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Mehra S, Taylor J. The clonal hydra: neoantigen-specific T-cell response in germ cell tumors. Haematologica 2024; 109:2038-2040. [PMID: 38268457 PMCID: PMC11215347 DOI: 10.3324/haematol.2023.284862] [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: 01/09/2024] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
Not available.
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2
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Zalewski K, Cantor E, Chu R, Mody R, Yanik G, Sedig L. Concurrent primary mediastinal germ cell tumor and acute myeloid leukemia: Case report of sustained remission and review of the literature. Pediatr Blood Cancer 2024; 71:e31012. [PMID: 38616378 DOI: 10.1002/pbc.31012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/22/2024] [Accepted: 03/27/2024] [Indexed: 04/16/2024]
MESH Headings
- Humans
- Male
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Leukemia, Myeloid, Acute/drug therapy
- Mediastinal Neoplasms/pathology
- Mediastinal Neoplasms/therapy
- Mediastinal Neoplasms/drug therapy
- Neoplasms, Germ Cell and Embryonal/pathology
- Neoplasms, Germ Cell and Embryonal/therapy
- Neoplasms, Germ Cell and Embryonal/drug therapy
- Neoplasms, Multiple Primary/pathology
- Neoplasms, Multiple Primary/therapy
- Remission Induction
- Adolescent
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Affiliation(s)
- Kristina Zalewski
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Evan Cantor
- Division of Hematology and Oncology, Connecticut Children's Medical Center, Hartford, Connecticut, USA
- Department of Pediatrics, UCONN School of Medicine, Farmington, Connecticut, USA
| | - Roland Chu
- Department of Hematology and Oncology, Central Michigan University College of Medicine, Mount Pleasant, Michigan, USA
- Department of Hematology and Oncology, Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Rajen Mody
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
- Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Greg Yanik
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
- Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Laura Sedig
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
- Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan, USA
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3
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Genoud V, Dutoit V, Thang NNT, Janowczyk A, McKee T, Chalandon Y, Tsantoulis P, Dietrich PY. Neoantigen-specific T-cell response after donor lymphocyte infusion associates with favorable outcome in a patient with i(12p) germ cell tumor, acute leukemia and sarcoma of the same clonal origin. Haematologica 2024; 109:2364-2367. [PMID: 38186348 PMCID: PMC11215358 DOI: 10.3324/haematol.2023.284318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/27/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
| | - Valérie Dutoit
- Laboratory of tumor immunology, Faculty of Medicine and Centre for Translational Research in Onco-Hematology, University of Geneva, Switzerland; Swiss Cancer Centre Léman
| | | | | | - Thomas McKee
- Swiss Cancer Centre Léman, Switzerland; Clinical Pathology Service, Geneva University Hospital, Geneva
| | - Yves Chalandon
- Departement of oncology, Geneva University Hospital, Geneva, Switzerland; Swiss Cancer Centre Léman
| | - Petros Tsantoulis
- Departement of oncology, Geneva University Hospital, Geneva, Switzerland; Swiss Cancer Centre Léman
| | - Pierre-Yves Dietrich
- Departement of oncology, Geneva University Hospital, Geneva, Switzerland; Laboratory of tumor immunology, Faculty of Medicine and Centre for Translational Research in Onco-Hematology, University of Geneva, Switzerland; Swiss Cancer Centre Léman.
