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  • 1
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 2382-2382
    Abstract: Recent data indicate that mutations in exon 12 of the nucleophosmin (NPM1) gene characterize a distinct subgroup of adult and pediatric acute myeloid leukemia (AML). AML carrying NPM1 mutations account for about one-third of all adult AML, exhibit distinctive biological and clinical features and show a strong association to AML with normal karyotype (55% mutated). However, the role of NPM1 in leukemogenesis still remains elusive. Here we present data on a cohort of n=66 AML cases with normal karyotype analyzed by high-density whole genome expression microarrays (Affymetrix HG-U133 Plus 2.0). In parallel melting curve analysis was used to assess NPM1 mutational status: 41 cases were characterized as mutated (NPM1+) and 25 cases were unmutated (NPM1−). We first investigated the gene signature that discriminated NPM1+ from NPM1− cases. Genes that were significantly overexpressed comparing NPM1+ against NPM1– cases included a strong homeobox genes signature (HOXA1, HOXA5, HOXA7, HOXA9, HOXA10, HOXA11, HOXB2, HOXB4, HOXB5, HOXB6, HOXB7, MEIS1, and PBX3). A functional analysis (Gene Ontology) revealed a clear association of the group of overexpressed genes with the cell components nucleosome, chromatin, and the nuclear envelope-endoplasmatic reticulum network as well as involvement in the biological processes of nucleosome and chromatin assembly, establishment of protein transport and localization, and Notch signaling pathway. In contrast, the cellular processes completely differed when genes were investigated that were significantly underexpressed in NPM1+ cases compared to NPM1− cases. This group of genes encoded membrane-related proteins (gap junction, intercellular junction, signalosome complex) and proteins involved in cellular morphogenesis and cell communication. The differences in gene expression signatures between NPM1+ and NPM1− cases permit a robust classification approach by gene expression profiling. Support Vector Machine analysis resulted in & gt;92% prediction accuracy of NPM1 mutation status (10-fold cross-validation). The sensitivity was very high for the positive detection of NPM1+ cases ( & gt;97%). Using a 100-fold re-sampling approach and splitting the complete data set into a training set (n=44) and testing set (n=22) the following genes were most frequently selected as top discriminatory genes: HOXA5, HOXB4, HOXB5, HOXB6, MEIS1, PBX3, FGFR1, ADAM17, PRICKLE1, and TMPO. Interestingly, the classification was less accurate when also FLT3 internal tandem duplication mutation status was taken into account. The study cohort (n=66) then was distributed as follows: 19 NPM1+/FLT3+, 22 NPM1+/FLT3−, 4 NPM1−/FLT3+, and 21 NPM1−/FLT3− negative cases. Only 14 of 22 (64%) NPM1+/FLT3– cases were correctly predicted, with miscalls falling both into the group of NPM1+/FLT3+ and NPM1−/FLT3− cases. In conclusion, NPM1 mutations are the most frequent mutations in adult AML to date and their central prognostic role is increasingly recognized. Given the fact that they are nearly mutually exclusive with major recurrent genetic abnormalities and that they can be characterized by a distinctive gene expression program these data especially for of NPM1+/FLT3− AML with better outcome may support to classify this as a separate biological subgroup of AML with normal karyotype.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
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  • 2
    In: Blood, American Society of Hematology, Vol. 118, No. 23 ( 2011-12-01), p. 6153-6163
    Abstract: Among acute myeloid leukemia (AML) patients with a normal karyotype (CN-AML), NPM1 and CEBPA mutations define World Health Organization 2008 provisional entities accounting for approximately 60% of patients, but the remaining 40% are molecularly poorly characterized. Using whole-exome sequencing of one CN-AML patient lacking mutations in NPM1, CEBPA, FLT3-ITD, IDH1, and MLL-PTD, we newly identified a clonal somatic mutation in BCOR (BCL6 corepressor), a gene located on chromosome Xp11.4. Further analyses of 553 AML patients showed that BCOR mutations occurred in 3.8% of unselected CN-AML patients and represented a substantial fraction (17.1%) of CN-AML patients showing the same genotype as the AML index patient subjected to whole-exome sequencing. BCOR somatic mutations were: (1) disruptive events similar to the germline BCOR mutations causing the oculo-facio-cardio-dental genetic syndrome; (2) associated with decreased BCOR mRNA levels, absence of full-length BCOR, and absent or low expression of a truncated BCOR protein; (3) virtually mutually exclusive with NPM1 mutations; and (4) frequently associated with DNMT3A mutations, suggesting cooperativity among these genetic alterations. Finally, BCOR mutations tended to be associated with an inferior outcome in a cohort of 422 CN-AML patients (25.6% vs 56.7% overall survival at 2 years; P = .032). Our results for the first time implicate BCOR in CN-AML pathogenesis.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2011
