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Stankovic T, Skowronska A. The role of ATM mutations and 11q deletions in disease progression in chronic lymphocytic leukemia. Leuk Lymphoma 2013; 55:1227-39. [PMID: 23906020 DOI: 10.3109/10428194.2013.829919] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Abstract ATM gene alteration is a frequent event in pathogenesis of chronic lymphocytic leukemia (CLL) and occurs as monoallelic loss in the form of 11q23 deletion, with and without mutation in the remaining ATM allele. ATM is a principal DNA damage response gene and biallelic ATM alterations lead to ATM functional loss and chemoresistance. The introduction of new therapies, such as intensive chemoimmunotherapy and inhibition of B-cell receptor (BCR) signaling, has changed clinical responses for the majority of CLL tumors including those with 11q deletion, but it remains to be determined whether these strategies can prevent clonal evolution of tumors with biallelic ATM alterations. In this review we discuss ATM function and the consequences of its loss during CLL pathogenesis, differences in clinical behavior of tumors with monoallelic and biallelic ATM alterations, and we outline possible approaches for targeting the ATM null CLL phenotype.
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Affiliation(s)
- Tatjana Stankovic
- School of Cancer Sciences, University of Birmingham , Birmingham , UK
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2
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Teimori H, Ashoori S, Akbari MT, Mojtabavi Naeini M, Hashemzade Chaleshtori M. FISH Analysis for del6q21 and del17p13 in B-cell Chronic Lymphocytic Leukemia in Iranians. IRANIAN RED CRESCENT MEDICAL JOURNAL 2013; 15:107-12. [PMID: 23682321 PMCID: PMC3652496 DOI: 10.5812/ircmj.4990] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 09/29/2012] [Accepted: 01/08/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND B-cell chronic lymphocytic leukemia (B-CLL) is the most common leukemia in the Western world. Major progress has been made in assessing typical chromosomal abnormalities and recognition of the correlation of these chromosomal abnormalities with laboratory features and clinical course of the disease. The most frequent genomic changes are deletions at 13q14, 11q22-23 and 17p13 and trisomy of chromosome 12. OBJECTIVES The aim of this study was to investigate the frequency of chromosomal aberrations in B-CLL patients' peripheral blood and/or bone marrow using a molecular cytogenetic method, interphase fluorescence in situ hybridization (I-FISH) and to evaluate the correlation between these genomic changes and clinical findings. PATIENTS AND METHODS I-FISH analyses were performed on bone marrow and blood samples of 66 B-CLL patients. RESULTS Deletion of 17p13 was found in 11 (16.6%) and deletion 6q21 was present in 5 (7.5%). Statistical analyses were performed to investigate the correlation of these molecular-cytogenetic findings with family history, Rai staging and CD38 marker. No clear differences in distribution was noted for del17p13 and del6q21 among patients with and without family history, and no direct correlation was noted between these genomic changes and CD38 marker, but the correlation of del17p13 and Rai stage was significant. There was a high frequency of Rai stage II within del17p13 patients. CONCLUSIONS It was demonstrated that the presence of del6q21 in B-CLL patients indicates poor prognosis and on the contrary, presence of del17p13 points at the good prognostic value of the disease.
