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Genomic subtyping and therapeutic targeting of acute erythroleukemia.


ABSTRACT: Acute erythroid leukemia (AEL) is a high-risk leukemia of poorly understood genetic basis, with controversy regarding diagnosis in the spectrum of myelodysplasia and myeloid leukemia. We compared genomic features of 159 childhood and adult AEL cases with non-AEL myeloid disorders and defined five age-related subgroups with distinct transcriptional profiles: adult, TP53 mutated; NPM1 mutated; KMT2A mutated/rearranged; adult, DDX41 mutated; and pediatric, NUP98 rearranged. Genomic features influenced outcome, with NPM1 mutations and HOXB9 overexpression being associated with a favorable prognosis and TP53, FLT3 or RB1 alterations associated with poor survival. Targetable signaling mutations were present in 45% of cases and included recurrent mutations of ALK and NTRK1, the latter of which drives erythroid leukemogenesis sensitive to TRK inhibition. This genomic landscape of AEL provides the framework for accurate diagnosis and risk stratification of this disease, and the rationale for testing targeted therapies in this high-risk leukemia.

SUBMITTER: Iacobucci I 

PROVIDER: S-EPMC6828160 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Genomic subtyping and therapeutic targeting of acute erythroleukemia.

Iacobucci Ilaria I   Wen Ji J   Meggendorfer Manja M   Choi John K JK   Shi Lei L   Pounds Stanley B SB   Carmichael Catherine L CL   Masih Katherine E KE   Morris Sarah M SM   Lindsley R Coleman RC   Janke Laura J LJ   Alexander Thomas B TB   Song Guangchun G   Qu Chunxu C   Li Yongjin Y   Payne-Turner Debbie D   Tomizawa Daisuke D   Kiyokawa Nobutaka N   Valentine Marcus M   Valentine Virginia V   Basso Giuseppe G   Locatelli Franco F   Enemark Eric J EJ   Kham Shirley K Y SKY   Yeoh Allen E J AEJ   Ma Xiaotu X   Zhou Xin X   Sioson Edgar E   Rusch Michael M   Ries Rhonda E RE   Stieglitz Elliot E   Hunger Stephen P SP   Wei Andrew H AH   To L Bik LB   Lewis Ian D ID   D'Andrea Richard J RJ   Kile Benjamin T BT   Brown Anna L AL   Scott Hamish S HS   Hahn Christopher N CN   Marlton Paula P   Pei Deqing D   Cheng Cheng C   Loh Mignon L ML   Ebert Benjamin L BL   Meshinchi Soheil S   Haferlach Torsten T   Mullighan Charles G CG  

Nature genetics 20190329 4


Acute erythroid leukemia (AEL) is a high-risk leukemia of poorly understood genetic basis, with controversy regarding diagnosis in the spectrum of myelodysplasia and myeloid leukemia. We compared genomic features of 159 childhood and adult AEL cases with non-AEL myeloid disorders and defined five age-related subgroups with distinct transcriptional profiles: adult, TP53 mutated; NPM1 mutated; KMT2A mutated/rearranged; adult, DDX41 mutated; and pediatric, NUP98 rearranged. Genomic features influen  ...[more]

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