1
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Kim SY, Song IC, Kim J, Kwon GC. Analysis of CSF3R mutations in atypical chronic myeloid leukemia and other myeloid malignancies. Ann Diagn Pathol 2024; 71:152317. [PMID: 38642470 DOI: 10.1016/j.anndiagpath.2024.152317] [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: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/22/2024]
Abstract
We report a series of patients with CSF3R-mutant (CSF3Rmut) atypical chronic myeloid leukemia (aCML), chronic neutrophilic leukemia (CNL) or other hematologic malignancies. We included 25 patients: 5 aCML and 4 CNL CSF3Rmut patients; 1 aCML, 2 CNL, and 2 myelodysplastic/myeloproliferative neoplasm, not otherwise specified patients without CSF3R mutation; and 11 CSF3Rmut patients with other diseases [8 acute myeloid leukemia (AML), 1 chronic myelomonocytic leukemia (CMML), 1 myelodysplastic syndrome (MDS), and 1 acute lymphoblastic leukemia (ALL)]. Patients with aCML or CNL were tested by Sanger sequencing and pyrosequencing to identify CSF3R T618I. Twenty-two patients underwent gene panel analysis. CSF3R mutations, mostly T618I (8/9), were found at high frequencies in both aCML and CNL patients [5/6 aCML and 4/6 CNL]. Two aCML patients in early adulthood with CSF3R T618I and biallelic or homozygous CEBPA mutations without other mutations presented with increased blasts and exhibited remission for >6 years after transplantation. The other 7 CSF3Rmut aCML or CNL patients were elderly adults who all had ASXL1 mutations and frequently presented with SEBP1 and SRSF2 mutations. Five AML patients had CSF3R exon 14 or 15 point mutations, and 6 other patients (3 AML, 1 CMML, 1 MDS, and 1 ALL) had truncating mutations, demonstrating differences in leukocyte counts and mutation status. In conclusion, CSF3R mutations were found at a higher frequency in aCML patients than in previous studies, which might reflect ethnic differences. Additional studies are needed to confirm these findings and the relationship between CSF3R and CEBPA mutations.
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MESH Headings
- Humans
- Receptors, Colony-Stimulating Factor/genetics
- Male
- Female
- Mutation
- Middle Aged
- Aged
- Adult
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/pathology
- Aged, 80 and over
- Leukemia, Neutrophilic, Chronic/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
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Affiliation(s)
- Seon Young Kim
- Department of Laboratory Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
| | - Ik-Chan Song
- Division of Hematology/Oncology, Department of Internal Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
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2
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Mohamed A, Gao J, Chen YH, Abaza Y, Altman J, Jennings L, Vormittag-Nocito E, Sukhanova M, Lu X, Chen Q. CSF3R mutated myeloid neoplasms: Beyond chronic neutrophilic leukemia. Hum Pathol 2024:S0046-8177(24)00109-6. [PMID: 38879086 DOI: 10.1016/j.humpath.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 06/07/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024]
Abstract
CSF3R activating mutation is a genetic hallmark of chronic neutrophilic leukemia (CNL), and is also present in a subset of atypical chronic myeloid leukemia (aCML), but infrequent in other myeloid neoplasms. However, the occurrence of CSF3R mutations in various myeloid neoplasms is not well studied. Here we evaluate the spectrum of CSF3R mutations and the clinicopathologic features of CSF3R mutated myeloid neoplasms. We retrospectively identified CSF3R mutations in a variety of myeloid neoplasms: two CNL, three atypical chronic myeloid leukemia (aCML), nine acute myeloid leukemia (AML), one chronic myelomonocytic leukemia, and one myeloproliferative neoplasm. The prototypic T618I mutation was found in 50% of cases: CNL (2/2), aCML (2/3) and AML (4/9). We observed a new recurrent CSF3R mutation Q776* in 25% of cases, and a potential-germline mutation in a 20-year-old patient. Co-occurring mutations were often in epigenetic modifier and spliceosome. IDH/RUNX1 and tumor suppressor mutations were frequent in AML but absent in CNL/aCML. All CNL/aCML patients succumbed within 2-years of diagnosis. We demonstrate that CSF3R mutations are not restricted to CNL. CNL and aCML show similar clinicopathologic and molecular features, suggesting that CNL may be best classified as myelodysplastic/myeloproliferative neoplasm rather than myeloproliferative neoplasm.
