The research was led by investigators at the Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) and at University of Texas M.D. Anderson Cancer Center, working in collaboration with investigators at seven other centers in Italy and the United States. The findings were published recently in the Journal of the American Medical Association (JAMA).
The network involves genes on chromosome 13, chromosome 11 and chromosome 17, along with the important tumor-suppressor gene TP53, the prognostically important molecule called ZAP-70 and two sets of regulatory molecules called microRNA.
“Our findings might allow doctors to better identify which CLL patients need closer follow-up or earlier treatment,” says first author Dr. Muller Fabbri, a research scientist at the OSUCCC – James. “Moreover, our study provides important new information about how CLL develops and identifies new molecular targets for the development of new treatments.”
CLL is the most common leukemia in the U.S., where 15,000 new cases were expected in 2010, along with 4,400 deaths from the disease.
The disease has an extremely variable clinical outcome, Fabbri notes. While most patients have a slowly progressing form of the disease that requires little or no treatment for many years, others have aggressive disease that requires immediate therapy.
Chromosome damage is common in CLL, and it often involves the loss of pieces of chromosome 13. The loss of pieces of chromosomes 11 and 17 may also occur. More specifically, these changes are called the 13q deletion, and the 11q and 17p deletions.
“Patients with a 13q deletion generally have a better prognosis than patients with the 11q or 17p deletion,” Muller says. “But we don’t know why the loss of part of chromosome 13 results in a better prognosis. Our discovery helps unravel this mystery. It identifies a molecular mechanism that explains why these deletions affect patient outcome.”
This study, led by Dr. Carlo M. Croce, professor of molecular virology, immunology and medical genetics, and director of the Human Cancer Genetics program at the OSUCCC – James, shows that loss of chromosome 13q interrupts a biochemical network that involves two families of microRNA and the TP53 tumor-suppressor gene. The interruption leads to greater activity of two genes (BCL2 and MCL1), which prevents cancer cells from dying when they should, and to less activity by a gene called ZAP70. Low levels of ZAP70 are associated with milder disease, while high levels are associated with aggressive disease.
Funding from the National Cancer Institute, the Federazione Italiana Ricerca sul Cancro, the University of Texas M. D. Anderson Research Trust, The University of Texas System Regents Research Scholar Program, the CLL Global Research Foundation, the U.S. Department of Defense, a Leukemia SPORE Developmental Research Award and a Kimmel Scholar Award supported this research.
Croce is the John W. Wolfe Chair in Human Cancer Genetics.
Other researchers involved in this study were Arianna Bottoni, Nicola Valeri, Federica Calore, Hansjuerg Alder, Tatsuya Nakamura, Brett Adair and Sylwia E. Wojcik, of The Ohio State University; Masayoshi Shimizu, Riccardo Spizzo, Milena S. Nicoloso, Simona Rossi, Elisa Barbarotto, Deepa Sampath, George A. Calin, Michael J. Keating of University of Texas M. D. Anderson Cancer Center; Elisa Barbarotto, Massimo Negrini of the University of Ferrara, Italy; Amelia Cimmino of the National Research Council (CNR), Naples, Italy; Francesca Fanini, Ivan Vannini, Gerardo Musuraca and Dino Amadori of the Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola, Italy; Marie Dell’Aquila, Laura Z. Rassenti and Thomas J. Kipps of the University of California San Diego; Ramana V. Davuluri of the Wistar Institute; Neil E. Kay of the Mayo Clinic College of Medicine; and Kanti R. Rai Long Island Jewish Medical Center.
The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (http://cancer.osu.edu) is one of only 40 Comprehensive Cancer Centers in the United States designated by the National Cancer Institute. Ranked by U.S. News & World Report among the top cancer hospitals in the nation, The James is the 205-bed adult patient-care component of the cancer program at The Ohio State University. The OSUCCC-James is one of only seven funded programs in the country approved by the NCI to conduct both phase I and phase II clinical trials.
Darrell E. Ward
Medical Center Communications