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细胞遗传学和基因组学在 CML 及其他骨髓增殖性肿瘤中的应用。

Cytogenetics and genomics in CML and other myeloproliferative neoplasms.

机构信息

Department of Pathology, Germany.

Department of Human Genetics, Hannover Medical School (MHH), Hannover, Germany.

出版信息

Best Pract Res Clin Haematol. 2024 Jun;37(2):101552. doi: 10.1016/j.beha.2024.101552. Epub 2024 Apr 3.

Abstract

Chronic myeloid leukemia is defined by the presence of the Philadelphia translocation t (9; 22) resulting in the BCR::ABL1 fusion. The other myeloproliferative neoplasms (MPN) subtypes also carry typical chromosomal abnormalities, which however are not pathognomonic for a specific entity of MPN. According to the WHO classification the distinction between these entities is still based on the integration of cytological, histopathological and molecular findings. Progression of CML into accelerated and blastic phase is usually driven by additional chromosome abnormalities and ABL1 kinase mutations. In the other MPN subtypes the additional mutations besides driver gene mutations in JAK2, MPL and CALR have a decisive impact on the propensity for progression. In addition, the sequence in which the driver mutations and risk conveying additional mutations have been acquired appears to play an important role. Here, we review cytogenetic and molecular changes in CML and MPN that should be evaluated during diagnosis and disease monitoring.

摘要

慢性髓性白血病的定义是存在费城易位 t(9;22),导致 BCR::ABL1 融合。其他骨髓增殖性肿瘤 (MPN) 亚型也携带典型的染色体异常,但这些异常并非 MPN 特定实体的特征。根据世界卫生组织 (WHO) 的分类,这些实体之间的区分仍然基于细胞遗传学、组织病理学和分子发现的综合评估。CML 向加速期和急变期的进展通常是由额外的染色体异常和 ABL1 激酶突变驱动的。在其他 MPN 亚型中,除了 JAK2、MPL 和 CALR 中的驱动基因突变外,其他突变对进展的倾向具有决定性影响。此外,获得驱动突变和风险传递额外突变的顺序似乎也起着重要作用。在这里,我们回顾了在诊断和疾病监测期间应评估的 CML 和 MPN 中的细胞遗传学和分子变化。

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