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  • 3
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 144-144
    Abstract: Abstract 144 PicoTiterPlate (PTP) pyrosequencing allows the detection of low-abundance oncogene aberrations in complex samples even with low tumor content. Here, we compared deep sequencing data of two Next-Generation Sequencing (NGS) assays to detect molecular mutations using a PCR-based strategy and, in addition, to uncover inversions, translocations, and insertions in a targeted sequence enrichment workflow (454 Life Sciences, Roche Diagnostics Corporation, Branford, CT). First, we studied 95 patients (CMML, n=81; AML, n=6; MDS, n=3; MPS, n=3; ET, n=2) using the amplicon approach and investigated seven candidate genes with relevance in oncogenesis of myeloid malignancies: TET2, RUNX1, JAK2, MPL, KRAS, NRAS, and CBL. 43 primer pairs were designed to cover the complete coding regions of TET2, RUNX1 (beta isoform), and hotspot regions of the latter genes. In total, 4128 individual PCR reactions were performed with DNA isolated from bone marrow mononuclear cells, followed by product purification, fluorometric quantitation, and equimolar pooling of the corresponding 43 amplicon products to generate one single sequence library per patient. For sequencing, a 454 8-lane PTP was used applying standard FLX chemistry and representing one patient per lane. The median number of base pairs sequenced per patient was 9.23 Mb. For each amplicon a median of 840 reads was generated (coverage range: 485–1929 reads). As initial proof-of-concept analysis 27 of the 95 patients with known mutations (n=32) as detected by conventional sequencing or melting curve analyses were investigated (range of cells carrying the respective mutation: 1.1% for JAK2 V617F to 98.14% for TET2 C1464X). In all cases, 454 NGS confirmed results from routine diagnostic methods (GS Amplicon Variant Analyzer software version 2.0.01). We then investigated the remaining 69 CMML patients: In median, 2 variances (range 1–8 variances), i.e. differences in comparison to the reference sequence, per patient were detected. These variances included both point mutations in all candidate genes and large deletions (12-19 bp) in CBL, RUNX1, and TET2. Only 20/81 patients of the CMML-cohort (24.69%) were without any detectable mutation. Secondly, in a cohort of six AML bone marrow specimens a custom NimbleGen array (385K format; Madison, WI) was used to perform a targeted DNA sequence enrichment procedure. In total, capture probes spanning 1.91 Mb were designed to represent all coding regions of 92 target genes (1559 exons) with relevance in hematological malignancies (e.g. KIT, NF1, TP53, BCR, ABL1, NPM1, or FLT3). In addition, the complete genomic regions were targeted for RUNX1, CBFB, and MLL. For sequencing, 454 Titanium chemistry was applied, loading three patients per lane on a 2-lane PTP including three molecular identifiers (MIDs) each. Data analysis was performed using the GS Reference Mapper software version 2.0.01. For the enrichment assay, the median enrichment of the targeted genomic loci was 207-fold, as assessed by ligation-mediated LM-PCR. Overall, 1,098,132 reads were generated in the two lanes, yielding a total sequence length of 386,097,740 bases. In median, 96.52% of the sequenced bases mapped against the human genome, and 66.0% were derived from the customized NimbleGen array capture probes, resulting in a median coverage of 18.7-fold . With this method it was possible to detect and confirm point mutations (KIT, FLT3-TKD, and KRAS) and insertions (FLT3-ITD). Moreover, by capturing chimeric DNA fragments and generating reads mapping to both fusion partners this approach detected balanced aberrations, i.e. inv(16)(p13q22) and the translocations t(8;21)(q22;q22) or t(9;11)(p22;q23). In conclusion, both assays to specifically