1
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Patwardhan PP, Aarabi M, Aggarwal N. Genomics of myelodysplastic/myeloproliferative neoplasm. Semin Diagn Pathol 2023; 40:195-201. [PMID: 37105794 DOI: 10.1053/j.semdp.2023.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
Myelodysplastic/ Myeloproliferative neoplasms (MDS/MPN) demonstrate overlapping pathologic and molecular features of myelodysplastic (MDS) and myeloproliferative (MPN) neoplasms. Diagnosis is difficult based on morphology alone, requiring exclusion of various non-neoplastic causes for CBC abnormalities and morphologic findings and other myeloid neoplasms. Identifying a clonal abnormality by cytogenetics or molecular studies has vastly improved our ability to diagnose MDS/MPN and has been incorporated in the different classification schemas. Currently two separate classification systems are in use- The 5th edition WHO and international consensus classification. The two competing classifications emphasize genetic work-up and are similar on many levels; however, they do introduce diagnostic dilemma when diagnosing certain entities such as chronic myelomonocytic leukemia in the presence of NPM1 mutations. The genetic profile overlaps among different subentities; however, the combination and the incidence of mutations; together with the clinical features and morphology helps in further subclassification. In this review, we discuss the advances in molecular characterization of MDS/MPN. We attempt to summarize the differences between the various classification schemes, and highlight the changes made in the diagnostic criteria.
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Affiliation(s)
| | - Mahmoud Aarabi
- UPMC Medical Genetics & Genomics Laboratories, UPMC Magee-Womens Hospital, Pittsburgh, PA, 15213, United States of America; Departments of Pathology, and Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, United States of America
| | - Nidhi Aggarwal
- University of Pittsburgh School of Medicine, Pittsburgh, PA, United States of America.
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2
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Mohiuddin Malla T, Amin Shah Z, Hussain Bhat A, Ahmad Malik M, Anjum Baba R, Rasool R, Rasool J, Ashaq S, Haq F. Fishing for ETV6/RUNX1 fusion and MLL gene rearrangements and their additional abnormalities in childhood acute lymphoblastic leukemia patients of Kashmir. Gene 2023; 856:147128. [PMID: 36565795 DOI: 10.1016/j.gene.2022.147128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/28/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Evidence suggests that ETV6/RUNX1 translocation in pediatric acute lymphocytic leukemia shows geographical variation. Therefore, the present study aimed at unveiling the incidence of ETV6/RUNX1 fusion in pediatric acute lymphocytic leukemia cases of this region using fluorescent in-situ hybridization. Besides, we aimed to determine the incidence of MLL gene rearrangement and the pattern of chromosomal abnormalities in this study group. METHODS Samples from 57 acute lymphocytic leukemia cases of pediatric age group were subjected to fluorescent in-situ hybridization and conventional cytogenetic analysis using standard methods. RESULTS Conventional cytogenetic analysis revealed chromosomal abnormalities in 19.3% cases. The other major chromosomal abnormalities reported were monosomies in 10.5%, hypodiploidy in 7%, marker chromosomes in 3.5% and deletions in 3.5% cases. We found a 44,XX,-7,-18, r(5), i(17q) complex karyotype in one of the cases. Fluorescent in-situ hybridization analysis revealed ETV6/RUNX1 translocation to be present in 28.07% cases and MLL gene rearrangement in 3.5% cases. 12.5% of ETV6/RUNX1 fusion positive cases were found to have a loss of ETV6 allele. Besides, 8.8% cases were found to exhibit a signal pattern suggestive of RUNX1 amplification. ETV6 gene deletion and MLL gene amplification was detected in 3.5% cases each, of our study. CONCLUSIONS Frequency of ETV6/RUNX1 fusion oncogene was found to be higher in pediatric ALL cases of Kashmir region as compared to that reported from other parts of India. Besides, a case was found to have a karyotype viz 44,XX,-7,-18, r(5), i(17q) that has not been reported elsewhere in the childhood ALL.
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Affiliation(s)
- Tahir Mohiuddin Malla
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Zafar Amin Shah
- Department of Immunology & Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
| | - Aashiq Hussain Bhat
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Manzoor Ahmad Malik
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Rafia Anjum Baba
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Roohi Rasool
- Department of Immunology & Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Javaid Rasool
- Department of Hematology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Sozi Ashaq
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Faizanul Haq
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
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3
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Prakash S, Arber DA, Bueso-Ramos C, Hasserjian RP, Orazi A. Advances in myelodysplastic/myeloproliferative neoplasms. Virchows Arch 2023; 482:69-83. [PMID: 36469102 DOI: 10.1007/s00428-022-03465-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/07/2022]
Abstract
The myelodysplastic syndrome/myeloproliferative neoplasms (MDS/MPN) category includes a heterogeneous group of diseases characterized by the co-occurrence of clinical and pathologic features of both myelodysplastic and myeloproliferative neoplasms. The recently published International Consensus Classification of myeloid neoplasms revised the entities included in the MDS/MPN category as well as criteria for their diagnosis. In addition to the presence of one or more increased peripheral blood cell counts as evidence of myeloproliferative features, concomitant cytopenia as evidence of ineffective hematopoiesis is now an explicit requirement to diagnose the diseases included in this category. The increasing availability of modern gene sequencing has allowed better understanding of the biologic characteristics of these myeloid neoplasms. The presence of specific mutations in the appropriate clinicopathologic context is now included in the diagnostic criteria for some of MDS/MPN entities. In this review, we highlight what has changed in the diagnostic criteria of MDS/MPN from the WHO 2016 classification while providing practical guidance in diagnosing these diseases.
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Affiliation(s)
- Sonam Prakash
- Department of Laboratory Medicine, University of California, San Francisco, CA, USA
| | - Daniel A Arber
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Carlos Bueso-Ramos
- Division of Pathology and Laboratory Medicine, Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Robert P Hasserjian
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Attilio Orazi
- Department of Pathology, Texas Tech University Health Sciences Center, El Paso, TX, USA.
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4
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Kanagal-Shamanna R, Orazi A, Hasserjian RP, Arber DA, Reichard K, Hsi ED, Bagg A, Rogers HJ, Geyer J, Darbaniyan F, Do KA, Devins KM, Pozdnyakova O, George TI, Cin PD, Greipp PT, Routbort MJ, Patel K, Garcia-Manero G, Verstovsek S, Medeiros LJ, Wang SA, Bueso-Ramos C. Myelodysplastic/myeloproliferative neoplasms-unclassifiable with isolated isochromosome 17q represents a distinct clinico-biologic subset: a multi-institutional collaborative study from the Bone Marrow Pathology Group. Mod Pathol 2022; 35:470-479. [PMID: 34775472 PMCID: PMC8967812 DOI: 10.1038/s41379-021-00961-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 12/14/2022]
Abstract
Classification of myeloid neoplasms with isolated isochromosome i(17q) [17p deletion with inherent monoallelic TP53 loss plus 17q duplication] is controversial. Most cases fall within the WHO unclassifiable myelodysplastic/myeloproliferative neoplasms (MDS/MPN-U) category. The uniformly dismal outcomes warrant better understanding of this entity. We undertook a multi-institutional retrospective study of 92 adult MDS/MPN-U cases from eight institutions. Twenty-nine (32%) patients had isolated i(17q) [MDS/MPN-i(17q)]. Compared to MDS/MPN without i(17q), MDS/MPN-i(17q) patients were significantly younger, had lower platelet and absolute neutrophil counts, and higher frequency of splenomegaly and circulating blasts. MDS/MPN-i(17q) cases showed frequent bilobed neutrophils (75% vs. 23%; P = 0.03), hypolobated megakaryocytes (62% vs. 20%; P = 0.06), and a higher frequency of SETBP1 (69% vs. 5%; P = 0.002) and SRSF2 (63% vs. 5%; P = 0.006) mutations that were frequently co-existent (44% vs. 0%; P = 0.01). TP53 mutations were rare. The mutation profile of MDS/MPN-U-i(17q) was similar to other myeloid neoplasms with i(17q) including atypical chronic myeloid leukemia, chronic myelomonocytic leukemia, myelodysplastic/myeloproliferative neoplasm with ring sideroblasts and thrombocytosis, myelodysplastic syndrome and acute myeloid leukemia, with frequent concomitant SETBP1/SRSF2 mutations observed across all the diagnostic entities. Over a median follow-up of 52 months, patients with MDS/MPN-i(17q) showed a shorter median overall survival (11 vs. 28 months; P < 0.001). The presence of i(17q) retained independent poor prognostic value in multivariable Cox-regression analysis [HR 3.686 (1.17-11.6); P = 0.026] along with splenomegaly. We suggest that MDS/MPN-i(17q) warrants recognition as a distinct subtype within the MDS/MPN-U category based on its unique clinico-biologic features and uniformly poor prognosis.
