HAEM5:Gamma heavy chain disease: Difference between revisions

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<blockquote class='blockedit'>{{Box-round|title=Content Update To WHO 5th Edition Classification Is In Process; Content Below is Based on WHO 4th Edition Classification|This page was converted to the new template on 2023-12-07. The original page can be found at [[HAEM4:Gamma Heavy Chain Disease]].
<blockquote class="blockedit">{{Box-round|title=Content Update To WHO 5th Edition Classification Is In Process; Content Below is Based on WHO 4th Edition Classification|This page was converted to the new template on 2023-12-07. The original page can be found at [[HAEM4:Gamma Heavy Chain Disease]].
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<span style="color:#0070C0">(General Instructions – The main focus of these pages is the clinically significant genetic alterations in each disease type. Use [https://www.genenames.org/ <u>HUGO-approved gene names and symbols</u>] (italicized when appropriate), [https://varnomen.hgvs.org/ HGVS-based nomenclature for variants], as well as generic names of drugs and testing platforms or assays if applicable. Please complete tables whenever possible and do not delete them (add N/A if not applicable in the table and delete the examples); to add (or move) a row or column to a table, click within the table and select the > symbol that appears to be given options. Please do not delete or alter the section headings. The use of bullet points alongside short blocks of text rather than only large paragraphs is encouraged. Additional instructions below in italicized blue text should not be included in the final page content. Please also see </span><u>[[Author_Instructions]]</u><span style="color:#0070C0"> and [[Frequently Asked Questions (FAQs)|<u>FAQs</u>]] as well as contact your [[Leadership|<u>Associate Editor</u>]] or [mailto:CCGA@cancergenomics.org <u>Technical Support</u>])</span>
<span style="color:#0070C0">(General Instructions – The focus of these pages is the clinically significant genetic alterations in each disease type. This is based on up-to-date knowledge from multiple resources such as PubMed and the WHO classification books. The CCGA is meant to be a supplemental resource to the WHO classification books; the CCGA captures in a continually updated wiki-stye manner the current genetics/genomics knowledge of each disease, which evolves more rapidly than books can be revised and published. If the same disease is described in multiple WHO classification books, the genetics-related information for that disease will be consolidated into a single main page that has this template (other pages would only contain a link to this main page). Use [https://www.genenames.org/ <u>HUGO-approved gene names and symbols</u>] (italicized when appropriate), [https://varnomen.hgvs.org/ <u>HGVS-based nomenclature for variants</u>], as well as generic names of drugs and testing platforms or assays if applicable. Please complete tables whenever possible and do not delete them (add N/A if not applicable in the table and delete the examples); to add (or move) a row or column in a table, click nearby within the table and select the > symbol that appears. Please do not delete or alter the section headings. The use of bullet points alongside short blocks of text rather than only large paragraphs is encouraged. Additional instructions below in italicized blue text should not be included in the final page content. Please also see </span><u>[[Author_Instructions]]</u><span style="color:#0070C0"> and [[Frequently Asked Questions (FAQs)|<u>FAQs</u>]] as well as contact your [[Leadership|<u>Associate Editor</u>]] or [mailto:CCGA@cancergenomics.org <u>Technical Support</u>].)</span>


==Primary Author(s)*==
==Primary Author(s)*==
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Loma Linda University, Medical Center, CA
Loma Linda University, Medical Center, CA
__TOC__
==WHO Classification of Disease==
==WHO Classification of Disease==


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==Definition / Description of Disease==
==Related Terminology==


