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Boucher L, Sorel N, Desterke C, Chollet M, Rozalska L, Gallego Hernanz MP, Cayssials E, Raimbault A, Bennaceur-Griscelli A, Turhan AG, Chomel JC. Deciphering Potential Molecular Signatures to Differentiate Acute Myeloid Leukemia (AML) with BCR::ABL1 from Chronic Myeloid Leukemia (CML) in Blast Crisis. Int J Mol Sci 2023; 24:15441. [PMID: 37895120 PMCID: PMC10607477 DOI: 10.3390/ijms242015441] [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: 09/27/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Acute myeloid leukemia (AML) with BCR::ABL1 has recently been recognized as a distinct subtype in international classifications. Distinguishing it from myeloid blast crisis chronic myeloid leukemia (BC-CML) without evidence of a chronic phase (CP), remains challenging. We aimed to better characterize this entity by integrating clonal architecture analysis, mutational landscape assessment, and gene expression profiling. We analyzed a large retrospective cohort study including CML and AML patients. Two AML patients harboring a BCR::ABL1 fusion were included in the study. We identified BCR::ABL1 fusion as a primary event in one patient and a secondary one in the other. AML-specific variants were identified in both. Real-time RT-PCR experiments demonstrated that CD25 mRNA is overexpressed in advanced-phase CML compared to AML. Unsupervised principal component analysis showed that AML harboring a BCR::ABL1 fusion was clustered within AML. An AML vs. myeloid BC-CML differential expression signature was highlighted, and while ID4 (inhibitor of DNA binding 4) mRNA appears undetectable in most myeloid BC-CML samples, low levels are detected in AML samples. Therefore, CD25 and ID4 mRNA expression might differentiate AML with BCR::ABL1 from BC-CML and assign it to the AML group. A method for identifying this new WHO entity is then proposed. Finally, the hypothesis of AML with BCR::ABL1 arising from driver mutations on a BCR::ABL1 background behaving as a clonal hematopoiesis mutation is discussed. Validation of our data in larger cohorts and basic research are needed to better understand the molecular and cellular aspects of AML with a BCR::ABL1 entity.
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MESH Headings
- Humans
- Blast Crisis/genetics
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/metabolism
- Retrospective Studies
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- RNA, Messenger
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Affiliation(s)
- Lara Boucher
- CHU de Poitiers, Service de Cancérologie Biologique, F86000 Poitiers, France; (L.B.); (N.S.); (A.R.)
| | - Nathalie Sorel
- CHU de Poitiers, Service de Cancérologie Biologique, F86000 Poitiers, France; (L.B.); (N.S.); (A.R.)
| | - Christophe Desterke
- Faculté de Médecine, Université Paris Saclay, F94270 Le Kremlin-Bicêtre, France; (C.D.); (A.B.-G.); (A.G.T.)
| | - Mélanie Chollet
- CHU de Poitiers, Service d’Hématologie Biologique, F86000 Poitiers, France; (M.C.); (L.R.)
| | - Laura Rozalska
- CHU de Poitiers, Service d’Hématologie Biologique, F86000 Poitiers, France; (M.C.); (L.R.)
| | - Maria Pilar Gallego Hernanz
- CHU de Poitiers, Service d’Oncologie Hématologique et Thérapie Cellulaire, F86000 Poitiers, France; (M.P.G.H.); (E.C.)
- INSERM, CIC-P 1402, F86000 Poitiers, France
| | - Emilie Cayssials
- CHU de Poitiers, Service d’Oncologie Hématologique et Thérapie Cellulaire, F86000 Poitiers, France; (M.P.G.H.); (E.C.)
- INSERM, CIC-P 1402, F86000 Poitiers, France
| | - Anna Raimbault
- CHU de Poitiers, Service de Cancérologie Biologique, F86000 Poitiers, France; (L.B.); (N.S.); (A.R.)
- CHU de Poitiers, Service d’Hématologie Biologique, F86000 Poitiers, France; (M.C.); (L.R.)
| | - Annelise Bennaceur-Griscelli
- Faculté de Médecine, Université Paris Saclay, F94270 Le Kremlin-Bicêtre, France; (C.D.); (A.B.-G.); (A.G.T.)
