ABL TYROSINE KINASE INHIBITOR. HOWEVER, WE FOUND THAT IM CAUSED CONSIDERABLE INHIBITION OF NORMAL HEMATOPOIETIC PROGENITOR CELLS UPON TREATING CONTROL BONE MARROW (BM) CULTURES. IN VITRO IM TREATMENT GAVE A DECREASE IN THE YIELD AND SIZE OF COLONIES FROM BM OF UNTREATED CP-CML PATIENTS THAT WAS ONLY TWO TO THREE TIMES THAT FROM THE NORMAL SAMPLES. MOREOVER, ABOUT 30% OF MYELOID PROGENITORS (CFU-GM) FROM CML BM STILL FORMED COLONIES IN THE PRESENCE OF IM, MOST OF WHICH HAD BCR-ABL RNA. ABOUT HALF OF THESE TREATED COLONIES ALSO DISPLAYED METHYLATION OF THE INTERNAL ABL PA PROMOTER, A CML-SPECIFIC EPIGENETIC ALTERATION, WHICH WAS USED IN THIS STUDY AS A MARKER FOR BCR-ABL TRANSLOCATION-CONTAINING CELLS. HOWEVER, ~5-8% OF THE TREATED OR THE UNTREATED CML BM-DERIVED COLONIES HAD NO DETECTABLE BCR-ABL RNA BY TWO OR THREE ROUNDS OF RT-PCR DESPITE BEING POSITIVE FOR THE INTERNAL STANDARD RNA AND DISPLAYING HALLMARKS OF CML, EITHER T(9;22)(Q34;QL 1) OR ABL PA METHYLATION. OUR RESULTS INDICATE THAT IM IS ONLY PARTIALLY SPECIFIC FOR CML PROGENITOR CELLS COMPARED TO NORMAL HEMATOPOIETIC PROGENITOR CELLS AND SUGGEST THAT SOME CML CELLS MAY HAVE A SILENT BCR-ABL ONCOGENE THAT COULD INTERFERE WITH THERAPY.	2003	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
2  2765  43 EXPRESSION, EPIGENETIC REGULATION, AND HUMORAL IMMUNOGENICITY OF CANCER-TESTIS ANTIGENS IN CHRONIC MYELOID LEUKEMIA. OBJECTIVE: CANCER-TESTIS (CT) ANTIGENS REPRESENT ATTRACTIVE TARGETS FOR TUMOR IMMUNOTHERAPY BASED ON THEIR TUMOR-RESTRICTED EXPRESSION AND IMMUNOGENICITY. HOWEVER, A BROAD PICTURE OF THE EXPRESSION OF CT ANTIGENS AND ASSOCIATED HUMORAL IMMUNE RESPONSES IN CHRONIC MYELOID LEUKEMIA (CML) IS STILL MISSING. METHODS: WE SCREENED CML CELL LINES AND BONE MARROW (BM) SAMPLES FROM HEALTHY DONORS BY RT-PCR FOR THE EXPRESSION OF 31 CT ANTIGENS BEFORE AND AFTER TREATMENT WITH EPIGENETIC AGENTS. EXPRESSION OF TUMOR-RESTRICTED ANTIGENS WAS FURTHER EXAMINED IN 60 CML PATIENTS AND HUMORAL IMMUNE RESPONSES AGAINST 15 CT ANTIGENS WERE SCREENED BY ELISA. RESULTS: IN UNTREATED CELL LINES WE DETECTED THE EXPRESSION OF 17 CT ANTIGENS THAT WERE ABSENT FROM NORMAL BM. EXPRESSION OF MOST ANTIGENS INCREASED FOLLOWING DEMETHYLATING TREATMENT WITH 5'-AZA-2'-DEOXYCYTIDINE. IN THESE SAMPLES, ONLY PRAME WAS REPEATEDLY DETECTED AND EXPRESSION CORRELATED WITH SEVERAL CLINICOPATHOLOGICAL PARAMETERS AND DECREASED OVERALL SURVIVAL. WE FURTHER SHOW THAT A LOWER FREQUENCY OF PRAME-POSITIVE SAMPLES DURING IMATINIB TREATMENT WAS NOT CAUSED BY GENE-SPECIFIC DOWNREGULATION. ANALYZING THE PATIENTS' ANTIBODY RESPONSES WE FOUND THAT THE VAST MAJORITY OF PATIENTS LACKED SPONTANEOUS IMMUNITY AGAINST CT ANTIGENS INCLUDING PRAME. CONCLUSIONS: CT ANTIGEN EXPRESSION CAN BE INCREASED BY THE APPLICATION OF EPIGENETIC AGENTS AND THE EXPRESSION OF PRAME CORRELATES WITH CLINICOPATHOLOGICAL PARAMETERS AND OVERALL SURVIVAL IN PATIENTS WITH CML, BUT DOES NOT LEAD TO HUMORAL IMMUNE RESPONSES. PRAME-SPECIFIC IMMUNOTHERAPY MIGHT REPRESENT A PROMISING APPROACH FOR THE ERADICATION OF RESIDUAL THERAPY-RESISTANT LEUKEMIC CELLS DUE TO ITS FREQUENT EXPRESSION AND STABILITY UNDER IMATINIB TREATMENT.	2010	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
3  2216  44 EPIGENETIC MODIFICATIONS IN CHRONIC MYELOID LEUKEMIA CELLS THROUGH RUXOLITINIB TREATMENT. CHRONIC MYELOID LEUKEMIA IS A CLONAL MALIGNANCY OF HEMATOPOIETIC STEM CELL THAT IS CHARACTERIZED BY THE OCCURRENCE OF T(9;22)(Q34;Q11.2) TRANSLOCATION, NAMED PHILADELPHIA CHROMOSOME. RUXOLITINIB IS A POWERFUL JANUS TYROSINE KINASE 1 AND 2 INHIBITOR THAT IS USED FOR MYELOFIBROSIS TREATMENT. DNA-HISTONE CONNECTION MEDIATES A WIDE RANGE OF GENES THAT CODE METHYLATION, DEMETHYLATION, ACETYLATION, DEACETYLATION, UBIQUITINATION, AND PHOSPHORYLATION ENZYMES. EPIGENETIC MODIFICATIONS REGULATE CHROMATIN COMPACTNESS, WHICH PLAYS PIVOTAL ROLES IN CRITICAL BIOLOGICAL PROCESSES INCLUDING THE TRANSCRIPTIONAL ACTIVITY AND CELL PROLIFERATION AS WELL AS VARIOUS PATHOLOGICAL MECHANISMS, INCLUDING CML. THIS STUDY IS AIMED TO DETERMINE THE ALTERATIONS OF THE EXPRESSION LEVELS OF EPIGENETIC MODIFICATION-RELATED GENES AFTER RUXOLITINIB TREATMENT. TOTAL RNA WAS ISOLATED FROM K-562 CELLS TREATED WITH THE IC(50) VALUE OF RUXOLITINIB AND UNTREATED K-562 CONTROL CELLS. A REVERSE TRANSCRIPTION PROCEDURE WAS PERFORMED FOR COMPLEMENTARY DNA SYNTHESIS, AND GENE EXPRESSIONS WERE DETECTED BY REAL-TIME POLYMERASE CHAIN REACTION COMPARED WITH THE UNTREATED CELLS. RUXOLITINIB TREATMENT CAUSED A SIGNIFICANT ALTERATION IN THE EXPRESSION LEVELS OF EPIGENETIC REGULATION-RELATED GENES IN K-562 CELLS. OUR NOVEL RESULTS SUGGESTED THAT RUXOLITINIB HAS INHIBITOR EFFECTS ON EPIGENETIC MODIFICATION-REGULATOR GENES.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
