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The genomic landscape of juvenile myelomonocytic leukemia.


ABSTRACT: Juvenile myelomonocytic leukemia (JMML) is a myeloproliferative neoplasm (MPN) of childhood with a poor prognosis. Mutations in NF1, NRAS, KRAS, PTPN11 or CBL occur in 85% of patients, yet there are currently no risk stratification algorithms capable of predicting which patients will be refractory to conventional treatment and could therefore be candidates for experimental therapies. In addition, few molecular pathways aside from the RAS-MAPK pathway have been identified that could serve as the basis for such novel therapeutic strategies. We therefore sought to genomically characterize serial samples from patients at diagnosis through relapse and transformation to acute myeloid leukemia to expand knowledge of the mutational spectrum in JMML. We identified recurrent mutations in genes involved in signal transduction, splicing, Polycomb repressive complex 2 (PRC2) and transcription. Notably, the number of somatic alterations present at diagnosis appears to be the major determinant of outcome.

SUBMITTER: Stieglitz E 

PROVIDER: S-EPMC4626387 | biostudies-literature | 2015 Nov

REPOSITORIES: biostudies-literature

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The genomic landscape of juvenile myelomonocytic leukemia.

Stieglitz Elliot E   Taylor-Weiner Amaro N AN   Chang Tiffany Y TY   Gelston Laura C LC   Wang Yong-Dong YD   Mazor Tali T   Esquivel Emilio E   Yu Ariel A   Seepo Sara S   Olsen Scott S   Rosenberg Mara M   Archambeault Sophie L SL   Abusin Ghada G   Beckman Kyle K   Brown Patrick A PA   Briones Michael M   Carcamo Benjamin B   Cooper Todd T   Dahl Gary V GV   Emanuel Peter D PD   Fluchel Mark N MN   Goyal Rakesh K RK   Hayashi Robert J RJ   Hitzler Johann J   Hugge Christopher C   Liu Y Lucy YL   Messinger Yoav H YH   Mahoney Donald H DH   Monteleone Philip P   Nemecek Eneida R ER   Roehrs Philip A PA   Schore Reuven J RJ   Stine Kimo C KC   Takemoto Clifford M CM   Toretsky Jeffrey A JA   Costello Joseph F JF   Olshen Adam B AB   Stewart Chip C   Li Yongjin Y   Ma Jing J   Gerbing Robert B RB   Alonzo Todd A TA   Getz Gad G   Gruber Tanja T   Golub Todd T   Stegmaier Kimberly K   Loh Mignon L ML  

Nature genetics 20151012 11


Juvenile myelomonocytic leukemia (JMML) is a myeloproliferative neoplasm (MPN) of childhood with a poor prognosis. Mutations in NF1, NRAS, KRAS, PTPN11 or CBL occur in 85% of patients, yet there are currently no risk stratification algorithms capable of predicting which patients will be refractory to conventional treatment and could therefore be candidates for experimental therapies. In addition, few molecular pathways aside from the RAS-MAPK pathway have been identified that could serve as the  ...[more]

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