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4
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Ozgun G, Nichols C, Kollmannsberger C, Nappi L. Genomic features of mediastinal germ cell tumors: a narrative review. MEDIASTINUM (HONG KONG, CHINA) 2022; 6:34. [PMID: 36582975 PMCID: PMC9792832 DOI: 10.21037/med-22-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Germ cell tumors (GCTs) are uncommon malignancies generally originating from gonads. However, about 5% of GCTs arise outside the gonad (extragonadal), of which 80% develop from the mediastinum. While the prognosis of seminomas is not affected by the gonadal or extragonadal primary location, the prognosis of nonseminoma primary mediastinal GCTs (NS-PMGCTs) is poor, compared to its gonadal counterpart with an estimated 5-year overall survival of about 50%. The current treatments are sub-optimal to increase the cure rate of these rare GCTs. Therefore, molecular insights into these tumors would be valuable to develop novel therapies. The main objective of this review is to describe and dissect the genomic features associated with primary mediastinal GCTs (PMGCTs), highlighting the more frequent genomic alterations and their correlation with clinical outcomes. METHODS We conducted a narrative review of the English literature available in PubMed and Google Scholar between 1982 and 2021, including meta-analyses, systematic reviews, case series and case reports regarding the genomic and clinical features of PMGCTs. We analyzed the available data to describe the molecular characteristics of PMGCTs compared to testicular GCTs (TGCTs), highlighting the most relevant biological and prognostic factors. KEY CONTENT AND FINDINGS The high percentage of platinum resistance, the unique association with hematologic malignancies (HMs) and other malignancies, the higher prevalence of P53 mutations, and a distinct genomic landscape characterize this rare disease. CONCLUSIONS Although some studies have unveiled recurrent molecular alterations in PMGCTs, few are particularly suitable for targeted therapy. Due to the rarity of PMGCTs, data sharing and the creation of an international consortium would be helpful to have a better understanding of the molecular drivers of these tumors.
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Affiliation(s)
- Guliz Ozgun
- Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, British Columbia, Canada
| | | | | | - Lucia Nappi
- Vancouver Prostate Centre, Department of Urologic Sciences, University of British Columbia, British Columbia, Canada
- Department of Medical Oncology, BC Cancer, British Columbia, Canada
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Wang H, Chen Y, Lin H, Ni W, Zhang Q, Lan J, Jin L. Acute Mast Cell Leukemia Preceded by Malignant Mediastinal Germ Cell Tumor: A Case Report and Literature Review. Cancer Manag Res 2022; 14:1783-1794. [PMID: 35637940 PMCID: PMC9148177 DOI: 10.2147/cmar.s363508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background Case Presentation Conclusion
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Affiliation(s)
- Huafang Wang
- Cancer Center, Department of Hematology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Yuan Chen
- Cancer Center, Department of Pathology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Huijun Lin
- Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Wanmao Ni
- Cancer Center, Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Qiaolei Zhang
- Department of Hematology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, Zhejiang, 310022, People’s Republic of China
| | - Jianping Lan
- Cancer Center, Department of Hematology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China
| | - Lai Jin
- Cancer Center, Department of Hematology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China
- Correspondence: Lai Jin; Jianping Lan, Cancer Center, Department of Hematology, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), No. 158 Shangtang Road, Hangzhou, Zhejiang, 310014, People’s Republic of China, Tel +86-571-85893497, Email ;
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Fang H, Toruner GA, Tang Z, Tang G, Weissferdt A, Tashakori M, El Hussein S, Thakral B, Quesada AE, Wang W, Patel KP, Garcia-Manero G, Medeiros LJ, Bueso-Ramos CE, Jelloul FZ. Primary mediastinal germ cell tumor and clonally related and unique hematologic neoplasms with i(12p) and TP53 mutation: A report of two cases. Ann Diagn Pathol 2022; 59:151951. [DOI: 10.1016/j.anndiagpath.2022.151951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/14/2022] [Indexed: 11/01/2022]
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7
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Pini GM, Colecchia M. Mediastinal germ cell tumors: a narrative review of their traits and aggressiveness features. MEDIASTINUM (HONG KONG, CHINA) 2022; 6:5. [PMID: 35340833 PMCID: PMC8841550 DOI: 10.21037/med-21-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 08/06/2021] [Indexed: 05/25/2023]
Abstract
OBJECTIVE Mediastinal extragonadal germ-cell tumors (MEGCTs) are rare neoplasms with a multifaceted clinical behavior. This paper is devoted to review their main characteristics, including histological patterns and different factors of aggressiveness in MEGCTs. Proper understanding of the latter can help to better stratify patients' prognoses and improve clinical management. BACKGROUND Different theories exist on the origin of MEGCTs, including primordial germ cells deposition during embryogenesis. MEGCTs predominantly affects young males and aggressiveness follows the ability of local and systemic spread of each germ-cell neoplasia subtype, as well as their distinct responsiveness to therapy. Indeed, non-seminomatous MEGCTs have a worse prognosis. Unfortunately, they are also more frequent than seminomas in the mediastinum. Regardless of histological type, local aggressiveness can follow tumoral expansion with compression on or infiltration of mediastinal structures. Chemotherapy can be effective in reducing neoplastic volume, but different levels of sensitivity can be found in different MGCTs. In particular, a chemo-resistant teratoma component of a mixed MEGCTs can undergo a paradoxical enlargement after chemotherapy, while other components of the tumor regress. This is reflected by a concomitant normalization of serum tumoral markers and cardiopulmonary deterioration due to compression. Such clinical phenomenon, called growing-teratoma syndrome (GTS), requires a prompt surgical approach. METHODS A literature research of pertinent epidemiological, pathological and clinical articles was conducted. CONCLUSION The mediastinum can harbor different kinds of neoplasia, including GCTs. The full spectrum of MEGCTs includes a variety of tumors with different clinical behaviors. Aggressiveness follows the inherent ability of local and systemic spread of each neoplastic type, as well as their distinct responsiveness to therapy.
