Blood:短端粒综合征个体的易患肿瘤及预后

2020-02-22 QQY MedSci原创

中心点:肺外短端粒综合征表型使MDS/AML患者的自然史和克隆造血复杂化。大多数短端粒实体瘤发生于DKC1突变男性;这部分人可能从癌症筛查中获益更多。摘要:短端粒与癌症风险相关,但也有证据表明短端粒具有肿瘤抑制作用。在本研究中,研究人员汇报了携带端粒和其他端粒维持基因胚系突变的个体的癌症预后。在以医院为基础的背景下评估的180个人中,12.8%患有癌症。实体瘤罕见(2.8%);几乎所有癌症患者均为

中心点:

肺外短端粒综合征表型使MDS/AML患者的自然史和克隆造血复杂化。

大多数短端粒实体瘤发生于DKC1突变男性;这部分人可能从癌症筛查中获益更多。

摘要:

短端粒与癌症风险相关,但也有证据表明短端粒具有肿瘤抑制作用。在本研究中,研究人员汇报了携带端粒和其他端粒维持基因胚系突变的个体的癌症预后。

在以医院为基础的背景下评估的180个人中,12.8%患有癌症。实体瘤罕见(2.8%);几乎所有癌症患者均为携带DKC1突变的年轻男性,他们手术切除肿瘤后的预后普遍较好。

骨髓增生异常综合症(MDS)最常见,其次是急性髓系白血病(AML);它们占了75%的癌症。年龄超过50岁是最大的风险因素,MDS/AML常表现为骨髓发育不全、7号染色体单体,但与未被筛选的患者相比,其体细胞突变情况不明显。

1年和2年生存率分别为61%和39%,2/3的MDS/AML患者死于肺纤维化和/或肝肺综合征。一半的MDS/AML患者表现出反复发作的外周血型获得性粒细胞特异性端粒缩短。这种损耗在非MDS/AML的年龄匹配突变携带者中不存在。

研究人员还检测了短端粒的非MDS/AML成人患者是否也有不确定的潜在的(CHIP)相关突变的克隆造血,结果发现30%的个体受到了影响。这些患者在随访中也主要表现为肺纤维化。

本研究表明,孟德尔短端粒综合征与一个相对较窄的癌症谱相关,主要是MDS和AML;短端粒长度足以驱动这些遗传疾病中与年龄相关的不成熟克隆造血。

原始出处:

Kristen E Schratz, et al.Cancer spectrum and outcomes in the Mendelian short telomere syndromes.Blood. FEBRUARY 19, 2020

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