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Takahashi K, Nakada D, Goodell M. Distinct landscape and clinical implications of therapy-related clonal hematopoiesis. J Clin Invest 2024; 134:e180069. [PMID: 39352380 PMCID: PMC11444158 DOI: 10.1172/jci180069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2024] Open
Abstract
Therapy-related clonal hematopoiesis (t-CH) is defined as clonal hematopoiesis detected in individuals previously treated with chemotherapy and/or radiation therapy. With the increased use of genetic analysis in oncological care, the detection of t-CH among cancer patients is becoming increasingly common. t-CH arises through the selective bottleneck imposed by chemotherapies and potentially through direct mutagenesis from chemotherapies, resulting in a distinct mutational landscape enriched with mutations in DNA damage-response pathway genes such as TP53, PPM1D, and CHEK2. Emerging evidence sheds light on the mechanisms of t-CH development and potential strategies to mitigate its emergence. Due to its unique characteristics that predominantly affect cancer patients, t-CH has clinical implications distinct from those of CH in the general population. This Review discusses the potential mechanisms of t-CH development, its mutational landscape, mutant-drug relationships, and its clinical significance. We highlight the distinct nature of t-CH and call for intensified research in this field.
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Affiliation(s)
- Koichi Takahashi
- Departments of Leukemia and Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | | | - Margaret Goodell
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, USA
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2
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Tan L, Young SG, Sinclair AH, Hunter MF, Ayers KL. Consider CUX1 variants in children with a variation of sex development: a case report and review of the literature. BMC Med Genomics 2024; 17:195. [PMID: 39103808 PMCID: PMC11299396 DOI: 10.1186/s12920-024-01945-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/21/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND The Cut Homeobox 1 (CUX1) gene has been implicated in a number of developmental processes and has recently emerged as an important cause of developmental delay and impaired intellectual development. Individuals with variants in CUX1 have been described with a variety of co-morbidities including variations in sex development (VSD) although these features have not been closely documented. CASE PRESENTATION The proband is a 14-year-old male who presented with congenital complex hypospadias, neurodevelopmental differences, and subtle dysmorphism. A family history of neurodevelopmental differences and VSD was noted. Microarray testing and whole exome sequencing found the 46,XY proband had a large heterozygous in-frame deletion of exons 4-10 of the CUX1 gene. CONCLUSIONS Our review of the literature has revealed that variants in CUX1 are associated with a range of VSD and suggest this gene should be considered in cases where a VSD is noted at birth, especially if there is a familial history of VSD and/or neurodevelopmental differences. Further work is required to fully investigate the role and regulation of CUX1 in sex development.
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Affiliation(s)
- Lynn Tan
- Monash Genetics, Monash Health, Melbourne, VIC, Australia.
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
| | - Shelley G Young
- The Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Andrew H Sinclair
- The Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
| | - Matthew F Hunter
- Monash Genetics, Monash Health, Melbourne, VIC, Australia
- Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Katie L Ayers
- The Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, The University of Melbourne, Victoria, Australia
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3
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Hatem BA, Jabir FA. The Role of ACE2 Receptor and Its Polymorphisms in COVID-19 Infection and Severity and Its Association with Lipid Profile, Thrombin, and D-Dimer Levels in Iraqi Patients: A Cross-Sectional Study. Biochem Genet 2024:10.1007/s10528-024-10890-7. [PMID: 39085685 DOI: 10.1007/s10528-024-10890-7] [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: 05/27/2023] [Accepted: 01/02/2024] [Indexed: 08/02/2024]
Abstract
COVID-19 patients experience a complex interplay involving ACE2, thrombin, D-dimer, and lipid profile, yet its full understanding remains elusive. ACE2, a pivotal regulator of the renin-angiotensin system and the primary receptor for SARS-CoV-2 undergoes downregulation upon viral binding, potentially leading to severe cases with acute respiratory distress syndrome (ARDS). A specific ACE2 gene polymorphism (rs2285666) may be associated with COVID-19 susceptibility, with the A allele potentially increasing infection risk. COVID-19 disease progression is linked to coagulation abnormalities, but the exact connection with thrombin and D-dimer remains uncertain. A study examining coagulation parameters in COVID-19 patients admitted to Al-Diwania Educational Hospital from February to May 2022 found that thrombin and D-dimer levels were directly related to disease severity. Severe cases exhibited significantly altered coagulation function compared to mild and recovered cases, with notably higher D-dimer levels and elevated thrombin serum concentrations. Moreover, dyslipidemia, particularly low HDL cholesterol, is a prevalent comorbidity in COVID-19 patients and may be linked to worse outcomes. In conclusion, COVID-19 is associated with a prothrombotic state and dysregulation of the renin-angiotensin system due to ACE2 downregulation following viral binding. The intricate interplay between ACE2, thrombin, D-dimer, and lipid profile necessitates further investigation. The multifaceted nature of the disease demands continued research to unravel its pathogenesis and identify potential therapeutic targets.
