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Gagnon MF, Bruehl FK, Sill DR, Meyer RG, Greipp PT, Hoppman NL, Xu X, Baughn LB, Peterson JF, McPhail ED, Ketterling RP, King RL. Cytogenetic and pathologic characterization of MYC-rearranged B-cell lymphomas in pediatric and young adult patients. J Hematop 2024:10.1007/s12308-024-00579-6. [PMID: 38561469 DOI: 10.1007/s12308-024-00579-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
MYC-rearranged B-cell lymphoma (BCL) in the pediatric/young adult (YA) age group differs substantially in disease composition from adult cohorts. However, data regarding the partner genes, concurrent rearrangements, and ultimate diagnoses in these patients is scarce compared to that in adult cohorts. We aimed to characterize the spectrum of MYC-rearranged (MYC-R) mature, aggressive BCL in the pediatric/YA population. A retrospective study of morphologic, immunophenotypic, and fluorescence in situ hybridization (FISH) results of patients age ≤ 30 years with suspected Burkitt lymphoma (BL), diffuse large B-cell lymphoma (DLBCL) or high-grade B-cell lymphoma (HGBCL), and a MYC-R by FISH between 2013-2022 was performed. Two-hundred fifty-eight cases (129 (50%) pediatric (< 18 years) and 129 (50%) YA (18-30 years)) were included. Most MYC-R BCL in pediatric (89%) and YA (66%) cases were BL. While double-hit (DH) cytogenetics (MYC with BCL2 and/or BCL6-R, HGBCL-DH) was rare in the pediatric population (2/129, 2%), HGBCL-DH increased with age and was identified in 17/129 (13%) of YA cases. Most HGBCL-DH had MYC and BCL6-R, while BCL2-R were rare in both groups (3/258, 1%). MYC-R without an IG partner was more common in the YA group (14/116 (12%) vs 2/128 (2%), p = 0.001). The pediatric to YA transition is characterized by decreasing frequency in BL and increasing genetic heterogeneity of MYC-R BCL, with emergence of DH-BCL with MYC and BCL6-R. FISH to evaluate for BCL2 and BCL6 rearrangements is likely not warranted in the pediatric population but should continue to be applied in YA BCL.
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Affiliation(s)
- Marie-France Gagnon
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Frido K Bruehl
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Daniel R Sill
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Reid G Meyer
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Hoppman
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Xinjie Xu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ellen D McPhail
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rhett P Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rebecca L King
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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2
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Gagnon MF, Midthun SM, Fangel JA, Schuh CM, Luoma IM, Pearce KE, Meyer RG, Ailawadhi S, Arribas MJ, Braggio E, Fonseca R, Rajkumar SV, Zepeda-Mendoza C, Xu X, Greipp PT, Timm MM, Otteson GE, Shi M, Jevremovic D, Olteanu H, Peterson JF, Ketterling RP, Kumar S, Baughn LB. Superior detection rate of plasma cell FISH using FACS-FISH. Am J Clin Pathol 2024; 161:60-70. [PMID: 37658775 DOI: 10.1093/ajcp/aqad108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/26/2023] [Indexed: 09/05/2023] Open
Abstract
OBJECTIVES Fluorescence in situ hybridization (FISH) for plasma cell neoplasms (PCNs) requires plasma cell (PC) identification or purification strategies to optimize results. We compared the efficacy of cytoplasmic immunoglobulin FISH (cIg-FISH) and fluorescence-activated cell sorting FISH (FACS-FISH) in a clinical laboratory setting. METHODS The FISH analysis results of 14,855 samples from individuals with a suspected PCN subjected to cytogenetic evaluation between 2019 and 2022 with cIg-FISH (n = 6917) or FACS-FISH (n = 7938) testing were analyzed. RESULTS Fluorescence-activated cell sorting-FISH increased the detection rate of abnormalities in comparison with cIg-FISH, with abnormal results documented in 54% vs 50% of cases, respectively (P < .001). It improved the detection of IGH::CCND1 (P < .001), IGH::MAF (P < .001), IGH::MAFB (P < .001), other IGH rearrangements (P < .001), and gains/amplifications of 1q (P < .001), whereas the detection rates of IGH::FGFR3 fusions (P = .3), loss of 17p (P = .3), and other abnormalities, including hyperdiploidy (P = .5), were similar. Insufficient PC yield for FISH analysis was decreased between cIg-FISH and FACS-FISH (22% and 3% respectively, P < .001). Flow cytometry allowed establishment of ploidy status in 91% of cases. In addition, FACS-FISH decreased analysis times, workload efforts, and operating costs. CONCLUSIONS Fluorescence-activated cell sorting-FISH is an efficient PC purification strategy that affords significant improvement in diagnostic yield and decreases workflow requirements in comparison with cIg-FISH.
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Affiliation(s)
- Marie-France Gagnon
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - Sally M Midthun
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - James A Fangel
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - Cynthia M Schuh
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - Ivy M Luoma
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - Kathryn E Pearce
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - Reid G Meyer
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
| | - Sikander Ailawadhi
- Department of Medicine, Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, US
| | - Mariano J Arribas
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Scottsdale, AZ, US
| | - Esteban Braggio
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Scottsdale, AZ, US
| | - Rafael Fonseca
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Scottsdale, AZ, US
| | - S Vincent Rajkumar
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, US
| | - Cinthya Zepeda-Mendoza
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Xinjie Xu
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Michael M Timm
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Gregory E Otteson
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Min Shi
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Dragan Jevremovic
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Horatiu Olteanu
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Jess F Peterson
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Rhett P Ketterling
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
| | - Shaji Kumar
- Department of Internal Medicine, Division of Hematology, Mayo Clinic, Jacksonville, FL, US
| | - Linda B Baughn
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, US
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, US
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Tekin B, Hofich CD, Pitel BA, Schoolmeester JK, Whaley RD, Raghunathan A, Ebare K, Stanton ML, Reynolds JP, Sharma V, Thompson RH, Boorjian SA, Leibovich BC, Herrera Hernandez LP, Jimenez RE, Cheville JC, Ketterling RP, Geiersbach KB, Greipp PT, Sukov WR, Kipp BR, Halling KC, Gupta S. Next generation sequencing-based identification of fusion-driven renal neoplasia: A single institution experience. Hum Pathol 2023:S0046-8177(23)00253-8. [PMID: 38145826 DOI: 10.1016/j.humpath.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/19/2023] [Indexed: 12/27/2023]
Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Christopher D Hofich
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Beth A Pitel
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | | | - Rumeal D Whaley
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Aditya Raghunathan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Kingsley Ebare
- The Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA.
| | - Melissa L Stanton
- The Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA.
| | - Jordan P Reynolds
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA.
| | - Vidit Sharma
- The Department of Urology, Mayo Clinic, Rochester, MN, USA.
| | | | | | | | | | - Rafael E Jimenez
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Rhett P Ketterling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | | | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - William R Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Benjamin R Kipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Kevin C Halling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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4
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Gagnon MF, Penheiter AR, Harris F, Sadeghian D, Johnson SH, Karagouga G, McCune A, Zepeda-Mendoza C, Greipp PT, Xu X, Ketterling RP, McPhail ED, King RL, Peterson JF, Vasmatzis G, Baughn LB. Unraveling the genomic underpinnings of unbalanced MYC break-apart FISH results using whole genome sequencing analysis. Blood Cancer J 2023; 13:190. [PMID: 38114462 PMCID: PMC10730864 DOI: 10.1038/s41408-023-00967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- Marie-France Gagnon
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Alan R Penheiter
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Faye Harris
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Dorsay Sadeghian
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sarah H Johnson
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Alexa McCune
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Cinthya Zepeda-Mendoza
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Xinjie Xu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rhett P Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ellen D McPhail
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rebecca L King
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - George Vasmatzis
- Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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5
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Gurney M, Greipp PT, Gliem T, Knudson R, Al-Kali A, Gangat N, Lasho T, Mangaonkar AA, Finke CM, Patnaik MM. TET2 somatic copy number alterations and allelic imbalances in chronic myelomonocytic leukemia. Leuk Res 2023; 134:107391. [PMID: 37769597 DOI: 10.1016/j.leukres.2023.107391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/10/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Mark Gurney
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA; Cytogenetics Core Facility, Mayo Clinic, Rochester, MN, USA
| | - Troy Gliem
- Cytogenetics Core Facility, Mayo Clinic, Rochester, MN, USA
| | - Ryan Knudson
- Cytogenetics Core Facility, Mayo Clinic, Rochester, MN, USA
| | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Terra Lasho
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
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6
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Gao RW, Fleuranvil R, Harmsen WS, Greipp PT, Baughn LB, Jevremovic D, Gonsalves WI, Kourelis T, Stish BJ, Peterson JL, Rule WG, Hoppe BS, Breen W, Lester SC. Predictors of Local Control with Palliative Radiotherapy for Multiple Myeloma. Int J Radiat Oncol Biol Phys 2023; 117:S108. [PMID: 37784284 DOI: 10.1016/j.ijrobp.2023.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Palliative radiotherapy (RT) is employed for patients with multiple myeloma to improve or prevent symptoms. However, the optimal dose fractionation is not well defined. The role of cytogenetics in informing RT warrants further study. We performed an institutional analysis of patients with multiple myeloma receiving palliative RT and assessed factors associated with local progression, with a focus on dose fractionation and cytogenetic abnormalities. MATERIALS/METHODS We queried a prospectively maintained, departmental database for consecutive patients who received palliative RT for multiple myeloma at our institution from 2015 to 2020. Double- and triple-hit were defined as the presence of two and three high-risk cytogenetic abnormalities. RT dose fractionation data were extracted from the database. Follow-up imaging was used to evaluate for progression. RESULTS A total of 239 patients with 362 treated lesions were included. Twenty-five patients (10.4%) with 39 lesions had double-hit cytogenetics, and 4 patients (1.7%) with 7 lesions were triple-hit. Patients had the following number of lesions treated with RT: 1 (156, 65.3%), 2 (53, 22.2%), 3 (17, 7.1%), or >3 (13, 5.4%). The most commonly targeted sites were spine (125, 34.5%), abdomen/pelvis (67, 18.5%), and lower extremity (53, 14.6%). Most lesions received doses of 20 Gy/5 fx (132, 36.5%), 8 Gy/1 fx (93, 25.7%), or 30 Gy/10 fx (48, 13.3%). RT equivalent dose in 2 Gray fractions (EQD2) was <2000 cGy for 126 lesions (34.8%) and ≥2000 cGy for 236 lesions (65.2%). At a median follow-up of 4.3 years, the risk of local progression on a per lesion basis at 1 and 4 years was 7.8% (95% CI: 5.5-11.1) and 13.4% (10.3-17.5), respectively. No cytogenetic abnormalities were correlated with local progression. Factors significant on univariate analysis included female sex [hazard ratio (HR): 1.94 (1.02-3.71), p = .045], LDH at diagnosis [HR per 10 units/liter: 1.04 (1.09-1.08), p = .016], and number of treated lesions [HR per lesion: 1.38 (1.02-1.89), p = .039]. These three covariates were included on multivariable analysis, and the only covariate to approach significance was number of treated lesions [HR for >3 versus 1: 2.43 (0.88-6.74), p = .059]. In the overall cohort, EQD2 did not impact risk of progression. Among those with >3 treated lesions, EQD2 ≥2000 cGy was associated with a significantly lower risk of progression [HR: 0.05 (0.01-0.23), p<.001]. Double- and triple-hit status were not correlated with progression. Median overall survival in all patients was 4.1 years versus 1.5 and 0.6 years in those with double- and triple-hit disease, respectively. CONCLUSION In this large, institutional study of patients with multiple myeloma, palliative RT achieves durable long-term local control. Patients with high disease burden may be at increased risk of progression at treated sites. This group may benefit from an EQD ≥2000 cGy. Cytogenetics, including double- and triple-hit status, do not appear to influence RT response.