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Affiliation(s)
- Giacomo M. Pini
- Department of Medicine and Surgery, Unit of Pathology, University of Insubria, Varese, Italy
| | - Maurizio Colecchia
- Department of Pathology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
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8
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Primary Mediastinal and Testicular Germ Cell Tumors in Adolescents and Adults: A Comparison of Genomic Alterations and Clinical Implications. Cancers (Basel) 2021; 13:cancers13205223. [PMID: 34680371 PMCID: PMC8533956 DOI: 10.3390/cancers13205223] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/11/2021] [Accepted: 10/14/2021] [Indexed: 11/28/2022] Open
Abstract
Simple Summary The germ cell tumors (GCTs) family is a heterogeneous group of neoplasms that includes tumors affecting testis (TGCTs) and rarer cases occurring in extragonadal sites. Mediastinal germ cell tumors (MGCTs) are more aggressive and have poorer prognosis. Due to their rarity of MGCTs, few molecular and clinical studies are reported. MGCTs share biological similarities with TGCT, and international guidelines recommend use of the same therapies validated for TGCT. However, while high response rate is achieved in TGCT, MGCT tend to be resistant to therapy. This review resumes all molecular findings reported in MGCTs, summarizing molecular characteristics common with TGCT and highlighting the different molecular alterations that characterize mediastinal tumors. A deeper understanding of the MGCT biology will help in clinical management of these patients. Abstract Mediastinal germ cell tumors (MGCTs) share histologic, molecular and biomarkers features with testicular GCTs; however, nonseminomatous MGCTs are usually more aggressive and have poorer prognosis than nonseminomatous TGCTs. Most nonseminomatous MGCT cases show early resistance to platinum-based therapies and seldom have been associated with the onset of one or more concomitant somatic malignancies, in particular myeloid neoplasms with recent findings supporting a common, shared genetic precursor with the primary MGCT. Genomic, transcriptomic and epigenetic features of testicular GCTs have been extensively studied, allowing for the understanding of GCT development and transformation of seminomatous and nonseminomatous histologies. However, MGCTs are still lacking proper multi-omics analysis and only few data are reported in the literature. Understanding of the mechanism involved in the development, in the progression and in their higher resistance to common therapies is still poorly understood. With this review, we aim to collect all molecular findings reported in this rare disease, resuming the similarities and disparities with the gonadal counterparts.
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Ichikawa S, Fujiwara T, Saito K, Sakurai K, Inokura K, Fukuhara N, Yokoyama H, Onodera K, Onishi Y, Kameoka J, Harigae H. Salvage Cord Blood Transplantation for Sustained Remission of Acute Megakaryoblastic Leukemia That Relapsed Early after Myeloablative Transplantation. Intern Med 2021; 60:3015-3019. [PMID: 33814495 PMCID: PMC8502674 DOI: 10.2169/internalmedicine.6796-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Acute megakaryoblastic leukemia (AMKL) is a rare subtype of acute myeloid leukemia accompanied by an aggressive clinical course and dismal prognosis. We herein report a case of AMKL preceded by mediastinal germ cell tumor that relapsed early after allogeneic hematopoietic stem cell transplantation with myeloablative conditioning but was successfully treated using salvage cord blood transplantation (CBT) with reduced-intensity conditioning. Although several serious complications developed, sustained remission with a favorable general condition was ultimately achieved. Although an optimal therapeutic strategy remains to be established, the graft-versus-leukemia effect of CBT may be promising, even for the treatment of refractory AMKL.