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MESH Headings
- Adult
- Biological Products
- Bone Marrow/pathology
- Humans
- Isochromosomes/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/diagnosis
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/pathology
- Mutation
- Retrospective Studies
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Affiliation(s)
| | - Attilio Orazi
- Texas Tech University Health Science Center, El Paso, TX, USA
| | | | | | | | - Eric D Hsi
- Wake Forest Baptist Health, Winston-Salem, NC, USA
| | - Adam Bagg
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Julia Geyer
- Weill Cornell Medical College, New York, NY, USA
| | | | - Kim-Anh Do
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kyle M Devins
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | | | | | - Mark J Routbort
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur Patel
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Srdan Verstovsek
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Sa A Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Tuna M, Amos CI, Mills GB. Whole-chromosome arm acquired uniparental disomy in cancer development is a consequence of isochromosome formation. Neoplasia 2022; 25:9-17. [PMID: 35065533 PMCID: PMC8788198 DOI: 10.1016/j.neo.2021.12.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 01/09/2023]
Abstract
Using SNP-based microarray data from The Cancer Genome Atlas (TCGA), we investigated isochromosomes (deletion of one arm and duplication of the other arm) and related acquired uniparental disomy in 12 tumor types. We observed a high frequency of isochromosomes (25.98%) across all type of tumors except thyroid cancers. The highest frequency of isochromosomes was found in lung squamous cell carcinoma (54.18%). Moreover, whole-chromosome arm acquired uniparental disomy (aUPD) was common in the deleted arms of isochromosomes. These data are consistent with whole-chromosome arm aUPD likely being a consequence of isochromosomes formation. Our findings implicated aUPD as occurring through error-prone DNA repair of a deleted arm or segment of a chromosome that leads to homozygosity for existing alterations. Isochromosomes were significantly more frequent in TP53 mutated samples than wild types in 6 types of tumors with loss of TP53 function potentially contributing to development of isochromosomes. Isochromosomes are common alterations in cancer, and losing one arm of a chromosome could result in duplication of the lost arm. Duplication of the remaining arm leads promulgation of the effects on any defects in the remaining allele, due to subsequent homozygosity.
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Affiliation(s)
- Musaffe Tuna
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza room 100.23D, Houston, TX 77030, USA.
| | - Christopher I Amos
- Department of Medicine, Baylor College of Medicine, One Baylor Plaza room 100.23D, Houston, TX 77030, USA; Institute of Clinical and Translational Medicine, Baylor College of Medicine, USA
| | - Gordon B Mills
- Department of Cell, Developmental & Cancer Biology, School of Medicine, Oregon Health Science University, Portland, OR, USA; Precision Oncology, Knight Cancer Institute, Portland, OR, USA
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6
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Kuendgen A, Kasprzak A, Germing U. Hybrid or Mixed Myelodysplastic/Myeloproliferative Disorders - Epidemiological Features and Overview. Front Oncol 2021; 11:778741. [PMID: 34869027 PMCID: PMC8635204 DOI: 10.3389/fonc.2021.778741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
The WHO-category Myelodysplastic/Myeloproliferative neoplasms (MDS/MPNs) recognizes a unique group of clonal myeloid malignancies exhibiting overlapping features of myelodysplastic as well as myeloproliferative neoplasms. The group consists of chronic myelomonocytic leukemia (CMML), atypical chronic myeloid leukemia, BCR-ABL1-negative (aCML), juvenile myelomonocytic leukemia (JMML), myelodysplastic/myeloproliferative neoplasm with ringed sideroblasts and thrombocytosis (MDS/MPN-RS-T), and myelodysplastic/myeloproliferative neoplasms, unclassifiable (MDS/MPN-U). The most frequent entity in this category is CMML, while all other diseases are extremely rare. Thus, only very limited data on the epidemiology of these subgroups exists. An appropriate diagnosis and classification can be challenging since the diagnosis is still largely based on morphologic criteria and myelodysplastic as well as myeloproliferative features can be found in various occurrences. The diseases in this category share several features that are common in this specific WHO-category, but also exhibit specific traits for each disease. This review summarizes published data on epidemiological features and offers a brief overview of the main diagnostic criteria and clinical characteristics of the five MDS/MPN subgroups.
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Affiliation(s)
- Andrea Kuendgen
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University Hospital Duesseldorf, Duesseldorf, Germany
| | - Annika Kasprzak
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University Hospital Duesseldorf, Duesseldorf, Germany
| | - Ulrich Germing
- Department of Hematology, Oncology, and Clinical Immunology, Heinrich-Heine-University Hospital Duesseldorf, Duesseldorf, Germany
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7
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Shallis RM, Siddon AJ, Zeidan AM. Clinical and Molecular Approach to Adult-Onset, Neoplastic Monocytosis. Curr Hematol Malig Rep 2021; 16:276-285. [PMID: 33890194 DOI: 10.1007/s11899-021-00632-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/01/2021] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW In this review, we provide a comprehensive and contemporary understanding of malignant monocytosis and provide a framework by which the appropriate diagnosis with malignant monocytosis can be rendered. RECENT FINDINGS Increasing data support the use of molecular data to refine the diagnostic approach to persistent monocytosis. The absence of a TET2, SRSF2, or ASXL1 mutation has ≥ 90% negative predictive value for a diagnosis of CMML. These data may also reliably differentiate chronic myelomonocytic leukemia, the malignancy that is most associated with mature monocytosis, from several other diseases that can be associated with typically a lesser degree of monocytosis. These include acute myelomonocytic leukemia, acute myeloid leukemia with monocytic differentiation, myelodysplastic syndromes, and myeloproliferative neoplasms driven by BCR-ABL1, PDGFRA, PDGFRB, or FGFR1 rearrangements or PCM1-JAK2 fusions among other rarer aberrations. The combination of monocyte partitioning with molecular data in patients with persistent monocytosis may increase the predictive power for the ultimate development of CMM but has not been prospectively validated. Many conditions, both benign and malignant, can be associated with an increase in mature circulating monocytes. After reasonably excluding a secondary or reactive monocytosis, there should be a concern for and investigation of malignant monocytosis, which includes hematopathologic review of blood and marrow tissues, flow cytometric analysis, and cytogenetic and molecular studies to arrive at an appropriate diagnosis.
