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Hoover A, Turcotte LM, Phelan R, Barbus C, Rayannavar A, Miller BS, Reardon EE, Theis-Mahon N, MacMillan ML. Longitudinal clinical manifestations of Fanconi anemia: A systematized review. Blood Rev 2024:101225. [PMID: 39107201 DOI: 10.1016/j.blre.2024.101225] [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: 06/05/2024] [Revised: 07/29/2024] [Accepted: 07/29/2024] [Indexed: 08/09/2024]
Abstract
Fanconi anemia (FA) is a rare and complex inherited genetic disorder characterized by impaired DNA repair mechanisms leading to genomic instability. Individuals with FA have increased susceptibility to congenital anomalies, progressive bone marrow failure, leukemia and malignant tumors, endocrinopathies and other medical issues. In recent decades, steadily improved approaches to hematopoietic cell transplantation (HCT), the only proven curative therapy for the hematologic manifestations of FA, have significantly increased the life expectancy of affected individuals, illuminating the need to understand the long-term consequences and multi-organ ramifications. Utilizing a systematized review approach with narrative synthesis of each primary issue and organ system, we shed light on the challenges and opportunities for optimizing the care and quality of life for individuals with FA and identify knowledge gaps informing future research directions.
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Affiliation(s)
- Alex Hoover
- Division of Blood and Marrow Transplantation & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA.
| | - Lucie M Turcotte
- Division of Hematology and Oncology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Rachel Phelan
- Division of Hematology, Oncology, and Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Crystal Barbus
- Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Arpana Rayannavar
- Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Bradley S Miller
- Division of Endocrinology, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Erin E Reardon
- Woodruff Health Sciences Center Library, Emory University, Atlanta, GA, USA
| | | | - Margaret L MacMillan
- Division of Blood and Marrow Transplantation & Cellular Therapy, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Santana NCM, de Sena ACVP, Rocha PADS, de Arruda JAA, Torres-Pereira CC, Abreu LG, Fournier BPJ, Warnakulasuriya S, Silva TA. Oral cancer and oral potentially malignant disorders in patients with Fanconi anemia - A systematic review. Oral Oncol 2024; 150:106699. [PMID: 38309198 DOI: 10.1016/j.oraloncology.2024.106699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/10/2024] [Accepted: 01/18/2024] [Indexed: 02/05/2024]
Abstract
The purpose of the present study was to perform a systematic review focusing on oral squamous cell carcinoma (OSCC) and oral potentially malignant disorders (OPMD) in Fanconi anemia (FA) individuals. Electronic searches were undertaken in five databases supplemented by manual scrutiny and gray literature. Case reports and/or cases series were included. The searches yielded 55 studies describing 112 cases of OSCC (n = 107) and/or OPMD (n = 5) in FA individuals. The mean age at diagnosis of OSCC/OPMD was 27.1 (±9.6) years, and females (51.8 %) were slightly more affected. Ulcer (n = 37) or mass (n = 25) were described as clinical presentations for OSCC and OPMD. White lesions (n = 4) were the most common manifestation in OPMD. Tongue (47.2 %) was the most frequent location. Sixty-one (54.5 %) individuals underwent HSCT. Surgical resection (n = 75) was the main treatment adopted. The estimated rate of OPMD malignant transformation was 1.8 % and recurrences following OSCC excision occurred in 26.8 % of individuals. Overall, at 60 months of follow-up, the probability of survival fell to 25.5 % and at 64 months the probability of recurrence increased to 63.2 %. The present data support the need for strict surveillance of patients with FA, even in the absence of OPMD, for early OSCC detection and reduction of mortality.
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Affiliation(s)
- Nayara Conceição Marcos Santana
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | | | - Paula Alves da Silva Rocha
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - José Alcides Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Cassius Carvalho Torres-Pereira
- Department of Stomatology, School of Dentistry, Universidade Federal do Paraná, Curitiba, Paraná, Brazil; Multiprofessional Residency Program in Oncology and Hematology, Complexo Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Paraná, Brazil.
