DOI QR코드

DOI QR Code

Molecular Evaluation of DNMT3A and IDH1/2 Gene Mutation: Frequency, Distribution Pattern and Associations with Additional Molecular Markers in Normal Karyotype Indian Acute Myeloid Leukemia Patients

  • Published : 2014.02.01

Abstract

Mutations in the DNMT3A and IDH genes represent the most common genetic alteration after FLT3/NPM1 in acute myeloid leukemia (AML). We here analyzed the frequency and distribution pattern of DNMT3A and IDH mutations and their associations with other molecular markers in normal karyotype AML patients. Fortyfive patients were screened for mutations in DNMT3A (R882), IDH1 (R132) and IDH2 (R140 and R172) genes by direct sequencing. Of the 45 patients screened, DNMT3A and IDH mutations were observed in 6 (13.3%) and 7 (15.4%), respectively. Patients with isolated DNMT3A mutations were seen in 4 cases (9%), isolated IDH mutations in 5 (11.1%), while interestingly, two cases showed both DNMT3A and IDH mutations (4.3%). Nucleotide sequencing of DNMT3A revealed missense mutations (R882H and R882C), while that of IDH revealed R172K, R140Q, R132H and R132S. Both DNMT3A and IDH mutations were observed only in adults, with a higher frequency in males. DNMT3A and IDH mutations were significantly associated with NPM1, while trends towards higher coexistence with FLT3 mutations were observed. This is the first study to evaluate DNMT3A/IDH mutations in Indian patients. Significant associations among the various molecular markers was observed, that highlights cooperation between them and possible roles in improved risk stratification.