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Affiliation(s)
- Rory M Shallis
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, 333 Cedar Street, PO Box 208028, New Haven, CT, 06520-8028, USA
| | - Alexa J Siddon
- Departments of Laboratory Medicine & Pathology, Yale University, New Haven, CT, USA
| | - Amer M Zeidan
- Section of Hematology, Department of Internal Medicine, Yale University School of Medicine and Yale Cancer Center, 333 Cedar Street, PO Box 208028, New Haven, CT, 06520-8028, USA.
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8
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Koczkodaj D, Muzyka-Kasietczuk J, Chocholska S, Podhorecka M. Prognostic significance of isochromosome 17q in hematologic malignancies. Oncotarget 2021; 12:708-718. [PMID: 33868591 PMCID: PMC8021031 DOI: 10.18632/oncotarget.27914] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 02/19/2021] [Indexed: 11/29/2022] Open
Abstract
Isochromosome 17q [i(17q)] with its two identical long arms is formed by duplication of the q arm and loss of the short p arm. The breakpoint in chromosome 17 that allows the formation of this isochromosome is located at 17p11.2, and the ~240 kb region with its large, palindromic, low-copy repeat sequences are present here. The region is highly unstable and susceptible to a variety of genomic alterations which may be induced by or without toxic agents. One molecular consequence of i(17q) development is the obligatory loss of a single TP53 allele of the tumor suppressor P53 protein located at 17p13.1. Isochromosome 17q is involved in cancer development and progression. It occurs in combination with other chromosomal defects (complex cytogenetics), and rarely as a single mutation. The i(17q) rearrangement has been described as the most common chromosomal aberration in primitive neuroectodermal tumors and medulloblastomas. This isochromosome is also detected in different hematological disorders. In this article, we analyze literature data on the presence of i(17q) in proliferative disorders of the hematopoietic system in the context of its role as a prognostic factor of disease progression. The case reports are added to support the presented data. Currently, there are no indications for the use of specific treatment regimens in the subjects with a presence of the isochromosome 17q. Thus, it is of importance to continue studies on the prognostic role of this abnormality and even single cases should be reported as they may be used for further statistical analyses or meta-analyses.
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Affiliation(s)
- Dorota Koczkodaj
- Department of Cancer Genetics with the Cytogenetic Laboratory, Medical University of Lublin, Lublin, Poland
| | - Justyna Muzyka-Kasietczuk
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Sylwia Chocholska
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
| | - Monika Podhorecka
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, Lublin, Poland
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9
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Sangiorgio VFI, Orazi A, Arber DA. Myelodysplastic/myeloproliferative neoplasms: are morphology and immunophenotyping still relevant? Best Pract Res Clin Haematol 2019; 33:101139. [PMID: 32460987 DOI: 10.1016/j.beha.2019.101139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 01/16/2023]
Abstract
The term myelodysplastic/myeloproliferative neoplasm (MDS/MPN) refers to a group of clonal hematopoietic neoplasms with overlapping clinical, morphologic and genetic myelodysplastic and myeloproliferative features observed at the time of first presentation. Impaired hematopoiesis morphologically associated with evidence of myelodysplasia manifests clinically with cytopenia/s. Simultaneously, myeloproliferation is seen within the bone marrow and leads to cytosis in the peripheral blood. The diagnostic category of MDS/MPN encompasses a heterogeneous group of diseases which share similarities among them, but at the same time have distinct clinical and pathologic features and eventually diverse prognosis; such differences justify their separation in a classification scheme. In the era of genetic and genomic tests, their distinction from conventional myelodysplastic syndromes or myeloproliferative neoplasms still relies on close clinocopathological correlation, with evaluation of both peripheral blood and bone marrow samples being essential in this sense. A multiparametric integration of clinicopathologic data and cytogenetics and molecular genetics results is the preferred diagnostic approach.
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Affiliation(s)
- V F I Sangiorgio
- Department of Cellular Pathology, The Royal London Hospital, London, UK
| | - A Orazi
- Department of Pathology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - D A Arber
- Department of Pathology, University of Chicago, Chicago, IL, USA.
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10
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Ganguly S, Uvodich M, Dias A, McGuirk JP. Clinical characteristics and treatment outcome of patients with isochromosome 17q (i17q) abnormality and myeloid neoplasms: A single center experience. Leuk Res Rep 2019; 10:55-56. [PMID: 30596010 PMCID: PMC6308020 DOI: 10.1016/j.lrr.2018.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 06/16/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Siddhartha Ganguly
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
| | - Mason Uvodich
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
| | - Ajoy Dias
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
| | - Joseph P McGuirk
- Division of Hematological Malignancies and Cellular Therapeutics, University of Kansas Health System, 2330 Shawnee Mission Parkway; Suite 210, Westwood, Kansas 66207, USA
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11
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Kanagal-Shamanna R, Luthra R, Yin CC, Patel KP, Takahashi K, Lu X, Lee J, Zhao C, Stingo F, Zuo Z, Routbort MJ, Singh RR, Fox P, Ravandi F, Garcia-Manero G, Medeiros LJ, Bueso-Ramos CE. Myeloid neoplasms with isolated isochromosome 17q demonstrate a high frequency of mutations in SETBP1, SRSF2, ASXL1 and NRAS. Oncotarget 2017; 7:14251-8. [PMID: 26883102 PMCID: PMC4924712 DOI: 10.18632/oncotarget.7350] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 01/29/2016] [Indexed: 01/08/2023] Open
Abstract
Isolated isochromosome 17q, i(17q), accounts for less than 1% of myeloid neoplasms that are commonly classified as myelodysplastic/myeloproliferative neoplasms, acute myeloid leukemia (AML), myelodysplastic syndrome (MDS) or myeloproliferative neoplasms (MPN). We have shown previously that these cases have distinctive clinicopathologic features, a poor prognosis and absence of TP53 mutations. However, their molecular mutation profile has not been studied. Here, we explored the mutation profile of 32 cases of myeloid neoplasm with isolated i(17q) that included AML, MDS/MPN, MDS and MPN. In addition to the common i(17q), these neoplasms had frequent mutations in SRSF2 (55%), SETBP1 (59%), ASXL1 (55%), and NRAS (31%); TET2 and TP53 mutations were rare. Eight of 28 patients (29%) showed concurrent mutations in ASXL1, SRSF2, SETBP1 and RAS. There was a significant association between mutations in SETBP1 and RAS (p = 0.003). The mutation pattern was independent of the morphologic diagnosis. Sequential analysis of 5 cases showed evolution from a diploid karyotype to i(17q) and that SRSF2 and ASXL1 mutations precede the detection of i(17q) whereas SETBP1 mutations are associated with i(17q).
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Affiliation(s)
- Rashmi Kanagal-Shamanna
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rajyalakshmi Luthra
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Cameron C Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keyur P Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Koichi Takahashi
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xinyan Lu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - John Lee
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Chong Zhao
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Francesco Stingo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Zhuang Zuo
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mark J Routbort
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rajesh R Singh
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Patricia Fox
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Farhad Ravandi
- Department of Statistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Guillermo Garcia-Manero
- Department of Statistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Myeloid Neoplasms with Isolated Isochromosome 17q: a yet to be Defined Entity. Mediterr J Hematol Infect Dis 2017; 9:e2017066. [PMID: 29181143 PMCID: PMC5667532 DOI: 10.4084/mjhid.2017.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/12/2017] [Indexed: 12/30/2022] Open
Abstract
Myeloid neoplasms with isolated isochromosome 17q [MN i(17q)] has been described as a distinct entity with poor prognosis. However, literature reports show a considerable clinical and molecular heterogeneity. We describe a 58-year-old male patient who was diagnosed as refractory anemia with multilineage dysplasia and ringed sideroblasts with isolated i(17q). Though he initially responded well to erythropoietin, he gradually progressed to an aggressive form of MDS/MPN refractory to azacytidine and died 29 months after the first diagnosis. Notably, in contrast to disease advancement, his karyotype reverted to normal, whereas his mutational profile remained unchanged. To our knowledge, this is the first report of karyotype normalization during disease progression in patients with MN i(17q). It suggests that the i(17q) anomaly is dispensable for the leukemic transformation and highlighting the underlying clinical and molecular complexity which both has to be resolved before the establishment of MN with isolated i(17q) as a distinct entity.