*gHCD is a B-cell neoplasm of lymphocytes, plasmacytoid lymphocytes and plasma cells<ref name=":0">{{Cite journal|last=Fermand|first=J. P.|last2=Brouet|first2=J. C.|last3=Danon|first3=F.|last4=Seligmann|first4=M.|date=1989-11|title=Gamma heavy chain "disease": heterogeneity of the clinicopathologic features. Report of 16 cases and review of the literature|url=https://pubmed.ncbi.nlm.nih.gov/2509855|journal=Medicine|volume=68|issue=6|pages=321–335|issn=0025-7974|pmid=2509855}}</ref><ref name=":1">{{Cite journal|last=Ramasamy|first=I.|last2=Rudzki|first2=Z.|date=2018|title=Two Cases of γ-Heavy Chain Disease and a Review of the Literature|url=https://pubmed.ncbi.nlm.nih.gov/30186642|journal=Case Reports in Hematology|volume=2018|pages=4832619|doi=10.1155/2018/4832619|issn=2090-6560|pmc=6109557|pmid=30186642}}</ref>
*Heterogenous clinical and pathological presentation<ref name=":0" />
*Disseminated lymphoproliferative disorder is present in most patients at diagnosis<ref name=":0" /><ref name=":1" /><ref name=":2">{{Cite journal|last=Wahner-Roedler|first=Dietlind L.|last2=Witzig|first2=Thomas E.|last3=Loehrer|first3=Laura L.|last4=Kyle|first4=Robert A.|date=2003-07|title=Gamma-heavy chain disease: review of 23 cases|url=https://pubmed.ncbi.nlm.nih.gov/12861101|journal=Medicine|volume=82|issue=4|pages=236–250|doi=10.1097/01.md.0000085058.63483.7f|issn=0025-7974|pmid=12861101}}</ref>
*It produces truncated monoclonal gamma (g) immunoglobulin (IgG) heavy chain that is incapable of associating with light chains<ref name=":1" />
*Have concomitant autoimmune disease (mostly rheumatoid arthritis)
*Three clusters of γ-HCD patients are identified:
*#In around 60% of cases, γ-HCD is associated to disseminated lymphoma and patients typically have poor condition.
*#In 25% of patients, γ-HCD is associated to localized lymphoma, affecting bone marrow, skin, thyroid, parotid, gastrointestinal or oropharynx tract (MALT lymphoma)
*#In 15% of patients, γ-HCD is associated with autoimmune disease, mainly RA<ref>{{Cite journal|last=Danic|first=Gwenvaël|last2=Dejoie|first2=Thomas|last3=Caillon|first3=Hélène|last4=Achille|first4=Aurélie|last5=Pottier|first5=Pierre|last6=Agard|first6=Christian|date=2021-03-17|title=Gamma heavy chain disease associated with rheumatoid arthritis: a case report|url=https://pubmed.ncbi.nlm.nih.gov/33726782|journal=Journal of Medical Case Reports|volume=15|issue=1|pages=121|doi=10.1186/s13256-021-02696-7|issn=1752-1947|pmc=7968189|pmid=33726782}}</ref>
==Synonyms / Terminology==
*Franklin disease<ref>{{Cite journal|last=Franklin|first=E. C.|last2=Lowenstein|first2=J.|last3=Bigelow|first3=B.|last4=Meltzer|first4=M.|date=1964-09|title=HEAVY CHAIN DISEASE- A NEW DISORDER OF SERUM GAMMA-GLOBULINS : REPORT OF THE FIRST CASE|url=https://pubmed.ncbi.nlm.nih.gov/14209281|journal=The American Journal of Medicine|volume=37|pages=332–350|doi=10.1016/0002-9343(64)90191-3|issn=0002-9343|pmid=14209281}}</ref>/ γHCD
==Epidemiology / Prevalence==
*Incidence: Very rare, till date, ~only 200 cases have been reported in the literature<ref name=":3">{{Cite journal|last=Munshi|first=Nikhil C.|last2=Digumarthy|first2=Subba|last3=Rahemtullah|first3=Aliyah|date=2008-04-24|title=Case records of the Massachusetts General Hospital. Case 13-2008. A 46-year-old man with rheumatoid arthritis and lymphadenopathy|url=https://pubmed.ncbi.nlm.nih.gov/18434654|journal=The New England Journal of Medicine|volume=358|issue=17|pages=1838–1848|doi=10.1056/NEJMcpc0800959|issn=1533-4406|pmid=18434654}}</ref>
*Median age: 68 years (range, 42–87 years)<ref>{{Cite journal|last=Zhou|first=Hebing|last2=Chen|first2=Wenming|last3=Zhang|first3=Juan|last4=Zeng|first4=Hui|last5=Jian|first5=Yuan|last6=Fu|first6=Chenxiao|date=2016-06|title=T cell receptor rearrangements in a patient with γ-heavy chain disease: A case report|url=https://pubmed.ncbi.nlm.nih.gov/27313757|journal=Oncology Letters|volume=11|issue=6|pages=4147–4151|doi=10.3892/ol.2016.4515|issn=1792-1074|pmc=4888291|pmid=27313757}}</ref>
*Slight female predominance<ref name=":2" />
==Clinical Features==
Put your text here and fill in the table <span style="color:#0070C0">(''Instruction: Can include references in the table. Do not delete table.'') </span>
{| class="wikitable"
{| class="wikitable"
|'''Signs and Symptoms'''
|+
|<span class="blue-text">EXAMPLE:</span> Asymptomatic (incidental finding on complete blood counts)
|Acceptable
 
|N/A
<span class="blue-text">EXAMPLE:</span> B-symptoms (weight loss, fever, night sweats)
 
<span class="blue-text">EXAMPLE:</span> Fatigue
 
<span class="blue-text">EXAMPLE:</span> Lymphadenopathy (uncommon)
|-
|-
|'''Laboratory Findings'''
|Not Recommended
|<span class="blue-text">EXAMPLE:</span> Cytopenias
|Franklin disease
 
<span class="blue-text">EXAMPLE:</span> Lymphocytosis (low level)
|}
|}


 
==Gene Rearrangements==
<blockquote class='blockedit'>{{Box-round|title=v4:Clinical Features|The content below was from the old template. Please incorporate above.}}</blockquote>
 
 
'''Signs & Symptoms'''
 
*Anorexia
*Fever
*Weakness
*Weight loss
*Recurrent bacterial infections
*Concomitant autoimmune disorder
**Rheumatoid arthritis
**Myasthenia Gravis
**Autoimmune cytopenia
**Systemic Lupus Erythematosus
**Thyroiditis
**Vasculitis
**Wasting
**Sjögren syndrome
**Thrombocytopenia
**Autoimmune hemolytic anemia
 
'''Laboratory Findings'''
 
*Anemia
*Thrombocytopenia
 
'''Molecular Biology and Genetics'''
 
