Implementation of an NGS-based sequencing and gene fusion panel for clinical screening of patients with suspected hematologic malignancies.


Journal

European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 18 03 2019
revised: 27 05 2019
accepted: 03 06 2019
pubmed: 10 6 2019
medline: 25 1 2020
entrez: 10 6 2019
Statut: ppublish

Résumé

The diagnosis of hematologic malignancies integrates multiple diagnostic and clinical disciplines. Historically, targeted (single-analyte) genetic testing has been used as reflex to initial prescreening by other diagnostic modalities including flow cytometry, anatomic pathology, and clinical cytogenetics. Given the wide range of mutations associated with hematologic malignancies a DNA/RNA-based NGS panel can provide a more effective and economical approach to comprehensive testing of patients as an initial, tier-1 screen. Using a cohort of 380 patients, we performed clinical validation of a gene panel designed to assess 40 genes (DNA), and 29 fusion driver genes with over 600 gene fusion partners (RNA), including sample exchange data across three clinical laboratories, and correlation with cytogenetic testing results. The clinical validation of this technology demonstrated that its accuracy, sensitivity, and specificity are comparable to the majority of targeted single-gene approaches, while assessment of the initial patient cohort data demonstrated a high diagnostic yield of 50.5%. Implementation of a tier-1 NGS-based protocol for gene panel screening provides a comprehensive alternative to targeted molecular testing in patients with suspected hematologic malignancies, with increased diagnostic yield, scalability, reproducibility, and cost effectiveness, making it ideally suited for implementation in clinical laboratories.

Identifiants

pubmed: 31177553
doi: 10.1111/ejh.13272
doi:

Substances chimiques

Biomarkers, Tumor 0
Oncogene Proteins, Fusion 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

178-189

Subventions

Organisme : London Health Sciences Centre Pathology and Laboratory Medicine Research and Innovation Fund

Informations de copyright

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

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Auteurs

Michael A Levy (MA)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Stephanie Santos (S)

Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Jennifer Kerkhof (J)

Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Alan Stuart (A)

Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Erfan Aref-Eshghi (E)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Fen Guo (F)

Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Ben Hedley (B)

Pathology and Laboratory Medicine, London Health Sciences Centre, London, Ontario, Canada.

Henry Wong (H)

Clinical Laboratories, Kingston Health Sciences Centre, Kingston, Ontario, Canada.

Michael Rauh (M)

Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.

Harriet Feilotter (H)

Department of Pathology and Molecular Medicine, Queen's University, Kingston, Ontario, Canada.
Molecular Diagnostics, Kingston Health Sciences Centre, Kingston, Ontario, Canada.

Philip Berardi (P)

University of Ottawa, Ottawa, Ontario, Canada.
Eastern Ontario Regional Laboratory Association (EORLA), The Ottawa Hospital, Ottawa, Ontario, Canada.

Laura Semenuk (L)

DNA Diagnostics & Cytogenetics Laboratory, Kingston Health Sciences Centre, Kingston, Ontario, Canada.

Ping Yang (P)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Cytogenetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Joan Knoll (J)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Peter Ainsworth (P)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.
Department of Biochemistry, Western University, London, Ontario, Canada.

Catherine Meg McLachlin (CM)

Department of Pathology, London Health Sciences Centre, London, Ontario, Canada.

Ian Chin-Yee (I)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.

Michael Kovacs (M)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.

Uday Deotare (U)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Departments of Medicine and Oncology, London Health Sciences Centre, London, Ontario, Canada.

Alejandro Lazo-Langner (A)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.
Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.

Cyrus Hsia (C)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.

Mike Keeney (M)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.

Anargyros Xenocostas (A)

Hematology Division, London Health Sciences Centre, London, Ontario, Canada.
Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Christopher Howlett (C)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Hanxin Lin (H)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

Bekim Sadikovic (B)

Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.
Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada.

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