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The clinical mutatome of core binding factor leukemia.
Leukemia ( IF 12.8 ) Pub Date : 2020-01-02 , DOI: 10.1038/s41375-019-0697-0
Sabrina Opatz 1, 2, 3, 4 , Stefanos A Bamopoulos 1 , Klaus H Metzeler 1, 2, 3, 4 , Tobias Herold 1 , Bianka Ksienzyk 1 , Kathrin Bräundl 1, 2, 3, 4 , Sebastian Tschuri 1, 3, 4 , Sebastian Vosberg 2 , Nikola P Konstandin 1 , Christine Wang 1 , Luise Hartmann 1, 2, 3, 4 , Alexander Graf 5 , Stefan Krebs 5 , Helmut Blum 5 , Stephanie Schneider 1, 6 , Christian Thiede 3, 4, 7 , Jan Moritz Middeke 3, 4, 7 , Friedrich Stölzel 3, 4, 7 , Christoph Röllig 3, 4, 7 , Johannes Schetelig 3, 4, 7 , Gerhard Ehninger 3, 4, 7 , Alwin Krämer 3, 4 , Jan Braess 8 , Dennis Görlich 9 , Maria Cristina Sauerland 9 , Wolfgang E Berdel 10 , Bernhard J Wörmann 11 , Wolfgang Hiddemann 1, 2, 3, 4 , Karsten Spiekermann 1, 2, 3, 4 , Stefan K Bohlander 12 , Philipp A Greif 1, 2, 3, 4
Affiliation  

The fusion genes CBFB/MYH11 and RUNX1/RUNX1T1 block differentiation through disruption of the core binding factor (CBF) complex and are found in 10-15% of adult de novo acute myeloid leukemia (AML) cases. This AML subtype is associated with a favorable prognosis; however, nearly half of CBF-rearranged patients cannot be cured with chemotherapy. This divergent outcome might be due to additional mutations, whose spectrum and prognostic relevance remains hardly defined. Here, we identify nonsilent mutations, which may collaborate with CBF-rearrangements during leukemogenesis by targeted sequencing of 129 genes in 292 adult CBF leukemia patients, and thus provide a comprehensive overview of the mutational spectrum ('mutatome') in CBF leukemia. Thereby, we detected fundamental differences between CBFB/MYH11- and RUNX1/RUNX1T1-rearranged patients with ASXL2, JAK2, JAK3, RAD21, TET2, and ZBTB7A being strongly correlated with the latter subgroup. We found prognostic relevance of mutations in genes previously known to be AML-associated such as KIT, SMC1A, and DHX15 and identified novel, recurrent mutations in NFE2 (3%), MN1 (4%), HERC1 (3%), and ZFHX4 (5%). Furthermore, age >60 years, nonprimary AML and loss of the Y-chromosomes are important predictors of survival. These findings are important for refinement of treatment stratification and development of targeted therapy approaches in CBF leukemia.

中文翻译:

核心结合因子白血病的临床突变。

融合基因CBFB / MYH11和RUNX1 / RUNX1T1通过破坏核心结合因子(CBF)复合物来阻断分化,并且在10-15%的成年新生急性髓性白血病(AML)病例中发现。这种AML亚型与预后良好相关。但是,将近一半的CBF重排患者无法通过化学疗法治愈。这种不同的结果可能是由于其他突变所致,这些突变的范围和预后相关性仍然难以确定。在这里,我们确定了非沉默突变,它可以通过对292名成人CBF白血病患者中的129个基因进行靶向测序来与白血病发生过程中的CBF重排协同作用,从而全面概述CBF白血病的突变谱(“ mutatome”)。从而,我们检测到CBFB / MYH11-和RUNX1 / RUNX1T1重排的ASXL2,JAK2,JAK3,RAD21,TET2和ZBTB7A患者之间的根本差异与后者具有高度相关性。我们发现先前已知与AML相关的基因(例如KIT,SMC1A和DHX15)中突变的预后相关性,并在NFE2(3%),MN1(4%),HERC1(3%)和ZFHX4中发现了新的复发性突变(5%)。此外,年龄> 60岁,非原发性AML和Y染色体缺失是生存的重要预测指标。这些发现对于改善治疗分层和发展CBF白血病的靶向治疗方法非常重要。我们发现以前已知与AML相关的基因(例如KIT,SMC1A和DHX15)中突变的预后相关性,并在NFE2(3%),MN1(4%),HERC1(3%)和ZFHX4中发现了新的复发性突变(5%)。此外,年龄> 60岁,非原发性AML和Y染色体缺失是生存的重要预测指标。这些发现对于改善治疗分层和发展CBF白血病的靶向治疗方法非常重要。我们发现以前已知与AML相关的基因(例如KIT,SMC1A和DHX15)中突变的预后相关性,并在NFE2(3%),MN1(4%),HERC1(3%)和ZFHX4中发现了新的复发性突变(5%)。此外,年龄> 60岁,非原发性AML和Y染色体缺失是生存的重要预测指标。这些发现对于改善治疗分层和发展CBF白血病的靶向治疗方法非常重要。
更新日期:2020-01-02
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