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Gourdin TS, Zou Y, Ning Y, Emadi A, Duong VH, Tidwell ML, Chen C, Rassool FV, Baer MR. High frequency of rare structural chromosome abnormalities at relapse of cytogenetically normal acute myeloid leukemia with FLT3 internal tandem duplication. Cancer Genet 2014; 207:467-73. [PMID: 25441683 DOI: 10.1016/j.cancergen.2014.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 08/30/2014] [Accepted: 09/01/2014] [Indexed: 01/13/2023]
Abstract
FLT3 internal tandem duplication (ITD) mutations are present in acute myeloid leukemia (AML) in 30% of patients with acute myeloid leukemia (AML), most commonly in those with a normal karyotype, and are associated with short relapse-free survival. Both in vitro and in vivo studies of FLT3-ITD cell lines have demonstrated reactive oxygen species-mediated DNA double-strand breaks and associated error-prone DNA repair as a mechanism of genomic instability, and we hypothesized that genomic instability might be manifested by cytogenetic changes at relapse of FLT3-ITD AML. We retrospectively reviewed charts of patients with cytogenetically normal (CN) FLT3-ITD AML treated at the University of Maryland Greenebaum Cancer Center, with attention to metaphase analysis results at relapse. Cytogenetic data were available from first and, when applicable, subsequent relapses for 15 patients diagnosed with CN FLT3-ITD AML. Among 12 patients with documented FLT3-ITD at first and, when applicable, subsequent relapse, 10 had cytogenetic changes, including nine with rare structural abnormalities. The high frequency of rare structural chromosome abnormalities at relapse in our case series supports a role of genomic instability in the genesis of relapse, and suggests that reactive oxygen species-generating and DNA repair pathways might be therapeutic targets in FLT3-ITD AML.
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Affiliation(s)
- Theodore S Gourdin
- University of Maryland Greenebaum Cancer Center, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ying Zou
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | - Yi Ning
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | - Ashkan Emadi
- University of Maryland Greenebaum Cancer Center, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Vu H Duong
- University of Maryland Greenebaum Cancer Center, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Michael L Tidwell
- University of Maryland Greenebaum Cancer Center, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD
| | - Ching Chen
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD
| | - Feyruz V Rassool
- University of Maryland Greenebaum Cancer Center, Baltimore, MD; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD
| | - Maria R Baer
- University of Maryland Greenebaum Cancer Center, Baltimore, MD; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD.
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Abstract
The consistent occurrence of nonrandom chromosome changes in human malignancies suggests that they are not trivial epiphonomena. Whereas we do not understand their significance at present, one possible role which they may fulfill is to provide the chromosomally aberrant cells with a proliferative advantage as the result of alteration in the number or location of genes related to nucleic acid biosynthesis. The proliferative advantage provided by various chromosome aberrations is likely to differ in patients with different genetic constitutions.
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