*gHCD seems to be caused by deletions and/or insertions within the rearranged variable region genes (V), which could be a by-product of somatic hypermutation<ref name=":1" /><ref name=":5">{{Cite journal|last=Goossens|first=T.|last2=Klein|first2=U.|last3=Küppers|first3=R.|date=1998-03-03|title=Frequent occurrence of deletions and duplications during somatic hypermutation: implications for oncogene translocations and heavy chain disease|url=https://pubmed.ncbi.nlm.nih.gov/9482908|journal=Proceedings of the National Academy of Sciences of the United States of America|volume=95|issue=5|pages=2463–2468|doi=10.1073/pnas.95.5.2463|issn=0027-8424|pmc=PMC19376|pmid=9482908}}</ref>
 
 
<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":2" /><blockquote class="blockedit">
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<center><span style="color:Maroon">'''End of V4 Section'''</span>
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</blockquote>
==Sites of Involvement==
 
*Bone marrow
*Peripheral blood
*Spleen
*Liver
*Lymph nodes
*Waldeyer ring
*Gastrointestinal tract
*Extranodal sites
 
==Morphologic Features==
 
 
*Mixed proliferation of various cell types:
**Lymphocytes
**Plasmacytoid lymphocytes
**Plasma cells
**Scattered immunoblasts
**Reed–Sternberg cells
**Eosinophils and histiocytes
*Vascular proliferation may give rise to the histologic differential diagnosis of Hodgkin’s lymphoma or certain forms of T-cell lymphoma
 
 
<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":3" /><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
----
</blockquote>
==Immunophenotype==




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"
|-
|-
!Finding!!Marker
!Driver Gene!!Fusion(s) and Common Partner Genes!!Molecular Pathogenesis!!Typical Chromosomal Alteration(s)
!Prevalence -Common >20%, Recurrent 5-20% or Rare <5% (Disease)
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Clinical Relevance Details/Other Notes
|-
|-
|Positive (B-cell lineage marker)||CD19, CD20, CD79a, IgG (cytoplasmic) without light chain
|<span class="blue-text">EXAMPLE:</span> ''ABL1''||<span class="blue-text">EXAMPLE:</span> ''BCR::ABL1''||<span class="blue-text">EXAMPLE:</span> The pathogenic derivative is the der(22) resulting in fusion of 5’ BCR and 3’ABL1.||<span class="blue-text">EXAMPLE:</span> t(9;22)(q34;q11.2)
|<span class="blue-text">EXAMPLE:</span> Common (CML)
|<span class="blue-text">EXAMPLE:</span> D, P, T
|<span class="blue-text">EXAMPLE:</span> Yes (WHO, NCCN)
|<span class="blue-text">EXAMPLE:</span>
The t(9;22) is diagnostic of CML in the appropriate morphology and clinical context (add reference). This fusion is responsive to targeted therapy such as Imatinib (Gleevec) (add reference). BCR::ABL1 is generally favorable in CML (add reference).
|-
|-
|Positive-Plasmacytoid cells||MUM1/IRF4
|<span class="blue-text">EXAMPLE:</span> ''CIC''
|<span class="blue-text">EXAMPLE:</span> ''CIC::DUX4''
|<span class="blue-text">EXAMPLE:</span> Typically, the last exon of ''CIC'' is fused to ''DUX4''. The fusion breakpoint in ''CIC'' is usually intra-exonic and removes an inhibitory sequence, upregulating ''PEA3'' genes downstream of ''CIC'' including ''ETV1'', ''ETV4'', and ''ETV5''.
|<span class="blue-text">EXAMPLE:</span> t(4;19)(q25;q13)
|<span class="blue-text">EXAMPLE:</span> Common (CIC-rearranged sarcoma)
|<span class="blue-text">EXAMPLE:</span> D
|
|<span class="blue-text">EXAMPLE:</span>
 
''DUX4'' has many homologous genes; an alternate translocation in a minority of cases is t(10;19), but this is usually indistinguishable from t(4;19) by short-read sequencing (add references).
|-
|-
|Positive-Plasma cells
|<span class="blue-text">EXAMPLE:</span> ''ALK''
|CD38, CD138
|<span class="blue-text">EXAMPLE:</span> ''ELM4::ALK''
|-
|Negative||CD5, CD10
|}




<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":3" /><blockquote class="blockedit">
Other fusion partners include ''KIF5B, NPM1, STRN, TFG, TPM3, CLTC, KLC1''
<center><span style="color:Maroon">'''End of V4 Section'''</span>
|<span class="blue-text">EXAMPLE:</span> Fusions result in constitutive activation of the ''ALK'' tyrosine kinase. The most common ''ALK'' fusion is ''EML4::ALK'', with breakpoints in intron 19 of ''ALK''. At the transcript level, a variable (5’) partner gene is fused to 3’ ''ALK'' at exon 20. Rarely, ''ALK'' fusions contain exon 19 due to breakpoints in intron 18.
----
|<span class="blue-text">EXAMPLE:</span> N/A
</blockquote>
|<span class="blue-text">EXAMPLE:</span> Rare (Lung adenocarcinoma)
==Chromosomal Rearrangements (Gene Fusions)==
|<span class="blue-text">EXAMPLE:</span> T
|
|<span class="blue-text">EXAMPLE:</span>


Put your text here and fill in the table
Both balanced and unbalanced forms are observed by FISH (add references).
 
