Germ line variants in patients with acute myeloid leukemia without a suspicion of hereditary hematologic malignancy syndrome

• Published in: Blood advances Vol. 7; no. 19; pp. 5799 - 5811
• Main Authors: Guijarro, Francesca, López-Guerra, Monica, Morata, Jordi, Bataller, Alex, Paz, Sara, Cornet-Masana, Josep Maria, Banús-Mulet, Antònia, Cuesta-Casanovas, Laia, Carbó, Josep Maria, Castaño-Díez, Sandra, Jiménez-Vicente, Carlos, Cortés-Bullich, Albert, Triguero, Ana, Martínez-Roca, Alexandra, Esteban, Daniel, Gómez-Hernando, Marta, Álamo Moreno, José Ramón, López-Oreja, Irene, Garrote, Marta, Risueño, Ruth M., Tonda, Raúl, Gut, Ivo, Colomer, Dolors, Díaz-Beya, Marina, Esteve, Jordi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 10.10.2023; The American Society of Hematology
• Subjects: Myeloid Neoplasia
• ISSN: 2473-9529; 2473-9537
• DOI: 10.1182/bloodadvances.2023009742

•Cancer-predisposing GVs are present in patients with AML without suspicion of hereditary hematologic malignancy syndrome.•ATM nonsense mutations were found in 6.4% of patients of our cohort, warranting further studies to clarify their role in AML predisposition. [Display omitted] Germ line predisposition in acute myeloid leukemia (AML) has gained attention in recent years because of a nonnegligible frequency and an impact on management of patients and their relatives. Risk alleles for AML development may be present in patients without a clinical suspicion of hereditary hematologic malignancy syndrome. In this study we investigated the presence of germ line variants (GVs) in 288 genes related to cancer predisposition in 47 patients with available paired, tumor-normal material, namely bone marrow stroma cells (n = 29), postremission bone marrow (n = 17), and saliva (n = 1). These patients correspond to 2 broad AML categories with heterogeneous genetic background (AML myelodysplasia related and AML defined by differentiation) and none of them had phenotypic abnormalities, previous history of cytopenia, or strong cancer aggregation. We found 11 pathogenic or likely pathogenic variants, 6 affecting genes related to autosomal dominant cancer predisposition syndromes (ATM, DDX41, and CHEK2) and 5 related to autosomal recessive bone marrow failure syndromes (FANCA, FANCM, SBDS, DNAJC21, and CSF3R). We did not find differences in clinical characteristics nor outcome between carriers of GVs vs noncarriers. Further studies in unselected AML cohorts are needed to determine GV incidence and penetrance and, in particular, to clarify the role of ATM nonsense mutations in AML predisposition.