Keywords

References

  1. Abbas S, Lugthart S, Kavelaars FG, et al (2010). Acquired mutations in the genes encoding IDH1 and IDH2 both are recurrent aberrations in acute myeloid leukemia: prevalence and prognostic value. Blood, 116, 2122-6. https://doi.org/10.1182/blood-2009-11-250878
  2. Ahmad F, Mandava S, Das BR (2010). Analysis of FLT3-ITD and FLT3-Asp835 mutations in de novo acute myeloid leukemia: evaluation of incidence, distribution pattern, correlation with cytogenetics and characterization of internal tandem duplication from Indian population. Cancer Invest, 28, 63-73. https://doi.org/10.3109/07357900903095649
  3. Ahmad F, D'Souza W,Mandava S, et al (2011). Molecular analysis of WT1 and KIT mutations in patients from an Indian population with de novo acute myeloid leukemia: determination of incidence, distribution patterns, and report of a novel KIT mutation. Leuk Lymphoma, 52, 865-76. https://doi.org/10.3109/10428194.2011.552137
  4. Ahmad F, Mandava S, Das BR (2009). Mutations of NPM1 gene in de novo acute myeloid leukaemia: determination of incidence, distribution pattern and identification of two novel mutations in Indian population. Hematol Oncol, 27, 90-7. https://doi.org/10.1002/hon.883
  5. Ahmad F, Rajput S, Mandava S, et al (2012). Molecular evaluation of CEBPA gene mutation in normal karyotype acute myeloid leukemia: a comparison of two methods and report of novel CEBPA mutations from Indian acute myeloid leukemia patients. Genet Test Mol Biomarkers, 16, 707-15. https://doi.org/10.1089/gtmb.2011.0317
  6. Boissel N, Nibourel O, Renneville A, et al (2010). Prognostic impact of isocitrate dehydrogenase enzyme isoforms 1 and 2 mutations in acute myeloid leukemia: a study by the Acute Leukemia French Association group. J Clin Oncol, 28, 3717-23. https://doi.org/10.1200/JCO.2010.28.2285
  7. Brenner C, Fuks F (2006). DNA methyltransferases:facts, clues, mysteries. Curr Top Microbiol Immunol, 301, 45-66.
  8. Chen T, Li E (2006). Establishment and maintenance of DNA methylation patterns in mammals. Curr Top Microbiol Immunol, 301, 179-201.
  9. Chotirat S, Thongnoppakhun W, Promsuwicha O, et al (2012). Molecular alterations of Isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) metabolic genes and additional genetic mutations in newly diagnosed acute myeloid leukemia patients. J Hematol Oncol, 5, 1-10. https://doi.org/10.1186/1756-8722-5-1
  10. Chou WC, Hou HA, Chen CY, et al (2010). Distinct clinical and biologic characteristics in adult acute myeloid leukemia bearing the isocitrate dehydrogenase 1 mutation. Blood, 115, 2749-54. https://doi.org/10.1182/blood-2009-11-253070
  11. Delhommeau F, Dupont S, Della Valle V, et al., 2009) Mutation in TET2 in myeloid cancers. N Engl J Med, 360, 2289-301. https://doi.org/10.1056/NEJMoa0810069
  12. Fernandez-Mercado M, Yip BH, Pellagatti A, et al (2012). Mutation Patterns of 16 Genes in Primary and Secondary Acute Myeloid Leukemia (AML) with Normal Cytogenetics. PLOS ONE, 7, 42334. https://doi.org/10.1371/journal.pone.0042334
  13. Fried I, Bodner C, Pichler MM, et al (2012). A. Frequency, onset and clinical impact of somatic DNMT3A mutations in therapy-related and secondary acute myeloid leukemia, Haematologica, 97, 246-50. https://doi.org/10.3324/haematol.2011.051581
  14. Gaidzik V, Dohner K (2008). Prognostic implications of gene mutations in acute myeloid leukemia with normal cytogenetics. Semin Oncol, 35, 346-55. https://doi.org/10.1053/j.seminoncol.2008.04.005
  15. Green CL, Evans CM, Zhao L, et al (2011). The prognostic significance of IDH2 mutations in AML depends on the location of the mutation. Blood, 118, 409-12. https://doi.org/10.1182/blood-2010-12-322479
  16. Grimwade D, Walker H, Oliver F, et al (1998). The importance of diagnostic cytogenetics on outcome in AML: analysis of 1,612 patients entered into the MRC AML 10 trial, The Medical Research Council Adult and Children's Leukaemia Working Parties. Blood, 92, 2322-33.
  17. Gross S, Cairns RA, Minden MD, et al (2010). Cancer-associated metabolite 2-hydroxyglutarate accumulates in acute myelogenous leukemia with isocitrate dehydrogenase 1 and 2 mutations. J Exp Med, 207, 339-44. https://doi.org/10.1084/jem.20092506
  18. Ho PA, Alonzo TA, Kopecky KJ, et al (2010). Molecular alterations of the IDH1 gene in AML: a Children's Oncology Group and Southwest Oncology Group study. Leukemia, 24, 909-13. https://doi.org/10.1038/leu.2010.56
  19. Ho PA, Kutny MA, Alonzo TA, et al (2011). Leukemic mutations in the methylation-associated genes DNMT3A and IDH2 are rare events in pediatric AML: a report from the Children's Oncology Group. Pediatr Blood Cancer, 57, 204-9. https://doi.org/10.1002/pbc.23179
  20. Holz-Schietinger C, Matje DM, Reich NO (2012). Mutations in DNA methyltransferase (DNMT3A) observed in acute myeloid leukemia patients disrupt processive methylation. J Biol Chem, 287, 30941-51. https://doi.org/10.1074/jbc.M112.366625
  21. Hou HA, Kuo YY, Liu CY, et al (2012). DNMT3A mutations in acute myeloid leukemia: stability during disease evolution and clinical implications. Blood, 119, 559-68. https://doi.org/10.1182/blood-2011-07-369934
  22. Jeha S, Smith FO, Estey E, et al (2002). Comparison between pediatric acute myeloid leukemia (AML) and adult AML in VEGF and KDR (VEGF-R2) protein levels. Leuk Res, 26, 399-402. https://doi.org/10.1016/S0145-2126(01)00149-7
  23. LaRochelle O, Bertoli S, Vergez F, et al (2011). Do AML patients with DNMT3A exon 23 mutations benefit from idarubicin as compared to daunorubicin? A single center experience, Oncotarget, 2, 850-61.