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Affiliation(s)
| | - Tohru Fujiwara
- Department of Hematology, Tohoku University Hospital, Japan
| | - Kei Saito
- Department of Hematology, Tohoku University Hospital, Japan
| | - Kazuki Sakurai
- Department of Hematology, Tohoku University Hospital, Japan
| | - Kyoko Inokura
- Department of Hematology, Tohoku University Hospital, Japan
| | | | | | - Koichi Onodera
- Department of Hematology, Tohoku University Hospital, Japan
| | - Yasushi Onishi
- Department of Hematology, Tohoku University Hospital, Japan
| | - Junichi Kameoka
- Department of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University Hospital, Japan
| | - Hideo Harigae
- Department of Hematology, Tohoku University Hospital, Japan
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10
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Gullapalli V, Hsu H, Bhargava V, Presgrave P. Synchronous Development of Acute Megakaryoblastic Leukaemia and Disseminated Melanoma following Treatment of a Germ Cell Tumour: A Case Report. Case Rep Oncol 2021; 14:1638-1644. [PMID: 38352119 PMCID: PMC10862075 DOI: 10.1159/000519663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 09/14/2021] [Indexed: 02/16/2024] Open
Abstract
Somatic malignant transformation of germ cell tumours is a well-described but poorly understood phenomenon. It is characterized by differentiation of pluripotent teratoma cells into somatic tumour cells. Following malignant transformation, the most common histologies are sarcomas and primitive neuroectodermal tumours; however, other subtypes have been recognized including melanoma, leukaemia, and renal cell carcinoma. We report a case of a 38-year-old male who had recently completed treatment for a mediastinal germ cell tumour with teratomatous components. He presented several months after completion of chemotherapy with metastatic lesions in his spine and liver accompanied with severe pancytopenia. He was subsequently diagnosed with acute megakaryoblastic leukaemia (AMKL), and a biopsy of a liver lesion was consistent with metastatic melanoma. This case illustrates the simultaneous development of 2 rare malignant entities: mediastinal germ cell tumour-associated AMKL and somatic malignant transformation to melanoma. It also highlights the importance of close surveillance to detect these metastatic sequelae and the emerging role of tumour sequencing to establish targetable pathways.
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Affiliation(s)
- Veena Gullapalli
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Hannah Hsu
- Department of Haematology, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Vanita Bhargava
- Department of Anatomical Pathology, Wollongong Hospital, Wollongong, New South Wales, Australia
| | - Peter Presgrave
- Department of Haematology, Wollongong Hospital, Wollongong, New South Wales, Australia
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11
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Tang KHK, Ip AHW, Kwong YL. Clonal derivation of sequential seminoma and acute megakaryoblastic leukaemia. Ann Hematol 2021; 100:1337-1339. [PMID: 33760949 DOI: 10.1007/s00277-021-04443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/26/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Karen H K Tang
- Department of Medicine, Queen Mary Hospital, Hong Kong, China
| | - Alvin H W Ip
- Department of Pathology, Queen Mary Hospital, Hong Kong, China
| | - Yok-Lam Kwong
- Department of Medicine, Professorial Block, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.