4  1061  36 CLINICAL REMISSION OF SIGHT-THREATENING NON-INFECTIOUS UVEITIS IS CHARACTERIZED BY AN UPREGULATION OF PERIPHERAL T-REGULATORY CELL POLARIZED TOWARDS T-BET AND TIGIT. BACKGROUND: NON-INFECTIOUS UVEITIS CAN CAUSE CHRONIC RELAPSING AND REMITTING OCULAR INFLAMMATION, WHICH MAY REQUIRE HIGH DOSE SYSTEMIC IMMUNOSUPPRESSION TO PREVENT SEVERE SIGHT LOSS. IT HAS BEEN CLASSICALLY DESCRIBED AS AN AUTOIMMUNE DISEASE, MEDIATED BY PRO-INFLAMMATORY TH1 AND TH17 T-CELL SUBSETS. STUDIES SUGGEST THAT NATURAL IMMUNOSUPPRESSIVE CD4(+)CD25(+)FOXP3(+) T-REGULATORY CELLS (TREGS) ARE INVOLVED IN RESOLUTION OF INFLAMMATION AND MAY BE INVOLVED IN THE MAINTENANCE OF CLINICAL REMISSION. OBJECTIVE: TO INVESTIGATE WHETHER THERE IS A PERIPHERAL BLOOD IMMUNOREGULATORY PHENOTYPE ASSOCIATED WITH CLINICAL REMISSION OF SIGHT-THREATENING NON-INFECTIOUS UVEITIS BY COMPARING PERIPHERAL BLOOD LEVELS OF TREG, TH1, AND TH17, AND ASSOCIATED DNA METHYLATION AND CYTOKINE LEVELS IN PATIENTS WITH ACTIVE UVEITIC DISEASE, CONTROL SUBJECTS AND PATIENTS (WITH PREVIOUSLY ACTIVE DISEASE) IN CLINICAL REMISSION INDUCED BY IMMUNOSUPPRESSIVE DRUGS. METHODS: ISOLATED PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMC) FROM PERIPHERAL BLOOD SAMPLES FROM PROSPECTIVELY RECRUITED SUBJECTS WERE ANALYZED BY FLOW CYTOMETRY FOR CD3, CD4, FOXP3, TIGIT, T-BET, AND RELATED ORPHAN RECEPTOR GAMMAT. EPIGENETIC DNA METHYLATION LEVELS OF FOXP3 TREG-SPECIFIC DEMETHYLATED REGION (TSDR), FOXP3 PROMOTER, TBX21, RORC2, AND TIGIT LOCI WERE DETERMINED IN CRYOPRESERVED PBMC USING A NEXT-GENERATION SEQUENCING APPROACH. RELATED CYTOKINES WERE MEASURED IN BLOOD SERA. FUNCTIONAL SUPPRESSIVE CAPACITY OF TREG WAS ASSESSED USING T-CELL PROLIFERATION ASSAYS. RESULTS: FIFTY PATIENTS WITH UVEITIS (INTERMEDIATE, POSTERIOR, AND PANUVEITIS) AND 10 CONTROL SUBJECTS WERE RECRUITED. THE FREQUENCY OF CD4(+)CD25(+)FOXP3(+) TREG, TIGIT(+) TREG, AND T-BET(+) TREG AND THE RATIO OF TREG TO TH1 WERE SIGNIFICANTLY HIGHER IN REMISSION PATIENTS COMPARED WITH PATIENTS WITH ACTIVE UVEITIC DISEASE; AND TIGIT(+) TREGS WERE A SIGNIFICANT PREDICTOR OF CLINICAL REMISSION. TREG FROM PATIENTS IN CLINICAL REMISSION DEMONSTRATED A HIGH LEVEL OF IN VITRO SUPPRESSIVE FUNCTION COMPARED WITH TREG FROM CONTROL SUBJECTS AND FROM PATIENTS WITH UNTREATED ACTIVE DISEASE. PBMC FROM PATIENTS IN CLINICAL REMISSION HAD SIGNIFICANTLY LOWER METHYLATION LEVELS AT THE FOXP3 TSDR, FOXP3 PROMOTER, AND TIGIT LOCI AND HIGHER LEVELS AT RORC LOCI THAN THOSE WITH ACTIVE DISEASE. CLINICAL REMISSION WAS ALSO ASSOCIATED WITH SIGNIFICANTLY HIGHER SERUM LEVELS OF TRANSFORMING GROWTH FACTOR BETA AND IL-10, WHICH POSITIVELY CORRELATED WITH TREG LEVELS, AND LOWER SERUM LEVELS OF IFNGAMMA, IL-17A, AND IL-22 COMPARED WITH PATIENTS WITH ACTIVE DISEASE. CONCLUSION: CLINICAL REMISSION OF SIGHT-THREATENING NON-INFECTIOUS UVEITIS HAS AN IMMUNOREGULATORY PHENOTYPE CHARACTERIZED BY UPREGULATION OF PERIPHERAL TREG, POLARIZED TOWARD T-BET AND TIGIT. THESE FINDINGS MAY ASSIST WITH INDIVIDUALIZED THERAPY OF UVEITIS, BY INFORMING WHETHER DRUG THERAPY HAS INDUCED PHENOTYPICALLY STABLE TREG ASSOCIATED WITH LONG-TERM CLINICAL REMISSION.	2018	

5  5478  31 RESULTS OF A RANDOMIZED STUDY OF 3 SCHEDULES OF LOW-DOSE DECITABINE IN HIGHER-RISK MYELODYSPLASTIC SYNDROME AND CHRONIC MYELOMONOCYTIC LEUKEMIA. EPIGENETIC THERAPY WITH HYPOMETHYLATING DRUGS IS NOW THE STANDARD OF CARE IN MYELODYSPLASTIC SYNDROME (MDS). RESPONSE RATES REMAIN LOW, AND MECHANISM-BASED DOSE OPTIMIZATION HAS NOT BEEN REPORTED. WE INVESTIGATED THE CLINICAL AND PHARMACODYNAMIC RESULTS OF DIFFERENT DOSE SCHEDULES OF DECITABINE. ADULTS WITH ADVANCED MDS OR CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) WERE RANDOMIZED TO 1 OF 3 DECITABINE SCHEDULES: (1) 20 MG/M2 INTRAVENOUSLY DAILY FOR 5 DAYS; (2) 20 MG/M2 SUBCUTANEOUSLY DAILY FOR 5 DAYS; AND (3) 10 MG/M2 INTRAVENOUSLY DAILY FOR 10 DAYS. RANDOMIZATION FOLLOWED A BAYESIAN ADAPTIVE DESIGN. NINETY-FIVE PATIENTS WERE TREATED (77 WITH MDS, AND 18 WITH CMML). OVERALL, 32 PATIENTS (34%) ACHIEVED A COMPLETE RESPONSE (CR), AND 69 (73%) HAD AN OBJECTIVE RESPONSE BY THE NEW MODIFIED INTERNATIONAL WORKING GROUP CRITERIA. THE 5-DAY INTRAVENOUS SCHEDULE, WHICH HAD THE HIGHEST DOSE-INTENSITY, WAS SELECTED AS OPTIMAL; THE CR RATE IN THAT ARM WAS 39%, COMPARED WITH 21% IN THE 5-DAY SUBCUTANEOUS ARM AND 24% IN THE 10-DAY INTRAVENOUS ARM (P < .05). THE HIGH DOSE-INTENSITY ARM WAS ALSO SUPERIOR AT INDUCING HYPOMETHYLATION AT DAY 5 AND AT ACTIVATING P15 EXPRESSION AT DAYS 12 OR 28 AFTER THERAPY. WE CONCLUDE THAT A LOW-DOSE, DOSE-INTENSITY SCHEDULE OF DECITABINE OPTIMIZES EPIGENETIC MODULATION AND CLINICAL RESPONSES IN MDS.	2007	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
