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The incidence, genetic characteristics, and prognosis of leukemia with concurrent pathogenic fusion genes: a series of 25 cases from a large cohort of leukemia patients

Cancer Gene Therapy volume 27, pages 89–97 (2020)Cite this article

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Abstract

Recurrent fusion genes (FGs) with clinical significances in leukemias are mainly mutually exclusive, and the coexistence of different FGs has been rarely reported. In this study, we retrospectively analyzed the incidence, genetic characteristics, and prognosis of leukemias with concurrent pathogenic FGs, which commonly reported in hematological malignancies in 8226 leukemia patients. A total of 25 patients with coexistence of double FGs were identified, accounting for 0.30% of all cases enrolled. More than half of the cases (14/25, 56%) were diagnosed as chronic myeloid leukemia in accelerated or blast phase, another six and five cases were acute myeloid leukemia and acute lymphocytic leukemia, respectively. Most cases (20/25, 80%) carried constitutively activated tyrosine kinases FGs (BCR-ABL1 or ETV6-PDGFRB) and transcription factors associated FGs simultaneously. Of the 11 patients with contemporaneous karyotype, 5 (45%) showed visible chromosomal abnormalities corresponding to both FGs. The concurrency of FGs was often associated with disease progressions. The prognosis was pessimistic for patients with concurrent FGs, even with the combination of targeted therapy and chemotherapy. Performing allogeneic hematopoietic stem cell transplantation as soon as possible after complete remission can ameliorate the dismal prognosis.

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Acknowledgements

We thank Lin Zhou, Na Wang, Lan Wang, Xinna Liu, and Qing Yin from Divison of Pathology & Laboratory Medicine of Hebei Yanda Lu Daopei Hospital for technical support. We thank Yanli Zhao, Yue Lu, Xingyu Cao, Jiarui Zhou, Ruijuan Sun, Jianping Zhang, Min Xiong, and Zhijie Wei from Bone Marrow Transplantation Department and Xian Zhang, Junfang Yang, Fanyong Lv from Hematology Department of Hebei Yanda Lu Daopei Hospital for patient and sample supports.

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Authors and Affiliations

  1. Divison of Pathology & Laboratory Medicine, Hebei Yanda Lu Daopei Hospital, Langfang, 065201, China

    Xue Chen, Fang Wang, Tong Wang, Yang Zhang, Xiaoli Ma, Lili Yuan, Wen Teng, Lei Guo, Mingyue Liu, Ming Liu, Jiaqi Chen, Daijing Nie, Yu Zhang, Xiaosu Zhou & Hongxing Liu

  2. Department of Hematology, Peking University First Hospital, Beijing, 100034, China

    Mangju Wang & Ping Zhu

  3. Beijing Lu Daopei Institute of Hematology, Beijing, 100076, China

    Kylan N. Chen & Hongxing Liu

  4. Divison of Pathology & Laboratory Medicine, Beijing Lu Daopei Hospital, Beijing, 100076, China

    Hongxing Liu

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Correspondence to Hongxing Liu.

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Chen, X., Wang, F., Wang, T. et al. The incidence, genetic characteristics, and prognosis of leukemia with concurrent pathogenic fusion genes: a series of 25 cases from a large cohort of leukemia patients. Cancer Gene Ther 27, 89–97 (2020). https://doi.org/10.1038/s41417-019-0147-1

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