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Affiliation(s)
- R W Gao
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | - W S Harmsen
- Department of Biostatistics and Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | - B J Stish
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - W G Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - B S Hoppe
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - W Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
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7
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Zhao CY, Gao RW, Fleuranvil R, Harmsen WS, Greipp PT, Baughn LB, Jevremovic D, Gonsalves WI, Kourelis T, Villasboas Bisneto J, Amundson A, Peterson JL, Rule WG, Hoppe BS, Lester SC, Breen W. Change in Blood Counts after Palliative Radiotherapy for Multiple Myeloma. Int J Radiat Oncol Biol Phys 2023; 117:e498-e499. [PMID: 37785567 DOI: 10.1016/j.ijrobp.2023.06.1740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation therapy (RT) can provide effective palliation and prevent symptomatic local progression of multiple myeloma (MM). However, RT is sometimes avoided due to concerns for secondary impact to bone marrow, potentially decreasing blood cell counts and precluding ability to receive future systemic therapies. We reviewed a series of MM patients who received palliative RT to assess changes in blood counts from pre-RT to post-RT, hypothesizing that blood counts would not significantly decline after treatment with modern RT volumes and techniques. MATERIALS/METHODS We utilized a prospectively maintained departmental database and included patients who received palliative RT for MM from 2015 to 2020. Lab values immediately pre-RT (within one month of RT start date) and post-RT (within three months of RT completion) including hemoglobin, lymphocytes, neutrophils, and platelets were collected. Statistical differences from pre-RT to post-RT were assessed using t-tests. ANOVA was used to compare change in blood counts between common dose fractionation regimens (30 Gy in 10 Fractions, 20 Gy in 5, and 8 Gy in 1). RESULTS A total of 334 MM patients receiving 424 courses of RT were included in this analysis. The median age at start of first treatment was 67 (IQR: 60-76) years. One-hundred ninety-five (58%) were male. Median RT dose was 20 (IQR: 8-24.5) Gy delivered over a median 5 (IQR: 1-5) fractions. Between pre-RT and post-RT, there was no significant change in hemoglobin (+0.1 g/dL (IQR: -0.8, +0.5), p = .076), lymphocyte counts (-0.3*10^9 cells/L (IQR: -0.6, 0), p = .435), or neutrophil counts (-0.1*10^9 cells/L (IQR: -1.1, +0.9), p = .310). In contrast, platelet counts significantly decreased from pre-RT (median 165*10^9 cells/L, IQR: 112-210) to post-RT (median 146, IQR: 93-194) by a median of 17.5 *10^9 cells/L (IQR: -52.5, +14.0, p<0.0001). There were no differences in changes in hemoglobin, neutrophils, or platelets between the common dose fractionations. However, there was a significantly greater drop in lymphocytes after 30 Gy in 10 fractions (p = .039, mean lymphocyte count change (in 10^9 cells/L) for 30 Gy in 10: -0.87, 20 Gy in 5: -0.47, and 8 Gy in 1: -0.27). CONCLUSION In this large dataset of patients receiving modern palliative RT for MM, hemoglobin, lymphocytes, and neutrophils did not significantly decline from pre-RT to post-RT. In contrast, there was a statistically significant drop in platelet count by a median 17.5*10^9 cells/L from pre-RT to post-RT, which may or may not be clinically significant depending on clinical context. Patients receiving 30 Gy in 10 fractions had greater drops in lymphocytes than those receiving lower doses. Further analyses will be performed to determine clinical, dosimetric, and volumetric predictors of decline in blood counts after radiation.
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Affiliation(s)
| | - R W Gao
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | | | - W S Harmsen
- Department of Biostatistics and Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | | | - A Amundson
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - J L Peterson
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - W G Rule
- Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ
| | - B S Hoppe
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL
| | - S C Lester
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
| | - W Breen
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN
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8
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Pitel BA, Zepeda-Mendoza C, Sachs Z, Tang H, Shivaram S, Sharma N, Smadbeck JB, Smoley SA, Pearce KE, Luoma IM, Cook J, Litzow MR, Hoppman NL, Viswanatha D, Xu X, Ketterling RP, Greipp PT, Peterson JF, Baughn LB. Prospective evaluation of genome sequencing to compare conventional cytogenetics in acute myeloid leukemia. Blood Cancer J 2023; 13:138. [PMID: 37673866 PMCID: PMC10482828 DOI: 10.1038/s41408-023-00908-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/07/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Affiliation(s)
- Beth A Pitel
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Cinthya Zepeda-Mendoza
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Zohar Sachs
- Division of Hematology, Oncology, and Transplantation, Department of Medicine and Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Hongwei Tang
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Suganti Shivaram
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Neeraj Sharma
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - James B Smadbeck
- Center for Individualized Medicine-Biomarker Discovery, Mayo Clinic, Rochester, MN, USA
| | - Stephanie A Smoley
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Kathryn E Pearce
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Ivy M Luoma
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Joselle Cook
- Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Mark R Litzow
- Department of Medicine, Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Hoppman
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - David Viswanatha
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Xinjie Xu
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Rhett P Ketterling
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Jess F Peterson
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA.
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Fadl A, Bennani NN, Comfere N, Durani U, Greipp PT, Feldman AL. Primary cutaneous gamma/delta T-cell lymphoma with simultaneous JAK2 and TP63 rearrangements: a new double-hit? Histopathology 2023; 83:492-495. [PMID: 37308177 PMCID: PMC10524708 DOI: 10.1111/his.14973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/14/2023]
Affiliation(s)
- Amr Fadl
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Nneka Comfere
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | | | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Andrew L. Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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10
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Fritchie KJ, Dermawan JK, Astbury C, Sharma A, Bakhshwin A, Fuller L, Agrawal S, Wieland CN, Greipp PT, Azzato EM, Folpe AL, Billings SD. Novel NONO::TFE3 fusion and ALK co-expression identified in a subset of cutaneous microcystic/reticular schwannoma. Virchows Arch 2023; 483:237-243. [PMID: 37468653 DOI: 10.1007/s00428-023-03605-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/09/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
Microcystic/reticular schwannoma (MRS) is a benign variant of schwannoma with a predilection for the gastrointestinal tract and skin. To date, genetic characterization of this tumor is limited. Prompted by the identification of TFE3::NONO fusion and ALK overexpression in an index case of MRS, a cohort of tumors was collected from institutional and consultation archives of two institutions. Next-generation sequencing (NGS), TFE3 fluorescence in situ hybridization (FISH), and TFE3 and ALK immunohistochemistry were performed, while clinicopathologic variables were documented. Eighteen MRS cases were identified (35 to 85 years) arising in the skin (n=8), gastrointestinal tract (n=5), adrenal gland (n=3), abdominal wall (n=1), and unknown site (n=1). Tumors showed a circumscribed to multinodular to plexiform low-power architecture with variable amounts of microcystic/reticular and solid schwannian components. Mitotic figures were scarce (0-1/10 HPFs), and atypia was absent. S100 protein and/or SOX10 immunoreactivity was noted in the microcystic/reticular and schwannian areas of all cases. NGS performed on two cutaneous tumors yielded NONO exon 12 fusion with TFE3 exon 4, and these lesions also showed HMB45 and ALK expression. Two additional cases showed ALK expression (1 weak), while a third was positive for TFE3, but these cases failed to show ALK or TFE3 rearrangement by FISH/NGS. There were no morphologic variables that correlated with the presence of NONO::TFE3. We identified a subset of microcystic/reticular schwannomas with NONO::TFE3 fusions and ALK co-expression, adding to the cohort of mesenchymal neoplasms that show ALK overexpression without rearrangement of the ALK gene.
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Affiliation(s)
- Karen J Fritchie
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA.
| | - Josephine K Dermawan
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
| | - Caroline Astbury
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
| | - Anurag Sharma
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
| | - Ahmed Bakhshwin
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
| | - Lanisha Fuller
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
| | - Shruti Agrawal
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carilyn N Wieland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Elizabeth M Azzato
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Steven D Billings
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 2119 E 93rd Street, L15, Cleveland, OH, 44195, USA
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11
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Fischer GM, Gliem TJ, Greipp PT, Rosenberg AE, Folpe AL, Hornick JL. Anaplastic Kaposi Sarcoma: A Clinicopathologic and Molecular Genetic Analysis. Mod Pathol 2023; 36:100191. [PMID: 37080393 DOI: 10.1016/j.modpat.2023.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/22/2023]
Abstract
Kaposi sarcoma (KS) is a human herpesvirus 8 (HHV8)-associated vascular proliferation that most often involves the skin. Rarely, KS shows marked nuclear atypia or pleomorphism; such examples are known as "anaplastic" KS. This poorly characterized variant often pursues an aggressive course; little is known of its genetic landscape. This study evaluated the clinicopathologic and genomic features of anaplastic KS. We identified 9 anaplastic KS cases from 7 patients and 8 conventional KS cases, including a matched conventional KS and primary metastasis anaplastic KS pair from a single patient (anaplastic KS diagnosed 9 years after conventional KS). All patients with anaplastic KS were men, aged 51 to 82 years, who had locally aggressive tumors predominantly affecting the soft tissue and bone of the lower extremities (5/7 patients). Four patients were known to be HIV positive (all on antiretrovirals), 2 were HIV negative, and 1 was of unknown HIV status. The tumors showed angiosarcoma-like or pleomorphic spindle cell sarcoma morphology. Plasma cell-rich chronic inflammation and hemosiderin deposition were commonly present. Single-nucleotide polymorphism-based chromosomal microarray analysis showed the anaplastic KS cohort to demonstrate highly recurrent whole chromosome (chr) gains of chr 7, 11, 19, and 21, which primarily affected olfactory and G protein-coupled receptor signaling and losses of chr6_q and chrY. Compared with conventional KS, anaplastic KS cases showed significantly more total copy number alterations and more frequent gains of chr7 and chr11_q13.1 (MARK2, RELA, and ESRRA, including high copy number gain in 1 case). Pathway analysis demonstrated that these gains preferentially affected genes that facilitate cyclin-dependent cell signaling. Furthermore, anaplastic KS cases were phylogenetically distinct from conventional KS cases, including the patient-matched primary metastasis anaplastic KS pair and conventional KS. Our study is the first to demonstrate that a more complex genome and distinct copy number alterations distinguish anaplastic KS from conventional KS. Gains of chr7 and chr11_q13.1 appear central to biological transformation.
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Affiliation(s)
- Grant M Fischer
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Troy J Gliem
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Andrew E Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
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12
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Abdallah NH, Smith AN, Geyer S, Binder M, Greipp PT, Kapoor P, Dispenzieri A, Gertz MA, Baughn LB, Lacy MQ, Hayman SR, Buadi FK, Dingli D, Hwa YL, Lin Y, Kourelis T, Warsame R, Kyle RA, Rajkumar SV, Kumar SK. Conditional survival in multiple myeloma and impact of prognostic factors over time. Blood Cancer J 2023; 13:78. [PMID: 37188699 DOI: 10.1038/s41408-023-00852-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/22/2023] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
Overall survival estimates from diagnosis are valuable for guiding treatment, but do not consider the years already survived. Conditional survival (CS) provides dynamic survival predictions over time. This study was conducted to estimate CS at 1-8 years from diagnosis and the impact of baseline prognostic factors on CS in multiple myeloma (MM) patients. This is a retrospective study including 2556 MM patients diagnosed between 2004 and 2019. CS (t | s) was defined as the probability of surviving t years given survival of s years. Median age was 64 years. Median follow-up was 6.2 years and median overall survival from diagnosis was 7.5 years. The 5-year CS estimates at s = 0, 1, 2, 3, and 5 years were 0.64, 0.61, 0.61, 0.61, and 0.58, respectively. On multivariate analysis, age ≥ 65 and proteasome inhibitor+immunomodulatory-based induction were associated with decreased survival and increased survival, respectively, retained at 5 years. The adverse impact of 1q gain/amplification, high-risk IgH translocation, and ISS-3 was significant at 1 and 3 years but not 5 years. Chromosome 17 abnormality was associated with decreased survival only at 1 year. Among MM patients, 5-year CS was stable at 1-5 years from diagnosis. The prognostic impact of high-risk cytogenetic factors decreased with additional years survived.
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Affiliation(s)
| | | | - Susan Geyer
- Department of biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Moritz Binder
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Morie A Gertz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Martha Q Lacy
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Yi L Hwa
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Rahma Warsame
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Robert A Kyle
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Shaji K Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.
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13
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Panakkal V, Lakshman A, Shi M, Olteanu H, Horna P, Timm MM, Otteson GE, Baughn LB, Greipp PT, Gonsalves WI, Kapoor P, Gertz MA, Binder M, Buadi FK, Dispenzieri A, Rajkumar SV, Kumar SK, Jevremovic D. Utility of flow cytometry screening before MRD testing in multiple myeloma. Blood Cancer J 2023; 13:55. [PMID: 37080968 PMCID: PMC10119092 DOI: 10.1038/s41408-023-00832-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/31/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Affiliation(s)
- Vandana Panakkal
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Arjun Lakshman
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Min Shi
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Horatiu Olteanu
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Pedro Horna
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Michael M Timm
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | | | - Linda B Baughn
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Wilson I Gonsalves
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Prashant Kapoor
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Morie A Gertz
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Moritz Binder
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Francis K Buadi
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Angela Dispenzieri
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - S Vincent Rajkumar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Shaji K Kumar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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14
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Al-Kali A, Nanaa A, Viswanatha D, He R, Nguyen P, Jevremovic D, Foran JM, Yi CA, Greipp PT, Gangat N, Patnaik M, Tefferi A, Litzow MR, Mangaonkar AA, Shah MV, Badar T, Alkhateeb HB. Observation and treatment in DDX41-mutated acute myeloid leukemia and myelodysplastic syndrome. Blood Cancer J 2023; 13:49. [PMID: 37032414 PMCID: PMC10083167 DOI: 10.1038/s41408-023-00818-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/04/2023] [Accepted: 03/14/2023] [Indexed: 04/11/2023] Open
Affiliation(s)
- Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Ahmad Nanaa
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
- John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, 60612, USA
| | - David Viswanatha
- Division of Hematopathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Rong He
- Division of Hematopathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Phuong Nguyen
- Division of Hematopathology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | - James M Foran
- Division of Hematology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | | | - Naseema Gangat
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Mrinal Patnaik
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ayalew Tefferi
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN, 55905, USA
| | | | | | - Talha Badar
- Division of Hematology, Mayo Clinic, Jacksonville, FL, 32224, USA
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15
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Dutta AK, Alberge JB, Lightbody ED, Boehner CJ, Dunford A, Sklavenitis-Pistofidis R, Mouhieddine TH, Cowan AN, Su NK, Horowitz EM, Barr H, Hevenor L, Beckwith JB, Perry J, Cao A, Lin Z, Kuhr FK, Mastro RGD, Nadeem O, Greipp PT, Stewart C, Auclair D, Getz G, Ghobrial IM. MinimuMM-seq: Genome Sequencing of Circulating Tumor Cells for Minimally Invasive Molecular Characterization of Multiple Myeloma Pathology. Cancer Discov 2023; 13:348-363. [PMID: 36477267 DOI: 10.1158/2159-8290.cd-22-0482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/20/2022] [Accepted: 11/09/2022] [Indexed: 12/12/2022]
Abstract
Multiple myeloma (MM) develops from well-defined precursor stages; however, invasive bone marrow (BM) biopsy limits screening and monitoring strategies for patients. We enumerated circulating tumor cells (CTC) from 261 patients (84 monoclonal gammopathy of undetermined significance, 155 smoldering multiple myeloma, and 22 MM), with neoplastic cells detected in 84%. We developed a novel approach, MinimuMM-seq, which enables the detection of translocations and copy-number abnormalities through whole-genome sequencing of highly pure CTCs. Application to CTCs in a cohort of 51 patients, 24 with paired BM, was able to detect 100% of clinically reported BM biopsy events and could replace molecular cytogenetics for diagnostic yield and risk classification. Longitudinal sampling of CTCs in 8 patients revealed major clones could be tracked in the blood, with clonal evolution and shifting dynamics of subclones over time. Our findings provide proof of concept that CTC detection and genomic profiling could be used clinically for monitoring and managing disease in MM. SIGNIFICANCE In this study, we established an approach enabling the enumeration and sequencing of CTCs to replace standard molecular cytogenetics. CTCs harbored the same pathognomonic MM abnormalities as BM plasma cells. Longitudinal sampling of serial CTCs was able to track clonal dynamics over time and detect the emergence of high-risk genetic subclones. This article is highlighted in the In This Issue feature, p. 247.