6    18  33 5-AZACYTIDINE MODULATES CPG METHYLATION LEVELS OF EZH2 AND NOTCH1 IN MYELODYSPLASTIC SYNDROMES. PURPOSE: MOLECULAR MECHANISMS OF RESPONSE TO HYPOMETHYLATING AGENTS IN PATIENTS WITH MYELODYSPLASTIC SYNDROMES (MDS) AND CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) STILL REMAIN LARGELY UNKNOWN. THEREFORE, THE EFFECTS OF 5-AZACYTIDINE (AZA) ON CLONAL ARCHITECTURE AND DNA METHYLATION WERE INVESTIGATED IN THIS STUDY. METHODS: USING NEXT-GENERATION SEQUENCING (NGS), 30 MYELOID LEUKEMIA-ASSOCIATED GENES WERE ANALYZED IN 15 MDS/CMML PATIENTS WITH EXCELLENT RESPONSE TO AZA. EFFECTS ON METHYLATION LEVELS WERE ANALYZED BY QUANTITATIVE METHYLATION ANALYSIS USING PYROSEQUENCING FOR THE GLOBAL METHYLATION MARKER LINE-1 IN PATIENTS AND MYELOID CELL LINES. VARIOUS MYELOID CELL LINES AND A HEALTHY COHORT WERE SCREENED FOR METHYLATION LEVELS IN 23 GENES. SELECTED TARGETS WERE VERIFIED ON THE MDS/CMML COHORT. RESULTS: THE STUDY PRESENTED HERE SHOWED A STABLE VARIANT ALLELE FREQUENCY AND STABLE GLOBAL METHYLATION LEVELS IN RESPONDING PATIENTS. A SIGNIFICANT DEMETHYLATION OF EZH2 AND NOTCH1 WAS REVEALED IN PATIENTS WITH AZA RESPONSE. CONCLUSIONS: A RESPONSE TO AZA IS NOT ASSOCIATED WITH ERADICATION OF MALIGNANT CLONES, BUT RATHER WITH A STABILIZATION OF THE CLONAL ARCHITECTURE. WE SUGGEST CHANGES IN CPG METHYLATION LEVELS OF EZH2 AND NOTCH1 AS POTENTIAL TARGETS OF EPIGENETIC RESPONSE TO AZA TREATMENT WHICH MAY ALSO SERVE AS USEFUL BIOMARKERS AFTER CLINICAL EVALUATION.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
7  1627  43 DNMT1 MODULATION IN CHRONIC HEPATITIS B PATIENTS AND HYPOTHETIC INFLUENCE ON MITOCHONDRIAL DNA METHYLATION STATUS DURING LONG-TERM NUCLEO(T)SIDE ANALOGS THERAPY. INHIBITION OF VIRAL REPLICATION IS THE MOST IMPORTANT GOAL IN PATIENTS WITH HEPATITIS B VIRUS CHRONIC INFECTION (CHB). CURRENTLY, FIVE ORAL NUCLEO(T)SIDE ANALOGS (NAS), INCLUDING LAMIVUDINE, ADEFOVIR, TELBIVUDINE, ENTECAVIR, AND TENOFOVIR, HAVE BEEN APPROVED FOR TREATMENT. THE WIDESPREAD USE OF NAS HAS ALSO BEEN LINKED WITH A PROGRESSIVE GROWTH OF UNLIKELY ANOMALY ATTRIBUTABLE TO MITOCHONDRIAL DYSFUNCTIONS, NOT PREVIOUSLY RECOGNIZED. HERE, WE EXPLORE THE HYPOTHESIS THAT NAS MAY CAUSE PERSISTENT EPIGENETIC CHANGES DURING PROLONGED NAS THERAPY IN CHB PATIENTS. WE OBTAINED PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMC) FROM WHOLE BLOOD SAMPLES OF CONSECUTIVE PATIENTS WITH CHRONIC HBV INFECTION, 18 RECEIVING NAS AND 20 UNTREATED PATIENTS. ALL PATIENTS WERE CAUCASIAN AND ITALIANS. EPIGENETIC ANALYSIS WAS PERFORMED BY BISULPHITE SEQUENCING PCR TO SEARCH THE EXISTENCE OF METHYLATED CYTOSINE RESIDUES IN THE LIGHT (L)-STRANDS OF MITOCHONDRIAL DNA CONTROL REGION (D-LOOP). GENE EXPRESSION ANALYSIS OF DNA METHYLTRANSFERASES 1 WAS PERFORMED BY A QUANTITATIVE RELATIVE REAL-TIME POLYMERASE CHAIN REACTION (PCR). DNMT1 EXPRESSION WAS SIGNIFICANTLY (P < 000001) HIGHER IN NA TREATED PATIENTS (4.09, IQR 3.52-5.15) WHEN COMPARED WITH HBV NAIVES (0.61, IQR 0.34-0.82). BESIDES, DNMT1 EXPRESSION WAS SIGNIFICANTLY CORRELATED WITH NA THERAPY DURATION (SPEARMAN RHO = 0.67; P < 0.05). FURTHERMORE, NA THERAPY DURATION WAS THE ONLY SIGNIFICANT PREDICTOR OF DNMT1 EXPRESSION AT MULTIVARIATE ANALYSIS (BETA = 0.95, P < 0.0000001). BISULPHITE PCR SEQUENCING SHOWED THAT METHYLATION OF CYTOSINE RESIDUES OCCURRED IN A HIGHER PERCENTAGE IN PATIENTS TREATED WITH NAS IN COMPARISON WITH UNTREATED PATIENTS AND HEALTHY CONTROLS. OUR DATA SHOWED A DNMT1 OVEREXPRESSION SIGNIFICANTLY CORRELATED TO NA THERAPY DURATION AND AN HIGHER REGIONAL MTDNA HYPERMETHYLATION. THIS MIGHT SUGGEST AN EPIGENETIC ALTERATION THAT COULD BE INVOLVED IN ONE OF THE POSSIBLE MECHANISMS OF MITOCHONDRIAL GENE REGULATION DURING NAS THERAPY.	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
8  2760  36 EXPRESSION OF PD-L1, PD-L2, PD-1 AND CTLA4 IN MYELODYSPLASTIC SYNDROMES IS ENHANCED BY TREATMENT WITH HYPOMETHYLATING AGENTS. BLOCKADE OF IMMUNE CHECKPOINTS IS EMERGING AS A NEW FORM OF ANTICANCER THERAPY. WE STUDIED THE EXPRESSION OF PROGRAMMED DEATH LIGAND 1 (PD-L1), PD-L2, PROGRAMMED DEATH 1 (PD-1) AND CYTOTOXIC T LYMPHOCYTE-ASSOCIATED ANTIGEN 4 (CTLA4) MRNA IN CD34+ CELLS FROM MYELODYSPLASTIC SYNDROME (MDS), CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) AND ACUTE MYELOID LEUKEMIA (AML) PATIENTS (N=124). ABERRANT UPREGULATION (?2-FOLD) WAS OBSERVED IN 34, 14, 15 AND 8% OF THE PATIENTS. INCREASED EXPRESSION OF THESE FOUR GENES WAS ALSO OBSERVED IN PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMNCS) (N=61). THE RELATIVE EXPRESSION OF PD-L1 FROM PBMNC WAS SIGNIFICANTLY HIGHER IN MDS (P=0.018) AND CMML (P=0.0128) COMPARED WITH AML. BY IMMUNOHISTOCHEMICAL