Trends in mortality from leukemia in Europe: an update to 2009 and a projection to 2012.

We considered trends in mortality from leukemia in Europe over the period 1970-2009 using data from the World Health Organization. We computed age-standardized (world population) mortality rates, at all ages and in selected age groups, in 11 selected European countries, the European Union (EU) and, for comparative purposes, in the USA and Japan. For the EU, we also provided projections of the mortality to 2012. Over the period considered, mortality from leukemia steadily declined in most European countries in children and young adults, as well as in western and southern Europe at middle-age (45-69 years); in central/eastern Europe, reductions at ages 45-69 started since the mid-late 1990s. In the EU, annual percent changes were -3.7% in males and -3.8% in females at age 0-14, -2% in both sexes at age 15-44, and -0.6% in males and -1% in females at middle-age and overall. No decline was observed at age 70 or more. Between 1997 and 2007, overall EU rates decreased from 5.4 to 4.8/100,000 males and from 3.4 to 2.9/100,000 females. Declines were from 6.2 to 5.5/100,000 males and from 3.7 to 3.2/100,000 females in the USA and from 3.9 to 3.5/100,000 males and from 2.5 to 2.0/100,000 females in Japan. Projected overall rates in the EU at 2012 are 4.3/100,000 males (-11% compared to 2007) and 2.6/100,000 females (-12%).

Detection of CBP rearrangements in acute myelogenous leukemia with t(8;16).

The CREB-binding protein (CBP) is a large nuclear protein that regulates many signal transduction pathways and is involved in chromatin-mediated transcription. The translocation t(8;16)(p11;p13.3) consistently disrupts two genes: the CBP gene on chromosome band 16p13.3 and the MOZ gene on chromosome band 8p11. Although a fusion of these two genes as a result of the translocation is expected, attempts at detecting the fusion transcript by reverse transcriptase polymerase chain reaction (RT-PCR) have proven difficult; to date, only one in-frame CBP/MOZ fusion transcript has been reported. We therefore sought other reliable means of detecting CBP rearrangements. We applied fluorescence in situ hybridization (FISH) and Southern blot analyses to a series of AML patients with a t(8;16) and detected DNA rearrangements of both the CBP and the MOZ loci in all cases tested. All six cases examined for CBP rearrangements have breakpoints within a 13 kb breakpoint cluster region at the 5' end of the CBP gene. Additionally, we used a MOZ cDNA probe to construct a surrounding cosmid contig and detect DNA rearrangements in three t(8;16) cases, all of which display rearrangements within a 6 kb genomic fragment of the MOZ gene. We have thus developed a series of cosmid probes that consistently detect the disruption of the CBP gene in t(8;16) patients. These clones could potentially be used to screen other cancer-associated or congenital translocations involving chromosome band 16p13.3 as well.

Canonical WNT signaling in hematopoiesis and leukemia

SummaryCanonical Wnt signaling is crucial for embryonic development and the homeostasis of certain adult tissues such as the gut and the skin. The role of canonical Wnt signaling in hematopoiesis is still debated. The expression of a dominant-active β-catenin in hematopoietic stem cells (HSCs) enhances the self-renewal capacity of HSCs but is detrimental for long-term hematopoiesis. In contrast, loss of function experiments show that absence of β- and γ-catenin does not impair steady-state hematopoiesis. It has been argued that the inducible deletion of β-catenin using the IFN-responsive Mx promoter may somehow influence stem cell fate. Herein we used the constitutive deletion of β-catenin specifically in hematopoietic cells to show that the absence of β- catenin, as well as γ-catenin deletion, does not impair normal hematopoiesis and self-renewal capacity of HSCs.Dysregulation of canonical Wnt signaling is causal for several types of cancer, including colon carcinoma or breast cancer. Recently, it was found that Wnt signal transduction was upregulated in certain leukemias. Based on these data, we have investigated whether β- and γ-catenin play a role for the induction of leukemias by oncogenic BCR-ABL translocation product. We show that the induction of B-ALL (B cell acute lymphocytic leukemia) is strongly reduced in the absence of γ-catenin, while the induction of CML (chronic myeloid leukemia) occurs at a normal rate. In the combined absence of β- and γ-catenin the induction of both CML and B-ALL is essentially blocked. Consistent with these data others have found that β-catenin is essential for the induction of CML by BCR-ABL.Collectively, we find that β- and γ-catenin are dispensable for normal hematopoiesis but essential for the development of BCR-ABL induced leukemias. These findings suggest that the canonical Wnt pathway may represent a promising target for the therapy of leukemia.RésuméLa voie de signalisation canonique Wnt est essentielle pour le développement embryonnaire ainsi que l'homéostasie de certains tissus adultes, comme les intestins et la peau. Le rôle de la voie canonique Wnt pour l'hématopoïèse est encore incertain. D'un coté l'expression d'une forme active de β-catenine dans les cellules souches de la moelle augmente leur potentiel d'auto- renouvellement mais est préjudiciable pour l'hématopoïèse à long terme. Par contre, l'absence de β- et γ-catenine n'empêche pas le déroulement normal de l'hématopoïèse. La façon dont est supprimée β-catenine, en utilisant le promoteur IFN-inductible Mx, pourrait influencer le sort des cellules souches. Ici nous détruisons β-catenine spécifiquement dans les cellules hématopoïétiques de manière constitutive et montrons que, en combinaison avec l'absence de γ-catenine, l'absence de β-catenine n'affecte pas le déroulement normal de l'hématopoïèse et la capacité des cellules souches de la moelle à se renouveler.Plusieurs sortes de cancers, comme celui du colon ou du sein, sont parfois dus à une dérégulation de la voie canonique Wnt. Récemment, certaines leucémies ont présenté une activation du signal Wnt. A partir de ces données, nous avons examiné si β- et γ-catenine jouent un rôle dans l'induction des leucémies causées par le produit de translocation BCR-ABL. Nous avons montré que l'induction de la leucémie aiguë lymphoïde de cellules Β (LAL-B) est grandement diminuée en l'absence de γ-catenin, alors que l'induction de la leucémie myéloïde chronique (LMC) n'est pas affectée. En l'absence des deux catenines, l'induction des deux leucémies LAL-B et LMC est presque complètement bloquée. En confirmation de nos données, un autre groupe a montré que β-catenine est essentielle pour le développement de la LMC. Ensemble, ces données nous montrent que β- et γ-catenine ne sont pas nécessaires pour l'hématopoïèse normale, mais essentielle pour le développement des leucémies induites par BCR-ABL. Cela suggère que la voie de signalisation canonique Wnt est une cible prometteuse pour de futures thérapies.