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Affiliation(s)
- Ahmed Mohamed
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Juehua Gao
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA.
| | - Yi-Hua Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Yasmin Abaza
- Hematology Oncology Division, Department of Medicine, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Jessica Altman
- Hematology Oncology Division, Department of Medicine, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Lawrence Jennings
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Erica Vormittag-Nocito
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Madina Sukhanova
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Xinyan Lu
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
| | - Qing Chen
- Department of Pathology, Northwestern University Feinberg School of Medicine, 251 E Huron Street, Chicago, IL, 60611, USA
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3
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Deng Y, Han S, Gao X, Liu Y, Gao J. Commentary: Case report: Chronic neutrophilic leukemia associated with monoclonal gammopathies. A case series and review of genetic characteristics and practical management. Front Oncol 2024; 14:1360791. [PMID: 38476370 PMCID: PMC10928800 DOI: 10.3389/fonc.2024.1360791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 03/14/2024] Open
Affiliation(s)
- Yifan Deng
- Yangzhou University Medical College, Yangzhou, Jiangsu, China
| | - Shuai Han
- Yangzhou University Medical College, Yangzhou, Jiangsu, China
| | - Xiaohui Gao
- Department of Hematology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, China
| | - Yang Liu
- Yangzhou University Medical College, Yangzhou, Jiangsu, China
| | - Jiapei Gao
- Yangzhou University Medical College, Yangzhou, Jiangsu, China
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4
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Gao J, Han S, Deng B, Deng Y, Gao X. Research progress of additional pathogenic mutations in chronic neutrophilic leukemia. Ann Hematol 2023:10.1007/s00277-023-05550-6. [PMID: 37993585 DOI: 10.1007/s00277-023-05550-6] [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: 09/28/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
Chronic neutrophilic leukemia (CNL) is a rare type of myeloproliferative neoplasm (MPN). Due to its nonspecific clinical symptoms and lack of specific molecular markers, it was previously difficult to distinguish it from other diseases with increased neutrophils. However, the discovery of the CSF3R mutation in CNL 10 years ago and the update of the diagnostic criteria by the World Health Organization (WHO) in 2016 brought CNL into a new era of molecular diagnosis. Next-generation sequencing (NGS) technology has led to the identification of numerous mutant genes in CNL. While CSF3R is commonly recognized as the driver mutation of CNL, other mutations have also been detected in CNL using NGS, including mutations in other signaling pathway genes (CBL, JAK2, NARS, PTPN11) and chromatin modification genes (ASXL1, SETBP1, EZH2), DNA methylation genes (DNMT3A, TET2), myeloid-related transcription factor genes (RUNX1, GATA2), and splicing and RNA metabolism genes (SRSF2, U2AF1). The coexistence of these mutated genes and CSF3R mutations, as well as the different evolutionary sequences of clones, deepens the complexity of CNL molecular biology. The purpose of this review is to summarize the genetic research findings of CNL in the last decade, focusing on the common mutated genes in CNL and their clinical significance, as well as the clonal evolution pattern and sequence of mutation acquisition in CNL, to provide a basis for the appropriate management of CNL patients.
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Affiliation(s)
- Jiapei Gao
- Department of Hematology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Shuai Han
- Yangzhou University Medical College, Yangzhou, Jiangsu Province, China
| | - Bin Deng
- Department of Gastroenterology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Yifan Deng
- Yangzhou University Medical College, Yangzhou, Jiangsu Province, China
| | - Xiaohui Gao
- Department of Hematology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, China.
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5
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Robak E, Braun M, Robak T. Leukemia Cutis-The Current View on Pathogenesis, Diagnosis, and Treatment. Cancers (Basel) 2023; 15:5393. [PMID: 38001655 PMCID: PMC10670312 DOI: 10.3390/cancers15225393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
Leukemia cutis (LC) is defined as the leukemic infiltration of the epidermis, the dermis, and the subcutaneous tissue. Leukemia cutis may follow or occur simultaneously with the diagnosis of systemic leukemia. However, cutaneous lesions are occasionally diagnosed as the primary manifestation of leukemia. Leukemic skin infiltrations demonstrate considerable variation regarding a number of changes, distribution, and morphology. The highest incidence of LC is observed in chronic lymphocytic leukemia, monocytic and myelomonocytic acute myeloid leukemia, and T-cell lineage leukemia. Although the pathogenic mechanism of the invasion of leukemic cells into the skin is not well understood, chemokine receptors and adhesion molecules as well as the genetic characteristics of leukemia are thought to play a role. Leukemic skin lesions may be localized or disseminated and may occur alone or in combination on any site of the skin, most frequently in the trunk and extremities. The most common clinical presentations of leukemia cutis are papules, nodules, macules, plaques, and ulcers. In most patients, the complete or partial resolution of cutaneous infiltrations occurs simultaneously with hematologic remission. However, in patients with resistant disease or recurrent skin infiltration, local radiotherapy can be used. This review presents recent data on the pathogenesis, diagnosis, and treatment of leukemic skin involvement in different types of leukemia.
