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Microbiota Influences on Hematopoiesis and Blood Cancers: New Horizons? 微生物群对造血和血癌的影响:新视野?
IF 11.5 Q1 HEMATOLOGY Pub Date : 2023-07-05 DOI: 10.1158/2643-3230.BCD-22-0172
Jessica R Galloway-Peña, Christian Jobin

Hematopoiesis governs the generation of immune cells through the differentiation of hematopoietic stem cells (HSC) into various progenitor cells, a process controlled by intrinsic and extrinsic factors. Among extrinsic factors influencing hematopoiesis is the microbiota, or the collection of microorganisms present in various body sites. The microbiota has a profound impact on host homeostasis by virtue of its ability to release various molecules and structural components, which promote normal organ function. In this review, we will discuss the role of microbiota in influencing hematopoiesis and how disrupting the microbiota/host network could lead to hematologic malignancies, as well as highlight important knowledge gaps to move this field of research forward.

Significance: Microbiota dysfunction is associated with many pathologic conditions, including hematologic malignancies. In this review, we discuss the role of microbiota in influencing hematopoiesis and how disrupting the microbiota/host network could lead to hematologic malignancies. Understanding how the microbiota influences hematologic malignancies could have an important therapeutic impact for patients.

造血是通过造血干细胞(HSC)分化成各种祖细胞来产生免疫细胞的,这一过程受内在和外在因素的控制。影响造血的外在因素包括微生物群,即存在于人体各个部位的微生物集合。微生物群能够释放各种分子和结构成分,促进器官的正常功能,因此对宿主的平衡有着深远的影响。在这篇综述中,我们将讨论微生物群在影响造血过程中的作用,以及破坏微生物群/宿主网络如何导致血液系统恶性肿瘤,并强调推动这一研究领域发展的重要知识缺口:微生物群功能失调与包括血液系统恶性肿瘤在内的许多病理状况有关。在这篇综述中,我们讨论了微生物群在影响造血过程中的作用,以及破坏微生物群/宿主网络如何导致血液恶性肿瘤。了解微生物群如何影响血液恶性肿瘤可能会对患者产生重要的治疗影响。
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引用次数: 0
Abstract A04: Modulation of RNA splicing enhances response to BCL2 inhibition in leukemia 摘要:RNA剪接的调节增强了白血病对BCL2抑制的应答
Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a04
Eric Wang, Omar Abdel-Wahab, Robert K Bradley, Jose Mario Bello, Won Jun Kim, Carine Bossard
Abstract Therapy resistance is a major challenge in the treatment of cancer. Here, we performed CRISPR/Cas9 screens across a broad range of therapies used in acute myeloid leukemia to identify genomic determinants of drug response. Our screens uncovered a selective dependency on RNA splicing factors whose loss preferentially enhanced response to the BCL2 inhibitor venetoclax. Loss of the splicing factor RBM10 augmented response to venetoclax in leukemia yet was completely dispensable for normal hematopoiesis. Combined RBM10 and BCL2 inhibition led to mis-splicing and inactivation of the inhibitor of apoptosis XIAP and downregulation of BCL2A1, an anti-apoptotic protein implicated in venetoclax resistance. A novel inhibitor of splicing kinase families CLKs and DYRKs led to aberrant splicing of key splicing and apoptotic factors that synergized with venetoclax and overcame resistance to BCL2 inhibition. Our findings underscore the importance of splicing in modulating response to therapies and provide a strategy to improve venetoclax-based treatments. Citation Format: Eric Wang, Omar Abdel-Wahab, Robert K Bradley, Jose Mario Bello, Won Jun Kim, Carine Bossard. Modulation of RNA splicing enhances response to BCL2 inhibition in leukemia [abstract]. In: Proceedings of the AACR Special Conference: Acute Myeloid Leukemia and Myelodysplastic Syndrome; 2023 Jan 23-25; Austin, TX. Philadelphia (PA): AACR; Blood Cancer Discov 2023;4(3_Suppl):Abstract nr A04.
治疗耐药是癌症治疗中的一个重大挑战。在这里,我们在急性髓性白血病的广泛治疗中进行了CRISPR/Cas9筛选,以确定药物反应的基因组决定因素。我们的筛选揭示了对RNA剪接因子的选择性依赖,这些剪接因子的缺失优先增强了对BCL2抑制剂venetoclax的反应。剪接因子RBM10的缺失增强了白血病患者对venetoclax的反应,但对正常造血是完全必要的。RBM10和BCL2联合抑制导致细胞凋亡抑制剂XIAP的错误剪接和失活,以及BCL2A1(一种与venetoclax耐药有关的抗凋亡蛋白)的下调。剪接激酶家族CLKs和DYRKs的一种新型抑制剂导致关键剪接和凋亡因子的异常剪接,这些因子与venetoclax协同并克服了对BCL2抑制的抗性。我们的研究结果强调了剪接在调节治疗反应中的重要性,并提供了一种改进venetoclax治疗的策略。引文格式:Eric Wang, Omar Abdel-Wahab, Robert K Bradley, Jose Mario Bello, Won Jun Kim, Carine Bossard。RNA剪接调节增强白血病对BCL2抑制的应答[摘要]。摘自:AACR特别会议论文集:急性髓性白血病和骨髓增生异常综合征;2023年1月23-25日;费城(PA): AACR;血癌发现[j]; 2009;4(3 -增刊):摘要nr A04。
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引用次数: 0
Global Shift in Alternative Splicing and Therapeutic Susceptibilities in Leukemia Driven by METTL3 Overexpression. METTL3过表达驱动的白血病选择性剪接和治疗易感性的整体变化。
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3230.BCD-23-0035
Maxime Janin, Manel Esteller

Summary: Mutations in splicing factors are commonly observed in chronic lymphocytic leukemia (CLL); however, other mechanisms can also contribute to the dysregulation of alternative splicing. One example is the overexpression of the m6A RNA methyltransferase METTL3, that by depositing the epitranscriptomic mark in spliceosome transcripts leads to aberrant splicing, but at the same time creates vulnerability to METTL3 inhibitors. See related article by Wu et al., p. 228 (8) .