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Chronic lymphocytic leukemia with isochromosome 17q: An aggressive subgroup associated with TP53 mutations and complex karyotypes. Cancer Lett 2017; 409:42-48. [PMID: 28888994 DOI: 10.1016/j.canlet.2017.08.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/24/2017] [Accepted: 08/28/2017] [Indexed: 10/18/2022]
Abstract
Although i(17q) [i(17q)] is frequently detected in hematological malignancies, few studies have assessed its clinical role in chronic lymphocytic leukemia (CLL). We recruited a cohort of 22 CLL patients with i(17q) and described their biological characteristics, mutational status of the genes TP53 and IGHV and genomic complexity. Furthermore, we analyzed the impact of the type of cytogenetic anomaly bearing the TP53 defect on the outcome of CLL patients and compared the progression-free survival (PFS) and overall survival (OS) of i(17q) cases with those of a group of 38 CLL patients harboring other 17p aberrations. We detected IGHV somatic hypermutation in all assessed patients, and TP53 mutations were observed in 71.4% of the cases. Patients with i(17q) were more commonly associated with complex karyotypes (CK) and tended to have a poorer OS than patients with other anomalies affecting 17p13 (median OS, 44 vs 120 months, P = 0.084). Regarding chromosomal alterations, significant differences in the median OS were found among groups (P = 0.044). In conclusion, our findings provide new insights regarding i(17q) in CLL and show a subgroup with adverse prognostic features.
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de Mel S, Lee J, Chua C, Chua SP, Gole L, Poon L, Li J, Ng SB, Liu TC, Chng WJ, Chee YL. Isochromosome 17q; A Novel Finding in Myeloid Sarcoma. J Clin Exp Hematop 2017; 56:130-134. [PMID: 27980303 DOI: 10.3960/jslrt.56.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Sanjay de Mel
- Department of Haematology, Oncology, National University Cancer Institute, National University Health System
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Jung M, Pützer S, Gevensleben H, Meller S, Kristiansen G, Dietrich D. Diagnostic and prognostic value of SHOX2 and SEPT9 DNA methylation and cytology in benign, paramalignant, and malignant ascites. Clin Epigenetics 2016; 8:24. [PMID: 26937257 PMCID: PMC4774089 DOI: 10.1186/s13148-016-0192-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/25/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Cytology remains the gold standard for the detection of malignant cells in ascites. However, its sensitivity is limited. The aim of this study was to evaluate DNA methylation biomarkers for the differential diagnosis of benign (ascites in patients without malignancy), malignant (ascites in cancer patients directly caused by malignancy), and paramalignant (ascites in cancer patients caused by comorbidities but not by malignancy) ascites. METHODS A cohort of 283 patients (134 cancer patients, 149 patients with benign diseases) presenting with ascites was prospectively enrolled. Ascites was evaluated by means of cytopathological investigation and DNA methylation of SHOX2 and SEPT9 in the cell-free and cellular fraction. DNA methylation in bisulfite-converted DNA was determined using quantitative methylation specific real-time PCR. Cytopathological and DNA methylation results were evaluated with regard to diagnosis and overall survival (OS). RESULTS Patients with positive DNA methylation had a poor overall survival compared to methylation-negative patients (hazard ratio: HR = 1.97, p = 0.001). In multivariate survival analysis, DNA methylation was an independent prognostic parameter (p = 0.003) together with age (HR = 1.03, p < 0.001) and the presence of malignant disease (HR = 1.87, p < 0.001). The combination of methylation with cytopathological analyses led to a 42 % increase in the detection rate of malignant ascites, resulting in 37 % positively diagnosed cancer patients and a specificity of 97 %. Among cancer patients, patients with DNA methylation-positive ascites showed an adverse clinical course (HR = 1.63, p = 0.039). CONCLUSIONS DNA methylation testing adds diagnostic and prognostic information and might constitute an effective ancillary method for the differential diagnosis of malignant, paramalignant, and benign ascites.
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Affiliation(s)
- Maria Jung
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Svenja Pützer
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Heidrun Gevensleben
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Sebastian Meller
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Glen Kristiansen
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Dimo Dietrich
- Institute of Pathology, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany.,Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
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Meggendorfer M, Haferlach C, Zenger M, Macijewski K, Kern W, Haferlach T. The landscape of myeloid neoplasms with isochromosome 17q discloses a specific mutation profile and is characterized by an accumulation of prognostically adverse molecular markers. Leukemia 2016; 30:1624-7. [DOI: 10.1038/leu.2016.21] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Isochromosome 17q in Chronic Lymphocytic Leukemia. LEUKEMIA RESEARCH AND TREATMENT 2015; 2015:489592. [PMID: 26697230 PMCID: PMC4677221 DOI: 10.1155/2015/489592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 10/21/2015] [Accepted: 11/17/2015] [Indexed: 11/17/2022]
Abstract
In chronic lymphocytic leukemia (CLL), presence of acquired cytogenetic abnormalities may help to estimate prognosis. However, deletion of TP53 gene, which is associated with an aggressive course of the disease and poor prognosis along with a lack of response to treatment, is one of the alterations which may escape cytogenetic diagnoses in CLL. Thus, other techniques have emerged such as interphase fluorescence in situ hybridization (iFISH). Deletion of TP53 may but must not go together with the formation of an isochromosome i(17q); surprisingly this subgroup of patients was not in the focus of CLL studies yet. This study was about if presence of i(17q) could be indicative for a new subgroup in CLL with more adverse prognosis. As a result, TP53 deletion was detected in 18 out of 150 (12%) here studied CLL cases. Six of those cases (~33%) had the TP53 deletion accompanied by an i(17q). Interestingly, the cases with i(17q) showed a tendency towards more associated chromosomal aberrations. These findings may be the bases for follow-up studies in CLL patients with TP53 deletion with and without i(17q); it may be suggested that the i(17q) presents an even more adverse prognostic marker than TP53 deletion alone.
