使用MiSeq对急性髓系白血病进行基于二代测序的多基因突变筛查:在诊断和疾病监测中的适用性
Next-generation sequencing-based multigene mutational screening for acute myeloid leukemia using MiSeq: applicability for diagnostics and disease monitoring.
作者信息
Luthra Rajyalakshmi, Patel Keyur P, Reddy Neelima G, Haghshenas Varan, Routbort Mark J, Harmon Michael A, Barkoh Bedia A, Kanagal-Shamanna Rashmi, Ravandi Farhad, Cortes Jorge E, Kantarjian Hagop M, Medeiros L Jeffrey, Singh Rajesh R
出版信息
Haematologica. 2014 Mar;99(3):465-73. doi: 10.3324/haematol.2013.093765. Epub 2013 Oct 18.
Routine molecular testing in acute myeloid leukemia involves screening several genes of therapeutic and prognostic significance for mutations. A comprehensive analysis using single-gene assays requires large amounts of DNA, is cumbersome and timely consolidation of results for clinical reporting is challenging. High throughput, next-generation sequencing platforms widely used in research have not been tested vigorously for clinical application. Here we describe the clinical application of MiSeq, a next-generation sequencing platform to screen mutational hotspots in 54 cancer-related genes including genes relevant in acute myeloid leukemia (NRAS, KRAS, FLT3, NPM1, DNMT3A, IDH1/2, JAK2, KIT and EZH2). We sequenced 63 samples from patients with acute myeloid leukemia/myelodysplastic syndrome using MiSeq and compared the results with those obtained using another next-generation sequencing platform, Ion-Torrent Personal Genome Machine and other conventional testing platforms. MiSeq detected a total of 100 single nucleotide variants and 23 NPM1 insertions that were confirmed by Ion Torrent or conventional platforms, indicating complete concordance. FLT3-internal tandem duplications (n=10) were not detected; however, re-analysis of the MiSeq output by Pindel, an indel detection algorithm, did detect them. Dilution studies of cancer cell-line DNA showed that the quantitative accuracy of mutation detection was up to an allelic frequency of 1.5% with a high level of inter- and intra-run assay reproducibility, suggesting potential utility for monitoring response to therapy, clonal heterogeneity and evolution. Examples demonstrating the advantages of MiSeq over conventional platforms for disease monitoring are provided. Easy work-flow, high throughput multiplexing capability, 4-day turnaround time and simultaneous assessment of routinely tested and emerging markers make MiSeq highly applicable for clinical molecular testing in acute myeloid leukemia.
急性髓系白血病的常规分子检测包括筛查多个具有治疗和预后意义的基因是否存在突变。使用单基因检测进行全面分析需要大量DNA,操作繁琐,且及时整合结果用于临床报告具有挑战性。广泛应用于研究的高通量新一代测序平台尚未经过严格的临床应用测试。在此,我们描述了MiSeq这一新一代测序平台在临床中的应用,该平台用于筛查54个癌症相关基因中的突变热点,包括与急性髓系白血病相关的基因(NRAS、KRAS、FLT3、NPM1、DNMT3A、IDH1/2、JAK2、KIT和EZH2)。我们使用MiSeq对63例急性髓系白血病/骨髓增生异常综合征患者的样本进行了测序,并将结果与使用另一个新一代测序平台Ion-Torrent个人基因组测序仪以及其他传统检测平台所获得的结果进行了比较。MiSeq共检测到100个单核苷酸变异和23个NPM1插入,这些结果经Ion Torrent或传统平台确认,表明完全一致。未检测到FLT3内部串联重复(n = 10);然而,使用插入缺失检测算法Pindel对MiSeq输出结果进行重新分析时确实检测到了它们。癌细胞系DNA的稀释研究表明,突变检测的定量准确性高达1.5%的等位基因频率,且批间和批内检测具有高度可重复性,这表明其在监测治疗反应、克隆异质性和进化方面具有潜在用途。文中提供了一些实例,展示了MiSeq在疾病监测方面优于传统平台的优势。简单的工作流程、高通量多重检测能力、4天的周转时间以及对常规检测和新出现标志物的同时评估,使得MiSeq非常适用于急性髓系白血病的临床分子检测。
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