sequence targeted regions with oncogenic relevance on a NGS platform demonstrated promising results and are feasible. The amplicon approach is more suitable for detection of mutations in a routine setting and is ideally suited for large genes such as TET2, ATM, and NF1, which are labor-intensive to sequence conventionally. The array-based capturing assay is characterized by a complex and time-consuming workflow with low-throughput. However, the ability to detect balanced genomic aberrations which are detectable thus far only by cytogenetics and FISH has the potential to become an important diagnostic assay, especially in tumors in which cytogenetics can not be applied successfully. Disclosures: Grossmann: MLL Munich Leukemia Laboratory: Employment. Kohlmann:MLL Munich Leukemia Laboratory: Employment. Haferlach:MLL Munich Leukemia Laboratory: Equity Ownership. Dicker:MLL Munich Leukemia Laboratory: Employment. Kazak:MLL Munich Leukemia Laboratory: Employment. Schindela:MLL Munich Leukemia Laboratory: Employment. Schnittger:MLL Munich Leukemia Laboratory: Equity Ownership. Kern:MLL Munich Leukemia Laboratory: Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Equity Ownership.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 4
    In: Blood, American Society of Hematology, Vol. 116, No. 21 ( 2010-11-19), p. 175-175
    Abstract: Abstract 175 Acute myeloid leukemia (AML) is a heterogeneous disease and based on cytogenetic stratification AML with a normal karyotype (AML-NK) is an intermediate-risk group. In recent years the detection of novel molecular mutations allowed to further stratify AML-NK into different prognostic subgroups. However, thus far still in a subset of AML-NK no recurrent mutations have been identified. In order to detect novel recurrent mutations we performed DNA sequence enrichment from complex genomic samples using microarrays to enable a targeted Next-Generation Sequencing (NGS) analysis. We combined 454 PicoTiterPlate (PTP) pyrosequencing with long-oligonucleotide sequence capture arrays to apply this technique for the comprehensive molecular genetic characterization of AML-NK. 6 bone marrow specimens from untreated de novo AML patients at diagnosis were analyzed (n=4 AML-NOS; n=2 AML-MRC according to WHO classification). All cases were shown to be negative for the most frequent mutations in FLT3 (both internal tandem duplication and tyrosine kinase domain), MLL partial tandem duplication, NPM1, and CEBPA. A custom 1.91 Mb microarray was designed to contain capture probes for all coding regions of 95 genes, in total 1608 exons (NimbleGen 385K format; Madison, WI). These 95 target genes had been selected according to their relevance in leukemogenic pathways, i.e. cell cycle control, cell proliferation and differentiation, multidrug resistance, growth factor receptors, oncogenes, tumor suppressors, and homeobox genes. Starting with 20 μ g of genomic DNA, this array design allowed a median 294-fold DNA enrichment of these targeted genomic loci, as assessed by ligation-mediated LM-PCR. Three patients per lane were sequenced on a 2-lane PTP using the large volume Titanium chemistry assay (454 Life Sciences, Branford, CT). Each case was tagged by a molecular 10-base barcode. Overall, 1,070,724 reads with a median length of 352 bp were generated in the two lanes (GS Reference Mapper software version 2.3). In median, 72.3% on-target bases were derived from the capture array probes, resulting in a 16-fold median coverage. In total, in this proof-of-principle cohort of 6 patients, in median 1534 variants per case were detected. After excluding single nucleotide polymorphisms and noncoding aberrations, 13 nonsynonymous mutations were found in 11/95 genes analyzed (1-4 mutations per case). Single missense mutations were found for transcriptional repressor SPEN (Q340R), histone acetyltransferase and transcriptional coactivator CREBBP (K622R), multi-drug resistance transporter ABCC1 (R633Q), epidermal growth factor EGF (A995P), runt-related transcription factor RUNX1 (G138S) and mixed-lineage leukemia gene MLL (D2890G). A TET2 nonsense mutation was observed in exon 5 (E1178X), being located in a conserved domain as described by Delhommeau et al. (N Engl J Med. 2009 360:2289-301). In addition, in two patients two genes were recurrently hit by a mutation: MYH11 and NOTCH1. MYH11 missense mutations were detected in exons 36 and 39 (E1840D; M1661V). We further observed two missense NOTCH1 mutations in exons 2 and 13 (P22S; E694K), located