[斯特拉斯堡大学医院发生 RUNX1 基因突变的急性髓性白血病]。

Baptiste Panaget, Laurent Mauvieux, Laurent Miguet, Luc-Mathieu Fornecker, Bruno Lioure, Marie-Pierre Ledoux, Delphine Rolland, Caroline Mayeur-Rousse
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摘要

RUNX1 在人类造血过程中至关重要。已有大量 RUNX1 基因失调的描述,包括易位、种系突变或体细胞突变。急性髓性白血病(AML)中反复出现的新RUNX1突变促使2016年世界卫生组织将RUNX1突变的AML作为一个临时实体。此外,最近的基因组研究强调,罕见的急性髓性白血病患者具有浆细胞树突状细胞(pDC)扩增和高RUNX1突变频率。为了更好地描述RUNX1突变的急性髓细胞性白血病,我们对斯特拉斯堡大学医院确诊的32名患者进行了回顾性研究。我们汇总了详细的临床和生物学特征。通过细胞学和流式细胞术评估了是否存在 pDC 特质。在我们的队列中,无论是在细胞学、白血病停滞阶段还是突变特征方面,都没有发现共同特征。根据我们的观察,突变的RUNX1急性髓细胞性白血病似乎不是一种独特的急性髓细胞性白血病实体。2022 年世界卫生组织的新分类将 RUNX1 基因突变的急性髓细胞性白血病纳入急性髓细胞性白血病骨髓增生异常相关类别。我们还在队列中发现了一名符合AML-pDC标准的急性髓细胞性白血病患者,这是WHO最新分类中新纳入的一种罕见类型。
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[Acute myeloid leukemia with mutated RUNX1 at the university hospitals of Strasbourg].

RUNX1 is essential during human hematopoiesis. Numerous RUNX1 deregulations have been described, including translocations and germline or somatic mutations. Recurrent de novo RUNX1 mutations in acute myeloid leukemias (AML) prompted the creation of a provisional entity of AML with mutated RUNX1 in the 2016 WHO. In addition, recent genomic studies underlined rare AML patients with plasmacytoid dendritic cell (pDC) expansion and high RUNX1 mutations frequency. To better characterized AML with RUNX1 mutations, we retrospectively investigated a cohort of 32 patients diagnosed at Strasbourg University Hospital. Detailed clinical and biological features were aggregated. The presence of a pDC contingent was assessed by cytology and flow cytometry. In our cohort, no common features were identified either in term of cytology, stage of leukemia arrest or mutational features. Based on our observations, mutated RUNX1 AMLs do not appear to be a distinct AML entity. The new 2022 WHO classification includes AML with mutated RUNX1 within AML myelodysplasia-related category. We also identified within our cohort a patient whose AML fulfilled AML-pDC criteria, a rare and newly included entity in the last WHO classification.

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