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Affiliation(s)
- Ankit K Dutta
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Jean-Baptiste Alberge
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Elizabeth D Lightbody
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Cody J Boehner
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Andrew Dunford
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Romanos Sklavenitis-Pistofidis
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Tarek H Mouhieddine
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Annie N Cowan
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Nang Kham Su
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Erica M Horowitz
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Hadley Barr
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Laura Hevenor
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Jenna B Beckwith
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Jacqueline Perry
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Amanda Cao
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Ziao Lin
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Frank K Kuhr
- Menarini Silicon Biosystems, Huntingdon Valley, Pennsylvania
| | | | - Omar Nadeem
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic Comprehensive Cancer Center, Rochester, Minnesota
| | - Chip Stewart
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Daniel Auclair
- Multiple Myeloma Research Foundation, Norwalk, Connecticut
| | - Gad Getz
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
- Cancer Center and Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Irene M Ghobrial
- Center for Prevention of Progression of Blood Cancers, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Medical Oncology, Harvard Medical School, Boston, Massachusetts
- Cancer Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts
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16
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Katamesh B, Nanaa A, He R, Viswanatha DS, Nguyen P, Greipp PT, Foran J, Badar T, Litzow MR, Hogan WJ, Mangaonkar A, Shah MV, Al-Kali A, Alkhateeb HB. Hematopoietic Stem Cell Transplant Outcome in STAG2-Mutated Myeloid Neoplasms. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00203-8] [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: 02/07/2023]
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17
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Aviles-Hernandez X, Rahman ZA, Heckman M, Miller KC, Alkhateeb HB, Patnaik MM, Sproat LZ, Jiang L, Roy V, Murthy H, Ayala E, Hogan WJ, Greipp PT, Kharfan-Dabaja MA, Litzow MR, Ray JC, Foran J. Prediction of Atrial Arrhythmia after Allogenic Transplantation Using Artificial Intelligence-Enabled ECG. Transplant Cell Ther 2023. [DOI: 10.1016/s2666-6367(23)00652-8] [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: 02/07/2023]
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18
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Venable ER, Gagnon MF, Pitel BA, Palmer JM, Peterson JF, Baughn LB, Hoppman NL, Greipp PT, Ketterling RP, Patnaik MS, Kelemen K, Xu X. A TRIP11:: FLT3 gene fusion in a patient with myeloid/lymphoid neoplasm with eosinophilia and tyrosine kinase gene fusions: a case report and review of the literature. Cold Spring Harb Mol Case Stud 2023; 9:mcs.a006243. [PMID: 36627146 PMCID: PMC10111796 DOI: 10.1101/mcs.a006243] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/13/2022] [Indexed: 01/12/2023] Open
Abstract
Myeloid/lymphoid neoplasms with FLT3 gene fusions have recently been included among myeloid/lymphoid neoplasms with eosinophilia and tyrosine kinase gene fusions (MLN-TK) in the World Health Organization classification and International Consensus Classification. As this entity remains remarkably rare, its scope and phenotypic features are evolving. In this report, we describe a 33-yr-old male with MLN-TK. Conventional chromosome analysis revealed a t(13;14)(q12;q32). Further analysis with mate-pair sequencing (MPseq) confirmed a TRIP11::FLT3 gene fusion. A diagnosis of MLN-TK was rendered. To the best of our knowledge, we report the third case of MLN-TK with a TRIP11::FLT3 gene fusion. In contrast to previously described cases, our case exhibited distinctly mild clinical features and disease behavior, emphasizing the diverse spectrum of MLN-TK at primary presentation and variability in disease course. MLN-TK with FLT3 gene fusions are a genetically defined entity which may be targetable with tyrosine kinase inhibitors with anti-FLT3 activity. Accordingly, from diagnostic and therapeutic viewpoints, genetic testing for FLT3 rearrangements using fluorescence in situ hybridization (FISH) or sequencing-based assays should be pursued for patients with chronic eosinophilia.
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Affiliation(s)
- Elise R Venable
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Marie-France Gagnon
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Beth A Pitel
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Jeanne M Palmer
- Division of Hematology and Oncology, Department of Medicine, Mayo Clinic, Phoenix, Arizona 85054, USA
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Rochester, Minnesota 55905, USA
| | - Linda B Baughn
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Rochester, Minnesota 55905, USA
| | - Nicole L Hoppman
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Rochester, Minnesota 55905, USA
| | - Rhett P Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Rochester, Minnesota 55905, USA
| | - Mrinal S Patnaik
- Division of Hematology and Oncology, Department of Medicine Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Katalin Kelemen
- Division of Hematopathology, Department of Laboratory Medicine and Pathology; Mayo Clinic, Phoenix, Arizona 85054, USA
| | - Xinjie Xu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Rochester, Minnesota 55905, USA;
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19
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Koleilat A, Smadbeck JB, Zepeda‐Mendoza CJ, Williamson CM, Pitel BA, Golden CL, Xu X, Greipp PT, Ketterling RP, Hoppman NL, Peterson JF, Harrison CJ, Akkari YMN, Tsuchiya KD, Shago M, Baughn LB. Characterization of unusual iAMP21 B-lymphoblastic leukemia (iAMP21-ALL) from the Mayo Clinic and Children's Oncology Group. Genes Chromosomes Cancer 2022; 61:710-719. [PMID: 35771717 PMCID: PMC9549522 DOI: 10.1002/gcc.23084] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/06/2022] [Accepted: 06/27/2022] [Indexed: 01/01/2023] Open
Abstract
Acute lymphoblastic leukemia (B-ALL) with intrachromosomal amplification of chromosome 21 (iAMP21-ALL) represents a recurrent high-risk cytogenetic abnormality and accurate identification is critical for appropriate clinical management. Identification of iAMP21-ALL has historically relied on fluorescence in situ hybridization (FISH) using a RUNX1 probe. Current classification requires ≥ five copies of RUNX1 per cell and ≥ three additional copies of RUNX1 on a single abnormal iAMP21-chromosome. We sought to evaluate the performance of the RUNX1 probe in the identification of iAMP21-ALL. This study was a retrospective evaluation of iAMP21-ALL in the Mayo Clinic and Children's Oncology Group cohorts. Of 207 cases of iAMP21-ALL, 188 (91%) were classified as "typical" iAMP21-ALL, while 19 (9%) cases were classified as "unusual" iAMP21-ALL. The "unusual" iAMP21 cases did not meet the current definition of iAMP21 by FISH but were confirmed to have iAMP21 by chromosomal microarray. Half of the "unusual" iAMP21-ALL cases had less than five RUNX1 signals, while the remainder had ≥ five RUNX1 signals with some located apart from the abnormal iAMP21-chromosome. Nine percent of iAMP21-ALL cases fail to meet the FISH definition of iAMP21-ALL demonstrating that laboratories are at risk of misidentification of iAMP21-ALL when relying only on the RUNX1 FISH probe. Incorporation of chromosomal microarray testing circumvents these risks.
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Affiliation(s)
- Alaa Koleilat
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - James B. Smadbeck
- Division of Computational Biology, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | - Cynthia M. Williamson
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Beth A. Pitel
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Crystal L. Golden
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Xinjie Xu
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Patricia T. Greipp
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Rhett P. Ketterling
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Nicole L. Hoppman
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Jess F. Peterson
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Christine J. Harrison
- Leukaemia Research Cytogenetics Group, Translational and Clinical Research InstituteNewcastle University Centre for CancerNewcastle‐upon‐TyneUK
| | | | - Karen D. Tsuchiya
- Department of Laboratory Medicine and PathologyUniversity of WashingtonSeattleWAUSA
| | - Mary Shago
- Department of Paediatric Laboratory Medicine, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | - Linda B. Baughn
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
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20
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Reichard KK, Tefferi A, Abdelmagid M, Orazi A, Alexandres C, Haack J, Greipp PT. Pure (acute) erythroid leukemia: morphology, immunophenotype, cytogenetics, mutations, treatment details, and survival data among 41 Mayo Clinic cases. Blood Cancer J 2022; 12:147. [PMID: 36323674 PMCID: PMC9630502 DOI: 10.1038/s41408-022-00746-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023] Open
Abstract
Pure erythroid leukemia (PEL), also known as acute erythroid leukemia (AEL), is recognized as a distinct morphologic entity by both the 2016 and 2022 World Health Organization (WHO) classification system. By contrast, the 2022 International Consensus Classification (ICC) includes PEL under a broader category of "acute myeloid leukemia with mutated TP53". We identified 41 Mayo Clinic cases of PEL (mean age 66 years, range 27-86; 71% males) and provide a comprehensive account of bone marrow morphology, immunophenotype, cytogenetic and mutation profiles. PEL was primary in 14 cases, therapy-related in 14, secondary in 12, and undetermined in one. All cases expressed biallelic TP53 alterations, including TP53 deletion/single TP53 mutation (68%), two TP53 mutations (29%) or two TP53 deletions (3%); additional mutations were infrequent. Karyotype was complex in all cases and monosomal in 90%. Treatment details were available in 29 patients: hypomethylating agent (HMA) alone (n = 5), HMA + venetoclax (n = 12), intensive chemotherapy (n = 4), supportive care/other (n = 8); no responses or allogeneic stem cell transplants were documented, and all patients died at a median 1.8 months (range 0.2-9.3). The current study highlights a consistent and reproducible set of morphologic and genetic characteristics that identify PEL as a distinct AML variant whose dismal prognosis requires urgent attention.
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Affiliation(s)
- Kaaren K. Reichard
- grid.66875.3a0000 0004 0459 167XDepartment of Laboratory Medicine and Pathology – Division of Hematopathology; Mayo Clinic Rochester, Rochester, MN USA
| | - Ayalew Tefferi
- grid.66875.3a0000 0004 0459 167XDivision of Hematology; Mayo Clinic Rochester, Rochester, MN USA
| | - Maymona Abdelmagid
- grid.66875.3a0000 0004 0459 167XDivision of Hematology; Mayo Clinic Rochester, Rochester, MN USA
| | - Attilio Orazi
- grid.416992.10000 0001 2179 3554Department of Pathology, Texas Tech University Health Sciences Center, El Paso, TX USA
| | - Christina Alexandres
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Mayo Clinic Rochester, Rochester, MN USA
| | - Joanna Haack
- grid.66875.3a0000 0004 0459 167XDepartment of Laboratory Medicine and Pathology – Division of Hematopathology; Mayo Clinic Rochester, Rochester, MN USA
| | - Patricia T. Greipp
- grid.66875.3a0000 0004 0459 167XDepartment of Laboratory Medicine and Pathology – Division of Hematopathology; Mayo Clinic Rochester, Rochester, MN USA
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21
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Ding X, Zakharia K, Moser CD, Campbell NA, Hu C, Razumilava N, Chaiteerakij R, Shaleh HM, Greipp PT, Graham RP, Zou X, Chandan VS, Roberts LR. Establishment and Characterization of a New Human Intrahepatic Cholangiocarcinoma Cell Line LIV27. Cancers (Basel) 2022; 14:5080. [PMID: 36291862 PMCID: PMC9600735 DOI: 10.3390/cancers14205080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Accepted: 10/14/2022] [Indexed: 11/17/2022] Open
Abstract
Cholangiocarcinoma (CCA) is a highly lethal cancer arising from the biliary tract epithelium. The cancer biology of this neoplasm is not well understood. To date, only a few CCA cell lines have been reported, which were mostly developed from Asian patients. In this study, we report and characterize a new intrahepatic CCA cell line, LIV27, derived from a surgically resected tumor in a 67-year-old Caucasian woman with primary sclerosing cholangitis (PSC). LIV27 cells grow well in collagen-coated flasks or plates with a doubling time of 57.8 h at passage 14. LIV27 cells have high tumorigenicity in nude mice and stain positive for CK7 and CK19, markers that differentiate CCA from hepatocellular carcinoma. Karyotype analysis showed that LIV27 is aneuploid. We established a single-locus short tandem repeat profile for the LIV27 cell line. This newly established cell line will be a useful model for studying the molecular pathogenesis of, and developing novel therapies for, cholangiocarcinoma.