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12
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Taylor J, Donoghue MT, Ho C, Petrova-Drus K, Al-Ahmadie HA, Funt SA, Zhang Y, Aypar U, Rao P, Chavan SS, Haddadin M, Tamari R, Giralt S, Tallman MS, Rampal RK, Baez P, Kappagantula R, Kosuri S, Dogan A, Tickoo SK, Reuter VE, Bosl GJ, Iacobuzio-Donahue CA, Solit DB, Taylor BS, Feldman DR, Abdel-Wahab O. Germ cell tumors and associated hematologic malignancies evolve from a common shared precursor. J Clin Invest 2021; 130:6668-6676. [PMID: 32897884 DOI: 10.1172/jci139682] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/03/2020] [Indexed: 12/12/2022] Open
Abstract
Germ cell tumors (GCTs) are the most common cancer in men between the ages of 15 and 40. Although most patients are cured, those with disease arising in the mediastinum have distinctly poor outcomes. One in every 17 patients with primary mediastinal nonseminomatous GCTs develop an incurable hematologic malignancy and prior data intriguingly suggest a clonal relationship exists between hematologic malignancies and GCTs in these cases. To date, however, the precise clonal relationship between GCTs and the diverse additional somatic malignancies arising in such individuals have not been determined. Here, we traced the clonal evolution and characterized the genetic features of each neoplasm from a cohort of 15 patients with GCTs and associated hematologic malignancies. We discovered that GCTs and hematologic malignancies developing in such individuals evolved from a common shared precursor, nearly all of which harbored allelically imbalanced p53 and/or RAS pathway mutations. Hematologic malignancies arising in this setting genetically resembled mediastinal GCTs rather than de novo myeloid neoplasms. Our findings argue that this scenario represents a unique clinical syndrome, distinct from de novo GCTs or hematologic malignancies, initiated by an ancestral precursor that gives rise to the parallel evolution of GCTs and blood cancers in these patients.
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Affiliation(s)
- Justin Taylor
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Division of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | | | | | | | - Samuel A Funt
- Genitourinary Oncology Service, Department of Medicine
| | | | | | - Pavitra Rao
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - Shweta S Chavan
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology
| | - Michael Haddadin
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Roni Tamari
- Bone Marrow Transplant Service, Department of Medicine
| | - Sergio Giralt
- Bone Marrow Transplant Service, Department of Medicine
| | | | | | - Priscilla Baez
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Rajya Kappagantula
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | | | | | - George J Bosl
- Genitourinary Oncology Service, Department of Medicine
| | - Christine A Iacobuzio-Donahue
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Pathology
| | - David B Solit
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Marie-Josée and Henry R. Kravis Center for Molecular Oncology.,Genitourinary Oncology Service, Department of Medicine
| | - Barry S Taylor
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Marie-Josée and Henry R. Kravis Center for Molecular Oncology.,Deparment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Omar Abdel-Wahab
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Leukemia Service, Department of Medicine
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13
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Amra N, Zarate LV, Punia JN, Mahajan P, Stevens AM, Roy A, Curry CV, Cortes-Santiago N, Fisher KE. Mediastinal Germ Cell Tumor and Acute Megakaryoblastic Leukemia With Co-occurring KRAS Mutation and Complex Cytogenetics. Pediatr Dev Pathol 2020; 23:461-466. [PMID: 32815783 DOI: 10.1177/1093526620951327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Young males have a unique but rare predilection to develop mediastinal nonseminomatous germ cell tumors (NSGCTs) and concomitant acute megakaryoblastic leukemia (AMKL). Common cytogenetic and molecular abnormalities such as isochromosome 12p and somatic Tumor Protein P53(TP53) and Phosphatase And Tensin Homolog (PTEN) mutations have been reported in the presumed mutual neoplastic clones of origin. We report the case of a 17-year-old male who presented with a mediastinal NSGCT with high-grade sarcomatous transformation and a diagnosis of AMKL approximately 4 months later. Next-generation sequencing revealed identical KRAS Proto-Oncogene, GTPase (KRAS) p.Ala146Thr, TP53 p.Leu257Pro, and PTEN p.Leu181Pro missense mutations at similar variant allele frequencies in both the NSGCT and AMKL samples. Cytogenetic and microarray analyses detected shared copy gains in all chromosomes except chromosomes 9, 13, and Y. Multiple additional clonal chromosomal alterations were detected in the AMKL sample when compared with the NSGCT. This case emphasizes the shared clonal origins of these malignancies and identifies KRAS and other copy number alterations as potential molecular drivers in a subset of these combined diseases.
