Prognostic analysis of smoldering ATLL with skin eruptions based on genomic aberrations

Kosuke Mochida; Shingo Nakahata; Yutaka Suzuki; Kentaro Inoue; Sayaka Moriguchi; Atsushi Yamashita; Masahiro Amano; Kazuhiro Morishita

doi:10.1016/j.jdermsci.2023.02.001

Prognostic analysis of smoldering ATLL with skin eruptions based on genomic aberrations

J Dermatol Sci. 2023 Feb;109(2):80-88. doi: 10.1016/j.jdermsci.2023.02.001. Epub 2023 Feb 14.

Authors

Kosuke Mochida¹, Shingo Nakahata², Yutaka Suzuki³, Kentaro Inoue⁴, Sayaka Moriguchi⁵, Atsushi Yamashita⁵, Masahiro Amano¹, Kazuhiro Morishita⁶

Affiliations

¹ Department of Dermatology, University of Miyazaki Faculty of Medicine, Miyazaki, Japan.
² Division of Tumor and Cellular Biochemistry, Department of Medical Sciences, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; Division of HTLV-1/ATL carcinogenesis and therapeutics, Joint Research Center for Human Retrovirus Infection, Kagoshima University, Kagoshima, Japan.
³ Department of Computational Biology and Medical Sciences, the University of Tokyo, Kashiwa, Japan.
⁴ Department of Computer Science and Systems Engineering, Faculty of Engineering, University of Miyazaki, Miyazaki, Japan.
⁵ Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
⁶ Division of Tumor and Cellular Biochemistry, Department of Medical Sciences, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; Project for Advanced Medical Research and Development, Project Research Division, Frontier Science Research Center, University of Miyazaki, Miyazaki, Japan.

PMID: 36842846
DOI: 10.1016/j.jdermsci.2023.02.001

Abstract

Background: Patients with smoldering ATLL often present with a skin eruption due to skin infiltration of ATLL cells. Although skin eruption type is known to be associated with prognosis based on its pattern, it is unknown why different types of skin eruptions are associated with different prognoses.

Objective: Genomic analysis of patients with skin eruptions of smoldering ATLL will be performed to determine the mechanism of ATLL development and its association with prognosis.

Methods: DNA from skin biopsy specimens was used for targeted sequencing of 280 genes to examine the association between genomic variation and prognosis.

Results: Due to the small number of smoldering ATLL patients (27 cases), we could not find a clear relationship between skin eruption and prognosis in this study. Genomic analysis identified 247 genomic variants (108 genes), with an average of 9.2 variants and 3.2 variants as driver genes. Pathway analysis of the driver genes showed activation of the pathway associated with HTLV-1 infection, as well as activation of the signaling pathway observed throughout ATLL. Furthermore, multivariate analysis identified age>70 years and STAT3 mutation as prognostic risk factors and TBL1XR1 mutation as a risk factor for progression-free survival.

Conclusion: Although the small number of patient samples did not allow us to determine a prognostic association with skin eruption, STAT3 mutation was identified as a prognostic risk factor for smoldering ATLL with skin eruption. Further studies are needed to increase the number of patients with this disease.

Keywords: Genomic aberrations; STAT3 mutation; Smoldering ATLL with skin eruption.

MeSH terms

Aged
Exanthema*
Genomics
Human T-lymphotropic virus 1* / genetics
Humans
Leukemia-Lymphoma, Adult T-Cell* / pathology
Mutation
Prognosis