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血液系统恶性肿瘤患者种系易感性综合征的处理方法

Approach Toward Germline Predisposition Syndromes in Patients with Hematologic Malignancies.

作者信息

Atluri Himachandana, Gerstein Yoheved S, DiNardo Courtney D

机构信息

Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.

Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.

出版信息

Curr Hematol Malig Rep. 2022 Dec;17(6):275-285. doi: 10.1007/s11899-022-00684-2. Epub 2022 Oct 24.

Abstract

PURPOSE OF REVIEW

Hematologic malignancies were previously thought to be primarily sporadic cancers without germline predispositions. However, over the last two decades, with the widespread use of next generation sequencing (NGS), there have been several genes have been identified that carry a risk of inheriting hematologic malignancies. Identification of individuals with hereditary hematologic malignancies (HHM) involves a high index of suspicion and careful attention to family history, clinical features, and variant allele frequency on somatic NGS panels.

RECENT FINDINGS

Over the last several years, many genetic predisposition syndromes have been recognized to have unique features with both hematologic and non-hematologic co-morbidities. Multidisciplinary evaluation, including genetic counseling, is critical to optimizing diagnostic testing of individuals and at-risk family members. Prompt recognition of affected patients is imperative not only for personalized surveillance strategies but also for proper donor selection for those undergoing stem cell transplantation to avoid familial donors who also may share the same germline mutation. Herein, we describe our approach to recognizing patients suspected to carry a germline predisposition to hematologic malignancies and evaluation within a hereditary hematologic malignancies clinic (HHMC).

摘要

综述目的

血液系统恶性肿瘤以前被认为主要是散发性癌症,不存在种系易感性。然而,在过去二十年中,随着下一代测序(NGS)的广泛应用,已经鉴定出几个携带遗传性血液系统恶性肿瘤风险的基因。识别遗传性血液系统恶性肿瘤(HHM)患者需要高度的怀疑指数,并仔细关注家族史、临床特征以及体细胞NGS检测板上的变异等位基因频率。

最新发现

在过去几年中,许多遗传易感性综合征已被认识到具有血液系统和非血液系统合并症的独特特征。多学科评估,包括遗传咨询,对于优化个体及高危家庭成员的诊断检测至关重要。及时识别受影响的患者不仅对于个性化监测策略至关重要,而且对于接受干细胞移植的患者选择合适的供体也很重要,以避免家族供体也可能携带相同的种系突变。在此,我们描述了我们在遗传性血液系统恶性肿瘤诊所(HHMC)中识别疑似携带血液系统恶性肿瘤种系易感性患者并进行评估的方法。

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