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Hordyjewska-Kowalczyk E, Wuyts W, Boeckx N, Verdonck A, Hendrickx G, Mortier G. RUNX2-related metaphyseal dysplasia with maxillary hypoplasia: A rare skeletal disorder resembling SFRP4-related Pyle disease. Clin Genet 2024; 105:434-439. [PMID: 38108099 DOI: 10.1111/cge.14474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
Metaphyseal dysplasia with maxillary hypoplasia with or without brachydactyly (MDMHB) is an ultra-rare skeletal dysplasia caused by heterozygous intragenic RUNX2 duplications, comprising either exons 3 to 5 or exons 3 to 6 of RUNX2. In this study, we describe a 14-year-old Belgian boy with metaphyseal dysplasia with maxillary hypoplasia but without brachydactyly. Clinical and radiographic examination revealed mild facial dysmorphism, dental anomalies, enlarged clavicles, genua valga and metaphyseal flaring and thin cortices with an osteoporotic skeletal appearance. Exome sequencing led to the identification of a de novo heterozygous tandem duplication within RUNX2, encompassing exons 3 to 7. This duplication is larger than the ones previously reported in MDMHB cases since it extends into the C-terminal activation domain of RUNX2. We review previously reported cases with MDMHB and highlight the resemblance of this disorder with Pyle disease, which may be explained by intersecting molecular pathways between RUNX2 and sFRP4. This study expands our knowledge on the genotypic and phenotypic characteristics of MDMHB and the role of RUNX2 in rare bone disorders.
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Affiliation(s)
- Ewa Hordyjewska-Kowalczyk
- Laboratory for Skeletal Dysplasia Research, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Wim Wuyts
- Department of Medical Genetics, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Nele Boeckx
- Department of Medical Genetics, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - An Verdonck
- Department of Oral Health Sciences - Orthodontics, KU Leuven, Leuven, Belgium
- Service of Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Gretl Hendrickx
- Laboratory for Skeletal Dysplasia Research, Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Geert Mortier
- Laboratory for Skeletal Dysplasia Research, Department of Human Genetics, KU Leuven, Leuven, Belgium
- Centre for Human Genetics, University Hospital Leuven, Leuven, Belgium
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2
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Meester JAN, Hebert A, Bastiaansen M, Rabaut L, Bastianen J, Boeckx N, Ashcroft K, Atwal PS, Benichou A, Billon C, Blankensteijn JD, Brennan P, Bucks SA, Campbell IM, Conrad S, Curtis SL, Dasouki M, Dent CL, Eden J, Goel H, Hartill V, Houweling AC, Isidor B, Jackson N, Koopman P, Korpioja A, Kraatari-Tiri M, Kuulavainen L, Lee K, Low KJ, Lu AC, McManus ML, Oakley SP, Oliver J, Organ NM, Overwater E, Revencu N, Trainer AH, Trivedi B, Turner CLS, Whittington R, Zankl A, Zentner D, Van Laer L, Verstraeten A, Loeys BL. Expanding the clinical spectrum of biglycan-related Meester-Loeys syndrome. NPJ Genom Med 2024; 9:22. [PMID: 38531898 PMCID: PMC10966070 DOI: 10.1038/s41525-024-00413-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
Pathogenic loss-of-function variants in BGN, an X-linked gene encoding biglycan, are associated with Meester-Loeys syndrome (MRLS), a thoracic aortic aneurysm/dissection syndrome. Since the initial publication of five probands in 2017, we have considerably expanded our MRLS cohort to a total of 18 probands (16 males and 2 females). Segregation analyses identified 36 additional BGN variant-harboring family members (9 males and 27 females). The identified BGN variants were shown to lead to loss-of-function by cDNA and Western Blot analyses of skin fibroblasts or were strongly predicted to lead to loss-of-function based on the nature of the variant. No (likely) pathogenic missense variants without additional (predicted) splice effects were identified. Interestingly, a male proband with a deletion spanning the coding sequence of BGN and the 5' untranslated region of the downstream gene (ATP2B3) presented with a more severe skeletal phenotype. This may possibly be explained by expressional activation of the downstream ATPase ATP2B3 (normally repressed in skin fibroblasts) driven by the remnant BGN promotor. This study highlights that aneurysms and dissections in MRLS extend beyond the thoracic aorta, affecting the entire arterial tree, and cardiovascular symptoms may coincide with non-specific connective tissue features. Furthermore, the clinical presentation is more severe and penetrant in males compared to females. Extensive analysis at RNA, cDNA, and/or protein level is recommended to prove a loss-of-function effect before determining the pathogenicity of identified BGN missense and non-canonical splice variants. In conclusion, distinct mechanisms may underlie the wide phenotypic spectrum of MRLS patients carrying loss-of-function variants in BGN.
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Affiliation(s)
- Josephina A N Meester
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Anne Hebert
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Maaike Bastiaansen
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Laura Rabaut
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Jarl Bastianen
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Nele Boeckx
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Kathryn Ashcroft
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds Teaching Hospitals, NHS Foundation Trust, Leeds, UK
| | - Paldeep S Atwal
- Genomic and Personalized Medicine, Atwal Clinic, Palm Beach, FL, USA
| | - Antoine Benichou
- Department of Internal and Vascular Medicine, CHU Nantes, Nantes Université, Nantes, France
| | - Clarisse Billon
- Service de Médecine Génomique des Maladies Rares, Groupe Hospitalier Universitaire Centre, Paris, Assistance Publique Hôpitaux de Paris, Paris, France
- Université de Paris Cité, Inserm, PARCC, Paris, France
| | - Jan D Blankensteijn
- Department of Vascular Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Paul Brennan
- Northern Genetics Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Ian M Campbell
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Solène Conrad
- Service de Génétique Médicale, CHU Nantes, Nantes, France
| | - Stephanie L Curtis
- Bristol Heart Institute, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Majed Dasouki
- Department of Medical Genetics & Genomics, AdventHealth Medical Group, Orlando, FL, USA
| | - Carolyn L Dent
- South West Genomic Laboratory Hub, Bristol Genetics Laboratory, Bristol, UK
| | - James Eden
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester, UK
| | | | - Verity Hartill
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds Teaching Hospitals, NHS Foundation Trust, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Arjan C Houweling
- Department of Human Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Nicola Jackson
- Clinical Genetics Service, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Pieter Koopman
- Department of Cardiology, Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium
| | - Anita Korpioja
- Department of Clinical Genetics, Research Unit of Clinical Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Minna Kraatari-Tiri
- Department of Clinical Genetics, Research Unit of Clinical Medicine, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Liina Kuulavainen
- Department of Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kelvin Lee
- Department of Medical Genetics & Genomics, AdventHealth Medical Group, Orlando, FL, USA
| | - Karen J Low
- Clinical Genetics Department, University Hospitals Bristol and Weston NHS Foundation Trust St Michael's Hospital, Bristol, UK
- University of Bristol, Canynge Hall, Bristol, UK
| | - Alan C Lu
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Morgan L McManus
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stephen P Oakley
- John Hunter Hospital, New Lambton Heights, NSW, Australia
- College of Health, Medicine and Wellbeing, School of Medicine, University of Newcastle, Newcastle, NSW, Australia
| | - James Oliver
- Genomic Diagnostics Laboratory, Manchester Centre for Genomic Medicine, Manchester, UK
| | - Nicole M Organ
- John Hunter Hospital, New Lambton Heights, NSW, Australia
| | - Eline Overwater
- Department of Human Genetics, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Nicole Revencu
- Center for Human Genetics, Cliniques Universitaires Saint-Luc and Université Catholique de Louvain, Brussels, Belgium
| | - Alison H Trainer
- Department of Genomic Medicine, The Royal Melbourne Hospital and University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Bhavya Trivedi
- Department of Medical Genetics & Genomics, AdventHealth Medical Group, Orlando, FL, USA
| | - Claire L S Turner
- Department of Clinical Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | | | - Andreas Zankl
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Department of Clinical Genetics, Children's Hospital at Westmead, Sydney, NSW, Australia
- Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Dominica Zentner
- Department of Genomic Medicine, The Royal Melbourne Hospital and University of Melbourne, Parkville, Melbourne, VIC, Australia
| | - Lut Van Laer
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Aline Verstraeten
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Bart L Loeys
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium.
- Department of Clinical Genetics, Radboud University Medical Center, Nijmegen, The Netherlands.
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Luyckx I, Walton IS, Boeckx N, Van Schil K, Pang C, De Praeter M, Lord H, Watson CM, Bonthron DT, Van Laer L, Wilkie AOM, Loeys B. Homozygous SMAD6 variants in two unrelated patients with craniosynostosis and radioulnar synostosis. J Med Genet 2024; 61:363-368. [PMID: 38290823 PMCID: PMC10982635 DOI: 10.1136/jmg-2023-109151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/29/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND SMAD6 encodes an intracellular inhibitor of the bone morphogenetic protein (BMP) signalling pathway. Until now, rare heterozygous loss-of-function variants in SMAD6 were demonstrated to increase the risk of disparate clinical disorders including cardiovascular disease, craniosynostosis and radioulnar synostosis. Only two unrelated patients harbouring biallelic SMAD6 variants presenting a complex cardiovascular phenotype and facial dysmorphism have been described. CASES Here, we present the first two patients with craniosynostosis harbouring homozygous SMAD6 variants. The male probands, both born to healthy consanguineous parents, were diagnosed with metopic synostosis and bilateral or unilateral radioulnar synostosis. Additionally, one proband had global developmental delay. Echocardiographic evaluation did not reveal cardiac or outflow tract abnormalities. MOLECULAR ANALYSES The novel missense (c.[584T>G];[584T>G], p.[(Val195Gly)];[(Val195Gly)]) and missense/splice-site variant (c.[817G>A];[817G>A], r.[(817g>a,817delins[a;817+2_817+228])];[(817g>a,817delins[a;817+2_817+228])], p.[(Glu273Lys,Glu273Serfs*72)];[(Glu273Lys,Glu273Serfs*72)]) both locate in the functional MH1 domain of the protein and have not been reported in gnomAD database. Functional analyses of the variants showed reduced inhibition of BMP signalling or abnormal splicing, respectively, consistent with a hypomorphic mechanism of action. CONCLUSION Our data expand the spectrum of variants and phenotypic spectrum associated with homozygous variants of SMAD6 to include craniosynostosis.
