1
|
Tria FP, Ang DC, Fan G. Myelodysplastic Syndrome: Diagnosis and Screening. Diagnostics (Basel) 2022; 12:1581. [PMID: 35885487 PMCID: PMC9319204 DOI: 10.3390/diagnostics12071581] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/26/2022] [Accepted: 06/27/2022] [Indexed: 11/16/2022] Open
Abstract
Myelodysplastic syndromes (MDS) are heterogeneous groups of clonal myeloid disorders characterized by unexplained persistent peripheral blood (PB) cytopenia(s) of one or more of the hematopoietic lineages, or bone marrow (BM) morphologic dysplasia in hematopoietic cells, recurrent genetic abnormalities, and an increased risk of progression to acute myeloid leukemia (AML). In the past several years, diagnostic, prognostic, and therapeutic approaches have substantially improved with the development of Next Generation Sequencing (NGS) diagnostic testing and new medications. However, there is no single diagnostic parameter specific for MDS, and correlations with clinical information, and laboratory test findings are needed to reach the diagnosis.
Collapse
Affiliation(s)
- Francisco P. Tria
- Section of Cellular Immunology and Molecular Pathology, Institute of Pathology, St. Luke’s Medical Center—Global City, Taguig 1634, Metro Manila, Philippines; (F.P.T.IV); (D.C.A.)
| | - Daphne C. Ang
- Section of Cellular Immunology and Molecular Pathology, Institute of Pathology, St. Luke’s Medical Center—Global City, Taguig 1634, Metro Manila, Philippines; (F.P.T.IV); (D.C.A.)
| | - Guang Fan
- Department of Hematopathology, Oregon Health & Science University, Portland, OR 97239, USA
| |
Collapse
|
2
|
Martín I, Villamón E, Abellán R, Calasanz MJ, Irigoyen A, Sanz G, Such E, Mora E, Gutiérrez M, Collado R, García-Serra R, Vara M, Blanco ML, Oiartzabal I, Álvarez S, Bernal T, Granada I, Xicoy B, Jerez A, Calabuig M, Diez R, Gil Á, Díez-Campelo M, Solano C, Tormo M. Myelodysplastic syndromes with 20q deletion: incidence, prognostic value and impact on response to azacitidine of ASXL1 chromosomal deletion and genetic mutations. Br J Haematol 2021; 194:708-717. [PMID: 34296432 DOI: 10.1111/bjh.17675] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
In myelodysplastic syndromes (MDS), the 20q deletion [del(20q)] may cause deletion of the ASXL1 gene. We studied 153 patients with MDS and del(20q) to assess the incidence, prognostic value and impact on response to azacitidine (AZA) of ASXL1 chromosomal alterations and genetic mutations. Additionally, in vitro assay of the response to AZA in HAP1 (HAP1WT ) and HAP1 ASXL1 knockout (HAP1KN ) cells was performed. ASXL1 chromosomal alterations were detected in 44 patients (28·5%): 34 patients (22%) with a gene deletion (ASXL1DEL ) and 10 patients (6·5%) with additional gene copies. ASXL1DEL was associated with a lower platelet count. The most frequently mutated genes were U2AF1 (16%), ASXL1 (14%), SF3B1 (11%), TP53 (7%) and SRSF2 (6%). ASXL1 alteration due to chromosomal deletion or genetic mutation (ASXL1DEL /ASXL1MUT ) was linked by multivariable analysis with shorter overall survival [hazard ratio, (HR) 1·84; 95% confidence interval, (CI): 1·11-3·04; P = 0·018] and a higher rate for acute myeloid leukaemia progression (HR 2·47; 95% CI: 1·07-5·70, P = 0·034). ASXL1DEL /ASXL1MUT patients were correlated by univariable analysis with a worse response to AZA. HAP1KN cells showed more resistance to AZA compared to HAP1WT cells. In conclusion, ASXL1 alteration exerts a negative impact on MDS with del(20q) and could become useful for prognostic risk stratification and treatment decisions.
Collapse
Affiliation(s)
- Iván Martín
- Hematology Department, Hospital Clínico Universitario de Valencia, INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Eva Villamón
- Hematology Department, Hospital Clínico Universitario de Valencia, INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Rosario Abellán
- Biochemistry and Molecular Pathology Department, Hospital Clínico Universitario de Valencia, INCLIVA Research Institute, Valencia, Spain
| | | | - Aroa Irigoyen
- CIMA LAB Diagnostics, Universidad de Navarra, Pamplona, Spain
| | - Guillermo Sanz
- Hematology Department, Hospital Universitario y Politécnico La Fe, Health Research Institute Hospital La Fe, IIS La Fe, Valencia, Spain
| | - Esperanza Such
- Hematology Department, Hospital Universitario y Politécnico La Fe, Health Research Institute Hospital La Fe, IIS La Fe, Valencia, Spain
| | - Elvira Mora
- Hematology Department, Hospital Universitario y Politécnico La Fe, Health Research Institute Hospital La Fe, IIS La Fe, Valencia, Spain
| | - Míriam Gutiérrez
- Genetics Department, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - Rosa Collado
- Hematology Department, Consorcio Hospital General Universitario de Valencia, Research Foundation of the General University Hospital of Valencia, Valencia, Spain
| | - Rocío García-Serra
- Hematology Department, Consorcio Hospital General Universitario de Valencia, Research Foundation of the General University Hospital of Valencia, Valencia, Spain
| | - Míriam Vara
- Hematology Department, Hospital Universitario de Cruces, Barakaldo, Spain
| | - Mª Laura Blanco
- Hematology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Itziar Oiartzabal
- Hematology Department, Hospital de Txagorritxu, Vitoria-Gasteiz, Spain
| | - Sara Álvarez
- NIMGenetics, Genómica y Medicina, Madrid, Spain.,Hematology Department, Hospital HM Sanchinarro, Madrid, Spain
| | - Teresa Bernal
- Hematology Department, Hospital Universidad de Asturias, IISPA, IUOPA, Oviedo, Spain
| | - Isabel Granada
- Hematology Department, Hospital Germans Trias i Pujol, Institut Català d'Oncologia, Josep Carreras Leukaemia Research Institute (IJC), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Blanca Xicoy
- Hematology Department, Hospital Germans Trias i Pujol, Institut Català d'Oncologia, Josep Carreras Leukaemia Research Institute (IJC), Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Andrés Jerez
- Hematology Department, Hospital Universitario Morales Meseguer, Murcia, Spain
| | - Marisa Calabuig
- Hematology Department, Hospital Clínico Universitario de Valencia, INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Rosana Diez
- Hematology Department, Hospital Universitario Miguel Servet de Zaragoza, Zaragoza, Spain
| | - Ángela Gil
- Hematology Department, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - María Díez-Campelo
- Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain
| | - Carlos Solano
- Hematology Department, Hospital Clínico Universitario de Valencia, INCLIVA Research Institute, University of Valencia, Valencia, Spain.,Department of Medicine, School of Medicine, University of Valencia, Valencia, Spain
| | - Mar Tormo
- Hematology Department, Hospital Clínico Universitario de Valencia, INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | | |
Collapse
|