Abstract
Lenalidomide is a therapeutically effective drug in chronic lymphocytic leukemia (CLL). Twenty-seven CLL patients were treated with lenalidomide in a phase II clinical trial. Ten patients were grouped as responders (R) and 6 as nonresponders (NR). We evaluated T lymphocytes, NK, monocytes and dendritic cells at baseline and after treatment. A gene expression analysis was performed on 16 CLL samples collected before treatment. The levels of immune cells or immune-related cytokines are not different between R and NR patients. However, CLL patients sensitive to lenalidomide clearly show a peculiar gene expression profile in leukemic cells. The most up-regulated gene (fold change = +23 in R vs. NR) is Wnt inhibitor SHISA homolog 3 (SHISA3). SHISA3highCLL are characterized by a restrained activation of Wnt signaling and sensibility to lenalidomide-induced apoptosis. In conclusion, SHISA3 is a candidate gene for the identification of CLL patients who will benefit of lenalidomide treatment as single agent.
| Original language | English |
|---|---|
| Pages (from-to) | 423-433 |
| Number of pages | 11 |
| Journal | Leukemia and Lymphoma |
| Volume | 59 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Feb 2018 |
Keywords
- Chronic lymphocytic leukemia
- SHISA3
- Wnt signaling
- clinical response
- lenalidomide