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Affiliation(s)
- Ilse Luyckx
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
- Department of Clinical Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Isaac Scott Walton
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Nele Boeckx
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Kristof Van Schil
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Chingyiu Pang
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Mania De Praeter
- Department of Paediatric Neurosurgery, University Hospital Antwerp, Antwerp, Belgium
| | - Helen Lord
- Oxford Medical Genetics Laboratories, Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Oxford, UK
| | - Christopher Mark Watson
- Leeds Institute of Medical Research, University of Leeds, St. James's University Hospital, Leeds, UK
| | - David T Bonthron
- Leeds Institute of Medical Research, University of Leeds, St. James's University Hospital, Leeds, UK
| | - Lut Van Laer
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Andrew O M Wilkie
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Bart Loeys
- Center of Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
- Department of Clinical Genetics, Radboud University Medical Center, Nijmegen, Netherlands
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Greene D, Pirri D, Frudd K, Sackey E, Al-Owain M, Giese APJ, Ramzan K, Riaz S, Yamanaka I, Boeckx N, Thys C, Gelb BD, Brennan P, Hartill V, Harvengt J, Kosho T, Mansour S, Masuno M, Ohata T, Stewart H, Taibah K, Turner CLS, Imtiaz F, Riazuddin S, Morisaki T, Ostergaard P, Loeys BL, Morisaki H, Ahmed ZM, Birdsey GM, Freson K, Mumford A, Turro E. Genetic association analysis of 77,539 genomes reveals rare disease etiologies. Nat Med 2023; 29:679-688. [PMID: 36928819 PMCID: PMC10033407 DOI: 10.1038/s41591-023-02211-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/06/2023] [Indexed: 03/18/2023]
Abstract
The genetic etiologies of more than half of rare diseases remain unknown. Standardized genome sequencing and phenotyping of large patient cohorts provide an opportunity for discovering the unknown etiologies, but this depends on efficient and powerful analytical methods. We built a compact database, the 'Rareservoir', containing the rare variant genotypes and phenotypes of 77,539 participants sequenced by the 100,000 Genomes Project. We then used the Bayesian genetic association method BeviMed to infer associations between genes and each of 269 rare disease classes assigned by clinicians to the participants. We identified 241 known and 19 previously unidentified associations. We validated associations with ERG, PMEPA1 and GPR156 by searching for pedigrees in other cohorts and using bioinformatic and experimental approaches. We provide evidence that (1) loss-of-function variants in the Erythroblast Transformation Specific (ETS)-family transcription factor encoding gene ERG lead to primary lymphoedema, (2) truncating variants in the last exon of transforming growth factor-β regulator PMEPA1 result in Loeys-Dietz syndrome and (3) loss-of-function variants in GPR156 give rise to recessive congenital hearing impairment. The Rareservoir provides a lightweight, flexible and portable system for synthesizing the genetic and phenotypic data required to study rare disease cohorts with tens of thousands of participants.
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Affiliation(s)
- Daniel Greene
- Department of Medicine, University of Cambridge, Cambridge, UK
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Daniela Pirri
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Karen Frudd
- National Heart and Lung Institute, Imperial College London, London, UK
- University College London Institute of Ophthalmology, University College London, London, UK
| | - Ege Sackey
- Molecular and Clinical Sciences Institute, St. George's University of London, London, UK
| | - Mohammed Al-Owain
- Department of Medical Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Arnaud P J Giese
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Khushnooda Ramzan
- Department of Clinical Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Sehar Riaz
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Itaru Yamanaka
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Nele Boeckx
- Center for Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Chantal Thys
- Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium
| | - Bruce D Gelb
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Paul Brennan
- Northern Genetics Service, Newcastle upon Tyne Hospitals National Health Service Trust International Centre for Life, Newcastle upon Tyne, UK
| | - Verity Hartill
- Department of Clinical Genetics, Chapel Allerton Hospital, Leeds Teaching Hospitals National Health Service Trust, Leeds, UK
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Julie Harvengt
- Centre for Medical Genetics, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Tomoki Kosho
- Department of Medical Genetics, Shinshu University School of Medicine, Nagano, Japan
- Center for Medical Genetics, Shinshu University Hospital, Nagano, Japan
| | - Sahar Mansour
- Molecular and Clinical Sciences Institute, St. George's University of London, London, UK
- South West Thames Regional Genetics Service, St. George's University Hospitals National Health Service Foundation Trust, London, UK
| | - Mitsuo Masuno
- Department of Medical Genetics, Kawasaki Medical School Hospital, Okayama, Japan
| | | | - Helen Stewart
- Oxford University Hospitals National Health Service Foundation Trust, Oxford, UK
| | - Khalid Taibah
- Ear Nose and Throat Medical Centre, Riyadh, Saudi Arabia
| | - Claire L S Turner
- Peninsula Clinical Genetics Service, Royal Devon & Exeter Hospital, Exeter, UK
| | - Faiqa Imtiaz
- Department of Clinical Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia
| | - Saima Riazuddin
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Takayuki Morisaki
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan
- Division of Molecular Pathology and Department of Internal Medicine, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Pia Ostergaard
- Molecular and Clinical Sciences Institute, St. George's University of London, London, UK
| | - Bart L Loeys
- Center for Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hiroko Morisaki
- Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan
| | - Zubair M Ahmed
- Department of Otorhinolaryngology Head and Neck Surgery, School of Medicine, University of Maryland, Baltimore, MD, USA
- Department of Biochemistry and Molecular Biology, School of Medicine, University of Maryland, Baltimore, MD, USA
| | - Graeme M Birdsey
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Kathleen Freson
- Department of Cardiovascular Sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium
| | - Andrew Mumford
- School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK
- South West National Health Service Genomic Medicine Service Alliance, Bristol, UK
| | - Ernest Turro
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
- Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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5
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Blomme S, Nollet F, Boeckx N, Cauwelier B, Snauwaert S, Emmerechts J. Diagnostic utility of the lymphoid screening tube supplemented with TRBC1 for the assessment of T-cell clonality. Int J Lab Hematol 2023. [PMID: 36856131 DOI: 10.1111/ijlh.14045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 02/06/2023] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Flow cytometric panels for the investigation of lymphoproliferative disorders, such as the EuroFlow Lymphoid Screening Tube (LST), often fail to demonstrate T-cell clonality, as a suitable clonality marker was unavailable until recently. Aim of this study was to evaluate the added value of supplementing TRBC1, a flow cytometric T-cell clonality marker, to the LST. METHODS Flow cytometric analysis was performed on 830 routine samples referred to our lab for suspicion of hematological malignancy. T-cells with monotypic TRBC1-expression were additionally characterized with a 12-color T-cell tube and molecular T-cell receptor gamma gene rearrangement (TRG). RESULTS LST analysis revealed 97 (11.7%) samples with the presence of a monotypic T-cell population according to TRBC1, including 21 (2.5%) "high-count" (≥500 cells/μL blood or ≥15% of lymphocytes) and 76 (9.2%) "low-count" (<500 cells/μL blood or <15% of lymphocytes) populations. Clinical symptoms indicative for T-CLPD could be correlated to 11/21 "high-count" and 17/76 "low-count" monotypic T-cell populations. Molecular TRG analysis demonstrated a monoclonal result in 76% (16/21) of "high-count" samples and in 64% (42/66; 10 samples not tested) of "low-count" samples, but also in 9/20 samples with polytypic TRBC1 results. CONCLUSION Analysis of an LST tube supplemented with TRBC1 led to the detection of a high number of monotypic T-cell populations. The detection of numerous small monotypic T-cell populations raises the question of their clinical significance. A possible flowchart for assessment of these populations, based on the available literature, is proposed. Molecular TRG analysis is complementary and cannot be omitted from T-cell clonality assessment.
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Affiliation(s)
- S Blomme
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium.,Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - F Nollet
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
| | - B Cauwelier
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - S Snauwaert
- Department of Clinical Hematology, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
| | - J Emmerechts
- Department of Laboratory Medicine, AZ Sint-Jan Hospitals Brugge-Oostende, Brugge, Belgium
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6
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Rodrigues Bento J, Krebsová A, Van Gucht I, Valdivia Callejon I, Van Berendoncks A, Votypka P, Luyckx I, Peldova P, Laga S, Havelka M, Van Laer L, Trunecka P, Boeckx N, Verstraeten A, Macek M, Meester JAN, Loeys B. Isolated aneurysmal disease as an underestimated finding in individuals with JAG1 pathogenic variants. Hum Mutat 2022; 43:1824-1828. [PMID: 35819173 PMCID: PMC10084246 DOI: 10.1002/humu.24433] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/28/2022] [Accepted: 07/06/2022] [Indexed: 01/24/2023]
Abstract
Pathogenic variants in JAG1 are known to cause Alagille syndrome (ALGS), a disorder that primarily affects the liver, lung, kidney, and skeleton. Whereas cardiac symptoms are also frequently observed in ALGS, thoracic aortic aneurysms have only been reported sporadically in postmortem autopsies. We here report two families with segregating JAG1 variants that present with isolated aneurysmal disease, as well as the first histological evaluation of aortic aneurysm tissue of a JAG1 variant carrier. Our observations shed more light on the pathomechanisms behind aneurysm formation in JAG1 variant harboring individuals and underline the importance of cardiovascular imaging in the clinical follow-up of such individuals.