- INSERM U1310, F94807 Villejuif, France
- INGESTEM-ESTeam Paris Sud, F94800 Villejuif, France
- Service d’Onco-Hématologie, Hôpital Paul Brousse, AP-HP Université Paris Saclay, F94804 Villejuif, France
- Service d’Hématologie, Hôpital Bicêtre, AP-HP Université Paris Saclay, F94270 Le Kremlin-Bicêtre, France
| | - Ali G. Turhan
- Faculté de Médecine, Université Paris Saclay, F94270 Le Kremlin-Bicêtre, France; (C.D.); (A.B.-G.); (A.G.T.)
- INSERM U1310, F94807 Villejuif, France
- INGESTEM-ESTeam Paris Sud, F94800 Villejuif, France
- Service d’Onco-Hématologie, Hôpital Paul Brousse, AP-HP Université Paris Saclay, F94804 Villejuif, France
- Service d’Hématologie, Hôpital Bicêtre, AP-HP Université Paris Saclay, F94270 Le Kremlin-Bicêtre, France
| | - Jean-Claude Chomel
- CHU de Poitiers, Service de Cancérologie Biologique, F86000 Poitiers, France; (L.B.); (N.S.); (A.R.)
- INSERM U1310, F94807 Villejuif, France
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2
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Young PE, Kanagal-Shamanna R, Hu S, Tang G, Thakral B, Daver N, Issa GC, Medeiros LJ, Konoplev S. Chronic myeloid leukemia, BCR-ABL1-positive, carrying NPM1 mutation - First case series from a single institution. Leuk Res 2021; 111:106685. [PMID: 34438119 DOI: 10.1016/j.leukres.2021.106685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Paul E Young
- Department of Pathology, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555, USA
| | - Rashmi Kanagal-Shamanna
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Ghayas C Issa
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA
| | - Sergej Konoplev
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX, 77030, USA.
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3
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Henry A, Bracquemart C, Naguib D, Chantepie S, Cheze S, Johnson-Ansah HA. Does eventually NPM1 mutation in blast phase chronic myeloid leukemia (BP-CML) exist? That is the question. Br J Haematol 2021; 195:469-471. [PMID: 34396510 DOI: 10.1111/bjh.17761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alexandra Henry
- Caen University Hospital, Hematology Institute, Caen, France
| | | | - Dina Naguib
- Department of Hematological Biology, Caen University Hospital, Caen, France
| | | | - Stephane Cheze
- Caen University Hospital, Hematology Institute, Caen, France
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4
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Laying the foundation for genomically-based risk assessment in chronic myeloid leukemia. Leukemia 2019; 33:1835-1850. [PMID: 31209280 DOI: 10.1038/s41375-019-0512-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 04/23/2019] [Indexed: 12/16/2022]
Abstract
Outcomes for patients with chronic myeloid leukemia (CML) have substantially improved due to advances in drug development and rational treatment intervention strategies. Despite these significant advances there are still unanswered questions on patient management regarding how to more reliably predict treatment failure at the time of diagnosis and how to select frontline tyrosine kinase inhibitor (TKI) therapy for optimal outcome. The BCR-ABL1 transcript level at diagnosis has no established prognostic impact and cannot guide frontline TKI selection. BCR-ABL1 mutations are detected in ~50% of TKI resistant patients but are rarely responsible for primary resistance. Other resistance mechanisms are largely uncharacterized and there are no other routine molecular testing strategies to facilitate the evaluation and further stratification of TKI resistance. Advances in next-generation sequencing technology has aided the management of a growing number of other malignancies, enabling the incorporation of somatic mutation profiles in diagnosis, classification, and prognostication. A largely unexplored area in CML research is whether expanded genomic analysis at diagnosis, resistance, and disease transformation can enhance patient management decisions, as has occurred for other cancers. The aim of this article is to review publications that reported mutated cancer-associated genes in CML patients at various disease phases. We discuss the frequency and type of such variants at initial diagnosis and at the time of treatment failure and transformation. Current limitations in the evaluation of mutants and recommendations for future reporting are outlined. The collective evaluation of mutational studies over more than a decade suggests a limited set of cancer-associated genes are indeed recurrently mutated in CML and some at a relatively high frequency. Genomic studies have the potential to lay the foundation for improved diagnostic risk classification according to clinical and genomic risk, and to enable more precise early identification of TKI resistance.
