HAEM5:B-lymphoblastic leukaemia/lymphoma with hypodiploidy: Difference between revisions
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{{DISPLAYTITLE:B-lymphoblastic leukaemia/lymphoma with hypodiploidy}} | {{DISPLAYTITLE:B-lymphoblastic leukaemia/lymphoma with hypodiploidy}} | ||
[[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]] | [[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]] | ||
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==Gene Rearrangements== | ==Gene Rearrangements== | ||
No recurrent gene rearrangements have been described. | |||
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Details on clinical significance such as prognosis and other important information can be provided in the notes section. Please include references throughout the table. Do not delete the table.'')</span> | Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Details on clinical significance such as prognosis and other important information can be provided in the notes section. Please include references throughout the table. Do not delete the table.'')</span> | ||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
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This category is not often included in hypodiploid. | This category is not often included in hypodiploid. | ||
'''Note: A slight variation in the range of chromosome number has been reported in the literature in the classification of NH, LH, HH and NH'''<ref name=":0" /><ref name=":1">{{Cite journal|last=Terwilliger|first=T.|last2=Abdul-Hay|first2=M.|date=2017|title=Acute lymphoblastic leukemia: a comprehensive review and 2017 update|url=https://www.ncbi.nlm.nih.gov/pubmed/28665419|journal=Blood Cancer Journal|volume=7|issue=6|pages=e577|doi=10.1038/bcj.2017.53|issn=2044-5385|pmc=5520400|pmid=28665419}}</ref><ref name=":2" /><ref name=":5" /><ref name=":3" /><ref>{{Cite journal|last=Safavi|first=Setareh|last2=Paulsson|first2=Kajsa|date=2017|title=Near-haploid and low-hypodiploid acute lymphoblastic leukemia: two distinct subtypes with consistently poor prognosis|url=https://www.ncbi.nlm.nih.gov/pubmed/27903530|journal=Blood|volume=129|issue=4|pages=420–423|doi=10.1182/blood-2016-10-743765|issn=1528-0020|pmid=27903530}}</ref><ref>{{Cite journal|last=Mehta|first=Parinda A.|last2=Zhang|first2=Mei-Jie|last3=Eapen|first3=Mary|last4=He|first4=Wensheng|last5=Seber|first5=Adriana|last6=Gibson|first6=Brenda|last7=Camitta|first7=Bruce M.|last8=Kitko|first8=Carrie L.|last9=Dvorak|first9=Christopher C.|date=2015|title=Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/25865650|journal=Biology of Blood and Marrow Transplantation: Journal of the American Society for Blood and Marrow Transplantation|volume=21|issue=7|pages=1273–1277|doi=10.1016/j.bbmt.2015.04.008|issn=1523-6536|pmc=4465998|pmid=25865650}}</ref><ref>{{Cite journal|last=Mullighan|first=Charles G.|date=2012|title=Molecular genetics of B-precursor acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/23023711|journal=The Journal of Clinical Investigation|volume=122|issue=10|pages=3407–3415|doi=10.1172/JCI61203|issn=1558-8238|pmc=3461902|pmid=23023711}}</ref><ref>{{Cite journal|last=Harrison|first=Christine J.|last2=Moorman|first2=Anthony V.|last3=Broadfield|first3=Zoë J.|last4=Cheung|first4=Kan L.|last5=Harris|first5=Rachel L.|last6=Reza Jalali|first6=G.|last7=Robinson|first7=Hazel M.|last8=Barber|first8=Kerry E.|last9=Richards|first9=Sue M.|date=2004|title=Three distinct subgroups of hypodiploidy in acute lymphoblastic leukaemia|url=https://www.ncbi.nlm.nih.gov/pubmed/15147369|journal=British Journal of Haematology|volume=125|issue=5|pages=552–559|doi=10.1111/j.1365-2141.2004.04948.x|issn=0007-1048|pmid=15147369}}</ref><ref>{{Cite journal|last=Wang|first=Yunhong|last2=Miller|first2=Sue|last3=Roulston|first3=Diane|last4=Bixby|first4=Dale|last5=Shao|first5=Lina|date=2016|title=Genome-Wide Single-Nucleotide Polymorphism Array Analysis Improves Prognostication of Acute Lymphoblastic Leukemia/Lymphoma|url=https://www.ncbi.nlm.nih.gov/pubmed/27161658|journal=The Journal of molecular diagnostics: