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Schwartz JR, Ma J, Kamens J, Westover T, Walsh MP, Brady SW, Robert Michael J, Chen X, Montefiori L, Song G, Wu G, Wu H, Branstetter C, Hiltenbrand R, Walsh MF, Nichols KE, Maciaszek JL, Liu Y, Kumar P, Easton J, Newman S, Rubnitz JE, Mullighan CG, Pounds S, Zhang J, Gruber T, Ma X, Klco JM. The acquisition of molecular drivers in pediatric therapy-related myeloid neoplasms. Nat Commun 2021; 12:985. [PMID: 33579957 PMCID: PMC7880998 DOI: 10.1038/s41467-021-21255-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 01/15/2021] [Indexed: 12/21/2022] Open
Abstract
Pediatric therapy-related myeloid neoplasms (tMN) occur in children after exposure to cytotoxic therapy and have a dismal prognosis. The somatic and germline genomic alterations that drive these myeloid neoplasms in children and how they arise have yet to be comprehensively described. We use whole exome, whole genome, and/or RNA sequencing to characterize the genomic profile of 84 pediatric tMN cases (tMDS: n = 28, tAML: n = 56). Our data show that Ras/MAPK pathway mutations, alterations in RUNX1 or TP53, and KMT2A rearrangements are frequent somatic drivers, and we identify cases with aberrant MECOM expression secondary to enhancer hijacking. Unlike adults with tMN, we find no evidence of pre-existing minor tMN clones (including those with TP53 mutations), but rather the majority of cases are unrelated clones arising as a consequence of cytotoxic therapy. These studies also uncover rare cases of lineage switch disease rather than true secondary neoplasms.
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Affiliation(s)
- Jason R Schwartz
- Vanderbilt University Medical Center, Department of Pediatrics, Nashville, TN, US
| | - Jing Ma
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Jennifer Kamens
- Stanford University School of Medicine, Department of Pediatrics, Stanford, CA, US
| | - Tamara Westover
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Michael P Walsh
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Samuel W Brady
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - J Robert Michael
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Xiaolong Chen
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Lindsey Montefiori
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Guangchun Song
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Gang Wu
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Huiyun Wu
- St. Jude Children's Research Hospital, Department of Biostatistics, Memphis, TN, US
| | - Cristyn Branstetter
- Arkansas Children's Northwest Hospital, Department of Hematology/Oncology, Springdale, AR, US
| | - Ryan Hiltenbrand
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Michael F Walsh
- Memorial Sloan Kettering Cancer Center, Department of Pediatrics, New York, NY, US
| | - Kim E Nichols
- St. Jude Children's Research Hospital, Department of Oncology, Memphis, TN, US
| | - Jamie L Maciaszek
- St. Jude Children's Research Hospital, Department of Oncology, Memphis, TN, US
| | - Yanling Liu
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Priyadarshini Kumar
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - John Easton
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Scott Newman
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Jeffrey E Rubnitz
- St. Jude Children's Research Hospital, Department of Oncology, Memphis, TN, US
| | - Charles G Mullighan
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US
| | - Stanley Pounds
- St. Jude Children's Research Hospital, Department of Biostatistics, Memphis, TN, US
| | - Jinghui Zhang
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US
| | - Tanja Gruber
- Stanford University School of Medicine, Department of Pediatrics, Stanford, CA, US.
- Stanford University School of Medicine, Stanford Cancer Institute, Stanford, CA, US.
| | - Xiaotu Ma
- St. Jude Children's Research Hospital, Department of Computational Biology, Memphis, TN, US.
| | - Jeffery M Klco
- St. Jude Children's Research Hospital, Department of Pathology, Memphis, TN, US.