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Affiliation(s)
- Jotte Rodrigues Bento
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Alice Krebsová
- Department of Cardiology, Center for Inherited Cardiovascular Disorders, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Ilse Van Gucht
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Irene Valdivia Callejon
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - An Van Berendoncks
- Department of Cardiology, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Pavel Votypka
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Ilse Luyckx
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Petra Peldova
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Steven Laga
- Department of Cardiac Surgery, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Marek Havelka
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Lut Van Laer
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Pavel Trunecka
- Department of Hepatology and Gastroenterology, Transplant Center of Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic
| | - Nele Boeckx
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Aline Verstraeten
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Milan Macek
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Josephina A N Meester
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium
| | - Bart Loeys
- Centre of Medical Genetics, Antwerp University Hospital/University of Antwerp, Antwerp, Belgium.,Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
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7
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Beyltjens T, Boudin E, Revencu N, Boeckx N, Bertrand M, Schütz L, Haack TB, Weber A, Biliouri E, Vinkšel M, Zagožen A, Peterlin B, Pai S, Telegrafi A, Henderson LB, Ells C, Turner L, Wuyts W, Van Hul W, Hendrickx G, Mortier GR. Heterozygous pathogenic variants involving CBFB cause a new skeletal disorder resembling cleidocranial dysplasia. J Med Genet 2022; 60:498-504. [PMID: 36241386 PMCID: PMC10176335 DOI: 10.1136/jmg-2022-108739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/03/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Cleidocranial dysplasia (CCD) is a rare skeletal dysplasia with significant clinical variability. Patients with CCD typically present with delayed closure of fontanels and cranial sutures, dental anomalies, clavicular hypoplasia or aplasia and short stature. Runt-related transcription factor 2 (RUNX2) is currently the only known disease-causing gene for CCD, but several studies have suggested locus heterogeneity. METHODS The cohort consists of eight subjects from five unrelated families partially identified through GeneMatcher. Exome or genome sequencing was applied and in two subjects the effect of the variant was investigated at RNA level. RESULTS In each subject a heterozygous pathogenic variant in CBFB was detected, whereas no genomic alteration involving RUNX2 was found. Three CBFB variants (one splice site alteration, one nonsense variant, one 2 bp duplication) were shown to result in a premature stop codon. A large intragenic deletion was found to delete exon 4, without affecting CBFB expression. The effect of a second splice site variant could not be determined but most likely results in a shortened or absent protein. Affected individuals showed similarities with RUNX2-related CCD, including dental and clavicular abnormalities. Normal stature and neurocognitive problems were however distinguishing features. CBFB encodes the core-binding factor β subunit, which can interact with all RUNX proteins (RUNX1, RUNX2, RUNX3) to form heterodimeric transcription factors. This may explain the phenotypic differences between CBFB-related and RUNX2-related CCD. CONCLUSION We confirm the previously suggested locus heterogeneity for CCD by identifying five pathogenic variants in CBFB in a cohort of eight individuals with clinical and radiographic features reminiscent of CCD.
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Affiliation(s)
- Tessi Beyltjens
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Eveline Boudin
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Nicole Revencu
- Center for Human Genetics, Cliniques universitaires Saint-Luc and University of Louvain, Brussels, Belgium
| | - Nele Boeckx
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Miriam Bertrand
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Leon Schütz
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Tobias B Haack
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Axel Weber
- Institute of Human Genetics, Justus Liebig University, Giessen, Germany
| | - Eleni Biliouri
- Institute of Human Genetics, Justus Liebig University, Giessen, Germany
| | - Mateja Vinkšel
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana Division of Internal Medicine, Ljubljana, Slovenia
| | - Anja Zagožen
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana Division of Internal Medicine, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Genomic Medicine, University Medical Centre Ljubljana Division of Internal Medicine, Ljubljana, Slovenia
| | - Shashidhar Pai
- Children's Health, Division of Genetics, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | | - Courtney Ells
- Provincial Medical Genetics Program, Eastern Health, St. John's, Newfoundland, Canada
| | - Lesley Turner
- Provincial Medical Genetics Program, Eastern Health, St. John's, Newfoundland, Canada.,Memorial University of Newfoundland, St. John's, Newfoundland, Canada
| | - Wim Wuyts
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Wim Van Hul
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Gretl Hendrickx
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium .,Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Geert R Mortier
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Department of Human Genetics, KU Leuven, Leuven, Belgium.,Center for Human Genetics, University Hospital Leuven, Leuven, Belgium
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8
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Abstract
OBJECTIVES Coronavirus disease 2019 (COVID-19) was first discovered in Wuhan, China, in December 2019, and soon spread around the entire world. As no effective treatment is known, prediction of disease severity is very important in order to estimate a patients outcome. Aim of this study was to evaluate routine hematology parameters in time after admission. METHODS Data from routine blood analyses from confirmed COVID-19 cases admitted to the University Hospital of Leuven in Belgium were collected. COVID-19 patients (n = 197) were assigned to three groups: a 'non-ICU' group, a 'ICU' group and a 'deceased' group. A control group of 60 Influenza A (non-COVID-19) patients was also included. The parameters evaluated were platelet count (PLT, 109/L), hemoglobin concentration (Hb, g/dL), leukocyte count (LEU, 109/L), neutrophil count (NEU, %), eosinophil count (EO, %), lymphocyte count (LYM, %) and monocyte count (MONO, %). RESULTS Deceased COVID-19 patients had significant lower platelet count, higher leukocyte/neutrophil count, and lower eosinophil/lymphocyte/monocyte count compared to recovered patients. Especially lymphocyte count showed important differences; they were significantly lower between day 9 and 12 after admission making this time window important in predicting clinical worsening of a patient. CONCLUSION Patients with COVID-19 with poor outcome showed significant differences in results of routine hematological parameters compared with patients that recovered. Especially lymphocyte count can be helpful in the prediction of a patients outcome.
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Affiliation(s)
- S. Blomme
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - L. Smets
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - M. Van Ranst
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Laboratory of Clinical and Epidemiological Virology (Rega Institute), KU Leuven, Leuven, Belgium
| | - N. Boeckx
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Departement of Oncology, KU Leuven, Leuven, Belgium
| | - C. Van Laer
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Departement of Cardiovascular Sciences, Center for Molecular and Vascular Biology, KU Leuven, Leuven, Belgium
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9
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Boeckx N, Op de Beeck K, Beyens M, Deschoolmeester V, Hermans C, De Clercq P, Garrigou S, Normand C, Monsaert E, Papadimitriou K, Laurent-Puig P, Pauwels P, Van Camp G, Taly V, Peeters M. Mutation and Methylation Analysis of Circulating Tumor DNA Can Be Used for Follow-up of Metastatic Colorectal Cancer Patients. Clin Colorectal Cancer 2018; 17:e369-e379. [DOI: 10.1016/j.clcc.2018.02.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/12/2018] [Accepted: 02/14/2018] [Indexed: 01/04/2023]
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10
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Janssens K, Boeckx N, Van Camp G, De Beeck KO, Fransen E, Calay F, Van Damme N, Peeters M. Comparing survival in left-sided and right-sided colorectal carcinoma: A Belgian population-based study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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Boeckx N, Koukakis R, Op de Beeck K, Rolfo C, Van Camp G, Siena S, Tabernero J, Douillard JY, André T, Peeters M. Primary tumor sidedness has an impact on prognosis and treatment outcome in metastatic colorectal cancer: results from two randomized first-line panitumumab studies. Ann Oncol 2018; 28:1862-1868. [PMID: 28449055 PMCID: PMC5834073 DOI: 10.1093/annonc/mdx119] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background Previous studies have reported the prognostic impact of primary tumor sidedness in metastatic colorectal cancer (mCRC) and its influence on cetuximab efficacy. The present retrospective analysis of two panitumumab trials investigated a possible association between tumor sidedness and treatment efficacy in first-line mCRC patients with RAS wild-type (WT) primary tumors. Materials and methods Data from two randomized first-line panitumumab trials were analyzed for treatment outcomes by primary tumor sidedness for RAS WT patients. PRIME (phase 3; NCT00364013) compared panitumumab plus FOLFOX versus FOLFOX alone; PEAK (phase 2; NCT00819780) compared panitumumab plus FOLFOX versus bevacizumab plus FOLFOX. Primary tumors located in the cecum to transverse colon were coded as right-sided, while tumors located from the splenic flexure to rectum were considered left-sided. Results Tumor sidedness ascertainment (RAS WT population) was 83% (n = 559/675); 78% of patients (n = 435) had left-sided and 22% (n = 124) had right-sided tumors. Patients with right-sided tumors did worse for all efficacy parameters compared with patients with left-sided disease in the RAS WT population and also in the RAS/BRAF WT subgroup. In patients with left-sided tumors, panitumumab provided better outcomes than the comparator treatment, including on median overall survival (PRIME: 30.3 versus 23.6 months, adjusted hazard ratio = 0.73, P = 0.0112; PEAK: 43.4 versus 32.0 months, adjusted hazard ratio = 0.77, P = 0.3125). Conclusion The results of these retrospective analyses confirm that in RAS WT patients, right-sided primary tumors are associated with worse prognosis than left-sided tumors, regardless of first-line treatment received. RAS WT patients with left-sided tumors derive greater benefit from panitumumab-containing treatment than chemotherapy alone or combined with bevacizumab, including an overall survival advantage (treatment difference: PRIME 6.7 months; PEAK 11.4 months). No final conclusions regarding optimal treatment could be drawn for RAS WT patients with right-sided mCRC due to the relatively low number of paxtients. Further research in this field is warranted. Trial registration (Clinicaltrials.gov) PRIME (NCT00364013), PEAK (NCT00819780).
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Affiliation(s)
- N Boeckx
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | | | - K Op de Beeck
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - C Rolfo
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Department of Oncology, Antwerp University Hospital, Edegem, Belgium
| | - G Van Camp
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - S Siena
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy.,Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano, Milan, Italy
| | - J Tabernero
- Medical Oncology Department, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J-Y Douillard
- Medical Oncology, Institut de Cancérologie de l'Ouest (ICO) René Gauducheau, Nantes, France
| | - T André
- Department of Medical Oncology, Hôpital Saint Antoine; Sorbonne Universités, UMPC Paris 06 and GERCOR, Paris, France
| | - M Peeters
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Department of Oncology, Antwerp University Hospital, Edegem, Belgium
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12
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Boeckx N, Koukakis R, Op de Beeck K, Rolfo C, Van Camp G, Siena S, Tabernero J, Douillard JY, André T, Peeters M. Effect of Primary Tumor Location on Second- or Later-line Treatment Outcomes in Patients With RAS Wild-type Metastatic Colorectal Cancer and All Treatment Lines in Patients With RAS Mutations in Four Randomized Panitumumab Studies. Clin Colorectal Cancer 2018; 17:170-178.e3. [PMID: 29627309 DOI: 10.1016/j.clcc.2018.03.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/05/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND The primary tumor location has a prognostic impact in metastatic colorectal cancer (mCRC). We report the results from retrospective analyses assessing the effect of tumor location on prognosis and efficacy of second- and later-line panitumumab treatment in patients with RAS wild-type (WT) mCRC and on prognosis in all lines of treatment in patients with RAS mutant (MT) mCRC. PATIENTS AND METHODS RAS WT data (n = 483) from 2 randomized phase III panitumumab trials (ClinicalTrials.gov identifiers, NCT00339183 and NCT00113763) were analyzed for treatment outcomes stratified by tumor location. The second analysis assessed the effect of tumor location in RAS MT patients (n = 1205) from 4 panitumumab studies (ClinicalTrials.gov identifiers, NCT00364013, NCT00819780, NCT00339183, and NCT00113763). Primary tumors located in the cecum to transverse colon were coded as right-sided; those located from the splenic flexure to the rectum were coded as left-sided. RESULTS Of all patients, the tumor location was ascertained for 83% to 88%; 71% to 77% of patients had left-sided tumors. RAS WT patients with right-sided tumors did worse for all efficacy parameters compared with those with left-sided tumors. The patients with left-sided tumors had better outcomes with panitumumab than with the comparator treatment. Because of the low patient numbers, no conclusions could be drawn for right-sided mCRC. The prognostic effect of tumor location on survival was unclear for RAS MT patients. CONCLUSION These retrospective analyses have confirmed that RAS WT right-sided mCRC is associated with a poor prognosis, regardless of the treatment. RAS WT patients with left-sided tumors benefitted from the addition of panitumumab in second or later treatment lines. Further research is warranted to determine the optimum management of right-sided mCRC and RAS MT tumors.