摘要:剪接因子突变在慢性淋巴细胞白血病(CLL)中常见;然而,其他机制也可能导致选择性剪接的失调。一个例子是m6A RNA甲基转移酶METTL3的过表达,通过在剪接体转录物中沉积表转录组标记,导致异常剪接,但同时产生对METTL3抑制剂的易感性。参见吴等人的相关文章,第228(8)页。
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引用次数: 0
Abstract A26: Age and Dose Related Changes to the Bone Marrow Microenvironment after Cytotoxic Conditioning with Busulfan 摘要:布苏凡细胞毒性调节后骨髓微环境的年龄和剂量相关变化
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a26
J. Spencer, C. Burns, R. Verrinder, Farhad Ghazali, N. Abbasizadeh
Hematopoietic Cell Transplantation (HCT) is a frequently used treatment for hematologic malignancies such as acute myeloid leukemia, multiple myeloma, lymphoma and non-malignant diseases. Preparative regimens before HCT damage the Bone Marrow (BM) niche, but it is not fully known how the cytotoxic preconditioning, whether High or Low intensity, impacts bone and BM remodeling, regeneration, and subsequent hematopoietic recovery over time. In addition, the effect of recipient age on these factors has not been completely described. In this study, we sought to longitudinally investigate bone and BM remodeling after Low and High intensity Busulfan (BU) conditioning with the aim of understanding the role that BM niche alterations play in the recovery of the hematopoietic system after transplantation. Using two-photon intravital microscopy, we visualized bone and BM changes in young and adult mice on days 2, 5, and 42 post-transplantation. Both Low and High intensity conditioning were administered with injections of 40 mg/kg and 80 mg/kg busulfan, respectively. Busulfan is a DNA alkylating drug that in combination with cyclophosphamide is being clinically used to treat leukemia. Mice were then transplanted with 1 × 106 whole BM cells from a C57BL/6-Tg(UBC-GFP) mouse. During live imaging, functionality of the vascular system and hematopoietic recovery were studied. For ex vivo imaging, vascular labeling fluorescent antibodies (Alexafluor 647 conjugated to anti-CD31, CD144, and Sca-1) and calcium binding dyes (dye1; Calcein, Dye2; Alizarin) were administered before intracardiac perfusion. Then long bones were harvested, frozen, and the cortical layer was shaved to enable visualization of the BM. Vascular analysis indicated increased leakage in both Low and High intensity conditioning even after 42 days suggesting delayed endothelial recovery following conditioning. Morphological evaluation of the vascular network revealed a decrease in the frequency and increase in the size and density of the vessels at early timepoints that was partially restored by day 42 in young mice only. Bone remodeling in young mice showed a reduction in the dye1/dye2 ratio at day 5 and a more significant decrease by day 42. In the adult mice, a low ratio was observed in BU-conditioned mice only at day 42 post treatment. To further investigate, we classified the metaphyseal and epiphyseal long bone cavities as deposition type, mixed type, and resorption type based on the ratio of the two dyes. The classification analysis indicates that the reduction in dye1/dye2 ratio in BU-conditioned mice over time is primarily due to an increase in resorption type bone cavities in BU-conditioned mice compared to the control. Although donor HSC engraftment is known to be age and dose dependent, our results indicate that long-term microenvironmental changes in the bone and bone marrow may further impact hematopoietic recovery. Overall, our results demonstrate new aspects of bone remodeling and b
造血细胞移植(HCT)是一种常用的血液恶性肿瘤治疗方法,如急性髓性白血病、多发性骨髓瘤、淋巴瘤和非恶性疾病。HCT前的准备方案会损伤骨髓(BM)生态位,但目前尚不完全清楚细胞毒性预处理(无论是高强度还是低强度)如何随着时间的推移影响骨和BM的重塑、再生和随后的造血恢复。此外,受体年龄对这些因素的影响还没有完全描述。在这项研究中,我们试图纵向研究低强度和高强度Busulfan (BU)调节后的骨和BM重塑,目的是了解BM生态位改变在移植后造血系统恢复中的作用。利用双光子活体显微镜,我们观察了移植后第2天、第5天和第42天幼龄和成年小鼠的骨和骨髓变化。低强度和高强度调节分别注射40 mg/kg和80 mg/kg丁硫凡。Busulfan是一种DNA烷基化药物,与环磷酰胺联合用于临床治疗白血病。然后用C57BL/6-Tg(UBC-GFP)小鼠的1 × 106个全BM细胞移植小鼠。在实时成像中,研究了血管系统的功能和造血恢复。对于离体成像,血管标记荧光抗体(Alexafluor 647偶联抗cd31、CD144和Sca-1)和钙结合染料(dye1;钙黄绿素,Dye2;在心内灌注前给予茜素。然后收获长骨,冷冻,削去皮质层,使BM可视化。血管分析显示,即使在42天后,低强度和高强度调理中渗漏都增加,表明调理后内皮恢复延迟。血管网络的形态学评估显示,在早期时间点,血管的频率减少,血管的大小和密度增加,仅在年轻小鼠中,在第42天部分恢复。幼龄小鼠的骨重塑在第5天显示出染料1/染料2比率的降低,到第42天下降更为显著。在成年小鼠中,仅在治疗后第42天,在bu条件小鼠中观察到低比例。为了进一步研究,我们根据两种染料的比例将干骺端长骨腔分为沉积型、混合型和吸收型。分类分析表明,随着时间的推移,bu条件小鼠中染料1/染料2比值的降低主要是由于与对照组相比,bu条件小鼠中吸收型骨腔的增加。尽管已知供体HSC移植与年龄和剂量有关,但我们的研究结果表明,骨和骨髓的长期微环境变化可能进一步影响造血功能的恢复。总之,我们的结果展示了骨重塑和骨髓再生可能影响造血恢复的新方面,值得进一步研究。引用格式:Joel A Spencer, Christian Burns, Ruth Verrinder, Farhad Ghazali, Nastaran Abbasizadeh。布苏凡细胞毒性调节后骨髓微环境的年龄和剂量相关变化[摘要]。摘自:AACR特别会议论文集:急性髓性白血病和骨髓增生异常综合征;2023年1月23-25日;费城(PA): AACR;血癌发现[j]; 2009;4(3 -增刊):摘要/ Abstract
