HAEM5:B lymphoblastic leukaemia/lymphoma with TCF3::HLF fusion: Difference between revisions
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{{DISPLAYTITLE:B lymphoblastic leukaemia/lymphoma with TCF3::HLF fusion}} | PAX5{{DISPLAYTITLE:B lymphoblastic leukaemia/lymphoma with TCF3::HLF fusion}} | ||
[[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]] | [[HAEM5:Table_of_Contents|Haematolymphoid Tumours (WHO Classification, 5th ed.)]] | ||
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Aiko Otsubo Ph.D FACMG | |||
==WHO Classification of Disease== | ==WHO Classification of Disease== | ||
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==Gene Rearrangements== | ==Gene Rearrangements== | ||
B lymphoblastic leukaemia/lymphoma (B-ALL) with t(17;19)(q22;p13), resulting in the TCF3::HLF gene fusion, is newly recognized as a distinct entity in the WHO 5th edition classification. TCF3 rearrangements are identified in approximately 5–11% of B-ALL cases, with several fusion partners reported, including PBX1, HLF, and ZNF384. B-ALL with TCF3::PBX1 fusion is also classified as a separate entity in the latest WHO edition<ref>WHO Classification of Tumours Editorial Board, eds, WHO Classification of Tumours, Haematolymphoid Tumours, 5th edition, IARC Press:Lyon, 2024. Online at WHO Classification of Tumours</ref>. | |||
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!Clinical Relevance Details/Other Notes | !Clinical Relevance Details/Other Notes | ||
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| | |''TCF3''||''TCF3 (E2A)::HLF''||The pathogenic derivative is the der(19) resulting in fusion of 5’ TCF3 and 3’HLF.||t(17;19)(q22;p13) | ||
| | |Rare | ||
| | |D, P | ||
| | |Yes (WHO, NCCN) | ||
| | | | ||
* This ALL subtype is classified based on the presence of a t(17;19)(q22;p13), which results in fusion of the 5’ portion of ''TCF3'' at “19p13” and the 3’ portion of ''HLF'' at “17q22”. | |||
* The t(17;19) occurs in <1% of childhood B-ALL cases. Although the majority of cases are pediatric, it has also been reported in adults<ref>{{Cite journal|last=Ahmed|first=Maria Z.|last2=Venkatadasari|first2=Indrani|last3=Dyer|first3=Sara|last4=Wall|first4=Kerry|last5=Huxley|first5=Emma|last6=Lovell|first6=Richard|last7=Kishore|first7=Bhuvan|last8=Dassanayake|first8=Hansini|last9=Francis|first9=Sebastian|date=2022-11|title=Clonal evolution in adult TCF3::HLF-positive acute lymphoblastic leukemia undergoing stem cell transplantation|url=https://pubmed.ncbi.nlm.nih.gov/35907039|journal=Annals of Hematology|volume=101|issue=11|pages=2553–2554|doi=10.1007/s00277-022-04941-5|issn=1432-0584|pmid=35907039}}</ref><ref>{{Cite journal|last=Zeckanovic|first=Aida|last2=Mouttet|first2=Brice|last3=Vinti|first3=Luciana|last4=Ancliff|first4=Philip|last5=Brethon|first5=Benoît|last6=Cario|first6=Gunnar|last7=Elitzur|first7=Sarah|last8=Hazar|first8=Volkan|last9=Kunz|first9=Joachim|date=2025-06-01|title=Update on long-term outcomes of a cohort of patients with TCF3::HLF-positive acute lymphoblastic leukemia treated with blinatumomab and stem cell transplantation|url=https://pubmed.ncbi.nlm.nih.gov/39911115|journal=Haematologica|volume=110|issue=6|pages=1373–1378|doi=10.3324/haematol.2024.286111|issn=1592-8721|pmc=12130763|pmid=39911115}}</ref> | |||