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Visconte V, Tabarroki A, Zhang L, Hasrouni E, Gerace C, Frum R, Ai J, Advani AS, Duong HK, Kalaycio M, Saunthararajah Y, Sekeres MA, His ED, Shetty S, Rogers HJ, Tiu RV. Clinicopathologic and molecular characterization of myeloid neoplasms harboring isochromosome 17(q10). Am J Hematol 2014; 89:862. [PMID: 24796269 DOI: 10.1002/ajh.23755] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Accepted: 04/29/2014] [Indexed: 11/11/2022]
Affiliation(s)
- Valeria Visconte
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Ali Tabarroki
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Li Zhang
- University of California, San Francisco, School of Medicine; Department of Medicine; San Francisco California
| | - Edy Hasrouni
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Chris Gerace
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Robyn Frum
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Jing Ai
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Anjali S. Advani
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Hien K. Duong
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Matt Kalaycio
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Yogen Saunthararajah
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Mikkael A. Sekeres
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
| | - Eric D. His
- Department of Laboratory Medicine; Cleveland Clinic; Cleveland Ohio
| | | | - Heesun J. Rogers
- Department of Laboratory Medicine; Cleveland Clinic; Cleveland Ohio
| | - Ramon V. Tiu
- Department of Translational Hematology and Oncology Research; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
- Leukemia Program, Department of Hematologic Oncology and Blood Disorders; Taussig Cancer Institute, Cleveland Clinic; Cleveland Ohio
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Lindsley RC, Ebert BL. Molecular pathophysiology of myelodysplastic syndromes. ANNUAL REVIEW OF PATHOLOGY-MECHANISMS OF DISEASE 2012; 8:21-47. [PMID: 22934674 DOI: 10.1146/annurev-pathol-011811-132436] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The clinicopathologic heterogeneity of myelodysplastic syndromes (MDS) is driven by diverse, somatically acquired genetic abnormalities. Recent technological advances have enabled the identification of many new mutations, which have implicated novel pathways in MDS pathogenesis, including RNA splicing and epigenetic regulation of gene expression. Molecular abnormalities, either somatic point mutations or chromosomal lesions, can be identified in the vast majority of MDS cases and underlie specific disease phenotypes. As the full array of molecular abnormalities is characterized, genetic variables are likely to complement standard morphologic evaluation in future MDS classification schemes and risk models.
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Affiliation(s)
- R Coleman Lindsley
- Division of Hematology, Brigham and Women's Hospital, Boston, MA 02215, USA
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20
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Kanagal-Shamanna R, Bueso-Ramos CE, Barkoh B, Lu G, Wang S, Garcia-Manero G, Vadhan-Raj S, Hoehn D, Medeiros LJ, Yin CC. Myeloid neoplasms with isolated isochromosome 17q represent a clinicopathologic entity associated with myelodysplastic/myeloproliferative features, a high risk of leukemic transformation, and wild-type TP53. Cancer 2012; 118:2879-88. [PMID: 22038701 DOI: 10.1002/cncr.26537] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 07/18/2011] [Accepted: 08/08/2011] [Indexed: 02/03/2023]
Abstract
BACKGROUND Isolated isochromosome (17q) is a rare cytogenetic abnormality in Philadelphia chromosome-negative myeloid neoplasms, usually myelodysplastic and/or myeloproliferative neoplasms (MDS/MPN). De novo acute myeloid leukemia (AML) with isochromosome 17q has rarely been reported. The frequency of genetic mutations is unknown. METHODS The authors assessed clinicopathologic, immunophenotypic, and molecular genetic features of 22 myeloid neoplasms with isolated isochromosome 17q. RESULTS Fourteen patients presented as MDS/MPN; 8 as de novo AML. Most presented with leukocytosis, anemia, thrombocytopenia, and splenomegaly. Morphologically, all showed myelodysplastic and myeloproliferative features, including pseudo-Pelger-Huet-like neutrophils, micromegakaryocytic hyperplasia, hypercellularity, fibrosis, and osteosclerosis. Blasts were increased (median, 40% in de novo AML; 9% in MDS/MPN). Immunohistochemical assessment of proliferation and apoptosis rates in AML were similar to a matched group without isochromosome 17q. In most patients, isochromosome 17q occurred at time of blast transformation or disease progression. DNA sequencing revealed no mutation in the uninvolved TP53 allele. Mutational analyses showed rare mutations in NRAS (3 of 10), FLT3 (2 of 16), and JAK2 (1 of 18), and no mutations in NPM1 (0 of 15), KIT (0 of 4), and CEBPA (0 of 4). The median overall survival was 14.5 months for de novo AML, and 11.0 months for MDS/MPN. With a median follow-up of 8.5 months (range, 1.5-107 months), 15 died of disease, 6 had persistent disease, and 1 was in remission after bone marrow transplantation. CONCLUSIONS The authors conclude that myeloid neoplasms with isolated isochromosome 17q represent a distinct clinicopathologic entity with myelodysplastic and myeloproliferative features, high risk of leukemic transformation, and wild-type TP53.
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Affiliation(s)
- Rashmi Kanagal-Shamanna
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA
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Vardiman J, Hyjek E. World health organization classification, evaluation, and genetics of the myeloproliferative neoplasm variants. HEMATOLOGY. AMERICAN SOCIETY OF HEMATOLOGY. EDUCATION PROGRAM 2011; 2011:250-256. [PMID: 22160042 DOI: 10.1182/asheducation-2011.1.250] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
There is no single category in the fourth edition (2008) of the World Health Organization (WHO) classification of myeloid neoplasms that encompasses all of the diseases referred to by some authors as the myeloproliferative neoplasm (MPN) "variants." Instead, they are considered as distinct entities and are distributed among various subgroups of myeloid neoplasms in the classification scheme. These relatively uncommon neoplasms do not meet the criteria for any so-called "classical" MPN (chronic myelogenous leukemia, polycythemia vera, primary myelofibrosis, or essential thrombocythemia) and, although some exhibit myelodysplasia, none meets the criteria for any myelodysplastic syndrome (MDS). They are a diverse group of neoplasms ranging from fairly well-characterized disorders such as chronic myelomonocytic leukemia to rare and thus poorly characterized disorders such as chronic neutrophilic leukemia. Recently, however, there has been a surge of information regarding the genetic infrastructure of neoplastic cells in the MPN variants, allowing some to be molecularly defined. Nevertheless, in most cases, correlation of clinical, genetic, and morphologic findings is required for diagnosis and classification. The fourth edition of the WHO classification provides a framework to incorporate those neoplasms in which a genetic abnormality is a major defining criterion of the disease, such as those associated with eosinophilia and abnormalities of PDGFRA, PDGFRB, and FGFR1, as well as for those in which no specific genetic defect has yet been discovered and which remain clinically and pathologically defined. An understanding of the clinical, morphologic, and genetic features of the MPN variants will facilitate their diagnosis.
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Affiliation(s)
- James Vardiman
- Department of Pathology, University of Chicago, Chicago, IL 60637, USA.
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Shao L, Kang SHL, Li J, Hixson P, Taylor J, Yatsenko SA, Shaw CA, Milosavljevic A, Chang CC, Cheung SW, Patel A. Array comparative genomic hybridization detects chromosomal abnormalities in hematological cancers that are not detected by conventional cytogenetics. J Mol Diagn 2010; 12:670-9. [PMID: 20724749 DOI: 10.2353/jmoldx.2010.090192] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Application of array comparative genomic hybridization (aCGH) has allowed an unprecedented high-resolution analysis of cancer genomes. We developed a custom genome-wide oligonucleotide microarray interrogating 493 genes involved in hematological disorders. We analyzed 55 patients with hematological neoplasms by using this microarray. In 33 patients with apparent normal conventional cytogenetic analysis, aneuploidy or isochromosomes were detected in 12% (4 of 33) of the patients by aCGH. The chromosomal changes included trisomy of chromosomes 10, 14, and 15, tetrasomy 11, and isochromosome 17q. In 17 patients with chronic lymphocytic leukemia who were initially investigated by using a panel of standard fluorescence in situ hybridization probes, additional copy number changes that were not interrogated by the fluorescence in situ hybridization (FISH) panel were detected in 47% (8 of 17) of the patients by aCGH. Important copy number changes included gain on 2p16 involving REL and BCL11A genes, rearrangements of chromosomes 8 and 15, and trisomy of chromosomes 19 and 22. In five patients with known abnormal karyotypes, aCGH identified the origin of two marker chromosomes and detected microdeletions at five breakpoints involved in three apparent balanced translocations. Our results suggest that a subset of potentially significant genomic alterations is missed by the currently available cytogenetic techniques. This pilot study clearly demonstrates high sensitivity of oligonucleotide aCGH for potential use in diagnosis and follow-up in patients with hematological neoplasms.