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Affiliation(s)
- Nele Boeckx
- Center for Oncological Research, University of Antwerp, Wilrijk, Belgium; Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | | | - Ken Op de Beeck
- Center for Oncological Research, University of Antwerp, Wilrijk, Belgium; Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Christian Rolfo
- Center for Oncological Research, University of Antwerp, Wilrijk, Belgium; Department of Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Guy Van Camp
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Salvatore Siena
- Niguarda Cancer Center, Grande Ospedale Metropolitano Niguarda, Milan, Italy; Dipartimento di Oncologia e Emato-Oncologia, Università degli Studi di Milano, Milan, Italy
| | - Josep Tabernero
- Vall d'Hebron University Hospital and Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Thierry André
- Hôpital Saint Antoine, Sorbonne Universités, UPMC Paris 06 and GERCOR, Paris, France
| | - Marc Peeters
- Center for Oncological Research, University of Antwerp, Wilrijk, Belgium; Department of Oncology, Antwerp University Hospital, Edegem, Belgium.
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13
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Beyens M, Boeckx N, Van Camp G, Op de Beeck K, Vandeweyer G. pyAmpli: an amplicon-based variant filter pipeline for targeted resequencing data. BMC Bioinformatics 2017; 18:554. [PMID: 29237398 PMCID: PMC5729461 DOI: 10.1186/s12859-017-1985-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 12/05/2017] [Indexed: 11/12/2022] Open
Abstract
Background Haloplex targeted resequencing is a popular method to analyze both germline and somatic variants in gene panels. However, involved wet-lab procedures may introduce false positives that need to be considered in subsequent data-analysis. No variant filtering rationale addressing amplicon enrichment related systematic errors, in the form of an all-in-one package, exists to our knowledge. Results We present pyAmpli, a platform independent parallelized Python package that implements an amplicon-based germline and somatic variant filtering strategy for Haloplex data. pyAmpli can filter variants for systematic errors by user pre-defined criteria. We show that pyAmpli significantly increases specificity, without reducing sensitivity, essential for reporting true positive clinical relevant mutations in gene panel data. Conclusions pyAmpli is an easy-to-use software tool which increases the true positive variant call rate in targeted resequencing data. It specifically reduces errors related to PCR-based enrichment of targeted regions. Electronic supplementary material The online version of this article (10.1186/s12859-017-1985-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthias Beyens
- Center of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, 2650, Antwerp, Belgium. .,Center of Oncological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium.
| | - Nele Boeckx
- Center of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, 2650, Antwerp, Belgium.,Center of Oncological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Guy Van Camp
- Center of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, 2650, Antwerp, Belgium.,Center of Oncological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Ken Op de Beeck
- Center of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, 2650, Antwerp, Belgium.,Center of Oncological Research, University of Antwerp, Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Geert Vandeweyer
- Center of Medical Genetics, University of Antwerp, Prins Boudewijnlaan 43, 2650, Antwerp, Belgium
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14
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Boeckx N, Janssens K, Van Camp G, Rasschaert M, Papadimitriou K, Peeters M, Op de Beeck K. The predictive value of primary tumor location in patients with metastatic colorectal cancer: A systematic review. Crit Rev Oncol Hematol 2017; 121:1-10. [PMID: 29279095 DOI: 10.1016/j.critrevonc.2017.11.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/22/2017] [Accepted: 11/06/2017] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer (CRC) is one of the most frequently diagnosed cancers worldwide. It has been reported that left- and right-sided CRC harbor varying disease characteristics, which leads to a difference in prognosis and response to therapy. Recently, there have been retrospective studies about tumor location in metastatic CRC (mCRC) and its potential to predict the effect of anti-vascular endothelial growth factor and anti-epidermal growth factor receptor (anti-EGFR) therapies. In this review, we provide a comprehensive overview of the latest trials studying the predictive value of primary tumor location in mCRC and discuss biomarkers that might be associated with the differences in treatment response. Although data need to be interpreted with caution due to the absence of randomized trials stratified based on tumor location, patients with left-sided CRC seem to benefit more from anti-EGFR therapy than patients with right-sided CRC. Further clinical trials, stratified for tumor location, are warranted.
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Affiliation(s)
- Nele Boeckx
- Center of Oncological Research (CORE), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Prins Boudewijnlaan 43/6, 2650 Edegem, Belgium.
| | - Katleen Janssens
- Center of Oncological Research (CORE), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Guy Van Camp
- Center of Oncological Research (CORE), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Prins Boudewijnlaan 43/6, 2650 Edegem, Belgium.
| | - Marika Rasschaert
- Department of Oncology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
| | | | - Marc Peeters
- Center of Oncological Research (CORE), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Department of Oncology, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Belgium.
| | - Ken Op de Beeck
- Center of Oncological Research (CORE), University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium; Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Prins Boudewijnlaan 43/6, 2650 Edegem, Belgium.
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15
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Graindor N, Blomme S, Jughmans S, Boeckx N, Kieffer D. Performance evaluation of the Spinit ® -BC, a new point-of-care assay for total WBC count with 5-part differential and hematocrit measurement. Int J Lab Hematol 2017; 39:e155-e158. [PMID: 28984031 DOI: 10.1111/ijlh.12747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/24/2017] [Indexed: 11/28/2022]
Affiliation(s)
- N Graindor
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - S Blomme
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - S Jughmans
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - N Boeckx
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KULeuven-University of Leuven, Leuven, Belgium
| | - D Kieffer
- Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Microbiology and Immunology, KULeuven-University of Leuven, Leuven, Belgium
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16
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Mercier T, Devos T, Mukovnikova M, Boeckx N. Diagnosing nocturnal paroxysmal hemoglobinuria: a single-center 4-year experience. Int J Lab Hematol 2017; 39:329-336. [DOI: 10.1111/ijlh.12631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 01/06/2017] [Indexed: 12/21/2022]
Affiliation(s)
- T. Mercier
- Department of Internal Medicine; University Hospitals Leuven; Leuven Belgium
| | - T. Devos
- Department of Hematology; University Hospitals Leuven; Leuven Belgium
- Department of Microbiology and Immunology; KU Leuven; Leuven Belgium
| | - M. Mukovnikova
- Department of Laboratory Medicine; University Hospitals Leuven; Leuven Belgium
| | - N. Boeckx
- Department of Laboratory Medicine; University Hospitals Leuven; Leuven Belgium
- Department of Oncology; KU Leuven; Leuven Belgium
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17
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Boeckx N, Toler A, de Beeck KO, Kafatos G, Deschoolmeester V, Rolfo C, Lowe K, Van Camp G, Demonty G, Peeters M. Primary tumor sidedness impacts on prognosis and treatment outcome: results from three randomized studies of panitumumab plus chemotherapy versus chemotherapy or chemotherapy plus bevacizumab in 1st and 2nd line RAS/BRAF WT mCRC. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw363.37] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Maes B, Bakkus M, Boeckx N, Boone E, Cauwelier B, Denys B, De Schouwer P, Devos T, El Housni H, Hillen F, Jacobs K, Lambert F, Louagie H, Maes MB, Meeus P, Moreau E, Nollet F, Peeters K, Saussoy P, Van Lint P, Vaerman JL, Vaeyens F, Vandepoele K, Vannuffel P, Ver Elst K, Vermeulen K, Bruyndonckx R. A novel approach forBCR-ABL1standardization to improve International Scale estimation. Int J Lab Hematol 2016; 38:674-684. [DOI: 10.1111/ijlh.12556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/13/2016] [Indexed: 01/06/2023]
Affiliation(s)
- B. Maes
- Laboratory for Molecular Diagnostics; Jessa Hospital; Hasselt Belgium
| | - M. Bakkus
- Laboratory of Haematology; University Hospital Brussels; Brussels Belgium
| | - N. Boeckx
- Department of Laboratory Medicine; University Hospitals Leuven; Leuven Belgium
| | - E. Boone
- Laboratory for Molecular Diagnostics; AZ Delta; Roeselare Belgium
| | - B. Cauwelier
- Department of Laboratory Medicine; AZ Sint-Jan Brugge-Oostende AV; Brugge Belgium
| | - B. Denys
- Laboratory for Molecular Diagnostics - Haematology; University Hospital Gent; Gent Belgium
| | | | - T. Devos
- Department of Haematology; University Hospitals; Leuven Belgium
| | | | - F. Hillen
- Laboratory for Molecular Diagnostics; Jessa Hospital; Hasselt Belgium
| | - K. Jacobs
- Clinical Laboratory; AZ Sint-Lucas; Gent Belgium
| | - F. Lambert
- Laboratory for Molecular Diagnostics; Haemato-Oncology Unit; University Hospital Liege; Liege Belgium
| | - H. Louagie
- Clinical Laboratory; AZ Sint-Lucas; Gent Belgium
| | - M.-B. Maes
- Laboratory of Haematology; University Hospital of Antwerp; Antwerp Belgium
| | - P. Meeus
- Laboratory for Molecular Diagnostics; OLV Ziekenhuis Aalst; Aalst Belgium
| | - E. Moreau
- Laboratory for Molecular Diagnostics; AZ Delta; Roeselare Belgium
| | - F. Nollet
- Department of Laboratory Medicine; AZ Sint-Jan Brugge-Oostende AV; Brugge Belgium
| | | | - P. Saussoy
- Laboratoire de biologie moléculaire; Cliniques Universitaires Saint-Luc; Bruxelles Belgium
| | - P. Van Lint
- Department of Molecular Diagnostics; GZA St-Augustinus; Wilrijk Belgium
| | - J.-L. Vaerman
- Laboratoire de biologie moléculaire; Cliniques Universitaires Saint-Luc; Bruxelles Belgium
| | - F. Vaeyens
- Laboratory for Molecular Diagnostics; OLV Ziekenhuis Aalst; Aalst Belgium
| | - K. Vandepoele
- Laboratory for Molecular Diagnostics - Haematology; University Hospital Gent; Gent Belgium
| | - P. Vannuffel
- Institut de Pathologie et de Génétique; Gosselies Belgium
| | - K. Ver Elst
- Department of Molecular Diagnostics; GZA St-Augustinus; Wilrijk Belgium
| | - K. Vermeulen
- Laboratory of Haematology; University Hospital of Antwerp; Antwerp Belgium
| | - R. Bruyndonckx
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-BIOSTAT); University of Hasselt; Diepenbeek Belgium
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19
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Sommen M, Schrauwen I, Vandeweyer G, Boeckx N, Corneveaux JJ, van den Ende J, Boudewyns A, De Leenheer E, Janssens S, Claes K, Verstreken M, Strenzke N, Predöhl F, Wuyts W, Mortier G, Bitner-Glindzicz M, Moser T, Coucke P, Huentelman MJ, Van Camp G. DNA Diagnostics of Hereditary Hearing Loss: A Targeted Resequencing Approach Combined with a Mutation Classification System. Hum Mutat 2016; 37:812-9. [PMID: 27068579 DOI: 10.1002/humu.22999] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 03/29/2016] [Indexed: 12/12/2022]
Abstract
Although there are nearly 100 different causative genes identified for nonsyndromic hearing loss (NSHL), Sanger sequencing-based DNA diagnostics usually only analyses three, namely, GJB2, SLC26A4, and OTOF. As this is seen as inadequate, there is a need for high-throughput diagnostic methods to detect disease-causing variations, including single-nucleotide variations (SNVs), insertions/deletions (Indels), and copy-number variations (CNVs). In this study, a targeted resequencing panel for hearing loss was developed including 79 genes for NSHL and selected forms of syndromic hearing loss. One-hundred thirty one presumed autosomal-recessive NSHL (arNSHL) patients of Western-European ethnicity were analyzed for SNVs, Indels, and CNVs. In addition, we established a straightforward variant classification system to deal with the large number of variants encountered. We estimate that combining prescreening of GJB2 with our panel leads to a diagnosis in 25%-30% of patients. Our data show that after GJB2, the most commonly mutated genes in a Western-European population are TMC1, MYO15A, and MYO7A (3.1%). CNV analysis resulted in the identification of causative variants in two patients in OTOA and STRC. One of the major challenges for diagnostic gene panels is assigning pathogenicity for variants. A collaborative database collecting all identified variants from multiple centers could be a valuable resource for hearing loss diagnostics.