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Affiliation(s)
- Ban Adnan Hatem
- Chemistry Department, College of Science, Al-Qadisiyah University, Al Diwaniyah, Iraq.
| | - Ferdous A Jabir
- Biochemistry Department, College of Medicine, Al-Qadisiyah University, Al Diwaniyah, Iraq
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Kaur A, Rojek AE, Symes E, Nawas MT, Patel AA, Patel JL, Sojitra P, Aqil B, Sukhanova M, McNerney ME, Wu LP, Akmatbekov A, Segal J, Tjota MY, Gurbuxani S, Cheng JX, Yeon SY, Ravisankar HV, Fitzpatrick C, Lager A, Drazer MW, Saygin C, Wanjari P, Katsonis P, Lichtarge O, Churpek JE, Ghosh SB, Patel AB, Menon MP, Arber DA, Wang P, Venkataraman G. Real world predictors of response and 24-month survival in high-grade TP53-mutated myeloid neoplasms. Blood Cancer J 2024; 14:99. [PMID: 38890297 PMCID: PMC11189545 DOI: 10.1038/s41408-024-01077-9] [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: 04/08/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024] Open
Abstract
Current therapies for high-grade TP53-mutated myeloid neoplasms (≥10% blasts) do not offer a meaningful survival benefit except allogeneic stem cell transplantation in the minority who achieve a complete response to first line therapy (CR1). To identify reliable pre-therapy predictors of complete response to first-line therapy (CR1) and outcomes, we assembled a cohort of 242 individuals with TP53-mutated myeloid neoplasms and ≥10% blasts with well-annotated clinical, molecular and pathology data. Key outcomes examined were CR1 & 24-month survival (OS24). In this elderly cohort (median age 68.2 years) with 74.0% receiving frontline non-intensive regimens (hypomethylating agents +/- venetoclax), the overall cohort CR1 rate was 25.6% (50/195). We additionally identified several pre-therapy factors predictive of inferior CR1 including male gender (P = 0.026), ≥2 autosomal monosomies (P < 0.001), -17/17p (P = 0.011), multi-hit TP53 allelic state (P < 0.001) and CUX1 co-alterations (P = 0.010). In univariable analysis of the entire cohort, inferior OS24 was predicated by ≥2 monosomies (P = 0.004), TP53 VAF > 25% (P = 0.002), TP53 splice junction mutations (P = 0.007) and antecedent treated myeloid neoplasm (P = 0.001). In addition, mutations/deletions in CUX1, U2AF1, EZH2, TET2, CBL, or KRAS ('EPI6' signature) predicted inferior OS24 (HR = 2.0 [1.5-2.8]; P < 0.0001). In a subgroup analysis of HMA +/-Ven treated individuals (N = 144), TP53 VAF and monosomies did not impact OS24. A risk score for HMA +/-Ven treated individuals incorporating three pre-therapy predictors including TP53 splice junction mutations, EPI6 and antecedent treated myeloid neoplasm stratified 3 prognostic distinct groups: intermediate, intermediate-poor, and poor with significantly different median (12.8, 6.0, 4.3 months) and 24-month (20.9%, 5.7%, 0.5%) survival (P < 0.0001). For the first time, in a seemingly monolithic high-risk cohort, our data identifies several baseline factors that predict response and 24-month survival.