  24. Lee SH, Jo SH, Lee SM, et al (2004). Role of NADP- dependent isocitrate dehydrogenase(NADP_-ICDH) on cellular defence against oxidative injury bygammarays. Int J Radiat Biol, 80, 635-42. https://doi.org/10.1080/09553000400007680
  25. Ley TJ, Ding L,Walter MJ, et al (2010). DNMT3A mutations in Acute myeloid leukemia. N Engl J Med, 36, 2424-33.
  26. Lin J, Qian J, Yao DM, et al (2011). Rapid and reliable detection of IDH1 R132 mutations in acute myeloid leukemia using high-resolution melting curve analysis. Clin Biochem, 44, 779-83. https://doi.org/10.1016/j.clinbiochem.2011.04.014
  27. Lin J, Yao D-m, Qian J, et al (2011). Recurrent DNMT3A R882 Mutations in Chinese Patients with Acute Myeloid Leukemia and Myelodysplastic Syndrome. PLOS ONE, 6, 1-7.
  28. Marcucci G, Metzeler KH, Schwind S, et al (2012). Age-related prognostic impact of different types of DNMT3A mutations in adults with primary cytogenetically normal acute myeloid leukemia. J Clin Oncol, 30, 742-50. https://doi.org/10.1200/JCO.2011.39.2092
  29. Marcuccii G, Maharry K, Wu YZ, et al (2010). IDH1 and IDH2 Gene Mutations Identify Novel Molecular Subsets Within De novo Cytogenetically Normal Acute Myeloid Leukemia: A Cancer and Leukemia Group B Study. J Clin Oncol, 28, 2348-55. https://doi.org/10.1200/JCO.2009.27.3730
  30. Mardis ER, Ding L, Dooling DJ, et al (2009). Recurring mutations found by sequencing an acute myeloid leukemia genome. N Engl J Med, 36, 1058-66.
  31. Markova J, Michkova P, Burckova K, et al (2012). Prognostic impact of DNMT3A mutations in patients with intermediate cytogenetic risk profile acute myeloid leukemia. Eur J Haematol, 88, 128-35. https://doi.org/10.1111/j.1600-0609.2011.01716.x
  32. Mrozek K, Dohner H, Bloomfield CD (2007). Influence of new molecular Prognostic markers in patients with karyotypically normal acute myeloid leukemia: recent advances. Curr Opin Hematol, 14, 106-14. https://doi.org/10.1097/MOH.0b013e32801684c7
  33. Paschka P, Schlenk RF, Gaidzik VI, et al (2010). IDH1 and IDH2 mutations are frequent genetic alterations in acute myeloid leukemia and confer adverse prognosis in cytogenetically normal acute myeloid leukemia with NPM1 mutation without FLT3 internal tandem duplication. J Clin Oncol, 28, 3636-43. https://doi.org/10.1200/JCO.2010.28.3762
  34. Patel JP, Gonen M, Figueroa ME, et al (2012). Prognostic relevance of integrated genetic profiling in acute myeloid leukemia. N Engl J Med, 366, 1079-89. https://doi.org/10.1056/NEJMoa1112304
  35. Patel KP, Ravandi F, Ma D, et al (2011). Acute Myeloid Leukemia With IDH1 or IDH2 Mutation: Frequency and Clinicopathologic Features. Am J Clin Pathol, 135, 35-45. https://doi.org/10.1309/AJCPD7NR2RMNQDVF
  36. Qiao C, Sun C, Zhang SJ, et al (2011). Analysis of DNMT3a gene mutations in acute myelogenous leukemia, Zhongguo Shi Yan Xue Ye Xue Za Zhi, 19, 303-7.
  37. Rakheja D, Konoplev S, Medeiros LJ, et al (2012). IDH mutations in acute myeloid leukemia, Hum Pathol, 43, 1541-51. https://doi.org/10.1016/j.humpath.2012.05.003
  38. Renneville A, Boissel N, Nibourel O, et al (2012). Prognostic significance of DNA methyltransferase 3A mutations in cytogenetically normal acute myeloid leukemia: a study by the Acute Leukemia French Association. Leukemia, 26, 1247-54. https://doi.org/10.1038/leu.2011.382
  39. Ribeiro AF, Pratcorona M, Erpelinck-Verschueren C, et al (2012). Mutant DNMT3A: a marker of poor prognosis in acute myeloid leukemia. Blood, 119, 5824-31. https://doi.org/10.1182/blood-2011-07-367961
  40. Schnittger S, Haferlach C, Ulke M, et al (2010). IDH1 mutations are detected in 6.6% of 1414 AML patients and are associated with intermediate risk karyotype and unfavorable prognosis in adults younger than 60 years and unmutated NPM1 status. Blood, 116, 5486-96. https://doi.org/10.1182/blood-2010-02-267955
  41. Slovak ML, KopeckyKJ, Cassileth PA, et al (2000). Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/ Eastern Cooperative Oncology Group study. Blood, 96, 4075-83.
  42. Swerdlow SH, Campo E, Harris NL, et al (2008). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edn. Lyon, International Agency for Research on Cancer (IARC).
  43. Takahashi S (2011). Downstream molecular pathways of FLT3 in the pathogenesis of acute myeloid leukemia: biology and therapeutic implications. J Hematol Oncol, 4, 13. https://doi.org/10.1186/1756-8722-4-13
  44. Takahashi SJ (2011). Current findings for recurring mutations in acute myeloid leukemia. J Hematol Oncol, 36, 1-11.
  45. Thol F, Damm F, Ludeking A, et al (2011). Incidence and prognostic influence of DNMT3A mutations in acute myeloid leukemia. J Clin Oncol, 29, 2889-96. https://doi.org/10.1200/JCO.2011.35.4894
  46. Thol F, Damm F, Wagner K, et al (2010). Prognostic impact of IDH2 mutations in cytogenetically normal acute myeloid leukemia. Blood, 116, 614-6. https://doi.org/10.1182/blood-2010-03-272146
  47. Wagner K, Damm F, Gohring G, et al (2010). Impact of IDH1 R132 mutations and an IDH1 single nucleotide polymorphism in cytogenetically normal acute myeloid leukemia: SNP rs11554137 is an adverse prognostic factor. J Clin Oncol, 28, 2356-64. https://doi.org/10.1200/JCO.2009.27.6899
  48. Zhang Y, Wei H, Wang M, et al (2011). Some novel features of IDH1-mutated acute myeloid leukemia revealed in Chinese patients. Leuk Res, 35, 1301-6. https://doi.org/10.1016/j.leukres.2011.01.019
  49. Zou Y, Zeng Y, Zhang DF, et al (2010). IDH1 and IDH2 mutations are frequent in Chinese patients with acute myeloid leukemia but rare in other types of hematological disorders. Biochem Biophys Res Commun, 402, 378-83. https://doi.org/10.1016/j.bbrc.2010.10.038