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Affiliation(s)
- Manou Sommen
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Isabelle Schrauwen
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona
| | - Geert Vandeweyer
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Nele Boeckx
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | - Jason J Corneveaux
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona
| | - Jenneke van den Ende
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Antwerp University Hospital, Antwerp, Belgium
| | - An Boudewyns
- Department of Otorhinolaryngology, Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium
| | - Els De Leenheer
- Center of Medical Genetics, Ghent University, Ghent, Belgium
| | - Sandra Janssens
- Center of Medical Genetics, Ghent University, Ghent, Belgium
| | - Kathleen Claes
- Center of Medical Genetics, Ghent University, Ghent, Belgium
| | - Margriet Verstreken
- University Department Otolaryngology, St. Augustinus Hospital, Antwerp, Belgium
| | - Nicola Strenzke
- Inner Ear Lab, Department of Otolaryngology, University Medical Center Göttingen, Göttingen, Germany
| | - Friederike Predöhl
- Inner Ear Lab, Department of Otolaryngology, University Medical Center Göttingen, Göttingen, Germany
| | - Wim Wuyts
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Antwerp University Hospital, Antwerp, Belgium
| | - Geert Mortier
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium.,Antwerp University Hospital, Antwerp, Belgium
| | - Maria Bitner-Glindzicz
- Clinical and Molecular Genetics Unit, UCL Institute of Child Health and Great Ormond Street Hospital NHS Trust, London, UK
| | - Tobias Moser
- Inner Ear Lab, Department of Otolaryngology, University Medical Center Göttingen, Göttingen, Germany.,Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Paul Coucke
- Center of Medical Genetics, Ghent University, Ghent, Belgium
| | - Matthew J Huentelman
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona
| | - Guy Van Camp
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
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20
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Cross NCP, White HE, Ernst T, Welden L, Dietz C, Saglio G, Mahon FX, Wong CC, Zheng D, Wong S, Wang SS, Akiki S, Albano F, Andrikovics H, Anwar J, Balatzenko G, Bendit I, Beveridge J, Boeckx N, Cerveira N, Cheng SM, Colomer D, Czurda S, Daraio F, Dulucq S, Eggen L, El Housni H, Gerrard G, Gniot M, Izzo B, Jacquin D, Janssen JJWM, Jeromin S, Jurcek T, Kim DW, Machova-Polakova K, Martinez-Lopez J, McBean M, Mesanovic S, Mitterbauer-Hohendanner G, Mobtaker H, Mozziconacci MJ, Pajič T, Pallisgaard N, Panagiotidis P, Press RD, Qin YZ, Radich J, Sacha T, Touloumenidou T, Waits P, Wilkinson E, Zadro R, Müller MC, Hochhaus A, Branford S. Development and evaluation of a secondary reference panel for BCR-ABL1 quantification on the International Scale. Leukemia 2016; 30:1844-52. [PMID: 27109508 PMCID: PMC5240017 DOI: 10.1038/leu.2016.90] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/11/2016] [Indexed: 12/24/2022]
Abstract
Molecular monitoring of chronic myeloid leukemia patients using robust BCR-ABL1 tests standardized to the International Scale (IS) is key to proper disease management, especially when treatment cessation is considered. Most laboratories currently use a time-consuming sample exchange process with reference laboratories for IS calibration. A World Health Organization (WHO) BCR-ABL1 reference panel was developed (MR1–MR4), but access to the material is limited. In this study, we describe the development of the first cell-based secondary reference panel that is traceable to and faithfully replicates the WHO panel, with an additional MR4.5 level. The secondary panel was calibrated to IS using digital PCR with ABL1, BCR and GUSB as reference genes and evaluated by 44 laboratories worldwide. Interestingly, we found that >40% of BCR-ABL1 assays showed signs of inadequate optimization such as poor linearity and suboptimal PCR efficiency. Nonetheless, when optimized sample inputs were used, >60% demonstrated satisfactory IS accuracy, precision and/or MR4.5 sensitivity, and 58% obtained IS conversion factors from the secondary reference concordant with their current values. Correlation analysis indicated no significant alterations in %BCR-ABL1 results caused by different assay configurations. More assays achieved good precision and/or sensitivity than IS accuracy, indicating the need for better IS calibration mechanisms.
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Affiliation(s)
- N C P Cross
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - H E White
- Wessex Regional Genetics Laboratory, Salisbury NHS Foundation Trust, Salisbury, UK.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - T Ernst
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - L Welden
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia
| | - C Dietz
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - G Saglio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - F-X Mahon
- Bergonie Institute Cancer Center Bordeaux, INSERM U1218, University of Bordeaux, Bordeaux, France
| | - C C Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - D Zheng
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Wong
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S-S Wang
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
| | - S Akiki
- West Midlands Regional Genetics Laboratory, Birmingham, UK
| | - F Albano
- Department of Hematology, University of Bari, Bari, Italy
| | - H Andrikovics
- Laboratory of Molecular Diagnostics, Hungarian National Blood Transfusion Service, Budapest, Hungary.,Department of Pathophysiology, Semmelweis University, Budapest, Hungary
| | - J Anwar
- King's College Hospital London, London, UK
| | - G Balatzenko
- National Specialized Hospital for Active Treatment of Hematological Diseases, Sofia, Bulgaria
| | - I Bendit
- Laboratorio de Biologia Tumoral, Disciplina de Hematologia do HC-FMUSP, São Paulo, Brazil
| | - J Beveridge
- PathWest Laboratory Medicine WA, Department of Haematology, Fiona Stanley Hospital, Perth, WA, Australia
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, KUL, Leuven, Belgium
| | - N Cerveira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
| | - S-M Cheng
- Department of Hematology and Oncology, Quest Diagnostics Nichols Institute, San Juan Capistrano, CA, USA
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - S Czurda
- Division of Molecular Microbiology, Children's Cancer Research Institute, Vienna, Austria
| | - F Daraio
- Department of Clinical and Biological Sciences, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - S Dulucq
- Laboratoire Hematologie, Centre Hospitalier Universitaire de Bordeaux, Universite Bordeaux, Bordeaux, France
| | - L Eggen
- Laboratory of Molecular Pathology, Oslo University Hospital, Oslo, Norway
| | - H El Housni
- Clinique de Genetique Oncologique-Service de genetique, Hopital Erasme, Brussels, Belgium
| | - G Gerrard
- Imperial Molecular Pathology, Hammersmith Hospital, London, UK
| | - M Gniot
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy.,CEINGE - Biotecnologie Avanzate, Naples, Italy
| | | | - J J W M Janssen
- Department of Hematology and Molecular Diagnostics, VU University Medical Center, Amsterdam, The Netherlands
| | - S Jeromin
- MLL Munich Leukemia Laboratory, Munich, Germany
| | - T Jurcek
- Center of Molecular Biology and Gene Therapy, Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - D-W Kim
- Seoul St Mary's Hospital, Leukemia Research Institute, The Catholic University of Korea, Seoul, Korea
| | - K Machova-Polakova
- Department of Molecular Genetics, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - J Martinez-Lopez
- Department of Hematology, Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO, Madrid, Spain
| | - M McBean
- Division of Cancer Medicine, Department of Pathology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - S Mesanovic
- Pathology Department, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - G Mitterbauer-Hohendanner
- Department of Laboratory Medicine, Division of Medical and Chemical Laboratory Diagnostics, Medical University of Vienna, Vienna, Austria
| | | | - M-J Mozziconacci
- Departement de Biopathologie, Institut Paoli-Calmettes, Marseille, France
| | - T Pajič
- Specialized Haematology Laboratory, Department of Haematology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - N Pallisgaard
