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Updated: Jul 6, 2025

Next Generation Sequencing for the Detection of Actionable Mutations in Solid and Liquid Tumors
Published on: September 20, 2016
EPAS1-mutated paragangliomas associated with haemoglobin disorders
Maxence Mancini1, Alexandre Buffet1,2, Baptiste Porte1
1Université Paris Cité, Inserm, Paris Centre de Recherche Cardiovasculaire (PARCC), Equipe Labellisée Ligue contre le Cancer, Paris, France.
Patients with EPAS1-mutated paraganglioma (PGL) often have chronic hypoxia, with many showing haemoglobin disorders like sickle cell disease. This suggests sickle cell trait carriers may face higher EPAS1-PGL risks, impacting surveillance strategies.
Area of Science:
- Endocrinology
- Oncology
- Genetics
Background:
- EPAS1 gene mutations are linked to paraganglioma (PGL).
- Chronic hypoxia is a potential underlying factor in PGL development.
- Hemoglobinopathies, including sickle cell disease, are common in certain populations.
Purpose of the Study:
- To investigate the prevalence of chronic hypoxia causes in patients with EPAS1-mutated PGL.
- To explore the association between hemoglobin disorders and EPAS1-PGL.
- To characterize the histological and transcriptomic features of EPAS1-PGL.
Main Methods:
- Retrospective analysis of 40 patients with EPAS1-mutated PGL.
- Assessment for chronic hypoxia, including hypoxemic heart disease.
- Hemoglobin electrophoresis to identify hemoglobin disorders.
- Histological and transcriptomic analysis of tumor samples.
Main Results:
- Four patients had hypoxemic heart disease.
- 59% of patients with available results had a hemoglobin disorder (sickle cell disease, sickle cell trait, hemoglobin C disease).
- EPAS1 tumors showed increased angiogenesis and resembled VHL-mutated PGLs.
Conclusions:
- Sickle hemoglobinopathy carriers may have an increased risk of developing EPAS1-PGL.
- These findings necessitate consideration in the management and surveillance of patients with EPAS1-PGL and hemoglobin disorders.
- EPAS1-PGLs share similarities with pseudohypoxic PGLs, suggesting common underlying pathways.
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