Abstract:
:Specific myeloid-related and inositide-specific gene mutations can be linked to myelodysplastic syndromes (MDS) pathogenesis and therapy. Here, 44 higher-risk MDS patients were treated with azacitidine and lenalidomide and mutations analyses were performed at baseline and during the therapy. Results were then correlated to clinical outcome, overall survival (OS), leukemia-free-survival (LFS) and response to therapy. Collectively, 34/44 patients were considered evaluable for response, with an overall response rate of 76.25% (26/34 cases): 17 patients showed a durable response, 9 patients early lost response and 8 patients never responded. The most frequently mutated genes were ASXL1, TET2, RUNX1, and SRSF2. All patients early losing response, as well as cases never responding, acquired the same 3 point mutations during therapy, affecting respectively PIK3CD (D133E), AKT3 (D280G), and PLCG2 (Q548R) genes, that regulate cell proliferation and differentiation. Moreover, Kaplan-Meier analyses revealed that this mutated cluster was significantly associated with a shorter OS, LFS, and duration of response. All in all, a common mutated cluster affecting 3 inositide-specific genes is significantly associated with loss of response to azacitidine and lenalidomide therapy in higher risk MDS. Further studies are warranted to confirm these data and to further analyze the functional role of this 3-gene cluster.
journal_name
Leukemiajournal_title
Leukemiaauthors
Follo MY,Pellagatti A,Armstrong RN,Ratti S,Mongiorgi S,De Fanti S,Bochicchio MT,Russo D,Gobbi M,Miglino M,Parisi S,Martinelli G,Cavo M,Luiselli D,McCubrey JA,Suh PG,Manzoli L,Boultwood J,Finelli C,Cocco Ldoi
10.1038/s41375-019-0416-xsubject
Has Abstractpub_date
2019-09-01 00:00:00pages
2276-2290issue
9eissn
0887-6924issn
1476-5551pii
10.1038/s41375-019-0416-xjournal_volume
33pub_type
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