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Benjamin P J Fournier
- Department of Oral Biology, Université de Paris, Dental Faculty, France; Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, Laboratory of Molecular Oral Pathophysiology, France; AP-HP, Reference Center for Dental Rare Diseases, Rothschild Hospital (ORARES), Paris, France.
| | - Saman Warnakulasuriya
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK; WHO Collaborating Centre for Oral Cancer, London, UK.
| | - Tarcília Aparecida Silva
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Department of Oral Biology, Université de Paris, Dental Faculty, France; Centre de Recherche des Cordeliers, Université de Paris, Sorbonne Université, Inserm, Laboratory of Molecular Oral Pathophysiology, France.
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3
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Long Y, Li C, Zhang X, Ren Z, Liu W. The onset and progression of oral potentially malignant disorders in Fanconi anemia patients: Highlighting early detection of oral cancer. J Dent Sci 2024; 19:620-625. [PMID: 38303850 PMCID: PMC10829660 DOI: 10.1016/j.jds.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/01/2023] [Indexed: 02/03/2024] Open
Abstract
In 2020, Fanconi anemia (FA) was classified as a syndrome with insufficient epidemiological evidence in the oral potentially malignant disorder (OPMD) group by the WHO Collaborating Centre. The paucity of case reports on FA-associated OPMD limits evidence-based management, and such cases have not been analyzed collectively in detail. Hence, the objective of this short communication is to summarize the evidence on the onset and progression of OPMD in FA patients, so as to better understand the natural history of oral cancer development in patients affected by FA. A total of 11 eligible papers containing 1332 FA patients are involved in onset and progression of OPMD in FA patients. Of these, 186 (14.0%) were diagnosed with OPMD. With available data from 4 follow-up studies, 30 (41.1%) of 73 FA patients compatible with OPMD further developed into OSCC at young age (10-30 years old). The evidence on FA with malignant potential comprise clinical epidemiology, oral cytology abnormalities, DNA aneuploidy, loss of autofluorescence, loss of heterozygosity, high-risk human papillomavirus infection, DNA mutations in saliva and plasma samples. Collectively, these can consummate the evidence on FA as a syndrome that may potentiate cancer development in oral cavity mentioned by the WHO. Importantly, it highlights close surveillance is instrumental for FA patients with OPMD to early detect oral cancer.
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Affiliation(s)
- Yuanyuan Long
- Department of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chenxi Li
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaochen Zhang
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenhu Ren
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Liu
- College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Archibald H, Kalland K, Kuehne A, Ondrey F, Roby B, Jakubowski L. Oral Premalignant and Malignant Lesions in Fanconi Anemia Patients. Laryngoscope 2023; 133:1745-1748. [PMID: 36054728 DOI: 10.1002/lary.30370] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE There is a lack of data supporting cancer surveillance in pediatric Fanconi Anemia patients. We sought to describe the rates of upper aerodigestive lesions and malignancy in this population to augment current management guidelines. METHODS A retrospective cohort study of patients with Fanconi Anemia from a quaternary referral center between 2007-2021 was completed for head and neck cancer risk. RESULTS One hundred and five FA patients were reviewed. Average age at presentation was 11.3 years old and 90.5% of patients underwent hematopoietic stem cell transplant (HSCT). A total of 8.6% of patients had leukoplakia or erythroplakia and 3.8% developed malignancy. The standardized incidence ratio of head and neck malignancy was 483.8. Patients presented with leukoplakia and malignancy at an average age of 14.6 and 25.1 years old, respectively. Malignancies were aggressive and marked by recurrence. There were no premalignant or malignant lesions found on flexible laryngoscopy. This series represents the largest longitudinal series of pediatric FA head and neck lesions. CONCLUSIONS Fanconi Anemia patients should begin screening for head and neck cancer at age 10 or after HSCT. LEVEL OF EVIDENCE Level 4 Laryngoscope, 133:1745-1748, 2023.
