Molecular and genetic biomarkers implemented from next-generation sequencing provide treatment insights in clinical practice for Waldenström macroglobulinemia

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved..

Waldenström macroglobulinemia (WM) is a distinct type of indolent lymphoplasmacytic lymphoma (LPL) with a high frequency of MYD88L265P mutation. Treatment for WM/LPL is highly variable in clinic and ibrutinib (a Bruton tyrosine kinase inhibitor, BTKi) has become a new treatment option for WM. To investigate the clinical impact of genetic alterations in WM, we assembled a large cohort of 219 WMs and 12 LPLs dividing into two subcohorts: a training cohort, patients sequenced by a same targeted 29-gene next-generation sequencing (NGS) panel, and a validation cohort, patients sequenced by allele specific-PCR or other targeted NGS panels. In both training and validation subcohorts, MYD88L265P and TP53 mutations showed favorable and adverse prognostic effects, respectively. CXCR4 nonsense/missense mutations (CXCR4NS/MS), cytogenetic complex karyotypes, and a family history of lymphoma/leukemia in first-degree relatives were associated with significantly worse clinical outcomes only or more in the validation subcohort. We further investigated the efficacy of various treatments and interaction with genetic factors in the entire cohort. Upfront dexamethasone usage was associated with poorer clinical outcomes in patients who received non-proteasome-containing chemotherapy as first-line treatment independent of genetic factors. Maintenance rituximab was associated with better survival. Ibrutinib/BTKi showed potential benefit in relapsed/refractory patients and patients without CXCR4NS/MS including those with TP53 mutations. In conclusion, genetic testing for MYD88L265P, TP53, and CXCR4 mutations and cytogenetic analysis provide important information for prognosis prediction and therapy selection. The findings in these study are valuable for improving treatment decisions on therapies available for WM/LPL patients with integration of NGS in clinic.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:23

Enthalten in:

Neoplasia (New York, N.Y.) - 23(2021), 4 vom: 20. Apr., Seite 361-374

Sprache:

Englisch

Beteiligte Personen:

Wang, Yingjun [VerfasserIn]
Gali, Vasantha Lakshmi [VerfasserIn]
Xu-Monette, Zijun Y [VerfasserIn]
Sano, Dahlia [VerfasserIn]
Thomas, Sheeba K [VerfasserIn]
Weber, Donna M [VerfasserIn]
Zhu, Feng [VerfasserIn]
Fang, Xiaosheng [VerfasserIn]
Deng, Manman [VerfasserIn]
Zhang, Mingzhi [VerfasserIn]
Hagemeister, Fredrick B [VerfasserIn]
Li, Yong [VerfasserIn]
Orlowski, Robert Z [VerfasserIn]
Lee, Hans Chulhee [VerfasserIn]
Young, Ken H [VerfasserIn]

Links:

Volltext

Themen:

1X70OSD4VX
4F4X42SYQ6
7S5I7G3JQL
Adenine
Agammaglobulinaemia Tyrosine Kinase
Antineoplastic Agents
BTK protein, human
CXCR4
CXCR4 protein, human
Cytogenetic karyotype
Dexamethasone
EC 2.7.10.2
Ibrutinib
Immunoglobulin A
Immunoglobulin G
Immunoglobulin M
JAC85A2161
Journal Article
MYD88
MYD88 protein, human
Myeloid Differentiation Factor 88
Piperidines
Receptors, CXCR4
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Rituximab
TP53
TP53 protein, human
Tumor Suppressor Protein p53
Waldenström macroglobulinemia

Anmerkungen:

Date Completed 16.11.2021

Date Revised 16.11.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.neo.2021.02.002

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM322921716