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Frequent somatic TET2 mutations in chronic NK-LGL leukemia with distinct patterns of cytopenias
Abstract
Chronic natural killer large granular lymphocyte (NK-LGL) leukemia, also referred to as chronic lymphoproliferative disorder of NK cells, is a rare disorder defined by prolonged expansion of clonal NK cells. Similar prevalence of STAT3 mutations in chronic T-LGL and NK-LGL leukemia is suggestive of common pathogenesis. We undertook whole-genome sequencing to identify mutations unique to NK-LGL leukemia. The results were analyzed to develop a resequencing panel that was applied to 58 patients. Phosphatidylinositol 3-kinase pathway gene mutations (PIK3CD/PIK3AP1) and TNFAIP3 mutations were seen in 5% and 10% of patients, respectively. TET2 was exceptional in that mutations were present in 16 (28%) of 58 patient samples, with evidence that TET2 mutations can be dominant and exclusive to the NK compartment. Reduced-representation bisulfite sequencing revealed that methylation patterns were significantly altered in TET2 mutant samples. The promoter of TET2 and that of PTPRD, a negative regulator of STAT3, were found to be methylated in additional cohort samples, largely confined to the TET2 mutant group. Mutations in STAT3 were observed in 19 (33%) of 58 patient samples, 7 of which had concurrent TET2 mutations. Thrombocytopenia and resistance to immunosuppressive agents were uniquely observed in those patients with only TET2 mutation (Games-Howell post hoc test, P = .0074; Fisher’s exact test, P = .00466). Patients with STAT3 mutation, inclusive of those with TET2 comutation, had lower hematocrit, hemoglobin, and absolute neutrophil count compared with STAT3 wild-type patients (Welch’s t test, P ≤ .015). We present the discovery of TET2 mutations in chronic NK-LGL leukemia and evidence that it identifies a unique molecular subtype.
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“Finally, several studies have described co-occurrence of lymphoid and myeloid malignancies harbouring DNMT3A or TET2 mutations within the same patient 226,240,241 .”
From Clonal haematopoiesis and dysregulation of the immune system (2023) · cites this paper as [226]
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Cited by
Clonal haematopoiesis and dysregulation of the immune system
Belizaire, R., Wong, W. J., Robinette, M. L., & Ebert, B. L. (2023) · Nature Reviews Immunology · doi:10.1038/s41577-023-00843-3 · Cited by 161
Metadata
- Authors
- Olson, T. L., Cheon, H., Xing, J. C., Olson, K. C., Paila, U., Hamele, C. E., Neelamraju, Y., Shemo, B. C., Schmachtenberg, M., Sundararaman, S. K., Toro, M. F., Keller, C. A., Farber, E. A., Onengut-Gumuscu, S., Garrett-Bakelman, F. E., Hardison, R. C., Feith, D. J., Ratan, A., & Loughran, T. P.
- Affiliations
- University of Virginia Cancer Center, Charlottesville, VA;
- Center for Public Health Genomics, University of Virginia, Charlottesville; VA;
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA;
- Department of Biochemistry and Molecular Biology, Center for Computational Biology & Bioinformatics, The Pennsylvania State University, State College, PA; and
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2021-03-30
- Volume
- 138
- Issue
- 8
- Pages
- 662-673
- ISSN
- 0006-4971
- 1528-0020
- Cited by
- 65
- References
- 57
- Language
- en
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- Olson, T. L., Cheon, H., Xing, J. C., Olson, K. C., Paila, U., Hamele, C. E., Neelamraju, Y., Shemo, B. C., Schmachtenberg, M., Sundararaman, S. K., Toro, M. F., Keller, C. A., Farber, E. A., Onengut-Gumuscu, S., Garrett-Bakelman, F. E., Hardison, R. C., Feith, D. J., Ratan, A., & Loughran, T. P. (2021). Frequent somatic TET2 mutations in chronic NK-LGL leukemia with distinct patterns of cytopenias. Blood. https://doi.org/10.1182/blood.2020005831
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
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