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Affiliation(s)
- Xiwei Ding
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210000, China
| | - Kais Zakharia
- Division of Gastroenterology and Hepatology, University of Iowa, Iowa City, IA 52242, USA
- Aurora St. Luke’s Medical Center, GI Associates, Milwaukee, WI 53215, USA
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
| | - Catherine D. Moser
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
| | - Nellie A. Campbell
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
| | - Chunling Hu
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
| | - Nataliya Razumilava
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
| | - Roongruedee Chaiteerakij
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Hassan M. Shaleh
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
| | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Rondell P. Graham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Xiaoping Zou
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210000, China
| | - Vishal S. Chandan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Pathology and Laboratory Medicine, School of Medicine, University of California, Irvine, CA 92697, USA
| | - Lewis R. Roberts
- Mayo Clinic and Mayo Clinic Cancer Center, Division of Gastroenterology and Hepatology, College of Medicine and Science, Rochester, MN 55905, USA
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22
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Geiersbach KB, Gliem TJ, Jenkins SM, Gaitatzes AG, Brodersen PR, Negro ME, Clees MJ, Swanson KE, Boeckman RM, Natrop TJ, Sukov WR, Shah KK, Greipp PT, Rowsey RA, Flotte TJ, Erickson LA, Guo R. Single-Nucleotide Polymorphism Array for Histologically Ambiguous Melanocytic Tumors: Knowns and Unknowns. J Mol Diagn 2022; 24:1160-1170. [PMID: 36115511 DOI: 10.1016/j.jmoldx.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/10/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022] Open
Abstract
Genome-wide copy number profiling by single-nucleotide polymorphism (SNP) array is increasingly employed in the clinical diagnostic workup of melanocytic tumors. We present our SNP array results on 675 melanocytic tumors, including 615 histologically ambiguous tumors evaluated by our institution's dermatopathology consultation service and a separate validation cohort of 26 known benign nevi and 34 known malignant melanomas. The total number of somatic copy number abnormalities, sub-chromosomal copy number abnormalities, regions of homozygosity, and abnormalities at disease-associated regions was significantly associated with a diagnosis of malignancy across disease categories. In our study, the number of copy number abnormalities was the factor that best discriminated between benign versus malignant diagnoses, confirming recent published research. Histologically ambiguous tumors had a range and spectrum of abnormalities, including recurrent 11p gains, copy state transitions over kinase genes, and 3p deletions overlapping BAP1 in neoplasms with spitzoid morphology. Our data suggest that histologically ambiguous melanocytic neoplasms and early primary melanomas have a range of abnormalities that is intermediate between unambiguous benign or malignant melanocytic neoplasms. Careful technical review and an integrated diagnostic approach are essential for the accurate interpretation of SNP array results on histologically ambiguous melanocytic tumors.
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Affiliation(s)
| | - Troy J Gliem
- Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota
| | - Sarah M Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | | | - Pamela R Brodersen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Megan E Negro
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Megan J Clees
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Kirsten E Swanson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Riley M Boeckman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Travis J Natrop
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - William R Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Kabeer K Shah
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; SSM Health St. Mary's Hospital, Madison, Wisconsin
| | - Patricia T Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota
| | - Ross A Rowsey
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Thomas J Flotte
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Lori A Erickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Ruifeng Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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23
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Ocal JL, Feldman AL, Greipp PT, Rimsza LM. Mediastinal B-cell lymphoma with MYC, BCL2, and BCL6 rearrangements. J Hematop 2022. [DOI: 10.1007/s12308-022-00505-8] [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: 10/17/2022] Open
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24
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Nanaa A, He R, Viswanatha D, Nguyen P, Jevremovic D, Foran JM, Yi CA, Greipp PT, Gangat N, Patnaik M, Tefferi A, Litzow MR, Mangaonkar AA, Shah MV, Badar T, Alkhateeb HB, Al-Kali A. Comparison between GATA2 and DDX41-mutated myeloid neoplasms. Leuk Res 2022; 121:106931. [PMID: 36037623 DOI: 10.1016/j.leukres.2022.106931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Ahmad Nanaa
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA; John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, USA
| | - Rong He
- Division of Hematopathology, Mayo Clinic, Rochester, MN 55905, USA
| | - David Viswanatha
- Division of Hematopathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Phuong Nguyen
- Division of Hematopathology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - James M Foran
- Division of Hematology, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | | | - Naseema Gangat
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mrinal Patnaik
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ayalew Tefferi
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA
| | | | | | - Talha Badar
- Division of Hematology, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN 55905, USA.
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25
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Jevremovic D, Nanaa A, Geyer SM, Timm M, Azouz H, Hengel C, Reberg A, He R, Viswanatha D, Salama ME, Shi M, Olteanu H, Horna P, Otteson G, Greipp PT, Xie Z, Alkhateeb HB, Hogan W, Litzow M, Patnaik MM, Shah M, Al-Kali A, Nguyen PL. Abnormal CD13/HLA-DR Expression Pattern on Myeloblasts Predicts Development of Myeloid Neoplasia in Patients With Clonal Cytopenia of Undetermined Significance. Am J Clin Pathol 2022; 158:530-536. [PMID: 35938646 PMCID: PMC9535519 DOI: 10.1093/ajcp/aqac083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/09/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Patients with clonal cytopenia of undetermined significance (CCUS) are at increased risk of developing myeloid neoplasia (MN). We evaluated whether a simple flow cytometry immunophenotyping (FCIP) assay could differentiate the risk of development of MN in patients with CCUS. METHODS Bone marrow aspirates were assessed by FCIP panel in a cohort of 80 patients identified as having CCUS based on next-generation sequencing or cytogenetics from March 2015 to May 2020, with available samples. Flow cytometric assay included CD13/HLA-DR expression pattern on CD34-positive myeloblasts; CD13/CD16 pattern on maturing granulocytic precursors; and aberrant expression of CD2, CD7, or CD56 on CD34-positive myeloblasts. Relevant demographic, comorbidity, and clinical and laboratory data, including the type and extent of genetic abnormalities, were extracted from the electronic health record. RESULTS In total, 17 (21%) patients with CCUS developed MN over the follow-up period (median survival follow-up, 28 months [95% confidence interval, 19-31]). Flow cytometry immunophenotyping abnormalities, including the aberrant pattern of CD13/HLA-DR expression, as detected at the time of the diagnosis of CCUS, were significantly associated with risk of developing MN (hazard ratio, 2.97; P = .006). Additional FCIP parameters associated with the development of MN included abnormal expression of CD7 on myeloblasts and the presence vs absence of any FCIP abnormality. CONCLUSIONS A simple FCIP approach that includes assessment of CD13/HLA-DR pattern on CD34-positive myeloblasts can be useful in identifying patients with CCUS at higher risk of developing MN.
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Affiliation(s)
| | - Ahmad Nanaa
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Susan M Geyer
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Michael Timm
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Haya Azouz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Cynthia Hengel
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | | | - Rong He
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Min Shi
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Horatiu Olteanu
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Pedro Horna
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Gregory Otteson
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA.,Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Zhuoer Xie
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - William Hogan
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Mark Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Mithun Shah
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Phuong L Nguyen
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
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26
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Shi M, Timm MM, Howard MT, Jevremovic D, Yuan J, Greipp PT, Peterson JF, Roh DJ, Horna P, Olteanu H. Spurious CD34 expression in B-cell lymphoma due to nonspecific binding to PerCP-Cy5.5 fluorochrome conjugates: A rare phenomenon and a diagnostic pitfall. Cytometry B Clin Cytom 2022; 102:326-328. [PMID: 35652321 DOI: 10.1002/cyto.b.22079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/20/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Min Shi
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael M Timm
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Matthew T Howard
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Dragan Jevremovic
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Ji Yuan
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Dana J Roh
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Pedro Horna
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Horatiu Olteanu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
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27
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Ghosh T, Greipp PT, Knutson D, Kloft-Nelson S, Jenkins S, Mounajjed T, Said S, La Rosa S, Vanoli A, Sessa F, Naini BV, Bellizzi A, Zhang L, Kerr SE, Graham RP. BRAF Rearrangements and BRAF V600E Mutations Are Seen in a Subset of Pancreatic Carcinomas With Acinar Differentiation. Arch Pathol Lab Med 2022; 146:840-845. [PMID: 34614142 DOI: 10.5858/arpa.2020-0739-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Comprehensive genomic profiling has demonstrated that approximately 20% of pancreatic carcinomas with acinar differentiation harbor potentially targetable BRAF fusions that activate the MAPK pathway. OBJECTIVES.— To validate the above finding by BRAF break-apart fluorescence in situ hybridization (FISH) in a large series of pure acinar cell carcinomas (ACCs), evaluate tumors for the presence of BRAF V600E mutations, and compare clinicopathologic features of tumors with BRAF rearrangements with those without. DESIGN.— Thirty cases of pure ACC and 6 cases of mixed acinar-neuroendocrine carcinoma (ACC-NEC) were retrieved. A break-apart FISH probe was used to detect BRAF rearrangements. Immunohistochemistry for BRAF V600E was performed. RESULTS.— BRAF rearrangements by FISH were found in 6 of 36 cases (17%), 5 of which were pure ACC and 1 was a mixed ACC-NEC. Follow-up was available in 29 of 36 cases (81%). The median survival was 22 months for BRAF-rearranged cases and 16 months for BRAF-intact cases; the 2-year overall survival was 50% for BRAF-rearranged cases and 35% for BRAF-intact cases. No significant clinicopathologic differences were identified in cases with BRAF rearrangement compared with those without BRAF rearrangement. BRAF V600E mutation was identified in 2 of 34 cases (6%), both of which were pure ACC and were BRAF-intact by FISH. CONCLUSIONS.— This study supports the finding that BRAF rearrangements are present in approximately 20% of cases and identified BRAF V600E mutations in approximately 5% of cases. These cases may benefit from targeted therapy.
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Affiliation(s)
- Toshi Ghosh
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Patricia T Greipp
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Darlene Knutson
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Sara Kloft-Nelson
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Sarah Jenkins
- From the Department of Health Sciences Research (Jenkins), Mayo Clinic, Rochester, Minnesota
| | - Taofic Mounajjed
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Samar Said
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Stefano La Rosa
- From the Institute of Pathology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland (La Rosa)
| | - Alessandro Vanoli
- From the Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia, and IRCCS San Matteo Hospital, Pavia, Italy (Vanoli)
| | - Fausto Sessa
- From the Anatomic Pathology Unit, Department of Medicine and Surgery, University of Insubria, Varese, Italy (Sessa)
| | - Bita V Naini
- From the Department of Pathology, University of California, Los Angeles (Naini)
| | - Andrew Bellizzi
- From the Department of Pathology, University of Iowa, Iowa City (Bellizzi)
| | - Lizhi Zhang
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Sarah E Kerr
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
| | - Rondell P Graham
- From the Department of Laboratory Medicine and Pathology (Ghosh, Greipp, Knutson, Kloft-Nelson, Mounajjed, Said, Zhang, Kerr, Graham), Mayo Clinic, Rochester, Minnesota
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Katamesh B, Nanaa A, He R, Viswanatha D, Nguyen PL, Greipp PT, Gangat N, Begna K, Mangaonkar AA, Patnaik M, Hogan WJ, Litzow MR, Shah MV, Arana Yi CY, Foran JM, Badar T, Alkhateeb HB, Al-Kali A. Characteristics and prognosis of mutated STAG2 myeloid neoplasms. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e19014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19014 Background: Stromal Antigen 2 ( STAG2), located on Xq25, is the most mutated (m) cohesin-complex gene in myeloid neoplasm (MN) patients (pts). mSTAG2 is present in around 5% of MN and has been linked to secondary AML and potential poor impact on outcome. Methods: We retrospectively screened MN pts who had next-generation sequencing (NGS) (OncoHeme) performed at Mayo Clinic between 2018-2021. m STAG2 pts were included at the date of NGS. Charts were reviewed for clinical information after obtaining IRB approval. BlueSky Software V7.40 was used for statistical analysis. Results: Characteristics: 70 pts with mSTAG2 MN were identified, their median age was 72 years (range 25-91); with 55 pts (79%) being males. Complete blood counts showed median white blood cell count of 2.8 x109/L, hemoglobin of 8.9 gm/dL and platelets of 89 x109/L. The diagnosis was MDS in 38 pts (54%), AML in 20 (29%), MDS/MPN in 9 (13%), MPN in 2 (3%), and CCUS in 1 (1%). 11 cases (16%) were defined as therapy-related MN (tMN). Cytogenetics were normal in 45 pts (64%) and abnormal in 22 (31%). 10/50 non-AML pts progressed to AML (after median time of 9.8 months). Hematopoietic cell transplantation (HCT) was done in 20 pts (29%). mSTAG2: median VAF (mVAF) was 50% (range, 5%-100%). Males had higher mVAF compared to females (64% vs. 27%, p= .001), and tMN pts had higher mVAF compared to de novo (dn) MN pts (66% vs. 43%, p= .03). mVAF had no correlation with disease classification (50% in AML, 52% in MDS, 41% in MDS/MPN, 36% in MPN and 5% in CCUS, p= .5). STAG2 mutations were nonsense, frameshift, and splice site in 50%, 37%, and 13%, respectively. Co-mutations : median number of co-mutations was 3 (range, 0-6). Most common co-mutations were ASXL1 (66%), SRSF2 (37%), TET2 (36%), RUNX1 (29%), IDH2 (21%), BCOR (20%) and U2AF1 (16%) while least common were TP53, SETBP and ZRSR2 (1% each). Neither number (p= .08) nor type of co-mutation correlated with MN classification. There was no difference in the co-mutational pattern between tMN and dnMN pts. Survival : median overall survival (mOS) was 16.3 months with a median follow up time of 24.5 months. Pts who received HCT had better OS compared to non-HCT pts (mOS not reached vs. 14.9 months, p= .003). Pts with an isolated m STAG2 had better OS than co-mutated pts (p= .04), while the type of STAG2 mutation did not affect OS (p= .3). Pts with tMN had worse OS than dnMN pts (9.9 vs. 20.4 months, p= .02). VAF ≥75% had a negative impact on OS (20.5 vs 8.1 months, p= .008). mOS did not differ based on MN diagnosis. On multivariate analysis, only HCT (HR 0.3, p= .01) and VAF ≥75% (HR 2.3, p= .02) had impact on OS. Conclusions: mSTAG2 was more common in elderly males and MDS diagnosis. mSTAG2 was uncommon as an isolated mutation, indicating a possible role in disease progression with preferred certain co-mutations ( ASXL1/SRSF2/RUNX1/IDH2). mOS was poor regardless of MN diagnosis indicating a molecularly driven significance of an aggressive disease. The study needs to be validated by larger studies.