{| class="wikitable sortable"
|-
|-
!Chromosomal Rearrangement!!Genes in Fusion (5’ or 3’ Segments)!!Pathogenic Derivative!!Prevalence
|<span class="blue-text">EXAMPLE:</span> ''ABL1''
!Diagnostic Significance (Yes, No or Unknown)
|<span class="blue-text">EXAMPLE:</span> N/A
!Prognostic Significance (Yes, No or Unknown)
|<span class="blue-text">EXAMPLE:</span> Intragenic deletion of exons 2–7 in ''EGFR'' removes the ligand-binding domain, resulting in a constitutively active tyrosine kinase with downstream activation of multiple oncogenic pathways.
!Therapeutic Significance (Yes, No or Unknown)
|<span class="blue-text">EXAMPLE:</span> N/A
!Notes
|<span class="blue-text">EXAMPLE:</span> Recurrent (IDH-wildtype Glioblastoma)
|<span class="blue-text">EXAMPLE:</span> D, P, T
|
|
|-
|-
|<span class="blue-text">EXAMPLE:</span> t(9;22)(q34;q11.2)||<span class="blue-text">EXAMPLE:</span> 3'ABL1 / 5'BCR||<span class="blue-text">EXAMPLE:</span> der(22)||<span class="blue-text">EXAMPLE:</span> 20% (COSMIC)
|
<span class="blue-text">EXAMPLE:</span> 30% (add reference)
|
|Yes
|
|No
|
|Yes
|
|<span class="blue-text">EXAMPLE:</span>
|
 
|
The t(9;22) is diagnostic of CML in the appropriate morphology and clinical context (add reference). This fusion is responsive to targeted therapy such as Imatinib (Gleevec) (add reference).
|
|}
|}


<blockquote class='blockedit'>{{Box-round|title=v4:Chromosomal Rearrangements (Gene Fusions)|The content below was from the old template. Please incorporate above.}}</blockquote>
<blockquote class="blockedit">{{Box-round|title=v4:Chromosomal Rearrangements (Gene Fusions)|The content below was from the old template. Please incorporate above.}}</blockquote>


*No consistent gene fusions<ref>{{Cite journal|last=Witzig|first=Thomas E.|last2=Wahner-Roedler|first2=Dietlind L.|date=2002-06|title=Heavy chain disease|url=https://pubmed.ncbi.nlm.nih.gov/12057070|journal=Current Treatment Options in Oncology|volume=3|issue=3|pages=247–254|doi=10.1007/s11864-002-0014-3|issn=1527-2729|pmid=12057070}}</ref>
*No consistent gene fusions<ref>{{Cite journal|last=Witzig|first=Thomas E.|last2=Wahner-Roedler|first2=Dietlind L.|date=2002-06|title=Heavy chain disease|url=https://pubmed.ncbi.nlm.nih.gov/12057070|journal=Current Treatment Options in Oncology|volume=3|issue=3|pages=247–254|doi=10.1007/s11864-002-0014-3|issn=1527-2729|pmid=12057070}}</ref>
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<blockquote class='blockedit'>{{Box-round|title=v4:Clinical Significance (Diagnosis, Prognosis and Therapeutic Implications).|Please incorporate this section into the relevant tables found in:
<blockquote class="blockedit">{{Box-round|title=v4:Clinical Significance (Diagnosis, Prognosis and Therapeutic Implications).|Please incorporate this section into the relevant tables found in:
* Chromosomal Rearrangements (Gene Fusions)
* Chromosomal Rearrangements (Gene Fusions)
* Individual Region Genomic Gain/Loss/LOH
* Individual Region Genomic Gain/Loss/LOH
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* N/A
*N/A




<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":4">{{Cite journal|last=Singer|first=Sara|last2=Efebera|first2=Yvonne|last3=Bumma|first3=Naresh|last4=Khan|first4=Abdullah|last5=Devarakonda|first5=Srinivas|last6=Chaudhry|first6=Maria|last7=Benson|first7=Don|last8=Rosko|first8=Ashley E.|date=2020-08|title=Heavy Lifting: Nomenclature and Novel Therapy for Gamma Heavy Chain Disease and Other Heavy Chain Disorders|url=https://pubmed.ncbi.nlm.nih.gov/32245744|journal=Clinical Lymphoma, Myeloma & Leukemia|volume=20|issue=8|pages=493–498|doi=10.1016/j.clml.2020.02.020|issn=2152-2669|pmid=32245744}}</ref><blockquote class="blockedit">
<blockquote class="blockedit">{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":4">{{Cite journal|last=Singer|first=Sara|last2=Efebera|first2=Yvonne|last3=Bumma|first3=Naresh|last4=Khan|first4=Abdullah|last5=Devarakonda|first5=Srinivas|last6=Chaudhry|first6=Maria|last7=Benson|first7=Don|last8=Rosko|first8=Ashley E.|date=2020-08|title=Heavy Lifting: Nomenclature and Novel Therapy for Gamma Heavy Chain Disease and Other Heavy Chain Disorders|url=https://pubmed.ncbi.nlm.nih.gov/32245744|journal=Clinical Lymphoma, Myeloma & Leukemia|volume=20|issue=8|pages=493–498|doi=10.1016/j.clml.2020.02.020|issn=2152-2669|pmid=32245744}}</ref><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
<center><span style="color:Maroon">'''End of V4 Section'''</span>
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</blockquote>
</blockquote>
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</blockquote>
==Individual Region Genomic Gain / Loss / LOH==
==Individual Region Genomic Gain/Loss/LOH==


Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Includes aberrations not involving gene fusions. Can include references in the table. Can refer to CGC workgroup tables as linked on the homepage if applicable. Do not delete table.'') </span>


Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Includes aberrations not involving gene rearrangements. Details on clinical significance such as prognosis and other important information can be provided in the notes section. Can refer to CGC workgroup tables as linked on the homepage if applicable. Please include references throughout the table. Do not delete the table.'') </span>
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Chr #!!Gain / Loss / Amp / LOH!!Minimal Region Genomic Coordinates [Genome Build]!!Minimal Region Cytoband
!Chr #!!Gain, Loss, Amp, LOH!!Minimal Region Cytoband and/or Genomic Coordinates [Genome Build; Size]!!Relevant Gene(s)
!Diagnostic Significance (Yes, No or Unknown)
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T
!Prognostic Significance (Yes, No or Unknown)
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Therapeutic Significance (Yes, No or Unknown)
!Clinical Relevance Details/Other Notes
!Notes
|-
|-
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
7
7
|<span class="blue-text">EXAMPLE:</span> Loss
|<span class="blue-text">EXAMPLE:</span> Loss
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
chr7
chr7:1- 159,335,973 [hg38]
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
Unknown
chr7
|<span class="blue-text">EXAMPLE:</span> D, P
|Yes
|<span class="blue-text">EXAMPLE:</span> No
|Yes
|No
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
Presence of monosomy 7 (or 7q deletion) is sufficient for a diagnosis of AML with MDS-related changes when there is ≥20% blasts and no prior therapy (add reference).  Monosomy 7/7q deletion is associated with a poor prognosis in AML (add references).
Presence of monosomy 7 (or 7q deletion) is sufficient for a diagnosis of AML with MDS-related changes when there is ≥20% blasts and no prior therapy (add reference).  Monosomy 7/7q deletion is associated with a poor prognosis in AML (add reference).
|-
|-
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
8
8
|<span class="blue-text">EXAMPLE:</span> Gain
|<span class="blue-text">EXAMPLE:</span> Gain
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
chr8
chr8:1-145,138,636 [hg38]
|<span class="blue-text">EXAMPLE:</span>
Unknown
|<span class="blue-text">EXAMPLE:</span> D, P
|
|<span class="blue-text">EXAMPLE:</span>
Common recurrent secondary finding for t(8;21) (add references).
|-
|<span class="blue-text">EXAMPLE:</span>
17
|<span class="blue-text">EXAMPLE:</span> Amp
|<span class="blue-text">EXAMPLE:</span>
17q12; chr17:39,700,064-39,728,658 [hg38; 28.6 kb]
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
''ERBB2''
chr8
|<span class="blue-text">EXAMPLE:</span> D, P, T
|No
|
|No
|No
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
Amplification of ''ERBB2'' is associated with HER2 overexpression in HER2 positive breast cancer (add references). Add criteria for how amplification is defined.
Common recurrent secondary finding for t(8;21) (add reference).
|-
|
|
|
|
|
|
|
|}
|}


<blockquote class='blockedit'>{{Box-round|title=v4:Genomic Gain/Loss/LOH|The content below was from the old template. Please incorporate above.}}</blockquote>
<blockquote class="blockedit">{{Box-round|title=v4:Genomic Gain/Loss/LOH|The content below was from the old template. Please incorporate above.}}</blockquote>




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<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":1" /><ref name=":5" /><blockquote class="blockedit">
<blockquote class="blockedit">{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":1">{{Cite journal|last=Ramasamy|first=I.|last2=Rudzki|first2=Z.|date=2018|title=Two Cases of γ-Heavy Chain Disease and a Review of the Literature|url=https://pubmed.ncbi.nlm.nih.gov/30186642|journal=Case Reports in Hematology|volume=2018|pages=4832619|doi=10.1155/2018/4832619|issn=2090-6560|pmc=6109557|pmid=30186642}}</ref><ref name=":5">{{Cite journal|last=Goossens|first=T.|last2=Klein|first2=U.|last3=Küppers|first3=R.|date=1998-03-03|title=Frequent occurrence of deletions and duplications during somatic hypermutation: implications for oncogene translocations and heavy chain disease|url=https://pubmed.ncbi.nlm.nih.gov/9482908|journal=Proceedings of the National Academy of Sciences of the United States of America|volume=95|issue=5|pages=2463–2468|doi=10.1073/pnas.95.5.2463|issn=0027-8424|pmc=PMC19376|pmid=9482908}}</ref><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
<center><span style="color:Maroon">'''End of V4 Section'''</span>
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</blockquote>
</blockquote>
</blockquote>
</blockquote>
==Characteristic Chromosomal Patterns==
==Characteristic Chromosomal or Other Global Mutational Patterns==