Cited by

  1. Survival Outcome of AML Patients with and without TKD Mutations vol.15, pp.24, 2015, https://doi.org/10.7314/APJCP.2014.15.24.10995
  2. Overall Survival in Acute Myeloid Leukaemia Patients with and without Internal Tandem Duplication vol.16, pp.1, 2015, https://doi.org/10.7314/APJCP.2015.16.1.393
  3. Prognostic Value of a CYP2B6 Gene Polymorphism in Patients with Acute Myeloid Leukemia vol.16, pp.11, 2015, https://doi.org/10.7314/APJCP.2015.16.11.4583
  4. Mutation Analysis of IDH1/2 Genes in Unselected De novo Acute Myeloid Leukaemia Patients in India - Identification of A Novel IDH2 Mutation vol.16, pp.9, 2015, https://doi.org/10.7314/APJCP.2015.16.9.4095
  5. Demographic and Clinical Characteristics of Adult Acute Myeloid Leukemia - Tertiary Care Experience vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.357
  6. Acute Myeloid Leukemia: Clinical Spectrum of 125 Patients vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.369
  7. Outcome of Inversion 16 in TKD Positive and Negative Acute Myeloid Leukemia Patients vol.17, pp.4, 2016, https://doi.org/10.7314/APJCP.2016.17.4.2343
  8. Decitabine priming prior to low-dose chemotherapy improves patient outcomes in myelodysplastic syndromes-RAEB: a retrospective analysis vs. chemotherapy alone vol.143, pp.5, 2017, https://doi.org/10.1007/s00432-016-2331-0
  9. Beyond Brooding on Oncometabolic Havoc in IDH-Mutant Gliomas and AML: Current and Future Therapeutic Strategies vol.10, pp.2, 2018, https://doi.org/10.3390/cancers10020049
  10. Isocitrate dehydrogenase 2 mutations correlate with leukemic transformation and are predicted by 2-hydroxyglutarate in myelodysplastic syndromes vol.144, pp.6, 2018, https://doi.org/10.1007/s00432-018-2627-3