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Affiliation(s)
- Lina Shao
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas 77021-2039, USA
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Kim M, Lee SA, Park HI, Oh EJ, Park CW, Lim J, Han K, Kim Y. Two distinct clonal populations in acute promyelocytic leukemia, one involving chromosome 17 and the other involving an isochromosome 17. ACTA ACUST UNITED AC 2010; 197:185-8. [PMID: 20193853 DOI: 10.1016/j.cancergencyto.2008.08.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2008] [Accepted: 08/22/2008] [Indexed: 11/18/2022]
Abstract
Acute promyelocytic leukemia (APL) is characterized by a t(15;17)(q22;q21) rearrangement. Additional chromosomal rearrangements have been reported in 25-40% of APL patients. The most common abnormality involving chromosome 17 is ider(17). Here we report the case of a patient with APL with isochromosome 17q combined with ider(17), confirmed by fluorescence in situ hybridization. Cytogenetic data strongly suggest that the involvement of chromosomes 15 and 17 in translocation occurs after formation of the isochromosome 17. The case reported here presents the novel finding of two separate clonal events apparently occurring at the same time in an APL patient.
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Affiliation(s)
- Myungshin Kim
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 505 Banpo-dong, Seocho-gu, Seoul, Korea
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Pozdnyakova O, Miron PM, Tang G, Walter O, Raza A, Woda B, Wang SA. Cytogenetic abnormalities in a series of 1,029 patients with primary myelodysplastic syndromes: a report from the US with a focus on some undefined single chromosomal abnormalities. Cancer 2008; 113:3331-40. [PMID: 18988232 DOI: 10.1002/cncr.23977] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Conventional karyotype has an established role in myelodysplastic syndrome (MDS) and is included in the International Prognostic Scoring System (IPSS) for patient risk stratification and treatment selection. Although some chromosomal abnormalities have been well characterized, the significance of several miscellaneous, infrequent, single chromosomal abnormalities remains to be defined. In addition, the emerging therapeutic agents may change the natural course of disease in patients with MDS and the cytogenetic impact on risk stratification. METHODS Clinicopathologic data were retrieved on 1029 patients who had a diagnosis of primary MDS and had available cytogenetic data (karyotype) on file. RESULTS Cytogenetic abnormalities were identified in 458 patients (45%) and occurred most frequently in patients who had refractory anemia with excess blasts (62%). Overall, the 3 cytogenetic risk groups defined by the IPSS -- good, intermediate, and poor -- effectively stratified the patients' overall survival (OS) (64 months, 31 months, and 12 months, respectively; P < .001). With the exception of gain of chromosome 8, single cytogenetic abnormalities within the intermediate group were extremely infrequent in the series but demonstrated variable OS ranging from 10 months for patients who had isochromosome (17q) to 69 months for patients who had deletion of 12p [del(12p)], suggesting different prognostic significance. In the poor cytogenetic risk group, patients with isolated del(7q) and derivative (1;7)(q10;p10) had a significantly better median OS than patients who had either loss of chromosome 7 or a complex karyotype (P < .05). CONCLUSIONS The current data generated from a large cohort of patients with primary MDS indicated that some specific cytogenetic abnormalities carry different risk than their IPSS cytogenetic risk-group assignment, especially in the new treatment era. Because of the extreme low frequency, additional combined studies are needed to better categorize some rare single cytogenetic abnormalities within the intermediate cytogenetic risk group.
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Affiliation(s)
- Olga Pozdnyakova
- Department of Pathology, University of Massachusetts Memorial Medical Center, University of Massachusetts School of Medicine, Worcester, MA, USA
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Nishida H, Ueno H, Park JW, Yano T. Isochromosome i(17q) as a sole cytogenetic abnormality in a case of leukemic transformation from myelodysplastic syndrome (MDS)/myeloproliferative diseases (MPD). Leuk Res 2008; 32:1325-7. [DOI: 10.1016/j.leukres.2007.11.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 11/15/2007] [Accepted: 11/15/2007] [Indexed: 12/21/2022]
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The myelodysplastic/myeloproliferative neoplasms: myeloproliferative diseases with dysplastic features. Leukemia 2008; 22:1308-19. [DOI: 10.1038/leu.2008.119] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Mihara K, Takihara Y, Kimura A. Genetic and epigenetic alterations in myelodysplastic syndrome. Cytogenet Genome Res 2007; 118:297-303. [DOI: 10.1159/000108313] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2006] [Accepted: 11/09/2006] [Indexed: 12/31/2022] Open
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Panani AD, Roussos C. Cytogenetic aspects of adult primary myelodysplastic syndromes: Clinical implications. Cancer Lett 2006; 235:177-90. [PMID: 15935553 DOI: 10.1016/j.canlet.2005.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2005] [Revised: 04/08/2005] [Accepted: 04/11/2005] [Indexed: 01/24/2023]
Abstract
Myelodysplastic syndrome (MDS) is a heterogeneous disease from the clinical, biological and morphological point of view. The pathogenesis of MDS is not well established and it appears to occur complex changes in the stem cell biology. Clonal chromosomal aberrations are found in 30-50% of primary MDS and no specific cytogenetic abnormality has as yet been defined. The chromosomal abnormalities are predominantly characterized by partial/total chromosomal losses or chromosomal gains. These chromosomal abnormalities include mainly -5/del(5q), -7/del(7q), del(11q), del(12p), del(20q), -Y, and +8. The role of cytogenetic analysis in the diagnosis, prognosis, taking treatment decisions and follow up of patients with MDS has been clearly defined. Despite its difficulties in obtaining for analysis high quality metaphases conventional cytogenetics continues to be the basic technique for cytogenetic evaluation of a MDS patient. Other molecular cytogenetic methods have been shown to be complementary, without replacing the information obtained with this technique. Further investigations with both conventional and molecular cytogenetics in relation to clinical features as well as other molecular methods will undoubtedly contribute to improve understanding of the underlying genetic events responsible for the development and evolution of MDS leading to more accurate classification and management of MDS patients.
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Affiliation(s)
- Anna D Panani
- Critical Care Department, Research Unit, Medical School of Athens University, Evangelismos Hospital, Ipsilandou 45-47, Athens 10676, Greece.