Behavior of nuclear matrix proteins during camptothecin-induced apoptosis in HL-60 human leukemia cells.

In this study we focused our attention on the behavior of four nuclear matrix proteins during the various stages of apoptosis in the HL-60 cell line exposed to the DNA topoisomerase I inhibitor, camptothecin. We have examined the following antigens by immunocytochemical techniques: (i) the 180-kDa nucleolar isoform of DNA topoisomerase II; (ii) a 126-kDa polypeptide of nuclear bodies; (iii) a 125-kDa protein; and (iv) a 160-kDa polypeptide which are known to be components of the matrix inner network. Indirect immunofluorescence experiments were performed to follow these nuclear matrix antigens during apoptosis. Moreover, the ultrastructural localization of both 125- and 160-kDa proteins was investigated by electron microscope immunocytochemistry with gold-conjugated secondary antibodies. While the antibody to the nucleolar isoform of DNA topoisomerase II gave a fluorescent pattern that was well-maintained until the late phases of apoptosis, the other three nuclear antigens showed marked modifications in their distribution. A common feature, particularly evident for 125- and 160-kDa proteins, was their absence from cap-shaped chromatin marginations, whereas they were present in the areas of remaining decondensed chromatin. The 126-kDa polypeptide concentrated progressively in an irregular mass at the opposite side of the crescentic caps and then broke up in fine spots. The 125- and 160-kDa proteins localized in the nucleolus and precisely within certain granules which are known to appear in the nucleolar area after camptothecin administration. These results show that, in addition to the well-known chromatin changes, nuclear organization undergoes other rearrangements during the apoptotic process.

Health-related quality of life in long-term survivors of relapsed childhood acute lymphoblastic leukemia.

BACKGROUND: Relapses occur in about 20% of children with acute lymphoblastic leukemia (ALL). Approximately one-third of these children can be cured. Their risk for late effects is high because of intensified treatment, but their health-related quality of life (HRQOL) was largely unmeasured. Our aim was to compare HRQOL of ALL survivors with the general population, and of relapsed with non-relapsed ALL survivors. METHODOLOGY/PRINCIPAL FINDINGS: As part of the Swiss Childhood Cancer Survivor Study (SCCSS) we sent a questionnaire to all ALL survivors in Switzerland who had been diagnosed between 1976-2003 at age <16 years, survived ≥5 years, and were currently aged ≥16 years. HRQOL was assessed with the Short Form-36 (SF-36), which measures four aspects of physical health and four aspects of mental health. A score of 50 corresponded to the mean of a healthy reference population. We analyzed data from 457 ALL survivors (response: 79%). Sixty-one survivors had suffered a relapse. Compared to the general population, ALL survivors reported similar or higher HRQOL scores on all scales. Survivors with a relapse scored lower in general health perceptions (51.6) compared to those without (55.8;p=0.005), but after adjusting for self-reported late effects, this difference disappeared. CONCLUSION/SIGNIFICANCE: Compared to population norms, ALL survivors reported good HRQOL, even after a relapse. However, relapsed ALL survivors reported poorer general health than non-relapsed. Therefore, we encourage specialists to screen for poor general health in survivors after a relapse and, when appropriate, specifically seek and treat underlying late effects. This will help to improve patients' HRQOL.