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Affiliation(s)
- Hossein Teimori
- Cellular and Molecular Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Saeede Ashoori
- Cellular and Molecular Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Mohamad Taghi Akbari
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
| | - Marjan Mojtabavi Naeini
- Cellular and Molecular Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Morteza Hashemzade Chaleshtori
- Cellular and Molecular Research Center, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
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Marasca R, Maffei R, Martinelli S, Fiorcari S, Bulgarelli J, Debbia G, Rossi D, Rossi FM, Rigolin GM, Martinelli S, Gattei V, Del Poeta G, Laurenti L, Forconi F, Montillo M, Gaidano G, Luppi M. Clinical heterogeneity ofde novo11q deletion chronic lymphocytic leukaemia: prognostic relevance of extent of 11q deleted nuclei inside leukemic clone. Hematol Oncol 2012; 31:88-95. [DOI: 10.1002/hon.2028] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/05/2012] [Accepted: 09/07/2012] [Indexed: 11/06/2022]
Affiliation(s)
- Roberto Marasca
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Rossana Maffei
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Silvia Martinelli
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Stefania Fiorcari
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Jenny Bulgarelli
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Giulia Debbia
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
| | - Davide Rossi
- Division of Hematology, Department of Clinical and Experimental Medicine; Amedeo Avogadro University of Eastern Piedmont; Novara; Italy
| | - Francesca Maria Rossi
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico; I.R.C.C.S.; Aviano; PN; Italy
| | - Gian Matteo Rigolin
- Hematology Section, Department of Biomedical Sciences; Azienda Ospedaliero-Universitaria Arcispedale S. Anna, University of Ferrara; Ferrara; Italy
| | - Sara Martinelli
- Hematology Section, Department of Biomedical Sciences; Azienda Ospedaliero-Universitaria Arcispedale S. Anna, University of Ferrara; Ferrara; Italy
| | - Valter Gattei
- Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico; I.R.C.C.S.; Aviano; PN; Italy
| | - Giovanni Del Poeta
- Division of Hematology; S. Eugenio Hospital and University of Tor Vergata; Rome; Italy
| | - Luca Laurenti
- Institute of Hematology; Catholic University of the Sacred Heart; Rome; Italy
| | | | | | - Gianluca Gaidano
- Division of Hematology, Department of Clinical and Experimental Medicine; Amedeo Avogadro University of Eastern Piedmont; Novara; Italy
| | - Mario Luppi
- Division of Hematology, Dipartimento di Scienze Mediche e Chirurgiche Materno-infantili e dell'Adulto; University of Modena and Reggio Emilia; Modena; Italy
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Mozaheb Z, NazarAbadi MHH, Aghaee MA. Chronic Lymphocytic Leukemia and Prognostic Factors. Asian Pac J Cancer Prev 2012; 13:3009-13. [DOI: 10.7314/apjcp.2012.13.7.3009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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5
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Abstract
B-cell chronic lymphocytic leukemia (B-CLL) is a heterogeneous malignant disease, both in terms of molecular abnormalities and clinical course. The most frequent chromosomal aberrations in B-CLL are deletions on 13q, 11q, and 17p, and trisomy 12, all of which are of prognostic significance. These aberrations can be detected by conventional cytogenetic analysis and fluorescence in situ hybridization (FISH), but cytogenetics are hampered by the low mitotic index of B-CLL cells, and FISH depends on genetic information of candidate regions. Microsatellites are unique highly polymorphic and informative genetic markers dispersed in the human genome. They have become the most commonly used markers to trace loss of heterozygosity in tumors. Their detection by PCR is rapid and can be semi-automated with maximal robustness and reproducibility. In this review, we discuss the implications of a recent genome-wide analysis in B-CLL with 400 microsatellite markers. This analysis led to the detection of new aberrant loci in B-CLL which are not visible in the leukemic conventional karyotype. We conclude that microsatellite allelotyping provides a complementary comprehensive view of genetic alterations in B-CLL, and it may identify new loci with candidate genes relevant in the molecular biology of B-CLL.
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Affiliation(s)
- Urban Novak
- Department of Medical Oncology and Haematology, University and Inselspital Berne, Switzerland
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Abstract
Chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) is a clonal lymphoproliferative disorder characterized by proliferation of morphologically and immunophenotypically mature lymphocytes. CLL/SLL may proceed through different phases: an early phase in which tumor cells are predominantly small in size, with a low proliferation rate and prolonged cell survival, and a transformation phase with the frequent occurrence of extramedullary proliferation and an increase in large, immature cells. Although some patients with CLL have an indolent disease course and die after many years of unrelated causes, others have very rapidly disease progression and die of the disease within a few years of the diagnosis. In the past few years, considerable progress has been made in our ability to diagnose and classify CLL accurately. Through cytogenetics and molecular biology, it has been shown that CLL and variants are associated with a unique genotypic profile and that these genetic lesions often have a direct bearing on the pathogenesis and prognosis of the disease. Similarly, the development of antibodies to new biologic markers has allowed the identification of a unique immunophenotypic profile for CLL and variants. Moreover, accumulating evidence suggests that CLL cells respond to selected microenvironmental signals and that this confers a growth advantage and an extended survival to CLL cells. In this article, we will review the progress in the pathobiology of CLL and give an update on prognostic markers and tools in current pathology practice for risk stratification of CLL.