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5
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Kim MJ, Ahn S, Jeong SH, Jang JH, Han JH, Choi JR, Cho SR. Minor BCR-ABL1-Positive Acute Myeloid Leukemia Associated With the NPM1 Mutation and FLT3 Internal Tandem Duplication. Ann Lab Med 2017; 36:263-5. [PMID: 26915617 PMCID: PMC4773269 DOI: 10.3343/alm.2016.36.3.263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 12/21/2015] [Accepted: 01/29/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Moon Jung Kim
- Department of Laboratory Medicine, Seonam University College of Medicine, Goyang, Korea
| | - Sunhyun Ahn
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.,SQ Laboratory, Yongin, Korea
| | - Seong Hyun Jeong
- Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
| | | | - Jae Ho Han
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Jong Rak Choi
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung Ran Cho
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea.
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6
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Chantepie SP, Michallet M, Blaise D, Maury S, Deconinck E, Tabrizi R, Contentin N, Mohty M, Nguyen S, Lioure B, Raus N, Peffault de Latour R, Yakoub-Agha I, Reman O. Allogeneic stem cell transplantation (allo-SCT) for de novo Ph+ AML: a study from the French Society of Bone Marrow Transplantation and Cell Therapy. Bone Marrow Transplant 2015; 50:1586-8. [PMID: 26367219 DOI: 10.1038/bmt.2015.206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S P Chantepie
- Institut d'Hématologie de Basse-Normandie, Centre Hospitalier Universitaire, Côte de Nacre, Caen Cedex, France
| | - M Michallet
- Service d'hématologie, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - D Blaise
- Service d'hématologie, Institut Paoli-Calmettes, Marseille, France
| | - S Maury
- INSERM U 955, Hôpital Henri-Mondor, Créteil, France
| | - E Deconinck
- Service d'Hématologie, CHU Jean Minjoz, Besançon, France
| | - R Tabrizi
- Service d'Hématologie, Hôpital HAUT-LEVEQUE, CHU de Bordeaux, Pessac, France
| | - N Contentin
- Service d'Hématologie, Centre Henri Becquerel, Rouen, France
| | - M Mohty
- Hôpital Saint-Antoine, APHP, Paris, France.,Université Pierre & Marie Curie, Paris, France.,INSERM, UMRs 938, Paris, France
| | - S Nguyen
- Service d'Hématologie, Hopital Pitié-Salpétrière, Paris, France
| | - B Lioure
- Département d'Hématologie et Oncologie, Hôpital de Hautepierre, Strasbourg, France
| | - N Raus
- Service d'Hématologie, Hôpital Edouard Herriot, Lyon, France
| | | | - I Yakoub-Agha
- Greffe de moelle osseuse, Hôpital Huriez, Lille, France
| | - O Reman
- Institut d'Hématologie de Basse-Normandie, Centre Hospitalier Universitaire, Côte de Nacre, Caen Cedex, France
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7
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Skalska-Sadowska J, Januszkiewicz-Lewandowska D, Derwich K, Pieczonka A, Samborska M, Wachowiak J. Ph-negative isolated myeloid sarcoma with NPM1 gene mutation in adolescent with Ph-positive chronic myeloid leukemia in remission after treatment with allogeneic bone marrow transplantation and imatinib mesylate. Pediatr Blood Cancer 2015; 62:1070-1. [PMID: 25631405 DOI: 10.1002/pbc.25428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 12/18/2014] [Indexed: 12/26/2022]
Abstract
Few patients in remission of Ph-positive chronic myelogenous leukemia (CML) develop Ph-negative MDS/AML, usually with clonal cytogenetic abnormalities. Isolated Ph-negative myeloid sarcoma (MS) is presented here as a form of such disorder, different from Ph-positive MS establishing CML relapse in blastic phase. We describe 11-year-old male who developed Ph-negative isolated MS with NPM1 mutation, remaining in complete molecular remission of Ph-positive chronic myeloid leukemia treated with allo-HSCT in first chronic phase and with imatinib and donor lymphocyte infusion in molecular relapse. The possible mechanisms of the tumor formation are reviewed with stress on importance of comprehensive molecular/cytogenetic evaluations.