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He XF, Wang QR, Cen JN, Qiu HY, Sun AN, Chen SN, Wu DP. [EVI1 expression, clinical and cytogenetical characteristics in 447 patients with acute myeloid leukemia]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2016; 37:936-941. [PMID: 27995876 PMCID: PMC7348514 DOI: 10.3760/cma.j.issn.0253-2727.2016.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Indexed: 02/05/2023]
Abstract
Objective: To investigate EVI1 expression and its associated clinical and cytogenetic characteristics in 447 acute myeloid leukemia (AML) patients. Methods: EVI1 expressions were measured in 447 AML cases from Jan. 2007 to Apr. 2015 to couple with clinical, cytogenetic and mutations' characteristics to summarize the features of AMLs with high EVI1 expression. Results: 17.9% of AML were high EVI1 expression (EVI1 +), and the remainder low EVI1 expression (EVI1-). No significant differences between the two groups in terms of age, sex, hemoglobin level, white blood cell count and platelet count were observed. More M0, M5 and M6 subtypes were observed in EVI1+ group (P= 0.027, 0.004 and 0.011, respectively). Cytogenetic abnormalities of 11q15, 11q23/MLL, 3q26, -7/7q- and t (9;11) were observed more frequently in EVI1 + group (P<0.001, <0.001, <0.001, <0.001, =0.014, respectively). Normal karyotype, inv (16), t (8;21) were observed more frequent in EVI1- group (P=0.001, 0.009, 0.002, respectively). EVI1 + was more observed in high risk cytogenetics. Mutation of NPM1 was more observed in EVI1- group (P <0.001). Remission rate in EVI1 + group was significantly lower than EVI1- group (P<0.001). Leukemia-free survival was improved in EVI1 + AML patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Conclusions: High EVI1 expression was more observed in FAB subgroup M5, harbored more cytogenetic abnormalities of 11p15, 11q23/MLL, 3q26 rearrangement, -7/7q- and t (9;11). Remission rate of high EVI1 expression AML was lower, which could be improved by allo-HSCT.
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Affiliation(s)
- X F He
- Jiangsu Institute of Hematology, the First Affiliated Hospital of Soochow University, Collaborative Innovation Center of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, Suzhou 215006, China
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Burillo-Sanz S, Morales-Camacho RM, Caballero-Velázquez T, Vargas MT, García-Lozano JR, Falantes JF, Prats-Martín C, Bernal R, Pérez-Simón JA. NUP98-HOXA9 bearing therapy-related myeloid neoplasm involves myeloid-committed cell and induces HOXA5, EVI1, FLT3, and MEIS1 expression. Int J Lab Hematol 2015; 38:64-71. [PMID: 26418229 DOI: 10.1111/ijlh.12435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/26/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Chromosomal rearrangements involving NUP98 gene have been associated with human leukemias such as de novo AML, therapy-related AML (t-AML), myelodysplastic syndrome (MDS), and chronic myeloid leukemia (CML). Genetic fusion NUP98-HOXA9, caused by t(7;11)(p15;p15), is a recurrent cytogenetic alteration in de novo acute myeloid leukemia (AML) usually found in young Asian patients and its description in therapy-related myeloid neoplasms (t-MN) is rare. Only one Asian case with molecular demonstration of the NUP98-HOXA9 fusion has been reported in therapy-related leukemia. NUP98-HOXA9 leukemogenic mechanism is derived from the transcription factor activity of the chimeric protein, which enhances the expression of genes related to cellular differentiation arrest and proliferation. PATIENTS AND METHODS We studied a Caucasian woman with a therapy-related acute myeloid leukemia after Ewing's sarcoma. Molecular demonstration of the genetic fusion NUP98-HOXA9 was performed by RT-PCR, and gene expression was analyzed by real-time PCR, including four AML patients with MLL rearrangements for comparative analysis. Cytologic and flow cytometric analysis was also carried out. RESULTS After cytologic and flow cytometric analysis diagnostics was therapy-related myeloid neoplasm (t-MN). The major component of blasts in the acute leukemia was with neutrophilic differentiation, but 13% erythroid lineage blasts were also found. Cytogenetic and FISH analysis revealed t(7;11)(p15;p15) and NUP98-HOXA9 fusion gene was demonstrated. Gene expression analysis showed upregulation of EVI1 and MEIS1 in the index patient, both of them previously related to a worst outcome. CONCLUSION In this work, we include a detailed molecular, clinical, cytological, and cytometric study of the second t-AML bearing NUP98-HOXA9 genetic fusion.
