Comparison of TP53 mutations in myelodysplasia and acute leukemia suggests divergent roles in initiation and progression

Ashwini Jambhekar , Emily E. Ackerman , Berk A. Alpay , Galit Lahav , Scott B. Lovitch
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Abstract

TP53 mutation predicts adverse prognosis in many cancers, including myeloid neoplasms, but the mechanisms by which specific mutations affect disease biology, and whether they differ between disease categories, remain unknown. We analyzed TP53 mutations in 4 myeloid neoplasm subtypes (myelodysplastic syndrome [MDS], acute myeloid leukemia [AML], AML with myelodysplasia-related changes [AML-MRC], and therapy-related AML), and identified differences in mutation types, spectrum, and hot spots between disease categories and in comparison to solid tumors. Missense mutations in the DNA-binding domain were most common across all categories, whereas inactivating mutations and mutations outside the DNA binding domain were more common in AML-MRC than in MDS. TP53 mutations in MDS were more likely to retain transcriptional activity, and comutation profiles were distinct between disease categories and mutation types. Our findings suggest that mutated TP53 contributes to initiation and progression of neoplasia via distinct mechanisms, and support the utility of specific identification of TP53 mutations in myeloid malignancies.

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比较骨髓增生异常和急性白血病中的 TP53 基因突变,发现它们在发病和发展过程中发挥着不同的作用
摘要TP53突变可预测包括骨髓性肿瘤在内的许多癌症的不良预后,但特定突变影响疾病生物学的机制及其在不同疾病类别中是否存在差异仍是未知数。我们分析了4种骨髓肿瘤亚型(骨髓增生异常综合征[MDS]、急性髓性白血病[AML]、骨髓增生异常相关病变的急性髓性白血病[AML-MRC]和治疗相关的急性髓性白血病)中的TP53突变,发现了不同疾病类别之间以及与实体瘤相比在突变类型、谱系和热点方面的差异。在所有类别中,DNA结合域的错义突变最为常见,而失活突变和DNA结合域外的突变在AML-MRC中比在MDS中更为常见。MDS中的TP53突变更有可能保留转录活性,不同疾病类别和突变类型之间的突变情况也各不相同。我们的研究结果表明,突变的TP53通过不同的机制促进了肿瘤的发生和发展,并支持对骨髓恶性肿瘤中的TP53突变进行特异性鉴定。
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