in the extracellular epidermal growth factor-like repeats domain which is required for ligand interaction. Thus far, activating NOTCH1 mutations have been reported in the context of T cell acute lymphoblastic leukemia (heterodimerization and PEST domains). In conclusion, we demonstrated that the combination of a targeted DNA sequence enrichment assay followed by NGS technology enabled a molecular characterization of 95 genes in AML-NK in a one-step approach. New recurrent aberrations such as NOTCH1 mutations are interesting targets for a broader screening in AML subtypes. In particular, methods like this will enable an unbiased comprehensive genetic characterization of leukemias and other malignancies and are suitable to identify markers to further stratify AML-NK into different risk groups. Disclosures: Kohlmann: MLL Munich Leukemia Laboratory: Employment. Grossmann:MLL Munich Leukemia Laboratory: Employment. Schnittger:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Kern:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership; Roche Diagnostics GmbH: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2010
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  • 5
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 4703-4703
    Abstract: Chronic lymphocytic leukemia (CLL) is a genetically heterogeneous disease. Recently, several genetic aberrations have been identified that allow to distinguish different biological subgroups within CLL. Translocation t(14;19)(q32;q13) leading to a fusion of IGH and BCL3 is a rare but recurrent abnormality in CLL and still poorly described. Based on karyotype data we identified 12 cases with t(14;19)(q32;q13) in a cohort of 1051 CLL (1.1%). In all these cases 1 to 10 chromosomal aberrations were observed in addition to t(14;19) (median: 3). Recurring accompanying aberrations were: +12 (n=8), loss of 18p (n=2), and gain of 10q (n=2). Interestingly, trisomy 12 is also the most frequent additional abnormality in CLL with t(14;18)(q32;q21). Remarkably, neither 13q deletions nor 11q deletions which are frequently observed in CLL overall, were found in addition to t(14;19). A TP53-deletion and a 6q21 deletion were observed in one case each. In 8/12 cases the mutation status of the immunoglobulin variable heavy chain gene (IgVH) was available. All 8 cases showed an unmutated IgVH status. Gene expression analysis (Affymetrix, HG U133 Plus 2.0) was performed in 9 cases with t(14;19) and compared to 44 cases with CLL comprising various chromosome aberrations excluding t(14;19). Using 10fold cross validation resulted in an assignment of 7 out of 9 cases with t(14;19) into the correct class, none of the cases without t(14;19) was classified into the t(14;19) group (accuracy 96%, sensitivity 78%, specificity 100%). Classification based on an independent test set led to comparable results (median accuracy 94%, sensitivity 67%, specificity 100%). The 10 most differentially expressed genes showing a higher expression in t(14;19)+ CLL were: TUBB6, CPSF6, RFC5, MAP3K8, CUGBP2, BCAT1, BCAT1, LOC647135, TSPAN13, SIGLEC6 and are involved in transition of mitotic cell cycle, DNA replication and RNA processing. The 10 most differentially expressed genes showing a lower expression in t(14;19)+ CLL were: LSR, APLP2, C2orf10, HS3ST1, LRRC32, PALM2-AKAP2, DFNB31, PDE4A, CTLA4, PDCD4 and are involved in signal transduction, apoptosis and immune response. In conclusion: t(14;19)(q32;q13) is a rare, recurrent chromosome abnormality in CLL. It is very frequently accompanied by additional chromosomal aberrations. The most frequent additional aberration is trisomy 12. t(14;19) is associated with an unmutated IgVH status. Comparable to other translocations leading to fusion genes it is associated with a distinct gene expression profile.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 6
    In: British Journal of Haematology, Wiley, Vol. 157, No. 3 ( 2012-05), p. 387-390
    Type of Medium: Online Resource
    ISSN: 0007-1048
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2012
    detail.hit.zdb_id: 1475751-5
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  • 7
    In: The Journal of Molecular Diagnostics, Elsevier BV, Vol. 15, No. 4 ( 2013-07), p. 473-484
    Type of Medium: Online Resource
    ISSN: 1525-1578
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    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
    detail.hit.zdb_id: 2032654-3
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  • 8
