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Visani G, Etebari M, Fuligni F, Di Guardo A, Isidori A, Loscocco F, Paolini S, Navari M, Piccaluga PP. Use of Next Generation Sequencing to Define the Origin of Primary Myelofibrosis. Cancers (Basel) 2023; 15:cancers15061785. [PMID: 36980671 PMCID: PMC10046249 DOI: 10.3390/cancers15061785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
Primary myelofibrosis (PMF) is a chronic myeloproliferative neoplasm (MPN) characterized by progressive bone marrow sclerosis, extra-medullary hematopoiesis, and possible transformation to acute leukemia. In the last decade, the molecular pathogenesis of the disease has been largely uncovered. Particularly, genetic and genomic studies have provided evidence of deregulated oncogenes in PMF as well as in other MPNs. However, the mechanisms through which transformation to either the myeloid or lymphoid blastic phase remain obscure. Particularly, it is still debated whether the disease has origins in a multi-potent hematopoietic stem cells or instead in a commissioned myeloid progenitor. In this study, we aimed to shed light upon this issue by using next generation sequencing (NGS) to study both myeloid and lymphoid cells as well as matched non-neoplastic DNA of PMF patients. Whole exome sequencing revealed that most somatic mutations were the same between myeloid and lymphoid cells, such findings being confirmed by Sanger sequencing. Particularly, we found 126/146 SNVs to be the e same (including JAK2V617F), indicating that most genetic events likely to contribute to disease pathogenesis occurred in a non-commissioned precursor. In contrast, only 9/27 InDels were similar, suggesting that this type of lesion contributed instead to disease progression, occurring at more differentiated stages, or maybe just represented “passenger” lesions, not contributing at all to disease pathogenesis. In conclusion, we showed for the first time that genetic lesions characteristic of PMF occur at an early stage of hematopoietic stem cell differentiation, this being in line with the possible transformation of the disease in either myeloid or lymphoid acute leukemia.
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Affiliation(s)
- Giuseppe Visani
- Hematology and Stem Cell Transplantation, AORMIN, 61121 Pesaro, Italy
| | - Maryam Etebari
- Department of Medical Biotechnology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh 33787-95196, Iran
- Research Center of Advanced Technologies in Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh 33787-95196, Iran
- Department of Medical Science and Surgery (DIMEC), University of Bologna, 40126 Bologna, Italy
| | - Fabio Fuligni
- The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Antonio Di Guardo
- Department of Medical Science and Surgery (DIMEC), University of Bologna, 40126 Bologna, Italy
| | | | - Federica Loscocco
- Hematology and Stem Cell Transplantation, AORMIN, 61121 Pesaro, Italy
| | - Stefania Paolini
- Biobank of Research, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Mohsen Navari
- Department of Medical Biotechnology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh 33787-95196, Iran
- Research Center of Advanced Technologies in Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh 33787-95196, Iran
- Bioinformatics Research Center, Mashhad University of Medical Sciences, Mashhad 91778-99191, Iran
| | - Pier Paolo Piccaluga
- Department of Medical Science and Surgery (DIMEC), University of Bologna, 40126 Bologna, Italy
- Biobank of Research, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Correspondence: ; Tel.:+39-0512144043; Fax:+39-0512144037
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Landtblom AR, Bower H, Andersson TML, Dickman PW, Samuelsson J, Björkholm M, Kristinsson SY, Hultcrantz M. Second malignancies in patients with myeloproliferative neoplasms: a population-based cohort study of 9379 patients. Leukemia 2018. [PMID: 29535425 DOI: 10.1038/s41375-018-0027-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
To determine the risk of a wide range of second malignancies in patients with myeloproliferative neoplasms (MPNs), we conducted a large population-based study and compared the results to matched controls. From national Swedish registers, 9379 patients with MPNs diagnosed between 1973 and 2009, and 35,682 matched controls were identified as well as information on second malignancies, with follow-up until 2010. Hazard ratios (HRs) with 95 % confidence intervals (CIs) were calculated using Cox regression and a flexible parametric model. There was a significantly increased risk of any non-hematologic cancer with HR of 1.6 (95% CI: 1.5-1.7). The HRs for non-melanoma skin cancer was 2.8 (2.4-3.3), kidney cancer 2.8 (2.0-4.0), brain cancer 2.8 (1.9-4.2), endocrine cancers 2.5 (1.6-3.8), malignant melanoma 1.9 (1.4-2.7), pancreas cancer 1.8 (1.2-2.6), lung cancer 1.7 (1.4-2.2), and head and neck cancer 1.7 (1.2-2.6). The HR of second malignancies was similar across all MPN subtypes, sex, and calendar periods of MPN diagnosis. The risk of developing a hematologic malignancy was also significantly increased; the HR for acute myeloid leukemia was 46.0 (32.6-64.9) and for lymphoma 2.6 (2.0-3.3). In conclusion, our study provides robust population-based support of an increased cancer risk in MPN patients.
