ID

45799

Description

Principal Investigator: Adolfo Ferrando, MD, PhD, Columbia University, New York, NY, USA MeSH: Leukemia, Lymphoid,Lymphoblastic Leukemia, Acute, T-Cell,Precursor B-Cell Lymphoblastic Leukemia https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001072 Although multi-agent combination chemotherapy is curative in a significant fraction of childhood acute lymphoblastic leukemia (ALL) patients, 20% of cases relapse and most die due to chemo-refractory disease. Here we used whole-exome and whole-genome sequencing to analyze the mutational landscape and pattern of clonal evolution at relapse in pediatric ALL cases. These analyses showed that ALL relapses originate from a common ancestral precursor clone of the diagnosis and relapsed populations and frequently harbor mutations implicated in chemotherapy resistance. RAS-MAPK pathway activating mutations in NRAS, KRAS and PTPN11 were present in 24/55 (44%) cases in our series. Notably, while some cases showed emergence of RAS mutant clones at relapse, in others, RAS mutant clones present at diagnosis were replaced by RAS wild type populations. Mechanistically, functional dissection of mouse and human wild type Kras and mutant Kras (Kras G12D) isogenic leukemia cells demonstrated induction of methotrexate resistance, but also improved response to vincristine, in mutant Kras- expressing lymphoblasts. These results identify chemotherapy driven selection as a central mechanism of leukemia clonal evolution and pave the road for the development of tailored personalized therapies for the treatment of relapsed ALL.

Link

dbGaP-study=phs001072

Keywords

  1. 6/23/23 6/23/23 - Chiara Middel
Copyright Holder

Adolfo Ferrando, MD, PhD, Columbia University, New York, NY, USA

Uploaded on

June 23, 2023

DOI

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License

Creative Commons BY 4.0

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dbGaP phs001072 Genomic Analysis of Relapsed Pediatric Acute Lymphoblastic Leukemia

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This subject phenotype table contains subject ID, age and gender of participant.

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
pht005356
C3846158 (UMLS CUI [1,1])
SUBJECT_ID
Item
De-identified Subject ID
string
C4684638 (UMLS CUI [1,1])
C2348585 (UMLS CUI [1,2])
AGE
Item
Subject age
float
C0001779 (UMLS CUI [1,1])
Item
Gender of participant
text
C0079399 (UMLS CUI [1,1])
Code List
Gender of participant
CL Item
Female (F)
C0086287 (UMLS CUI [1,1])
CL Item
Male (M)
C0086582 (UMLS CUI [1,1])
CL Item
Unknown (UNK)
CL Item
Other (Oth)
CL Item
Not applicable (NA)
C1272460 (UMLS CUI [1,1])

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