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 2075-2075
    Abstract: CLL is a genetically heterogeneous disease. Genetic aberrations allow to distinguish different biological subgroups within CLL. Based on chromosome banding analysis we identified complete and partial gain of the short arm of chromosome 2 always including 2p23 to 2p25 in 28/1051 CLL cases (2.7%) as a new recurring chromosome aberration. Recurring aberrations accompanying gain of 2p were: loss of 1p (n=3), 1q (n=3), 2q (n=3), 6q (n=3), 8p (n=7), 11q (n=10), 12q (n=4), 13q (n=21), 17p (n=7), 17q (n=3), 18p (n=5), and gain of 2q (n=3), 3q (n=3), 13q (n=3), 21q (n=3). In 24/28 cases the mutational status of the immunoglobulin variable heavy chain gene (IgVH) was available. 20 cases showed an unmutated and only 4 a mutated IgVH status. Thus, 2p gain is significantly associated with an unmutated IgVH status as compared to the non 2p group (83% vs 51%, p=0.002). In 8 cases an ATM deletion (29%) and in 5 cases a TP53 deletion (18%) (1 case showed both) were observed (frequency in non 2p+ cohort: 12%; p=0.036 and 7%; p=0.031). A median number of 4 chromosome aberrations per case was observed in 2p+ CLL (range: 1–16, mean=5.2) as compared to only 1 abnormality per case in the non 2p+ cohort (range: 0–10, mean 1.7) (p & lt;0.0001). In 4 cases the rearrangement leading to 2p+ was the sole abnormality. In 6 cases 2p gain was found in a subclone only. Gene expression analysis (Affymetrix, HG U133 Plus 2.0) was performed in 25 cases with gain of 2p and compared to 11 cases with CLL and normal karyotype. Using 10fold cross validation (10f CV) resulted in an assignment of all 25 cases with 2p into the correct class, however 4 cases with normal karyotype were misclassified into the 2p group (accuracy (a) 89%, sensitivity (s) 100%, specificity (sp) 64% for 2p+). Classification based on an independent test set led to comparable results (median a: 83%, s: 100%, sp: 50% for 2p+). In addition cases with gain of 2p were compared to 48 CLL cases comprising various chromosome aberrations excluding gain of 2p. Using 10f CV resulted in an assignment of only 13 of 25 cases with 2p into the correct class (a: 75%, s: 52%, sp: 88%). Classification based on an independent test set led to comparable results (median a: 79%, s: 50%, sp: 94%). However, focussing on the top 100 differentially expressed probe sets comprising 88 genes revealed that 10 of 28 genes with a higher expression in the 2p+ group as compared to the non 2p+ group were located on 2p (LOC56902, PPP3R1, MSH6, RTN4, COX7A2L, HADHA, TTC32, ACP1, CPSF3, PDIA6). These are involved in mismatch repair and in negative regulation of anti-apoptosis. In contrast only one of the top 60 genes showing a lower expression in the 2p+ group was located on 2p. Interestingly, ATM showed a significantly lower expression in the 2p+ group. In conclusion: Gain of 2p is a new recurrent chromosome abnormality in CLL. It occurs both as the sole abnormality and as a secondary event during clonal evolution. Gain of 2p is associated with an unmutated IgVH status, a complex aberrant karyotype, and a high frequency of ATM- and TP53-deletion. Comparable to other unbalanced chromosome abnormalities gain of 2p is not associated with a distinct gene expression profile sufficient for classification but leads to a higher expression of genes located on 2p.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
    detail.hit.zdb_id: 1468538-3
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  • 9
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 885-885
    Abstract: Effects of gene dosage on gene expression have been demonstrated in several leukemia entities. We asked the question whether unbalanced chromosome aberrations can be reliably identified based on gene expression data. Therefore, we performed genomic arrays (Affymetrix 10K arrays) and gene expression arrays (Affymetrix U133A+B or 2.0 plus) in 33 AML with a complex aberrant karyotype. For comparison gene expression data of 100 AML with normal karyotype were used. Based on this data set an algorithm was developed for the detection of higher and lower expression of groups of genes located in chromosomal bands (CB) in individual patients. Therefore, a “normal” expression status was defined for each CB based on gene expression data of AML with normal karyotype. Next for each individual case the gene expression status of each CB in relation to the earlier defined “normal” expression status was calculated and