Genome profiling of chronic myelomonocytic leukemia: frequent alterations of RAS and RUNX1genes

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Gelsi-Boyer, Véronique | Trouplin, Virginie | Adélaïde, José | Aceto, Nicola | Remy, Virginie | Pinson, Stephane | Houdayer, Claude | Arnoulet, Christine | Sainty, Danielle | Bentires-Alj, Mohamed | Olschwang, Sylviane | Vey, Norbert | Mozziconacci, Marie-Joëlle | Birnbaum, Daniel | Chaffanet, Max

Edité par CCSD ; BioMed Central -

International audience. Abstract Background Chronic myelomonocytic leukemia (CMML) is a hematological disease close to, but separate from both myeloproliferative disorders (MPD) and myelodysplastic syndromes and may show either myeloproliferative (MP-CMML) or myelodysplastic (MD-CMML) features. Not much is known about the molecular biology of this disease. Methods We studied a series of 30 CMML samples (13 MP- and 11 MD-CMMLs, and 6 acutely transformed cases) from 29 patients by using Agilent high density array-comparative genomic hybridization (aCGH) and sequencing of 12 candidate genes. Results Two-thirds of samples did not show any obvious alteration of aCGH profiles. In one-third we observed chromosome abnormalities (e.g. trisomy 8, del20q) and gain or loss of genes (e.g. NF1 , RB1 and CDK6 ). RAS mutations were detected in 4 cases (including an uncommon codon 146 mutation in KRAS ) and PTPN11 mutations in 3 cases. We detected 11 RUNX1 alterations (9 mutations and 2 rearrangements). The rearrangements were a new, cryptic inversion of chromosomal region 21q21-22 leading to break and fusion of RUNX1 to USP16 . RAS and RUNX1 alterations were not mutually exclusive. RAS pathway mutations occurred in MP-CMMLs (~46%) but not in MD-CMMLs. RUNX1 alterations (mutations and cryptic rearrangement) occurred in both MP and MD classes (~38%). Conclusion We detected RAS pathway mutations and RUNX1 alterations. The latter included a new cryptic USP16-RUNX1 fusion. In some samples, two alterations coexisted already at this early chronic stage.

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