ANALYSIS, PD-L1 PROTEIN EXPRESSION WAS OBSERVED IN MDS CD34+ CELLS, WHEREAS STROMA/NON-BLAST CELLULAR COMPARTMENT WAS POSITIVE FOR PD-1. IN A COHORT OF PATIENTS TREATED WITH EPIGENETIC THERAPY, PD-L1, PD-L2, PD-1 AND CTLA4 EXPRESSION WAS UPREGULATED. PATIENTS RESISTANT TO THERAPY HAD RELATIVE HIGHER INCREMENTS IN GENE EXPRESSION COMPARED WITH PATIENTS WHO ACHIEVED RESPONSE. TREATMENT OF LEUKEMIA CELLS WITH DECITABINE RESULTED IN A DOSE-DEPENDENT UPREGULATION OF ABOVE GENES. EXPOSURE TO DECITABINE RESULTED IN PARTIAL DEMETHYLATION OF PD-1 IN LEUKEMIA CELL LINES AND HUMAN SAMPLES. THIS STUDY SUGGESTS THAT PD-1 SIGNALING MAY BE INVOLVED IN MDS PATHOGENESIS AND RESISTANCE MECHANISMS TO HYPOMETHYLATING AGENTS. BLOCKADE OF THIS PATHWAY CAN BE A POTENTIAL THERAPY IN MDS AND AML.	2014	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
9  3983  34 LONG-TERM EXPOSURE TO CIGARETTE SMOKE EXTRACT INDUCES HYPOMETHYLATION AT THE RUNX3 AND IGF2-H19 LOCI IN IMMORTALIZED HUMAN UROTHELIAL CELLS. CIGARETTE SMOKING IS THE SINGLE MOST IMPORTANT EPIDEMIOLOGICAL RISK FACTOR FOR BLADDER CANCER BUT IT IS NOT KNOWN WHETHER EXPOSURE OF UROTHELIAL CELLS TO THE SYSTEMIC SOLUBLE CONTENTS OF CIGARETTE SMOKE IS DIRECTLY CAUSATIVE TO BLADDER CANCER AND THE ASSOCIATED EPIGENETIC CHANGES SUCH AS TUMOR SUPPRESSOR GENE HYPERMETHYLATION. WE UNDERTOOK THIS STUDY TO INVESTIGATE IF LONG-TERM TREATMENT OF HUMAN UROTHELIAL CELLS WITH CIGARETTE SMOKE EXTRACT (CSE) RESULTS IN TUMOR SUPPRESSOR GENE HYPERMETHYLATION, A PHENOTYPE THAT WAS PREVIOUSLY ASSOCIATED WITH LONG-TERM CONSTANT CSE TREATMENT OF AIRWAY EPITHELIAL CELLS. WE CHRONICALLY TREATED AN IMMORTALIZED HUMAN UROTHELIAL CELL LINE UROTSA WITH CSE USING A CYCLIC DAILY REGIMEN BUT THE CELLS WERE CULTURED IN CSE-FREE MEDIUM BETWEEN DAILY TREATMENTS. BISULFITE SEQUENCING AND REAL-TIME PCR ARRAY-BASED METHYLATION PROFILING WERE EMPLOYED TO EVALUATE METHYLATION CHANGES AT TUMOR SUPPRESSOR GENE LOCI IN THE CHRONICALLY CSE-TREATED CELLS VERSUS THE PASSAGE-MATCHED UNTREATED CONTROL CELLS. THE RUNX3 TUMOR SUPPRESSOR GENE PROMOTER WAS HYPOMETHYLATED WITH A SIGNIFICANT INCREASE IN PROPORTION OF THE COMPLETELY UNMETHYLATED HAPLOTYPE AFTER THE LONG-TERM CSE TREATMENT; WHEREAS RUNX3 PROMOTER HYPERMETHYLATION WAS PREVIOUSLY REPORTED FOR BLADDER CANCERS OF SMOKERS. HYPOMETHYLATION INDUCED BY THE LONG-TERM CSE TREATMENT WAS ALSO OBSERVED FOR THE IGF2-H19 LOCUS. THE METHYLATION STATUS AT THE PRSS8/PROSTASIN AND 16 ADDITIONAL LOCI HOWEVER, WAS UNAFFECTED BY THE CHRONIC CSE TREATMENT. TRANSIENT CSE TREATMENT OVER 1 DAILY REGIMEN RESULTED IN TRANSCRIPTIONAL DOWN-REGULATION OF RUNX3 AND H19, BUT ONLY THE H19 TRANSCRIPTION WAS DOWN-REGULATED IN THE CHRONICALLY CSE-TREATED UROTHELIAL CELLS. TRANSCRIPTION OF A KEY ENZYME IN ONE-CARBON METABOLISM, DIHYDROFOLATE REDUCTASE (DHFR) WAS GREATLY REDUCED BY THE LONG-TERM CSE TREATMENT, POTENTIALLY SERVING AS A MECHANISM FOR THE HYPOMETHYLATION PHENOTYPE VIA A REDUCED SUPPLY OF METHYL DONOR. IN CONCLUSION, CHRONIC CYCLIC CSE TREATMENT OF UROTHELIAL CELLS INDUCED HYPOMETHYLATION RATHER THAN HYPERMETHYLATION AT SPECIFIC LOCI.	2013	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
10  2081  36 EPIGENETIC DOWN-REGULATION OF BIM EXPRESSION IS ASSOCIATED WITH REDUCED OPTIMAL RESPONSES TO IMATINIB TREATMENT IN CHRONIC MYELOID LEUKAEMIA. BACKGROUND: EXPRESSION OF THE PRO-APOPTOTIC BCL-2-INTERACTING MEDIATOR (BIM) HAS RECENTLY BEEN IMPLICATED IN IMATINIB-INDUCED APOPTOSIS OF BCR-ABL1(+) CELLS. HOWEVER, THE MECHANISMS INVOLVED IN THE REGULATION OF BIM IN CML AND ITS ROLE IN THE CLINICAL SETTING HAVE NOT BEEN ESTABLISHED. DESIGN AND METHODS: WE ANALYSED THE MRNA EXPRESSION OF BIM IN 100 NEWLY DIAGNOSED PATIENTS WITH CML IN CHRONIC PHASE BY Q-RT-PCR AND THE PROTEIN LEVELS BY WESTERN BLOT ANALYSIS. METHYLATION STATUS WAS ANALYSED BY BISULPHITE GENOMIC SEQUENCING AND MSP. CML CELL LINES WERE TREATED WITH IMATINIB AND 5-AZA-2'-DEOXYCYTIDINE, AND WERE TRANSFECTED WITH TWO DIFFERENT SIRNAS AGAINST BIM AND CELL PROLIFERATION AND APOPTOSIS WERE ANALYSED. RESULTS: WE DEMONSTRATED THAT DOWN-REGULATION OF BIM EXPRESSION WAS PRESENT IN 36% OF THE PATIENTS AND WAS SIGNIFICANTLY ASSOCIATED WITH A LACK OF OPTIMAL RESPONSE TO IMATINIB AS INDICATED BY THE DECREASE IN CYTOGENETIC AND MOLECULAR RESPONSES AT 6, 12 AND 18 MONTHS IN COMPARISON WITH PATIENTS WITH NORMAL BIM EXPRESSION (P<0.05). EXPRESSION OF BIM WAS MEDIATED BY PROMOTER HYPERMETHYLATION AS DEMONSTRATED BY RESTORATION OF BIM EXPRESSION AFTER TREATMENT OF CML CELLS WITH 5-AZA-2'-DEOXYCYTIDINE. USING CML CELL LINES WITH LOW AND NORMAL EXPRESSION OF BIM WE FURTHER DEMONSTRATED THAT THE EXPRESSION OF BIM IS REQUIRED FOR IMATINIB-INDUCED CML APOPTOSIS. CONCLUSION: OUR DATA INDICATE THAT DOWN-REGULATION OF BIM IS EPIGENETICALLY CONTROLLED BY METHYLATION IN A PERCENTAGE OF CML PATIENTS AND HAS AN UNFAVOURABLE PROGNOSTIC IMPACT, AND THAT THE COMBINATION OF IMATINIB WITH A DE-METHYLATING AGENT MAY RESULT IN IMPROVED RESPONSES IN PATIENTS WITH DECREASED EXPRESSION OF BIM.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
