Herold, T. ; Metzeler, K.H. ; Vosberg, S. ; Hartmann, L. ; Röllig, C.* ; Stölzel, F.* ; Schneider, S.* ; Hubmann, M. ; Zellmeier, E.* ; Ksienzyk, B.* ; Jurinovic, V.* ; Pasalic, Z.* ; Kakadia, P.M.* ; Dufour, A.* ; Graf, A.* ; Krebs, S.* ; Blum, H.* ; Sauerland, M.C.* ; Büchner, T.* ; Berdel, W.E.* ; Woermann, B.J.* ; Bornhäuser, M.* ; Ehninger, G.* ; Mansmann, U.* ; Hiddemann, W. ; Bohlander, S.K.* ; Spiekermann, K. ; Greif, P.A.
Isolated trisomy 13 defines a genetically homogenous AML subgroup with high frequency of mutations in spliceosome genes and poor prognosis.
Blood 124, 1304-1311 (2014)
Isolated trisomy 13 (AML+13) is a rare chromosomal abnormality in acute myeloid leukemia (AML), and its prognostic relevance is poorly characterized. We analyzed the clinical course of 34 AML+13 patients enrolled in the German AMLCG-1999 and SAL trials and studied their biological characteristics by exome sequencing, targeted sequencing of candidate genes and gene expression profiling. Relapse-free (RFS) and overall survival (OS) of AML+13 patients were inferior compared to other ELN Intermediate-II patients (n=855) (median RFS, 7.8 vs 14.1 months, p=0.006; median OS 9.3 vs. 14.8 months, p=0.004). Besides the known high frequency of RUNX1 mutations (75%), we identified mutations in spliceosome components in 88%, including SRSF2 codon 95 mutations in 81%, of AML+13 patients. Moreover, recurring mutations were detected in ASXL1 (44%) and BCOR (25%). Two patients carried mutations in CEBPZ, suggesting that CEBPZ is a novel recurrently mutated gene in AML. Gene expression analysis revealed a homogenous expression profile including upregulation of FOXO1 and FLT3 and downregulation of SPRY2. This is the most comprehensive clinical and biological characterization of AML+13 to date, and reveals a striking clustering of lesions in a few genes, defining AML+13 as a genetically homogenous leukemia subgroup with alterations in a few critical cellular pathways. These studies were registered at clinicaltrials.gov, identifiers: AMLCG-1999: NCT00266136; AML96: NCT00180115; AML2003: NCT00180102; and AML60+: NCT00893373.
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Article: Journal article
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Scientific Article
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Keywords
Acute Myeloid-leukemia; Chronic Lymphocytic-leukemia; Increased Flt3 Expression; European Leukemianet; Down-regulation; Cancer; Recommendations; Consolidation; Mitoxantrone; Abnormality
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english
Publication Year
2014
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2014
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0006-4971
e-ISSN
1528-0020
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Volume: 124,
Issue: 8,
Pages: 1304-1311
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American Society of Hematology
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Washington
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Peer reviewed
POF-Topic(s)
30504 - Mechanisms of Genetic and Environmental Influences on Health and Disease
Research field(s)
Immune Response and Infection
PSP Element(s)
G-521000-001
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Erfassungsdatum
2014-06-15