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Zhao C, Wang M, Zhan Y, Xu Y, Chen S, Wang Q, An J, Liu T. A Novel IL3-ETV6 Fusion in Chronic Eosinophilic Leukemia Not Otherwise Specified With t(5; 12) (q31; p13): A Case Report and Literature Review. Front Oncol 2022; 12:887945. [PMID: 35747804 PMCID: PMC9213071 DOI: 10.3389/fonc.2022.887945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/26/2022] [Indexed: 12/04/2022] Open
Abstract
Chronic eosinophilic leukemia not otherwise specified (CEL-NOS) is classified as Myeloproliterative Neoplasms (MPN) and refers to chronic eosinophilic leukemia with some atypical recurrent genetic evidence(1). A rare fusion of ACSL6-ETV6 was previously identified in patients with the t(5;12) (q31; p13) karyotype(2). Here, we report a case of CEL-NOS with a translocation of t(5;12) (q31; p13) and identify IL3-ETV6 transcription, which has not been identified in hematologic diseases. In this patient, eosinophilia was observed. And compared with CEL-NOS patients without ETV6 fusion, a higher mRNA expression level of IL3 was found. After failing treatment with dasatinib, the patient was given hydroxyurea (HU). Subsequently his white blood cell (WBC) and eosinophils decreased significantly and remained in the normal range until publication. Due to the side effects, treatment with HU was replaced by PEG-interferon (PEG-IFN). What’s more, we summarized the case in our study and 21 patients with the karyotype of t(5; 12) (q31; p13) reported by other groups. It was found that most of them had similar clinical manifestations of eosinophilia and tyrosine kinase inhibitor (TKI) insensitivity. The ectopic mRNA expression of IL3 may be the main cause of eosinophilia, and HU and prednisone acetate (PAT), as well as IFN, were considered treatments for this group.
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Affiliation(s)
- Cenzhu Zhao
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Man Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yuchen Zhan
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Yang Xu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- *Correspondence: Qinrong Wang, ; Jingnan An, ; Tianhui Liu, ; Yang Xu,
| | - Suning Chen
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
| | - Qinrong Wang
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- *Correspondence: Qinrong Wang, ; Jingnan An, ; Tianhui Liu, ; Yang Xu,
| | - Jingnan An
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- *Correspondence: Qinrong Wang, ; Jingnan An, ; Tianhui Liu, ; Yang Xu,
| | - Tianhui Liu
- National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
- Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China
- *Correspondence: Qinrong Wang, ; Jingnan An, ; Tianhui Liu, ; Yang Xu,
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2
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De Braekeleer E, Douet-Guilbert N, Morel F, Le Bris MJ, Basinko A, De Braekeleer M. ETV6 fusion genes in hematological malignancies: a review. Leuk Res 2012; 36:945-61. [PMID: 22578774 DOI: 10.1016/j.leukres.2012.04.010] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 03/13/2012] [Accepted: 04/16/2012] [Indexed: 01/01/2023]
Abstract
Translocations involving band 12p13 are one of the most commonly observed chromosomal abnormalities in human leukemia and myelodysplastic syndrome. Their frequently result in rearrangements of the ETV6 gene. At present, 48 chromosomal bands have been identified to be involved in ETV6 translocations, insertions or inversions and 30 ETV6 partner genes have been molecularly characterized. The ETV6 protein contains two major domains, the HLH (helix-loop-helix) domain, encoded by exons 3 and 4, and the ETS domain, encoded by exons 6 through 8, with in between the internal domain encoded by exon 5. ETV6 is a strong transcriptional repressor, acting through its HLH and internal domains. Five potential mechanisms of ETV6-mediated leukemogenesis have been identified: constitutive activation of the kinase activity of the partner protein, modification of the original functions of a transcription factor, loss of function of the fusion gene, affecting ETV6 and the partner gene, activation of a proto-oncogene in the vicinity of a chromosomal translocation and dominant negative effect of the fusion protein over transcriptional repression mediated by wild-type ETV6. It is likely that ETV6 is frequently involved in leukemogenesis because of the large number of partners with which it can rearrange and the several pathogenic mechanisms by which it can lead to cell transformation.
