Author:
Bertrums Eline J.M.,Smith Jenny L.,Harmon Lauren,Ries Rhonda E.,Wang Yi-Cheng J.,Alonzo Todd A.,Menssen Andrew J.,Chisholm Karen M.,Leonti Amanda R.,Tarlock Katherine,Ostronoff Fabiana,Pogosova-Agadjanyan Era L.,Kaspers Gertjan J.L.,Hasle Henrik,Dworzak Michael,Walter Christiane,Muhlegger Nora,Morerio Cristina,Pardo Laura,Hirsch Betsy,Raimondi Susana,Cooper Todd M.,Aplenc Richard,Gamis Alan S.,Kolb Edward A.,Farrar Jason E.,Stirewalt Derek,Ma Xiaotu,Shaw Tim I.,Furlan Scott N.,Brodersen Lisa Eidenschink,Loken Michael R.,Van den Heuvel-Eibrink Marry M.,Zwaan C. Michel,Triche Timothy J.,Goemans Bianca F.,Meshinchi Soheil
Abstract
NUP98 fusions comprise a family of rare recurrent alterations in AML, associated with adverse outcomes. In order to define the underlying biology and clinical implications of this family of fusions, we performed comprehensive transcriptome, epigenome, and immunophenotypic profiling of 2,235 children and young adults with AML and identified 160 NUP98 rearrangements (7.2%), including 108 NUP98-NSD1 (4.8%), 32 NUP98-KDM5A (1.4%) and 20 NUP98-X cases (0.9%) with 13 different fusion partners. Fusion partners defined disease characteristics and biology; patients with NUP98-NSD1 or NUP98-KDM5A had distinct immunophenotypic, transcriptomic, and epigenomic profiles. Unlike the two most prevalent NUP98 fusions, NUP98-X variants are typically not cryptic. Furthermore, NUP98-X cases are associated with WT1 mutations, and have epigenomic profiles that resemble either NUP98-NSD1 or NUP98-KDM5A. Cooperating FLT3-ITD and WT1 mutations define NUP98-NSD1, and chromosome 13 aberrations are highly enriched in NUP98-KDM5A. Importantly, we demonstrate that NUP98 fusions portend dismal overall survival, with the noteworthy exception of patients bearing abnormal chromosome 13 (clinicaltrials gov. Identifiers: NCT00002798, NCT00070174, NCT00372593, NCT01371981).
Publisher
Ferrata Storti Foundation (Haematologica)