JMD|volume=18|issue=4|pages=595–603|doi=10.1016/j.jmoldx.2016.03.004|issn=1943-7811|pmid=27161658}}</ref><ref>{{Cite journal|last=Safavi|first=Setareh|last2=Olsson|first2=Linda|last3=Biloglav|first3=Andrea|last4=Veerla|first4=Srinivas|last5=Blendberg|first5=Molly|last6=Tayebwa|first6=Johnbosco|last7=Behrendtz|first7=Mikael|last8=Castor|first8=Anders|last9=Hansson|first9=Markus|date=2015|title=Genetic and epigenetic characterization of hypodiploid acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/26544893|journal=Oncotarget|volume=6|issue=40|pages=42793–42802|doi=10.18632/oncotarget.6000|issn=1949-2553|pmc=4767471|pmid=26544893}}</ref> <ref>{{Cite journal|last=Moorman|first=Anthony V.|date=2016|title=New and emerging prognostic and predictive genetic biomarkers in B-cell precursor acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/27033238|journal=Haematologica|volume=101|issue=4|pages=407–416|doi=10.3324/haematol.2015.141101|issn=1592-8721|pmc=5004393|pmid=27033238}}</ref><ref>{{Cite journal|last=Fang|first=Min|last2=Becker|first2=Pamela S.|last3=Linenberger|first3=Michael|last4=Eaton|first4=Keith D.|last5=Appelbaum|first5=Frederick R.|last6=Dreyer|first6=ZoAnn|last7=Airewele|first7=Gladstone|last8=Redell|first8=Michele|last9=Lopez-Terrada|first9=Dolores|date=2015|title=Adult Low-Hypodiploid Acute B-Lymphoblastic Leukemia With IKZF3 Deletion and TP53 Mutation: Comparison With Pediatric Patients|url=https://www.ncbi.nlm.nih.gov/pubmed/26185311|journal=American Journal of Clinical Pathology|volume=144|issue=2|pages=263–270|doi=10.1309/AJCPW83OXPYKPEEN|issn=1943-7722|pmid=26185311}}</ref><ref>{{Cite journal|last=Mühlbacher|first=Verena|last2=Zenger|first2=Melanie|last3=Schnittger|first3=Susanne|last4=Weissmann|first4=Sandra|last5=Kunze|first5=Franziska|last6=Kohlmann|first6=Alexander|last7=Bellos|first7=Frauke|last8=Kern|first8=Wolfgang|last9=Haferlach|first9=Torsten|date=2014|title=Acute lymphoblastic leukemia with low hypodiploid/near triploid karyotype is a specific clinical entity and exhibits a very high TP53 mutation frequency of 93%|url=https://www.ncbi.nlm.nih.gov/pubmed/24619868|journal=Genes, Chromosomes & Cancer|volume=53|issue=6|pages=524–536|doi=10.1002/gcc.22163|issn=1098-2264|pmid=24619868}}</ref><ref>{{Cite journal|last=Woo|first=Jennifer S.|last2=Alberti|first2=Michael O.|last3=Tirado|first3=Carlos A.|date=2014|title=Childhood B-acute lymphoblastic leukemia: a genetic update|url=https://www.ncbi.nlm.nih.gov/pubmed/24949228|journal=Experimental Hematology & Oncology|volume=3|pages=16|doi=10.1186/2162-3619-3-16|issn=2162-3619|pmc=4063430|pmid=24949228}}</ref><ref>{{Cite journal|last=Collins-Underwood|first=J. R.|last2=Mullighan|first2=C. G.|date=2010|title=Genomic profiling of high-risk acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/20739952|journal=Leukemia|volume=24|issue=10|pages=1676–1685|doi=10.1038/leu.2010.177|issn=1476-5551|pmid=20739952}}</ref><ref name=":4">Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD (2018). Acute lymphoblastic leukemia (ALL). Medscape. emedicine, Medscape Article, Drugs & Diseases, Hematology.</ref> '''[1-17].''' | '''Note: A slight variation in the range of chromosome number has been reported in the literature in the classification of NH, LH, HH and NH'''<ref name=":0" /><ref name=":1">{{Cite journal|last=Terwilliger|first=T.|last2=Abdul-Hay|first2=M.|date=2017|title=Acute lymphoblastic leukemia: a comprehensive review and 2017 update|url=https://www.ncbi.nlm.nih.gov/pubmed/28665419|journal=Blood Cancer Journal|volume=7|issue=6|pages=e577|doi=10.1038/bcj.2017.53|issn=2044-5385|pmc=5520400|pmid=28665419}}</ref><ref name=":2" /><ref name=":5" /><ref name=":3" /><ref>{{Cite journal|last=Safavi|first=Setareh|last2=Paulsson|first2=Kajsa|date=2017|title=Near-haploid and low-hypodiploid acute lymphoblastic leukemia: two distinct subtypes with consistently poor prognosis|url=https://www.ncbi.nlm.nih.gov/pubmed/27903530|journal=Blood|volume=129|issue=4|pages=420–423|doi=10.1182/blood-2016-10-743765|issn=1528-0020|pmid=27903530}}</ref><ref>{{Cite journal|last=Mehta|first=Parinda A.