Put your text here <span style="color:#0070C0">(''EXAMPLE PATTERNS: 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. Do not delete table.'')</span>


Put your text here and fill in the table <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>
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Chromosomal Pattern
!Chromosomal Pattern
!Diagnostic Significance (Yes, No or Unknown)
!Molecular Pathogenesis
!Prognostic Significance (Yes, No or Unknown)
!Prevalence -
!Therapeutic Significance (Yes, No or Unknown)
Common >20%, Recurrent 5-20% or Rare <5% (Disease)
!Notes
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Clinical Relevance Details/Other Notes
|-
|-
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
Co-deletion of 1p and 18q
Co-deletion of 1p and 18q
|Yes
|<span class="blue-text">EXAMPLE:</span> See chromosomal rearrangements table as this pattern is due to an unbalanced derivative translocation associated with oligodendroglioma (add reference).
|No
|<span class="blue-text">EXAMPLE:</span> Common (Oligodendroglioma)
|No
|<span class="blue-text">EXAMPLE:</span> D, P
|
|
|-
|<span class="blue-text">EXAMPLE:</span>
|<span class="blue-text">EXAMPLE:</span>
 
Microsatellite instability - hypermutated
See chromosomal rearrangements table as this pattern is due to an unbalanced derivative translocation associated with oligodendroglioma (add reference).
|
|<span class="blue-text">EXAMPLE:</span> Common (Endometrial carcinoma)
|<span class="blue-text">EXAMPLE:</span> P, T
|
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|-
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|}
|}


<blockquote class='blockedit'>{{Box-round|title=v4:Characteristic Chromosomal Aberrations / Patterns|The content below was from the old template. Please incorporate above.}}</blockquote>
<blockquote class="blockedit">{{Box-round|title=v4:Characteristic Chromosomal Aberrations / Patterns|The content below was from the old template. Please incorporate above.}}</blockquote>


*No consistent pattern reported
*No consistent pattern reported
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</blockquote>
</blockquote>
==Gene Mutations (SNV / INDEL)==
==Gene Mutations (SNV/INDEL)==


Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: This table is not meant to be an exhaustive list; please include only genes/alterations that are recurrent and common as well as either disease defining and/or clinically significant. Can include references in the table. For clinical significance, denote associations with FDA-approved therapy (not an extensive list of applicable drugs) and NCCN or other national guidelines if applicable. Can also refer to CGC workgroup tables as linked on the homepage if applicable as well as any high impact papers or reviews of gene mutations in this entity. Do not delete table.'') </span>


Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: This table is not meant to be an exhaustive list; please include only genes/alterations that are recurrent or common as well either disease defining and/or clinically significant. If a gene has multiple mechanisms depending on the type or site of the alteration, add multiple entries in the table. For clinical significance, denote associations with FDA-approved therapy (not an extensive list of applicable drugs) and NCCN or other national guidelines if applicable; Can also refer to CGC workgroup tables as linked on the homepage if applicable as well as any high impact papers or reviews of gene mutations in this entity. Details on clinical significance such as prognosis and other important information such as concomitant and mutually exclusive mutations 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"
|-
|-
!Gene; Genetic Alteration!!'''Presumed Mechanism (Tumor Suppressor Gene [TSG] / Oncogene / Other)'''!!'''Prevalence (COSMIC /  TCGA / Other)'''!!'''Concomitant Mutations'''!!'''Mutually Exclusive Mutations'''
!Gene!!Genetic Alteration!!Tumor Suppressor Gene, Oncogene, Other!!Prevalence -
!'''Diagnostic Significance (Yes, No or Unknown)'''
Common >20%, Recurrent 5-20% or Rare <5% (Disease)
!Prognostic Significance (Yes, No or Unknown)
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T  
!Therapeutic Significance (Yes, No or Unknown)
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Notes
!Clinical Relevance Details/Other Notes
|-
|-
|<span class="blue-text">EXAMPLE:</span> TP53; Variable LOF mutations
|<span class="blue-text">EXAMPLE:</span>''EGFR''


<span class="blue-text">EXAMPLE:</span>
<br />
 
|<span class="blue-text">EXAMPLE:</span> Exon 18-21 activating mutations
EGFR; Exon 20 mutations
|<span class="blue-text">EXAMPLE:</span> Oncogene
 
|<span class="blue-text">EXAMPLE:</span> Common (lung cancer)
<span class="blue-text">EXAMPLE:</span> BRAF; Activating mutations
|<span class="blue-text">EXAMPLE:</span> T
|<span class="blue-text">EXAMPLE:</span> TSG
|<span class="blue-text">EXAMPLE:</span> Yes (NCCN)
|<span class="blue-text">EXAMPLE:</span> 20% (COSMIC)
|<span class="blue-text">EXAMPLE:</span> Exons 18, 19, and 21 mutations are targetable for therapy. Exon 20 T790M variants cause resistance to first generation TKI therapy and are targetable by second and third generation TKIs (add references).
 
