Genomic landscape of TP53-mutated myeloid malignancies

• Published in: Blood advances Vol. 7; no. 16; pp. 4586 - 4598
• Main Authors: Abel, Haley J., Oetjen, Karolyn A., Miller, Christopher A., Ramakrishnan, Sai M., Day, Ryan B., Helton, Nichole M., Fronick, Catrina C., Fulton, Robert S., Heath, Sharon E., Tarnawsky, Stefan P., Nonavinkere Srivatsan, Sridhar, Duncavage, Eric J., Schroeder, Molly C., Payton, Jacqueline E., Spencer, David H., Walter, Matthew J., Westervelt, Peter, DiPersio, John F., Ley, Timothy J., Link, Daniel C.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 22.08.2023; The American Society of Hematology
• Subjects: Chromosome Aberrations; Chromothripsis; Genomics; Humans; Leukemia, Myeloid, Acute - genetics; Leukemia, Myeloid, Acute - pathology; Mutation; Myelodysplastic Syndromes - genetics; Myelodysplastic Syndromes - pathology; Myeloid Neoplasia; Myeloproliferative Disorders - genetics; Tumor Suppressor Protein p53 - genetics
• ISSN: 2473-9529; 2473-9537
• DOI: 10.1182/bloodadvances.2023010156

•Telomere content is increased in TP53-mutated AML/MDS compared with other AMLs, implicating altered telomere maintenance for pathogenesis.•Alterations of ETV6 and NF1 are frequent cooperating events in TP53-mutated AML/MDS. [Display omitted] TP53-mutated myeloid malignancies are associated with complex cytogenetics and extensive structural variants, which complicates detailed genomic analysis by conventional clinical techniques. We performed whole-genome sequencing (WGS) of 42 acute myeloid leukemia (AML)/myelodysplastic syndromes (MDS) cases with paired normal tissue to better characterize the genomic landscape of TP53-mutated AML/MDS. WGS accurately determines TP53 allele status, a key prognostic factor, resulting in the reclassification of 12% of cases from monoallelic to multihit. Although aneuploidy and chromothripsis are shared with most TP53-mutated cancers, the specific chromosome abnormalities are distinct to each cancer type, suggesting a dependence on the tissue of origin. ETV6 expression is reduced in nearly all cases of TP53-mutated AML/MDS, either through gene deletion or presumed epigenetic silencing. Within the AML cohort, mutations of NF1 are highly enriched, with deletions of 1 copy of NF1 present in 45% of cases and biallelic mutations in 17%. Telomere content is increased in TP53-mutated AMLs compared with other AML subtypes, and abnormal telomeric sequences were detected in the interstitial regions of chromosomes. These data highlight the unique features of TP53-mutated myeloid malignancies, including the high frequency of chromothripsis and structural variation, the frequent involvement of unique genes (including NF1 and ETV6) as cooperating events, and evidence for altered telomere maintenance.