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Affiliation(s)
| | - Ahmad Nanaa
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | - Kebede Begna
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | | | | | - Talha Badar
- Division of Hematology, Mayo Clinic, Jacksonville, FL
| | | | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN
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Nanaa A, Alkhateeb HB, Badar T, Foran JM, Sproat LO, Arana Yi CY, Nguyen PL, Jevremovic D, Greipp PT, Gangat N, Tefferi A, Litzow MR, Shah MV, Mangaonkar AA, Patnaik M, Viswanatha D, He R, Al-Kali A. Characteristics and prognosis of DDX41- and GATA2-mutated myeloid neoplasms. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e19010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e19010 Background: Mutated DEAD-box helicase 41 (m DDX41), and mutated GATA2 are germline mutations associated with familial predisposition syndromes. In this study, we compare the clinical characteristics and survival outcomes (OS) of m DDX41 and m GATA2 MN patients (pts). Methods: We retrospectively screened pts who had next-generation sequencing (NGS) (OncoHeme panel) performed at Mayo Clinic. 4,524 consecutive pts (2018-2021) were screened for DDX41 mutations and 3,872 for GATA2 mutations (2015-2020) and included 36 MN pts with m DDX41 genetic alterations, and 55 m GATA2 MN pts. m GATA2 cases were included at NGS date while m DDX41 were included at diagnosis date. Germline workup was not done in all cases. JMP 16.2.0 Software was used for statistical analysis. Results: Patient characteristics: The most common diagnosis was MDS (N = 22, 61% in m DDX41 N = 17, 31% in m GATA2 group; p = .0044). MDS/MPN overlap was seen in m GATA2 group only; (29% vs. 0%; p = .0004). Majority of pts were males with median age of 68 and 67 years for m DDX41 and m GATA2 pts; respectively (p = .7). m DDX41 pts had higher hemoglobin, platelets, and MCV (< .0001, 0.005, < .0001; respectively) and significantly lower white blood cells (WBC) count compared to m GATA2 pts (< .0001). All m DDX41-AML pts were (ELN) intermediate-risk, and 64% of m DDX41 MDS were intermediate risk (IPSS-R). In contrast, of m GATA2 pts 62% of AML were adverse risk and 44% of MDS very high risk. Majority of m DDX41 pts had normal karyotype (N = 32; 91% vs. N = 19, 37%; p < .0001), had isolated mutations (N = 23; 64%) and the most common co-mutations were DNMT3A (38%), ASXL1 (30%), JAK2 (23%). The majority of m GATA2 pts were co-mutated (96%) with a different co-mutation pattern ASXL1 (60%), SRSF2 (34%), RUNX1 (19%). Germline data: One m GATA2 pts had proven germline mutation, and 10/11 (91%) m DDX41 pts were confirmed Survival and progression in MDS/AML: After median follow-up of 30 months in MDS/AML, 7 (21%) m DDX41 and 23 (77%) m GATA2 pts died with superior OS in m DDX41 compared to m GATA2 pts with median OS of (136.7 vs. 6.8 months, p < .0001). Seven (31%) of 22 m DDX41 and 6 (35%) m GATA2 MDS pts progressed into AML with a median time to progression of (11.2 vs. 5.2 months, p = .045). The leukemia free survival (LFS) for m DDX41 MDS pts was significantly longer than LFS of m GATA2 MDS pts (24.4 vs. 6 months, p < .0001). Conclusions: We compare the outcomes of two unique mutations associated with germline predisposition. We found m DDX41 pts had fewer cytogenetic aberrations, no MDS/MPN overlap, and lower WBC count. Majority of m DDX41 MDS/AML pts were intermediate risk category, compared to predominance of adverse risk disease in m GATA2 pts, translating into better OS and LFS. This study is limited by the small size, lack of germline workup in all cases, and retrospective nature. However, it supports the favorable prognosis and indolent course of m DDX41 pts recently described.
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Affiliation(s)
- Ahmad Nanaa
- Division of Hematology, Mayo Clinic, Rochester, MN
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aref Al-Kali
- Division of Hematology, Mayo Clinic, Rochester, MN
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30
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Gagnon MF, Berg HE, Meyer RG, Sukov WR, Van Dyke DL, Jenkins RB, Greipp PT, Thorland EC, Hoppman NL, Xu X, Baughn LB, Reichard KK, Ketterling RP, Peterson JF. Typical, atypical and cryptic t(15;17)(q24;q21) (PML::RARA) observed in acute promyelocytic leukemia: a retrospective review of 831 patients with concurrent chromosome and PML::RARA dual-color dual-fusion FISH studies. Genes Chromosomes Cancer 2022; 61:629-634. [PMID: 35639830 DOI: 10.1002/gcc.23070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/07/2022] Open
Abstract
The diagnosis of acute promyelocytic leukemia (APL) relies on the identification of PML::RARA fusion. While the majority of APL cases harbor a typical t(15;17)(q24;q21), atypical genetic mechanisms leading to the oncogenic PML::RARA fusion have been reported yet their frequency and scope remain poorly characterized. We assessed the genetic findings of 831 cases with APL investigated with concurrent chromosome banding analysis and dual-color dual-fusion fluorescence in situ hybridization (D-FISH) analysis at our institution over an 18.5-year timeframe. Seven-hundred twenty-three (87%) cases had a typical balanced t(15;17) with both testing modalities. Atypical karyotypic results including complex translocations, unbalanced rearrangements and insertional events occurred in 50 (6%) cases, while 6 (0.7%) cases were cryptic by conventional chromosome studies despite PML::RARA fusion by D-FISH evaluation. Atypical FISH patterns were observed in 48 (6%) cases despite apparently balanced t(15;17) on chromosome banding analysis. Two-hundred fifty (30%) cases displayed additional chromosome abnormalities of which trisomy/tetrasomy 8 (37%), del(7q)/add(7q) (12%) and del(9q) (7%) were most frequent. Complex and very complex karyotypes were observed in 81 (10%) and 34 (4%) cases, respectively. In addition, 4 (0.5%) cases presented as an apparently doubled, near-tetraploid stemline clone. This report provides the largest appraisal of cytogenetic findings in APL with conventional chromosome and PML::RARA D-FISH analysis. By characterizing the frequency and breadth of typical and atypical results through the lens of these cytogenetic testing modalities, this study serves as a pragmatic source of information for those involved in the investigation of APL in both the clinical and research laboratory settings.
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Affiliation(s)
- Marie-France Gagnon
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Holly E Berg
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Reid G Meyer
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - William R Sukov
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Daniel L Van Dyke
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Robert B Jenkins
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Erik C Thorland
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Hoppman
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Xinjie Xu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Kaaren K Reichard
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rhett P Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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31
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Shah MV, Chhetri R, Dholakia R, Kok CH, Gangat N, Alkhateeb HB, Al‐Kali A, Patnaik MM, Baranwal A, Greipp PT, He R, Begna KH, Tiong IS, Wei AH, Hiwase D. Outcomes following venetoclax-based treatment in therapy-related myeloid neoplasms. Am J Hematol 2022; 97:1013-1022. [PMID: 35560061 PMCID: PMC9541522 DOI: 10.1002/ajh.26589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 12/17/2022]
Abstract
Therapy‐related myeloid neoplasms (t‐MN) are aggressive malignancies in need of effective therapies. The BCL‐2 inhibitor venetoclax represents a paradigm shift in the treatment of acute myeloid leukemia. However, the effectiveness of venetoclax has not been studied in a large cohort of t‐MN. We retrospectively analyzed 378 t‐MN patients, of which 96 (25.4%, 47 therapy‐related acute myeloid leukemia, 1 therapy‐related chronic myelomonocytic leukemia, 48 therapy‐related myelodysplastic syndrome) received venetoclax. Median interval from t‐MN to venetoclax initiation was 2.9 (Interquartile range [IQR] 0.7–12) months, and patients received a median of 3 (IQR 1–4) cycles. The composite complete remission (CRc) rate, median progression‐free survival (PFS), and overall survival (OS) were 39.1%, 4.9 months, and 7 months, respectively. The upfront use of venetoclax and achieving CRc were associated with improved survival, whereas the presence of Chromosome 7 abnormalities was associated with an inferior survival. Neither the TP53‐status nor the percent bone marrow blast predicted the likelihood of CRc or survival. Paired genetic analysis performed at venetoclax initiation and failure did not show the evidence of the selection of the TP53‐mutated clone. In a propensity‐matched analysis, the use of venetoclax‐based regimen as the first‐line therapy was associated with a superior survival compared to hypomethylating agent (HMA)‐based first‐line therapy (9.4 vs. 6.1 months, p = .01). We conclude that the upfront use of venetoclax with HMA improved survival, though PFS and OS remain poor. As the phenotype at diagnosis or the percent blasts did not predict outcomes, venetoclax should be studied in all t‐MN phenotypes.
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Affiliation(s)
| | - Rakchha Chhetri
- Royal Adelaide Hospital Central Adelaide Local Health Network Adelaide South Australia
- University of Adelaide Adelaide South Australia
| | - Ruchita Dholakia
- Robert D. and Patricia E. Kern Center for Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA
| | - Chung H. Kok
- Precision Medicine Theme South Australian Health and Medical Research Institute (SAHMRI) Adelaide South Australia
| | | | | | - Aref Al‐Kali
- Division of Hematology Mayo Clinic Rochester Minnesota
| | | | | | | | - Rong He
- Robert D. and Patricia E. Kern Center for Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA
| | | | - Ing Soo Tiong
- Austin Health Melbourne Victoria Australia
- The Alfred Hospital and Monash University Melbourne Victoria Australia
| | - Andrew H. Wei
- The Alfred Hospital and Monash University Melbourne Victoria Australia
- Department of Clinical Haematology Peter MacCallum Cancer Centre and Royal Melbourne Hospital Melbourne Victoria Australia
- Division of Blood Cells and Blood Cancer Walter and Eliza Hall Institute of Medical Research Melbourne Victoria Australia
| | - Devendra Hiwase
- Royal Adelaide Hospital Central Adelaide Local Health Network Adelaide South Australia
- University of Adelaide Adelaide South Australia
- Precision Medicine Theme South Australian Health and Medical Research Institute (SAHMRI) Adelaide South Australia
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Angirekula M, Chang SY, Jenkins SM, Greipp PT, Sukov WR, Marks RS, Olivier KR, Cassivi SD, Roden AC. CD117, BAP1, MTAP, and TdT Is a Useful Immunohistochemical Panel to Distinguish Thymoma from Thymic Carcinoma. Cancers (Basel) 2022; 14:cancers14092299. [PMID: 35565429 PMCID: PMC9100150 DOI: 10.3390/cancers14092299] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The morphologic distinction between thymic carcinomas and thymomas, specifically types B3, A, and occasionally micronodular thymomas with lymphoid stroma (MNTLS) can be challenging, as has also been shown in interobserver reproducibility studies. Since thymic carcinomas have a worse prognosis than thymomas, the diagnosis is important for patient management and treatment. This study aimed to identify a panel of immunohistochemical (IHC) markers that aid in the distinction between thymomas and thymic carcinomas in routine practice. Materials and Method: Thymic carcinomas, type A and B3 thymomas, and MNTLS were identified in an institutional database of thymic epithelial tumors (TET) (1963–2021). IHC was performed using antibodies against TdT, Glut-1, CD5, CD117, BAP1, and mTAP. Percent tumor cell staining was recorded (Glut-1, CD5, CD117); loss of expression (BAP1, mTAP) was considered if essentially all tumor cells were negative; TdT was recorded as thymocytes present or absent (including rare thymocytes). Results: 81 specimens included 44 thymomas (25 type A, 11 type B3, 8 MNTLS) and 37 thymic carcinomas (including 24 squamous cell carcinomas). Using BAP1, mTAP, CD117 (cut-off, 10%), and TdT, 88.9% of thymic carcinomas (95.7% of squamous cell carcinomas) and 77.8% of thymomas could be predicted. Glut-1 expression was not found to be useful in that distinction. All tumors that expressed CD5 in ≥50% of tumor cells also expressed CD117 in ≥10% of tumor cells. In four carcinomas with homozygous deletion of CDKN2A, mTAP expression was lost in two squamous cell carcinomas and in a subset of tumor cells of an adenocarcinoma and was preserved in a lymphoepithelial carcinoma. Conclusion: A panel of immunostains including BAP1, mTAP, CD117 (using a cut-off of 10% tumor cell expression), and TdT can be useful in the distinction between thymomas and thymic carcinomas, with only a minority of cases being inconclusive.
