Myelodysplastic syndromes and acute leukemia with genetic predispositions: a new challenge for hematologists

Expert Rev Hematol. 2016 Dec;9(12):1189-1202. doi: 10.1080/17474086.2016.1257936. Epub 2016 Nov 21.

Abstract

The determination of an underlying genetic predisposition is not automatically part of the diagnosis of hematological malignancies (HM) in routine practice. However, it is assumed that genetic predispositions to HM are currently underestimated due to great variations in disease phenotype, variable latency and incomplete penetrance. Most of patients do not display any biological or clinical signs besides the overt hematological disease and many of them have a lack of personal or family history of malignancies. Areas covered: Collaborative studies and important advances in molecular testing have led to the discovery of several genes recurrently deregulated in familial HM including RUNX1, CEBPA, GATA2, ANKRD26, SRP72, PAX5, DDX41, ETV6, ATG2B/GSKIP and TERT/TERC. This review summarizes biological and clinical findings encountered within these disorders. Expert commentary: Identify and manage individuals with genetic predisposition is a current challenge for hematologists. Their identification has immediate implications for hematopoietic stem cell transplantation including donor selection and conditioning regimen. Importantly, several features, including familial and personal history as well as molecular and cytogenetic findings, may help clinicians to suspect an underlying genetic predisposition.

Keywords: ANKRD26; ATG2B/GSKIP; CEBPA; DDX41; ETV6; GATA2; GSKIP; PAX5; RUNX1; SRP72; TERC; TERT; acute leukemia; bone marrow failure; genetic predisposition; myelodysplastic syndrome.

Publication types

  • Review

MeSH terms

  • Blood Coagulation Disorders, Inherited / complications
  • Blood Coagulation Disorders, Inherited / genetics
  • Blood Platelet Disorders / complications
  • Blood Platelet Disorders / genetics
  • Comorbidity
  • Family
  • Genes, Dominant
  • Genetic Association Studies*
  • Genetic Predisposition to Disease*
  • Genetic Variation
  • Humans
  • Leukemia, Myeloid, Acute / complications
  • Leukemia, Myeloid, Acute / etiology*
  • Leukemia, Myeloid, Acute / genetics
  • Mutation
  • Myelodysplastic Syndromes / etiology*

Supplementary concepts

  • Platelet Disorder, Familial, with Associated Myeloid Malignancy