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MESH Headings
- Bone Marrow/pathology
- Chromosome Aberrations
- Diagnosis, Differential
- Female
- Humans
- Immunophenotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymph Nodes/pathology
- Male
- Prognosis
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Affiliation(s)
- Kedar V Inamdar
- Department of Hematopathology, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA
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Ripollés L, Ortega M, Ortuño F, González A, Losada J, Ojanguren J, Soler JA, Bergua J, Coll MD, Caballín MR. Genetic abnormalities and clinical outcome in chronic lymphocytic leukemia. ACTA ACUST UNITED AC 2006; 171:57-64. [PMID: 17074592 DOI: 10.1016/j.cancergencyto.2006.07.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2006] [Revised: 06/19/2006] [Accepted: 07/05/2006] [Indexed: 11/28/2022]
Abstract
B-cell chronic lymphocytic leukemia (B-CLL) is the most common leukemia in the elderly population. Under conventional cytogenetic (CC) analysis, approximately 50% of CLL cases show clonal aberrations. Using fluorescent in situ hybridization (FISH), the percentage of patients with abnormalities rises to almost 80%, the most frequent being 13q14, ATM, and TP53 deletions and trisomy 12. The aim of this study was to establish the incidence of genetic changes in B-CLL patients using CC and FISH and to evaluate the prognostic implications. Of the 65 patients analyzed, genetic aberrations were found in 36.7% with CC and in 68.4% with FISH. The frequencies of abnormalities were as follows: 13q deletion, 42.1%; trisomy 12, 19.2%; ATM deletion, 17.5%; and TP53 deletion, 8.7%. Significant differences were observed when the overall survival was correlated with Rai stage (P = 0.000). FISH abnormalities were correlated with age, sex, morphology, white blood cell count, CD38 expression, Rai stage, disease status, and survival. Significant differences were obtained with age (P = 0.05) and disease status (P = 0.01). Deletion of 13q was the most frequent abnormality (36.6%) among old patients (> or =60); trisomy 12 was the most frequent (31.3%) in younger patients (<60). Half of the patients with stable disease showed 13q deletion, and the most frequent abnormality in patients with progressive disease was ATM deletion (22.2%).
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MESH Headings
- ADP-ribosyl Cyclase 1/analysis
- Adult
- Aged
- Ataxia Telangiectasia Mutated Proteins
- Cell Cycle Proteins/genetics
- Chromosome Aberrations
- Chromosome Deletion
- DNA-Binding Proteins/genetics
- Disease Progression
- Female
- Gene Deletion
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Kaplan-Meier Estimate
- Karyotyping
- Leukemia, B-Cell/genetics
- Leukemia, B-Cell/metabolism
- Leukemia, B-Cell/pathology
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Prognosis
- Protein Serine-Threonine Kinases/genetics
- Translocation, Genetic
- Trisomy
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Proteins/genetics
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Affiliation(s)
- Lorena Ripollés
- Anthropologic Biology Unit, Animal Biology, Vegetal Biology and Ecology Department, Autonomus University of Barcelona, Edifici C, 08193 Bellaterra, Barcelona, Spain
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Collado R, Hueso J, Cabello AI, Oliver I, Egea M, Orero M, Miguel-Sosa A, Cigudosa JC, Benítez J, Barragán E, Carbonell F. New translocations in a case of atypical B-cell chronic lymphocytic leukemia: involvement of ATM, MLL, and TP53 genes. ACTA ACUST UNITED AC 2006; 169:176-8. [PMID: 16938579 DOI: 10.1016/j.cancergencyto.2006.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Revised: 02/08/2006] [Accepted: 02/28/2006] [Indexed: 11/17/2022]
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9