|-
<span class="blue-text">EXAMPLE:</span> 30% (add Reference)
|<span class="blue-text">EXAMPLE:</span> ''TP53''; Variable LOF mutations
|<span class="blue-text">EXAMPLE:</span> IDH1 R123H
<br />
|<span class="blue-text">EXAMPLE:</span> EGFR amplification
|<span class="blue-text">EXAMPLE:</span> Variable LOF mutations
|<span class="blue-text">EXAMPLE:</span> Tumor Supressor Gene
|<span class="blue-text">EXAMPLE:</span> Common (breast cancer)
|<span class="blue-text">EXAMPLE:</span> P
|
|<span class="blue-text">EXAMPLE:</span> >90% are somatic; rare germline alterations associated with Li-Fraumeni syndrome (add reference). Denotes a poor prognosis in breast cancer.
|-
|<span class="blue-text">EXAMPLE:</span> ''BRAF''; Activating mutations
|<span class="blue-text">EXAMPLE:</span> Activating mutations
|<span class="blue-text">EXAMPLE:</span> Oncogene
|<span class="blue-text">EXAMPLE:</span> Common (melanoma)
|<span class="blue-text">EXAMPLE:</span> T
|
|
|-
|
|
|
|
|
|
|
|
|
|
|<span class="blue-text">EXAMPLE:</span>  Excludes hairy cell leukemia (HCL) (add reference).
|}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.
<br />
|}
Note: A more extensive list of mutations can be found in cBioportal (https://www.cbioportal.org/), COSMIC (https://cancer.sanger.ac.uk/cosmic), ICGC (https://dcc.icgc.org/) and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.
 
==Epigenomic Alterations==
==Epigenomic Alterations==


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==Genes and Main Pathways Involved==
==Genes and Main Pathways Involved==


Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Can include references in the table. Do not delete table.'')</span>
 
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Please include references throughout the table. Do not delete the table.)''</span>
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome
!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome
|-
|-
|<span class="blue-text">EXAMPLE:</span> BRAF and MAP2K1; Activating mutations
|<span class="blue-text">EXAMPLE:</span> ''BRAF'' and ''MAP2K1''; Activating mutations
|<span class="blue-text">EXAMPLE:</span> MAPK signaling
|<span class="blue-text">EXAMPLE:</span> MAPK signaling
|<span class="blue-text">EXAMPLE:</span> Increased cell growth and proliferation
|<span class="blue-text">EXAMPLE:</span> Increased cell growth and proliferation
|-
|-
|<span class="blue-text">EXAMPLE:</span> CDKN2A; Inactivating mutations
|<span class="blue-text">EXAMPLE:</span> ''CDKN2A''; Inactivating mutations
|<span class="blue-text">EXAMPLE:</span> Cell cycle regulation
|<span class="blue-text">EXAMPLE:</span> Cell cycle regulation
|<span class="blue-text">EXAMPLE:</span> Unregulated cell division
|<span class="blue-text">EXAMPLE:</span> Unregulated cell division
|-
|-
|<span class="blue-text">EXAMPLE:</span>  KMT2C and ARID1A; Inactivating mutations
|<span class="blue-text">EXAMPLE:</span> ''KMT2C'' and ''ARID1A''; Inactivating mutations
|<span class="blue-text">EXAMPLE:</span>  Histone modification, chromatin remodeling
|<span class="blue-text">EXAMPLE:</span> Histone modification, chromatin remodeling
|<span class="blue-text">EXAMPLE:</span>  Abnormal gene expression program
|<span class="blue-text">EXAMPLE:</span> Abnormal gene expression program
|-
|
|
|
|}
|}


<blockquote class='blockedit'>{{Box-round|title=v4:Genes and Main Pathways Involved|The content below was from the old template. Please incorporate above.}}</blockquote>
<blockquote class="blockedit">{{Box-round|title=v4:Genes and Main Pathways Involved|The content below was from the old template. Please incorporate above.}}</blockquote>