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Affiliation(s)
- Ewa Robak
- Department of Dermatology, Medical University of Lodz, 90-647 Lodz, Poland;
| | - Marcin Braun
- Department of Pathology, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Tadeusz Robak
- Department of Hematology, Medical University of Lodz, 93-510 Lodz, Poland
- Department of General Hematology, Copernicus Memorial Hospital, 93-510 Lodz, Poland
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6
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Decamp M, Klein E, Godon C, Lestringant V, Roynard P, Theisen O, Jimenez-Pocquet M, Roche-Lestienne C, Bidet A, Veronese L. Cytogenetics in the management of myeloproliferative neoplasms, mastocytosis and myelodysplastic/myeloproliferative neoplasms: Guidelines from the Group Francophone de Cytogénétique Hématologique (GFCH). Curr Res Transl Med 2023; 71:103424. [PMID: 38011761 DOI: 10.1016/j.retram.2023.103424] [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: 07/09/2023] [Revised: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 11/29/2023]
Abstract
Myeloproliferative neoplasms, mastocytosis, myeloid/lymphoid neoplasms with hypereosinophilia and tyrosine kinase gene fusions, and myelodysplastic/myeloproliferative neoplasms are clonal hematopoietic cancers that, with the exception of certain entities, have an indolent course. In addition to their increasingly important role in the diagnosis of these entities, as shown by the recent classification of hematolymphoid tumors in the 5th edition of the World Health Organization and the International Consensus Classification of myeloid neoplasms and acute leukemias, identification of the profile of acquired genetic abnormalities is essential for adapting patient management and early detection of patients at high risk of progression. Alongside molecular abnormalities, cytogenetic abnormalities play an important role in the diagnosis, prognosis and follow-up of these diseases. Here, we review the recent literature on the impact of chromosomal abnormalities in these different entities and provide updated cytogenetic recommendations and guidelines for their management.
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Affiliation(s)
- Matthieu Decamp
- CHU de Caen Normandie, Service de Génétique, Avenue de la côte de Nacre, 14033 Cedex 9, Caen 14000, France.
| | - Emilie Klein
- Laboratoire d'Hématologie Biologique, CHU Bordeaux, Bordeaux, France
| | - Catherine Godon
- Laboratoire d'Hématologie Biologique, CHU Nantes, Nantes, France
| | | | - Pauline Roynard
- Institut de Génétique Médicale, CHRU de Lille, Lille, France
| | - Olivier Theisen
- Laboratoire d'Hématologie Biologique, CHU Nantes, Nantes, France
| | | | | | - Audrey Bidet
- Laboratoire d'Hématologie Biologique, CHU Bordeaux, Bordeaux, France
| | - Lauren Veronese
- Service de Cytogénétique Médicale, CHU Estaing, Clermont-Ferrand, France
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7
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Guastafierro V, Ubezio M, Manes N, Milanesi C, Della Porta M, Bonometti A. CSF3R-mutant chronic myelomonocytic leukemia is a distinct clinically subset with abysmal prognosis: a case report and systematic review of the literature. Leuk Lymphoma 2023; 64:1566-1573. [PMID: 37395413 DOI: 10.1080/10428194.2023.2227750] [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: 05/10/2023] [Revised: 06/09/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023]
Abstract
Chronic myelomonocytic leukemia (CMML) is a myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) chacaterized by persistent peripheral blood monocytosis, hypercellular bone marrow and dysplasia at least in one myeloid lineage. CMML shares much of its molecular landscape with other myeloid neoplasms, while differs from others such as chronic neutrophilic leukemia (CNL), given the high frequency of CSF3R mutations in the latter. In this article, we report a case of CSF3R-mutated CMML and dissect this rare entity by reviewing the medical literature, with the intent to understand how this rare mutation shapes CMML's clinical and morphological phenotype. CSF3R-mutated CMML emerges as a rare entity meeting the ICC/WHO diagnostic criteria for CMML and simultaneously showing clinical-pathological and molecular traits of CNL and atypical chronic myeloid leukemia, rising an important and difficult diagnostic and therapeutical issue.
