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Heatley SL, Page EC, Eadie LN, McClure BJ, Rehn J, Yeung DT, Osborn M, Revesz T, Kirby M, White DL. Case Report: Precision Medicine Target Revealed by In Vitro Modeling of Relapsed, Refractory Acute Lymphoblastic Leukemia From a Child With Neurofibromatosis. Front Oncol 2022; 12:851572. [PMID: 35515133 PMCID: PMC9065550 DOI: 10.3389/fonc.2022.851572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022] Open
Abstract
Children with neurofibromatosis have a higher risk of developing juvenile myelomonocytic leukemia and acute myeloid leukemia, but rarely develop B-cell acute lymphoblastic leukemia (B-ALL). Through in-vitro modeling, a novel NF1 p.L2467 frameshift (fs) mutation identified in a relapsed/refractory Ph-like B-ALL patient with neurofibromatosis demonstrated cytokine independence and increased RAS signaling, indicative of leukemic transformation. Furthermore, these cells were sensitive to the MEK inhibitors trametinib and mirdametinib. Bi-allelic NF1 loss of function may be a contributing factor to relapse and with sensitivity to MEK inhibitors, suggests a novel precision medicine target in the setting of neurofibromatosis patients with B-ALL.
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Affiliation(s)
- Susan L Heatley
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia.,Australian & New Zealand Children's Haematology/Oncology Group, Clayton, VIC, Australia
| | - Elyse C Page
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Science, University of Adelaide, Adelaide, SA, Australia
| | - Laura N Eadie
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - Barbara J McClure
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - Jacqueline Rehn
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia
| | - David T Yeung
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia.,Dept of Haematology, Royal Adelaide Hospital, Adelaide, SA, Australia.,Australasian Leukaemia & Lymphoma Group, Richmond, VIC, Australia
| | - Michael Osborn
- Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia.,Australian & New Zealand Children's Haematology/Oncology Group, Clayton, VIC, Australia.,Australasian Leukaemia & Lymphoma Group, Richmond, VIC, Australia.,Dept of Haematology & Oncology, Women's & Children's Hospital, Adelaide, SA, Australia
| | - Tamas Revesz
- Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia.,Australian & New Zealand Children's Haematology/Oncology Group, Clayton, VIC, Australia.,Dept of Haematology & Oncology, Women's & Children's Hospital, Adelaide, SA, Australia
| | - Maria Kirby
- Australian & New Zealand Children's Haematology/Oncology Group, Clayton, VIC, Australia.,Dept of Haematology & Oncology, Women's & Children's Hospital, Adelaide, SA, Australia
| | - Deborah L White
- Cancer Program, Precision Medicine Theme, South Australian Health & Medical Research Institute, Adelaide, SA, Australia.,Faculty of Health & Medical Science, University of Adelaide, Adelaide, SA, Australia.,Australian & New Zealand Children's Haematology/Oncology Group, Clayton, VIC, Australia.,Faculty of Science, University of Adelaide, Adelaide, SA, Australia.,Australasian Leukaemia & Lymphoma Group, Richmond, VIC, Australia.,Australian Genomics Health Alliance, Parkville, VIC, Australia
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