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Reddy KS. Chronic lymphocytic leukaemia profiled for prognosis using a fluorescence in situ hybridisation panel. Br J Haematol 2006; 132:705-22. [PMID: 16487171 DOI: 10.1111/j.1365-2141.2005.05919.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A panel of fluorescence in situ hybridisation (FISH) probes was used on 894 cases to target chromosome 11q, 13q, 17p deletions (del), trisomy 12 (+12) in all and 6q deletion in 59. Chronic lymphocytic leukaemia (CLL) immunophenotype (CD5 and CD19 with CD23) was found in 509 cases (average age 67.7 years, 319 males and 190 females). Among the 509 CLL cases 349 (68.6%) had FISH (4-probe panel) abnormalities: 160 del 13q [45.8% (122-del 13q, 18-biallelic del 13q, 20-monoallelic/biallelic del 13q)], 71 tri 12 (20.3%), 17 del ATM (5%), 12 del p53 (3.4%) and 89 > or = 2 FISH abnormalities (25.5%). Of 151/509 cases karyotyped, 108 were normal and 43 (43/151 = 28.5%) abnormal. Del 6q was found in 1/59 (1.6%) FISH cases and in 6/151 (4%) karyotypes. In 14 CD23 negative cases IGH/BCL1 FISH detected t(11;14) and was confirmed to be mantle cell lymphoma. Multiple probes/panels that included IGH probe were ordered for 57 CLL cases, 11 had an IGH rearrangement with an unidentified partner. This study favours the inclusion of del 6q and IGH probes in the CLL panel. The FISH panel could also serve to monitor 13q deletion for secondary changes with adverse prognosis. Understanding prognosis in specific types of 13q deletion would enhance outcome prediction.
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MESH Headings
- ADP-ribosyl Cyclase 1/genetics
- ADP-ribosyl Cyclase 1/immunology
- Age Factors
- Aged
- Antigens, CD19/immunology
- CD5 Antigens/genetics
- CD5 Antigens/immunology
- Chromosomes, Human, Pair 13/genetics
- Chromosomes, Human, Pair 13/immunology
- Cytogenetic Analysis/methods
- Diagnosis, Differential
- Female
- Gene Deletion
- Genetic Markers/genetics
- Genetic Markers/immunology
- Humans
- Immunophenotyping/methods
- In Situ Hybridization, Fluorescence/methods
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Male
- Middle Aged
- Mosaicism
- Prognosis
- Sex Factors
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Siew-Gek Lee A, Rudduck-Sivaswaren C, Khun-Hong Lie D, Li-Ming Chua C, Tien SL, Morsberger L, Griffin CA. Overlapping deletion regions at 11q23 in myelodysplastic syndrome and chronic lymphocytic leukemia, characterized by a novel BAC probe set. ACTA ACUST UNITED AC 2004; 153:151-7. [PMID: 15350305 DOI: 10.1016/j.cancergencyto.2004.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2003] [Revised: 01/05/2004] [Accepted: 01/07/2004] [Indexed: 10/26/2022]
Abstract
Translocations or deletions involving the 11q23 region have been observed in acute lymphoblastic leukemia (ALL), acute myelocytic leukemia (AML), myelodysplastic syndrome (MDS), and chronic lymphocytic leukemia (CLL). BAC probes encompassing the D11S29 and D11S924 markers and flanking the MLL gene were used in dual color fluorescence in situ hybridization. Fifteen patients with hematologic malignancies and cytogenetic abnormalities of 11q23 were analyzed. The BAC and MLL probes demonstrated split signals in five of 7 ALL or AML cases with translocations of 11q23. Of the remaining 2 cases, one had normal signals for both probe sets and the other had a submicroscopic deletion of the MLL 3' region. In one case of AML with del(11)(q23), deletion of the MLL 3' region and the region telomeric to the MLL gene was seen. Three CLL cases with deletion of part or the entire 11q23 region showed deletion of one copy of MLL, but retention of the region telomeric to MLL. However, in four MDS cases with deletions involving the 11q23 region, deletions of both the MLL gene and the flanking regions of the MLL gene were observed. Hence, the deletions on 11q23 are different but overlapping for CLL and MDS, implicating different genes involved for these diseases.
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Affiliation(s)
- Ann Siew-Gek Lee
- Division of Medical Sciences, National Cancer Centre, Division of Medical Sciences, 11 Hospital Drive, 169610 Singapore.
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