Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Epigenetics. 2021 May;16(5):567-576. doi: 10.1080/15592294.2020.1809871. Epub 2020 Aug 28.
Acute myeloid leukaemia (AML) is a heterogeneous myeloid malignancy characterized by recurrent clonal events, including mutations in epigenetically relevant genes such as , and . Next-generation sequencing analysis of a mother and son pair who both developed adult-onset diploid AML identified a novel germline missense mutation p.P709S. The p.P709S protein-altering variant resides in the highly conserved catalytic DNMT3A methyltransferase domain. Functional studies demonstrate that the p.P709S variant confers dominant negative effects when interacting with wildtype . LINE-1 pyrosequencing and reduced representation bisulphite sequencing (RBBS) analysis demonstrated global DNA hypomethylation in germline samples, not present in the leukaemic samples. Somatic acquisition of p.R172K mutations, in concert with additional acquired clonal DNMT3A events in both patients at the time of AML diagnosis, confirms the important pathogenic interaction of epigenetically active genes, and implies a strong selection and regulation of methylation in leukaemogenesis. Improved characterization of germline mutations may enable us to better predict malignant clonal evolution, improving our ability to provide customized treatment or future preventative strategies.
急性髓系白血病 (AML) 是一种异质性髓系恶性肿瘤,其特征是反复出现克隆事件,包括表观遗传相关基因的突变,如 、 和 。对一对均发生成年发病二倍体 AML 的母子进行下一代测序分析,鉴定出一种新型种系错义突变 p.P709S。p.P709S 蛋白改变变体位于高度保守的催化 DNMT3A 甲基转移酶结构域。功能研究表明,当与野生型 相互作用时,p.P709S 变体表现出显性负效应。LINE-1 焦磷酸测序和降低代表性亚硫酸氢盐测序 (RBBS) 分析表明,种系样本存在全基因组 DNA 低甲基化,而白血病样本中不存在。p.R172K 突变的体细胞获得,以及在 AML 诊断时两个患者中额外获得的克隆性 DNMT3A 事件,证实了表观遗传活性基因的重要致病相互作用,并暗示了在白血病发生过程中对甲基化的强烈选择和调控。对种系突变的更好表征可能使我们能够更好地预测恶性克隆进化,从而提高我们提供定制治疗或未来预防策略的能力。