- Department of Surgical Pathology, Zealand University Hospital, Roskilde, Denmark
| | - P Panagiotidis
- Hematology Unit, First Department of Internal Medicine, Laiko Hospital, University of Athens, Athens, Greece
| | - R D Press
- Department of Pathology and Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Y-Z Qin
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing, China
| | - J Radich
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - T Sacha
- Chair and Department of Hematology, Jagiellonian University, Kraków, Poland
| | - T Touloumenidou
- Laboratory of Molecular Biology, Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | - P Waits
- Bristol Genetics Laboratory, Bristol, UK
| | | | - R Zadro
- Faculty of Pharmacy and Biochemistry and University Hospital Center Zagreb, University of Zagreb, Zagreb, Croatia
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Universitätsklinikum Jena, Jena, Germany
| | - S Branford
- Department of Genetics and Molecular Pathology, Centre for Cancer Biology, SA Pathology, Adelaide, SA, Australia.,School of Pharmacy and Medical Science, University of South Australia, Adelaide, SA, Australia.,School of Medicine, University of Adelaide, SA, Adelaide, Australia.,School of Molecular and Biomedical Science, University of Adelaide, Adelaide, SA, Australia
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21
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Boeckx N, Laer CV, Roover JD, Wilmsen B, Bruyninckx K, Pauwels S. Comparison of molecular responses based on BCR-ABL1% (IS) results from an in-house TaqMan-based qPCR versus Xpert(®) assay in CML patients on tyrosine kinase inhibitor therapy. Acta Clin Belg 2015; 70:237-43. [PMID: 26166681 DOI: 10.1179/2295333715y.0000000009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Tyrosine kinase inhibitors (TKIs) have drastically changed the prospects for chronic myeloid leukemia (CML) patients. The European LeukemiaNet (ELN) recommends molecular monitoring of BCR-ABL1 mRNA levels at distinct time points to define an optimal response, warning, or failure of treatment. METHODS Sixty-four follow-up peripheral blood samples from CML patients on TKI were tested by two methods. Molecular responses based on BCR-ABL1% (IS) from an Xpert(®) BCR-ABL1 Monitor assay were compared with TaqMan-based qPCR. RESULTS Seven samples showed 'molecularly undetectable leukaemia' by both methods (11%). In-house qPCR showed 57 BCR-ABL1+ samples; 45/57 samples (79%) were concordant for 'major molecular response' (MMR, n = 32) and 'no MMR' (n = 13) by both assays, whereas nine were BCR-ABL1 negative by Xpert(®). Identical molecular responses (i.e. 'optimal') were defined in 41 samples. Discordances seen in patients < 10 months on TKI (n = 2) had no impact on clinical management, whereas for patients >12 months on TKI, a different molecular response was defined ('warning' versus 'optimal'). Thirteen samples had 'no MMR' by both methods. 10/13 showed identical intervals (>10%(IS), 1-10%(IS) or 0·1-1%(IS)), corresponding to seven 'failures' and three 'warnings'. Discordant intervals were seen in 3/13 samples (all defined as 'failures'). Deep molecular responses (MR(4·0) or MR(5·0)) with detectable BCR-ABL1 showed some fluctuations between both methods, nevertheless, all had 'optimal' responses. 'Molecularly undetectable leukaemia' was observed more frequently by Xpert(®) (n = 16) as by our in-house assay (n = 7). DISCUSSION Based on current ELN recommendations, Xpert(®) BCR-ABL1 assay defines identical molecular responses as TaqMan-based qPCR BCR-ABL1% (IS) data in 98% (63/64) of samples.
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22
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Labaere D, Boeckx N, Geerts I, Moens M, Van den Driessche M. Detection of malignant cells in serous body fluids by counting high-fluorescent cells on the Sysmex XN-2000 hematology analyzer. Int J Lab Hematol 2015; 37:715-22. [PMID: 26074270 DOI: 10.1111/ijlh.12393] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Accepted: 05/15/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The body fluid mode of the Sysmex XN-2000 hematology analyzer differentiates cells into mononuclear and polymorphonuclear white blood cells (WBC) and high-fluorescent cells (HFC). The aim of this study was to evaluate the performance of the HFC count for detecting malignant cells in serous body fluids. METHODS Two-hundred and thirty serous fluids were analyzed on the Sysmex XN body fluid mode. HFC were measured as relative count (HFC/100 WBC) and absolute count (HFC/μL). All samples were microscopically screened on cytospin slides for the presence of malignant cells. RESULTS Malignant cells were found by microscopic examination in 49 of 230 samples (21.3%). Malignant samples contained significantly higher percentages (10.2 vs. 2.6/100 WBC) and absolute numbers (65 vs. 10/μL) of HFC than nonmalignant samples (P < 0.001). Areas under the ROC curve for relative and absolute HFC count were 0.69 and 0.77, respectively. A cutoff level of ≥17 HFC/μL showed the best performance to predict malignancy, with 88% sensitivity and 61% specificity. CONCLUSION As serous body fluids will be more analyzed on automated analyzers in the future, HFC count can be a useful tool to select samples for microscopic review. Microscopic evaluation should be performed if HFC values are above a certain threshold (e.g. ≥17 HFC/μL) or in case of clinical suspicion of malignancy.
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Affiliation(s)
- D Labaere
- Department of Laboratory Medicine, Imelda Hospital, Bonheiden, Belgium
| | - N Boeckx
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Oncology, Catholic University of Leuven, Leuven, Belgium
| | - I Geerts
- Department of Laboratory Medicine, Imelda Hospital, Bonheiden, Belgium
| | - M Moens
- Department of Laboratory Medicine, Imelda Hospital, Bonheiden, Belgium
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23
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White H, Deprez L, Corbisier P, Hall V, Lin F, Mazoua S, Trapmann S, Aggerholm A, Andrikovics H, Akiki S, Barbany G, Boeckx N, Bench A, Catherwood M, Cayuela JM, Chudleigh S, Clench T, Colomer D, Daraio F, Dulucq S, Farrugia J, Fletcher L, Foroni L, Ganderton R, Gerrard G, Gineikienė E, Hayette S, El Housni H, Izzo B, Jansson M, Johnels P, Jurcek T, Kairisto V, Kizilors A, Kim DW, Lange T, Lion T, Polakova KM, Martinelli G, McCarron S, Merle PA, Milner B, Mitterbauer-Hohendanner G, Nagar M, Nickless G, Nomdedéu J, Nymoen DA, Leibundgut EO, Ozbek U, Pajič T, Pfeifer H, Preudhomme C, Raudsepp K, Romeo G, Sacha T, Talmaci R, Touloumenidou T, Van der Velden VHJ, Waits P, Wang L, Wilkinson E, Wilson G, Wren D, Zadro R, Ziermann J, Zoi K, Müller MC, Hochhaus A, Schimmel H, Cross NCP, Emons H. A certified plasmid reference material for the standardisation of BCR-ABL1 mRNA quantification by real-time quantitative PCR. Leukemia 2014; 29:369-76. [PMID: 25036192 PMCID: PMC4320294 DOI: 10.1038/leu.2014.217] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/21/2014] [Accepted: 06/25/2014] [Indexed: 11/14/2022]
Abstract
Serial quantification of BCR–ABL1 mRNA is an important therapeutic indicator in chronic myeloid leukaemia, but there is a substantial variation in results reported by different laboratories. To improve comparability, an internationally accepted plasmid certified reference material (CRM) was developed according to ISO Guide 34:2009. Fragments of BCR–ABL1 (e14a2 mRNA fusion), BCR and GUSB transcripts were amplified and cloned into pUC18 to yield plasmid pIRMM0099. Six different linearised plasmid solutions were produced with the following copy number concentrations, assigned by digital PCR, and expanded uncertainties: 1.08±0.13 × 106, 1.08±0.11 × 105, 1.03±0.10 × 104, 1.02±0.09 × 103, 1.04±0.10 × 102 and 10.0±1.5 copies/μl. The certification of the material for the number of specific DNA fragments per plasmid, copy number concentration of the plasmid solutions and the assessment of inter-unit heterogeneity and stability were performed according to ISO Guide 35:2006. Two suitability studies performed by 63 BCR–ABL1 testing laboratories demonstrated that this set of 6 plasmid CRMs can help to standardise a number of measured transcripts of e14a2 BCR–ABL1 and three control genes (ABL1, BCR and GUSB). The set of six plasmid CRMs is distributed worldwide by the Institute for Reference Materials and Measurements (Belgium) and its authorised distributors (https://ec.europa.eu/jrc/en/reference-materials/catalogue/; CRM code ERM-AD623a-f).
