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Clonal evolution in chronic lymphocytic leukemia is associated with an unmutated IGHV status and frequently leads to a combination of loss of TP53 and TP53 mutation. Mol Biol Rep 2022; 49:12247-12252. [PMID: 36169893 DOI: 10.1007/s11033-022-07888-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Chromosomal abnormalities and gene mutations determine the prognosis of patients with chronic lymphocytic leukemia (CLL). Genetic lesions can be acquired by clonal evolution (CE) likely correlating with clinical progression. METHODS AND RESULTS Samples of 169 CLL patients were analyzed for cytogenetic clonal evolution (CCE) and CE affecting the genes TP53 and SF3B1. Moreover, the mutational status of IGHV and the clinical outcome was evaluated. CCE was observed in 35% of CLL patients. The most frequently gained cytogenetic aberration was a deletion of TP53. Acquired TP53 deletion was more frequent in patients with SF3B1 mutations compared to those without (19% vs. 7%). CCE showed a tendency to occur more frequently in patients with an aberrant karyotype at first investigation than in patients with a normal karyotype. In 73% of patients with CCE (p = 0.002) and 92% of patients with CE affecting the genes TP53 and SF3B1 (p < 0.001) an unmutated IGHV status was present. CCE and CE affecting the genes TP53 and SF3B1 were significantly associated with each other (p < 0.001). In 7% of patients, CE resulted in the co-occurrence of TP53 deletion and TP53 mutation resulting in a significantly shorter overall survival. CONCLUSIONS The most frequently gained cytogenetic aberration during CCE was a deletion of TP53, which was associated with SF3B1 mutations. Moreover, CCE was associated with an unmutated IGHV status. Our results indicate the importance of re-evaluation of the TP53 status during the course of the disease to ensure correct treatment guidance.
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Falling prey to a wolf in sheep's clothing: T and NK cell neoplasms with aberrant CD20 expression. Virchows Arch 2020; 477:897-899. [PMID: 32803454 DOI: 10.1007/s00428-020-02911-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
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Matos DM. CD8 Antigen Expression in Chronic Lymphocytic Leukemia: Does it Have any Relevant Meaning? CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 96:96-98. [PMID: 30585400 DOI: 10.1002/cyto.b.21759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/17/2018] [Accepted: 12/03/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Daniel Mazza Matos
- Flow Cytometry Section, Cell Processing Center (CPC), Center of Hematology and Hemotherapy of Ceará (HEMOCE), Fortaleza, Ceará, Brazil
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Mandy F. Issue Highlights - November 2016. CYTOMETRY PART B-CLINICAL CYTOMETRY 2018; 90:480-482. [PMID: 27788287 DOI: 10.1002/cyto.b.21489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Vetro C, Haferlach T, Jeromin S, Stengel A, Zenger M, Nadarajah N, Baer C, Weissmann S, Kern W, Meggendorfer M, Haferlach C. Identification of prognostic parameters in CLL with no abnormalities detected by chromosome banding and FISH analyses. Br J Haematol 2018; 183:47-59. [PMID: 30022491 DOI: 10.1111/bjh.15498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 06/07/2018] [Indexed: 01/09/2023]
Abstract
Chronic Lymphocytic Leukaemia (CLL) is a heterogeneous disease with a clinical course dependent on cytogenetic features. However, in 15-20% of cases both chromosome banding and fluorescence in situ hybridisation analyses do not show any kind of abnormality. With the aim to identify dependable molecular prognostic factors in this subgroup, we performed a comprehensive analysis on 171 patients including genomic arrays (comparative genomic hybridisation and single nucleotide polymorphism), immunoglobulin heavy chain variable region genes (IGHV) status, flow cytometry and targeted sequencing. Genomic arrays detected 73 aberrations in 39 patients (23%). Most frequently, patients had 1 aberration (25/171; 15%), while 14 patients (8%) had at least 2 aberrations. IGHV status was unmutated in 53/171 (31%) patients. SF3B1 was the most frequently mutated gene (26/171 patients; 15%), followed by NOTCH1 (15/171; 9%). At univariate analysis, an adverse impact on time to treatment (TTT) was evident for SF3B1 mutations, higher white blood cell count, higher CLL cells percentage by flow cytometry, CD38 positivity, IGHV unmutated status and at least 2 genomic array abnormalities. Of these, SF3B1 mutations, CLL cells percentage, IGHV unmutated status and number of genomic array aberrations maintained their impact in multivariate analysis. In conclusion, by integrating genomic and molecular data, we identified patients at higher risk for treatment need.
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Affiliation(s)
| | | | | | - Anna Stengel
- MLL Munich Leukaemia Laboratory, Munich, Germany
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Jain M, Kushwaha R, Verma SP, Singh US, Tripathi AK, Goel MM, Kumar A. CD8 expression in B chronic lymphocytic leukemia: A case of immuno-phenotypic aberrancy. CYTOMETRY PART B-CLINICAL CYTOMETRY 2017; 94:679-682. [PMID: 28557280 DOI: 10.1002/cyto.b.21535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/08/2017] [Accepted: 05/25/2017] [Indexed: 11/10/2022]
Abstract
Immuno-phenotyping forms an integral part of laboratory work up of Chronic lymphocytic leukemia (CLL). Aberrant antigen expressions are a known phenomenon in leukemic blasts, however cross lineage antigen expression is rarely seen in mature B cell leukemia, the reported percentages varying from 1% to 3% in Europe and North America. CASE DETAILS We report a case of Rai stage 1 CLL showing aberrant expression of CD8 on flow cytometry. The patient had stable disease at a follow up of 9 months with no requirement of initiation of treatment. DISCUSSION CD8 expression in CLL is rare and approximately 120 cases have been reported from Western population. To the best of our knowledge, this is the first case to be reported from India. The prognostic significance has been variably reported from favorable to poor. At present, our case reflects the phenotypic heterogeneity of leukemia. Long term follow up and evaluation of more cases is required to predict the prognostic role in our patient population. © 2017 International Clinical Cytometry Society.