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引用次数: 0
Abstract A18: STC-15, a novel METTL3 inhibitor, and its combination with Venetoclax confer anti-tumour activity in AML models 摘要:STC-15是一种新型METTL3抑制剂,它与Venetoclax联合在AML模型中具有抗肿瘤活性
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a18
L. Vasiliauskaitė, Y. Ofir-Rosenfeld, M. Albertella, C. Hoareau-Aveilla, Jerry McMahon, Oliver Rausch
N6-methyladenosine (m6A) is one of the most abundant RNA modifications, which influences mRNA and lncRNA localization, half-life, translation, and splicing. The majority of m6A modifications on cellular mRNAs are deposited by the RNA methyltransferase METTL3. To date, METTL3 has been implicated in the initiation and progression of multiple cancer types, with the highest expression of METTL3 mRNA observed in acute myeloid leukemia (AML). Currently, one line of standard of care therapy for AML patients is Venetoclax, which targets the anti-apoptotic protein BCL2. It was shown that m6A, deposited by METTL3 on BCL2 transcript, affects BCL2 mRNA stability and translation. Storm Therapeutics has developed potent and selective METTL3 inhibitors, including the clinical candidate STC-15. Here, we explore pharmacological inhibition of METTL3 as monotherapy or in combination with Venetoclax in AML models in vitro and in vivo. Sulforhodamine B and CellTiterGloTM assays were used to assess the viability of AML cell lines and patient-derived xenografts (PDXs), respectively, following METTL3 inhibition in vitro. BCL2 protein level was evaluated by Western blotting. SynergyFinder software was used to assess the degree of synergy between METTL3 inhibitors and Venetoclax. Intra-tibial implantation of human-derived AML cells (AML-PDXs) in NSG mice was used to determine single agent and combination therapy efficacy. Multiple AML cells lines and AML-PDXs were sensitive to pharmacological inhibition of METTL3 in vitro, as assessed by loss of viability. Treatment with METTL3 inhibitors led to downregulation of BCL2 protein level in several AML cell lines, as previously suggested by literature. Based on these results, the synergy between METTL3 inhibition and Venetoclax was assessed. Matrix-combination experiments have shown a high degree of synergy between the two drugs (defined by a synergy score >10) in THP-1 and MOLM-13 cell lines. To test METTL3 inhibition as a monotherapy and in combination with Venetoclax in vivo, three AML-PDX studies were initiated. Significantly lower spleen weight was observed in all animals treated with STC-15 or STC-15 + Venetoclax, and reduced number of circulating hCD45+ cells was observed in 2 out of the 3 models. In one of the models, STC-15 monotherapy outperformed Venetoclax (median survival 68 days vs 58 days, respectively), while the combination therapy extended median group survival to 85 days in comparison to 51.5 days in the vehicle group. In conclusion, we demonstrated that METTL3 inhibition results in anti-tumour effects across different AML models. Moreover, we demonstrated a synergistic effect between the novel METTL3 inhibitor STC-15 and Venetoclax, both in vitro and in vivo. These studies provide evidence for the utility of METTL3 inhibitor as a new therapeutic agent to treat AML. Currently, STC-15 is under clinical development (NCT05584111). Citation Format: Lina Vasiliauskaite, Yaara Ofir-Rosenfeld, Mark Albertella, Co
n6 -甲基腺苷(m6A)是最丰富的RNA修饰之一,影响mRNA和lncRNA的定位、半衰期、翻译和剪接。细胞mrna上的大多数m6A修饰是由RNA甲基转移酶METTL3沉积的。迄今为止,METTL3已与多种癌症类型的发生和进展有关,在急性髓性白血病(AML)中观察到METTL3 mRNA的最高表达。目前,AML患者的一种标准治疗方法是Venetoclax,其靶向抗凋亡蛋白BCL2。结果表明,m6A通过METTL3沉积在BCL2转录本上,影响BCL2 mRNA的稳定性和翻译。Storm Therapeutics已经开发出强效和选择性的METTL3抑制剂,包括临床候选药物STC-15。在这里,我们探讨了METTL3作为单一疗法或与Venetoclax联合治疗在体外和体内AML模型中的药理抑制作用。使用Sulforhodamine B和CellTiterGloTM检测分别评估体外METTL3抑制后AML细胞系和患者来源的异种移植物(PDXs)的活力。Western blotting检测BCL2蛋白水平。使用SynergyFinder软件评估METTL3抑制剂与Venetoclax之间的协同作用程度。采用NSG小鼠胫骨内植入人源性AML细胞(AML- pdxs),观察单药和联合治疗的疗效。多种AML细胞系和AML- pdxs对体外药理抑制METTL3敏感,通过丧失活力来评估。METTL3抑制剂治疗导致几种AML细胞系BCL2蛋白水平下调,如先前文献所述。基于这些结果,评估了METTL3抑制与Venetoclax之间的协同作用。基质联合实验表明,两种药物在THP-1和MOLM-13细胞系中具有高度的协同作用(协同作用评分为bbb10)。为了在体内测试METTL3作为单一疗法和与Venetoclax联合使用的抑制作用,启动了三项AML-PDX研究。STC-15或STC-15 + Venetoclax处理的所有动物脾脏重量均显著降低,3个模型中有2个模型的循环hCD45+细胞数量减少。在其中一个模型中,STC-15单药治疗优于Venetoclax(中位生存期分别为68天和58天),而联合治疗将中位组生存期延长至85天,而载体组为51.5天。总之,我们证明了METTL3抑制在不同的AML模型中产生抗肿瘤作用。此外,我们证明了新型METTL3抑制剂STC-15和Venetoclax在体外和体内都具有协同效应。这些研究为METTL3抑制剂作为治疗AML的新药物提供了证据。目前,STC-15正在临床开发中(NCT05584111)。引文格式:Lina Vasiliauskaite, Yaara ofirl - rosenfeld, Mark Albertella, Coralie Hoareau-Aveilla, Jerry McMahon, Oliver Rausch。STC-15是一种新型的METTL3抑制剂,它与Venetoclax联合在AML模型中具有抗肿瘤活性[摘要]。摘自:AACR特别会议论文集:急性髓性白血病和骨髓增生异常综合征;2023年1月23-25日;费城(PA): AACR;血癌发现[j]; 2009;4(3 -增刊):摘要nr A18。