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Affiliation(s)
- H White
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - L Deprez
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - P Corbisier
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - V Hall
- National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK
| | - F Lin
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Mazoua
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - S Trapmann
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - A Aggerholm
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | - H Andrikovics
- Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - S Akiki
- Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - G Barbany
- Department of Molecular Medicine and Surgery, Clinical Genetics Karolinska Institutet, Stockholm, Sweden
| | - N Boeckx
- 1] Department of Laboratory Medicine, UZ Leuven, Belgium [2] Department of Oncology, KU Leuven, Belgium
| | - A Bench
- Molecular Malignancy Laboratory and Haemato-Oncology Diagnostic Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M Catherwood
- Haematology Department, Belfast City Hospital, Belfast, UK
| | - J-M Cayuela
- Haematology Laboratory and EA3518, University Hospital Saint-Louis, AP-HP, University Paris Diderot, Paris, France
| | - S Chudleigh
- Department of Molecular Haematology, Yorkhill NHS Trust, Glasgow, UK
| | - T Clench
- Molecular Haematology, Bristol Royal Infirmary, Bristol, UK
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - F Daraio
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - S Dulucq
- Laboratoire Hematologie, CHU Bordeaux, Hematopoiese Leucemique et Cibles Therapeutiques, INSERM U1035, Universite Bordeaux, Bordeaux, France
| | - J Farrugia
- Combined Laboratories, Derriford Hospital, Plymouth, UK
| | - L Fletcher
- Department of Genetics and Molecular Pathology, SA Pathology, Adelaide, SA, Australia
| | - L Foroni
- Imperial Molecular Pathology, Centre for Haematology, Imperial College London, London, UK
| | - R Ganderton
- Molecular Pathology, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - G Gerrard
- Imperial Molecular Pathology, Centre for Haematology, Imperial College London, London, UK
| | - E Gineikienė
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - S Hayette
- Laboratory of Molecular Biology and UMR5239, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - H El Housni
- Medical Genetics Department, Erasme Hospital, Brussels, Belgium
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy
| | - M Jansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - P Johnels
- Department of Clinical Genetics, University and Regional Laboratories, Lund, Sweden
| | - T Jurcek
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - V Kairisto
- Turku University Hospital, TYKSLAB, Laboratory of Molecular Genetics, Turku, Finland
| | - A Kizilors
- Laboratory for Molecular Haemato-Oncology, Kings College Hospital, London, UK
| | - D-W Kim
- Cancer Research Institute, The Catholic University of Korea, Seoul, South Korea
| | - T Lange
- Abteilung für Hämatologie und internistische Onkologie, Universität Leipzig, Leipzig, Germany
| | - T Lion
- Children's Cancer Research Institute/LabDia Labordiagnostik and Medical University, Vienna, Austria
| | - K M Polakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - G Martinelli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - S McCarron
- Cancer Molecular Diagnostics, St James's Hospital, Dublin, Ireland
| | - P A Merle
- VU Medical Centre, Department of Haematology, Amsterdam, The Netherlands
| | - B Milner
- Department of Medical Genetics, NHS-Grampian, Aberdeen, UK
| | | | - M Nagar
- Laboratory of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - G Nickless
- Molecular Oncology Diagnostics Unit, Guy's Hospital, London, UK
| | - J Nomdedéu
- Lab Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - D A Nymoen
- Division of Pathology, Rikshospital, Oslo University Hospital, Oslo, Norway
| | - E O Leibundgut
- Molecular Diagnostics Laboratory, Department of Hematology, University Hospital Bern, Bern, Switzerland
| | - U Ozbek
- Genetics Department, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | - T Pajič
- Specialized Haematology Laboratory, Division of Internal Medicine, Department of Haematology, University Medical Centre, Ljubljana, Slovenia
| | - H Pfeifer
- Department of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - C Preudhomme
- Laboratoire d'hématologie, CHU Lille, Lille, France
| | - K Raudsepp
- United Laboratories of Tartu University Hospitals, Tartu, Estonia
| | - G Romeo
- Molecular Haematology Laboratory, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA, Australia
| | - T Sacha
- Hematology Department, Jagiellonian University, Krakow, Poland
| | - R Talmaci
- Hematology Department, Fundeni Clinical Institute, University of Medicine and Pharmacy 'Carol Davila', Bucharest, Romania
| | - T Touloumenidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - P Waits
- Bristol Genetics Laboratory, Southmead Hospital, Bristol, UK
| | - L Wang
- Department of Haematology, Royal Liverpool University Hospital, Liverpool, UK
| | - E Wilkinson
- HMDS, Leeds Institute of Oncology, St James's University Hospital, Leeds, UK
| | - G Wilson
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - D Wren
- Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R Zadro
- Department of Laboratory Diagnostics, Clinical Hospital Center, Zagreb University School of Medicine, Zagreb, Croatia
| | - J Ziermann
- Department of Hematology/Oncology, Jena University Hospital, Jena, Germany
| | - K Zoi
- Haematology Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Jena University Hospital, Jena, Germany
| | - H Schimmel
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - N C P Cross
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Emons
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
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24
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Roobrouck V, Chakraborty S, Vanwelden T, Sels K, Lazarri E, Pandey S, Boeckx N, Delforge M, Verfaillie C. P-308 The effect of multipotent adult progenitor cells on bone marrow failure in myelodysplastic syndromes. Leuk Res 2013. [DOI: 10.1016/s0145-2126(13)70355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Weerkamp F, Dekking E, Ng YY, van der Velden VHJ, Wai H, Böttcher S, Brüggemann M, van der Sluijs AJ, Koning A, Boeckx N, Van Poecke N, Lucio P, Mendonça A, Sedek L, Szczepański T, Kalina T, Kovac M, Hoogeveen PG, Flores-Montero J, Orfao A, Macintyre E, Lhermitte L, Chen R, Brouwer-De Cock KAJ, van der Linden A, Noordijk AL, Comans-Bitter WM, Staal FJT, van Dongen JJM. Flow cytometric immunobead assay for the detection of BCR-ABL fusion proteins in leukemia patients. Leukemia 2009; 23:1106-17. [PMID: 19387467 DOI: 10.1038/leu.2009.93] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BCR-ABL fusion proteins show increased signaling through their ABL tyrosine kinase domain, which can be blocked by specific inhibitors, thereby providing effective treatment. This makes detection of BCR-ABL aberrations of utmost importance for diagnosis, classification and treatment of leukemia patients. BCR-ABL aberrations are currently detected by karyotyping, fluorescence in situ hybridization (FISH) or PCR techniques, which are time consuming and require specialized facilities. We developed a simple flow cytometric immunobead assay for detection of BCR-ABL fusion proteins in cell lysates, using a bead-bound anti-BCR catching antibody and a fluorochrome-conjugated anti-ABL detection antibody. We noticed protein stability problems in lysates caused by proteases from mature myeloid cells. This problem could largely be solved by adding protease inhibitors in several steps of the immunobead assay. Testing of 145 patient samples showed fully concordant results between the BCR-ABL immunobead assay and reverse transcriptase PCR of fusion gene transcripts. Dilution experiments with BCR-ABL positive cell lines revealed sensitivities of at least 1%. We conclude that the BCR-ABL immunobead assay detects all types of BCR-ABL proteins in leukemic cells with high specificity and sensitivity. The assay does not need specialized laboratory facilities other than a flow cytometer, provides results within approximately 4 h, and can be run in parallel to routine immunophenotyping.
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Affiliation(s)
- F Weerkamp
- Department of Immunology, Erasmus MC, Rotterdam, The Netherlands
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26
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Sprangers B, Van Wijmeersch B, Luyckx A, Sagaert X, De Somer L, Rutgeerts O, Lenaerts C, Landuyt W, Boeckx N, Dubois B, De Wolf-Peeters C, Waer M, Billiau AD. Allogeneic bone marrow transplantation and donor lymphocyte infusion in a mouse model of irradiation-induced myelodysplastic/myeloproliferation syndrome (MD/MPS): evidence for a graft-versus-MD/MPS effect. Leukemia 2008; 23:340-9. [PMID: 18987665 DOI: 10.1038/leu.2008.298] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The role of graft-versus-malignancy reactivity in the effects of allogeneic hematopoietic stem cell transplantation and donor lymphocyte infusion (DLI) for myelodysplastic syndromes is as yet not well established. Clinical data are limited and animal models are scarce. Here, we report on the effects of allogeneic bone marrow transplantation (alloBMT) and DLI in a novel model of irradiation-induced murine myelodysplastic/myeloproliferation syndrome (MD/MPS). Total body irradiation with 8.5 Gy in SJL/J mice gave rise to a lethal wasting syndrome in 60% of mice, characterized by 1 degrees normocellular bone marrow with dysplastic features in erythroid, myeloid and megakaryocytic cell lineages, 2 degrees lymphosplenomegaly with spleens harboring a prominent extramedullary hematopoiesis with erythroid, myeloid and megakaryocytic lineages exhibiting dysplastic features, and foci of dysplastic hematomyelopoiesis in the liver, 3 degrees peripheral thrombocytopenia and 4 degrees evidence of disseminated infection or leukemic transformation in selected animals. This clinicopathological picture was consistent with a murine form of MD/MPS. Syngeneic or allogeneic (BALB/c) T cell-depleted BMT could not prevent the occurrence of lethal MD/MPS. In contrast, DLI at weeks 2-4 after BMT led to restoration of the dysbalanced hematomyelopoiesis. However, severe DLI-induced acute graft-versus-host disease occurred, precluding a survival advantage. We present evidence of the existence of a post-alloBMT DLI-induced graft-versus-MD/MPS effect in murine irradiation-induced MD/MPS.
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Affiliation(s)
- B Sprangers
- Laboratory of Experimental Transplantation, University of Leuven, Leuven, Belgium
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27
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MESH Headings
- Adolescent
- Antineoplastic Agents/therapeutic use
- Bone Marrow Examination
- Bone Marrow Transplantation
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 19
- Cytogenetic Analysis
- Female
- Histiocytosis/genetics
- Histiocytosis/immunology
- Humans
- Immunophenotyping
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/immunology
- Leukemia, Monocytic, Acute/therapy
- Translocation, Genetic
- Transplantation, Homologous
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Affiliation(s)
- N Boeckx
- Department of Laboratory Medicine, Laboratory of Haematology, University Hospital Gasthuisberg, Leuven, Belgium.
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28
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Cloos J, Goemans BF, Hess CJ, van Oostveen JW, Waisfisz Q, Corthals S, de Lange D, Boeckx N, Hählen K, Reinhardt D, Creutzig U, Schuurhuis GJ, Zwaan CM, Kaspers GJL. Stability and prognostic influence of FLT3 mutations in paired initial and relapsed AML samples. Leukemia 2006; 20:1217-20. [PMID: 16642044 DOI: 10.1038/sj.leu.2404246] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In acute myeloid leukemia (AML), activating mutations in the fms-like tyrosine kinase 3 (FLT3) gene predict poor prognosis. We determined FLT3 internal tandem duplications (FLT3/ITD) and D835 point mutations in paired initial and relapse samples from 80 pediatric and adult AML patients. One D835 point mutation was found in an initial pediatric AML sample. Fms-like tyrosine kinase 3/ITDs were present in 21 initial and 22 relapse samples (26.3 and 27.5%, respectively). Interestingly, FLT3/ITD positivity was related to a significantly shorter time to relapse, most pronounced when the ITD-positive status was found at relapse (P<0.001). However, FLT3/ITD status changed between diagnosis and relapse in 14 cases. In four patients, the FLT3/ITD became undetectable at relapse in five patients FLT3/ITDs were only detected at relapse, and in five patients the length or number of FLT3/ITDs changed. Gain of FLT3/ITDs may suggest oligoclonality with selective outgrowth of the FLT3/ITD-positive clone, whereas losses may reflect ITDs in the more mature leukemic cells rather than in the leukemic stem cell, or, alternatively, that other genetic aberrations provided a greater selective advantage. Studying FLT3/ITD kinetics in minimal residual disease setting may provide some answers for the changes we observed. Fms-like tyrosine kinase 3/ITD is a relevant marker for prognosis, and remains an important target for therapeutic inhibition.