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Affiliation(s)
- Hunter Archibald
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Krystina Kalland
- University of Minnesota Medical School, Minneapolis, Minnesota, U.S.A
| | - Alexander Kuehne
- University of Minnesota Medical School, Minneapolis, Minnesota, U.S.A
| | - Frank Ondrey
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Brianne Roby
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Ear, Nose, Throat (ENT) and Facial Plastic Surgery, Minnesota Childrens Hospital, Minneapolis, Minnesota, U.S.A
| | - Luke Jakubowski
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Ear, Nose, Throat (ENT) and Facial Plastic Surgery, Minnesota Childrens Hospital, Minneapolis, Minnesota, U.S.A
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Liu W, Ge S, Shi H, Shen X. Evaluation of inherited cancer syndromes with emphasis on Fanconi anemia classified as oral potentially malignant disorders. Int J Surg 2023; 109:1813-1815. [PMID: 37072134 PMCID: PMC10389419 DOI: 10.1097/js9.0000000000000400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/04/2023] [Indexed: 04/20/2023]
Affiliation(s)
- Wei Liu
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, College of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University
| | - Shuyun Ge
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, College of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University
| | - Huan Shi
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, College of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University
- Department of Oral Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Xuemin Shen
- Department of Oral Mucosal Diseases, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine
- Shanghai Key Laboratory of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, College of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University
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Errazquin R, Carrasco E, Del Marro S, Suñol A, Peral J, Ortiz J, Rubio JC, Segrelles C, Dueñas M, Garrido-Aranda A, Alvarez M, Belendez C, Balmaña J, Garcia-Escudero R. Early Diagnosis of Oral Cancer and Lesions in Fanconi Anemia Patients: A Prospective and Longitudinal Study Using Saliva and Plasma. Cancers (Basel) 2023; 15:cancers15061871. [PMID: 36980757 PMCID: PMC10046988 DOI: 10.3390/cancers15061871] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/21/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Fanconi anemia (FA) patients display an exacerbated risk of oral squamous cell carcinoma (OSCC) and oral potentially malignant lesions (OPMLs) at early ages. As patients have defects in their DNA repair mechanisms, standard-of-care treatments for OSCC such as radiotherapy and chemotherapy, give rise to severe toxicities. New methods for early diagnosis are urgently needed to allow for treatment in early disease stages and achieve better clinical outcomes. We conducted a prospective, longitudinal study wherein liquid biopsies from sixteen patients with no clinical diagnoses of OPML and/or OSCC were analyzed for the presence of mutations in cancer genes. The DNA from saliva and plasma were sequentially collected and deep-sequenced, and the clinical evaluation followed over a median time of approximately 2 years. In 9/16 FA patients, we detected mutations in cancer genes (mainly TP53) with minor allele frequencies (MAF) of down to 0.07%. Importantly, all patients that had mutations and clinical follow-up data after mutation detection (n = 6) developed oral precursor lesions or OSCC. The lead-time between mutation detection and tumor diagnosis ranged from 23 to 630 days. Strikingly, FA patients without mutations displayed a significantly lower risk of developing precursor lesions or OSCCs. Therefore, our diagnostic approach could help to stratify FA patients into risk groups, which would allow for closer surveillance for OSCCs or precursor lesions.