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引用次数: 0
Abstract A52: IDS and SETBP1 is highly prognostic in myelodysplastic neoplasms and is a candidate stem cell signature 摘要:IDS和SETBP1在骨髓增生异常肿瘤中具有高度预后作用,是一种候选的干细胞特征
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a52
A. Ediriwickrema, A. Gentles, R. Majeti
Myelodysplastic neoplasms (MDS) are heterogenous blood disorders that arise from dysfunctional hematopoietic stem cells (HSCs) and progenitor cells (HSPCs). According to the cancer stem cell (CSC) model, MDS is organized as a cellular hierarchy that arises from the malignant transformation of HSPCs into rare CSCs. MDS-CSCs are thought to persist during treatment and regenerate disease during relapse. Prior studies have linked MDS-CSCs to MDS-HSPC (Woll et al. Cancer Cell 2014, Pang et al, PNAS 2013, Will et al, Blood 2012), however, a specific cell type has not been isolated and purified as the MDS-CSC. Prognostic gene expression signatures in MDS have also been linked to immature HSPCs (Shiozawa et al, Blood 2017), however, a cell specific signature has not been identified. There is a need to characterize a cell specific gene signature for MDS-CSCs in order to study these cells. To address this need, we performed iterative statistical analyses on MDS gene expression data in order to identify a candidate CSC signature. We hypothesized that by analyzing genes specifically up-regulated in MDS-HSPCs, we can derive a CSC specific gene signature that is not only associated with poor outcomes in MDS, but also marks a subset of cells in MDS with stem cell programs. Up-regulated genes in MDS-HSPCs compared to healthy controls were derived by re-analyzing 73 sorted samples (Woll et al, Cancer Cell 2014) using the limma (Ritchie et al, Nucleic Acids Res 2015). Using these genes, we subsequently analyzed their association with survival in a cohort of 244 MDS patients (Shiozawa et al, Blood 2017, Gerstung et al, Nat Commun 2015, Tyner et al, Nature 2018). We performed iterative Cox proportional hazard models on a training data (n=146), using single and multiple gene combinations. A 2 gene score (i.e., MDS2), comprising IDS and SETBP1, was identified as the most significantly associated feature with decreased survival in MDS compared to Age, Sex, Cytogenetic Risk, and an established MDS score (Shiozawa et al, Blood 2017). Single cell expression of MDS2 was evaluated in MDS scRNA-seq samples (Dussiau et al, BMC Biol2022), and rare cells were identified expressing high levels of MDS2, i.e., MDS2 cells. These cells were integrated with healthy HSPCs. MDS2 cells reside primarily between HSCs and MPPs on a diffusion map, following a differentiation trajectory towards GMPs and monocyte precursors. These observations are consistent with prior studies, as MDS-CSCs were shown to be enriched in HSCs and GMPs (Pang et al, PNAS 2013, Woll et al, Cancer Cell 2014). Analysis of upregulated genes in MDS2 cells revealed that antigen processing, assembly and presentation were the most enriched processes. This analysis supports our approach for identifying a cell specific gene signature, and future work will focus on further single cell analyses and evaluation of CSC content and function of MDS2 cells. Citation Format: Asiri Ediriwickrema, Andrew Gentles, Ravindra Majeti. I
骨髓增生异常肿瘤(MDS)是由造血干细胞(hsc)和祖细胞(HSPCs)功能失调引起的异质血液疾病。根据癌症干细胞(CSC)模型,MDS是由HSPCs恶性转化为罕见的CSC而形成的细胞层次结构。MDS-CSCs被认为在治疗期间持续存在,在复发期间再生疾病。先前的研究已经将MDS-CSCs与MDS-HSPC联系起来(Woll等)。Cancer Cell 2014, Pang et al, PNAS 2013, Will et al, Blood 2012),然而,一种特定的细胞类型尚未被分离和纯化为MDS-CSC。MDS的预后基因表达特征也与未成熟的HSPCs有关(Shiozawa等人,Blood 2017),然而,尚未确定细胞特异性特征。为了研究MDS-CSCs,有必要对其细胞特异性基因特征进行表征。为了满足这一需求,我们对MDS基因表达数据进行了迭代统计分析,以确定候选的CSC特征。我们假设,通过分析MDS- hspcs中特异性上调的基因,我们可以得出CSC特异性基因标记,该标记不仅与MDS的不良预后相关,而且还将MDS中的一部分细胞标记为干细胞程序。与健康对照相比,MDS-HSPCs中的上调基因是通过重新分析73个分类样本(Woll等人,Cancer Cell 2014)使用limma (Ritchie等人,Nucleic Acids Res 2015)得出的。使用这些基因,我们随后分析了它们与244名MDS患者队列中生存的关系(Shiozawa等人,Blood 2017, gersting等人,Nat comm 2015, Tyner等人,Nature 2018)。我们使用单基因和多基因组合对训练数据(n=146)进行了迭代Cox比例风险模型。与年龄、性别、细胞遗传风险和已建立的MDS评分相比,由IDS和SETBP1组成的2个基因评分(即MDS2)被确定为与MDS生存率降低最显著相关的特征(Shiozawa等人,Blood 2017)。我们在MDS scRNA-seq样本中评估了MDS2的单细胞表达(Dussiau等人,BMC Biol2022),并发现了表达高水平MDS2的罕见细胞,即MDS2细胞。这些细胞与健康的造血干细胞结合。在扩散图上,MDS2细胞主要位于造血干细胞和mpp之间,遵循向gmp和单核细胞前体的分化轨迹。这些观察结果与先前的研究一致,因为MDS-CSCs被证明在hsc和gmp中富集(Pang等人,PNAS 2013, Woll等人,Cancer Cell 2014)。对MDS2细胞中上调基因的分析显示,抗原加工、组装和呈递是最富集的过程。该分析支持我们鉴定细胞特异性基因标记的方法,未来的工作将集中在进一步的单细胞分析和评估MDS2细胞的CSC含量和功能。引文格式:Asiri Ediriwickrema, Andrew Gentles, Ravindra Majeti。IDS和SETBP1在骨髓增生异常肿瘤中具有很高的预后价值,是一种候选的干细胞特征[摘要]。摘自:AACR特别会议论文集:急性髓性白血病和骨髓增生异常综合征;2023年1月23-25日;费城(PA): AACR;血癌发现[j]; 2009;4(3 -增刊):摘要/ Abstract