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Affiliation(s)
- Mounika Angirekula
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USA; (M.A.); (S.Y.C.); (P.T.G.); (W.R.S.)
| | - Sindy Y Chang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USA; (M.A.); (S.Y.C.); (P.T.G.); (W.R.S.)
| | - Sarah M. Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55902, USA;
| | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USA; (M.A.); (S.Y.C.); (P.T.G.); (W.R.S.)
| | - William R. Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USA; (M.A.); (S.Y.C.); (P.T.G.); (W.R.S.)
| | - Randolph S. Marks
- Department of Oncology, Division of Medical Oncology, Mayo Clinic, Rochester, MN 55902, USA;
| | - Kenneth R. Olivier
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN 55902, USA;
| | - Stephen D. Cassivi
- Division of General Thoracic Surgery, Mayo Clinic, Rochester, MN 55902, USA;
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55902, USA; (M.A.); (S.Y.C.); (P.T.G.); (W.R.S.)
- Correspondence:
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33
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Gagnon MF, Smadbeck JB, Sharma N, Blackburn PR, Demasi Benevides J, Akkari YMN, Jaroscak JJ, Znoyko I, Wolff DJ, Schandl CA, Meyer R, Greipp PT, Xu X, Hoppman NL, Ketterling RP, Peterson JF, Baughn LB. Apparent coexistence of ETV6::RUNX1 and KMT2A::MLLT3 fusions due to a nonproductive KMT2A rearrangement in B-ALL. Leuk Lymphoma 2022; 63:2243-2246. [DOI: 10.1080/10428194.2022.2064991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marie-France Gagnon
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
| | - James B. Smadbeck
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Neeraj Sharma
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
| | | | - Jonna Demasi Benevides
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
| | | | - Jennifer J. Jaroscak
- Division of Pediatric Hematology-Oncology, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Iya Znoyko
- Department of Pathology and Laboratory Medicine, Division of Cytogenetics and Genomics, Medical University of South Carolina, Charleston, SC, USA
| | - Daynna J. Wolff
- Department of Pathology and Laboratory Medicine, Division of Cytogenetics and Genomics, Medical University of South Carolina, Charleston, SC, USA
| | - Cynthia A. Schandl
- Department of Pathology and Laboratory Medicine, Division of Cytogenetics and Genomics, Medical University of South Carolina, Charleston, SC, USA
| | - Reid Meyer
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
| | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Xinjie Xu
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Nicole L. Hoppman
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
| | - Rhett P. Ketterling
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Jess F. Peterson
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Linda B. Baughn
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, Rochester, MN, USA
- Department of Laboratory Medicine and Pathology, Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
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34
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Rahi H, Olave MC, Fritchie KJ, Greipp PT, Halling KC, Kipp BR, Graham RP. Gene Fusions in Gastrointestinal Tract cancers. Genes Chromosomes Cancer 2022; 61:285-297. [PMID: 35239225 DOI: 10.1002/gcc.23035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Fusion genes have been identified a wide array of human neoplasms including hematologic and solid tumors, including gastrointestinal tract neoplasia. A fusion gene is the product of parts of two genes which are joined together following a deletion, translocation or chromosomal inversion. Together with single nucleotide variants, insertions, deletions, and amplification, fusion genes represent one of the key genomic mechanisms for tumor development. Detecting fusions in the clinic is accomplished by a variety of techniques including break-apart fluorescence in situ hybridization (FISH), reverse transcription-polymerase chain reaction (RT-PCR), and next-generation sequencing (NGS). Some recurrent gene fusions have been successfully targeted by small molecule or monoclonal antibody therapies (i.e. targeted therapies), while others are used for as biomarkers for diagnostic and prognostic purposes. The purpose of this review article is to discuss the clinical utility of detection of gene fusions in carcinomas and neoplasms arising primarily in the digestive system. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hamed Rahi
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Maria C Olave
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - Karen J Fritchie
- Division of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Patricia T Greipp
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Kevin C Halling
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, USA.,Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - Benjamin R Kipp
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, USA.,Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rondell P Graham
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, USA.,Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
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35
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Ida CM, Pulido J, Greipp PT, Garcia JJ, Olsen TW, Dalvin L, Salomão DR. BAP1 Immunostain Status in Intraocular Biopsy Specimens for Uveal Melanoma Highly Correlates with Other Prognostic Markers. Ocul Oncol Pathol 2022; 8:22-29. [PMID: 35356602 PMCID: PMC8914242 DOI: 10.1159/000515858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/14/2021] [Indexed: 02/03/2023] Open
Abstract
Introduction Loss of BAP1 protein expression emerged as a negative prognostic marker in uveal melanoma (UM) and has primarily been studied in enucleations. Intraocular biopsy is frequently performed prior to UM globe-conserving therapy. Methods We retrospectively evaluated BAP1 immunostaining of UM in 16 biopsies and 8 subsequent enucleations, and results were correlated with the UM-specific gene expression profile (GEP; n = 11), chromosome 3 status by FISH and/or chromosomal microarray (n = 12; 9 also had GEP), and clinical outcomes. Results UM involved the choroid in 15 (of 16) cases. Biopsy was performed for prognostication (n = 12) or diagnosis (n = 4). Treatment included brachytherapy (n = 13; 5 followed by enucleation) or enucleation only (n = 3). BAP1 nuclear immunostaining was positive in 9, negative in 4, and equivocal in 3 biopsies. For the 3 equivocal biopsies, BAP1 immunostaining was positive in 2 (of 3) subsequent enucleations. BAP1 immunostaining was concordant between all 5 remaining biopsies and enucleations. BAP1-positive biopsies had disomy 3 (n = 6) or 3p loss (n = 1) and class 1 GEP (n = 6). BAP1-negative biopsies had monosomy 3 (n = 3) and class 2 GEP (n = 2). Median follow-up was 62.5 months (range, 17-150). For BAP1-positive UM patients, 8 were alive (7 without metastatic disease) and 3 had died (1 melanoma-related death). Among BAP1-negative UM patients, 2 were alive (1 with metastatic disease) and 3 had melanoma-related deaths. Conclusion BAP1 immunostaining in biopsies highly correlates with results in subsequent enucleations and with well-established UM prognostic markers, representing a potential additional prognostic tool for UM biopsies.
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Affiliation(s)
- Cristiane M. Ida
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jose Pulido
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joaquin J. Garcia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy W. Olsen
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Lauren Dalvin
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA
| | - Diva Regina Salomão
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA,Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA,*Diva Regina Salomão,
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36
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Abdallah NH, Binder M, Rajkumar SV, Greipp PT, Kapoor P, Dispenzieri A, Gertz MA, Baughn LB, Lacy MQ, Hayman SR, Buadi FK, Dingli D, Go RS, Hwa YL, Fonder AL, Hobbs MA, Lin Y, Leung N, Kourelis T, Warsame R, Siddiqui MA, Kyle RA, Bergsagel PL, Fonseca R, Ketterling RP, Kumar SK. A simple additive staging system for newly diagnosed multiple myeloma. Blood Cancer J 2022; 12:21. [PMID: 35102148 PMCID: PMC8803917 DOI: 10.1038/s41408-022-00611-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/07/2021] [Accepted: 01/12/2022] [Indexed: 11/21/2022] Open
Abstract
Risk stratification in multiple myeloma is important for prognostication, patient selection for clinical trials, and comparison of treatment approaches. We developed and validated a staging system that incorporates additional FISH abnormalities not included in the R-ISS and reflects the additive effects of co-occurring high-risk disease features. We first evaluated the prognostic value of predefined cytogenetic and laboratory abnormalities in 2556 Mayo Clinic patients diagnosed between February 2004 and June 2019. We then used data from 1327 patients to develop a risk stratification model and validated this in 502 patients enrolled in the MMRF CoMMpass study. On multivariate analysis, high-risk IgH translocations [risk ratio (RR): 1.7], 1q gain/amplification (RR: 1.4), chromosome17 abnormalities (RR: 1.6), ISS III (RR: 1.7), and elevated LDH (RR: 1.3) were independently associated with decreased overall survival (OS). Among 1327 evaluable patients, OS was 11.0 (95% CI: 9.2–12.6), 7.0 (95% CI: 6.3–9.2), and 4.5 (95% CI: 3.7–5.2) years in patients with 0 (stage I), 1 (stage II), and ≥2 (stage III) high-risk factors, respectively. In the MMRF cohort, median OS was 7.8 (95% CI: NR-NR), 6.0 (95% CI: 5.7-NR), and 4.3 (95% CI: 2.7-NR) years in the 3 groups, respectively (P < 0.001). This 5-factor, 3-tier system is easy to implement in practice and improves upon the current R-ISS.
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Affiliation(s)
| | - Moritz Binder
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Morie A Gertz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Department of Laboratory Medicine and Pathology, Rochester, MN, USA
| | - Martha Q Lacy
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Yi L Hwa
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Amie L Fonder
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Yi Lin
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Nelson Leung
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.,Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | | | - Rahma Warsame
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Kyle
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Shaji K Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA.
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37
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Oliveira JL, Greipp PT, Rangan A, Jatoi A, Nguyen PL. Myeloid malignancies in cancer patients treated with poly(ADP-ribose) polymerase (PARP) inhibitors: a case series. Blood Cancer J 2022; 12:11. [PMID: 35078980 PMCID: PMC8789926 DOI: 10.1038/s41408-022-00607-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/03/2021] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Patricia T Greipp
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Aruna Rangan
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
| | - Aminah Jatoi
- Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA.
| | - Phuong L Nguyen
- Division of Hematopathology, Mayo Clinic, Rochester, MN, USA
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38
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Koleilat A, McGarrah PW, Olteanu H, Van Dyke DL, Smadbeck JB, Johnson SH, Vasmatzis G, Hoppman NL, Xu X, Ketterling RP, Greipp PT, Baughn LB, Patnaik MS, Peterson JF. Utilizing next-generation sequencing to characterize a case of acute myeloid leukemia with t(4;12)(q12;p13) in the absence of ETV6/CHIC2 and ETV6/PDGFRA gene fusions. Cancer Genet 2022; 260-261:1-5. [PMID: 34781094 DOI: 10.1016/j.cancergen.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 10/26/2021] [Accepted: 11/03/2021] [Indexed: 11/02/2022]
Abstract
The t(4;12)(q12;p13) has been rarely reported in both myeloid/lymphoid neoplasms with eosinophilia (ETV6/PDGFRA gene fusion) and acute myeloid leukemia (AML) (ETV6/CHIC2 gene fusion). The ability to accurately characterize t(4;12) is critical as myeloid neoplasms with PDGFRA rearrangements may be amenable to tyrosine kinase inhibitor (TKI) therapy. Herein, we describe a 60-year-old male with newly diagnosed AML and t(4;12)(q12;p13) by conventional chromosome studies. While the ETV6 break-apart fluorescence in situ hybridization (FISH) probe set demonstrated a balanced ETV6 gene rearrangement, the FIP1L1/CHIC2/PDGFRA tri-color and PDGFRA break-apart FISH probe sets could not resolve the ETV6 gene fusion partner. Mate-pair sequencing (MPseq), a next-generation sequencing assay, was subsequently performed and identified an ETV6 gene rearrangement (at 12p13) that involved an intergenic chromosomal region at 4q12, located between the CHIC2 and PDGFRA gene regions. Having excluded involvement by the PDGFRA gene region, the patient will not be considered for TKI therapy at any point during his medical management. The accurate characterization of structural rearrangements by NGS-based technologies, as demonstrated in this case, highlights the clinical relevance and potential impact on patient medical management of modern cytogenetic techniques.
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MESH Headings
- Chromosomes, Human, Pair 12/genetics
- Chromosomes, Human, Pair 4/genetics
- DNA-Binding Proteins/genetics
- High-Throughput Nucleotide Sequencing
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid, Acute/genetics
- Male
- Middle Aged
- Oncogene Proteins, Fusion/genetics
- Proto-Oncogene Proteins c-ets/genetics
- Receptor, Platelet-Derived Growth Factor alpha/genetics
- Repressor Proteins/genetics
- Sequence Analysis, DNA/methods
- Transcription Factors/genetics
- Translocation, Genetic
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- Alaa Koleilat
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Patrick W McGarrah
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Horatiu Olteanu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Daniel L Van Dyke
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - James B Smadbeck
- Center for Individualized Medicine-Biomarker Discovery, Mayo Clinic, Rochester, MN, USA
| | - Sarah H Johnson
- Center for Individualized Medicine-Biomarker Discovery, Mayo Clinic, Rochester, MN, USA
| | - George Vasmatzis
- Center for Individualized Medicine-Biomarker Discovery, Mayo Clinic, Rochester, MN, USA
| | - Nicole L Hoppman
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Xinjie Xu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rhett P Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mrinal S Patnaik
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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39
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Audil HY, Cook JM, Greipp PT, Kapoor P, Baughn LB, Dispenzieri A, Gertz MA, Buadi FK, Lacy MQ, Dingli D, Fonder AL, Hayman SR, Hobbs MA, Muchtar E, Siddiqui M, Gonsalves WI, Hwa YL, Leung N, Lin Y, Kourelis TV, Warsame R, Kyle RA, Ketterling RP, Rajkumar SV, Kumar SK. Prognostic significance of acquired 1q22 gain in multiple myeloma. Am J Hematol 2022; 97:52-59. [PMID: 34710241 DOI: 10.1002/ajh.26391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/08/2022]
Abstract
Gain of 1q22 at diagnosis portends poorer outcomes in multiple myeloma (MM), but the prognostic significance of acquired 1q22 gain is unknown. We identified 63 MM patients seen at Mayo Clinic from 1/2004 to 12/2019 without 1q22 gain at diagnosis who acquired it during follow up and compared them to 63 control patients who did not acquire 1q22 gain with similar follow up. We also compared outcomes in the acquired 1q22 gain group with outcomes in 126 patients with 1q22 gain present at diagnosis. The incidence of acquired 1q22 gain was 6.1% (median follow-up 6.8 years); median time to acquisition was 5.0 years (range: 0.7-11.5 years). Abnormalities on baseline fluorescence in situ hybridization (FISH) included trisomies (54%) and monosomy 13 (39%); 16 (25%) had high-risk (HR) translocations or del(17p). Median progression-free survival with front line therapy was 29.5 months in patients with acquired 1q22 gain, versus 31.4 months in control patients (p = .34) and 31.2 months in patients with de novo 1q22 gain (p = .04). Median overall survival (OS) from diagnosis was 10.9 years in patients with acquired 1q22 gain, versus 13.0 years in control patients (p = .03) and 6.3 years in patients with de novo 1q22 gain (p = .01). Presence of HR FISH at baseline increased risk of 1q22 gain acquisition. We demonstrate that acquisition of 1q22 gain is a significant molecular event in MM, associated with reduced OS. Among HR patients for whom this clonal evolution is determined, a risk-adapted approach and/or clinical trial should be considered.