11  6574  29 TREATMENT OF CHRONIC MYELOMONOCYTIC LEUKEMIA WITH 5-AZACYTIDINE: CASE REPORTS. EPIGENETIC THERAPY WITH HYPOMETHYLATING AGENT (5-AZACYTIDINE; AZA) IS COMMON IN THE MANAGEMENT OF SPECIFIC SUBTYPES OF MYELODYSPLASTIC SYNDROME (MDS), BUT THERE ARE ONLY FEW STUDIES IN CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) PATIENTS. IN THIS PAPER OUR EXPERIENCE WITH 3 CMML PATIENTS TREATED WITH AZA IS DESCRIBED. IN ONE PATIENT TRANSFUSION INDEPENDENCY WAS OBSERVED AFTER 4 TREATMENT CYCLES; IN ONE CASE A PARTIAL RESPONSE WAS RECORDED, BUT A PROGRESSION TO ACUTE MYELOID LEUKEMIA (AML) AFTER 13 AZA CYCLES HAS APPEARED. IN ONE PATIENT, AZA IN REDUCED DOSAGE WAS ADMINISTERED AS A BRIDGING TREATMENT BEFORE ALLOGENEIC STEM CELL TRANSPLANTATION (ASCT), BUT IN THE CONTROL BONE MARROW ASPIRATE (BEFORE ASCT) A PROGRESSION TO AML WAS RECORDED. FUTURE STUDIES ARE MANDATORY FOR EVALUATION OF NEW MOLECULAR AND CLINICAL FEATURES WHICH COULD PREDICT THE EFFICIENCY OF HYPOMETHYLATING AGENTS IN CMML THERAPY WITH RESPECT TO OVERALL SURVIVAL, EVENT-FREE SURVIVAL, QUALITY-ADJUSTED LIFE YEAR, AND PHARMACOECONOMY.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
12  5568  39 ROLE OF MARIJUANA COMPONENTS ON THE REGENERATIVE ABILITY OF STEM CELLS. STEM CELL THERAPY PROMOTES TISSUE REGENERATION AND WOUND HEALING. EFFORTS HAVE BEEN MADE TO PRIME STEM CELLS TO ENHANCE THEIR REGENERATIVE ABILITIES. CERTAIN MARIJUANA COMPONENTS, NAMELY THE NON-PSYCHOACTIVE CANNABIDIOL (CBD) AND PSYCHOACTIVE TETRAHYDROCANNABINOL (THC), ARE DEFINED AS IMMUNOMODULATORS.(9) WE TEST WHETHER TWO SOURCES OF STEM CELLS, PRIMED WITH CBD OR THC, WOULD DEMONSTRATE IMPROVED REGENERATIVE ABILITIES. HUMAN ADIPOSE-DERIVED STEM CELLS (ASCS) AND BONE MARROW-DERIVED STEM CELLS (BMDSCS), NOT OBTAINED FROM THE SAME INDIVIDUAL, WERE TREATED WITH LOW (300 NM) OR HIGH (3 MUM) CONCENTRATION CBD. PORCINE ASCS AND BMDSCS WERE ISOLATED FROM A SINGLE PIG, AND TREATED WITH EITHER LOW OR HIGH CONCENTRATIONS OF CBD OR THC. TRANSWELL MIGRATION AND MTT PROLIFERATION ASSAYS WERE PERFORMED ON THE HUMAN ASCS AND BMDSCS. ALSO, TRANSWELL MIGRATION ASSAY WAS PERFORMED ON THE PORCINE ASCS AND BMDSCS. FINALLY, A WOUND HEALING SCRATCH ASSAY IN PORCINE PRIMARY FIBROBLASTS (PFS) WAS PERFORMED, CO-CULTURED WITH THE CANNABINOID-TREATED ASCS. CBD PRIMING AT LOW CONCENTRATION INDUCES MIGRATION BY 180% (P < .01) IN PORCINE ASCS, AND BY ONLY 93% (P < .02) IN PORCINE BMDSCS. IN PORCINE STEM CELLS, THC PRIMING AT LOW CONCENTRATION INDUCES MIGRATION BY 91.6% (P < .01) IN ASCS BUT BY ONLY 44.3% (P < .03) IN BMDSCS. COMPARED TO PFS CO-CULTURED WITH UNTREATED ASCS, PFS CO-CULTURED WITH LOW CBD-PRIMED ASCS HAD 75% FASTER WOUND CLOSURE AT 18 HOURS (P < .01). CBD AND THC PRIMING OF ASCS AND BMDSCS, PARTICULARLY AT LOWER DOSES, ENHANCES A NUMBER OF REGENERATIVE PARAMETERS, SUGGESTING THAT THESE MAJOR MARIJUANA COMPONENTS MAY IMPROVE STEM CELL-BASED THERAPIES. SIGNIFICANCE OF THE STUDY: OUR STUDY DEMONSTRATES THAT CANNABINOIDS CAN ENHANCE THE REGENERATIVE CAPACITY OF TWO MAJOR SOURCES OF STEM CELLS, ADIPOSE- AND BONE MARROW-DERIVED, FROM HUMAN AND PORCINE DONORS. STEM CELL ISOLATION AND EXPANSION IS INVASIVE, COSTLY AND TIME CONSUMING. STEM CELLS WITH IMPROVED REGENERATIVE PROPERTIES MAY BE EFFECTIVE IN THE TREATMENT OF ACUTE OR CHRONIC WOUNDS. THIS IS THE FIRST STUDY TO COMPARE THE PRIMING POTENTIAL OF TWO SOURCES OF STEM CELLS FROM THE SAME ANIMAL, WITH THE SAME GENETIC AND EPIGENETIC PROFILE, AS WELL AS THE FIRST TO PRIME WITH THC.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
13    87  27 A PHASE 1 STUDY OF AZACITIDINE WITH HIGH-DOSE CYTARABINE AND MITOXANTRONE IN HIGH-RISK ACUTE MYELOID LEUKEMIA. IN THIS PHASE 1 STUDY, AZACITIDINE (AZA) WAS GIVEN BEFORE HIGH-DOSE CYTARABINE (HIDAC) AND MITOXANTRONE (MITO) BASED ON THE HYPOTHESIS THAT EPIGENETIC PRIMING WITH A HYPOMETHYLATING AGENT BEFORE CYTOTOXIC CHEMOTHERAPY WOULD IMPROVE RESPONSE RATES IN PATIENTS WITH HIGH-RISK ACUTE MYELOID LEUKEMIA (AML), INCLUDING RELAPSED/REFRACTORY DISEASE. THE PRIMARY OBJECTIVE WAS TO ESTABLISH THE RECOMMENDED PHASE 2 DOSE OF AZA GIVEN BEFORE STANDARD HIDAC/MITO. IN A DOSE ESCALATION SCHEME, 46 PATIENTS (MEDIAN AGE, 66 YEARS) RECEIVED AZA AT 37.5, 50, OR 75 MG/M2 SUBCUTANEOUSLY OR IV ONCE DAILY ON DAYS 1 TO 5 FOLLOWED BY HIDAC (3000 MG/M2) AND MITOXANTRONE (30 MG/M2) ONCE EACH ON DAYS 6 