Patel Umang, Luthra Rajyalakshmi, Medeiros L Jeffrey, Patel Keyur P
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX.
Clin Lymphoma Myeloma Leuk. 2017 Jul;17S:S62-S74. doi: 10.1016/j.clml.2017.02.015.
The classification and risk stratification of myeloid neoplasms, including acute myeloid leukemia, myelodysplastic syndromes, myelodysplastic syndromes/myeloproliferative neoplasms, and myeloproliferative neoplasms, have increasingly been guided by molecular genetic abnormalities. Gene expression analysis and next-generation sequencing have led to the ever increasing discovery of somatic gene mutations in myeloid neoplasms. Mutations have been identified in genes involved in epigenetic modification, RNA splicing, transcription factors, DNA repair, and the cohesin complex. These new somatic/acquired gene mutations have refined the classification of myeloid neoplasms and have been incorporated into the 2016 update of the World Health Organization (WHO) classification and the National Comprehensive Cancer Network guidelines. They have also been helpful in the development of new targeted therapeutic agents. In the present review, we describe the clinical utility of recently identified, clinically important gene mutations in myeloid neoplasms, including those incorporated in the 2016 update of the WHO classification.
髓系肿瘤的分类和风险分层,包括急性髓系白血病、骨髓增生异常综合征、骨髓增生异常综合征/骨髓增殖性肿瘤以及骨髓增殖性肿瘤,越来越多地由分子遗传学异常来指导。基因表达分析和新一代测序导致在髓系肿瘤中不断发现体细胞基因突变。已在参与表观遗传修饰、RNA剪接、转录因子、DNA修复以及黏连蛋白复合体的基因中鉴定出突变。这些新的体细胞/获得性基因突变完善了髓系肿瘤的分类,并已纳入世界卫生组织(WHO)2016年更新的分类以及美国国立综合癌症网络指南中。它们在新型靶向治疗药物的研发中也发挥了作用。在本综述中,我们描述了最近在髓系肿瘤中鉴定出的具有临床重要性的基因突变的临床应用,包括那些纳入WHO 2016年更新分类中的突变。