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MESH Headings
- Adolescent
- Adult
- Female
- Genetic Markers
- Genetic Predisposition to Disease/epidemiology
- Humans
- Leukemia, Erythroblastic, Acute/genetics
- Leukemia, Megakaryoblastic, Acute/genetics
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myelomonocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Neoplasm, Residual/epidemiology
- Neoplasm, Residual/genetics
- Point Mutation
- Prognosis
- Recurrence
- Risk Factors
- Tandem Repeat Sequences
- fms-Like Tyrosine Kinase 3/genetics
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Affiliation(s)
- J Cloos
- Department of Pediatric Oncology/Hematology, VU University Medical Center, Amsterdam, The Netherlands.
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29
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Boeckx N, De Roover J, van der Velden VHJ, Maertens J, Uyttebroeck A, Vandenberghe P, van Dongen JJM. Quantification of CBFB-MYH11 fusion gene levels in paired peripheral blood and bone marrow samples by real-time PCR. Leukemia 2005; 19:1988-90. [PMID: 16193088 DOI: 10.1038/sj.leu.2403961] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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30
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Boeckx N, Jansen MWJC, Haskovec C, Vandenberghe P, van der Velden VHJ, van Dongen JJM. Identification of e19a2 BCR–ABL fusions (μ-BCR breakpoints) at the DNA level by ligation-mediated PCR. Leukemia 2005; 19:1292-5. [PMID: 15843824 DOI: 10.1038/sj.leu.2403761] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Graux C, Cools J, Melotte C, Quentmeier H, Ferrando A, Levine R, Vermeesch JR, Stul M, Dutta B, Boeckx N, Bosly A, Heimann P, Uyttebroeck A, Mentens N, Somers R, MacLeod RAF, Drexler HG, Look AT, Gilliland DG, Michaux L, Vandenberghe P, Wlodarska I, Marynen P, Hagemeijer A. Fusion of NUP214 to ABL1 on amplified episomes in T-cell acute lymphoblastic leukemia. Nat Genet 2004; 36:1084-9. [PMID: 15361874 DOI: 10.1038/ng1425] [Citation(s) in RCA: 282] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2004] [Accepted: 08/09/2004] [Indexed: 11/10/2022]
Abstract
In T-cell acute lymphoblastic leukemia (T-ALL), transcription factors are known to be deregulated by chromosomal translocations, but mutations in protein tyrosine kinases have only rarely been identified. Here we describe the extrachromosomal (episomal) amplification of ABL1 in 5 of 90 (5.6%) individuals with T-ALL, an aberration that is not detectable by conventional cytogenetics. Molecular analyses delineated the amplicon as a 500-kb region from chromosome band 9q34, containing the oncogenes ABL1 and NUP214 (refs. 5,6). We identified a previously undescribed mechanism for activation of tyrosine kinases in cancer: the formation of episomes resulting in a fusion between NUP214 and ABL1. We detected the NUP214-ABL1 transcript in five individuals with the ABL1 amplification, in 5 of 85 (5.8%) additional individuals with T-ALL and in 3 of 22 T-ALL cell lines. The constitutively phosphorylated tyrosine kinase NUP214-ABL1 is sensitive to the tyrosine kinase inhibitor imatinib. The recurrent cryptic NUP214-ABL1 rearrangement is associated with increased HOX expression and deletion of CDKN2A, consistent with a multistep pathogenesis of T-ALL. NUP214-ABL1 expression defines a new subgroup of individuals with T-ALL who could benefit from treatment with imatinib.
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Affiliation(s)
- C Graux
- Department of Human Genetics, University of Leuven, Leuven, Belgium
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32
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van der Velden VHJ, Boeckx N, Jedema I, te Marvelde JG, Hoogeveen PG, Boogaerts M, van Dongen JJM. High CD33-antigen loads in peripheral blood limit the efficacy of gemtuzumab ozogamicin (Mylotarg) treatment in acute myeloid leukemia patients. Leukemia 2004; 18:983-8. [PMID: 15029214 DOI: 10.1038/sj.leu.2403350] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Gemtuzumab ozogamicin (Mylotarg) induces remission in approximately 30% of relapsed AML patients. We previously demonstrated that gemtuzumab infusion results in near-complete CD33 saturation in peripheral blood, and that saturating gemtuzumab levels result in continuous binding and internalization of gemtuzumab due to renewed CD33 expression. We now demonstrate that a high CD33-antigen load in peripheral blood is an independent adverse prognostic factor, likely due to peripheral consumption of gemtuzumab. Indeed, CD33 saturation in bone marrow is significantly reduced (40-90% saturation) as compared with CD33 saturation in corresponding peripheral blood samples (>90%). In vitro, such reduced CD33 saturation levels were strongly related with reduced cell kill. Apparently, high CD33-antigen loads in blood consume gemtuzumab and thereby limit its penetration into bone marrow. Consequently, CD33 saturation in bone marrow is reduced, which hampers efficient cell kill. Therefore, gemtuzumab should be administered at higher or repeated doses, or, preferably, after reduction of the leukemic cell burden by classical chemotherapy.
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MESH Headings
- Aminoglycosides/therapeutic use
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antigens, CD/blood
- Antigens, Differentiation, Myelomonocytic/blood
- Gemtuzumab
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/drug therapy
- Prognosis
- Sialic Acid Binding Ig-like Lectin 3
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Affiliation(s)
- V H J van der Velden
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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33
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van der Velden VHJ, Boeckx N, Gonzalez M, Malec M, Barbany G, Lion T, Gottardi E, Pallisgaard N, Beillard E, Hop WCJ, Hoogeveen PG, Gabert J, van Dongen JJM. Differential stability of control gene and fusion gene transcripts over time may hamper accurate quantification of minimal residual disease--a study within the Europe Against Cancer Program. Leukemia 2004; 18:884-6. [PMID: 14961029 DOI: 10.1038/sj.leu.2403309] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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34
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van der Velden VHJ, Boeckx N, van Wering ER, van Dongen JJM. Detection of minimal residual disease in acute leukemia. J BIOL REG HOMEOS AG 2004; 18:146-54. [PMID: 15471219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Detection of minimal residual disease (MRD) has prognostic value in acute lymphoblastic leukemia and acute myeloid leukemia. Particularly the evaluation of early treatment response has high prognostic value, because this allows identification of true low-risk and high-risk patients, who may profit from treatment reduction or treatment intensification, respectively. Consequently, monitoring of MRD is now being incorporated in many clinical protocols. Analysis of MRD in acute leukemia is currently mainly performed using flowcytometric immunophenotyping, real-time quantitative (RQ-)PCR analysis of fusion gene transcripts, and RQ-PCR analysis of rearranged immunoglobulin and/or T-cell receptor genes. These three techniques differ in their applicability and sensitivity and it should be noted that MRD results obtained by one method cannot yet easily be compared with MRD results obtained by another method. Also between laboratories applying the same method, significant variations in MRD results can be present. Consequently, multicenter clinical studies with MRD-based treatment intervention need standardization of MRD techniques and quality control of MRD results.
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35
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Vandenberghe P, Boeckx N, Ronsyn E, Decorte R, Verhoef G, Hagemeijer A. Imatinib mesylate induces durable complete remission of advanced CML persisting after allogeneic bone marrow transplantation. Leukemia 2003; 17:458-60. [PMID: 12592347 DOI: 10.1038/sj.leu.2402811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2002] [Accepted: 10/10/2002] [Indexed: 11/08/2022]
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36
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Boeckx N, Willemse MJ, Szczepanski T, van der Velden VHJ, Langerak AW, Vandekerckhove P, van Dongen JJM. Fusion gene transcripts and Ig/TCR gene rearrangements are complementary but infrequent targets for PCR-based detection of minimal residual disease in acute myeloid leukemia. Leukemia 2002; 16:368-75. [PMID: 11896540 DOI: 10.1038/sj.leu.2402387] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2001] [Accepted: 11/19/2001] [Indexed: 11/08/2022]
Abstract
PCR-based monitoring of minimal residual disease (MRD) in acute leukemias can be achieved via detection of fusion gene transcripts of chromosome aberrations or detection of immunoglobulin (Ig) and T cell receptor (TCR) gene rearrangements. We wished to assess whether both PCR targets are complementary in acute myeloid leukemia (AML). We investigated 105 consecutive AML cases for the presence of fusion gene transcripts by reverse transcriptase polymerase chain reaction (RT-PCR): AML1-ETO associated with t(8;21), CBFB-MYH11 with inv(16), PML-RARA with t(15;17), BCR-ABL with t(9;22), and MLL-AF4 with t(4;11). In 17 out of 105 AML cases (16%), fusion gene transcripts were found. Ninety-five of these AML patients (13 with fusion gene transcripts) were also investigated for the presence of IGH, IGK, TCRG and TCRD rearrangements by Southern blot and/or PCR heteroduplex analysis and sequencing. In nine out of 95 patients (9.5%), such rearrangements were found. Combined data revealed that only one patient with a fusion gene transcript had a coexistent Ig/TCR rearrangement. The nine AML patients with Ig/TCR rearrangements, as well as five additional AML patients from a previous study were investigated in more detail, revealing that Ig/TCR rearrangements in AML are immature and unusual. The presence of Ig/TCR rearrangements in AML did not correlate with RAG gene expression levels as determined by real-time quantitative PCR. In conclusion, fusion gene transcripts and Ig/TCR rearrangements are infrequent, but complementary MRD-PCR targets in AML.
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MESH Headings
- Acute Disease
- Adult
- Blotting, Southern
- Child
- Chromosome Aberrations
- DNA Primers/chemistry
- DNA Probes
- DNA, Neoplasm/analysis
- DNA-Binding Proteins/analysis
- Gene Rearrangement
- Gene Rearrangement, T-Lymphocyte/genetics
- Genes, Immunoglobulin/genetics
- Homeodomain Proteins/analysis
- Humans
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/genetics
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Nuclear Proteins
- Oncogene Proteins, Fusion/genetics
- RNA, Messenger/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Sensitivity and Specificity
- Translocation, Genetic
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Affiliation(s)
- N Boeckx
- Department of Immunology, Erasmus University Rotterdam/University Hospital Rotterdam, Rotterdam, The Netherlands
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37
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Abstract
We present a case of persistent polyclonal B-cell lymphocytosis (PPBL). This syndrome is characterized by a persistent lymphocytosis with circulating atypical binucleated lymphocytes. The patient had serological evidence of a previous EBV infection, had raised polyclonal serum IgM levels and was a heavy smoker. No malignancy was detected.
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Affiliation(s)
- L Ide
- Department of Haematology, Laboratory Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
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