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Affiliation(s)
- Nasir Amra
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
| | | | - Jyotinder N Punia
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
| | - Priya Mahajan
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
| | - Alexandra M Stevens
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
| | - Angshumoy Roy
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
| | - Choladda V Curry
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
| | | | - Kevin E Fisher
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas
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14
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FANCA, TP53, and del(5q)/RPS14 alterations in a patient with T-cell non-Hodgkin lymphoma and concomitant Fanconi anemia and Li-Fraumeni syndrome. Cancer Genet 2020; 256-257:179-183. [PMID: 33183999 DOI: 10.1016/j.cancergen.2020.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/01/2020] [Accepted: 10/25/2020] [Indexed: 11/23/2022]
Abstract
We traced the neoplastic history (from 5 to 11 years of age) of a child with concomitant Fanconi anemia and Li-Fraumeni syndrome. Interestingly, the patient developed a highly malignant T-cell non-Hodgkin lymphoma (NHL), which does not represent the typical tumor type in the two aforementioned syndromes, presumably due to the underlying genomic instability. By using a combination of molecular and immunohistochemical approaches, we characterized the accumulation of multiple genetic alterations in a single patient, with both germline (parentally inherited biallelic FANCA variants and a likely de novo nonsense variant in TP53) and somatic (TP53 loss of heterozygosity and 5q interstitial deletion) contributions. Our findings support the interplay of TP53 and FANC genes in DNA damage response pathways and further highlight the genetic heterogeneity of lymphomas as well as the contribution of genomic instability to lymphomagenesis.
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15
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Cisplatin Resistance in Testicular Germ Cell Tumors: Current Challenges from Various Perspectives. Cancers (Basel) 2020; 12:cancers12061601. [PMID: 32560427 PMCID: PMC7352163 DOI: 10.3390/cancers12061601] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/13/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
Testicular germ cell tumors share a marked sensitivity to cisplatin, contributing to their overall good prognosis. However, a subset of patients develop resistance to platinum-based treatments, by still-elusive mechanisms, experiencing poor quality of life due to multiple (often ineffective) interventions and, eventually, dying from disease. Currently, there is a lack of defined treatment opportunities for these patients that tackle the mechanism(s) underlying the emergence of resistance. Herein, we aim to provide a multifaceted overview of cisplatin resistance in testicular germ cell tumors, from the clinical perspective, to the pathobiology (including mechanisms contributing to induction of the resistant phenotype), to experimental models available for studying this occurrence. We provide a systematic summary of pre-target, on-target, post-target, and off-target mechanisms putatively involved in cisplatin resistance, providing data from preclinical studies and from those attempting validation in clinical samples, including those exploring specific alterations as therapeutic targets, some of them included in ongoing clinical trials. We briefly discuss the specificities of resistance related to teratoma (differentiated) phenotype, including the phenomena of growing teratoma syndrome and development of somatic-type malignancy. Cisplatin resistance is most likely multifactorial, and a combination of therapeutic strategies will most likely produce the best clinical benefit.
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Akizuki K, Sekine M, Kogure Y, Kameda T, Shide K, Koya J, Kamiunten A, Kubuki Y, Tahira Y, Hidaka T, Kiwaki T, Tanaka H, Sato Y, Kataoka H, Kataoka K, Shimoda K. TP53 and PTEN mutations were shared in concurrent germ cell tumor and acute megakaryoblastic leukemia. BMC Cancer 2020; 20:5. [PMID: 31898539 PMCID: PMC6941398 DOI: 10.1186/s12885-019-6497-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 12/23/2019] [Indexed: 01/08/2023] Open
Abstract
Background The occurrence of a mediastinal germ cell tumor (GCT) and hematological malignancy in the same patient is very rare. Due to its rarity, there have been only two reports of the concurrent cases undergoing detailed genetic analysis with whole-exome sequencing (WES), and the possible clonal relationship between the both tumors remained not fully elucidated. Methods We performed whole-exome sequencing analysis of mediastinal GCT and acute myeloid leukemia (AML) samples obtained from one young Japanese male adult patient with concurrent both tumors, and investigated the possible clonal relationship between them. Results Sixteen somatic mutations were detected in the mediastinal GCT sample and 18 somatic mutations in the AML sample. Mutations in nine genes, including TP53 and PTEN both known as tumor suppressor genes, were shared in both tumors. Conclusions All in our case and in the previous two cases with concurrent mediastinal GCT and AML undergoing with whole-exome sequencing analysis, TP53 and PTEN mutations were commonly shared in both tumors. These data not only suggest that these tumors share a common founding clone, but also indicate that associated mediastinal GCT and AML harboring TP53 and PTEN mutations represent a unique biological entity.