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引用次数: 0
Abstract A25: A niche directed therapy for the treatment of myelodysplasia and acute myeloid leukemia 摘要A25:一种治疗骨髓发育不良和急性髓系白血病的小生境定向疗法
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a25
I. Mosialou, A. Ali, Rachel Adams, A. Corper, C. Woods, Xiaomin Fan, A. Raza, S. Kousteni
Cells of the surrounding bone marrow microenvironment (niche) have emerged as important regulators of myeloid disease development and progression, leading to myeloproliferative neoplasms, myelodysplasia (MDS) or acute myeloid leukemia (AML). This not only highlights the complexity of the disease but may, at least in part, explain the limitations of current malignant cell targeted therapies to prevent relapse and at the same time opens new avenues for therapeutic intervention. To test this hypothesis, we examined here the therapeutic potential of targeting a potent, niche-driven oncogenic pathway, constitutive activation of b-catenin/Jagged1 signaling in osteoblasts. In humans, this pathway is activated in approximately 40% of MDS and AML patients; and also following hypermethylation of its regulators in MDS patients. Its activation levels increase with disease severity, correlate with MDS to AML transformation and with del(5q)-associated myeloid malignancies. In mice, it leads to MDS rapidly progressing to AML. To test its therapeutic potential, we inhibited Jagged1. We generated a chimeric human-mouse neutralizing antibody that efficiently and specifically binds JAG1 (anti-JAG1) and inhibits Notch1-induced signaling. Administration of anti-JAG1 in leukemic mice with activated b-catenin/Jag1 in their osteoblasts rescued anemia, thrombocytopenia, neutrophilia and lymphocytopenia, relieved myeloid differentiation block and eliminated blasts. Body weight increased with time and lethality was abrogated in treated mice. Blood chemistry profiling indicated lack of any toxicity following treatment as indicated by normal liver and kidney function and absence of inflammation, dyslipidemia or pancreatitis. In contrast, chemotherapy at a dose simulating the induction regimen used in patients, dramatically exacerbated anemia, thrombocytopenia and lymphocytopenia without decreasing blasts leading to increased lethality due to bone marrow failure. Emphasizing relevance to human disease, anti-JAG1 treatment of patient-derived samples with activated b-catenin/JAG1 in their osteoblasts, inhibited MDS and AML cell growth and survival and promoted myeloid and erythroid differentiation through its actions on osteoblasts. Responsiveness was observed across patients belonging to diverse disease subtypes and categories including patients with adverse cytogenetics and high-risk groups. Confirming the specificity of anti-JAG1 action, no effect was observed in cells from patients without activated b-catenin/JAG1 in their osteoblasts or healthy subjects and the magnitude of the response correlated with the levels of b-catenin/JAG1 activation in osteoblasts. These results suggest the therapeutic efficacy of blocking JAG1 and its superiority to chemotherapy in osteoblastic, b-catenin-driven MDS/AML that could impact 1/3 of MDS and AML patients. In addition, they suggest that targeting the niche may be an approach to avoid toxicity and overcome MDS/AML cell mutation depende
周围骨髓微环境(生态位)的细胞已成为骨髓疾病发展和进展的重要调节因子,导致骨髓增生性肿瘤、骨髓发育不良(MDS)或急性髓系白血病(AML)。这不仅突出了该疾病的复杂性,而且可能至少部分解释了目前恶性细胞靶向治疗预防复发的局限性,同时为治疗干预开辟了新的途径。为了验证这一假设,我们在这里研究了靶向一种有效的、小生境驱动的致癌途径的治疗潜力,即成骨细胞中β-连环蛋白/Jagged1信号的组成型激活。在人类中,大约40%的MDS和AML患者激活了该途径;以及在MDS患者中其调节因子的高甲基化之后。其激活水平随着疾病严重程度的增加而增加,与MDS向AML的转化以及del(5q)相关的髓系恶性肿瘤相关。在小鼠中,它会导致MDS迅速发展为AML。为了测试其治疗潜力,我们抑制了Jagged1。我们产生了一种嵌合的人-小鼠中和抗体,该抗体有效且特异性地结合JAG1(抗JAG1)并抑制Notch1诱导的信号传导。在白血病小鼠中给予抗JAG1,在其成骨细胞中含有活化的β-连环蛋白/JAG1,可挽救贫血、血小板减少、中性粒细胞增多和淋巴细胞减少,缓解骨髓分化障碍并消除成纤维细胞。体重随着时间的推移而增加,并且治疗小鼠的致死率被消除。血液化学分析表明,治疗后没有任何毒性,如肝和肾功能正常,没有炎症、血脂异常或胰腺炎。相反,以模拟患者诱导方案的剂量进行化疗,显著加剧了贫血、血小板减少症和淋巴细胞减少症,但没有减少母细胞,导致骨髓衰竭导致的死亡率增加。强调与人类疾病的相关性,在患者来源的样本的成骨细胞中用活化的β-连环蛋白/JAG1进行抗JAG1治疗,通过对成骨细胞的作用抑制MDS和AML细胞的生长和存活,并促进骨髓和红系分化。在属于不同疾病亚型和类别的患者中观察到反应性,包括具有不良细胞遗传学的患者和高危人群。证实了抗JAG1作用的特异性,在其成骨细胞或健康受试者中未观察到来自未激活b-连环蛋白/JAG1的患者的细胞中的作用,并且反应的大小与成骨细胞中b-连环素/JAG1激活的水平相关。这些结果表明,在成骨细胞、β-连环蛋白驱动的MDS/AML中,阻断JAG1的治疗效果及其优于化疗,这可能影响1/3的MDS和AML患者。此外,他们认为,靶向小生境可能是一种避免毒性、克服MDS/AML细胞突变依赖性和克隆耐药性的方法,遵循标准护理,从而防止复发。引文格式:Ioanna Mosialou,Abdullah M Ali,Rachel Adams,Adam Corper,Catherine M Woods,Xiaomin Fan,Azra Raza,Stavroula Koustini。一种小众定向治疗骨髓发育不良和急性髓系白血病的方法[摘要]。载:AACR特别会议论文集:急性髓细胞白血病和骨髓增生异常综合征;2023年1月23日至25日;德克萨斯州奥斯汀。费城(PA):AACR;血液癌症Discov 2023;4(3_Suppl):摘要编号A25。
