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VDJ-Seq: Deep Sequencing Analysis of Rearranged Immunoglobulin Heavy Chain Gene to Reveal Clonal Evolution Patterns of B Cell Lymphoma
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Clonal evolution in therapy-related neoplasms.

Emiliano Fabiani1,2, Giulia Falconi1,2, Luana Fianchi2

  • 1Department of Biomedicine and Prevention, Universita' Tor Vergata, Rome, Italy.

Oncotarget
|January 12, 2017
PubMed
Summary

Somatic mutations in therapy-related myeloid neoplasms (t-MN) can emerge before cytotoxic therapy, indicating heterogeneous clonal evolution. Some mutations may predate treatment, potentially influencing leukemic development in susceptible individuals.

Keywords:
NGSclonal evolutionmutationtherapy-related neoplasms

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Area of Science:

  • Hematology
  • Oncology
  • Genetics

Background:

  • Therapy-related myeloid neoplasms (t-MN) are late complications of cytotoxic therapy.
  • Understanding the genetic basis of t-MN development is crucial for predicting outcomes.

Purpose of the Study:

  • To investigate the development and timing of somatic mutations in therapy-related myeloid neoplasms.
  • To explore the clonal evolution preceding secondary leukemia in patients treated for primary hematologic malignancies.

Main Methods:

  • Sanger sequencing and next-generation sequencing (NGS) were used to identify mutations in t-MN patients.
  • Pyrosequencing and low-frequency NGS detected mutations in pre-leukemic bone marrow samples.

Main Results:

  • Eight distinct mutations were identified in 54% of t-MN patients.
  • Somatic mutations were detectable in bone marrow prior to cytotoxic treatment in three patients.
  • The t-acute lymphoblastic leukemia patient had a KMT2A/AFF1 fusion gene.

Conclusions:

  • Clonal evolution in t-MN is heterogeneous.
  • Some somatic mutations may precede cytotoxic therapy and contribute to leukemogenesis.
  • Further research is needed to understand the role of pre-existing mutations in t-MN development.