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Affiliation(s)
- Jolanta Skalska-Sadowska
- Department of Pediatric Hematology, Oncology and Transplantology University of Medical Sciences, Poznań, Poland
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8
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Coexpression Pattern Analysis of NPM1-Associated Genes in Chronic Myelogenous Leukemia. BIOMED RESEARCH INTERNATIONAL 2015; 2015:610595. [PMID: 25961029 PMCID: PMC4413041 DOI: 10.1155/2015/610595] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/29/2014] [Accepted: 01/07/2015] [Indexed: 02/03/2023]
Abstract
Background. Nucleophosmin 1 (NPM1) plays an important role in ribosomal synthesis and malignancies, but NPM1 mutations occur rarely in the blast-crisis and chronic-phase chronic myelogenous leukemia (CML) patients. The NPM1-associated gene set (GCM_NPM1), in total 116 genes including NPM1, was chosen as the candidate gene set for the coexpression analysis. We wonder if NPM1-associated genes can affect the ribosomal synthesis and translation process in CML. Results. We presented a distribution-based approach for gene pair classification by identifying a disease-specific cutoff point that classified the coexpressed gene pairs into strong and weak coexpression structures. The differences in the coexpression patterns between the normal and the CML groups were reflected from the overall structure by performing two-sample Kolmogorov-Smirnov test. Our developed method effectively identified the coexpression pattern differences from the overall structure: P value = 1.71 × 10−22 < 0.05 for the maximum deviation D = 0.109. Moreover, we found that genes involved in the ribosomal synthesis and translation process tended to be coexpressed in the CML group. Conclusion. Our developed method can identify the coexpression difference between two different groups. Dysregulation of ribosomal synthesis and translation process may be related to the CML disease. Our significant findings may provide useful information for the novel CML mechanism exploration and cancer treatment.
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9
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Reboursiere E, Chantepie S, Gac AC, Reman O. Rare but authentic Philadelphia-positive acute myeloblastic leukemia: two case reports and a literature review of characteristics, treatment and outcome. Hematol Oncol Stem Cell Ther 2014; 8:28-33. [PMID: 25300567 DOI: 10.1016/j.hemonc.2014.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 08/13/2014] [Accepted: 09/05/2014] [Indexed: 11/15/2022] Open
Abstract
The Philadelphia chromosome (Ph+), corresponding to translocation t(9;22), is found in chronic myeloid leukemia (CML) and acute lymphoblastic leukemia. Several cases of Ph+ acute myeloid leukemia (AML) have been reported in the literature. A retrospective study of Ph+ AML between 2001 and 2012 was conducted through a review of the literature. Among 400 AML patients, two cases of Ph+ AML (0.5%) were identified and treated with conventional chemotherapy with or without tyrosine kinase inhibitors (TKIs), followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT). One patient had a complex karyotype including 7 monosomy (-7) and p190 BCR-ABL fusion transcript. Both patients remain in complete molecular remission. To date, 21 Ph+ AML cases treated with TKIs have been described in the literature with a median overall survival of 18months. One-third of the patients had additional karyotypic abnormalities, and 14% had -7. Molecular analysis showed 59% p210 and 41% p190 fusion protein. Relapse rate was observed in 38% of patients with p190 compared to 10% in patients with p210. Allo-HSCT was performed in eight patients; two relapsed (25%). Cytogenetic (-7) and molecular features help to distinguish Ph+ AML from CML. Survival improved with TKIs, particularly in association with conventional chemotherapy and allo-HSCT. Further studies of Ph+ AML patients are needed to better define this entity, its prognostic value, and therapeutic strategy.
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Affiliation(s)
- Emilie Reboursiere
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France
| | - Sylvain Chantepie
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France.
| | - Anne-Claire Gac
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France
| | - Oumedaly Reman
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France
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10
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Menezes J, Salgado RN, Acquadro F, Gómez-López G, Carralero MC, Barroso A, Mercadillo F, Espinosa-Hevia L, Talavera-Casañas JG, Pisano DG, Álvarez S, Cigudosa JC. ASXL1, TP53 and IKZF3 mutations are present in the chronic phase and blast crisis of chronic myeloid leukemia. Blood Cancer J 2013; 3:e157. [PMID: 24212482 PMCID: PMC3880437 DOI: 10.1038/bcj.2013.54] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- J Menezes
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - R N Salgado
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - F Acquadro
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - G Gómez-López
- Bioinformatic Unit, Structural Biology and Biocomputing Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - M C Carralero
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - A Barroso
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - F Mercadillo
- Clinic Familial Cancer Unit, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - L Espinosa-Hevia
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - J G Talavera-Casañas
- Hematology and Hemotherapy Service, Ntra. Sra. de Candelaria Hospital, Santa Cruz de Tenerife, Spain
| | - D G Pisano
- Bioinformatic Unit, Structural Biology and Biocomputing Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - S Álvarez
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
| | - J C Cigudosa
- Molecular Cytogenetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Center–CNIO, Madrid, Spain
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