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引用次数: 0
Abstract A41: Single Cell Multiomic Analysis Reveals Association of TP53-mut Loss of Heterozygosity with Primitive Phenotype in Acute Myeloid Leukemia 摘要A41:单细胞多组分析揭示急性髓细胞白血病中TP53-mut杂合性缺失与原始表型的相关性
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a41
Edward Ayoub, V. Mohanty, Yuki Nishida, Tallie Patsilevas, Mahesh Basyal, Russell Pourebrahim, M. Muftuoglu, Ken Chen, G. Issa, M. Andreeff
TP53 mutations in acute myeloid leukemia (AML) are associated with copy number abnormalities (CNA), structural variants and high risk of relapse (Döhner et al., 2017; Giacomelli et al., 2018; Bernard et al. 2020). In spite of relatively high remission rates obtained by targeted therapies, TP53 mutant (TP53-mut) clones persist, invariably resulting in relapse (Short et al., 2021; Takahashi et al., 2016). Delineating the clonal architecture and the immunophenotypes of TP53-mut clones during AML therapy may provide a better understanding of the role of TP53-mutations in AML biology. Recent progress in sequencing technologies allows the integration of genotyping and phenotyping at the single cell level. Here, we took advantage of MissionBio Tapestri’s newest platform: single cell DNA + protein for simultaneous genotyping and phenotyping with 45 surface oligo-conjugated antibodies in 10 paired samples from 5 patients with TP53-mut AML before and after therapy. Samples with at least 70% viability were stained with the TotalSeq™-D Human Heme Oncology Cocktail, V1.0. Following surface marker staining, single-cell suspension, encapsulation, and barcoding were performed according to manufacturer’s instruction. For scDNA library preparation, we utilized a validated custom panel (Morita et al. 2020) consisting of 279 amplicons covering recurrent mutations in 37 genes in AML. We sequenced a total of 44,550 cells from 10 samples. We confirmed mutations reported by MD Anderson molecular diagnostic laboratory in the genes covered by the scDNA custom panel. The clonal architecture analysis distinguished between TP53-mut clones with or without loss of heterozygosity (LOH) of the normal TP53 allele. Our data show a primitive immunophenotype in TP53-mut with LOH (LOH+) clones in comparison to TP53-mut LOH- clones. We see 2.4 LOG2FC increase in CD34 and 1.8 LOG2FC increase in CD117 (p<0.001) in TP53-mut LOH+ clones in comparison to TP53-mut LOH- clones. Clonal evolution analysis shows that TP53-mut LOH+ clones are significantly more resistant to therapy than TP53-mut LOH-, consistent with previous publications. On the other hand, TP53-mut LOH- clones showed significantly higher levels of CD2, CD16, CD5, CD3, and CD8 among other lineage markers (LOG2FC= 1.1, 1.2, 1.4, 1.1, and 1.1 respectively; p.value <0.0001) compared to TP53-mut LOH+. This data indicates that TP53-mut LOH- cells can express lymphoid phenotypic markers. Single cell cytokine analysis (IsoPlexis) reveals profound lack of secreted cytokines in T-cells from TP53-mut AML. Further data from bulk-RNA sequencing, ddPCR, and CyTOF will be presented that validates a lymphoid phenotype of TP53-mut LOH-. In summary, we utilize a scDNA+protein multiomic approach to dissect clonal architecture and provide a link between genotype-phenotype in TP53-mut AML. We show that while TP53-mut LOH+ clones are exclusively primitive, TP53-mut LOH- clones retain the capacity to exist outside primitive immunophenotype and mig
急性髓细胞白血病(AML)中的TP53突变与拷贝数异常(CNA)、结构变异和高复发风险有关(Döhner等人,2017;Giacomelli等人,2018;Bernard等人2020)。尽管通过靶向治疗获得了相对较高的缓解率,但TP53突变体(TP53-mut)克隆仍然存在,总是导致复发(Short等人,2021;Takahashi等人,2016)。在AML治疗期间描绘TP53突变克隆的克隆结构和免疫表型可以更好地理解TP53突变在AML生物学中的作用。测序技术的最新进展允许在单细胞水平上整合基因分型和表型。在这里,我们利用MissionBio-Tapestri的最新平台:单细胞DNA+蛋白,在5名TP53-mut AML患者治疗前后的10个配对样本中,用45种表面寡聚缀合抗体同时进行基因分型和表型分型。用TotalSeq对具有至少70%活力的样品进行染色™-D人类血红素肿瘤学鸡尾酒,V1.0。表面标记染色后,根据制造商的说明进行单细胞悬浮、包封和条形码。对于scDNA文库的制备,我们使用了一个经过验证的自定义面板(Morita等人,2020),该面板由279个扩增子组成,覆盖AML中37个基因的复发突变。我们对10个样本中的44550个细胞进行了测序。我们证实了MD Anderson分子诊断实验室在scDNA定制小组覆盖的基因中报告的突变。克隆结构分析区分了具有或不具有正常TP53等位基因杂合性(LOH)缺失的TP53突变克隆。我们的数据显示,与TP53突变LOH-克隆相比,具有LOH(LOH+)克隆的TP53突变具有原始免疫表型。我们发现,与TP53 mut LOH-克隆相比,TP53 mut-LOH+克隆的CD34和CD117的LOG2FC分别增加了2.4和1.8(p<0.001)。克隆进化分析表明,TP53突变LOH+克隆对治疗的抵抗力明显高于TP53突变-LOH-,这与以前的出版物一致。另一方面,与TP53mut-LOH+相比,TP53mut LOH-克隆在其他谱系标记物中显示出显著更高的CD2、CD16、CD5、CD3和CD8水平(LOG2FC分别为1.1、1.2、1.4、1.1和1.1;p值<0.0001)。这些数据表明,TP53突变LOH细胞可以表达淋巴表型标记。单细胞细胞因子分析(IsoPlexis)显示TP53突变AML的T细胞中严重缺乏分泌的细胞因子。将提供来自大量RNA测序、ddPCR和CyTOF的进一步数据,以验证TP53突变LOH-的淋巴表型。总之,我们利用scDNA+蛋白质多组方法来剖析克隆结构,并提供TP53突变AML的基因型-表型之间的联系。我们发现,虽然TP53mut LOH+克隆仅是原始的,但TP53mut-LOH-克隆保留了在原始免疫表型之外存在的能力,并且可能缺乏分化阻断。引文格式:Edward Ayoub、Vakul Mohanty、Yuki Nishida、Tallie Patsilevas、Mahesh Basyal、Russell Pourebrahim、Muharrem Muftuoglu、Ken Chen、Ghayas C.Issa、Michael Andreeff。单细胞多组分析揭示急性髓细胞白血病中TP53-mut杂合性缺失与原始表型的相关性[摘要]。载:AACR特别会议论文集:急性髓细胞白血病和骨髓增生异常综合征;2023年1月23日至25日;德克萨斯州奥斯汀。费城(PA):AACR;血液癌症Discov 2023;4(3_Suppl):摘要编号A41。
