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Clappier E, Auclerc MF, Rapion J, Bakkus M, Caye A, Khemiri A, Giroux C, Hernandez L, Kabongo E, Savola S, Leblanc T, Yakouben K, Plat G, Costa V, Ferster A, Girard S, Fenneteau O, Cayuela JM, Sigaux F, Dastugue N, Suciu S, Benoit Y, Bertrand Y, Soulier J, Cavé H. An intragenic ERG deletion is a marker of an oncogenic subtype of B-cell precursor acute lymphoblastic leukemia with a favorable outcome despite frequent IKZF1 deletions. Leukemia 2013; 28:70-7. [PMID: 24064621 DOI: 10.1038/leu.2013.277] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 09/13/2013] [Accepted: 09/17/2013] [Indexed: 11/09/2022]
Abstract
Oncogenic subtypes in childhood B-cell precursor acute lymphoblastic leukemia (BCP-ALL) are used for risk stratification. However, a significant number of BCP-ALL patients are still genetically unassigned. Using array-comparative genomic hybridization in a selected BCP-ALL cohort, we characterized a recurrent V(D)J-mediated intragenic deletion of the ERG gene (ERG(del)). A breakpoint-specific PCR assay was designed and used to screen an independent non-selected cohort of 897 children aged 1-17 years treated for BCP-ALL in the EORTC-CLG 58951 trial. ERG(del) was found in 29/897 patients (3.2%) and was mutually exclusive of known classifying genetic lesions, suggesting that it characterized a distinct leukemia entity. ERG(del) was associated with higher age (median 7.0 vs. 4.0 years, P=0.004), aberrant CD2 expression (43.5% vs. 3.7%, P<0.001) and frequent IKZF1 Δ4-7 deletions (37.9% vs. 5.3%, P<0.001). However, ERG(del) patients had a very good outcome, with an 8-year event-free survival (8-y EFS) and an 8-year overall survival of 86.4% and 95.6%, respectively, suggesting that the IKZF1 deletion had no impact on prognosis in this genetic subtype. Accordingly, within patients with an IKZF1 Δ4-7 deletion, those with ERG(del) had a better outcome (8-y EFS: 85.7% vs. 51.3%; hazard ratio: 0.16; 95% confidence interval: 0.02-1.20; P=0.04). These findings have implications for further stratification including IKZF1 status.
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Affiliation(s)
- E Clappier
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Department of Genetics, Robert Debré Hospital, APHP, Paris, France [3] Hematology University Institute, University Paris-Diderot, Paris, France
| | - M F Auclerc
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Department of Pediatric Hematology, St-Louis Hospital, APHP, Paris, France
| | - J Rapion
- EORTC Headquarters, Brussels, Belgium
| | - M Bakkus
- Molecular Hematology Laboratory, UZ Brussels, Brussels, Belgium
| | - A Caye
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - A Khemiri
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - C Giroux
- Department of Genetics, Robert Debré Hospital, APHP, Paris, France
| | - L Hernandez
- U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France
| | - E Kabongo
- Molecular Hematology Laboratory, UZ Brussels, Brussels, Belgium
| | - S Savola
- MRC-Holland, Amsterdam, The Netherlands
| | - T Leblanc
- Department of Pediatric Hematology, St-Louis Hospital, APHP, Paris, France
| | - K Yakouben
- Department of Pediatric Hematology, Robert-Debré Hospital, APHP, Paris, France
| | - G Plat
- Department of Pediatric Onco-Hematology, University Hospital Purpan, Toulouse, France
| | - V Costa
- Department of Pediatrics, Portuguese Oncology Institute, Porto, Portugal
| | - A Ferster
- Department of Pediatric Onco-Hematology, Children's University Hospital Reine Fabiola, Brussels, Belgium
| | - S Girard
- Hematology Laboratory, IHOP, Lyon, France
| | - O Fenneteau
- Hematology Laboratory, Robert Debré Hospital, APHP, Paris, France
| | - J M Cayuela
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
| | - F Sigaux
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
| | - N Dastugue
- Hematology Laboratory, University Hospital Purpan, Toulouse, France
| | - S Suciu
- EORTC Headquarters, Brussels, Belgium
| | - Y Benoit
- Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Y Bertrand
- Department of Pediatric Hematology, IHOP and Claude Bernard University, Lyon, France
| | - J Soulier
- 1] U944 INSERM and Hematology laboratory, St-Louis Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
| | - H Cavé
- 1] Department of Genetics, Robert Debré Hospital, APHP, Paris, France [2] Hematology University Institute, University Paris-Diderot, Paris, France
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Schöffski P, Blay J, DeGreve J, Brain E, Machiels J, Soria J, Sleijfer S, Munzert G, Rapion J, Lacombe D. 1260 Multicenter parallel phase II trials of the polo-like kinase 1 inhibitor BI-2536 in patients with advanced head and neck cancer, breast cancer, ovarian cancer, soft tissue sarcoma and melanoma. The first protocol of the European Organisation for Research and Treatment of Cancer (EORTC) Network Of Core Institutes (NOCI). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70472-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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