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http://www.cro.sanita.fvg.it/pdf/Ricerca/Available%20Technologies%20-%20Portfolio%20of%20Ideas/DIAGNOSTIC%20TOOLS%20IN%20ONCO-HEMATOLOGY.pdf
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CENTRO DI RIFERIMENTO ONCOLOGICO
Technology Transfer Opportunities
Contact: Ermes Mestroni [email protected]
DIAGNOSTIC TOOLS IN ONCO-HEMATOLOGY
Technology Overview
The Clinical and Experimental Oncohematology Division of CRO Aviano constantly identifies novel
molecular and immunophenotypic diagnostic / prognostic profiles of hematological malignancies.
Likewise, research efforts are aimed at clarifying various aspects of the physiopathology of B cell chronic
lymphocytic leukemia (B-CLL).
Lab operation uses progressive state-of-the-art technologies and procedures to evaluate chromosomal
translocations and other gene abnormalities. 7 thermal cyclers (MJ Research PCT) for qualitative
Polymerase Chain Reaction detection, ABI Prism® 7700 Real Time PCR machine. For DNA sequencing
of rearranged products and others, a multi-color fluorescence-based 4 parallel-capillary ABI PRISM®
3130 Genetic Analyzer offers high-quality data and efficient sample processing. Core facility and Agilent
G2565AA scanner for GEP analysis.
Advantages
√ All the PCR protocols are characterized by the same cycling conditions and ready-to-use PCR tubes
for each specific translocation.
√ Up-to-date laboratories equipped with core facility for “gene expression profiling” (GEP),
instruments, reagents, study designed and data
analysis.
√ Fresh and frozen primary CLL cells available,
vials from at least 400 CLL cases well
characterized for IGHV gene status and
expression of prognosticators (CD38, CD49d,
ZAP-70 etc.), viable frozen samples of a wide
panel of human leukemia/lymphoma B cell lines.
√ Quickness of execution.
√ Expertise and extensive international network of
contacts.
Development Stage
Several PCR protocols have been developed to detect the most important genetic alterations involved in
the onco-hematological diseases. Study and identification of novel molecular diagnostic and prognostic
markers to be introduced in routine of clinical activities. Main genetic alterations detected (since 1996):
Lymphomas: - ALK/NPM [t(2;5)]
- BCL2/IgH [t(14;18) MBR]
- BCL2/IgH [t(14;18) mcr]
- BCL1/IgH [t(11;14) MTC]
- API2/MLT [t(11;18)]
- B cell Clonality: (FR1-JH/CDR3-JH)
- T cell Clonality: TCR gamma
Myeloproliferative disorders: - JAK-2 detection by Amplification Refractory Mutation System (ARMS-PCR)
Leukemias: - BCR/ABL [t(9;22) M-BCR]
- BCR/ABL [t(9;22) m-BCR]
- BCR/ABL [t(9;22) µ-BCR]
- AML1/ETO [t(8;21)]
- PML/RAR [t(15;17)]
- CBFß/MYH11 [inv(16)]
- MLL/AF4 [t(4;11)]
- E2A/PBX1 [t(1;19)]
- TEL/AML1 [t(12;21)]
- DEK-CAN [t(6;9)]
CENTRO DI RIFERIMENTO ONCOLOGICO
Technology Transfer Opportunities
Contact: Ermes Mestroni [email protected]
Chronic Lymphocytic Leukemia (CLL)
Patients with CLL from diagnosis to prognosis to therapeutic monitoring are investigated by use of state-
of-the-art technologies. A definitive diagnosis of CLL is obtained with morphology and flow-cytometry,
then, physicians can stratify risk with use of FISH and molecular testing.
IgVH Mutation Analysis in CLL
The Immunoglobulin Variable Region Heavy chain gene encodes antibodies that function in the immune
response. ~50-70% of CLL patients have evidence of IgVH somatic mutations whose status identifies 2
CLL subtypes with differing clinical course: indolent and aggressive.
* Patients with hypermutated IgVH have a better prognosis (median survival 293 months);
* Patients without hypermutated IgVH, poorer prognosis (117 months).
RNA is reverse transcribed into cDNA and amplified by the PCR using primer sets for the IgVH gene.
PCR products are analyzed by direct DNA sequencing using capillary gel electrophoresis and
fluorescence detection. The percentage mutation is assessed by comparison of the VH region sequence to
a germline gene sequence database (a sequence that differs by >2% is defined as Mutated).
Detection of the mutational status of IgVH genes in B-CLL for prognostic evaluation, i) Fluorescence-in-
situ hybridization (FISH) for 11q-, +12, 13q-, 17p- evaluation in B-CLL; ii) Zap70 detection.
Other Ig genes feature evaluations: evidence of antigen-driven selection, preferential usage of IgVH gene
segments, usage of stereotyped IgVH-CDR3-IgVL combinations refining the prognostic assessment of
CLL by identifying stereotyped BCR combinations associated with different prognosis, putative antigens
responsible for neoplastic transformation or Ig combination to be used as targets for immunotherapy.
p53 Mutation Analysis in CLL
Over 10% of B-CLL patients have a dysfunctional p53 tumor suppressor gene on chromosome 17p13.1:
p53 mutations, a p53 deletion or both, that predict a 6-31 month poor survival (Patients with normal
karyotype: >100 months). Alkylating agents, purine analogs and some monoclonal therapies are
ineffective in treating those CLL patients. Finally, chemotherapy can cause p53 gene alterations, such that
even if not present at initial diagnosis, refractory CLL can exhibit new alterations of p53.
The p53 mutation assay incorporates PCR amplification and bidirectional sequencing of p53 exons 5-9
along with their respective flanking splice sites. The assay can detect a mutation present in at least 20% of
a B-cell enriched sample. FISH analysis is also available to detect a deletion of the 17p chromosome.
Looking for
Tech transfer processes in both pre-clinical and diagnostic activities through the obtaining of state-of-the-
art technologies for patient management. Collaborations with industrial partners aimed to:
⇒ develop diagnostic kits ready-to-use for an advanced assessment of onco-hematological disease
(genetic alterations). Commercialization and distribution;
⇒ in vitro test of putative drugs for CCL therapy (evaluate the role, investigate the effect, analyze
the distribution, other). Service procedures on blood samples incl. FISH testing.
More Information
Valter Gattei, MD
Clinical and Experimental Onco-Hematology Unit
Tel.: +39-0434-659-410