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引用次数: 0
Abstract A16: Multi-omic analyses in genetically engineered mice reveal distinct and opposite effects of leukemogenic Idh and Tet2 mutations in hematopoietic stem and progenitor cells 摘要A16:基因工程小鼠的多组学分析揭示了造血干细胞和祖细胞中致白血病Idh和Tet2突变的不同和相反作用
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a16
J. Fortin, Ming-Feng Chiang, Cem Meydan, J. Foox, P. Ramachandran, Julie Leca, F. Lemonnier, Wanda Li, Miki S Gams, T. Sakamoto, Mandy F. Chu, Chantal Tobin, Eric Laugesen, Troy M Robinson, A. You-Ten, D. Butler, T. Berger, M. Minden, R. Levine, C. Guidos, A. Melnick, C. Mason, T. Mak
Mutations in IDH1, IDH2, and TET2 are recurrently observed in myeloid neoplasms. IDH1 and IDH2 encode isocitrate dehydrogenase isoforms, which normally catalyze the conversion of isocitrate to α-ketoglutarate (α-KG). Oncogenic IDH1/2 mutations confer neomorphic activity, leading to the production of D-2-hydroxyglutarate (D-2-HG), a potent inhibitor of α-KG-dependent enzymes which include the TET methylcytosine dioxygenases. Given their mutual exclusivity in myeloid neoplasms, IDH1, IDH2, and TET2 mutations may converge on a common oncogenic mechanism. Contrary to this expectation, we observed that they have distinct, and even opposite, effects on hematopoietic stem and progenitor cells in genetically engineered mice. Endogenous Idh2R172K caused much higher D-2-HG production compared to Idh1R132H and Idh2R140Q. This led to profound alterations in hematopoietic progenitor differentiation and to the development of myelodysplastic syndrome-like disease, with shorter survival compared to Tet2−/- mice. Epigenetic and single-cell transcriptomic analyses revealed that Idh2R172K and Tet2 loss-of-function have divergent and opposite effects on the expression and activity of key hematopoietic and leukemogenic regulators. Notably, chromatin accessibility and transcriptional deregulation in Idh2R172K cells were partially disconnected from DNA methylation alterations. These results highlight unanticipated divergent effects of IDH1/2 and TET2 mutations, which may inform the development of genotype-specific therapies. Citation Format: Jerome Fortin, Ming-Feng Chiang, Cem Meydan, Jonathan Foox, Parameswaran Ramachandran, Julie Leca, Francois Lemonnier, Wanda Y. Li, Miki S. Gams, Takashi Sakamoto, Mandy Chu, Chantal Tobin, Eric Laugesen, Troy M. Robinson, Annick You-Ten, Daniel J. Butler, Thorsten Berger, Mark D. Minden, Ross L. Levine, Cynthia J. Guidos, Ari M. Melnick, Christopher E. Mason, Tak W. Mak. Multi-omic analyses in genetically engineered mice reveal distinct and opposite effects of leukemogenic Idh and Tet2 mutations in hematopoietic stem and progenitor cells [abstract]. In: Proceedings of the AACR Special Conference: Acute Myeloid Leukemia and Myelodysplastic Syndrome; 2023 Jan 23-25; Austin, TX. Philadelphia (PA): AACR; Blood Cancer Discov 2023;4(3_Suppl):Abstract nr A16.
在髓系肿瘤中反复观察到IDH1、IDH2和TET2的突变。IDH1和IDH2编码异柠檬酸脱氢酶异构体,通常催化异柠檬酸转化为α-酮戊二酸(α-KG)。致癌IDH1/2突变赋予新形态活性,导致D-2-羟基戊二酸(D-2-HG)的产生,这是α-KG依赖性酶的有效抑制剂,包括TET甲基胞嘧啶双加氧酶。鉴于IDH1、IDH2和TET2突变在髓系肿瘤中的相互排他性,它们可能集中在一个共同的致癌机制上。与这一预期相反,我们观察到它们对基因工程小鼠的造血干细胞和祖细胞有不同甚至相反的影响。与Idh1R132H和Idh2R140Q相比,内源性Idh2R172K导致更高的D-2-HG产量。这导致了造血祖细胞分化的深刻改变,并导致骨髓增生异常综合征样疾病的发展,与Tet2−/-小鼠相比,存活时间更短。表观遗传学和单细胞转录组学分析表明,Idh2R172K和Tet2功能丧失对关键造血和白血病调节因子的表达和活性具有不同和相反的影响。值得注意的是,Idh2R172K细胞中的染色质可及性和转录失调与DNA甲基化改变部分断开。这些结果突出了IDH1/2和TET2突变的出乎意料的不同影响,这可能为基因型特异性疗法的发展提供信息。引文格式:Jerome Fortin,Ming Feng Chiang,Cem Meydan,Jonathan Foox,Parameswaran Ramachandran,Julie Leca,Francois Lemonnier,Wanda Y.Li,Miki S.Gams,Takashi Sakamoto,Mandy Chu,Chantal Tobin,Eric Laugesen,Troy M.Robinson,Annick You Ten,Daniel J.Butler,Thorsten Berger,Mark D.Minden,Ross L.Levine,Cynthia J.Guidos,Ari M.Melnick,Christopher E.Mason,Tak W.Mak。基因工程小鼠的多组学分析揭示了造血干细胞和祖细胞中致白血病Idh和Tet2突变的不同和相反作用[摘要]。载:AACR特别会议论文集:急性髓细胞白血病和骨髓增生异常综合征;2023年1月23日至25日;德克萨斯州奥斯汀。费城(PA):AACR;血液癌症Discov 2023;4(3_Suppl):摘要编号A16。
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引用次数: 0
Abstract A07: Single-cell proteomic assessment of FLT3-ITD AML landscape identifies distinct resistance patterns 摘要:FLT3-ITD AML的单细胞蛋白质组学评估确定了不同的耐药模式