|last2=Zhang|first2=Mei-Jie|last3=Eapen|first3=Mary|last4=He|first4=Wensheng|last5=Seber|first5=Adriana|last6=Gibson|first6=Brenda|last7=Camitta|first7=Bruce M.|last8=Kitko|first8=Carrie L.|last9=Dvorak|first9=Christopher C.|date=2015|title=Transplantation Outcomes for Children with Hypodiploid Acute Lymphoblastic Leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/25865650|journal=Biology of Blood and Marrow Transplantation: Journal of the American Society for Blood and Marrow Transplantation|volume=21|issue=7|pages=1273–1277|doi=10.1016/j.bbmt.2015.04.008|issn=1523-6536|pmc=4465998|pmid=25865650}}</ref><ref>{{Cite journal|last=Mullighan|first=Charles G.|date=2012|title=Molecular genetics of B-precursor acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/23023711|journal=The Journal of Clinical Investigation|volume=122|issue=10|pages=3407–3415|doi=10.1172/JCI61203|issn=1558-8238|pmc=3461902|pmid=23023711}}</ref><ref>{{Cite journal|last=Harrison|first=Christine J.|last2=Moorman|first2=Anthony V.|last3=Broadfield|first3=Zoë J.|last4=Cheung|first4=Kan L.|last5=Harris|first5=Rachel L.|last6=Reza Jalali|first6=G.|last7=Robinson|first7=Hazel M.|last8=Barber|first8=Kerry E.|last9=Richards|first9=Sue M.|date=2004|title=Three distinct subgroups of hypodiploidy in acute lymphoblastic leukaemia|url=https://www.ncbi.nlm.nih.gov/pubmed/15147369|journal=British Journal of Haematology|volume=125|issue=5|pages=552–559|doi=10.1111/j.1365-2141.2004.04948.x|issn=0007-1048|pmid=15147369}}</ref><ref>{{Cite journal|last=Wang|first=Yunhong|last2=Miller|first2=Sue|last3=Roulston|first3=Diane|last4=Bixby|first4=Dale|last5=Shao|first5=Lina|date=2016|title=Genome-Wide Single-Nucleotide Polymorphism Array Analysis Improves Prognostication of Acute Lymphoblastic Leukemia/Lymphoma|url=https://www.ncbi.nlm.nih.gov/pubmed/27161658|journal=The Journal of molecular diagnostics: JMD|volume=18|issue=4|pages=595–603|doi=10.1016/j.jmoldx.2016.03.004|issn=1943-7811|pmid=27161658}}</ref><ref>{{Cite journal|last=Safavi|first=Setareh|last2=Olsson|first2=Linda|last3=Biloglav|first3=Andrea|last4=Veerla|first4=Srinivas|last5=Blendberg|first5=Molly|last6=Tayebwa|first6=Johnbosco|last7=Behrendtz|first7=Mikael|last8=Castor|first8=Anders|last9=Hansson|first9=Markus|date=2015|title=Genetic and epigenetic characterization of hypodiploid acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/26544893|journal=Oncotarget|volume=6|issue=40|pages=42793–42802|doi=10.18632/oncotarget.6000|issn=1949-2553|pmc=4767471|pmid=26544893}}</ref> <ref>{{Cite journal|last=Moorman|first=Anthony V.|date=2016|title=New and emerging prognostic and predictive genetic biomarkers in B-cell precursor acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/27033238|journal=Haematologica|volume=101|issue=4|pages=407–416|doi=10.3324/haematol.2015.141101|issn=1592-8721|pmc=5004393|pmid=27033238}}</ref><ref>{{Cite journal|last=Fang|first=Min|last2=Becker|first2=Pamela S.|last3=Linenberger|first3=Michael|last4=Eaton|first4=Keith D.|last5=Appelbaum|first5=Frederick R.|last6=Dreyer|first6=ZoAnn|last7=Airewele|first7=Gladstone|last8=Redell|first8=Michele|last9=Lopez-Terrada|first9=Dolores|date=2015|title=Adult Low-Hypodiploid Acute B-Lymphoblastic Leukemia With IKZF3 Deletion and TP53 Mutation: Comparison With Pediatric Patients|url=https://www.ncbi.nlm.nih.gov/pubmed/26185311|journal=American Journal of Clinical Pathology|volume=144|issue=2|pages=263–270|doi=10.1309/AJCPW83OXPYKPEEN|issn=1943-7722|pmid=26185311}}</ref><ref name=":6">{{Cite journal|last=Mühlbacher|first=Verena|last2=Zenger|first2=Melanie|last3=Schnittger|first3=Susanne|last4=Weissmann|first4=Sandra|last5=Kunze|first5=Franziska|last6=Kohlmann|first6=Alexander|last7=Bellos|first7=Frauke|last8=Kern|first8=Wolfgang|last9=Haferlach|first9=Torsten|date=2014|title=Acute lymphoblastic leukemia with low hypodiploid/near triploid karyotype is a specific clinical entity and exhibits a very high TP53 mutation frequency of 93%|url=https://www.ncbi.nlm.nih.gov/pubmed/24619868|journal=Genes, Chromosomes & Cancer|volume=53|issue=6|pages=524–536|doi=10.1002/gcc.22163|issn=1098-2264|pmid=24619868}}</ref><ref>{{Cite journal|last=Woo|first=Jennifer S.|last2=Alberti|first2=Michael O.