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Affiliation(s)
- Etienne De Braekeleer
- Laboratoire d'Histologie, Embryologie et Cytogénétique, Université de Brest, Brest, France
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3
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Nand R, Bryke C, Kroft SH, Divgi A, Bredeson C, Atallah E. Myeloproliferative disorder with eosinophilia and ETV6–ABL gene rearrangement: Efficacy of second-generation tyrosine kinase inhibitors. Leuk Res 2009; 33:1144-6. [DOI: 10.1016/j.leukres.2009.03.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2009] [Revised: 01/28/2009] [Accepted: 03/09/2009] [Indexed: 10/20/2022]
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4
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Katsura Y, Suzukawa K, Nanmoku T, Nemoto N, Machino T, Obara N, Okoshi Y, Mukai HY, Hasegawa Y, Kojima H, Kawakami Y, Nagasawa T. Myelodysplastic syndrome accompanied by basophilia and eosinophilia with t(5;12)(q31;p13). ACTA ACUST UNITED AC 2007; 178:85-8. [PMID: 17889716 DOI: 10.1016/j.cancergencyto.2007.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 05/23/2007] [Accepted: 05/31/2007] [Indexed: 11/30/2022]
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5
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Murati A, Adélaïde J, Gelsi-Boyer V, Etienne A, Rémy V, Fezoui H, Sainty D, Xerri L, Vey N, Olschwang S, Birnbaum D, Chaffanet M, Mozziconacci MJ. t(5;12)(q23-31;p13) with ETV6-ACSL6 gene fusion in polycythemia vera. Leukemia 2006; 20:1175-8. [PMID: 16572202 DOI: 10.1038/sj.leu.2404194] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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6
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Keung YK, Beaty M, Steward W, Jackle B, Pettnati M. Chronic myelocytic leukemia with eosinophilia, t(9;12)(q34;p13), and ETV6-ABL gene rearrangement: case report and review of the literature. CANCER GENETICS AND CYTOGENETICS 2002; 138:139-42. [PMID: 12505259 DOI: 10.1016/s0165-4608(02)00609-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Chronic myelocytic leukemia (CML) is a chronic myeloproliferative disorder characterized by cytogenetic or molecular evidence of Philadelphia (Ph) chromosome, t(9;22)(q34;q11). Mild to moderate eosinophilia is commonly seen in CML. However, eosinophilia as a dominant feature of CML is extremely rare. We describe a case of Ph(-) CML with eosinophilia. Loeffler endocarditis, and t(9;12)(q34;p13) that resulted in an ETV6-ABL gene rearrangement/fusion identified to the best of our knowledge, for the first time by using commercially available fluorescence in situ hybridization probes.
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MESH Headings
- Adult
- Aged
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 9/genetics
- Eosinophilia/complications
- Eosinophilia/genetics
- Female
- Fusion Proteins, bcr-abl/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/complications
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Oncogene Proteins, Fusion/genetics
- Philadelphia Chromosome
- Protein-Tyrosine Kinases
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic/genetics
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Affiliation(s)
- Yi Kong Keung
- Department of Internal Medicine, Section on Hematology, and Oncology, Comprehensive Cancer Center, Winston-Salem, NC 27157, USA.
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7
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Affiliation(s)
- Rajeev Gupta
- Section of Gene Function and Regulation, The Institute of Cancer Research, Fulham Road, London SW3 6JB, UK.
