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Hematogones in patients with acute myeloid leukaemia: Prognostic value and correlation with minimal residual disease. Leuk Res Rep 2021; 15:100234. [PMID: 33489749 PMCID: PMC7810761 DOI: 10.1016/j.lrr.2021.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/12/2020] [Accepted: 01/05/2021] [Indexed: 11/21/2022] Open
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Grassi S, Guerrini F, Ciabatti E, Puccetti R, Salehzadeh S, Metelli MR, Di Vita A, Domenichini C, Caracciolo F, Orciuolo E, Pelosini M, Mazzantini E, Rossi P, Mazziotta F, Petrini M, Galimberti S. Digital Droplet PCR is a Specific and Sensitive Tool for Detecting IDH2 Mutations in Acute Myeloid LeuKemia Patients. Cancers (Basel) 2020; 12:cancers12071738. [PMID: 32629801 PMCID: PMC7407265 DOI: 10.3390/cancers12071738] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 12/19/2022] Open
Abstract
Isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) interfere with cellular metabolism contributing to oncogenesis. Mutations of IDH2 at R140 and R172 residues are observed in 20% of acute myeloid leukemias (AML), and the availability of the IDH2 inhibitor Enasidenib made IDH2 mutational screening a clinical need. The aim of this study was to set a new quantitative polymerase chain reaction (PCR) technique, the drop-off digital droplet PCR (drop-off ddPCR), as a sensitive and accurate tool for detecting IDH2 mutations. With this technique we tested 60 AML patients. Sanger sequencing identified 8/60 (13.5%) mutated cases, while ddPCR and the amplification refractory mutation system (ARMS) PCR, used as a reference technique, identified mutations in 13/60 (21.6%) cases. When the outcome of IDH2-mutated was compared to that of wild-type patients, no significant difference in terms of quality of response, overall survival, or progression-free survival was observed. Finally, we monitored IDH2 mutations during follow-up in nine cases, finding that IDH2 can be considered a valid marker of minimal residual disease (MRD) in 2/3 of our patients. In conclusion, a rapid screening of IDH2 mutations is now a clinical need well satisfied by ddPCR, but the role of IDH2 as a marker for MRD still remains a matter of debate.
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Affiliation(s)
- Susanna Grassi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
- Correspondence:
| | - Francesca Guerrini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Elena Ciabatti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Riccardo Puccetti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Serena Salehzadeh
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Maria Rita Metelli
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Alessia Di Vita
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Cristiana Domenichini
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Francesco Caracciolo
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Enrico Orciuolo
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Matteo Pelosini
- Hematology, Azienda Ospedaliero Universitaria Pisana (AOUP), 56126 Pisa, Italy; (M.R.M.); (A.D.V.); (C.D.); (F.C.); (E.O.); (M.P.)
| | - Elisa Mazzantini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Pietro Rossi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Francesco Mazziotta
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy
| | - Mario Petrini
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
| | - Sara Galimberti
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy; (F.G.); (E.C.); (R.P.); (S.S.); (E.M.); (P.R.); (F.M.); (M.P.); (S.G.)
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Abstract
Introduction: Trisomy 8 is one of the most common cytogenetic alterations in acute myeloid leukemia (AML), with a frequency between 10% and 15%.Areas covered: The authors summarize the latest research regarding biological, translational and clinical aspects of trisomy 8 in AML.Expert opinion: Trisomy 8 can be found together with other karyotypes, although it also occurs as a sole aberration. The last decade's research has brought attention to molecular genetic alterations as strong contributors of leukemogenesis. AML with trisomy 8 seems to be associated with mutations in DNA methylation genes, spliceosome complex genes, and myeloid transcription factor genes, and these alterations probably have stronger implication for leukemic pathogenesis, treatment and hence prognosis, than the existence of trisomy 8 itself. Especially mutations in the RUNX1 and ASXL1 genes occur in high frequencies, and search for such mutations should be mandatory part of the diagnostic workup. AML with trisomy 8 is classified as intermediate-risk AML after recent European Leukemia Net (ELN) classification, and hence allogenic hematopoietic stem cell transplantation (Allo-HSCT) should be consider as consolidation therapy for this patient group.Trisomy 8 is frequently occurring in AML, although future molecular genetic workup should be performed, to optimize the diagnosis and treatment of these patients.
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Affiliation(s)
- Anette Lodvir Hemsing
- Division for Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Randi Hovland
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway.,Department of Biological Sciences, University of Bergen, Bergen, Norway
| | - Galina Tsykunova
- Division for Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Håkon Reikvam
- Division for Hematology, Department of Medicine, Haukeland University Hospital, Bergen, Norway.,Institute of Clinical Science, University of Bergen, Bergen, Norway
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