AND 10 (THE HIDAC/MITO DOSE WAS REDUCED 33% IN ELDERLY SUBJECTS). TWO DOSE-LIMITING TOXICITIES OCCURRED (BOTH IN THE SAME PATIENT): ACUTE LIVER FAILURE AND KIDNEY INJURY AT THE 50 MG/M2 DOSE. THE 30-DAY INDUCTION DEATH RATE WAS 2.2% (1 OF 46). THE OVERALL RESPONSE RATE, INCLUDING COMPLETE REMISSION AND COMPLETE REMISSION WITH INCOMPLETE COUNT RECOVERY, WAS 61% (28 OF 46). PREVIOUSLY UNTREATED PATIENTS AGED >/=60 YEARS WITH THERAPY-RELATED AML AND DE NOVO AML WERE MORE LIKELY TO RESPOND THAN UNTREATED PATIENTS WITH AML PROGRESSING FROM AN ANTECEDENT HEMATOLOGIC DISORDER (MYELODYSPLASTIC SYNDROME AND CHRONIC MYELOMONOCYTIC LEUKEMIA). PATIENTS WITH FAVORABLE EUROPEAN LEUKEMIA NETWORK RISK (P = .008), NPM1 MUTATIONS (P = .007), OR IDH2 MUTATIONS (P = .03) WERE MORE LIKELY TO RESPOND, AND THOSE WITH TP53 MUTATIONS (P = .03) WERE LESS LIKELY TO RESPOND. THE RECOMMENDED PHASE 2 DOSE OF AZA IS 75 MG/M2 PER DAY ON DAYS 1 TO 5 FOLLOWED BY HIDAC (3000 MG/M2) AND MITOXANTRONE (30 MG/M2) ONCE EACH ON DAYS 6 AND 10. THIS TRIAL WAS REGISTERED AT WWW.CLINICALTRIALS.GOV AS #NCT01839240.	2020	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
14  2465  38 EPIGENETIC THERAPY WITH HYDRALAZINE AND MAGNESIUM VALPROATE REVERSES IMATINIB RESISTANCE IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA. THE EPIGENETIC DRUGS HYDRALAZINE AND VALPROATE WERE ADMINISTERED IN A COMPASSIONATE MANNER TO 8 PATIENTS WITH CHRONIC MYELOID LEUKEMIA (CML) REFRACTORY TO IMATINIB. TWO PATIENTS HAD A COMPLETE HEMATOLOGIC RESPONSE (25%),1 MAJOR CYTOGENETIC RESPONSE, 1 COMPLETE CYTOGENETIC RESPONSE (25% ANY CYTOGENETIC RESPONSE), AND 3 (37.5%)STABLE DISEASE. NO GRADE 3 OR 4 TOXICITY WAS OBSERVED. THESE RESULTS SHOW THE ABILITY OF EPIGENETIC THERAPY TO REVERT IMATINIB RESISTANCE. BACKGROUND: EPIGENETIC ALTERATIONS PARTICIPATE IN THE DEVELOPMENT OF ACQUIRED RESISTANCE TO IMATINIB, HENCE, THE DNA METHYLATION, AND HISTONE DEACETYLASE INHIBITORS HYDRALAZINE AND VALPROATE, RESPECTIVELY, HAS THE POTENTIAL TO OVERCOME IT. PATIENT AND METHODS: A SERIES OF 8 PATIENTS WITH CHRONIC MYELOID LEUKEMIA (CML) REFRACTORY TO IMATINIB MESYLATE WITH NO ACCESS TO SECOND-GENERATION TYROSINE KINASE INHIBITORS WERE TREATED WITH HYDRALAZINE AND VALPROATE IN A COMPASSIONATE MANNER. CLINICAL EFFICACY AND SAFETY OF THESE DRUGS ADDED TO IMATINIB MESYLATE WERE EVALUATED. RESULTS: TWO PATIENTS WERE IN THE BLAST PHASE, 5 WERE IN THE ACCELERATED PHASE, AND 1 WAS IN THE CHRONIC PHASE. ALL THE PATIENTS CONTINUED WITH THE SAME DOSE OF IMATINIB THAT THEY HAD BEEN RECEIVING AT THE TIME OF DEVELOPMENT OF RESISTANCE, WITH A MEDIAN DOSE OF 600 MG DAILY (RANGE, 400-800 MG). THE MEDIAN TIME FROM DIAGNOSIS OF CML TO THE START OF HYDRALAZINE AND VALPROATE WAS 53.6 MONTHS (RANGE, 19-84 MONTHS). TWO (25%) PATIENTS HAD A COMPLETE HEMATOLOGIC RESPONSE, ONE (12.5%) HAD AN MAJOR CYTOGENETIC RESPONSE, AND ONE (12.5%) HAD A COMPLETE CYTOGENETIC RESPONSE. THREE (37.5%) PATIENTS HAD STABLE DISEASE, AND ONLY ONE (12.5%) PATIENT FAILED TO RESPOND. AT A MEDIAN FOLLOW-UP TIME OF 18 MONTHS (RANGE, 3-18 MONTHS), THE MEDIAN SURVIVAL HAD NOT BEEN REACHED, AND THE PROJECTED OVERALL SURVIVAL WAS 63%. ALL THE PATIENTS HAD MILD NEUROLOGIC TOXICITY, INCLUDING DISTAL TREMOR AND SOMNOLENCE. NO GRADE 3 OR 4 TOXICITY WAS OBSERVED. CONCLUSIONS: OUR RESULTS SUGGEST THAT THE EPIGENETIC DRUGS HYDRALAZINE AND VALPROATE REVERT THE RESISTANCE TO IMATINIB IN PATIENTS WITH CML.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
15  3135  37 GLOBAL DNA METHYLATION AND HYDROXYMETHYLATION LEVELS IN PBMCS ARE ALTERED IN RRMS PATIENTS TREATED WITH IFN-BETA AND GA-A PRELIMINARY STUDY. MULTIPLE SCLEROSIS (MS) IS A CHRONIC DISEASE AFFECTING THE CENTRAL NERVOUS SYSTEM (CNS) DUE TO AN AUTOIMMUNE ATTACK ON AXONAL MYELIN SHEATHS. EPIGENETICS IS AN OPEN RESEARCH TOPIC ON MS, WHICH HAS BEEN INVESTIGATED IN SEARCH OF BIOMARKERS AND TREATMENT TARGETS FOR THIS HETEROGENEOUS DISEASE. IN THIS STUDY, WE QUANTIFIED GLOBAL LEVELS OF EPIGENETIC MARKS USING AN ELISA-LIKE APPROACH IN PERIPHERAL BLOOD MONONUCLEAR CELLS (PBMCS) FROM 52 PATIENTS WITH MS, TREATED WITH INTERFERON BETA (IFN-BETA) AND GLATIRAMER ACETATE (GA) OR UNTREATED, AND 30 HEALTHY CONTROLS. WE PERFORMED MEDIA COMPARISONS AND CORRELATION ANALYSES OF THESE EPIGENETIC MARKERS WITH CLINICAL VARIABLES IN SUBGROUPS OF PATIENTS AND CONTROLS. WE OBSERVED THAT DNA METHYLATION (5-MC) DECREASED IN TREATED PATIENTS COMPARED WITH UNTREATED AND HEALTHY CONTROLS. MOREOVER, 5-MC AND HYDROXYMETHYLATION (5-HMC) CORRELATED WITH CLINICAL VARIABLES. IN CONTRAST, HISTONE H3 AND H4 ACETYLATION DID NOT CORRELATE WITH THE DISEASE VARIABLES CONSIDERED. GLOBALLY QUANTIFIED EPIGENETIC DNA MARKS 5-MC AND 5-HMC CORRELATE WITH DISEASE AND WERE ALTERED WITH TREATMENT. HOWEVER, TO DATE, NO BIOMARKER HAS BEEN IDENTIFIED THAT CAN PREDICT THE POTENTIAL RESPONSE TO THERAPY BEFORE TREATMENT INITIATION.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