Juvenile delinquency in Switzerland over 50 years: assessing trends beyond statistics

The general public seems to be convinced that juvenile delinquency has massively increased over the last decades. However, this assumption is much less popular among academics and some media where doubts about the reality of this trend are often expressed. In the present paper, trends are followed using conviction statistics over 50 years, police and victimization data since the 1980s, and self-report data collected since 1992. All sources consistently point to a massive increase of offending among juveniles, particularly for violent offences during the 1990s. Given that trends were similar in most European countries, explanations should be sought at the European rather than the national level. The available evidence points to possible effects of increased opportunities for property offences since 1950, and although causality remains hard to prove, effects of increased exposure to extreme media violence since 1985.

Receptor activator for NF-κB ligand in acute myeloid leukemia: expression, function, and modulation of NK cell immunosurveillance.

The TNF family member receptor activator for NF-κB ligand (RANKL) and its receptors RANK and osteoprotegerin are key regulators of bone remodeling but also influence cellular functions of tumor and immune effector cells. In this work, we studied the involvement of RANK-RANKL interaction in NK cell-mediated immunosurveillance of acute myeloid leukemia (AML). Substantial levels of RANKL were found to be expressed on leukemia cells in 53 of 78 (68%) investigated patients. Signaling via RANKL into the leukemia cells stimulated their metabolic activity and induced the release of cytokines involved in AML pathophysiology. In addition, the immunomodulatory factors released by AML cells upon RANKL signaling impaired the anti-leukemia reactivity of NK cells and induced RANK expression, and NK cells of AML patients displayed significantly upregulated RANK expression compared with healthy controls. Treatment of AML cells with the clinically available RANKL Ab Denosumab resulted in enhanced NK cell anti-leukemia reactivity. This was due to both blockade of the release of NK-inhibitory factors by AML cells and prevention of RANK signaling into NK cells. The latter was found to directly impair NK anti-leukemia reactivity with a more pronounced effect on IFN-γ production compared with cytotoxicity. Together, our data unravel a previously unknown function of the RANK-RANKL molecule system in AML pathophysiology as well as NK cell function and suggest that neutralization of RANKL with therapeutic Abs may serve to reinforce NK cell reactivity in leukemia patients.

Stimulus statistics shape oscillations in nonlinear recurrent neural networks.

Rhythmic activity plays a central role in neural computations and brain functions ranging from homeostasis to attention, as well as in neurological and neuropsychiatric disorders. Despite this pervasiveness, little is known about the mechanisms whereby the frequency and power of oscillatory activity are modulated, and how they reflect the inputs received by neurons. Numerous studies have reported input-dependent fluctuations in peak frequency and power (as well as couplings across these features). However, it remains unresolved what mediates these spectral shifts among neural populations. Extending previous findings regarding stochastic nonlinear systems and experimental observations, we provide analytical insights regarding oscillatory responses of neural populations to stimulation from either endogenous or exogenous origins. Using a deceptively simple yet sparse and randomly connected network of neurons, we show how spiking inputs can reliably modulate the peak frequency and power expressed by synchronous neural populations without any changes in circuitry. Our results reveal that a generic, non-nonlinear and input-induced mechanism can robustly mediate these spectral fluctuations, and thus provide a framework in which inputs to the neurons bidirectionally regulate both the frequency and power expressed by synchronous populations. Theoretical and computational analysis of the ensuing spectral fluctuations was found to reflect the underlying dynamics of the input stimuli driving the neurons. Our results provide insights regarding a generic mechanism supporting spectral transitions observed across cortical networks and spanning multiple frequency bands.

The frequency and prognostic impact of dic(9;20)(p13.2;q11.2) in childhood B-cell precursor acute lymphoblastic leukemia: results from the NOPHO ALL-2000 trial.

The dic(9;20)(p13.2;q11.2) is reported to be present in ∼2% of childhood B-cell precursor acute lymphoblastic leukemia (BCP ALL). However, it easily escapes detection by G-banding analysis and its true prevalence is hence unknown. We performed interphase fluorescence in situ hybridization analyses-in a three-step manner-using probes for: (i) CDKN2A at 9p21, (ii) 20p and 20q subtelomeres and (iii) cen9 and cen20. Out of 1033 BCP ALLs diagnosed from 2001 to 2006, 533 were analyzed; 16% (84/533) displayed 9p21 deletions, of which 30% (25/84) had dic(9;20). Thus, dic(9;20)-positivity was found in 4.7% (25/533), making it the third most common genetic subgroup after high hyperdiploidy and t(12;21)(p13;q22). The dic(9;20) was associated with a female predominance and an age peak at 3 years; 18/25 (72%) were allocated to non-standard risk treatment at diagnosis. Including cases detected by G-banding alone, 29 dic(9;20)-positive cases were treated according to the NOPHO ALL 2000 protocol. Relapses occurred in 24% (7/29) resulting in a 5-year event-free survival of 0.69, which was significantly worse than for t(12;21) (0.87; P=0.002) and high hyperdiploidy (0.82; P=0.04). We conclude that dic(9;20) is twice as common as previously surmised, with many cases going undetected by G-banding analysis, and that dic(9;20) should be considered a non-standard risk abnormality.