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Pinheiro RF, Chauffaille MDLLF, Silva MRR. Isochromosome 17q in MDS: a marker of a distinct entity. ACTA ACUST UNITED AC 2006; 166:189-90. [PMID: 16631479 DOI: 10.1016/j.cancergencyto.2005.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Accepted: 10/18/2005] [Indexed: 11/29/2022]
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Mendrzyk F, Korshunov A, Toedt G, Schwarz F, Korn B, Joos S, Hochhaus A, Schoch C, Lichter P, Radlwimmer B. Isochromosome breakpoints on 17p in medulloblastoma are flanked by different classes of DNA sequence repeats. Genes Chromosomes Cancer 2006; 45:401-10. [PMID: 16419060 DOI: 10.1002/gcc.20304] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Medulloblastoma is a highly malignant embryonal tumor of the cerebellum that accounts for 20%-25% of all intracranial pediatric tumors. The most frequent chromosomal rearrangement in medulloblastoma is isochromosome 17, or i(17q). Its frequency suggests that it serves an important role in tumor pathogenesis, possibly mediated by the disruption or permanent activation of a gene at the breakpoint. To address this question, we performed a detailed analysis of chromosome 17 DNA copy number from 18 medulloblastomas previously shown to carry an apparent i(17q). We identified two breakpoint regions, one well within band 17p11.2 (n = 16) and a second within the pericentromeric region (n = 2). To map the breakpoints more precisely, we constructed a tiling-path matrix-CGH array covering chromosomal band 17p11.2 to the centromere and utilized it to delineate two small breakpoint intervals mapping at Mb 19.0 and 21.7 in seven of the medulloblastomas and in nine hematological neoplasias with i(17q). The former interval contains two breakpoint clusters that each colocalize with a pair of head-to-head inverted DNA sequence repeats, and the latter maps close to a region of alpha-satellite repeats. No consensus coding sequence localizes in these regions. Together, these data strongly suggest that the effects of i(17q) in medulloblastoma are mediated by gene-dosage effects of genes on 17p or 17q rather than by the disruption or deregulation of a "breakpoint" gene. Furthermore, we identified artifacts introduced in DNA copy number data by cross-hybridization of low-copy repeat sequences and discuss the challenge these can pose in the interpretation of diagnostic microarrays.
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Affiliation(s)
- Frank Mendrzyk
- Division of Molecular Genetics, German Cancer Research Center, Heidelberg, Germany
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Bien-Willner GA, Stankiewicz P, Lupski JR, Northup JK, Velagaleti GVN. Interphase FISH screening for the LCR-mediated common rearrangement of isochromosome 17q in primary myelofibrosis. Am J Hematol 2005; 79:309-13. [PMID: 16044457 DOI: 10.1002/ajh.20366] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Non-allelic homologous recombination (NAHR) between low-copy repeats (LCRs) has been implicated recently in somatic rearrangements including isochromosome i(17q), which is associated with hematologic malignancies as well as solid tumors. In hematological malignancies, the most common i(17q) breakpoint results from LCR-mediated NAHR, which creates a dicentric chromosome, idic(17)(p11.2). We report an elderly patient who presented with primary myelofibrosis (MF) with myeloid metaplasia (MMM), associated with idic(17)(p11.2) as the sole chromosomal abnormality, making this the first idic(17)(p11.2) myeloproliferative case reported in which the breakpoints are mapped to the breakpoint cluster region in proximal 17p. The rearrangement breakpoint maps to the previously defined LCR cluster, further suggesting that the genomic architecture of proximal 17p may be responsible for the formation of the majority of i(17q) cases. We describe our development of a rapid screening test using interphase FISH to detect idic(17)(p11.2), discuss the potential prognostic value of this molecular diagnostic test, and examine the relevance of LCR-mediated NAHR to common rearrangements in neoplasms.
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Affiliation(s)
- Gabriel A Bien-Willner
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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Marisavljević D, Rolović Z, Panitić M, Novak A, Djordjević V, Lazarević V, Bosković D, Colović M. [Chromosome 17 abnormalities in patients with primary myelodysplastic syndrome: incidence and biologic significance]. SRP ARK CELOK LEK 2004; 132:10-3. [PMID: 15227958 DOI: 10.2298/sarh0402010m] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Cytogenetic analysis has proven to be a mandatory part of the diagnosis of myelodysplastic syndromes (MDS) as well as a major indicator for predicting clinical course and outcome. Aside from the 5q-syndrome, no specific clinico-cytogenetic entity has been reported. To determine the incidence and clinical significance of acquired abnormalities of chromosome 17 in adult primary MDS, we reviewed the cytogenetic features of 271 patients detected at our institution during a 10-year period. Clonal cytogenetic abnormalities were identified in 109 cases. Among them, abnormalities of chromosome 17 were identified in 13 patients (11.9%). Five patients had "single" defects, while in eight patients abnormalities of chromosome 17 were associated with other chromosomal rearrangements ("complex" defects). After chromosomes 5, 7, 8 and 1, abnormalities of chromosome 17 were the most frequent chromosomal rearrangements in our patients with MDS. Following "single" defects of chromosome 17 were identified: del(17)(p12) in two cases, and i(17)(q10), del(17)(q21;q23) and del(17)(q12;q22) in one case each. Two patients with del(17p), one with RAEB-t and the other one with CMML, had an aggressive course of the disease with accelerated leukemic transformation and short survival. Patient with i(17q) had RARS subtype and died soon after diagnosis, while other two cases with interstitial deletions of the long arm of chromosome 17 had RAEB subtype and stable, no progressive course of the disease. Among "complex" karyotypes with abnormalities of chromosome 17 we identified der(17) in four, monosomy 17 in two, and del(17p) and l(17q) in one case each. Most of these patients transformed to acute leukemia and had very short survival. The results of this study suggest that abnormalities of chromosome 17 are frequent finding in MDS. Loss of genetic material in 17p, both in "single" and "complex" defects, seems to be closely related to poor prognosis of MDS patients.
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Barbouti A, Stankiewicz P, Nusbaum C, Cuomo C, Cook A, Höglund M, Johansson B, Hagemeijer A, Park SS, Mitelman F, Lupski JR, Fioretos T. The breakpoint region of the most common isochromosome, i(17q), in human neoplasia is characterized by a complex genomic architecture with large, palindromic, low-copy repeats. Am J Hum Genet 2004; 74:1-10. [PMID: 14666446 PMCID: PMC1181896 DOI: 10.1086/380648] [Citation(s) in RCA: 99] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2003] [Accepted: 10/07/2003] [Indexed: 11/03/2022] Open
Abstract
Although a great deal of information has accumulated regarding the mechanisms underlying constitutional DNA rearrangements associated with inherited disorders, virtually nothing is known about the molecular processes involved in acquired neoplasia-associated chromosomal rearrangements. Isochromosome 17q, or "i(17q)," is one of the most common structural abnormalities observed in human neoplasms. We previously identified a breakpoint cluster region for i(17q) formation in 17p11.2 and hypothesized that genome architectural features could be responsible for this clustering. To address this hypothesis, we precisely mapped the i(17q) breakpoints in 11 patients with different hematologic malignancies and determined the genomic structure of the involved region. Our results reveal a complex genomic architecture in the i(17q) breakpoint cluster region, characterized by large ( approximately 38-49-kb), palindromic, low-copy repeats, strongly suggesting that somatic rearrangements are not random events but rather reflect susceptibilities due to the genomic structure.
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MESH Headings
- Blast Crisis/genetics
- Chromosome Aberrations
- Chromosomes, Human, Pair 17/genetics
- Genome, Human
- Humans
- Isochromosomes/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Molecular Sequence Data
- Neoplasms/genetics
- Repetitive Sequences, Nucleic Acid
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Affiliation(s)
- Aikaterini Barbouti
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Pawel Stankiewicz
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Chad Nusbaum
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Christina Cuomo
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - April Cook
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Mattias Höglund
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Bertil Johansson
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Anne Hagemeijer
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Sung-Sup Park
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Felix Mitelman
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - James R. Lupski
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Thoas Fioretos
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden; Departments of Molecular and Human Genetics and Pediatrics, Baylor College of Medicine, and Texas Children’s Hospital, Houston; Whitehead Institute for Biomedical Research/Massachusetts Institute of Technology, Center for Genome Research, Cambridge, MA; and Department of Human Genetics, University of Leuven, Leuven, Belgium
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Adeyinka A, Dewald GW. Cytogenetics of chronic myeloproliferative disorders and related myelodysplastic syndromes. Hematol Oncol Clin North Am 2003; 17:1129-49. [PMID: 14560778 DOI: 10.1016/s0889-8588(03)00087-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The only MPD associated with any specific chromosome anomaly is CML, which is linked with t(9;22)(q34;q11.2) or a variant of this anomaly. An association exists for del(13)(q12q14) and CIMF; t(5;12)(q33;p13) and CEL; and del(20q11), +8, and +9 and PV, but these anomalies can be seen in various hematologic malignancies. The most common chromosomal anomalies among MPD in order of frequency are t(9;22)(q34;q11.2), -Y, +8, +9, -7, del(20) (q11q13), del(13)(q12q14), del(5)(q13q33), and del(12)(p12). FISH techniques are useful for MPD to study inadequate bone marrow or blood specimens and to monitor disease status among patients with known chromosome anomalies, but they are not more sensitive than conventional chromosome studies.