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Affiliation(s)
- Amandeep Kaur
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Alexandra E Rojek
- Hematology/Oncology Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Emily Symes
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Mariam T Nawas
- Hematology/Oncology Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Anand A Patel
- Hematology/Oncology Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Jay L Patel
- Departments of Pathology and Hematology/Oncology, University of Utah/ARUP, Salt Lake City, UT, USA
| | - Payal Sojitra
- Department of Pathology, Rutgers Robert Wood Johnson Medical School New Brunswick NJ, New Brunswick, NJ, USA
| | - Barina Aqil
- Department of Pathology, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Madina Sukhanova
- Department of Pathology, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Megan E McNerney
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Leo P Wu
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Aibek Akmatbekov
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Jeremy Segal
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Melissa Y Tjota
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Sandeep Gurbuxani
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Jason X Cheng
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Su-Yeon Yeon
- Department of Pathology, University of Illinois, Chicago, IL, USA
| | - Harini V Ravisankar
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Carrie Fitzpatrick
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Angela Lager
- Hematology/Oncology Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Michael W Drazer
- Hematology/Oncology Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Caner Saygin
- Hematology/Oncology Department of Medicine, University of Chicago Medicine, Chicago, IL, USA
| | - Pankhuri Wanjari
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | | | - Olivier Lichtarge
- Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Jane E Churpek
- Division of Hematology, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Sharmila B Ghosh
- Department of Pathology, Henry Ford Health Systems, Detroit, MI, USA
| | - Ami B Patel
- Departments of Pathology and Hematology/Oncology, University of Utah/ARUP, Salt Lake City, UT, USA
| | - Madhu P Menon
- Departments of Pathology and Hematology/Oncology, University of Utah/ARUP, Salt Lake City, UT, USA
| | - Daniel A Arber
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Peng Wang
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA
| | - Girish Venkataraman
- Department of Pathology, Sections of Hematopathology and Genomic Pathology, University of Chicago Medicine, Chicago, IL, USA.
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5
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Hall T, Gurbuxani S, Crispino JD. Malignant progression of preleukemic disorders. Blood 2024; 143:2245-2255. [PMID: 38498034 PMCID: PMC11181356 DOI: 10.1182/blood.2023020817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/23/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
ABSTRACT The spectrum of myeloid disorders ranges from aplastic bone marrow failure characterized by an empty bone marrow completely lacking in hematopoiesis to acute myeloid leukemia in which the marrow space is replaced by undifferentiated leukemic blasts. Recent advances in the capacity to sequence bulk tumor population as well as at a single-cell level has provided significant insight into the stepwise process of transformation to acute myeloid leukemia. Using models of progression in the context of germ line predisposition (trisomy 21, GATA2 deficiency, and SAMD9/9L syndrome), premalignant states (clonal hematopoiesis and clonal cytopenia of unknown significance), and myelodysplastic syndrome, we review the mechanisms of progression focusing on the hierarchy of clonal mutation and potential roles of transcription factor alterations, splicing factor mutations, and the bone marrow environment in progression to acute myeloid leukemia. Despite major advances in our understanding, preventing the progression of these disorders or treating them at the acute leukemia phase remains a major area of unmet medical need.
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Affiliation(s)
- Trent Hall
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN
| | - Sandeep Gurbuxani
- Section of Hematopathology, Department of Pathology, University of Chicago, Chicago, IL
| | - John D. Crispino
- Department of Hematology, St. Jude Children’s Research Hospital, Memphis, TN
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6
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Liu W, Kurkewich JL, Stoddart A, Khan S, Anandan D, Gaubil AN, Wolfgeher DJ, Jueng L, Kron SJ, McNerney ME. CUX1 regulates human hematopoietic stem cell chromatin accessibility via the BAF complex. Cell Rep 2024; 43:114227. [PMID: 38735044 PMCID: PMC11163479 DOI: 10.1016/j.celrep.2024.114227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/16/2024] [Accepted: 04/26/2024] [Indexed: 05/14/2024] Open
Abstract
CUX1 is a homeodomain-containing transcription factor that is essential for the development and differentiation of multiple tissues. CUX1 is recurrently mutated or deleted in cancer, particularly in myeloid malignancies. However, the mechanism by which CUX1 regulates gene expression and differentiation remains poorly understood, creating a barrier to understanding the tumor-suppressive functions of CUX1. Here, we demonstrate that CUX1 directs the BAF chromatin remodeling complex to DNA to increase chromatin accessibility in hematopoietic cells. CUX1 preferentially regulates lineage-specific enhancers, and CUX1 target genes are predictive of cell fate in vivo. These data indicate that CUX1 regulates hematopoietic lineage commitment and homeostasis via pioneer factor activity, and CUX1 deficiency disrupts these processes in stem and progenitor cells, facilitating transformation.
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Affiliation(s)
- Weihan Liu
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA; Committee on Cancer Biology, The University of Chicago, Chicago, IL 60637, USA
| | | | - Angela Stoddart
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA
| | - Saira Khan
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA
| | - Dhivyaa Anandan
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA
| | - Alexandre N Gaubil
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA
| | - Donald J Wolfgeher
- Department of Molecular Genetics and Cell Biology, The University of Chicago, Chicago, IL 60637, USA
| | - Lia Jueng
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA
| | - Stephen J Kron
- The University of Chicago Medicine Comprehensive Cancer Center, The University of Chicago, Chicago, IL 60637, USA; Committee on Cancer Biology, The University of Chicago, Chicago, IL 60637, USA; Department of Molecular Genetics and Cell Biology, The University of Chicago, Chicago, IL 60637, USA
| | - Megan E McNerney
- Department of Pathology, The University of Chicago, Chicago, IL 60637, USA; The University of Chicago Medicine Comprehensive Cancer Center, The University of Chicago, Chicago, IL 60637, USA; Committee on Cancer Biology, The University of Chicago, Chicago, IL 60637, USA; Department of Pediatrics, Section of Hematology/Oncology, The University of Chicago, Chicago, IL 60637, USA.
