Schlegelberger Brigitte, Heller Paula G
Department of Human Genetics, Hannover Medical School, Hannover, Germany.
Instituto de Investigaciones Médicas Alfredo Lanari, Universidad de Buenos Aires, IDIM-CONICET, Buenos Aires, Argentina.
Semin Hematol. 2017 Apr;54(2):75-80. doi: 10.1053/j.seminhematol.2017.04.006. Epub 2017 Apr 13.
In this review, we discuss disease-causing alterations of RUNT-related transcription factor 1 (RUNX1), a master regulator of hematopoietic differentiation. Familial platelet disorder with predisposition to myeloid leukemia (FPDMM) typically presents with (1) mild to moderate thrombocytopenia with normal-sized platelets; (2) functional platelets defects leading to prolonged bleeding; and (3) an increased risk to develop myelodysplastic syndromes (MDS), acute myeloid leukemia (AML), or T-cell acute lymphoblastic leukemia (T-ALL). Hematological neoplasms in carriers of a germline RUNX1 mutation need additional secondary mutations or chromosome aberrations to develop. If a disease-causing mutation is known in the family, it is important to prevent hematopoietic stem cell transplantation from a sibling or other relative carrying the familial mutation. First experiments introducing a wild-type copy of RUNX1 into induce pluripotent stem cells (iPSC) lines from patients with FPDMM appear to demonstrate that by gene correction reversal of the phenotype may be possible.
在本综述中,我们讨论了造血分化的主要调节因子——RUNT相关转录因子1(RUNX1)的致病改变。家族性血小板疾病伴髓系白血病倾向(FPDMM)通常表现为:(1)轻度至中度血小板减少,血小板大小正常;(2)功能性血小板缺陷导致出血时间延长;(3)发生骨髓增生异常综合征(MDS)、急性髓系白血病(AML)或T细胞急性淋巴细胞白血病(T-ALL)的风险增加。携带种系RUNX1突变的个体发生血液系统肿瘤还需要其他继发突变或染色体畸变。如果家族中已知致病突变,防止来自携带家族突变的兄弟姐妹或其他亲属进行造血干细胞移植非常重要。首次将RUNX1野生型拷贝导入FPDMM患者的诱导多能干细胞(iPSC)系的实验似乎表明,通过基因校正可能逆转表型。