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Affiliation(s)
- Adewale Adeyinka
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic Rochester, 200 First Street Southwest, Rochester MN 55905, USA
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36
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Abstract
The classification of myeloid neoplasms now includes CMPD, mixed CMPD/ MDS, MDS, and acute myeloid leukemias. CMPD and CMPD/MDS, both clonal stem cell diseases, share myeloproliferative features, including typical hypercellular marrows, organomegaly, and cell lineage maturation. The CMPD generally differ by which myeloid cell lineage dominates hematopoiesis, and the main diseases include CML, PV, ET, and CIM. The mixed CMPD/MDS disorders also show dysplastic features and variable amounts of effective hematopoiesis; these disorders include CMML, JMML, and atypical CML. Given the overlap in morphology among these diseases, correlation with clinical, hematologic, and cytogenetic/molecular genetic findings is imperative for precise classification.
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Affiliation(s)
- Tracy I George
- Department of Pathology, Stanford University Medical Center, 300 Pasteur Drive, Room H1501B, Stanford, CA 94305-5627, USA.
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37
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Lazarević V, Djordjević V, Magić Z, Marisavljevic D, Colović M. Refractory anemia with ring sideroblasts associated with i(17q) and mutation of the TP53 gene. CANCER GENETICS AND CYTOGENETICS 2002; 136:86-9. [PMID: 12165459 DOI: 10.1016/s0165-4608(02)00510-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A patient with a myelodysplastic syndrome ([MDS], i.e., refractory anemia with ring sideroblasts [RARS]) and a rapidly fatal clinical course is presented. A cytogenetic analysis showed an isochromosome 17q as a sole abnormality in all metaphases. An association between RARS and i(17q) has not been reported. Furthermore, a mutation of the remaining TP53 gene in exon 6 was evidenced by a single strand conformation polymorphism technique. This unique case illustrates heterogeneity of phenotypic expression of a stem cell disorder in MDS and indicates precaution in classifying hematologic syndromes especially when morphology is correlated with specific cytogenetic changes.
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Affiliation(s)
- Vladimir Lazarević
- Institute of Hematology, Clinical Center of Serbia, Koste Todorovića 2, 11000, Belgrade, Serbia.
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38
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Nathan PC, Chun K, Abdelhaleem M, Malkin D. Isochromosome (17)(q10) and translocation (4;12)(q12;p13) in a child with acute myeloid leukemia. CANCER GENETICS AND CYTOGENETICS 2001; 131:82-5. [PMID: 11734325 DOI: 10.1016/s0165-4608(01)00494-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Isochromosome 17q is a commonly observed cytogenetic aberration in hematologic malignancies. Isolated isochromosome 17q usually presents as a marker of a chronic myeloid disorder, with a high propensity for transformation into acute nonlymphoblastic leukemia (ANLL). t(4;12)(q11-12;p13) is a recently described translocation, associated with ANLL, predominantly in adults. In this article, we present a case of acute myeloblastic leukemia (AML) in a 14-year-old female in which i(17q) and t(4;12)(q12;p13) were found in the leukemic clone at diagnosis. We briefly review the literature and hypothesize as to the significance of the coexistence of these cytogenetic changes.
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MESH Headings
- Adolescent
- Chromosome Banding
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 4/genetics
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Isochromosomes/genetics
- Karyotyping
- Leukemia, Myeloid, Acute/drug therapy
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Translocation, Genetic/genetics
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Affiliation(s)
- P C Nathan
- Division of Haematology/Oncology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, 555 University Avenue, M5G 1X8, Toronto, Ontario, Canada
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Abstract
Cytogenetic abnormalities are seen in approximately 50% of cases of myelodysplastic syndrome (MDS) and 80% of cases of secondary MDS (following chemotherapy or radiotherapy). These abnormalities generally consist of partial or complete chromosome deletion or addition (del5q, -7, +8, -Y, del20q), whereas balanced or unbalanced translocations are rarely found in MDS. Fluorescence hybridization techniques (fluorescence in situ hybridization [FISH], multiplex FISH, and spectral karyotyping) are useful in detecting chromosomal anomalies in cases in which few mitoses are obtained or rearrangements are complex. Ras mutations are the molecular abnormalities most frequently found in MDS, followed by p15 gene hypermethylation, FLT3 duplications, and p53 mutations, but none of these abnormalities are specific for MDS. The rare cases of balanced translocations in MDS have allowed the identification of genes whose rearrangements appear to play a role in the pathogenesis of some cases of MDS. These genes include MDS1-EVI1 in t(3;3) or t(3;21) translocations, TEL in t(5;12), HIP1 in t(5;7), MLF1 in t(3;5), and MEL1 in t(1;3). Genes more frequently implicated in the pathogenesis of MDS cases, such as those involving del5q, remain unknown, although some candidate genes are currently being studied. Cytogenetic and known molecular abnormalities generally carry a poor prognosis in MDS and can be incorporated into prognostic scoring systems such as the International Prognostic Scoring System.
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40
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Hernández-Boluda JC, Cervantes F, Costa D, Carrió A, Montserrat E. Blast crisis of Ph-positive chronic myeloid leukemia with isochromosome 17q: report of 12 cases and review of the literature. Leuk Lymphoma 2000; 38:83-90. [PMID: 10811450 DOI: 10.3109/10428190009060321] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Isochromosome 17q [i(17q)] is frequently observed in the blast crisis (BC) of chronic myelogenous leukemia (CML). It has been suggested that this chromosome abnormality is associated with special hematological characteristics of the BC, but the information on this subject is scarce. The clinical, hematological and cytogenetic features of patients with i(17q) were analyzed in a series of 121 patients with BC of Ph-positive CML. Twelve patients (10%) displayed an i(17q), representing the third commonest cytogenetic abnormality, after trisomy 8 and Ph chromosome duplication. In seven of the 12 patients the BC was preceded by an accelerated phase, and 10 had more than 10% blood basophils at BC diagnosis. The blast cells had a myeloid phenotype in the 12 patients. Five patients exhibited cytogenetic abnormalities in addition to i(17q), with trisomy 8 and duplication of the Ph chromosome being the alterations most frequently observed. Median survival of patients with i(17q) was 22 weeks, which was not significantly different from the survival of patients with myeloid BC in the overall series. These results are similar to the findings in 181 patients with i(17q) from 12 series of the literature, and confirm the special hematologic profile of BC of CML with this cytogenetic abnormality.
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Affiliation(s)
- J C Hernández-Boluda
- Department of Hematology and Genetic Service, Hospital Clínic, IDIBAPS, University of Barcelona, Spain
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