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7
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Wong JC, Weinfurtner KM, Westover T, Kim J, Lebish EJ, Del Pilar Alzamora M, Huang BJ, Walsh M, Abdelhamed S, Ma J, Klco JM, Shannon K. 5G2 mutant mice model loss of a commonly deleted segment of chromosome 7q22 in myeloid malignancies. Leukemia 2024; 38:1182-1186. [PMID: 38443608 DOI: 10.1038/s41375-024-02205-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/07/2024]
Abstract
Monosomy 7 and del(7q) are among the most common and poorly understood genetic alterations in myelodysplastic neoplasms and acute myeloid leukemia. Chromosome band 7q22 is a minimally deleted segment in myeloid malignancies with a del(7q). However, the rarity of "second hit" mutations supports the idea that del(7q22) represents a contiguous gene syndrome. We generated mice harboring a 1.5 Mb germline deletion of chromosome band 5G2 syntenic to human 7q22 that removes Cux1 and 27 additional genes. Hematopoiesis is perturbed in 5G2+/del mice but they do not spontaneously develop hematologic disease. Whereas alkylator exposure modestly accelerated tumor development, the 5G2 deletion did not cooperate with KrasG12D, NrasG12D, or the MOL4070LTR retrovirus in leukemogenesis. 5G2+/del mice are a novel platform for interrogating the role of hemopoietic stem cell attrition/stress, cooperating mutations, genotoxins, and inflammation in myeloid malignancies characterized by monosomy 7/del(7q).
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Affiliation(s)
- Jasmine C Wong
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | | | - Tamara Westover
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jangkyung Kim
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Eric J Lebish
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | | | - Benjamin J Huang
- Department of Pediatrics, University of California, San Francisco, CA, USA
| | - Michael Walsh
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sherif Abdelhamed
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jing Ma
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jeffery M Klco
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Kevin Shannon
- Department of Pediatrics, University of California, San Francisco, CA, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
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8
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Martinez TC, McNerney ME. Haploinsufficient Transcription Factors in Myeloid Neoplasms. ANNUAL REVIEW OF PATHOLOGY 2024; 19:571-598. [PMID: 37906947 DOI: 10.1146/annurev-pathmechdis-051222-013421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Many transcription factors (TFs) function as tumor suppressor genes with heterozygous phenotypes, yet haploinsufficiency generally has an underappreciated role in neoplasia. This is no less true in myeloid cells, which are normally regulated by a delicately balanced and interconnected transcriptional network. Detailed understanding of TF dose in this circuitry sheds light on the leukemic transcriptome. In this review, we discuss the emerging features of haploinsufficient transcription factors (HITFs). We posit that: (a) monoallelic and biallelic losses can have distinct cellular outcomes; (b) the activity of a TF exists in a greater range than the traditional Mendelian genetic doses; and (c) how a TF is deleted or mutated impacts the cellular phenotype. The net effect of a HITF is a myeloid differentiation block and increased intercellular heterogeneity in the course of myeloid neoplasia.