* Two major distinct types of TCF3::HLF gene fusion have been identified<ref>{{Cite journal|last=Hunger|first=S. P.|last2=Devaraj|first2=P. E.|last3=Foroni|first3=L.|last4=Secker-Walker|first4=L. M.|last5=Cleary|first5=M. L.|date=1994-05-15|title=Two types of genomic rearrangements create alternative E2A-HLF fusion proteins in t(17;19)-ALL|url=https://pubmed.ncbi.nlm.nih.gov/8180393|journal=Blood|volume=83|issue=10|pages=2970–2977|issn=0006-4971|pmid=8180393}}</ref><ref>{{Cite journal|last=Panagopoulos|first=Ioannis|last2=Micci|first2=Francesca|last3=Thorsen|first3=Jim|last4=Haugom|first4=Lisbeth|last5=Tierens|first5=Anne|last6=Ulvmoen|first6=Aina|last7=Heim|first7=Sverre|date=2012-12|title=A novel TCF3-HLF fusion transcript in acute lymphoblastic leukemia with a t(17;19)(q22;p13)|url=https://pubmed.ncbi.nlm.nih.gov/23181981|journal=Cancer Genetics|volume=205|issue=12|pages=669–672|doi=10.1016/j.cancergen.2012.10.004|issn=2210-7762|pmid=23181981}}</ref><ref>{{Cite journal|last=Lejman|first=Monika|last2=Włodarczyk|first2=Monika|last3=Zawitkowska|first3=Joanna|last4=Kowalczyk|first4=Jerzy R.|date=2020-04-03|title=Comprehensive chromosomal aberrations in a case of a patient with TCF3-HLF-positive BCP-ALL|url=https://pubmed.ncbi.nlm.nih.gov/32245383|journal=BMC medical genomics|volume=13|issue=1|pages=58|doi=10.1186/s12920-020-0709-y|issn=1755-8794|pmc=7118981|pmid=32245383}}</ref>. | |||
** Type 1: TCF3 (NM_003200.3) exon 16 fused to HLF (NM_002126.4) exon 4 | |||
** Type 2: TCF3 exon 15 fused to HLF exon 4 | |||
* This subtype is characterized by an extremely poor prognosis, high resistance to conventional therapy, and early relapse, and is frequently accompanied by disseminated intravascular coagulation (DIC) and hypercalcemia<ref>{{Cite journal|last=Hunger|first=S. P.|date=1996-02-15|title=Chromosomal translocations involving the E2A gene in acute lymphoblastic leukemia: clinical features and molecular pathogenesis|url=https://pubmed.ncbi.nlm.nih.gov/8608207|journal=Blood|volume=87|issue=4|pages=1211–1224|issn=0006-4971|pmid=8608207}}</ref><ref>{{Cite journal|last=Matsunaga|first=Takayuki|last2=Inaba|first2=Toshiya|last3=Matsui|first3=Hirotaka|last4=Okuya|first4=Mayuko|last5=Miyajima|first5=Atsushi|last6=Inukai|first6=Takeshi|last7=Funabiki|first7=Tetsunori|last8=Endo|first8=Mikiya|last9=Look|first9=A. Thomas|date=2004-04-15|title=Regulation of annexin II by cytokine-initiated signaling pathways and E2A-HLF oncoprotein|url=https://pubmed.ncbi.nlm.nih.gov/15070701|journal=Blood|volume=103|issue=8|pages=3185–3191|doi=10.1182/blood-2003-09-3022|issn=0006-4971|pmid=15070701}}</ref><ref>{{Cite journal|last=Minson|first=Katherine A.|last2=Prasad|first2=Pinki|last3=Vear|first3=Susan|last4=Borinstein|first4=Scott|last5=Ho|first5=Richard|last6=Domm|first6=Jennifer|last7=Frangoul|first7=Haydar|date=2013|title=t(17;19) in Children with Acute Lymphocytic Leukemia: A Report of 3 Cases and a Review of the Literature|url=https://pubmed.ncbi.nlm.nih.gov/23346431|journal=Case Reports in Hematology|volume=2013|pages=563291|doi=10.1155/2013/563291|issn=2090-6560|pmc=3549381|pmid=23346431}}</ref><ref>{{Cite journal|last=Inukai|first=T.|last2=Hirose|first2=K.|last3=Inaba|first3=T.|last4=Kurosawa|first4=H.|last5=Hama|first5=A.|last6=Inada|first6=H.|last7=Chin|first7=M.|last8=Nagatoshi|first8=Y.|last9=Ohtsuka|first9=Y.|date=2007-02|title=Hypercalcemia in childhood acute lymphoblastic leukemia: frequent implication of parathyroid hormone-related peptide and E2A-HLF from translocation 17;19|url=https://pubmed.ncbi.nlm.nih.gov/17183364|journal=Leukemia|volume=21|issue=2|pages=288–296|doi=10.1038/sj.leu.2404496|issn=0887-6924|pmid=17183364}}</ref>. | |||
|} | |} | ||
==Individual Region Genomic Gain/Loss/LOH== | ==Individual Region Genomic Gain/Loss/LOH== | ||
