De novo childhood myelodysplastic/myeloproliferative disease with unique molecular characteristics

Olfat Ismael, Akira Shimada, Asahito Hama, Momen Elshazley, Hideki Muramatsu, Aya Goto, Hirotoshi Sakaguchi, Makito Tanaka, Yoshiyuki Takahashi, Xu Yinyan, Minoru Fukuda, Yuji Miyajima, Yuka Yamashita, Keizo Horibe, Ryoji Hanada, Masafumi Ito, Seiji Kojima

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Myelodysplastic/myeloproliferative uclassifiable (MDS/MPN-U) is a rare myeloid neoplasm characterized by myelodysplasia and myeloproliferation at the time of initial presentation, which is usually a diagnosis of exclusion. The molecular pathogenesis of MDS/MPN-U patients remains to be elucidated. Among five patients diagnosed with MDS/MPN-U, three patients harboured RUNX1 (AML1) mutations; one carried somatic mosaicism of RUNX1 mutation with JAK2V617F mutation and one had dual RUNX1 and FLT3-internal tandem duplication mutations with progression to acute myeloid leukaemia (AML). Germline mutation of TP53 was detected as a sole genetic lesion in one patient. JAK2V617F and somatic mosaicism of KRAS and TET2 mutations co-existed in one patient. Otherwise, no alterations were detected in PTPN11, NRAS, CBL and ASXL1 genes. ETV6-PDGFRB fusion transcript was not detected in all patients. Four patients recieved haematopoietic stem cell transplantation (HSCT); three patients relapsed and one achieved complete remission after three donor lymphocyte infusions. Our findings suggest that the mutational spectrum observed in childhood MDS/MPN-U is quite different from that seen in juvenile myelomonocytic leukaemia and, to some extent, resemble chronic myelomonocytic leukaemia. Moreover, two patients had constitutional alterations of genes frequently found in AML. Further investigations are required to define the roles of these genetic alterations in the pathogenesis of childhood MDS/MPN-U.

Original languageEnglish
Pages (from-to)129-137
Number of pages9
JournalBritish Journal of Haematology
Volume158
Issue number1
DOIs
Publication statusPublished - Jul 2012
Externally publishedYes

Keywords

  • JAK2
  • MDS/MPN-U
  • RUNX1
  • TET2
  • TP53

ASJC Scopus subject areas

  • Hematology

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