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Cools J, Mentens N, Odero MD, Peeters P, Wlodarska I, Delforge M, Hagemeijer A, Marynen P. Evidence for position effects as a variant ETV6-mediated leukemogenic mechanism in myeloid leukemias with a t(4;12)(q11-q12;p13) or t(5;12)(q31;p13). Blood 2002; 99:1776-84. [PMID: 11861295 DOI: 10.1182/blood.v99.5.1776] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The ETV6 gene (first identified as TEL) is a frequent target of chromosomal translocations in both myeloid and lymphoid leukemias. At present, more than 40 distinct translocations have been cytogenetically described, of which 13 have now also been characterized at the molecular level. These studies revealed the generation of in-frame fusion genes between different domains of ETV6 and partner genes encoding either kinases or transcription factors. However, in a number of cases-including a t(6;12)(q23;p13), the recurrent t(5;12)(q31;p13), and some cases of the t(4;12)(q11-q12;p13) described in this work-functionally significant fusions could not be identified, raising the question as to what leukemogenic mechanism is implicated in these cases. To investigate this, we have evaluated the genomic regions at 4q11-q12 and 5q31, telomeric to the breakpoints of the t(4;12)(q11-q12;p13) and t(5;12)(q31;p13). The homeobox gene GSH2 at 4q11-q12 and the IL-3/CSF2 locus at 5q31 were found to be located close to the respective breakpoints. In addition, GSH2 and IL-3 were found to be ectopically expressed in the leukemic cells, suggesting that expression of GSH2 and IL-3 was deregulated by the translocation. Our results indicate that, besides the generation of fusion transcripts, deregulation of the expression of oncogenes could be a variant leukemogenic mechanism for translocations involving the 5' end of ETV6, especially for those translocations lacking functionally significant fusion transcripts.
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MESH Headings
- 3T3 Cells
- Adult
- Animals
- Base Sequence
- Cell Transformation, Neoplastic/genetics
- Chromosome Breakage/genetics
- Chromosomes, Human, Pair 12
- Chromosomes, Human, Pair 4/genetics
- Chromosomes, Human, Pair 5/genetics
- DNA-Binding Proteins/genetics
- Down-Regulation/genetics
- Homeodomain Proteins/genetics
- Homeodomain Proteins/metabolism
- Humans
- Interleukin-3/genetics
- Interleukin-3/metabolism
- Leukemia, Myeloid/etiology
- Leukemia, Myeloid/genetics
- Male
- Mice
- Middle Aged
- Molecular Sequence Data
- Proto-Oncogene Proteins c-ets
- Repressor Proteins/genetics
- Transfection
- Translocation, Genetic/genetics
- Translocation, Genetic/physiology
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- Jan Cools
- Human Genome Laboratory, Center for Human Genetics-Flanders Interuniversity Institute for Biotechnology (VIB), University of Leuven, Belgium
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Temperani P, Luppi M, Giacobbi F, Medici V, Morselli M, Barozzi P, Marasca R, Torelli G, Emilia G. Late-appearing PML/RARalpha fusion transcript with coincidental t(12;13)(p13.2;q14) in acute promyelocytic leukemia lacking the t(15;17) cytogenetic anomaly. CANCER GENETICS AND CYTOGENETICS 2000; 119:121-6. [PMID: 10867147 DOI: 10.1016/s0165-4608(99)00233-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The late appearance of a cytogenetic/molecular hallmark in human leukemias is a rare event. We report on a case of acute myeloid leukemia with morphology, immunophenotype and clinical features typical of promyelocytic subtype (APL), in which the specific PML/RARalpha gene rearrangement was molecularly detected only at second relapse of disease, without cytogenetic evidence of the t(15;17). The emergence of the PML/RARalpha gene may be therapy-related or may represent the exceptional result of a clonal evolution during progression of neoplasia. At second relapse, a novel cell clone bearing a t(12;13)(p13.2;q14) was also observed and a molecular deletion and rearrangement of a locus at 13q14, distinct from retinoblastoma (Rb1) locus, was found. In this unusual case, the PML/RARalpha product seems to be not essential for the expression of the promyelocytic phenotype at diagnosis and, when detectable, it is not the sole genetic defect.
