Kotmayer Lili, Kállay Krisztián, Bödör Csaba
I. Sz. Patológiai és Kísérleti Rákkutató Intézet, Semmelweis Egyetem, MTA-SE Lendület Molekuláris Onkohematológia Kutatócsoport, Budapest, Hungary.
Gyermekhematológiai és Őssejt-transzplantációs Osztály, Dél-pesti Centrumkórház - Országos Hematológiai és Infektológiai Intézet, Budapest, Hungary.
Magy Onkol. 2020 Mar 17;64(1):43-55. Epub 2020 Feb 11.
The majority of haematological malignancies represent sporadic diseases, but hereditary entities with predisposing genetic alterations have also been described. Diseases of the myeloid and lymphoid cell lineages with genetic predispositions are associated with heterogeneous clinical manifestations, with many symptoms being specific for certain cytogenetic and molecular aberrations. Apart from the myeloid predisposition syndromes with clear Mendelian inheritance patterns, cases with ambiguous predisposing factors are also known, but their role in hereditary leukemogenesis is still poorly understood. The presence of these genetic lesions is usually associated with an increased risk of familial malignancies and often leads to familial disease aggregation. Lymphoid malignancies often lack the disease-associated germline pathogenic variants, with their propensity to familial aggregation being most likely explained by their complex genotype serving as a hereditary base to many sporadic diseases. The heterogeneous clinical features and the large number of potentially affected genes tend to make the diagnosis of hereditary haematological malignancies difficult, however the elevated familial risk caused by predisposing genetic alterations underlines the importance of testing for individuals and families with genetic susceptibility.
大多数血液系统恶性肿瘤属于散发性疾病,但也有遗传性实体疾病伴有易感性基因改变的报道。具有遗传易感性的髓系和淋巴系细胞谱系疾病与异质性临床表现相关,许多症状特定于某些细胞遗传学和分子异常。除了具有明确孟德尔遗传模式的髓系易感性综合征外,具有不明确易感因素的病例也有报道,但其在遗传性白血病发生中的作用仍知之甚少。这些基因损伤的存在通常与家族性恶性肿瘤风险增加相关,且常导致家族性疾病聚集。淋巴系恶性肿瘤往往缺乏与疾病相关的种系致病变异,其家族聚集倾向很可能是由于其复杂的基因型作为许多散发性疾病的遗传基础所致。异质性临床特征和大量潜在受累基因往往使遗传性血液系统恶性肿瘤的诊断变得困难,然而,由易感基因改变引起的家族风险升高凸显了对具有遗传易感性的个体和家族进行检测的重要性。