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Affiliation(s)
- Hadiyah Y. Audil
- Department of Internal Medicine Mayo Clinic Rochester Minnesota USA
| | - Joselle M. Cook
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Patricia T. Greipp
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA
| | - Prashant Kapoor
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Linda B. Baughn
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA
| | | | - Morie A. Gertz
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | | | - Martha Q. Lacy
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - David Dingli
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Amie L. Fonder
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | | | - Miriam A. Hobbs
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Eli Muchtar
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | | | | | - Yi Lisa Hwa
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Nelson Leung
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Yi Lin
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | | | - Rahma Warsame
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Robert A. Kyle
- Department of Hematology Mayo Clinic Rochester Minnesota USA
| | - Rhett P. Ketterling
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA
| | | | - Shaji K. Kumar
- Department of Hematology Mayo Clinic Rochester Minnesota USA
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40
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Berg HE, Greipp PT, Baughn LB, Falcon CP, Jackson CC, Peterson JF. Detection of a Cryptic KMT2A/AFDN Gene Fusion [ins(6;11)(q27;q23q23)] in a Pediatric Patient with Newly Diagnosed Acute Myeloid Leukemia. Lab Med 2021; 53:e95-e99. [PMID: 34894139 DOI: 10.1093/labmed/lmab109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
KMT2A gene rearrangements are a major oncogenic driver in multiple hematologic neoplasms. Apart from t(9;11)(p21;q23) (KMT2A/MLLT3) in acute myeloid leukemia (AML), KMT2A gene rearrangements are considered to convey high risk and poor overall survival. Herein, we report a case of a 7 year old boy with newly diagnosed AML and a cryptic KMT2A/AFDN gene fusion resulting from a 5'KMT2A insertional event. The results of conventional chromosome studies revealed trisomy 8 in all 20 metaphases, with normal-appearing chromosomes 6 and 11. A KMT2A break-apart FISH probe identified 2 intact copies of the KMT2A gene region and an extra 5'KMT2A signal in 85% of interphase nuclei. Subsequent FISH studies using a KMT2A/AFDN dual-color dual-fusion FISH probe revealed positive results for a single fusion in 82% of interphase nuclei, indicating a KMT2A/AFDN gene fusion. Subsequently, metaphase FISH confirmed the location of the KMT2A/AFDN fusion at 6q27. To our knowledge, this represents only the second time in the literature that a cryptic KMT2A/AFDN gene fusion resulting from a 5'KMT2A insertional event was reported.
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Affiliation(s)
- Holly E Berg
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Linda B Baughn
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Corey P Falcon
- Department of Pediatric Hematology and Oncology, Ochsner Health Center for Children, New Orleans, Louisiana
| | - Courtney C Jackson
- Department of Laboratory Medicine and Pathology, Ochsner Medical Center, New Orleans, Louisiana
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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41
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Gagnon MF, Pearce KE, Greipp PT, Xu X, Hoppman NL, Ketterling RP, McPhail ED, King RL, Baughn LB, Peterson JF. MYC break-apart FISH probe set reveals frequent unbalanced patterns of uncertain significance when evaluating aggressive B-cell lymphoma. Blood Cancer J 2021; 11:184. [PMID: 34819491 PMCID: PMC8613271 DOI: 10.1038/s41408-021-00578-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 12/14/2022] Open
Affiliation(s)
- Marie-France Gagnon
- grid.66875.3a0000 0004 0459 167XDivision of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Kathryn E. Pearce
- grid.66875.3a0000 0004 0459 167XDivision of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Patricia T. Greipp
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Xinjie Xu
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Nicole L. Hoppman
- grid.66875.3a0000 0004 0459 167XDivision of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Rhett P. Ketterling
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Ellen D. McPhail
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Rebecca L. King
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Linda B. Baughn
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | - Jess F. Peterson
- grid.66875.3a0000 0004 0459 167XDivision of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
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42
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Macke EL, Meyer RG, Hoppman NL, Ketterling RP, Greipp PT, Xu X, Baughn LB, Shafer DA, He RR, Peterson JF. Identification of a Cryptic t(8;20;21)(q22;p13;q22) Resulting in RUNX1T1/RUNX1 Fusion in a Patient with Newly Diagnosed Acute Myeloid Leukemia. Lab Med 2021; 53:e87-e90. [PMID: 34791328 DOI: 10.1093/labmed/lmab105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The detection of recurrent genetic abnormalities in acute myeloid leukemia (AML), including RUNX1T1/RUNX1 gene fusion, is critical for optimal medical management. Herein, we report a 45 year old woman with newly diagnosed AML and conventional chromosome studies that revealed an apparently balanced t(8;20)(q22;p13) in all 20 metaphases analyzed. A RUNX1T1/RUNX1 dual-color dual-fusion fluorescence in situ hybridization (FISH) probe set was subsequently performed and revealed a RUNX1T1/RUNX1 gene fusion. Metaphase FISH studies performed on abnormal metaphases revealed a cryptic, complex translocation resulting in RUNX1T1/RUNX1 fusion, t(8;20;21)(q22;p13;q22). This case study shows the importance of performing FISH studies or other high-resolution genetic testing concurrently with conventional chromosome studies for the detection of cryptic recurrent gene fusions in AML, particularly a focused genetic evaluation such as RUNX1T1/RUNX1 gene fusion, when specific abnormalities involving 8q22 are identified.
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Affiliation(s)
- Erica L Macke
- Center for Individualized Medicine, Mayo Clinic, Rochester, Minnesota, US
| | - Reid G Meyer
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
| | - Nicole L Hoppman
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
| | - Rhett P Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
| | - Patricia T Greipp
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
| | - Xinjie Xu
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
| | - Linda B Baughn
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
| | - Danielle A Shafer
- Inova Schar Cancer Institute, Inova Fairfax Hospital, Falls Church, Virginia, US
| | - Rui R He
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, US
| | - Jess F Peterson
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, US
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43
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Eschbacher KL, Rao AN, Greipp PT, Gliem TJ, Daniels DJ, Warad D, Eckel LJ, Raghunathan A. Pediatric Myxopapillary Ependymomas: A Clinicopathologic Evaluation. J Pediatr Hematol Oncol 2021; 43:e1194-e1200. [PMID: 33395181 DOI: 10.1097/mph.0000000000002041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/12/2020] [Indexed: 11/26/2022]
Abstract
Myxopapillary ependymomas (MPEs) have an indolent clinical course, corresponding to World Health Organization Grade I. A total of 13 pediatric MPEs have been reported in the literature with "anaplastic features," including elevated proliferative activity (≥5 mitoses/10 high-power fields), necrosis, and microvascular proliferation. No consensus exists regarding the prognostic significance of such features. A retrospective clinicopathologic review of pediatric MPEs diagnosed between 1996 and 2018 at Mayo Clinic was performed. Totally, 8 pediatric MPEs (6 male; age: 7.52 to 16.88 y) were identified. Totally, 3 had disseminated disease at presentation. All patients underwent surgical resection (7 gross total; 1 subtotal). Totally, 5 cases harbored ≥5 mitoses/10 high-power fields (range: 5 to 9), 3 of which showed necrosis (2 with disseminated disease). Postsurgery, 2 patients received radiation; one with disseminated disease and another with increased mitotic activity/necrosis; neither has recurred (follow-up: 1.18 and 3.19 y). In all, 2 patients with disseminated disease, elevated mitotic activity, and necrosis had new metastatic disease/progression of nonresected metastatic foci (2.6 and 26.8 mo), received radiation therapy, and remain progression free (3.01 and 9.34 y). All patients are alive (median follow-up 1.31 y, range: 0.66 to 11.75). Among pediatric MPEs, the concurrent presence of elevated mitotic activity and necrosis may be associated with an aggressive clinical course, warranting closer surveillance and consideration of adjuvant therapies.
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Affiliation(s)
| | - Amulya Nageswara Rao
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN
| | | | - Troy J Gliem
- Departments of Laboratory Medicine and Pathology
| | | | - Deepti Warad
- Division of Pediatric Hematology/Oncology, Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN
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44
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Abdel Rahman ZH, Parrondo RD, Heckman MG, Wieczorek M, Miller KC, Alkhateeb H, Sproat LZ, Murthy H, Hogan WJ, Kharfan-Dabaja MA, Peterson JF, Baughn LB, Hoppman N, Litzow MR, Ketterling RP, Greipp PT, Foran JM. Comparative study of therapy-related and de novo adult b-cell acute lymphoblastic leukaemia. Br J Haematol 2021; 196:963-968. [PMID: 34697797 PMCID: PMC9034764 DOI: 10.1111/bjh.17906] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 01/18/2023]
Abstract
We report a comparative analysis of patients with therapy‐related acute lymphoblastic leukaemia (tr‐ALL) vs de novo ALL. We identified 331 patients with B‐ALL; 69 (21%) were classified as tr‐ALL. The most common prior malignancies were breast (23·2%) and plasma cell disorders (20·3%). Patients with tr‐ALL were older (median 63·2 vs. 46·2 years, P < 0.001), more often female (66·7% vs. 43·5%, P < 0·001), and more likely to have hypodiploid cytogenetics (18·8% vs. 5·0%, P < 0·001). In multivariable analysis, patients with tr‐ALL were less likely to achieve complete remission [odds ratio (OR) = 0·16, P < 0·001] and more likely to be minimal residual disease‐positive (OR = 4·86, P = 0·01) but had similar OS after diagnosis and allo‐haematopoietic cell transplantation.
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Affiliation(s)
| | | | - Michael G Heckman
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | - Mikolaj Wieczorek
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | - Kevin C Miller
- Department of Internal Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Lisa Z Sproat
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Hemant Murthy
- Division of Hematology and Medical Oncology, Mayo Clinic, USA
| | | | | | - Jess F Peterson
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Nicole Hoppman
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - James M Foran
- Division of Hematology and Medical Oncology, Mayo Clinic, USA
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45
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Sharma N, Smadbeck JB, Abdallah N, Zepeda-Mendoza C, Binder M, Pearce KE, Asmann YW, Peterson JF, Ketterling RP, Greipp PT, Leif Bergsagel P, Vincent Rajkumar S, Kumar SK, Baughn LB. The Prognostic Role of MYC Structural Variants Identified by NGS and FISH in Multiple Myeloma. Clin Cancer Res 2021; 27:5430-5439. [PMID: 34233962 PMCID: PMC8738776 DOI: 10.1158/1078-0432.ccr-21-0005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/16/2021] [Accepted: 07/01/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE Structural variants (SV) of the MYC gene region are common in multiple myeloma and influence disease progression. However, the prognostic significance of different MYC SVs in multiple myeloma has not been clearly established. EXPERIMENTAL DESIGN We conducted a retrospective study of multiple myeloma comparing MYC SV subtypes identified by next-generation sequencing (NGS) and FISH to MYC expression and disease survival using 140 cases from Mayo Clinic and 658 cases from the MMRF CoMMpass study. RESULTS MYC SVs were found in 41% of cases and were classified into nine subtypes. A correlation between the presence of a MYC SV and increased MYC expression was identified. Among the nine MYC subtypes, the non-immunoglobulin (non-Ig) insertion subtype was independently associated with improved outcomes, while the Ig insertion subtype, specifically involving the IgL gene partner, was independently associated with poorer outcomes compared with other MYC SV subtypes. Although the FISH methodology failed to detect approximately 70% of all MYC SVs, those detected by FISH were associated with elevated MYC gene expression and poor outcomes suggesting a different pathogenic role for FISH-detected MYC subtypes compared with other MYC subtypes. CONCLUSIONS Understanding the impact of different MYC SVs on disease outcome is necessary for the reliable interpretation of MYC SVs in multiple myeloma. NGS approaches should be considered as a replacement technique for a more comprehensive evaluation of the multiple myeloma clone.