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Affiliation(s)
- Ricardo Errazquin
- Research Institute Hospital 12 de Octubre (Imas12), University Hospital 12 de Octubre, Av Cordoba s/n, 28041 Madrid, Spain
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
| | - Estela Carrasco
- Hereditary Cancer Genetics Group, Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Sonia Del Marro
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
| | - Anna Suñol
- Hereditary Cancer Genetics Group, Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Jorge Peral
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
| | - Jessica Ortiz
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
| | - Juan Carlos Rubio
- Research Institute Hospital 12 de Octubre (Imas12), University Hospital 12 de Octubre, Av Cordoba s/n, 28041 Madrid, Spain
- Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Carmen Segrelles
- Research Institute Hospital 12 de Octubre (Imas12), University Hospital 12 de Octubre, Av Cordoba s/n, 28041 Madrid, Spain
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Marta Dueñas
- Research Institute Hospital 12 de Octubre (Imas12), University Hospital 12 de Octubre, Av Cordoba s/n, 28041 Madrid, Spain
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Martina Alvarez
- Centro de Investigaciones Médico-Sanitarias (CIMES), 29071 Malaga, Spain
| | - Cristina Belendez
- Centro de Investigación Biomédica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Sección de Hematología y Oncología Pediátricas, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid, 28040 Madrid, Spain
- Instituto Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain
| | - Judith Balmaña
- Hereditary Cancer Genetics Group, Medical Oncology Department, Vall d'Hebron Institute of Oncology (VHIO), 08035 Barcelona, Spain
| | - Ramon Garcia-Escudero
- Research Institute Hospital 12 de Octubre (Imas12), University Hospital 12 de Octubre, Av Cordoba s/n, 28041 Madrid, Spain
- Molecular Oncology Unit, CIEMAT (Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas), Avenida Complutense 40, 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Mobile RZ, Mendes MC, Machado-Souza C, Queiroz PDM, Bonfim CMS, Torres-Pereira CC, Schussel JL. IL17A and IL17RA gene polymorphisms in Fanconi anemia. Braz Oral Res 2023; 37:e012. [PMID: 36790253 DOI: 10.1590/1807-3107bor-2023.vol37.0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 08/18/2022] [Indexed: 02/16/2023] Open
Abstract
Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far.
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Affiliation(s)
- Rafael Zancan Mobile
- Universidade Federal do Paraná - UFPR, Post Graduate Program in Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Monalisa Castilho Mendes
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Postgraduation Program in Biotechnology Applied in Health of Children and Adolescent, Curitiba, PR, Brazil
| | - Cleber Machado-Souza
- Instituto de Pesquisa Pelé Pequeno Príncipe, Faculdades Pequeno Príncipe, Postgraduation Program in Biotechnology Applied in Health of Children and Adolescent, Curitiba, PR, Brazil
| | - Priscila de Mattos Queiroz
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Carmem Maria Sales Bonfim
- Universidade Federal do Paraná - UFPR, Complexo Hospital de Clínicas, Bone Marrow Transplantation Program, Curitiba, PR, Brazil
| | | | - Juliana Lucena Schussel
- Universidade Federal do Paraná - UFPR, Post Graduate Program in Dentistry, Department of Stomatology, Curitiba, PR, Brazil
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Fiesco-Roa MÓ, García-de Teresa B, Leal-Anaya P, van ‘t Hek R, Wegman-Ostrosky T, Frías S, Rodríguez A. Fanconi anemia and dyskeratosis congenita/telomere biology disorders: Two inherited bone marrow failure syndromes with genomic instability. Front Oncol 2022; 12:949435. [PMID: 36091172 PMCID: PMC9453478 DOI: 10.3389/fonc.2022.949435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Inherited bone marrow failure syndromes (IBMFS) are a complex and heterogeneous group of genetic diseases. To date, at least 13 IBMFS have been characterized. Their pathophysiology is associated with germline pathogenic variants in genes that affect hematopoiesis. A couple of these diseases also have genomic instability, Fanconi anemia due to DNA damage repair deficiency and dyskeratosis congenita/telomere biology disorders as a result of an alteration in telomere maintenance. Patients can have extramedullary manifestations, including cancer and functional or structural physical abnormalities. Furthermore, the phenotypic spectrum varies from cryptic features to patients with significantly evident manifestations. These diseases require a high index of suspicion and should be considered in any patient with abnormal hematopoiesis, even if extramedullary manifestations are not evident. This review describes the disrupted cellular processes that lead to the affected maintenance of the genome structure, contrasting the dysmorphological and oncological phenotypes of Fanconi anemia and dyskeratosis congenita/telomere biology disorders. Through a dysmorphological analysis, we describe the phenotypic features that allow to make the differential diagnosis and the early identification of patients, even before the onset of hematological or oncological manifestations. From the oncological perspective, we analyzed the spectrum and risks of cancers in patients and carriers.
