EGR2 mutations define a new clinically aggressive subgroup of chronic lymphocytic leukemia

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Authors

YOUNG E. NOERENBERG D. MANSOURI L. LJUNGSTROM V. FRICK M. SUTTON L. A. BLAKEMORE S. J. GALAN-SOUSA J. PLEVOVÁ Karla BALIAKAS P. ROSSI D. CLIFFORD R. ROOS-WEIL D. NAVRKALOVÁ Veronika DOERKEN B. SCHMITT C. A. SMEDBY K. E. JULIUSSON G. GIACOPELLI B. BLACHLY J. S. BELESSI C. PANAGIOTIDIS P. CHIORAZZI N. DAVI F. LANGERAK A. W. OSCIER D. SCHUH A. GAIDANO G. GHIA P. XU W. FAN L. BERNARD O. A. NGUYEN-KHAC F. RASSENTI L. LI J. KIPPS T. J. STAMATOPOULOS K. POSPÍŠILOVÁ Šárka ZENZ T. OAKES C. C. STREFFORD J. C. ROSENQUIST R. DAMM F.

Year of publication 2017
Type Article in Periodical
Magazine / Source Leukemia
MU Faculty or unit

Central European Institute of Technology

Citation
Web http://www.nature.com/leu/journal/v31/n7/full/leu2016359a.html?foxtrotcallback=true
Doi http://dx.doi.org/10.1038/leu.2016.359
Field Oncology and hematology
Keywords IDENTIFIES RECURRENT MUTATIONS; LRF CLL4 TRIAL; GENE-MUTATIONS; MYELODYSPLASTIC SYNDROMES; TRANSCRIPTION FACTORS; CLONAL EVOLUTION; SF3B1 MUTATIONS; HIGH-THROUGHPUT; ATM MUTATIONS; NOTCH1
Description Recurrent mutations within EGR2 were recently reported in advanced-stage chronic lymphocytic leukemia (CLL) patients and associated with a worse outcome. To study their prognostic impact, 2403 CLL patients were examined for mutations in the EGR2 hotspot region including a screening (n = 1283) and two validation cohorts (UK CLL4 trial patients, n = 366; CLL Research Consortium (CRC) patients, n = 490). Targeted deep-sequencing of 27 known/postulated CLL driver genes was also performed in 38 EGR2-mutated patients to assess concurrent mutations. EGR2 mutations were detected in 91/2403 (3.8%) investigated cases, and associated with younger age at diagnosis, advanced clinical stage, high CD38 expression and unmutated IGHV genes. EGR2-mutated patients frequently carried ATM lesions (42%), TP53 aberrations (18%) and NOTCH1/FBXW7 mutations (16%). EGR2 mutations independently predicted shorter time-to-first-treatment (TTFT) and overall survival (OS) in the screening cohort; they were confirmed associated with reduced TTFT and OS in the CRC cohort and independently predicted short OS from randomization in the UK CLL4 cohort. A particularly dismal outcome was observed among EGR2-mutated patients who also carried TP53 aberrations. In summary, EGR2 mutations were independently associated with an unfavorable prognosis, comparable to CLL patients carrying TP53 aberrations, suggesting that EGR2-mutated patients represent a new patient subgroup with very poor outcome.
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