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Il ruolo del next generation sequencing nelle leucemie acute 12 aprile 2013 Bologna Ilaria Iacobucci Dipartimento di Medicina Specialistica, Diagnostica.

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Presentation on theme: "Il ruolo del next generation sequencing nelle leucemie acute 12 aprile 2013 Bologna Ilaria Iacobucci Dipartimento di Medicina Specialistica, Diagnostica."— Presentation transcript:

1 Il ruolo del next generation sequencing nelle leucemie acute 12 aprile 2013 Bologna Ilaria Iacobucci Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna

2 Genetic characterization of BCR-ABL1 like ALL Sample IDRearrangementKey Lesions PAKTALSTRN3-JAK2IKZF1 del and p.Leu117fs PAKKCAEBF1-PDGFRBIKZF1 (IK6); EBF1 del; PAX5 inv; CDKN2A/CDKN2B del PAKVKKNUP214-ABL1IKZF1 p.Ser402fs; PAX5 del; CDKN2A/CDKN2B del PALIBNIGH@-EPORIKZF1 e1-5 del; CDKN2A/CDKN2B del PAKYEBCR-JAK2IKZF1 (IK6); EBF1 del; PAX5 del and p.Gly24Arg; CDKN2A/CDKN2B del AMDRMIGH@-CRLF2JAK2 p.Ile682_Arg683insGlyPro; IKZF1 del e1-e6; EBF1 del; PAX5 p.Val319fs; CDKN2A/CDKN2B del PAKKXBIGH@-CRLF2IKZF1 (IK6); CDKN2A/CDKN2B del; FLT3 p.Asn609ins23aa PAKHZTIGH@-CRLF2JAK2 p.Arg867Gln; CDKN2A/CDKN2B del PANNGLPAX5-JAK2IKZF1 del PANSFDETV6-ABL1IKZF1 (IK6); PAX5 del; CDKN2A/CDKN2B del PANEHFRCSD1-ABL1N/A SJBALL085NUP214-ABL1IKZF1 (IK6) and p.Ala79fs SJBALL010RANBP2-ABL1PAX5 del Novel rearrangements, copy number alterations, and sequence mutations constitutively activating kinase signaling and dysregulating cytokine receptor signaling. Roberts KG et al. Cancer Cell, 2012

3 Genetic characterization of hypodiploid ALL Near haploid Receptor tyrosine kinase signaling and Ras signaling (71%) Focal deletions of a histone gene cluster at 6p22 (19.1%) IKZF3 encoding AIOLOS (13%) Low hypodiploidy TP53 (91.2%) IKZF2 encoding HELIOS (53%) RB1 (41%) Nature Genetics 45, 242–252 (2013) Li- Fraumeni associated mutations

4 5 validated novel missense mutations in BCR-ABL1-positive ALL Genetic characterization of BCR-ABL1 positive ALL

5 Genetic characterization of T-ALL Next Generation Sequencing in T-ALL Whole genomeX chromosome targeted sequencing 12 male T-ALL cases 12 ETP ALL Inactivating mutations and deletions in the X- linked plant homeodomain finger 6 (PHF6) gene in 16% of pediatric and 38% of adult primary T-ALL sample. Vlierberghe P, Nat Genet. 2010 Activating mutations in genes regulating cytokine receptor and RAS signalling (67% ); inactivating lesions disrupting haematopoietic development (58%); and histone-modifying genes (48%). Zhang G, et al. Nature 2012 Whole exome 67 T-ALL Mutations of CNOT3 7.9% adult T-ALLs; mutations affecting the ribosomal proteins RPL5 and RPL10 in 9.8% pediatric T-ALLs. De Keersmaecker K. Nature Genetics, 2013 Whole exome 5 T-ALL Mutations in NT5C2, which encodes a 5′- nucleotidase enzyme that is responsible for the inactivation of nucleoside-analog chemotherapy drugs. Tsoneva G. Nature Medicne, 2013

6 Minimal residual disease monitoring and NGS in ALL Deep-sequencing approach for minimal residual disease detection in acute lymphoblastic leukemia Faham M et al. Blood 2012;120:5173-5180 High-Throughput Sequencing Detects Minimal Residual Disease in Acute T Lymphoblastic Leukemia Wu D et al. Sci Transl Med 2012 Minimal residual disease monitoring and NGS in ALL


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