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Affiliation(s)
- Keiichi Akizuki
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Masaaki Sekine
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yasunori Kogure
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
| | - Takuro Kameda
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Kotaro Shide
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Junji Koya
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
| | - Ayako Kamiunten
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yoko Kubuki
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yuki Tahira
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Tomonori Hidaka
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Takumi Kiwaki
- Department of Pathology, Faculty of Medicine, Section of Oncopathology and Regenerative Biology, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Hiroyuki Tanaka
- Department of Pathology, Faculty of Medicine, Section of Oncopathology and Regenerative Biology, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yuichiro Sato
- Department of Diagnostic Pathology, Department of Pathology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Hiroaki Kataoka
- Department of Pathology, Faculty of Medicine, Section of Oncopathology and Regenerative Biology, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Keisuke Kataoka
- Division of Molecular Oncology, National Cancer Center Research Institute, Tokyo, Japan
| | - Kazuya Shimoda
- Department of Gastroenterology and Hematology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
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Mukherjee S, Ibrahimi S, John S, Adnan MM, Scordino T, Khalil MO, Cherry M. Non-seminomatous mediastinal germ cell tumor and acute megakaryoblastic leukemia. Ann Hematol 2017; 96:1435-1439. [PMID: 28578457 DOI: 10.1007/s00277-017-3037-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
The association between mediastinal germ cell tumors (MGCT) and acute megakaryoblastic (M7) leukemia has been known for many years. We hereby present this review to better characterize the coexistence of these entities as well as the salient features, the treatment options, and the overall prognosis. A search of PUBMED, Medline, and EMBASE databases via OVID engine for primary articles and case reports under keywords "germ cell tumors" and "acute myeloid leukemia" revealed a total of 26 cases in English that reported MGCT and M7 leukemia. The median age at diagnosis of MGCT was 24 (13-36) years. All cases were stage III. All cases of MGCT were of non-seminomatous origin and one case was unclassified. MGCT occurred prior to the diagnosis of leukemia in 46% of cases and concomitantly in 31% of cases. M7 leukemia was never reported prior to the appearance of MGCT. Complex cytogenetics and hyperdiploidy were the most commonly reported cytogenetic abnormalities. In the 23 cases where the treatment regimen was available, platinum-based chemotherapy directed towards management of the germ cell tumors was used initially in 21 cases and leukemia-directed treatment was used initially in 2 cases only. The median time from diagnosis of MGCT to development of M7 leukemia was 5 (2.25-39) months. Median time to death from the initial diagnosis of MGCT was 6 (0.5-60) months. Patients with a history of MGCT are at higher risk of developing M7 leukemia. They need long-term follow-up with a particular attention to the development of hematological malignancies. The overall prognosis remains poor.
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Affiliation(s)
- Sarbajit Mukherjee
- Department of Internal Medicine, Hematology and Oncology Section, University of Oklahoma Health Sciences Center, 800 N.E.10th Street, Oklahoma City, OK, USA.
| | - Sami Ibrahimi
- Department of Internal Medicine, Hematology and Oncology Section, University of Oklahoma Health Sciences Center, 800 N.E.10th Street, Oklahoma City, OK, USA
| | - Sonia John
- Department of Internal Medicine, Hematology and Oncology Section, University of Oklahoma Health Sciences Center, 800 N.E.10th Street, Oklahoma City, OK, USA
| | - Mohammed Muqeet Adnan
- Department of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, NM, USA
| | - Teresa Scordino
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Mohammad O Khalil
- Department of Internal Medicine, Hematology and Oncology Section, University of Oklahoma Health Sciences Center, 800 N.E.10th Street, Oklahoma City, OK, USA.,Department of Veterans Affairs Medical Center, Oklahoma City, OK, USA
| | - Mohamad Cherry
- Department of Internal Medicine, Hematology and Oncology Section, University of Oklahoma Health Sciences Center, 800 N.E.10th Street, Oklahoma City, OK, USA
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