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研究确定了侵袭性儿童白血病的基因组标记

Leukemia Cells under microscope
Leukemia Cells

New research published today in JAMA Oncology 报道了两种不同的DNA变化是如何在组合发生时预测侵袭性儿童白血病的. 在横跨多个大洲的几个研究地点进行了十年的工作, 研究人员评估了超过1例的肿瘤特征,300名儿童癌症患者诊断为b细胞急性淋巴细胞白血病(ALL), 一种影响骨髓白细胞的癌症. 白血病是儿童中最常见的癌症类型 & Lymphoma Society. 这项研究阐明了这种疾病在儿童中最坏结果的遗传学理解, including relapse and/or death.

Joshua Schiffman in lab coat
Joshua D. Schiffman, MD

研究小组研究了白血病细胞的DNA,以寻找共同的变化. "We found a barely noticeable area of DNA, known as 22q11.在大约30-40%的儿童b细胞ALL患者中缺失22个。 Joshua Schiffman, MD, co-senior author on the study. 希夫曼是亨茨曼癌症研究所(HCI)的儿科癌症医生兼科学家,也是美国国立卫生研究院儿科教授 University of Utah (U of U). “大发娱乐开始怀疑,这么小的东西是不是经常不见, could this missing piece of DNA impact survival?就在那时,研究小组将注意力转向了一个更知名的儿童白血病基因 IKZF1.

Luke Maese in Blue Dress Shirt and Red Tie Portrait
Luke Maese, DO

"IKZF1 changes have puzzled doctors for some time," explains Luke Maese, DO, 她是HCI的儿科肿瘤学家,也是犹他大学儿科副教授,在山间初级儿童医院照顾白血病儿童. "We have known for over a decade that IKZF1 这些变化预示着一些(但不是所有)患者的预后很差.研究小组开始调查22q11缺失的部分是否.22 could work together with IKZF1 changes to more reliably predict outcomes.

"Sure enough, we found that patients with both the 22q11.22 deletion and the IKZF1 基因突变——统称为“双重缺失”——在儿童白血病中有一些最糟糕的结果," says Schiffman. The team found that patients who already had an IKZF1 如果他们在22q11中也有一个缺失,那么变异的复发风险几乎是前者的两倍.22 region.

研究小组利用复杂的基因组分析技术来评估b细胞ALL儿童肿瘤的遗传和环境变化. 他们评估了多个州和国家儿童癌症患者的基因组信息. 该研究包括患有唐氏综合症的儿童白血病患者. Children with Down syndrome carry a higher risk of leukemia.

David Spencer Mangum Formal Portrait
David Spencer Mangum, MD

David Spencer Mangum, MD, 共同主要作者,现为内穆尔儿童健康中心儿科血液学/肿瘤学助理教授, 他还记得十多年前,他作为一名医学生访问HCI的希夫曼实验室时开始从事这项研究. “在我多年的训练中,大发娱乐从未停止过试图理解这是如何发生的.22 deletion could impact children with leukemia. 大发娱乐从许多不同的临床试验中收集数据,以确保这一发现是真实的和可重复的," explains Mangum. “大发娱乐的发现很重要,因为大发娱乐发现复发和死亡的可能性在多个不同的ALL患儿队列中是一致的, including children with Down syndrome."

研究小组希望这一发现能够为儿童白血病的治疗大发娱乐提供新的见解. For example, the frequency of the 22q11.22局灶性缺失表明它可能对白血病的发展很重要, 与更糟糕的结果相结合意味着它可能是未来一个有用的临床预后指标. “患有双缺失白血病的孩子可能需要更多的治疗,或者立即进行骨髓移植,而没有双缺失的孩子可能需要毒性较小的化疗,仍然可以达到良好的效果。. All of this needs to be further explored," says Schiffman.

The study was funded by the National Institutes of Health/National Cancer Institute including CA042014 and CA021765; the Pediatric Cancer Research Program funded by Intermountain Healthcare, Primary Children’s Hospital Foundation, and Department of Pediatrics at University of Utah; the Leukemia & Lymphoma Society Translational Research Program; the American Lebanese Syrian Associated Charities; and Huntsman Cancer Foundation. The study benefited from insights of Professor Sir Mel Greaves, an internationally renowned expert on childhood leukemia. 作者承认参与合作的每个个人和机构的关键作用, including other study co-first authors Clinton Mason, PhD, of University of Utah Health; and Julia Meyer, PhD, of the University of California, San Francisco; and co-senior author Karen Rabin, MD, PhD, of Baylor University. 在线查看该研究的作者和机构的完整名单.

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Huntsman Cancer Institute
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About Huntsman Cancer Institute at the University of Utah

Huntsman Cancer Institute at the University of Utah 是国家癌症研究所指定的犹他州综合癌症中心吗, Idaho, Montana, Nevada, and Wyoming. With a legacy of innovative cancer research, groundbreaking discoveries, and world-class patient care, we are transforming the way cancer is understood, prevented, diagnosed, treated, and survived. 亨斯迈癌症研究所致力于通过科学突破和尖端技术大发娱乐提供最先进的癌症治疗和预防,以推动未来的癌症治疗超越今天的护理标准. We have more than 300 open clinical trials and 250 research teams studying cancer. 亨斯迈癌症研究所发现的遗传性癌症基因比其他任何癌症中心都要多. 大发娱乐的科学家以了解癌症如何开始并利用这些知识开发创新方法来治疗每位患者的独特疾病而闻名于世. Huntsman Cancer Institute was founded by Jon M. and Karen Huntsman.

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