Deletions of PAX5, BTG1, and VPREB1 have been observed in TCF3::HLF-positive B-ALL. Of the 13 reported cases<ref>{{Cite journal|last=Ma|first=Xiaotu|last2=Edmonson|first2=Michael|last3=Yergeau|first3=Donald|last4=Muzny|first4=Donna M.|last5=Hampton|first5=Oliver A.|last6=Rusch|first6=Michael|last7=Song|first7=Guangchun|last8=Easton|first8=John|last9=Harvey|first9=Richard C.|date=2015-03-19|title=Rise and fall of subclones from diagnosis to relapse in pediatric B-acute lymphoblastic leukaemia|url=https://pubmed.ncbi.nlm.nih.gov/25790293|journal=Nature Communications|volume=6|pages=6604|doi=10.1038/ncomms7604|issn=2041-1723|pmc=4377644|pmid=25790293}}</ref><ref name=":0">{{Cite journal|last=Fischer|first=Ute|last2=Forster|first2=Michael|last3=Rinaldi|first3=Anna|last4=Risch|first4=Thomas|last5=Sungalee|first5=Stéphanie|last6=Warnatz|first6=Hans-Jörg|last7=Bornhauser|first7=Beat|last8=Gombert|first8=Michael|last9=Kratsch|first9=Christina|date=2015-09|title=Genomics and drug profiling of fatal TCF3-HLF-positive acute lymphoblastic leukemia identifies recurrent mutation patterns and therapeutic options|url=https://pubmed.ncbi.nlm.nih.gov/26214592|journal=Nature Genetics|volume=47|issue=9|pages=1020–1029|doi=10.1038/ng.3362|issn=1546-1718|pmc=4603357|pmid=26214592}}</ref>, 8 showed deletions of PAX5. The remaining cases had deletions of BTG1, VPREB1, or both, but not PAX5, indicating deletions of PAX5 are mutually exclusive from deletions of BTG1 and VPREB1. CDKN2A/B deletions have been observed in 3 cases. | |||
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!Clinical Relevance Details/Other Notes | !Clinical Relevance Details/Other Notes | ||
|- | |- | ||
| | |9 | ||
|Loss | |||
| | |9p21.3 | ||
| | |CDKN2A/B | ||
| | |||
| | |No | ||
|Common recurrent finding in various cancers | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | |9 | ||
|Loss | |||
| | |9p13 | ||
| | |PAX5 | ||
| | |||
| | | | ||
| | |No | ||
Common recurrent | |Common recurrent finding in B-ALL | ||
|- | |- | ||
| | |12 | ||
|Loss | |||
| | |12q21.33 | ||
| | |''BTG1'' | ||
| | |||
'' | |||
| | | | ||
| | |No | ||
|Common recurrent finding in B-ALL | |||
|- | |- | ||
|22 | |||
|Loss | |||
|22q11.2 | |||
|VPREB1 | |||
| | | | ||
| | |No | ||
| | |Common recurrent finding in B-ALL | ||
|} | |} | ||
==Characteristic Chromosomal or Other Global Mutational Patterns== | ==Characteristic Chromosomal or Other Global Mutational Patterns== | ||
Not applicable. <span style="color:#0070C0">(I''nstructions: Included in this category are alterations such as hyperdiploid; gain of odd number chromosomes including typically chromosome 1, 3, 5, 7, 11, and 17; co-deletion of 1p and 19q; complex karyotypes without characteristic genetic findings; chromothripsis; microsatellite instability; homologous recombination deficiency; mutational signature pattern; etc. 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> | |||
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|}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content. | |}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content. | ||
==Epigenomic Alterations== | ==Epigenomic Alterations== | ||
Not applicable. | |||
==Genes and Main Pathways Involved== | ==Genes and Main Pathways Involved== | ||