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Affiliation(s)
- Moisés Ó. Fiesco-Roa
- Laboratorio de Citogenética, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- Maestría y Doctorado en Ciencias Médicas, Universidad Nacional Autónoma de México (UNAM), Ciudad Universitaria, Ciudad de México, Mexico
| | | | - Paula Leal-Anaya
- Departamento de Genética Humana, Instituto Nacional de Pediatría, Ciudad de México, Mexico
| | - Renée van ‘t Hek
- Facultad de Medicina, Universidad Nacional Autoínoma de Meíxico (UNAM), Ciudad Universitaria, Ciudad de México, Mexico
| | - Talia Wegman-Ostrosky
- Subdirección de Investigación Básica, Instituto Nacional de Cancerología, Ciudad de México, Mexico
| | - Sara Frías
- Laboratorio de Citogenética, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
- *Correspondence: Alfredo Rodríguez, ; Sara Frías,
| | - Alfredo Rodríguez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México (UNAM), Ciudad de México, Mexico
- Unidad de Genética de la Nutrición, Instituto Nacional de Pediatría, Ciudad de México, Mexico
- *Correspondence: Alfredo Rodríguez, ; Sara Frías,
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9
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Oral Squamous Cell Carcinoma in a Patient with Fanconi Anemia. Case Rep Dent 2021; 2021:5571649. [PMID: 34258076 PMCID: PMC8245229 DOI: 10.1155/2021/5571649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/03/2021] [Indexed: 11/18/2022] Open
Abstract
Fanconi anemia (FA) is a rare autosomal recessive genetic disorder characterized by different types of malformations, skin lesions, bone marrow failure, and increased risk for both hematological malignancies and solid tumors, especially head and neck squamous cell carcinomas (HNSCC). FA patients may also display a low tolerance to oncologic treatments. The authors present a case of mandibular squamous cell carcinoma in a young FA patient. Because of the aggressive nature of the SCC and complex treatment options, we recommend a strict lifelong follow-up for all FA patients to detect early changes in the oral mucosa.
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Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, Lodi G, Mello FW, Monteiro L, Ogden GR, Sloan P, Johnson NW. Oral potentially malignant disorders: A consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis 2020; 27:1862-1880. [PMID: 33128420 DOI: 10.1111/odi.13704] [Citation(s) in RCA: 397] [Impact Index Per Article: 99.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/21/2020] [Accepted: 10/25/2020] [Indexed: 12/12/2022]
Abstract
Oral potentially malignant disorders (OPMDs) are associated with an increased risk of occurrence of cancers of the lip or oral cavity. This paper presents an updated report on the nomenclature and the classification of OPMDs, based predominantly on their clinical features, following discussions by an expert group at a workshop held by the World Health Organization (WHO) Collaborating Centre for Oral Cancer in the UK. The first workshop held in London in 2005 considered a wide spectrum of disorders under the term "potentially malignant disorders of the oral mucosa" (PMD) (now referred to as oral potentially malignant disorders: OPMD) including leukoplakia, erythroplakia, proliferative verrucous leukoplakia, oral lichen planus, oral submucous fibrosis, palatal lesions in reverse smokers, lupus erythematosus, epidermolysis bullosa, and dyskeratosis congenita. Any new evidence published in the intervening period was considered to make essential changes to the 2007 classification. In the current update, most entities were retained with minor changes to their definition. There is sufficient evidence for an increased risk of oral cancer among patients diagnosed with "oral lichenoid lesions" and among those diagnosed with oral manifestations of 'chronic graft-versus-host disease'. These have now been added to the list of OPMDs. There is, to date, insufficient evidence concerning the malignant potential of chronic hyperplastic candidosis and of oral exophytic verrucous hyperplasia to consider these conditions as OPMDs. Furthermore, due to lack of clear evidence of an OPMD in epidermolysis bullosa this was moved to the category with limited evidence. We recommend the establishment of a global research consortium to further study the natural history of OPMDs based on the classification and nomenclature proposed here. This will require multi-center longitudinal studies with uniform diagnostic criteria to improve the identification and cancer risk stratification of patients with OPMDs, link them to evidence-based interventions, with a goal to facilitate the prevention and management of lip and oral cavity cancer.