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Affiliation(s)
- Anna Ravn Landtblom
- Department of Medicine, Division of Hematology, Stockholm South Hospital and Karolinska Institutet, Stockholm, Sweden.
| | - Hannah Bower
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Therese M-L Andersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul W Dickman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jan Samuelsson
- Department of Medicine, Division of Hematology, Stockholm South Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Magnus Björkholm
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Sigurdur Yngvi Kristinsson
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.,Faculty of Medicine, University of Iceland and Department of Hematology, Landspitali National University Hospital, Reykjavik, Iceland
| | - Malin Hultcrantz
- Department of Medicine, Division of Hematology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden.,Department of Medicine, Myeloma Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Duarte S, Pereira SC, Rodrigues É, Pereira A. Concomitant chronic myeloid leukemia and monoclonal B cell lymphocytosis - a very rare condition. Rev Bras Hematol Hemoter 2017; 39:167-169. [PMID: 28577655 PMCID: PMC5457473 DOI: 10.1016/j.bjhh.2017.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/30/2017] [Accepted: 02/13/2017] [Indexed: 11/22/2022] Open
Affiliation(s)
- Sara Duarte
- Internal Medicine Service, District Hospital of Figueira da Foz, EPE, Figueira da Foz, Portugal; Clinical Hematology Department, University Hospital Center of Coimbra, Coimbra, Portugal.
| | - Sónia Campelo Pereira
- Internal Medicine Service, District Hospital of Figueira da Foz, EPE, Figueira da Foz, Portugal
| | - Élio Rodrigues
- Internal Medicine Service, District Hospital of Figueira da Foz, EPE, Figueira da Foz, Portugal
| | - Amélia Pereira
- Internal Medicine Service, District Hospital of Figueira da Foz, EPE, Figueira da Foz, Portugal
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van de Ree-Pellikaan C, van der Straten L, Riedl JA, Levin MD, Westerweel PE. High coincidence of chronic lymphocytic leukemia and myeloproliferative neoplasms: detection bias or a clue to a common pathophysiological path? Leuk Lymphoma 2016; 58:756-757. [PMID: 27908226 DOI: 10.1080/10428194.2016.1260123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Lina van der Straten
- a Department of Internal Medicine , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Jurgen A Riedl
- b Department of Clinical Chemistry , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Mark-David Levin
- a Department of Internal Medicine , Albert Schweitzer Hospital , Dordrecht , The Netherlands
| | - Peter E Westerweel
- a Department of Internal Medicine , Albert Schweitzer Hospital , Dordrecht , The Netherlands
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Acute Lymphoblastic Leukemia Arising in CALR Mutated Essential Thrombocythemia. Case Rep Hematol 2016; 2016:6545861. [PMID: 26904322 PMCID: PMC4745278 DOI: 10.1155/2016/6545861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/06/2016] [Accepted: 01/10/2016] [Indexed: 02/06/2023] Open
Abstract
The development of acute lymphoblastic leukemia in an existing myeloproliferative neoplasm is rare with historical cases unable to differentiate between concomitant malignancies or leukemic transformation. Molecular studies of coexisting JAK2 V617F-positive myeloproliferative neoplasms and mature B cell malignancies indicate distinct disease entities arising in myeloid and lymphoid committed hematopoietic progenitor cells, respectively. Mutations of CALR in essential thrombocythemia appear to be associated with a distinct phenotype and a lower risk of thrombosis yet their impact on disease progression is less well defined. The as yet undescribed scenario of pro-B cell acute lymphoblastic leukemia arising in CALR mutated essential thrombocythemia is presented. Intensive treatment for the leukemia allowed for expansion of the original CALR mutated clone. Whether CALR mutations in myeloproliferative neoplasms predispose to the acquisition of additional malignancies, particularly lymphoproliferative disorders, is not yet known.
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Diamantidis MD, Sogka EA. The presence of low-count chronic lymphocytic leukemia-like monoclonal B lymphocytosis in patients with Ph-myeloproliferative neoplasms: A random event or a shared causal pathobiology? Leuk Res 2015; 39:S0145-2126(15)30388-X. [PMID: 26422557 DOI: 10.1016/j.leukres.2015.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Eleni A Sogka
- Thalassemia Unit, General Hospital of Larissa, Tsakalov 1, 41221 Larissa, Greece
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