if a significant deviation was observed called “+” or “-”. First the new algorithm was tested for prediction of 5q deletions and their localization as well as for −7 and 17p deletion comprising 64 CB. Thus, overall 2112 pairs of genomic (GD) and gene expression data (GED) were compared in these 33 cases with AML. Based on GD 1011 CB were identified as deleted, 648 of these showed a significantly reduced gene expression. In addition gene expression was not reduced in 898 not deleted CB resulting in 1546/2112 (73.2%) concordant results between GD and GED. Thus, the sensitivity for prediction of deletion based on gene expression was 64% and the specificity 82%. In the next step gene expression data was correlated to karyotype data (KD) obtained by chromosome analysis. Therefore, 48 AML cases with available GED and a karyotype showing unbalanced chromosome aberrations such as trisomies of chromosomes 4 (n=2), 8 (n=14), 9 (n=1), 10 (n=1), 11 (n=3), 13 (n=8), 14 (n=3), 19 (n=1), 21 (n=3), and 22 (n=2) and monosomies of chromosomes 7 (n=7) and 13 (n=1) as well as gain of 1q (n=2), loss of 3q (n=1), 5q (n=11), 7q (n=4), 9q (n=3), 12p (n=1), and 10q (n=1) were evaluated. First we performed in this second cohort an analysis focusing again on loss of 5q, 7 and 17p. Based on KD 607 CB were identified as deleted, 390 of these showed a significantly reduced gene expression, in addition gene expression was not reduced in 2232 not deleted CB resulting in 2622/3408 (76.9%) concordant results between KD and GED. Thus, the sensitivity for prediction of deletion based on gene expression was 64% and the specificity 80%. Next an overall analysis on the whole genome broken down into 653 CB (excluding X and Y chromosome) was performed in the second cohort. Based on KD 1002 CB were gained, 820 lost and 29522 not affected by unbalanced rearrangements. A significantly higher gene expression was found in 570/1002 gained CB, a lower expression in 501/820 lost CB and an unchanged expression in 17366/29522 CB not affected, resulting in 18437/31344 (58.8%) concordant results between KD and GED. Thus, the sensitivity for prediction of deletion based on gene expression was 61% and the specificity 82% and for gain 57% and 81%. In conclusion, we present an approach for predicting unbalanced karyotype changes based on gene expression. It could be demonstrated genome wide that an association between gene dosage and gene expression exists.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
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  • 10
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 28, No. 24 ( 2010-08-20), p. 3858-3865
    Abstract: Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic malignancy that is characterized by features of both a myeloproliferative neoplasm and a myelodysplastic syndrome. Thus far, data on a comprehensive cytogenetic or molecular genetic characterization are limited. Patients and Methods Here, we analyzed 81 thoroughly characterized patients with CMML (CMML type 1, n = 45; CMML type 2, n = 36) by applying next-generation sequencing (NGS) technology to investigate CBL, JAK2, MPL, NRAS, and KRAS at known mutational hotspot regions. In addition, complete coding regions were analyzed for RUNX1 (β isoform) and TET2 aberrations. Results Cytogenetic aberrations were found in 18.2% of patients (14 of 77 patients). In contrast, at least one molecular mutation was observed in 72.8% of patients (59 of 81 patients). A mean of 1.6 mutations per patient was observed by this unprecedented screening. In total, 105 variances were detected by this comprehensive molecular screening. After excluding known polymorphisms or silent mutations, 82 distinct mutations remained (CBL, n = 15; JAK2V617F, n = 8; MPL, n = 0; NRAS, n = 10; KRAS, n = 12; RUNX1, n = 7; and TET2, n = 41). With respect to clinical data, a better outcome was seen for patients carrying TET2 mutations (P = .013). Conclusion The number of molecular markers used to categorize myeloid neoplasms is constantly increasing. Here, NGS screening has been demonstrated to support a comprehensive characterization of the molecular background in CMML. A pattern of molecular mutations translates into different biologic and prognostic categories of CMML.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
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    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2010
    detail.hit.zdb_id: 2005181-5
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