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Affiliation(s)
- S Burillo-Sanz
- Servicio de Inmunología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - R M Morales-Camacho
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - T Caballero-Velázquez
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - M T Vargas
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J R García-Lozano
- Servicio de Inmunología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J F Falantes
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - C Prats-Martín
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - R Bernal
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - J A Pérez-Simón
- Department of Hematology, Instituto de Biomedicina de Sevilla (IBIS)/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
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Shahjahani M, Khodadi E, Seghatoleslami M, Asl JM, Golchin N, Zaieri ZD, Saki N. Rare Cytogenetic Abnormalities and Alteration of microRNAs in Acute Myeloid Leukemia and Response to Therapy. Oncol Rev 2015; 9:261. [PMID: 26779308 PMCID: PMC4698590 DOI: 10.4081/oncol.2015.261] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/06/2014] [Accepted: 11/29/2014] [Indexed: 12/13/2022] Open
Abstract
Acute myeloid leukemia (AML) is the most common acute leukemia in adults, which is heterogeneous in terms of morphological, cytogenetic and clinical features. Cytogenetic abnormalities, including karyotype aberrations, gene mutations and gene expression abnormalities are the most important diagnostic tools in diagnosis, classification and prognosis in acute myeloid leukemias. Based on World Health Organization (WHO) classification, acute myeloid leukemias can be divided to four groups. Due to the heterogeneous nature of AML and since most therapeutic protocols in AML are based on genetic alterations, gathering further information in the field of rare disorders as well as common cytogenetic abnormalities would be helpful in determining the prognosis and treatment in this group of diseases. Recently, the role of microRNAs (miRNAs) in both normal hematopoiesis and myeloid leukemic cell differentiation in myeloid lineage has been specified. miRNAs can be used instead of genes for AML diagnosis and classification in the future, and can also play a decisive role in the evaluation of relapse as well as response to treatment in the patients. Therefore, their use in clinical trials can affect treatment protocols and play a role in therapeutic strategies for these patients. In this review, we have examined rare cytogenetic abnormalities in different groups of acute myeloid leukemias according to WHO classification, and the role of miRNA expression in classification, diagnosis and response to treatment of these disorders has also been dealt with.
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Affiliation(s)
- Mohammad Shahjahani
- Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elahe Khodadi
- Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Seghatoleslami
- Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Javad Mohammadi Asl
- Department of Medical Genetics, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Neda Golchin
- Noor Clinical & Specialty Laboratory, Ahvaz, Iran
| | - Zeynab Deris Zaieri
- Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmaldin Saki
- Health Research Institute, Research Center of Thalassemia & Hemoglobinopathy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Evi1 defines leukemia-initiating capacity and tyrosine kinase inhibitor resistance in chronic myeloid leukemia. Oncogene 2014; 33:5028-38. [PMID: 24747972 PMCID: PMC4217142 DOI: 10.1038/onc.2014.108] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2013] [Revised: 02/17/2014] [Accepted: 03/12/2014] [Indexed: 12/28/2022]
Abstract
Relapse of chronic myeloid leukemia (CML) is triggered by stem cells with a reconstituting capacity similar to that of hematopoietic stem cells (HSCs) and CML stem cells are a source of resistance in drug therapy with tyrosine kinase inhibitors (TKIs). Ecotropic viral integration site 1 (EVI1), a key transcription factor in HSC regulation, is known to predict poor outcomes in myeloid malignancies, however, incapability of prospective isolation of EVI1-high leukemic cells precludes the functional evaluation of intraindividual EVI1-high cells. Introduction of CML into Evi1-internal ribosomal entry site (IRES)-green fluorescent protein (GFP) knock-in mice, a versatile HSC-reporter strain, enables us to separate Evi1-high CML cells from the individual. Evi1-IRES-GFP allele models of CML in chronic phase (CML-CP), by retroviral overexpression of BCR-ABL and by crossing BCR-ABL transgenic mice, revealed that Evi1 is predominantly enriched in the stem cell fraction and associated with an enhanced proliferative as well as a leukemia-initiating capacity and that Evi1-high CML-CP cells exhibit resistance to TKIs. Overexpressing BCR-ABL and NUP98-HOXA9 in Evi1-IRES-GFP knock-in mice to model CML in blast crisis (CML-BC), in which Evi1-high cells turned to be a major population as opposed to a minor population in CML-CP models, showed that Evi1-high CML-BC cells have a greater potential to recapitulate the disease and appear resistant to TKIs. Furthermore, given that Evi1 heterozygosity ameliorates CML-CP and CML-BC development and that the combination of Evi1 and BCR-ABL causes acute myeloid leukemia resembling CML-BC, Evi1 could regulate CML development as a potent driver. In addition, in human CML-CP cases, we show that EVI1 is highly expressed in stem cell-enriched CD34+CD38-CD90+ fraction at single-cell level. This is the first report to clarify directly that Evi1-high leukemic cells themselves possess the superior potential to Evi1-low cells in oncogenic self-renewal, which highlights the role of Evi1 as a valuable and a functional marker of CML stem cells.
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Wei S, Wang S, Qiu S, Qi J, Mi Y, Lin D, Zhou C, Liu B, Li W, Wang Y, Wang M, Wang J. Clinical and laboratory studies of 17 patients with acute myeloid leukemia harboring t(7;11)(p15;p15) translocation. Leuk Res 2013; 37:1010-5. [DOI: 10.1016/j.leukres.2013.05.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 05/22/2013] [Accepted: 05/26/2013] [Indexed: 10/26/2022]
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