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Affiliation(s)
- Neeraj Sharma
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - James B. Smadbeck
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Nadine Abdallah
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | | | - Moritz Binder
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Kathryn E. Pearce
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Yan W. Asmann
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL
| | - Jess F. Peterson
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN,Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Rhett P. Ketterling
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN,Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Patricia T. Greipp
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN,Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - P. Leif Bergsagel
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ
| | - S. Vincent Rajkumar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Shaji K. Kumar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, MN
| | - Linda B. Baughn
- Division of Laboratory Genetics, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN,Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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46
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Dalland JC, Smadbeck JB, Sharma N, Meyer RG, Pearce KE, Greipp PT, Peterson JF, Kumar S, Ketterling RP, King RL, Baughn LB. Increased complexity of t(11;14) rearrangements in plasma cell neoplasms compared with mantle cell lymphoma. Genes Chromosomes Cancer 2021; 60:678-686. [PMID: 34124820 PMCID: PMC8453742 DOI: 10.1002/gcc.22977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/14/2022] Open
Abstract
Plasma cell neoplasms (PCN) and mantle cell lymphoma (MCL) can both harbor t(11;14)(q13;q32) (CCND1/IGH), usually resulting in cyclin D1 overexpression. In some cases, particularly at low levels of disease, it can be morphologically challenging to distinguish between these entities in the bone marrow (BM) since PCN with t(11;14) are often CD20-positive with lymphoplasmacytic cytology, while MCL can rarely have plasmacytic differentiation. We compared the difference in CCND1/IGH by fluorescence in situ hybridization (FISH) in PCN and MCL to evaluate for possible differentiating characteristics. We identified 326 cases of MCL with t(11;14) and 279 cases of PCN with t(11;14) from either formalin-fixed, paraffin-embedded tissue or fresh BM specimens. The "typical," balanced CCND1/IGH FISH signal pattern was defined as three total CCND1 signals, three total IGH signals, and two total fusion signals. Any deviation from the "typical" pattern was defined as an "atypical" pattern, which was further stratified into "gain of fusion" vs "complex" patterns. There was a significantly higher proportion of cases that showed an atypical FISH pattern in PCN compared with MCL (53% vs 27%, P < .0001). There was also a significantly higher proportion of cases that showed a complex FISH pattern in PCN compared with MCL (47% vs 17%, P < .0001). We confirmed these findings using mate-pair sequencing of 25 PCN and MCL samples. PCN more often have a complex CCND1/IGH FISH pattern compared with MCL, suggesting possible differences in the genomic mechanisms underlying these rearrangements in plasma cells compared with B cells.
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Affiliation(s)
- Joanna C. Dalland
- Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - James B. Smadbeck
- Division of Computational Biology, Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Neeraj Sharma
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Reid G. Meyer
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Kathryn E. Pearce
- Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Patricia T. Greipp
- Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Jess F. Peterson
- Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Shaji Kumar
- Division of Hematology, Department of Internal MedicineMayo ClinicRochesterMinnesotaUSA
| | - Rhett P. Ketterling
- Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Rebecca L. King
- Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Linda B. Baughn
- Division of Hematopathology, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA,Division of Laboratory Genetics and Genomics, Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
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47
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Abdel-Rahman ZH, Heckman MG, Anagnostou T, White LJ, Kloft-Nelson SM, Knudson RA, Alkhateeb HB, Sproat LZ, Khera N, Murthy HS, Ayala E, Hogan WJ, Roy V, Peterson JF, Kharfan-Dabaja MA, Ketterling RP, Litzow MR, Baughn LB, Patnaik M, Greipp PT, Foran JM. Identification of adult Philadelphia-like acute lymphoblastic leukemia using a FISH-based algorithm distinguishes prognostic groups and outcomes. Blood Cancer J 2021; 11:156. [PMID: 34548472 PMCID: PMC8455651 DOI: 10.1038/s41408-021-00538-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/23/2021] [Accepted: 07/29/2021] [Indexed: 01/02/2023] Open
Affiliation(s)
- Zaid H Abdel-Rahman
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Michael G Heckman
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | - Theodora Anagnostou
- Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Launia J White
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, FL, USA
| | - Sara M Kloft-Nelson
- Cytogenetics Core Laboratory, Medical Genome Facility, Mayo Clinic, Rochester, MN, USA
| | - Ryan A Knudson
- Cytogenetics Core Laboratory, Medical Genome Facility, Mayo Clinic, Rochester, MN, USA
| | | | - Lisa Z Sproat
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Nandita Khera
- Division of Hematology and Medical Oncology, Mayo Clinic, Phoenix, AZ, USA
| | - Hemant S Murthy
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Ernesto Ayala
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Vivek Roy
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Jess F Peterson
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | | | - Rhett P Ketterling
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - Mark R Litzow
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Linda B Baughn
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | | | - Patricia T Greipp
- Division of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN, USA
| | - James M Foran
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA.
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48
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Zanwar S, Abeykoon JP, Ansell SM, Gertz MA, Colby C, Larson D, Paludo J, He R, Warsame R, Greipp PT, King RL, Thompson CA, Witzig TE, Lacy MQ, Gonsalves W, Nowakowski GS, Dingli D, Go RS, Habermann TM, Vincent Rajkumar S, Kyle RA, Kumar S, Kapoor P. Disease outcomes and biomarkers of progression in smouldering Waldenström macroglobulinaemia. Br J Haematol 2021; 195:210-216. [PMID: 34340248 DOI: 10.1111/bjh.17691] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/26/2021] [Accepted: 06/03/2021] [Indexed: 12/19/2022]
Abstract
Patients with asymptomatic/smouldering Waldenström macroglobulinaemia (SWM) have a variable risk of progression to active WM. Our study evaluated 143 patients with SWM consecutively seen between January 1996 and December 2013. With a median [95% confidence interval (CI)] follow-up of 9·5 [8·1-11·5] years, the cumulative rate of progression was 11% at 1 year, 38% at 3 years and 55% at 5 years. On multivariate analysis, haemoglobin (Hb) ≤123 g/l [risk ratio (RR) 2·08; P = 0·009] and β2 -microglobulin (β2 M) ≥2·7 µg/ml (RR 2·0; P = 0·01) were independent predictors of a shorter time-to-progression (TTP) to active WM. Patients with myeloid differentiation factor 88 wild type (MYD88WT ) genotype (n = 11) demonstrated a trend toward shorter TTP [median (95% CI) 1·7 (0·7-8·7) vs. 4·7 (2·4-7·7) years for the MYD88L265P cohort, n = 42; P = 0·11]. The presence of C-X-C chemokine receptor type 4 (CXCR4) mutation (n = 29) did not impact the TTP (median: 3 years for CXCR4WT vs. 5·6 years for CXCR4MUT , P = 0·34). The overall survival (OS) for patients with SWM (median: 18·1 years) was comparable to an age-, sex- and calendar year-matched USA population (median: 20·3 years, P = 0·502). In conclusion, Hb and β2 M at diagnosis represent independent predictors of progression to active WM. Comparable survival of SWM and a matched USA population argues against pre-emptive intervention in this patient population.
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Affiliation(s)
| | | | | | - Morie A Gertz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Colin Colby
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Dirk Larson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jonas Paludo
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Rong He
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Rahma Warsame
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Rebecca L King
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Martha Q Lacy
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - David Dingli
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Robert A Kyle
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Shaji Kumar
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
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49
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Abeykoon JP, Zanwar S, Ansell SM, Muchtar E, He R, Greipp PT, King RL, Ailawadhi S, Paludo J, Larsen JT, Habermann TM, Inwards D, Go RS, Thanarajasingam G, Buadi F, Dispenzieri A, Thompson CA, Witzig TE, Lacy M, Gonsalves W, Nowakowski GS, Dingli D, Rajkumar SV, Kyle RA, Sher T, Roy V, Rosenthal A, Chanan‐Khan AA, Reeder C, Gertz MA, Kumar S, Kapoor P. Assessment of fixed-duration therapies for treatment-naïve Waldenström macroglobulinemia. Am J Hematol 2021; 96:945-953. [PMID: 33909933 DOI: 10.1002/ajh.26210] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 12/15/2022]
Abstract
Comparative data guiding initial therapy for Waldenström macroglobulinemia (WM), an infrequently encountered non-Hodgkin lymphoma, are sparse. We evaluated three commonly used rituximab-based frontline regimens: rituximab-bendamustine (R-Benda); dexamethasone, rituximab, cyclophosphamide (DRC); and bortezomib, dexamethasone, rituximab (BDR) in 220 treatment-naïve patients with WM, seen at Mayo Clinic between November 1, 2000 and October 31, 2019. The median follow-up was 4.5 (95%CI: 4-5) years. The R-Benda cohort (n = 83) demonstrated superior overall response rate (ORR: 98%), in comparison to DRC (n = 92, ORR: 78%) or BDR (n = 45, ORR: 84%) cohorts, p = 0.003. Similarly, longer progression-free survival (PFS) was evident with R-Benda use [median 5.2 vs. 4.3 (DRC) and 1.8 years (BDR), p < 0.001]. The time-to-next therapy (TTNT) favored R-Benda [median, not-reached, 4.4 (DRC) and 2.6 years (BDR), p < 0.001). These endpoints were comparable between the DRC and BDR cohorts. Overall survival (OS) was similar across the three cohorts, p = 0.77. In a subset analysis of 142 patients genotyped for MYD88L265P mutation, the ORR, PFS and TTNT were unaffected by the patients' MYD88 signature within each cohort. In conclusion, ORR, PFS and TTNT with R-Benda are superior compared to DRC or BDR in treatment-naïve patients with active WM. The patient outcomes with any one of these three regimens are unaffected by the MYD88L265P mutation status.
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Affiliation(s)
| | - Saurabh Zanwar
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | | | - Eli Muchtar
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | - Rong He
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA
| | - Patricia T. Greipp
- Division of Laboratory Genetics and Genomics Mayo Clinic Rochester Minnesota USA
| | - Rebecca L. King
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA
| | - Sikander Ailawadhi
- Division of Hematology and Oncology Mayo Clinic Jacksonville Florida USA
| | - Jonas Paludo
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | | | | | - David Inwards
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | - Ronald S. Go
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | | | - Francis Buadi
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | | | | | | | - Martha Lacy
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | | | | | - David Dingli
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | | | - Robert A. Kyle
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | - Taimur Sher
- Division of Hematology and Oncology Mayo Clinic Jacksonville Florida USA
| | - Vivek Roy
- Division of Hematology and Oncology Mayo Clinic Jacksonville Florida USA
| | | | | | - Craig Reeder
- Division of Hematology Mayo Clinic Phoenix Arizona USA
| | - Morie A. Gertz
- Division of Hematology Mayo Clinic Rochester Minnesota USA
| | - Shaji Kumar
- Division of Hematology Mayo Clinic Rochester Minnesota USA
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50
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King RL, Siaghani PJ, Wong K, Edlefsen K, Shane L, Howard MT, Reichard KK, Mai M, Viswanatha DS, Greipp PT, Goble TA, Ruiz M, Hara H. Novel t(1;8)(p31.3;q21.3) NFIA-RUNX1T1 Translocation in an Infant Erythroblastic Sarcoma. Am J Clin Pathol 2021; 156:129-138. [PMID: 33313700 DOI: 10.1093/ajcp/aqaa216] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pure erythroid leukemia (PEL) is exceptionally rare in the pediatric setting. Four pediatric PEL cases with t(1;16)(p31;q24) NFIA-CBFA2T3 were reported previously. We present a case of an infant with PEL presenting with erythroblastic sarcoma and harboring a novel t(1;8)(p31.3;q21.3) NFIA-RUNX1T1 fusion detected by RNA sequencing and conventional karyotype. METHODS Bone marrow (BM) and abdominal mass biopsies from the patient were evaluated with extensive immunohistochemical, flow cytometric, cytogenetic, and molecular studies. RESULTS The patient was a female infant who presented between 2 and 5 months of age with cytopenias and an enlarging abdominal mass. Blasts in the BM and abdominal mass expressed CD71 and CD117 with focal expression of CD43, E-cadherin, epithelial membrane antigen, and hemoglobin A. They were negative for additional myeloid, lymphoid, and nonhematolymphoid markers. These findings were most consistent with PEL and erythroblastic sarcoma. RNA sequencing revealed the novel NFIA-RUNX1T1 fusion. CONCLUSIONS Along with the previously reported PELs with NFIA-CBFA2T3 fusions, we describe a subset of PELs that occur in children, that frequently display extramedullary disease, and that harbor rearrangements of NFIA with core binding factor genes. We hypothesize that, together, these cases represent a rare but distinct clinicopathologic group of pediatric PELs with recurrent genetic abnormality.
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Affiliation(s)
- Rebecca L King
- Divisions of Hematopathology and Genomics, Mayo Clinic, Rochester, MN
| | | | - Katy Wong
- Divisions of Foundation Medicine, Cambridge, MA
| | - Kerstin Edlefsen
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle
| | - Lisa Shane
- Divisions of Pathology and Women’s Hospital, Long Beach, CA
| | - Matthew T Howard
- Divisions of Hematopathology and Genomics, Mayo Clinic, Rochester, MN
| | - Kaaren K Reichard
- Divisions of Hematopathology and Genomics, Mayo Clinic, Rochester, MN
| | - Ming Mai
- Divisions of Hematopathology and Genomics, Mayo Clinic, Rochester, MN
| | | | - Patricia T Greipp
- Divisions of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN
| | - Tony A Goble
- Divisions of Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN
| | - Maritza Ruiz
- Divisions of Pediatrics, MemorialCare, Miller Children’s and Women’s Hospital, Long Beach, CA
| | - Harneet Hara
- Divisions of Pediatrics, MemorialCare, Miller Children’s and Women’s Hospital, Long Beach, CA
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