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Affiliation(s)
- Saman Warnakulasuriya
- The WHO Collaborating Centre for Oral Cancer and Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Perth, WA, Australia
| | - José M Aguirre-Urizar
- Oral and Maxillofacial Medicine & Pathology Unit, Department of Stomatology II, Faculty of Medicine and Nursery, University of the Basque Country/EHU, Bilbao, Spain
| | - José V Bagan
- Oral Medicine, Valencia University, Valencia, Spain.,Department of Oral and Maxillofacial Surgery, University General Hospital, Valencia, Spain
| | - Miguel Ángel González-Moles
- School of Dentistry, University of Granada, Granada, Spain.,Biohealth Research Institute (IBS), Granada, Spain
| | - Alexander R Kerr
- Department of Oral and Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY, USA
| | - Giovanni Lodi
- Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, Milano, Italy
| | | | - Luis Monteiro
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde (IINFACTS), IUCS - Instituto Universitário de Ciências da Saúde, Gandra, Portugal
| | - Graham R Ogden
- Department of Oral Surgery, Dundee Dental School, Dundee, Scotland, UK
| | - Philip Sloan
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Qld, Australia.,Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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11
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Beddok A, Krieger S, Castera L, Stoppa-Lyonnet D, Thariat J. Management of Fanconi Anemia patients with head and neck carcinoma: Diagnosis and treatment adaptation. Oral Oncol 2020; 108:104816. [PMID: 32480311 DOI: 10.1016/j.oraloncology.2020.104816] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 05/20/2020] [Indexed: 12/18/2022]
Abstract
Fanconi anemia (FA) is a rare genetic disease that is mostly transmitted, according to a recessive model with biallelic germline alterations in one of the 22 genes of the FA pathway, or monoallelic alteration of the 23rd FA gene (RAD51). The FA pathway is implicated in interstrand DNA crosslink repair, induces genome stability, and is a potent driver of tumorigenesis. Patients with FA have a 500 to 1000-fold increased risk of developing head and neck squamous cell carcinoma (HNSCC). Patients with FA developing an HNSCC, usually have severe radiation toxicities. In this context, the modalities of radiation therapy should be adapted. Some patients with FA present a milder phenotype, especially in the case of medullary FA gene spontaneous reversion. Therefore, in an unusual context of HNSCC, such as no risk factors or a young age, it may be very useful to search anemia or development abnormalities, that may unravel a yet undiagnosed FA disease. Besides, in some young patients with HNSCC who did not suffer from FA, a monoallelic germline alteration in an FA gene could be combined with a second risk factor such as HPV infection or APOBEC alteration. Although several in vitro studies showed that normal cells with monoallelic FA gene alteration may have a particular radiosensitivity, these observations have not been confirmed in vivo in FA heterozygotes patients. Finally, some somatic activating alterations have also been found in HSNCC tumor samples and could be associated with radioresistance.
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Affiliation(s)
- Arnaud Beddok
- Department of Radiation Oncology, Curie Institute, Paris, France.
