[Targeted sequencing analysis of hyper-eosinophilic syndrome and chronic eosinophilic leukemia]

Zhonghua Xue Ye Xue Za Zhi. 2018 Jun 14;39(6):501-506. doi: 10.3760/cma.j.issn.0253-2727.2018.06.013.
[Article in Chinese]

Abstract

Objective: Analysis of the molecular characteristics of eosinophilia. Methods: Targeting sequence to 24 patients with chronic eosinophilic leukemia (CEL) with rearrangement of PDGFRA, PDGFRB, or FGFR1 and 62 patients with hyper-eosinophilic syndrome (HES). Mutation annotation and analysis of amino acid mutation using authoritative databases to speculate on possible pathogenic mutation. Results: Thirty-seven kinds of clonal variant were detected from 17 patients with CEL, no recurrent mutation site and hot spot region were found. No pathogenic mutation was detected in 19 patients with PDGFRA rearrangement, but pathogenic mutations of ASXL1, RUNX1 and NRAS were detected from 2 patients with FGFR1 rearrangement who progressed to acute myeloid leukemia and 1 patient with PDGFRB rearrangement who progressed to T lymphoblastic lymphoma, respectively. One hundred and two kinds of clonal abnormalities were detected in 49 patients with HES. The main hot spot mutation regions included: CEBPA Exon1, TET2 Exon3, ASXL1 Exon12, IDH1 Y208C, and FGFR3 L164V. CRRLF2 P224L and PDGFRB R370C point mutations were detected separately in 2 patients with HES who treated with imatinib monotherapy and achieved hematologic remission. Conclusion: The pathogenesis of CEL with PDGFRA, PDGFRB or FGFR1 rearrangement is usually single, and the progression of the disease may involve other driver mutation. A variety of genes with hot mutation regions may be involved in the pathogenesis of HES, and some mutation sites are sensitive to tyrosine kinase inhibitors.

目的: 分析嗜酸性粒细胞增多症的分子学特征。 方法: 对24例伴PDGFRA、PDGFRB或FGFR1重排的慢性嗜酸性粒细胞白血病(CEL)及62例高嗜酸性粒细胞综合征(HES)患者进行靶向测序,利用权威数据库进行变异注释及氨基酸突变分析,推测可能致病性突变。 结果: 17例(71%)CEL患者检出37种克隆性异常,但未发现重现性突变位点及热点突变区域,19例伴PDGFRA重排患者未检出致病性突变,2例进展为急性髓系白血病的伴FGFR1重排患者及1例进展为T淋巴母细胞淋巴瘤的伴PDGFRB重排患者分别检出ASXL1、RUNX1和NRAS的致病性突变。49例(71%)HES患者检出102种克隆性异常,主要热点突变区域包括:CEBPA Exon1、TET2 Exon3、ASXL1 Exon12、IDH1 Y208C和FGFR3 L164V。其中2例经伊马替尼单药治疗获得血液学缓解的HES患者分别检出CRRLF2 P224L和PDGFRB R370C点突变。 结论: 伴PDGFRA、PDGFRB或FGFR1重排的CEL致病因素单一,疾病进展可能有其他突变参与。HES可能由具有热点突变区域的多种基因参与致病,部分突变位点对酪氨酸激酶抑制剂治疗敏感。.

Keywords: Chronic eosinophilic leukemia; Eosinophilia; Hyper-eosinophilic syndrome; Targeted sequencing.

MeSH terms

  • Chronic Disease
  • Humans
  • Hypereosinophilic Syndrome*
  • Imatinib Mesylate
  • Leukemia*
  • Receptor, Platelet-Derived Growth Factor alpha
  • Receptor, Platelet-Derived Growth Factor beta

Substances

  • Imatinib Mesylate
  • Receptor, Platelet-Derived Growth Factor alpha
  • Receptor, Platelet-Derived Growth Factor beta

Supplementary concepts

  • Pdgfra-Associated Chronic Eosinophilic Leukemia

Grants and funding

基金项目:国家自然科学基金(81470295、81530008、81370611、81600098、81270585);天津市自然科学基金(16JCQNJC11400);中国医学科学院医学与健康科技创新工程项目(2016-I2M-1-001);协和学者与创新团队发展计划