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Pinto CM, Bertolucci CM, Severino AR, Dos Santos Tosi JF, Ikoma-Colturato MRV. Immunophenotypic markers for the evaluation of minimal/measurable residual disease in acute megakaryoblastic leukemia. Hematol Transfus Cell Ther 2023:S2531-1379(23)02586-5. [PMID: 38008596 DOI: 10.1016/j.htct.2023.09.2364] [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: 03/23/2023] [Revised: 07/21/2023] [Accepted: 09/04/2023] [Indexed: 11/28/2023] Open
Abstract
Acute megakaryoblastic leukemia is characterized by heterogeneous biology and clinical behavior. Immunophenotypic characteristics include the expression of megakaryocytic differentiation markers (e.g. CD41, CD42a, CD42b, CD61) associated with immaturity markers (CD34, CD117, HLA-DR) and myeloid markers (e.g. CD13, CD33) and even with lymphoid cross-lineage markers (e.g. CD7, CD56). Although the diagnostic immunophenotype has already been well described, given the rarity of the disease, its immunophenotypic heterogeneity and post-therapeutic instability, there is no consensus on the combination of monoclonal markers to detect minimal/measurable residual disease (MRD). Currently, MRD is an important tool for assessing treatment efficacy and prognostic risk. In this study, we evaluated the immunophenotypic profile of MRD in a retrospective cohort of patients diagnosed with acute megakaryoblastic leukemia, to identify which markers, positive or negative, were more stable after treatment and which could be useful for MRD evaluation. The expression profile of each marker was evaluated in sequential MRD samples. In conclusion, the markers evaluated in this study can be combined in an MRD immunophenotypic panel to investigate for megakaryoblastic leukemia. Although this study is retrospective and some data are missing, the information obtained may contribute to prospective studies to validate more specific strategies in the detection of MRD in acute megakaryoblastic leukemia.
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Su N, Li Z, Yang J, Fu Y, Zhu X, Miao H, Yu Y, Jiang W, Le J, Qian X, Wang H, Qian M, Zhai X. Revealing the intratumoral heterogeneity of non-DS acute megakaryoblastic leukemia in single-cell resolution. Front Oncol 2022; 12:915833. [PMID: 36003795 PMCID: PMC9394455 DOI: 10.3389/fonc.2022.915833] [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: 04/08/2022] [Accepted: 06/22/2022] [Indexed: 11/21/2022] Open
Abstract
Pediatric acute megakaryoblastic leukemia (AMKL) is a subtype of acute myeloid leukemia (AML) characterized by abnormal megakaryoblasts, and it is divided into the AMKL patients with Down syndrome (DS-AMKL) and AMKL patients without DS (non-DS-AMKL). Pediatric non-DS-AMKL is a heterogeneous disease with extremely poor outcome. We performed single-cell RNA sequencing (scRNA-seq) of the bone marrow from two CBFA2T3-GLIS2 fusion-positive and one RBM15-MKL1 fusion-positive non-DS-AMKL children. Meanwhile, we downloaded the scRNA-seq data of normal megakaryocyte (MK) cells of the fetal liver and bone marrow from healthy donors as normal controls. We conducted cell clustering, cell-type identification, inferCNV analysis, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and Monocle2 analysis to investigate the intratumoral heterogeneity of AMKL. Using canonical markers, we identified and characterized the abnormal blasts and other normal immune cells from three AMKL samples. We found intratumoral heterogeneity of AMKL in various cell-type proportions, malignant cells’ diverse copy number variations (CNVs), maturities, significant genes expressions, and enriched pathways. We also identified potential markers for pediatric AMKL, namely, RACK1, ELOB, TRIR, NOP53, SELENOH, and CD81. Our work offered insight into the heterogeneity of pediatric acute megakaryoblastic leukemia and established the single-cell transcriptomic landscape of AMKL for the first time.
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Affiliation(s)
- Narun Su
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Zifeng Li
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Jiapeng Yang
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Yang Fu
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Xiaohua Zhu
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Hui Miao
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Yi Yu
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Wenjin Jiang
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Jun Le
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Xiaowen Qian
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
| | - Hongsheng Wang
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
- *Correspondence: Xiaowen Zhai, ; Maoxiang Qian, ; Hongsheng Wang,
| | - Maoxiang Qian
- National Children’s Medical Center and the Shanghai Key Laboratory of Medical Epigenetics, Institute of Pediatrics, Institutes of Biomedical Sciences, Children’s Hospital of Fudan University, Fudan University, Shanghai, China
- *Correspondence: Xiaowen Zhai, ; Maoxiang Qian, ; Hongsheng Wang,
| | - Xiaowen Zhai
- Department of Hematology and Oncology, National Children’s Medical Center, Children’s Hospital of Fudan University, Shanghai, China
- *Correspondence: Xiaowen Zhai, ; Maoxiang Qian, ; Hongsheng Wang,
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Gillam J, Catic A, Paulraj P, Dalton J, Lai G, Jackson-Cook C, Turner S, Ferreira-Gonzalez A, Barrie E. Acute megakaryoblastic leukemia with trisomy 3 and CBFA2T3::GLIS2: A case report. Genes Chromosomes Cancer 2022; 61:491-496. [PMID: 35294081 PMCID: PMC9544894 DOI: 10.1002/gcc.23039] [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: 12/10/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
Non‐Down‐syndrome‐related acute megakaryoblastic leukemia (non‐DS‐AMKL) is a rare form of leukemia that can present with a variety of initial symptoms, including fever, rash, bruising, bleeding, or other more clinically challenging symptoms. Herein, we describe a 19‐month‐old female patient who presented with left lower extremity pain and language regression who was diagnosed with AMKL, not otherwise specified (NOS), on the basis of peripheral blood and bone marrow analysis, as well as cytogenetic and molecular diagnostic phenotyping. Of note, in addition to this patient's karyotype showing trisomy 3, a fusion between CBFA2T3 (core‐binding factor, alpha subunit 2, translocated to, 3) on chromosome 16 and GLIS2 (GLIS family zinc finger protein 2), also on chromosome 16, was observed. Patients with AMKL who have trisomy 3 with CBFA2T3::GLIS2 fusions are rare, and it is not known if the co‐occurrence of these abnormalities is coincidental or biologically related. This highlights the continued need for further expansion of genetic testing in individuals with rare disease to establish the groundwork for identifying additional commonalities that could potentially be used to identify therapeutic targets or improve prognostication.
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Affiliation(s)
- Joseph Gillam
- Department of Anatomic and Clinical Pathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Aida Catic
- Departments of Cytogenetics and Molecular Diagnostics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Prabakaran Paulraj
- Departments of Cytogenetics and Molecular Diagnostics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Justin Dalton
- Department of Hematopathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Guanhua Lai
- Department of Hematopathology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Colleen Jackson-Cook
- Departments of Cytogenetics and Molecular Diagnostics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Scott Turner
- Departments of Cytogenetics and Molecular Diagnostics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Andrea Ferreira-Gonzalez
- Departments of Cytogenetics and Molecular Diagnostics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Elizabeth Barrie
- Departments of Cytogenetics and Molecular Diagnostics, Virginia Commonwealth University, Richmond, Virginia, USA
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