|last3=Tirado|first3=Carlos A.|date=2014|title=Childhood B-acute lymphoblastic leukemia: a genetic update|url=https://www.ncbi.nlm.nih.gov/pubmed/24949228|journal=Experimental Hematology & Oncology|volume=3|pages=16|doi=10.1186/2162-3619-3-16|issn=2162-3619|pmc=4063430|pmid=24949228}}</ref><ref>{{Cite journal|last=Collins-Underwood|first=J. R.|last2=Mullighan|first2=C. G.|date=2010|title=Genomic profiling of high-risk acute lymphoblastic leukemia|url=https://www.ncbi.nlm.nih.gov/pubmed/20739952|journal=Leukemia|volume=24|issue=10|pages=1676–1685|doi=10.1038/leu.2010.177|issn=1476-5551|pmid=20739952}}</ref><ref name=":4">Karen Seiter, MD; Chief Editor: Emmanuel C Besa, MD (2018). Acute lymphoblastic leukemia (ALL). Medscape. emedicine, Medscape Article, Drugs & Diseases, Hematology.</ref> '''[1-17].''' | ||
Sorting patients into these three rare groups is easy. However, detecting the presence of a masked low-hypodiploid/masked near-hypodiploid group, which is endoreduplication of the low- and near-haploid groups and associated with a very poor prognosis, is difficult. Often karyotypes in these two groups, usually ranging from 56-78 chromosomes, are mistaken for hyperdiploidy/near-triploidy, which in itself is associated with a good prognosis. The key is to look for trisomies vs tetrasomies of the chromosomes. Typically, hyperdiploidy/near-triploidy should have three copies of several chromosomes (usually the X, 4, 10, 17, and 18), and four copies of 14 and 21. However, the masked low-hypodiploid/masked near-hypodiploid groups should show tetrasomies for the sex chromosomes and chromosomes 1, 14, 18, 21, and 22 while having only two copies of chromosomes 7 and 17. | Sorting patients into these three rare groups is easy. However, detecting the presence of a masked low-hypodiploid/masked near-hypodiploid group, which is endoreduplication of the low- and near-haploid groups and associated with a very poor prognosis, is difficult. Often karyotypes in these two groups, usually ranging from 56-78 chromosomes, are mistaken for hyperdiploidy/near-triploidy, which in itself is associated with a good prognosis. The key is to look for trisomies vs tetrasomies of the chromosomes. Typically, hyperdiploidy/near-triploidy should have three copies of several chromosomes (usually the X, 4, 10, 17, and 18), and four copies of 14 and 21. However, the masked low-hypodiploid/masked near-hypodiploid groups should show tetrasomies for the sex chromosomes and chromosomes 1, 14, 18, 21, and 22 while having only two copies of chromosomes 7 and 17. | ||
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!Clinical Relevance Details/Other Notes | !Clinical Relevance Details/Other Notes | ||
|- | |- | ||
| | |''TP53''<br /> | ||
|The majority are missense mutations located in exon 7, exon 8, exon 6, and exon 5. Less frequent frameshift mutations in exon 4 and 7 have been described<ref name=":6" />. In general are predicted to be loss of function (LOF) mutations. | |||
<br /> | |Tumor Supressor Gene | ||
|< | |Common (>90%) | ||
| | |No established significance | ||
| | |No | ||
| | |Approximately 50% of children with low-hypodiploid B-ALL/LBL carry germline ''TP53'' variants associated with Li–Fraumeni syndrome, an autosomal dominant disorder caused by ''TP53'' mutations. These alterations correlate with low-hypodiploid ALL (32–39 chromosomes) and poorer clinical outcomes<ref name=":2" />. | ||
| | |||
|- | |- | ||
|<span class="blue-text">EXAMPLE:</span> ''TP53''; Variable LOF mutations | |<span class="blue-text">EXAMPLE:</span> ''TP53''; Variable LOF mutations | ||
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!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | !Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | ||
|- | |- | ||
| | |''NF1, NRAS, KRAS, MAPK1, FLT3 or PTPN11''; Activating mutations<ref name=":2" /> | ||
|RTK or Ras signaling | |||
|Constitutive activation of mitogenic and anti-apoptotic pathways, driving uncontrolled cell proliferation, survival, and malignant transformation | |||
| | |||
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|} | |} | ||