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希腊成年人朗格汉斯组织细胞增生症中 突变的流行率。

Prevalence of the mutation in Greek adults with Langerhans cell histiocytosis.

机构信息

Department of Medical Research, LCH Adult Clinic, 251 Hellenic Air Force General Hospital, Athens, Greece.

St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.

出版信息

Pediatr Hematol Oncol. 2022 Sep;39(6):540-548. doi: 10.1080/08880018.2022.2029988. Epub 2022 Feb 10.

Abstract

Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasia with a broad spectrum of clinical manifestations. The activation of the MAP kinase pathway plays an integral role in its pathogenesis with genetic alterations found in the majority of cases that most frequently involve a somatic mutation of the oncogenic BRAF variant. In this study we investigated the prevalence of the BRAF mutation and its clinical relevance in adult Greek patients with LCH. Among 37 patients studied, the BRAF mutation was identified in 12 out of 31 (38.7%), whereas in six patients (19.3%) the results were in conclusive. The presence of the mutation did not correlate with age at diagnosis, organ involvement, disease extent, response to initial treatment, development of diabetes insipidus and relapse risk. In our series the prevalence of the mutation is at the lower range of the relative percentage found in children, but in line to that obtained in previous studies of adult patients with LCH that have found an up to 50% prevalence of the mutation in these patients. Further studies with a larger number of adults are needed to identify the exact prevalence of mutations in the RAS-RAF-MEK-ERK pathway and their role on clinical parameters and disease outcomes.Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2022.2029988 .

摘要

朗格汉斯细胞组织细胞增生症(LCH)是一种罕见的炎症性髓系肿瘤,具有广泛的临床表现。MAP 激酶通路的激活在其发病机制中起着重要作用,大多数病例中都发现了遗传改变,这些改变最常涉及致癌 BRAF 变体的体细胞突变。在这项研究中,我们研究了 BRAF 突变在希腊成年 LCH 患者中的流行率及其临床相关性。在 37 名研究患者中,31 名患者中有 12 名(38.7%)存在 BRAF 突变,而 6 名患者(19.3%)的结果不确定。突变的存在与诊断时的年龄、器官受累、疾病程度、对初始治疗的反应、尿崩症的发展和复发风险无关。在我们的研究中,突变的发生率处于儿童中相对百分比的较低范围,但与之前对成人 LCH 患者的研究一致,这些研究发现这些患者中 BRAF 突变的发生率高达 50%。需要进一步的研究来确定 RAS-RAF-MEK-ERK 通路中的突变的确切流行率及其对临床参数和疾病结局的作用。本文的补充数据可在 https://doi.org/10.1080/08880018.2022.2029988 在线获取。

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