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MESH Headings
- Chromosomes, Human, Pair 12/ultrastructure
- Chromosomes, Human, Pair 13/ultrastructure
- Chromosomes, Human, Pair 15/ultrastructure
- Chromosomes, Human, Pair 17/ultrastructure
- Clone Cells/pathology
- Disease Progression
- Fatal Outcome
- Female
- Humans
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- Middle Aged
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- RNA, Messenger/biosynthesis
- RNA, Neoplasm/biosynthesis
- Recurrence
- Time Factors
- Translocation, Genetic
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Affiliation(s)
- P Temperani
- Department of Medical Sciences, Section of Internal Medicine and Hematology, University of Modena, Modena, Italy
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10
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Abstract
Recent advances in our understanding of hypereosinophilia have related particularly to the definition of criteria for distinguishing between eosinophilic leukemia and the 'idiopathic' hypereosinophilic syndromes. In this article, leukemogenic mechanisms have been identified in a number of subtypes of eosinophilic leukemia, and the role of clones of T lymphocytes in the causation of otherwise unexplained eosinophilia has been further elucidated. The roles of various therapeutic modalities-including cytotoxic chemotherapy, interferon and bone marrow transplantation-in eosinophilic leukemia and in the idiopathic hypereosinophilic syndrome also have been further defined.
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Affiliation(s)
- B J Bain
- Department of Haematology, St Mary's Hospital, Campus of Imperial College School of Medicine, London, United Kingdom.
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11
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Yagasaki F, Jinnai I, Yoshida S, Yokoyama Y, Matsuda A, Kusumoto S, Kobayashi H, Terasaki H, Ohyashiki K, Asou N, Murohashi I, Bessho M, Hirashima K. Fusion of TEL/ETV6 to a novel ACS2 in myelodysplastic syndrome and acute myelogenous leukemia with t(5;12)(q31;p13). Genes Chromosomes Cancer 1999; 26:192-202. [PMID: 10502316 DOI: 10.1002/(sici)1098-2264(199911)26:3<192::aid-gcc2>3.0.co;2-e] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We identified a novel human long fatty acyl CoA synthetase 2 gene, ACS2, as a new ETV6 fusion partner gene in a recurrent t(5;12)(q31;p13) translocation in a patient with refractory anemia with excess blasts (RAEB) with basophilia, a patient with acute myelogenous leukemia (AML) with eosinophilia, and a patient with acute eosinophilic leukemia (AEL). ACS2 is expressed in the brain and bone marrow and is highly conserved in man and rats. The resulting ETV6/ACS2 fusion transcripts showed an out-frame fusion of exon 1 of ETV6 to exon 1 of ACS2 in the AEL case, an out-frame fusion of exon 1 of ETV6 to exon 11 of ACS2 in the AML case, and a short in-frame fusion of ETV6 exon 1 to the 3' untranslated region of ACS2 in the RAEB case. Reciprocal ACS2/ETV6 transcripts were identified in two of the cases. Fluorescence in situ hybridization (FISH) analysis with ETV6 cosmids on 12p13, and BACs and P1s on 5q31, demonstrated that the 5q31 breakpoints of the AML and AEL cases involved the 5' portion of the ACS2 gene, and that the 5q31, breakpoint of the RAEB case involved the 3' portion of the ACS2 gene. None of the resulting chimeric transcripts except for the ACS2/ETV6 transcript in the RAEB case led to a fusion protein. Disruption of the second ETV6 allele by t(12;19) was detected in the AML case by FISH analysis. These observations suggest that the disruption of ETV6 and/or ACS2 may lead to the pathogenesis of hematologic malignancies with t(5;12)(q31;p13).
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MESH Headings
- Adult
- Amino Acid Sequence
- Artificial Gene Fusion
- Base Sequence
- Blotting, Northern
- Chromosome Mapping
- Chromosomes, Human, Pair 12
- Chromosomes, Human, Pair 5
- Coenzyme A Ligases/genetics
- DNA, Neoplasm/analysis
- DNA-Binding Proteins/genetics
- Exons
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid, Acute/genetics
- Male
- Middle Aged
- Molecular Sequence Data
- Nuclear Proteins/genetics
- Phosphoproteins/genetics
- Proto-Oncogene Proteins c-ets
- RNA, Neoplasm/analysis
- Repressor Proteins
- Reverse Transcriptase Polymerase Chain Reaction
- Sequence Analysis, DNA
- Transcription Factors/genetics
- Translocation, Genetic
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- F Yagasaki
- First Department of Internal Medicine, Saitama Medical School, Saitama, Japan.
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