| | - Sophie Krieger
- Department of Cancer Biology and Genetics, Inserm U1245, Normandy Centre for Genomic and Personalized Medicine, François Baclesse Center, Caen, France
| | - Laurent Castera
- Department of Cancer Biology and Genetics, Inserm U1245, Normandy Centre for Genomic and Personalized Medicine, François Baclesse Center, Caen, France
| | | | - Juliette Thariat
- Department of Radiation Oncology, François Baclesse Center, Caen, France
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12
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Amenábar JM, Torres‐Pereira CC, Tang KD, Punyadeera C. Two enemies, one fight: An update of oral cancer in patients with Fanconi anemia. Cancer 2019; 125:3936-3946. [DOI: 10.1002/cncr.32435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/11/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
Affiliation(s)
- José M. Amenábar
- Stomatology Department Federal University of Parana Curitiba Parana Brazil
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovations Queensland University of Technology Brisbane Queensland Australia
| | | | - Kai D. Tang
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovations Queensland University of Technology Brisbane Queensland Australia
| | - Chamindie Punyadeera
- Saliva and Liquid Biopsy Translational Research Team, School of Biomedical Sciences, Institute of Health and Biomedical Innovations Queensland University of Technology Brisbane Queensland Australia
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13
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Frydrych AM, Kujan O, Farah CS. Chronic disease comorbidity in patients with oral leukoplakia. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41548-018-0015-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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14
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Salivary lactate dehydrogenase (LDH) as a tool for early diagnosis of oral cancer in individuals with Fanconi anemia. Med Hypotheses 2018; 119:29-31. [PMID: 30122487 DOI: 10.1016/j.mehy.2018.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 07/25/2018] [Indexed: 11/23/2022]
Abstract
Currently one of the greater challenges is the diagnosis and treatment of cancer. Many studies address the genetic and metabolic aspects to support in early diagnosis and increase the survival of individuals at high risk. Individuals with Fanconi anemia can be included in this high risk group because they have a predisposition to develop head and neck cancer. The use of salivary enzymes as biomarkers to detect the changes in oral tissue at the initial phase seems viable, because saliva is easy to obtain, it moisture oral mucosa and cells metabolic compounds can be found on it. Due to the metabolic characteristics of the cancer cell, an increase in Lactate Dehydrogenase (LDH) may indicate a carcinogenesis process. The hypothesis of this study is to use of salivary LDH as a tool in the early diagnosis of oral cancer on a high risk group such as Fanconi anemia's patients.
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15
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Porter S, Gueiros LA, Leão JC, Fedele S. Risk factors and etiopathogenesis of potentially premalignant oral epithelial lesions. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:603-611. [PMID: 29891084 DOI: 10.1016/j.oooo.2018.03.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/03/2018] [Accepted: 03/06/2018] [Indexed: 12/27/2022]
Abstract
Potentially malignant oral mucosal disease has some ability to give rise to malignancy of the oral epithelium, that is, oral squamous cell carcinoma (OSCC). The present article provides a succinct review of the possible or probable causes of potentially premalignant oral epithelial lesions. There is a focus upon studies that examined the causes or etiologic associations with clinically likely or histopathologically detectable oral epithelial dysplasia.
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Affiliation(s)
| | - Luiz Alcino Gueiros
- Oral Medicine Unit. Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Brazil
| | - Jair Carneiro Leão
- Oral Medicine Unit. Departamento de Clínica e Odontologia Preventiva, Universidade Federal de Pernambuco, Brazil
| | - Stefano Fedele
- UCL Eastman Dental Institute, London, UK; Oral Theme of the UCL/UCLH NIHR Biomedical Research Centre, UK
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16
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Pivovar A, Furquim CP, Bonfim C, Torres-Pereira CC. Mouth examination performance by children's parents and by adolescents in Fanconi anemia. Pediatr Blood Cancer 2017; 64. [PMID: 28500741 DOI: 10.1002/pbc.26622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 03/06/2017] [Accepted: 04/06/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Fanconi anemia (FA) is a rare genetic syndrome characterized by increased risk of developing malignant neoplasms, particularly oral squamous cell carcinoma. This study aims to ascertain the extent to which adolescents and guardians/parents of children with FA are aware of their oral cancer risks and assess their ability to perform mouth examination (ME). PROCEDURE A cross-sectional study was conducted among patients with FA (between 6 and 16 years) and their parents. A total of 45 patients, 19 children and 26 adolescents, participated in the study. Among children less than 12 years of age, caregivers performed ME and adolescents between 12 and 16 years of age performed mouth self-examination (MSE). All parents were given a self-reporting questionnaire to collect sociodemographic data, information about health-related behaviors, and oral cancer awareness. Performance was evaluated using criteria for mucosal visualization and retracting ability. Subsequently, a dentist clinically examined all patient participants. RESULTS Performance evaluation indicated that the examination quality was unsatisfactory in both groups. Statistical significance was found between ability to perform ME by marital status (P < 0.036), where divorced parents had more difficulty performing ME than nondivorced parents. CONCLUSION Oral mucosa surveillance performed by parents and adolescents seems to be inaccurate. However, as an oral examination is a relatively inexpensive form of secondary prevention, it merits attention to teaching the technique to patients with FA and their caregivers.
