Mutational spectrum analysis of chronic myelomonocytic leukemia includes genes associated with epigenetic regulation: UTX, EZH2, and DNMT3A

Blood. 2011 Oct 6;118(14):3932-41. doi: 10.1182/blood-2010-10-311019. Epub 2011 Aug 9.

Abstract

Chronic myelomonocytic leukemia (CMML), a myelodysplastic/myeloproliferative neoplasm, is characterized by monocytic proliferation, dysplasia, and progression to acute myeloid leukemia. CMML has been associated with somatic mutations in diverse recently identified genes. We analyzed 72 well-characterized patients with CMML (N = 52) and CMML-derived acute myeloid leukemia (N = 20) for recurrent chromosomal abnormalities with the use of routine cytogenetics and single nucleotide polymorphism arrays along with comprehensive mutational screening. Cytogenetic aberrations were present in 46% of cases, whereas single nucleotide polymorphism array increased the diagnostic yield to 60%. At least 1 mutation was found in 86% of all cases; novel UTX, DNMT3A, and EZH2 mutations were found in 8%, 10%, and 5.5% of patients, respectively. TET2 mutations were present in 49%, ASXL1 in 43%, CBL in 14%, IDH1/2 in 4%, KRAS in 7%, NRAS in 4%, and JAK2 V617F in 1% of patients. Various mutant genotype combinations were observed, indicating molecular heterogeneity in CMML. Our results suggest that molecular defects affecting distinct pathways can lead to similar clinical phenotypes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chromosome Aberrations
  • DNA (Cytosine-5-)-Methyltransferases / genetics*
  • DNA Methyltransferase 3A
  • DNA Mutational Analysis
  • DNA-Binding Proteins / genetics*
  • Enhancer of Zeste Homolog 2 Protein
  • Female
  • Gene Expression Regulation, Leukemic*
  • Histone Demethylases / genetics*
  • Humans
  • Leukemia, Myelomonocytic, Chronic / epidemiology
  • Leukemia, Myelomonocytic, Chronic / genetics*
  • Male
  • Middle Aged
  • Mutation*
  • Nuclear Proteins / genetics*
  • Polycomb Repressive Complex 2
  • Survival Analysis
  • Transcription Factors / genetics*

Substances

  • DNA-Binding Proteins
  • DNMT3A protein, human
  • Nuclear Proteins
  • Transcription Factors
  • Histone Demethylases
  • KDM6A protein, human
  • DNA (Cytosine-5-)-Methyltransferases
  • DNA Methyltransferase 3A
  • EZH2 protein, human
  • Enhancer of Zeste Homolog 2 Protein
  • Polycomb Repressive Complex 2