16  5283  31 PROPHYLACTIC OR PREEMPTIVE LOW-DOSE AZACITIDINE AND DONOR LYMPHOCYTE INFUSION TO PREVENT DISEASE RELAPSE FOLLOWING ALLOGENEIC TRANSPLANTATION IN PATIENTS WITH HIGH-RISK ACUTE MYELOGENOUS LEUKEMIA OR MYELODYSPLASTIC SYNDROME. BECAUSE OF THE PERSISTENTLY HIGH RATES OF RELAPSE OF PATIENTS WITH HIGH-RISK ACUTE MYELOGENOUS LEUKEMIA (AML) AND MYELODYSPLASTIC SYNDROME (MDS) FOLLOWING ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION (ALLO-HSCT), POST-TRANSPLANTATION MAINTENANCE THERAPY HAS BEEN PROPOSED. WE PREVIOUSLY INITIATED A PHASE II TRIAL IN WHICH EPIGENETIC THERAPY WAS COMBINED WITH IMMUNOTHERAPY IN AN ATTEMPT TO REDUCE DISEASE RELAPSE. IN THAT STUDY, LOW-DOSE AZACITIDINE (AZA) AND ESCALATING DOSES OF DONOR LYMPHOCYTE INFUSION (DLI) WERE GIVEN AS POST-ALLO-HSCT MAINTENANCE TREATMENT. IN THE PRESENT STUDY, WE RETROSPECTIVELY ANALYZE A LARGER COHORT OF PATIENTS RECEIVING POST-TRANSPLANTATION MAINTENANCE THERAPY AND PROVIDE UPDATES ON SOME PATIENTS OF THE EARLIER STUDY. THE OBJECTIVES OF THE PRESENT STUDY WERE TO ANALYZE THE CUMULATIVE INCIDENCE OF RELAPSE (CIR), OVERALL SURVIVAL (OS), AND PROGRESSION-FREE SURVIVAL (PFS) AND THE INCIDENCE OF ACUTE AND CHRONIC GRAFT-VERSUS-HOST DISEASE (GVHD) OF PATIENTS WITH HIGH-RISK AML OR MDS RECEIVING POST-TRANSPLANTATION MAINTENANCE TREATMENT WITH AZA WITH OR WITHOUT DLI. WE RETROSPECTIVELY ANALYZED 77 PATIENTS (54 WITH AML, 23 WITH MDS) CONSIDERED AT HIGH RISK BASED ON EITHER THEIR GENOMIC OR CLINICAL STATUS AT TRANSPLANTATION. FOLLOWING ALLOGENEIC TRANSPLANTATION, THEY RECEIVED AT LEAST 1 CYCLE OF PROPHYLACTIC OR PREEMPTIVE LOW-DOSE AZA WITH OR WITHOUT ESCALATING DOSES OF DLI TO PREVENT DISEASE RELAPSE. ALMOST ONE-HALF OF THE PATIENTS (47%) WERE ABLE TO RECEIVE THE FULL 12 CYCLES OF SCHEDULED AZA, AND A MAJORITY (79%) RECEIVED AT LEAST 1 DLI. WITH A MEDIAN FOLLOW-UP OF 24 MONTHS, 19 PATIENTS (25%; 16 WITH AML, 3 WITH MDS) RELAPSED, AT A MEDIAN OF 9.8 MONTHS (RANGE, 4 TO 58.6 MONTHS), GIVING A 22% CIR AT 24 MONTHS. OS AND PFS AT 24 MONTHS WERE 70.8% AND 68.3%, RESPECTIVELY. THE CUMULATIVE INCIDENCES OF GRADE II-IV ACUTE GVHD AND CHRONIC GVHD WERE 27.4% AND 45%, RESPECTIVELY. ONLY A MINORITY OF PATIENTS (11%) REQUIRED DELAYED ADMINISTRATION OF AZA. THESE FINDINGS CONFIRM THAT AZA-DLI MAINTENANCE IS BOTH TOLERABLE AND EFFECTIVE IN REDUCING THE RISK OF POST-TRANSPLANTATION RELAPSE.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
17  5613  26 SAFETY AND EFFICACY OF ABEXINOSTAT, A PAN-HISTONE DEACETYLASE INHIBITOR, IN NON-HODGKIN LYMPHOMA AND CHRONIC LYMPHOCYTIC LEUKEMIA: RESULTS OF A PHASE II STUDY. HISTONE DEACETYLASE INHIBITORS ARE MEMBERS OF A CLASS OF EPIGENETIC DRUGS THAT HAVE PROVEN ACTIVITY IN T-CELL MALIGNANCIES, BUT LITTLE IS KNOWN ABOUT THEIR EFFICACY IN B-CELL LYMPHOMAS. ABEXINOSTAT IS AN ORALLY AVAILABLE HYDROXAMATE-CONTAINING HISTONE DEACETYLASE INHIBITOR THAT DIFFERS FROM APPROVED INHIBITORS; ITS UNIQUE PHARMACOKINETIC PROFILE AND ORAL DOSING SCHEDULE, TWICE DAILY FOUR HOURS APART, ALLOWS FOR CONTINUOUS EXPOSURE AT CONCENTRATIONS REQUIRED TO EFFICIENTLY KILL TUMOR CELLS. IN THIS PHASE II STUDY, PATIENTS WITH RELAPSED/REFRACTORY NON-HODGKIN LYMPHOMA OR CHRONIC LYMPHOCYTIC LEUKEMIA RECEIVED ORAL ABEXINOSTAT AT 80 MG BID FOR 14 DAYS OF A 21-DAY CYCLE AND CONTINUED UNTIL PROGRESSIVE DISEASE OR UNACCEPTABLE TOXICITY. A TOTAL OF 100 PATIENTS WITH B-CELL MALIGNANCIES AND T-CELL LYMPHOMAS WERE ENROLLED BETWEEN OCTOBER 2011 AND JULY 2014. ALL PATIENTS RECEIVED AT LEAST ONE DOSE OF STUDY DRUG. PRIMARY REASONS FOR DISCONTINUATION INCLUDED PROGRESSIVE DISEASE (56%) AND ADVERSE EVENTS (25%). GRADE 3 OR OVER ADVERSE EVENTS AND ANY SERIOUS ADVERSE EVENTS WERE REPORTED IN 88% AND 73% OF PATIENTS, RESPECTIVELY. THE MOST FREQUENTLY REPORTED GRADE 3 OR OVER TREATMENT-EMERGENT RELATED ADVERSE EVENTS WERE THROMBOCYTOPENIA (80%), NEUTROPENIA (27%), AND ANEMIA (12%). AMONG THE 87 PATIENTS EVALUABLE FOR EFFICACY, OVERALL RESPONSE RATE WAS 28% (COMPLETE RESPONSE 5%), WITH HIGHEST RESPONSES OBSERVED IN PATIENTS WITH FOLLICULAR LYMPHOMA (OVERALL RESPONSE RATE 56%), T-CELL LYMPHOMA (OVERALL RESPONSE RATE 40%), AND DIFFUSE LARGE B-CELL LYMPHOMA (OVERALL RESPONSE RATE 31%). FURTHER INVESTIGATION OF THE SAFETY AND EFFICACY OF ABEXINOSTAT IN FOLLICULAR LYMPHOMA, T-CELL LYMPHOMA, AND DIFFUSE LARGE B-CELL LYMPHOMA IMPLEMENTING A LESS DOSE-INTENSE WEEK-ON-WEEK-OFF SCHEDULE IS WARRANTED. (TRIAL REGISTERED AT: EUDRACT-2009-013691-47).	2017	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
