Genomic landscape of pediatric B-other acute lymphoblastic leukemia in a consecutive European cohort.

Haematologica 2019 07 10;104(7):1396-1406. Epub 2019 Jan 10.

CLIP - Childhood Leukaemia Investigation Prague

Novel biological subtypes and clinically important genetic aberrations (druggable lesions, prognostic factors) have been described in B-other acute lymphoblastic leukemia (ALL) during the last decade; however, due to a lack of studies on unselected cohorts, their population frequency and mutual associations still have to be established. We studied 110 consecutively diagnosed and uniformly treated childhood B-other patients using single nucleotide polymorphism arrays and whole exome/transcriptome sequencing. The frequency of -rearranged, -like, -rearranged, -like, iAMP21 and -rearranged subtypes was 27%, 15%, 5%, 5%, 4%, and 2%, respectively; 43% of cases were not classified into any of these subtypes (B-rest). We found worse early response to treatment in -rearranged leukemia and a strong association of -rearranged leukemia with B-myeloid immunophenotype. Of the druggable lesions, JAK/STAT-class and RAS/RAF/MAPK-class aberrations were found in 21% and 43% of patients, respectively; an ABL-class aberration was found in one patient. A recently described negative prognostic factor, , was found in 14% of patients and was enriched in (but not exclusive for) -like subtype. fusions (including 4 novel), intragenic amplifications and P80R mutations were mutually exclusive and only occurred in the B-rest subset, altogether accounting for 20% of the B-other group. P80R was associated with a specific gene expression signature, potentially defining a novel leukemia subtype. Our study shows unbiased European population-based frequencies of novel ALL subtypes, recurrent (cyto)genetic aberrations and their mutual associations. This study also strengthens and widens the current knowledge of B-other ALL and provides an objective basis for optimization of current genetic diagnostics.

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Source
http://www.haematologica.org/lookup/doi/10.3324/haematol.201
Publisher Site
http://dx.doi.org/10.3324/haematol.2018.204974DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601078PMC
July 2019
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