TCF3 and HLF are both transcription factors, and their fusion generates a chimeric protein that combines the amino-terminal transactivation domains of TCF3 with the carboxy-terminal basic region/leucine zipper DNA-binding and dimerization domain of HLF. The resulting TCF3::HLF fusion protein exhibits altered DNA-binding specificity compared with wild-type HLF<ref>{{Cite journal|last=Hunger|first=S. P.|last2=Ohyashiki|first2=K.|last3=Toyama|first3=K.|last4=Cleary|first4=M. L.|date=1992-09|title=Hlf, a novel hepatic bZIP protein, shows altered DNA-binding properties following fusion to E2A in t(17;19) acute lymphoblastic leukemia|url=https://pubmed.ncbi.nlm.nih.gov/1516826|journal=Genes & Development|volume=6|issue=9|pages=1608–1620|doi=10.1101/gad.6.9.1608|issn=0890-9369|pmid=1516826}}</ref>. Functional studies have demonstrated that TCF3::HLF promotes anchorage-independent growth in mouse fibroblast cells<ref>{{Cite journal|last=Yoshihara|first=T.|last2=Inaba|first2=T.|last3=Shapiro|first3=L. H.|last4=Kato|first4=J. Y.|last5=Look|first5=A. T.|date=1995-06|title=E2A-HLF-mediated cell transformation requires both the trans-activation domains of E2A and the leucine zipper dimerization domain of HLF|url=https://pubmed.ncbi.nlm.nih.gov/7760820|journal=Molecular and Cellular Biology|volume=15|issue=6|pages=3247–3255|doi=10.1128/MCB.15.6.3247|issn=0270-7306|pmc=230557|pmid=7760820}}</ref><ref>{{Cite journal|last=Inukai|first=T.|last2=Inaba|first2=T.|last3=Yoshihara|first3=T.|last4=Look|first4=A. T.|date=1997-03|title=Cell transformation mediated by homodimeric E2A-HLF transcription factors|url=https://pubmed.ncbi.nlm.nih.gov/9032268|journal=Molecular and Cellular Biology|volume=17|issue=3|pages=1417–1424|doi=10.1128/MCB.17.3.1417|issn=0270-7306|pmc=231866|pmid=9032268}}</ref> and inhibits apoptosis, thereby enhancing cell survival<ref>{{Cite journal|last=Inaba|first=T.|last2=Inukai|first2=T.|last3=Yoshihara|first3=T.|last4=Seyschab|first4=H.|last5=Ashmun|first5=R. A.|last6=Canman|first6=C. E.|last7=Laken|first7=S. J.|last8=Kastan|first8=M. B.|last9=Look|first9=A. T.|date=1996-08-08|title=Reversal of apoptosis by the leukaemia-associated E2A-HLF chimaeric transcription factor|url=https://pubmed.ncbi.nlm.nih.gov/8700228|journal=Nature|volume=382|issue=6591|pages=541–544|doi=10.1038/382541a0|issn=0028-0836|pmid=8700228}}</ref><ref>{{Cite journal|last=Inukai|first=T.|last2=Inaba|first2=T.|last3=Ikushima|first3=S.|last4=Look|first4=A. T.|date=1998-10|title=The AD1 and AD2 transactivation domains of E2A are essential for the antiapoptotic activity of the chimeric oncoprotein E2A-HLF|url=https://pubmed.ncbi.nlm.nih.gov/9742120|journal=Molecular and Cellular Biology|volume=18|issue=10|pages=6035–6043|doi=10.1128/MCB.18.10.6035|issn=0270-7306|pmc=109189|pmid=9742120}}</ref>. Gene expression profiling of TCF3::HLF-positive B-ALL cases further revealed extensive transcriptional reprogramming toward an aberrant, immature hematopoietic state<ref name=":0" />. <span style="color:#0070C0">(''Instructions: Please include references throughout the table. Do not delete the table.)''</span> | |||
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==Genetic Diagnostic Testing Methods== | ==Genetic Diagnostic Testing Methods== | ||
Karyotype, FISH, RT-PCR, DNA or RNA-based NGS | |||
==Familial Forms== | ==Familial Forms== | ||
Not applicable. | |||
==Additional Information== | ==Additional Information== | ||
Put your text here | Put your text here | ||
==Links== | ==Links== | ||
[[TCF3]] | |||
HLF | |||
<span style="color:#0070C0">(''Instructions: Highlight the text to which you want to add a link in this section or elsewhere, select the "Link" icon at the top of the wiki page, and search the name of the internal page to which you want to link this text, or enter an external internet address by including the "<nowiki>http://www</nowiki>." portion.'')</span> | |||
==References== | ==References== | ||
<references /> | |||
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