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MESH Headings
- Humans
- Leukemia, Myelomonocytic, Chronic/diagnosis
- Leukemia, Myelomonocytic, Chronic/genetics
- Leukemia, Myelomonocytic, Chronic/pathology
- Leukemia, Neutrophilic, Chronic/diagnosis
- Leukemia, Neutrophilic, Chronic/genetics
- Mutation
- Myeloproliferative Disorders
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/pathology
- Prognosis
- Receptors, Colony-Stimulating Factor/genetics
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Affiliation(s)
- Vincenzo Guastafierro
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Pathology, IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Marta Ubezio
- IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Nicla Manes
- IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | | | - Matteo Della Porta
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Clinical and Research Center, Milan, Italy
| | - Arturo Bonometti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Pathology, IRCCS Humanitas Clinical and Research Center, Milan, Italy
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8
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Fontana D, Elli EM, Pagni F, Piazza R. Myelodysplastic Syndromes/Myeloproliferative Overlap Neoplasms and Differential Diagnosis in the WHO and ICC 2022 Era: A Focused Review. Cancers (Basel) 2023; 15:3175. [PMID: 37370785 DOI: 10.3390/cancers15123175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/05/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
The myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPN) category comprises a varied group of myeloid neoplastic diseases characterized by clinical and pathologic overlapping features of both myelodysplastic and myeloproliferative neoplasms. For these reasons, these tumors are challenging in terms of diagnosis. The recent World Health Organization (WHO) 2022 classification and the International Consensus Classification (ICC) made changes in the classification of MDS/MPN compared to the previous 2016 WHO classification and improved the diagnostic criteria of these entities. The aim of this review is to describe the main entities reported in the more recent classifications, focusing on chronic myelomonocytic leukemia (CMML), MDS/MPN with neutrophilia (or atypical CML [aCML]), and MDS/MPN with SF3B1 mutation and thrombocytosis/MDS/MPN with ring sideroblasts and thrombocytosis. A particular emphasis is given to the differential diagnosis and analysis of subtle divergences and semantic differences between the WHO classification and the ICC for these entities.
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Affiliation(s)
- Diletta Fontana
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Elena M Elli
- Hematology Division and Bone Marrow Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Fabio Pagni
- Department of Medicine and Surgery, Pathology, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Rocco Piazza
- Department of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
- Hematology Division and Bone Marrow Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
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Ye P, Lin Q, Jin M, Gu X, Lu Y. Successful Allogeneic Stem Cell Transplantation with Ruxolitinib Maintenance Therapy for CSF3R T618I Mutant Chronic Neutrophilic Leukemia. Turk J Haematol 2023; 40:73-74. [PMID: 36510384 PMCID: PMC9979739 DOI: 10.4274/tjh.galenos.2022.2022.0400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
- Peipei Ye
- The Affiliated People’s Hospital of Ningbo University, Department of Hematology, Ningbo, Zhejiang, China
| | - Qingqing Lin
- The Affiliated People’s Hospital of Ningbo University, Department of Hematology, Ningbo, Zhejiang, China
| | - Mingwei Jin
- The Affiliated People’s Hospital of Ningbo University, Department of Hematology, Ningbo, Zhejiang, China
| | - Xin Gu
- The Affiliated People’s Hospital of Ningbo University, Department of Hematology, Ningbo, Zhejiang, China
| | - Ying Lu
- The Affiliated People’s Hospital of Ningbo University, Department of Hematology, Ningbo, Zhejiang, China
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Zhang X, Ghiuzeli C, Jou E, Hsu P, Kolitz J, Brody JP. CSF3R T618I mutant myelodysplastic/myeloproliferative neoplasm in the elderly: An age-related disease with unfavorable prognosis. Leuk Res Rep 2022; 17:100334. [PMID: 35795468 PMCID: PMC9251566 DOI: 10.1016/j.lrr.2022.100334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/04/2022] [Accepted: 06/21/2022] [Indexed: 12/02/2022] Open
Abstract
We reported two MDS/MPN-U and one CMML patients with CSF3R T618I mutation. There were two males and one female, with a median age of 84 years. Three patients presented with leukocytosis and anemia, two with thrombocytopenia, and one with monocytosis. In all the patients, bone marrow showed hypercellularity with myeloid or erythroid predominant trilineage hematopoiesis and dysplasia. Two cases carried -7/-7q abnormalities. In addition to CSF3R T618/I mutation, each case carried 3–5 additional somatic mutations. The median survival was only 2 months. These rare patients were characterized by old age, high mutation rates, clonal hematopoiesis-associated mutations, clonal evolution, and unfavorable prognosis.
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