18   205  28 ACTIVATION OF HLA-G EXPRESSION BY 5-AZA-2 - DEOXYCYTIDINE IN MALIGNANT HEMATOPOETIC CELLS ISOLATED FROM LEUKEMIA PATIENTS. HUMAN LEUKOCYTE ANTIGEN - G (HLA-G) IS A NON-CLASSICAL HLA CLASS I ANTIGEN WITH RESTRICTED DISTRIBUTION IN NORMAL TISSUES. ECTOPIC HLA-G EXPRESSION OBSERVED AT SOME PATHOLOGICAL CIRCUMSTANCES AS MALIGNANT TRANSFORMATION MIGHT BE TRIGGERED BY EPIGENETIC MODIFICATIONS SUCH AS DNA DEMETHYLATION. RECENTLY IT WAS DEMONSTRATED THAT DNA METHYLTRANSFERASE INHIBITOR 5-AZA-2 - DEOXYCYTIDINE (ADC) INDUCES/ENHANCES HLA-G TRANSCRIPTION IN MANY LEUKEMIA CELL LINES OF DIFFERENT ORIGIN. HERE WE INVESTIGATED THE EFFECT OF ADC ON HLA-G EXPRESSION IN MALIGNANT HEMATOPOETIC CELLS ISOLATED FROM PATIENTS WITH ACUTE MYELOID LEUKEMIA (AML) AND CHRONIC LYMPHOCYTIC LEUKEMIA (B-CLL). WE DETECTED HLA-G EXPRESSION IN UNTREATED CELLS FROM SOME PATIENTS. NEVERTHELESS TREATMENT WITH 5-AZA-2 - DEOXYCYTIDINE ENHANCED HLA-G TRANSCRIPTION AND CONCOMITANTLY HLA-G PROTEIN SYNTHESIS IN SOME LEUKEMIA CELLS.	2009	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
19  6680  35 USING PERIPHERAL BLOOD CIRCULATING DNAS TO DETECT CPG GLOBAL METHYLATION STATUS AND GENETIC MUTATIONS IN PATIENTS WITH MYELODYSPLASTIC SYNDROME. MYELODYSPLASTIC SYNDROME (MDS) IS A HEMATOPOIETIC STEM CELL DISORDER. SEVERAL GENETIC/EPIGENETIC ABNORMALITIES ARE DEEPLY ASSOCIATED WITH THE PATHOGENESIS OF MDS. ALTHOUGH BONE MARROW (BM) ASPIRATION IS A COMMON STRATEGY TO OBTAIN MDS CELLS FOR EVALUATING THEIR GENETIC/EPIGENETIC ABNORMALITIES, BM ASPIRATION IS DIFFICULT TO PERFORM REPEATEDLY TO OBTAIN SERIAL SAMPLES BECAUSE OF PAIN AND SAFETY CONCERNS. HERE, WE REPORT THAT CIRCULATING CELL-FREE DNAS FROM PLASMA AND SERUM OF PATIENTS WITH MDS CAN BE USED TO DETECT GENETIC/EPIGENETIC ABNORMALITIES. THE PLASMA DNA CONCENTRATION WAS FOUND TO BE RELATIVELY HIGH IN PATIENTS WITH HIGHER BLAST CELL COUNTS IN BM, AND ACCUMULATION OF DNA FRAGMENTS FROM MONO-/DI-NUCLEOSOMES WAS CONFIRMED. USING SERIAL PERIPHERAL BLOOD (PB) SAMPLES FROM PATIENTS TREATED WITH HYPOMETHYLATING AGENTS, GLOBAL METHYLATION ANALYSIS USING BISULFITE PYROSEQUENCING WAS PERFORMED AT THE SPECIFIC CPG SITES OF THE LINE-1 PROMOTER. THE RESULTS CONFIRMED A DECREASE OF THE METHYLATION PERCENTAGE AFTER TREATMENT WITH AZACITIDINE (DAYS 3-9) USING DNAS FROM PLASMA, SERUM, AND PB MONO-NUCLEAR CELLS (PBMNC). PLASMA DNA TENDS TO SHOW MORE RAPID CHANGE AT DAYS 3 AND 6 COMPARED WITH SERUM DNA AND PBMNC. FURTHERMORE, THE TET2 GENE MUTATION IN DNAS FROM PLASMA, SERUM, AND BM CELLS WAS QUANTITATED BY PYROSEQUENCING ANALYSIS. THE EXISTENCE RATIO OF MUTATED GENES IN PLASMA AND SERUM DNA SHOWED ALMOST EQUIVALENT LEVEL WITH THAT IN THE CD34+/38- STEM CELL POPULATION IN BM. THESE DATA SUGGEST THAT GENETIC/EPIGENETIC ANALYSES USING PB CIRCULATING DNA CAN BE A SAFER AND PAINLESS ALTERNATIVE TO USING BM CELLS.	2012	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
20  1272  41 CYTOTOXIC ACTIVITY OF VALPROIC ACID ON PRIMARY CHRONIC LYMPHOCYTIC LEUKEMIA CELLS. BACKGROUND: CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS THE MOST COMMON ADULT LEUKEMIA IN WESTERN CIVILIZATION. THE ACCUMULATION OF CD5+CD19+ B LYMPHOCYTES IN PERIPHERAL BLOOD IS DUE TO A DEFECT IN THE APOPTOTIC PATHWAY RATHER THAN EXCESSIVE PROLIFERATION IN THE BONE MARROW AND LYMPH NODES. DESPITE A NUMBER OF TREATMENTS, CLL REMAINS AN INCURABLE DISEASE. VALPROIC ACID (VPA) ACTIVITY, AS A HISTONE DEACETYLASE INHIBITOR, COULD RESTORE THE EPIGENETIC CHANGES UNDERLYING THE PATHOGENESIS OF CLL AND THUS INDUCE CELL DEATH. OBJECTIVES: IN THE PRESENT STUDY WE HYPOTHESIZED THAT VPA COULD INDUCE CLL PRIMARY CELLS DEATH THROUGH ACTIVATION OF APOPTOSIS. MATERIAL AND METHODS: PERIPHERAL BLOOD SAMPLES WERE OBTAINED FROM 53 CLL PATIENTS. PERIPHERAL BLOOD MONONUCLEAR CELLS WERE ISOLATED THROUGH DENSITY GRADIENT CENTRIFUGATION AND WERE THE SUBJECT OF A 24-HOUR CELL CULTURE WITH 10 MM OF VPA. THE CYTOTOXIC EFFECT OF VPA WAS EVALUATED WITH AN XTT TEST AND THEREAFTER CONFIRMED USING ANNEXIN V-FITC/PI STAINING AND FLOW CYTOMETRY TECHNIQUES. RESULTS: IN THIS STUDY, A MEDIAN VPA CYTOTOXICITY OF 13.88% WITH A RANGE OF 0-54.65% WAS OBSERVED. ANNEXIN V/PI STAINING CONFIRMED THAT THE DEMONSTRATED CYTOTOXICITY WAS CAUSED BY INCREASED APOPTOSIS IN THE VPA TREATED CELLS AS COMPARED TO CONTROL CELLS. STATISTICAL ANALYSIS SHOWED THAT VPA'S EFFECT ON CLL CELLS DEPENDS ON LACTATE DEHYDROGENASE SERUM LEVELS, BUT IS INDEPENDENT OF ALL OTHER PROGNOSTIC MARKERS. CONCLUSIONS: THE RESULTS OF THE PRESENT EXPERIMENTS FOUND THAT VPA AT A CLINICALLY APPLICABLE CONCENTRATION SIGNIFICANTLY INDUCES APOPTOSIS INDEPENDENTLY OF THE DISEASE STAGE AND MIGHT BE A VALUABLE THERAPEUTIC AGENT FOR ALL CLL PATIENTS.	2015