Effects of bortezomib-based therapy on hemostasis system and circulating microparticles in multiple myeloma patients

AIM：To investigate the changes of hemostasis, thrombosis and total microparticles (TMPs) in multiple myeloma (MM) patients receiving bortezomib-based induction therapy (bortezomib+adriamycin+dexamethasone, PAD). METHODS：The levels of TMPs were detected by flow cytometry in 38 newly diagnosed MM patients and 30 healthy people. The changes of the platelet, coagulation, anticoagulation, fibrinolytic activation and TMPs in the MM patients before and after PAD teatment were also studied.RESULTS：Before treatment, the values of FVIII:C and vWF:Rco in MM patient were elevated ［(152.89±31.14)% and (165.69±38.43)%］, the activation of platelet aggregation was inhibited ［(63.76±21.36)%］, and the PAI level increased ［3.98(1.63)U/mL］. Compared with the healthy people, higher concentration of TMPs was observed in MM patients ［(640.65±214.22)/μL vs (134.29±63.09)/μL, P<0.01］, and the level of TMPs was positively correlated with serum β2-MG (r=0.672, P<0.01).After PAD therapy, platelet aggregation activation was restored ［(77.83±15.62)%, P=0.01］, and PAI level decreased ［0.88(1.38)U/mL, P<0.01］. The level of TMPs also decreased, after 3 cycles of PAD, to the value of (184.25±93.35)/μL. CONCLUSION：MM patients were characterized by impaired platelet, coagulation and fibrinolysis functions, and increased level of TMPs. PAD restored platelet function, decreased the levels of PAI and TMPs, which might partially explain the low incidence of thrombosis in the MM patients receiving bortezomib-based treatment.     

Lenalidomide alone or combined with bortezomib inhibits growth and induces apoptosis in KM3 cells

AIM: To investigate the effects of lenalidomide alone or combined with bortezomib on induction of apoptosis in multiple myeloma(MM) KM3 cells.METHODS: The KM3 cells were treated with lenalidomide alone or combined with bortezomib. The number of viable cells was determined by trypan blue exclusion. Apoptotic cells were simultaneously stained with annexin V-FITC and PI and determined by flow cytometry. RT-PCR was used to examine the level of p65 mRNA. Western blotting was used to examine the protein levels of P65, pP65, caspase-3,-8, -9, and poly (ADP-ribose) polymerase (PARP). RESULTS: Lenalidomide-inhibited the cell growth and induced apoptosis of KM3 cells. The mechanism responsible for lenalidomide-mediated inhibition was via NF-κB and activation of caspase-mediated induction of apoptosis. A synergistic effect was observed when combination of lenalidomide with bortezomib was used. CONCLUSION: Lenalidomide inhibits the growth and induces apoptosis in KM3 cells. There is a synergistical effect when combination of lenalidomide with bortezomib is in use.     

多发性骨髓瘤中医病机分析及证治思路

多发性骨髓瘤（multiple myeloma,MM）是一种浆细胞恶性肿瘤,随年龄增长发病率升高,多经意义未明的单克隆免疫球蛋白血症（monoclonal gammopathy of undetermined significance,MGUS）发展而来。本文在前人经验基础上,提出了完整的肾虚血瘀证治思想;认为肾虚无制、瘀毒肆虐是MM发生的关键;提出了补肾阴、扶正气、破瘀毒、解症状基本治法,使MM恢复到MGUS状态。     

Concurrent multiple myeloma and mast cell neoplasia in a 13‐year‐old castrated male Maine Coon cat

A 13‐year‐old, castrated male Maine Coon cat was presented to Oklahoma State University Boren Veterinary Medical Teaching Hospital for yearly echocardiographic examination monitoring hypertrophic cardiomyopathy (HCM) diagnosed in 2003. Physical examination revealed a heart murmur and premature beats, likely related to HCM, but was otherwise unremarkable. A biochemistry profile revealed a hyperglobulinemia (6.3 g/dL). Cytologic examination of fine‐needle aspirates from liver and spleen revealed increased numbers of plasma cells and mast cells, confirmed with subsequent histologic examination. Immunohistochemistry (IHC) for c‐kit in the spleen and liver showed mast cells predominantly exhibiting type I staining pattern, with moderate numbers exhibiting type II pattern in spleen, and scattered cells exhibiting type II and III patterns in liver. Bone marrow cytology and core biopsy documented approximately 22% plasma cells. Cutaneous masses on the cat's left shoulder and right carpus were cytologically confirmed mast cell tumors. Serum protein electrophoresis with immunofixation confirmed an IgG monoclonal gammopathy. This is an example of 2 hematologic neoplasms occurring simultaneously in a cat. Concurrent pathologies may be overlooked if a single disease is diagnosed and suspected of causing all clinical signs. Both neoplasms were well differentiated, and neoplastic cells could have easily been interpreted as a reactive population had a full workup not been performed. Missing either diagnosis could result in a potentially lethal outcome. Eleven months after diagnoses, the cat was clinically doing well following a splenectomy and oral prednisolone and chlorambucil chemotherapy. Globulins decreased to 4.9 g/dL.     

