Measurable residual disease analysis in paediatric acute lymphoblastic leukaemia patients with ABL-class fusions.


Journal

British journal of cancer
ISSN: 1532-1827
Titre abrégé: Br J Cancer
Pays: England
ID NLM: 0370635

Informations de publication

Date de publication:
09 2022
Historique:
received: 17 09 2021
accepted: 25 03 2022
revised: 12 03 2022
pubmed: 2 6 2022
medline: 3 9 2022
entrez: 1 6 2022
Statut: ppublish

Résumé

ABL-class fusions including NUP214-ABL1 and EBF1-PDGFRB occur in high risk acute lymphoblastic leukaemia (ALL) with gene expression patterns similar to BCR-ABL-positive ALL. Our aim was to evaluate new DNA-based measurable residual disease (MRD) tests detecting these fusions and IKZF1-deletions in comparison with conventional immunoglobulin/T-cell receptor (Ig/TCR) markers. Precise genomic breakpoints were defined from targeted or whole genome next generation sequencing for ABL-fusions and BCR-ABL1. Quantitative PCR assays were designed and used to re-measure MRD in remission bone marrow samples previously tested using Ig/TCR markers. All MRD testing complied with EuroMRD guidelines. ABL-class patients had 46% 5year event-free survival and 79% 5year overall survival. All had sensitive fusion tests giving high concordance between Ig/TCR and ABL-class fusion results (21 patients, n = 257 samples, r2 = 0.9786, P < 0.0001) and Ig/TCR and IKZF1-deletion results (9 patients, n = 143 samples, r2 = 0.9661, P < 0.0001). In contrast, in BCR-ABL1 patients, Ig/TCR and BCR-ABL1 tests were discordant in 32% (40 patients, n = 346 samples, r2 = 0.4703, P < 0.0001) and IKZF1-deletion results were closer to Ig/TCR (25 patients, n = 176, r2 = 0.8631, P < 0.0001). MRD monitoring based on patient-specific assays detecting gene fusions or recurrent assays for IKZF1-deletions is feasible and provides good alternatives to Ig/TCR tests to monitor MRD in ABL-class ALL.

Sections du résumé

BACKGROUND
ABL-class fusions including NUP214-ABL1 and EBF1-PDGFRB occur in high risk acute lymphoblastic leukaemia (ALL) with gene expression patterns similar to BCR-ABL-positive ALL. Our aim was to evaluate new DNA-based measurable residual disease (MRD) tests detecting these fusions and IKZF1-deletions in comparison with conventional immunoglobulin/T-cell receptor (Ig/TCR) markers.
METHODS
Precise genomic breakpoints were defined from targeted or whole genome next generation sequencing for ABL-fusions and BCR-ABL1. Quantitative PCR assays were designed and used to re-measure MRD in remission bone marrow samples previously tested using Ig/TCR markers. All MRD testing complied with EuroMRD guidelines.
RESULTS
ABL-class patients had 46% 5year event-free survival and 79% 5year overall survival. All had sensitive fusion tests giving high concordance between Ig/TCR and ABL-class fusion results (21 patients, n = 257 samples, r2 = 0.9786, P < 0.0001) and Ig/TCR and IKZF1-deletion results (9 patients, n = 143 samples, r2 = 0.9661, P < 0.0001). In contrast, in BCR-ABL1 patients, Ig/TCR and BCR-ABL1 tests were discordant in 32% (40 patients, n = 346 samples, r2 = 0.4703, P < 0.0001) and IKZF1-deletion results were closer to Ig/TCR (25 patients, n = 176, r2 = 0.8631, P < 0.0001).
CONCLUSIONS
MRD monitoring based on patient-specific assays detecting gene fusions or recurrent assays for IKZF1-deletions is feasible and provides good alternatives to Ig/TCR tests to monitor MRD in ABL-class ALL.

Identifiants

pubmed: 35650277
doi: 10.1038/s41416-022-01806-6
pii: 10.1038/s41416-022-01806-6
pmc: PMC9427854
doi:

Substances chimiques

Immunoglobulins 0
Receptors, Antigen, T-Cell 0
Fusion Proteins, bcr-abl EC 2.7.10.2

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

908-915

Informations de copyright

© 2022. The Author(s).

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Auteurs

Nicola C Venn (NC)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Libby Huang (L)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Lenka Hovorková (L)

Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
CLIP-Childhood Leukaemia Investigation Prague, Prague, Czech Republic.

Walter Muskovic (W)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Marie Wong (M)

Computational Biology, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Tamara Law (T)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Susan L Heatley (SL)

Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
School of Medicine, University of Adelaide, Adelaide, SA, Australia.

Seong Lin Khaw (SL)

Children's Cancer Centre, The Royal Children's Hospital, Melbourne, VIC, Australia.

Tom Revesz (T)

School of Medicine, University of Adelaide, Adelaide, SA, Australia.
Department of Clinical Haematology and Oncology, Women's and Children's Hospital, Adelaide, SA, Australia.

Luciano Dalla Pozza (L)

Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia.

Peter J Shaw (PJ)

Cancer Centre for Children, The Children's Hospital at Westmead, Sydney, NSW, Australia.

Chris Fraser (C)

Blood and Bone Marrow Transplant Program, Queensland Children's Hospital, Brisbane, QLD, Australia.

Andrew S Moore (AS)

Paediatric Oncology, Queensland Children's Hospital, Brisbane, QLD, Australia.

Siobhan Cross (S)

Children's Haematology/Oncology Centre Christchurch Hospital, Christchurch, New Zealand.

Katerina Bendak (K)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.

Murray D Norris (MD)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.

Michelle J Henderson (MJ)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.

Deborah L White (DL)

Precision Medicine Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
School of Medicine, University of Adelaide, Adelaide, SA, Australia.

Mark J Cowley (MJ)

Computational Biology, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.

Toby N Trahair (TN)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia.
Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia.

Jan Zuna (J)

Department of Paediatric Haematology and Oncology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
CLIP-Childhood Leukaemia Investigation Prague, Prague, Czech Republic.
University Hospital Motol, Prague, Czech Republic.

Rosemary Sutton (R)

Molecular Diagnostics, Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia. rsutton@ccia.unsw.edu.au.
School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia. rsutton@ccia.unsw.edu.au.

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