IF 11.2 Q1 HEMATOLOGY Pub Date : 2023-05-01 DOI: 10.1158/2643-3249.aml23-a07
Li Li, M. Muftuoglu, Mahesh Basyal, N. Daver, M. Andreeff
Acute myeloid leukemia (AML) represents a heterogeneous hematopoietic disorder characterized by accumulation of immature hematopoietic precursors with differentiation block. FLT3 internal tandem duplications (FLT3-ITD) are commonly occurring genetic alterations in AML and are associated with poor prognosis. Preclinical studies showed combining FLT3 inhibitor with MDM2 inhibitor, which is a negative regulator of p53, was synergistic in FLT3-ITD/TP53 wild type (WT) AML. We performed single-cell proteomic evaluation of leukemia landscape in FLT3-ITD patients treated with FLT3i and MDM2i to assess proteomic profiles associated with response and resistance. We performed CyTOF analysis of leukemia cells in serially collected samples from six FLT3-ITD and TP53 WT AML patients following treatment with FLT3i+MDM2i treatment. Using 51 features assessed in CyTOF, we first performed UMAP dimension reduction and clustering to identify distinct cells in leukemia compartment. Notably, the frequencies of blasts identified through CyTOF data analysis were compatible with clinical lab reports. In line with previous reports, we also detected that NPM mutant AML cells did not express CD34. Of note, CD34+ and CD34- leukemia cells were clustered together in NPM1 mut patients, indicating that they have overlapping proteomic profiles. Interestingly, the CD34+ leukemia cells were eliminated at the early time points in CR patients while the CD34- leukemia cells were still detectable after two months. On the other hand, CD34+ leukemia cells in nonresponders(NR) persisted despite therapy. These findings indicate CD34+ leukemia cells were more sensitive to the treatment compared to NPM1 mutant CD34- leukemia cells. Next, we interrogated leukemia proteomic landscape in serial samples, evaluated the therapy-induced alterations in proteomic profiles and sought to identify potential adaptive mechanisms. To this end, we performed differential expression analysis and observed that signaling pathways (p-4EBP1, p-GSK3, p-MEK1/2, p-S6) and differentiation markers(CD33, CD68,CXCR4 HLADR) were more enriched on day 8 post treatment in NR patients, revealing that compensatory signaling activity, phenotypic profiles and differentiation status could be associated with therapy response. Moreover, we found that leukemia cells in NR patients had distinct phenotypic profiles(CD11b,CD68,CXCR4), higher levels of anti-apoptotic molecules (BCL2,MCL1) and enriched survival pathways (p-GSK3, YTHDF2) compared to baseline. In contrast, we did not observe rebound increases in CR patients post-therapy. These findings demonstrate high levels of BCL2 and MCL1 and preferential survival of more differentiated cells may be associated with therapy resistance and treatment failure in NR patient treated with MDM2i and FLT3i. In conclusion, multiplexed single-cell proteomic analysis permitted longitudinal monitoring of leukemia landscape and identified proteomic alterations associated with therapy resistance.
急性髓性白血病(AML)是一种异质性造血疾病,其特征是未成熟造血前体积累并分化受阻。FLT3内部串联重复(FLT3- itd)是AML中常见的遗传改变,与不良预后相关。临床前研究表明,FLT3抑制剂与p53负调节因子MDM2抑制剂联合治疗FLT3- itd /TP53野生型(WT) AML具有协同作用。我们对接受FLT3i和MDM2i治疗的FLT3-ITD患者的白血病景观进行了单细胞蛋白质组学评估,以评估与反应和耐药性相关的蛋白质组学特征。在接受FLT3i+MDM2i治疗后,我们对6例FLT3-ITD和TP53 WT AML患者连续收集的样本进行了白血病细胞的CyTOF分析。利用CyTOF中评估的51个特征,我们首先进行了UMAP降维和聚类,以识别白血病室中的不同细胞。值得注意的是,通过CyTOF数据分析确定的爆炸频率与临床实验室报告一致。与之前的报道一致,我们还检测到NPM突变的AML细胞不表达CD34。值得注意的是,CD34+和CD34-白血病细胞在NPM1突变患者中聚集在一起,表明它们具有重叠的蛋白质组谱。有趣的是,CD34+白血病细胞在CR患者的早期时间点被清除,而CD34-白血病细胞在两个月后仍可检测到。另一方面,尽管接受了治疗,CD34+白血病细胞在无反应(NR)患者中仍然存在。这些发现表明,与NPM1突变体CD34-白血病细胞相比,CD34+白血病细胞对治疗更敏感。接下来,我们在一系列样本中询问白血病蛋白质组学景观,评估治疗诱导的蛋白质组学变化,并试图确定潜在的适应机制。为此,我们进行了差异表达分析,观察到信号通路(p-4EBP1, p-GSK3, p-MEK1/2, p-S6)和分化标志物(CD33, CD68,CXCR4 HLADR)在NR患者治疗后第8天更加丰富,表明代偿性信号活性,表型谱和分化状态可能与治疗反应有关。此外,我们发现与基线相比,NR患者的白血病细胞具有不同的表型特征(CD11b,CD68,CXCR4),更高水平的抗凋亡分子(BCL2,MCL1)和丰富的生存途径(p-GSK3, YTHDF2)。相反,我们没有观察到治疗后CR患者的反弹增加。这些发现表明,在接受MDM2i和FLT3i治疗的NR患者中,高水平的BCL2和MCL1以及更多分化细胞的优先存活可能与治疗耐药和治疗失败有关。总之,多重单细胞蛋白质组学分析允许对白血病景观进行纵向监测,并确定与治疗耐药性相关的蛋白质组学改变。引文格式:Li Li, Muharrem Muftuoglu, Mahesh Basyal, Naval Daver, Michael Andreeff。FLT3-ITD AML景观的单细胞蛋白质组学评估确定了不同的耐药模式[摘要]。摘自:AACR特别会议论文集:急性髓性白血病和骨髓增生异常综合征;2023年1月23-25日;费城(PA): AACR;血癌发现[j]; 2009;4(3 -增刊):摘要/ Abstract
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引用次数: 0
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Blood Cancer Discovery
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