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Affiliation(s)
- Mili Jain
- Department of Pathology, King George's Medical University, Uttar Pradesh, India
| | - Rashmi Kushwaha
- Department of Pathology, King George's Medical University, Uttar Pradesh, India
| | | | - Uma Shankar Singh
- Department of Pathology, King George's Medical University, Uttar Pradesh, India
| | - Anil Kumar Tripathi
- Department of Clinical Hematology, King George's Medical University, Uttar Pradesh, India
| | - Madhu Mati Goel
- Department of Pathology, King George's Medical University, Uttar Pradesh, India
| | - Ashutosh Kumar
- Department of Pathology, King George's Medical University, Uttar Pradesh, India
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Genetic characterization of MYD88-mutated lymphoplasmacytic lymphoma in comparison with MYD88-mutated chronic lymphocytic leukemia. Leukemia 2016; 31:1355-1362. [DOI: 10.1038/leu.2016.330] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/04/2016] [Accepted: 10/10/2016] [Indexed: 12/11/2022]
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8
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McCoy JP. Issue highlights--November 2014. CYTOMETRY PART B-CLINICAL CYTOMETRY 2015; 86:371-2. [PMID: 25336149 DOI: 10.1002/cyto.b.21186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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9
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Jeromin S, Weissmann S, Haferlach C, Dicker F, Bayer K, Grossmann V, Alpermann T, Roller A, Kohlmann A, Haferlach T, Kern W, Schnittger S. SF3B1 mutations correlated to cytogenetics and mutations in NOTCH1, FBXW7, MYD88, XPO1 and TP53 in 1160 untreated CLL patients. Leukemia 2014; 28:108-17. [PMID: 24113472 DOI: 10.1038/leu.2013.263] [Citation(s) in RCA: 181] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Accepted: 09/06/2013] [Indexed: 02/06/2023]
Abstract
We analyzed a large cohort of 1160 untreated CLL patients for novel genetic markers (SF3B1, NOTCH1, FBXW7, MYD88, XPO1) in the context of molecular, immunophenotypic and cytogenetic data. NOTCH1 mutations (mut) (12.3%), SF3B1mut (9.0%) and TP53mut (7.1%) were more frequent than XPO1mut (3.4%), FBXW7mut (2.5%) and MYD88mut (1.5%). SF3B1mut, NOTCH1mut, TP53mut and XPO1mut were highly correlated to unmutated, whereas MYD88mut were associated with mutated IGHV status. Associations of diverse cytogenetic aberrations and mutations emerged: (1) SF3B1mut with del(11q), (2) NOTCH1mut and FBXW7mut with trisomy 12 and nearly exclusiveness of SF3B1mut, (3) MYD88mut with del(13q) sole and low frequencies of SF3B1mut, NOTCH1mut and FBXW7mut. In patients with normal karyotype only SF3B1mut were frequent, whereas NOTCH1mut rarely occurred. An adverse prognostic impact on time to treatment (TTT) and overall survival (OS) was observed for SF3B1mut, NOTCH1mut and TP53 disruption. In multivariate analyses SF3B1mut, IGHV mutational status and del(11q) were the only independent genetic markers for TTT, whereas for OS SF3B1mut, IGHV mutational status and TP53 disruption presented with significant impact. Finally, our data suggest that analysis of gene mutations refines the risk stratification of cytogenetic prognostic subgroups and confirms data of a recently proposed model integrating molecular and cytogenetic data.
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MESH Headings
- Adult
- Aged
- Cell Cycle Proteins/genetics
- F-Box Proteins/genetics
- F-Box-WD Repeat-Containing Protein 7
- Female
- Genes, p53
- Genetic Predisposition to Disease
- Humans
- Immunophenotyping
- Karyopherins/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
- Mutation
- Myeloid Differentiation Factor 88/genetics
- Phosphoproteins/genetics
- Prognosis
- RNA Splicing Factors
- Receptor, Notch1/genetics
- Receptors, Cytoplasmic and Nuclear/genetics
- Ribonucleoprotein, U2 Small Nuclear/genetics
- Ubiquitin-Protein Ligases/genetics
- Exportin 1 Protein
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Affiliation(s)
- S Jeromin
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - S Weissmann
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - C Haferlach
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - F Dicker
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - K Bayer
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - V Grossmann
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Alpermann
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - A Roller
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - A Kohlmann
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Haferlach
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - W Kern
- MLL Munich Leukemia Laboratory, Munich, Germany
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Fasan A, Kern W, Grossmann V, Haferlach C, Haferlach T, Schnittger S. STAT3 mutations are highly specific for large granular lymphocytic leukemia. Leukemia 2012. [PMID: 23207521 DOI: 10.1038/leu.2012.350] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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