Effects of sodium valproate on RPMI8226 and U266 cell proliferation and IL-6/JAK/STAT signaling pathway

AIM: To investigate the effects of sodium valproate (VPA) on the proliferation of multiple myeloma cell lines RPMI8226 and U266 and the regulation of IL-6/JAK/STAT signaling pathway. METHODS: The cells were treated with different concentrations of VPA for 12 h and 24 h. The growth of RPMI8226 cells and U266 cells was detected by MTT assay. Apoptotic rates and cell cycle were analyzed by flow cytometry. The mRNA expression of STAT3, STAT5 and STAT target genes Bcl-xL, Mcl-1, c-Myc, CCND1 and VEGF was measured by RT-PCR. Western blotting analysis was used to determine the total proteins and protein phosphorylation levels of JAK2 and STAT5. RESULTS: VPA inhibited the growth and induced the apoptosis of RPMI8226 cells and U266 cells in a concentration- and time-dependent manner. The levels of IL-6 in the culture supernatants of RPMI8226 cells and U266 cells treated with VPA were significantly higher than that in negative control group. VPA down-regulated the mRNA expression of STAT3, STAT5, Bcl-xL, Mcl-1, c-Myc, CCND1 and VEGF. After treated with VPA, the protein levels of p-JAK2, JAK2, p-STAT5 and STAT5 in RPMI8226 cells and U266 cells were significantly lower than those in control group. CONCLUSION: VPA inhibits the proliferation of PRMI8226 cells and U266 cells in vitro. The modulation of IL-6/JAK/STAT signaling pathway may be involved in its potential mechanisms.     

IQGAP1 is overexpressed and interacts with ERK in human myeloma cells

AIM:To explore the role of IQ motif-containing GTPase-activating protein 1 (IQGAP1) in the cell proliferation of multiple myeloma and its mechanism. METHODS:RT-PCR and Western blotting were performed to detect the expression of IQGAP1 in human myeloma cell lines RPMI8226 and U266. shRNA-expressing plasmids were used to transfect into RPMI8226 cells to knock down the expression of IQGAP1. MTT assay was used to examine the proliferation of RPMI8226-shIQGAP1 (clone 1) cells, RPMI8226-shRNA negative control cells and un-transfected RPMI8226 cells with or without VEGF/IL-6 treatment. The protein levels of p-ERK1/2, ERK1/2, AKT, p-AKT, STAT3 and p-STAT3 in RPMI8226-shIQGAP1 (clone 1) cells, RPMI8226-shRNA negative control cells and un-transfected RPMI8226 cells were measured by Western blotting. The interaction between IQGAP1 and ERK was determined by the method of co-immunoprecipitation. RESULTS:IQGAP1 was overexpressed in human myeloma cell lines RPMI8226 and U266 as compared with normal lymphocytes. Transfection with shRNA targeting to IQGAP1 decreased the expression levels of IQGAP1 in RPMI8226 cells. The proliferation of RPMI8226 cells decreased when IQGAP1 was knocked down by shRNA with or without VEGF/IL-6 treatment. IQGAP1 affected the proliferation of RPMI8226 cells by regulation of MAP kinase (ERK1/2) pathway. The level of p-ERK1/2 in RPMI8226-shIQGAP1 (clone 1) cells decreased by 70.2% as compared with RPMI8226-shRNA negative control cells and un-transfected RPMI8226 cells. The interaction between IQGAP1 and ERK in RPMI8226 cells was observed. CONCLUSION: IQGAP1 plays an important role in the cell proliferation of multiple myeloma via MAP kinase (ERK) pathway.     

Advances of phosphatase of regenerating liver-3 in hematological malignancies

In recent years,accumulating evidence shows that phosphatase of regenerating liver-3(PRL-3) is closely implicated in tumor progression,especially in the stages of invasion and metastasis of various solid tumors,including colorectal cancer,gastric cancer and breast cancer.However,the study of PRL-3 in hematological malignancies is relatively lagged, but there are some advances in leukemia and myeloma,in which PRL-3 up-regulation is tightly associated with poor prognosis,while the underlying mechanism of signal transduction is gradually explored.In this review,we summarized the recent advances of PRL-3 in hematological malignancies such as acute myeloid leukemia,multiple myeloma and chronic myeloid leukemia,as well as the molecular mechanism of PRL-3 in pathogenesis.