* N/A
*N/A


<blockquote class="blockedit">
<blockquote class="blockedit">
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<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref>{{Cite journal|last=Mrosewski|first=Ingo|last2=Urbank|first2=Matthias|date=2020-01-01|title=Gamma Heavy Chain Disease - Diagnostic Challenges in an Unusual Case and a Brief Synopsis of the Current Literature|url=https://pubmed.ncbi.nlm.nih.gov/32013371|journal=Clinical Laboratory|volume=66|issue=1|doi=10.7754/Clin.Lab.2019.190623|issn=1433-6510|pmid=32013371}}</ref><ref>{{Cite journal|last=Thoren|first=Katie L.|last2=Eveillard|first2=Marion|last3=Chan|first3=Patrick|last4=Doddi|first4=Sital|last5=Cho|first5=Sun|last6=Murata|first6=Kazunori|date=2020-03|title=Identification of gamma heavy chain disease using MALDI-TOF mass spectrometry|url=https://pubmed.ncbi.nlm.nih.gov/31884198|journal=Clinical Biochemistry|volume=77|pages=57–61|doi=10.1016/j.clinbiochem.2019.12.010|issn=1873-2933|pmc=7046309|pmid=31884198}}</ref><ref>{{Cite journal|last=Ho|first=Y. H.|last2=Wang|first2=J. L.|last3=DeLelys|first3=M. E.|last4=Murali|first4=M. R.|last5=Pitman|first5=M. B.|last6=Sohani|first6=A. R.|date=2014-08|title=Gamma heavy chain disease: cytological diagnosis of a rare  lymphoid malignancy facilitated by correlation with key  laboratory findings|url=https://pubmed.ncbi.nlm.nih.gov/25180407|journal=Cytopathology: Official Journal of the British Society for Clinical Cytology|volume=25|issue=4|pages=270–273|doi=10.1111/cyt.12126|issn=1365-2303|pmid=25180407}}</ref><blockquote class="blockedit">
<blockquote class="blockedit">{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref>{{Cite journal|last=Mrosewski|first=Ingo|last2=Urbank|first2=Matthias|date=2020-01-01|title=Gamma Heavy Chain Disease - Diagnostic Challenges in an Unusual Case and a Brief Synopsis of the Current Literature|url=https://pubmed.ncbi.nlm.nih.gov/32013371|journal=Clinical Laboratory|volume=66|issue=1|doi=10.7754/Clin.Lab.2019.190623|issn=1433-6510|pmid=32013371}}</ref><ref>{{Cite journal|last=Thoren|first=Katie L.|last2=Eveillard|first2=Marion|last3=Chan|first3=Patrick|last4=Doddi|first4=Sital|last5=Cho|first5=Sun|last6=Murata|first6=Kazunori|date=2020-03|title=Identification of gamma heavy chain disease using MALDI-TOF mass spectrometry|url=https://pubmed.ncbi.nlm.nih.gov/31884198|journal=Clinical Biochemistry|volume=77|pages=57–61|doi=10.1016/j.clinbiochem.2019.12.010|issn=1873-2933|pmc=7046309|pmid=31884198}}</ref><ref>{{Cite journal|last=Ho|first=Y. H.|last2=Wang|first2=J. L.|last3=DeLelys|first3=M. E.|last4=Murali|first4=M. R.|last5=Pitman|first5=M. B.|last6=Sohani|first6=A. R.|date=2014-08|title=Gamma heavy chain disease: cytological diagnosis of a rare  lymphoid malignancy facilitated by correlation with key  laboratory findings|url=https://pubmed.ncbi.nlm.nih.gov/25180407|journal=Cytopathology: Official Journal of the British Society for Clinical Cytology|volume=25|issue=4|pages=270–273|doi=10.1111/cyt.12126|issn=1365-2303|pmid=25180407}}</ref><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
<center><span style="color:Maroon">'''End of V4 Section'''</span>
----
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<blockquote class='blockedit'>{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":4" /><blockquote class="blockedit">
<blockquote class="blockedit">{{Box-round|title=Unassigned References|The following referenees were placed in the header. Please place them into the appropriate locations in the text.}}</blockquote><ref name=":4" /><blockquote class="blockedit">
<center><span style="color:Maroon">'''End of V4 Section'''</span>
<center><span style="color:Maroon">'''End of V4 Section'''</span>
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==Links==
==Links==


* None
*None


==References==
==References==
(use the "Cite" icon at the top of the page) <span style="color:#0070C0">(''Instructions: Add each reference into the text above by clicking on where you want to insert the reference, selecting the “Cite” icon at the top of the page, and using the “Automatic” tab option to search such as by PMID to select the reference to insert. The reference list in this section will be automatically generated and sorted.''</span> <span style="color:#0070C0">''If a PMID is not available, such as for a book, please use the “Cite” icon, select “Manual” and then “Basic Form”, and include the entire reference''</span><span style="color:#0070C0">''.''</span><span style="color:#0070C0">) </span> <references />
(use the "Cite" icon at the top of the page) <span style="color:#0070C0">(''Instructions: Add each reference into the text above by clicking where you want to insert the reference, selecting the “Cite” icon at the top of the wiki page, and using the “Automatic” tab option to search by PMID to select the reference to insert. If a PMID is not available, such as for a book, please use the “Cite” icon, select “Manual” and then “Basic Form”, and include the entire reference. To insert the same reference again later in the page, select the “Cite” icon and “Re-use” to find the reference; DO NOT insert the same reference twice using the “Automatic” tab as it will be treated as two separate references. The reference list in this section will be automatically generated and sorted''</span><span style="color:#0070C0">''.''</span><span style="color:#0070C0">)</span> <references />


'''
<br />


==Notes==
==Notes==
<nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page.  If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the CCGA coordinators (contact information provided on the homepage)Additional global feedback or concerns are also welcome.
<nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page.  If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the [[Leadership|''<u>Associate Editor</u>'']] or other CCGA representativeWhen pages have a major update, the new author will be acknowledged at the beginning of the page, and those who contributed previously will be acknowledged below as a prior author.
 
Prior Author(s): 
 
       


<nowiki>*</nowiki>''Citation of this Page'': “Gamma heavy chain disease”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/HAEM5:Gamma_heavy_chain_disease</nowiki>.
<nowiki>*</nowiki>''Citation of this Page'': “Gamma heavy chain disease”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/HAEM5:Gamma_heavy_chain_disease</nowiki>.
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*No sequencing data is available till date.
*No sequencing data is available till date.


[[Category:HAEM5]][[Category:DISEASE]][[Category:Diseases G]]
[[Category:HAEM5]]
[[Category:DISEASE]]
[[Category:Diseases G]]
<references />