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Affiliation(s)
- Allana Pivovar
- Department of Stomatology, Post Graduate Program in Dentistry, Federal University of Paraná School of Dentistry, Curitiba, Paraná, Brazil
| | - Camila Pinheiro Furquim
- Department of Stomatology, Post Graduate Program in Dentistry, Federal University of Paraná School of Dentistry, Curitiba, Paraná, Brazil
| | - Carmem Bonfim
- Bone Marrow Transplantation Unit, Hospital de Clínicas, Federal University of Paraná., Curitiba, Paraná, Brazil
| | - Cassius Carvalho Torres-Pereira
- Department of Stomatology, Post Graduate Program in Dentistry, Federal University of Paraná School of Dentistry, Curitiba, Paraná, Brazil
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17
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Renaud-Vilmer C, Cavelier-Balloy B. [Precancerous lesions of the buccal epithelium]. Ann Dermatol Venereol 2016; 144:100-108. [PMID: 27939087 DOI: 10.1016/j.annder.2016.07.017] [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: 03/17/2016] [Revised: 07/01/2016] [Accepted: 07/29/2016] [Indexed: 10/20/2022]
Abstract
Squamous cell carcinomas of the oral cavity and lips consistently have a high incidence (they constitute the fifth most common form of cancer in France) and carry a heavy prognosis, particularly if diagnosed late. According to different studies, between 10 and 80% of such carcinomas occur in a pre-existing or precancerous lesion. The World Health Organisation (WHO) recommends the use of two terms for such lesions: precursor lesions, i.e. histological lesions associated with intraepithelial neoplasia (IEN) and verrucous hyperplasia (VH), frequently resulting clinically in leukoplakia or erythroplakia; "at risk" lesions, which include lichen planus, submucosal oral fibrosis and certain forms of genodermatosis.
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Affiliation(s)
- C Renaud-Vilmer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - B Cavelier-Balloy
- Service de pathologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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18
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Hisama FM, Oshima J, Martin GM. How Research on Human Progeroid and Antigeroid Syndromes Can Contribute to the Longevity Dividend Initiative. Cold Spring Harb Perspect Med 2016; 6:a025882. [PMID: 26931459 DOI: 10.1101/cshperspect.a025882] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Although translational applications derived from research on basic mechanisms of aging are likely to enhance health spans and life spans for most of us (the longevity dividend), there will remain subsets of individuals with special vulnerabilities. Medical genetics is a discipline that describes such "private" patterns of aging and can reveal underlying mechanisms, many of which support genomic instability as a major mechanism of aging. We review examples of three classes of informative disorders: "segmental progeroid syndromes" (those that appear to accelerate multiple features of aging), "unimodal progeroid syndromes" (those that impact on a single disorder of aging), and "unimodal antigeroid syndromes," variants that provide enhanced protection against specific disorders of aging; we urge our colleagues to expand our meager research efforts on the latter, including ancillary somatic cell genetic approaches.
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Affiliation(s)
- Fuki M Hisama
- Division of Medical Genetics, Department of Medicine, University of Washington School of Medicine, Seattle, Washington 98195 International Registry of Werner Syndrome, University of Washington School of Medicine, Seattle, Washington 98195
| | - Junko Oshima
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195 International Registry of Werner Syndrome, University of Washington School of Medicine, Seattle, Washington 98195 Department of Medicine, Chiba University, Chiba 260-8670, Japan
| | - George M Martin
- Department of Pathology, University of Washington School of Medicine, Seattle, Washington 98195 International Registry of Werner Syndrome, University of Washington School of Medicine, Seattle, Washington 98195
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