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by Zachary R. Hunter, Lian Xu, Nickolas Tsakmaklis, Maria G

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1 Insights into the genomic landscape of MYD88 wild-type Waldenström macroglobulinemia
by Zachary R. Hunter, Lian Xu, Nickolas Tsakmaklis, Maria G. Demos, Amanda Kofides, Cristina Jimenez, Gloria G. Chan, Jiaji Chen, Xia Liu, Manit Munshi, Joshua Gustine, Kirsten Meid, Christopher J. Patterson, Guang Yang, Toni Dubeau, Mehmet K. Samur, Jorge J. Castillo, Kenneth C. Anderson, Nikhil C. Munshi, and Steven P. Treon BloodAdv Volume 2(21): November 13, 2018 © 2018 by The American Society of Hematology

2 Zachary R. Hunter et al. Blood Adv 2018;2:2937-2946
© 2018 by The American Society of Hematology

3 Mutations identified in MYD88WT WM by whole exome sequencing.
Mutations identified in MYD88WTWM by whole exome sequencing. (A) The median number of somatic mutations for patients with paired tumor/germline samples was 33 and the number of mutations per patient for these individuals are shown. (B) Somatic mutations were associated with NF-κB signaling, epigenetic regulation, and DNA damage response. Each row represents a unique patient. Patient identifiers in bold type indicate that the patient is deceased. *Patients with disease that later transformed. (C) Location of conserved motifs in the protein coding domains of top affected genes are shown. ★Location of a somatic mutation. Zachary R. Hunter et al. Blood Adv 2018;2: © 2018 by The American Society of Hematology

4 Comparison of findings for MYD88WT and MYD88MUT WM
Comparison of findings for MYD88WT and MYD88MUT WM. Comparison of somatic mutation frequencies between MYD88WT and MYD88MUT WM patients. Comparison of findings for MYD88WTand MYD88MUTWM. Comparison of somatic mutation frequencies between MYD88WT and MYD88MUT WM patients. (A) Data for mutation frequencies for 53 MYD88MUT WM patients were acquired from our previous whole genome sequencing results, using high-quality somatic variants supported by at least 3 reads.10,11 (B) Kaplan-Meier curves for overall survival from time of diagnosis for WM patients with MYD88MUT, and MYD88WT with and without DDR mutations (log-rank P < .0001). Zachary R. Hunter et al. Blood Adv 2018;2: © 2018 by The American Society of Hematology

5 Findings from next-generation gene expression studies in MYD88WT WM
Findings from next-generation gene expression studies in MYD88WT WM. (A) The top 100 most statistically significant genes between samples from 18 MYD88WT and 75 MYD88MUT patients are shown, demonstrating a uniform gene signature associated with the MYD88WT population. Findings from next-generation gene expression studies in MYD88WTWM. (A) The top 100 most statistically significant genes between samples from 18 MYD88WT and 75 MYD88MUT patients are shown, demonstrating a uniform gene signature associated with the MYD88WT population. (B) Principal component analysis of the top 500 high variance genes revealed a clustering of MYD88WT and MYD88MUT WM samples, regardless of CXCR4 mutation status that was distinct from healthy donor peripheral blood B, memory B, and plasma cells. (C) These findings were also recapitulated in the supervised clustering of the top 100 most statistically significant differentially expressed genes between healthy donor memory B cells and MYD88WT WM samples, in which gene expression levels were very similar between all WM samples regardless of MYD88 and CXCR4 mutation status. Zachary R. Hunter et al. Blood Adv 2018;2: © 2018 by The American Society of Hematology

6 Genomic variants identified in MYD88 wild-type WM that affect NF-κB signaling.
Genomic variants identified in MYD88 wild-type WM that affect NF-κB signaling. Red triangle denotes variants identified by whole exome sequencing in MYD88 wild-type WM patients. Zachary R. Hunter et al. Blood Adv 2018;2: © 2018 by The American Society of Hematology


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