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Burkitt lymphoma in a patient with Kabuki syndrome carrying a novel KMT2D mutation
Emmanuel de Billy1, Luisa Strocchio1, Antonella Cacchione1
1Department of Pediatric Hematology/Oncology and Cellular and Gene Therapy, Bambino Gesù Children's Hospital, Rome, Italy.
Abstract:
Kabuki syndrome (KS) is an extremely rare genetic disorder, mainly caused by germline mutations at specific epigenetic modifier genes, including KMT2D. Because the tumor suppressor gene KMT2D is also frequently altered in many cancer types, it has been suggested that KS may predispose to the development of cancer. However, KS being a rare disorder, few data are available on the incidence of cancer in KS patients. Here, we report the case of a 5-year-old boy affected by KS who developed Burkitt lymphoma (BL). Genetic analysis revealed the presence of a novel heterozygous mutation in the splice site of the intron 4 of KMT2D gene in both peripheral blood-extracted DNA and tumour cells. In addition, the tumour sample of the patient was positive for the classical somatic chromosomal translocation t(8;14) involving the c-MYC gene frequently identified in BL. We propose that the mutated KMT2D gene contributes to the development of both KS and BL observed in our patient and we suggest that strict surveillance must be performed in KS patients.
Insights
Kabuki syndrome patients may have an increased risk of developing cancer, specifically Burkitt lymphoma. This rare genetic disorder involves KMT2D gene mutations, which may also contribute to cancer development, warranting close patient monitoring.
Area of Science:
- Genetics
- Oncology
- Pediatrics
Background:
- Kabuki syndrome (KS) is a rare genetic disorder caused by mutations in epigenetic modifier genes, notably KMT2D.
- The KMT2D gene, also a tumor suppressor, is frequently altered in various cancers, suggesting a potential link between KS and cancer predisposition.
Observation:
- A 5-year-old boy with Kabuki syndrome developed Burkitt lymphoma (BL).
- Genetic analysis identified a novel heterozygous KMT2D gene mutation in both the patient's blood and tumor cells.
- The patient's tumor exhibited the characteristic t(8;14) chromosomal translocation involving the c-MYC gene, common in BL.
Findings:
- A novel KMT2D mutation was found in a Kabuki syndrome patient who developed Burkitt lymphoma.
- The KMT2D mutation and the c-MYC translocation were present in the patient's tumor, suggesting a potential role in lymphomagenesis.
Implications:
- The study suggests a possible contribution of mutated KMT2D to the development of both Kabuki syndrome and Burkitt lymphoma.
- Close cancer surveillance is recommended for patients diagnosed with Kabuki syndrome due to potential predisposition.
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