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Affiliation(s)
- Tanner C Martinez
- Department of Pathology, Department of Pediatrics, Section of Hematology/Oncology, The University of Chicago Medicine Comprehensive Cancer Center, The University of Chicago, Chicago, Illinois, USA;
- Medical Scientist Training Program, The University of Chicago, Chicago, Illinois, USA
| | - Megan E McNerney
- Department of Pathology, Department of Pediatrics, Section of Hematology/Oncology, The University of Chicago Medicine Comprehensive Cancer Center, The University of Chicago, Chicago, Illinois, USA;
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9
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An N, Khan S, Imgruet MK, Jueng L, Gurbuxani S, McNerney ME. Oncogenic RAS promotes leukemic transformation of CUX1-deficient cells. Oncogene 2023; 42:881-893. [PMID: 36725889 PMCID: PMC10068965 DOI: 10.1038/s41388-023-02612-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/03/2023]
Abstract
-7/del(7q) is prevalent across subtypes of myeloid neoplasms. CUX1, located on 7q22, encodes a homeodomain-containing transcription factor, and, like -7/del(7q), CUX1 inactivating mutations independently carry a poor prognosis. As with loss of 7q, CUX1 mutations often occur early in disease pathogenesis. We reported that CUX1 deficiency causes myelodysplastic syndrome in mice but was insufficient to drive acute myeloid leukemia (AML). Given the known association between -7/del(7q) and RAS pathway mutations, we mined cancer genome databases and explicitly linked CUX1 mutations with oncogenic RAS mutations. To determine if activated RAS and CUX1 deficiency promote leukemogenesis, we generated mice bearing NrasG12D and CUX1-knockdown which developed AML, not seen in mice with either mutation alone. Oncogenic RAS imparts increased self-renewal on CUX1-deficient hematopoietic stem/progenitor cells (HSPCs). Reciprocally, CUX1 knockdown amplifies RAS signaling through reduction of negative regulators of RAS/PI3K signaling. Double mutant HSPCs were responsive to PIK3 or MEK inhibition. Similarly, low expression of CUX1 in primary AML samples correlates with sensitivity to the same inhibitors, suggesting a potential therapy for malignancies with CUX1 inactivation. This work demonstrates an unexpected convergence of an oncogene and tumor suppressor gene on the same pathway.
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Affiliation(s)
- Ningfei An
- Department of Pathology, The University of Chicago, Chicago, IL, USA
- Department of Pediatrics, Hematology/Oncology, The University of Chicago, Chicago, IL, USA
| | - Saira Khan
- Department of Pathology, The University of Chicago, Chicago, IL, USA
- Department of Pediatrics, Hematology/Oncology, The University of Chicago, Chicago, IL, USA
| | - Molly K Imgruet
- Department of Pathology, The University of Chicago, Chicago, IL, USA
- The University of Chicago Medicine Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA
| | - Lia Jueng
- Department of Pathology, The University of Chicago, Chicago, IL, USA
- Department of Pediatrics, Hematology/Oncology, The University of Chicago, Chicago, IL, USA
| | - Sandeep Gurbuxani
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| | - Megan E McNerney
- Department of Pathology, The University of Chicago, Chicago, IL, USA.
- Department of Pediatrics, Hematology/Oncology, The University of Chicago, Chicago, IL, USA.
- The University of Chicago Medicine Comprehensive Cancer Center, The University of Chicago, Chicago, IL, USA.
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10
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Chen L, Ge M, Huo J, Ren X, Shao Y, Li X, Huang J, Wang M, Nie N, Zhang J, Peng J, Zheng Y. Association between human leukocyte antigen and immunosuppressive treatment outcomes in Chinese patients with aplastic anemia. Front Immunol 2023; 14:1056381. [PMID: 36793734 PMCID: PMC9923019 DOI: 10.3389/fimmu.2023.1056381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023] Open
Abstract
Background Activated cytotoxic T cells (CTLs) recognize the auto-antigens presented on hematopoietic stem/progenitor cells (HSPCs) through class I human leukocyte antigen (HLA) molecules and play an important role in the immune pathogenesis of aplastic anemia (AA). Previous reports demonstrated that HLA was related to the disease susceptibility and response to immunosuppressive therapy (IST) in AA patients. Recent studies have indicated that specific HLA allele deletions, which helped AA patients to evade CTL-driven autoimmune responses and escape from immune surveillance, may lead to high-risk clonal evolution. Therefore, HLA genotyping has a particular predictive value for the response to IST and the risk of clonal evolution. However, there are limited studies on this topic in the Chinese population. Methods To explore the value of HLA genotyping in Chinese patients with AA, 95 AA patients treated with IST were retrospectively investigated. Results The alleles HLA-B*15:18 and HLA-C*04:01 were associated with a superior long-term response to IST (P = 0.025; P = 0.027, respectively), while the allele HLA-B*40:01 indicated an inferior result (P = 0.02). The allele HLA-A*01:01 and HLA-B*54:01 were associated with high-risk clonal evolution (P = 0.032; P = 0.01, respectively), and the former had a higher frequency in very severe AA (VSAA) patients than that in severe AA (SAA) patients (12.7% vs 0%, P = 0.02). The HLA-DQ*03:03 and HLA-DR*09:01 alleles were associated with high-risk clonal evolution and poor long-term survival in patients aged ≥40 years. Such patients may be recommended for early allogeneic hematopoietic stem cell transplantation rather than the routine IST treatment. Conclusion HLA genotype has crucial value in predicting the outcome of IST and long-term survival in AA patients, and thus may assist an individualized treatment strategy.
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Affiliation(s)
| | - Meili Ge
- *Correspondence: Meili Ge, ; Yizhou Zheng,
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