[229] Genome-Wide Profiling of High-Risk Pediatric Acute Lymphoblastic Leukemia (ALL): The ALL Pilot Project for the Therapeutically Applicable Research To Generate Effective Treatments (TARGET) Initiative. Session Type: Oral Session

Charles G. Mullighan, Xiaoping Su, Jing Ma, Wenjian Yang, Mary V. Relling, William L. Carroll, Gregory Reaman, Paul Bowman, Meenakshi Devidas, Stephen P. Hunger, James R. Downing Childrens Oncology Group; Hartwell Center for Bioinformatics and Biotechnology, St Jude Childrens Research Hospital, Memphis, TN, USA; Pathology, St Jude Childrens Research Hospital, Memphis, TN, USA; Pharmaceutical Sciences, St Jude Childrens Research Hospital, Memphis, TN, USA

Recent studies have identified a high frequency of recurrent acquired DNA copy number abnormalities in pediatric ALL, most commonly involving genes regulating lymphoid development (Nature 2007;446:758). The majority of B-progenitor ALL cases in this study harbored recurring chromosomal abnormalities such as hyperdiploidy and recurring translocations, many of which are associated with favorable outcome. Data from large cohorts of poor risk B-ALL have not been reported. Here we report genomic profiling data from a cohort of 221 pediatric ALL cases treated on the Childrens Oncology Group P9906 study from 2000-2003 with an augmented BFM regimen (N Engl J Med 1998;338:1663). The study targeted poor prognosis ALL cases, using age/WBC criteria designed to identify a subset of patients with NCI high risk ALL that historically had a very poor outcome. Cases with favorable (trisomy 4 + 10; ETV6-RUNX1) or unfavorable (BCR-ABL1 or hypodiploid) genetic features were excluded. The cohort included 25 TCF3-PBX1 and 19 MLL-rearranged cases. Profiling of DNA copy number abnormalities was performed using Affymetrix 250k Sty and Nsp arrays, reference normalization, dChipSNP, and circular binary segmentation. Germline SNP array data was available for 210 cases. The most frequent abnormalities were deletions of CDKN2A in 101 cases (45.7%), the B-lineage transcription factors PAX5 (N=68, 30.5%) and IKZF1 (Ikaros, N=32, 14.5%), ETV6 (N=29, 13.1%), RB1 (N=25, 11.3%), BTG1 (N=23, 10.4%), the tumor suppressor candidate TSC22D1 (N=20, 9%), the microRNA cluster at 13q14 (N=19, 8.6%), and deletion (N=3) or amplification (N=20, 4 focal, 16 broad) of the retinoic acid pathway gene CCDC26. Other recurring copy number abnormalities with relevance to leukemogenesis included deletions of BTLA, EBF, IL3RA, ERG, TOX, RAG1/2, KRAS, NRAS, NR3C2 and the adenosine deaminase pathway genes ADAR and ADARB2. An unexpected finding was focal deletion involving DMD (dystrophin) at Xp21.1 in 15 (6.8%) cases. Copy number abnormalities were uncommon in MLL rearranged leukemias, suggesting that fewer secondary mutations are needed for leukemogenesis in this genetic subtype of ALL. Clustering of copy number data using non-negative matrix factorization identified 11 clusters of cases, including clusters driven by isochromosome 7q, deletions of 9p, gains of 1q, multiple whole chromosomal gains, and intrachromosomal amplification of chromosome 21 (iamp21). These findings confirm the high frequency of deletions involving genes regulating B cell development and cell cycle such as PAX5 and CDKN2A in both standard and poor risk B-ALL. Furthermore ETV6 (TEL) deletions are shown to be common in B-ALL cases lacking the ETV6-RUNX1 translocation. The identification of novel recurring abnormalities (IL3RA, KRAS, NRAS) emphasizes the importance of high resolution copy number analysis in leukemia. These data are being integrated with gene expression data to select genes for resequencing as part of the TARGET project.
Abstract #229 appears in Blood, Volume 110, issue 11, November 16, 2007
Keywords: Acute Lymphoblastic Leukemia|High Risk|Single Nucleotide Polymorphism
Disclosure: Research Funding: 1. Roche-sponsored gene expression profiling research unrelated to the current studies. 2. St. Jude co-owns a pending patent application with the University of Mississippi (Pub. No. 2004/0018513) drawn to leukemia gene expression profiling which has been nonexclusively licensed to Affymetrix. Membership Information: Board of Scientific Consultants for the Memorial Sloan-Kettering Cancer Center (J.R.D.). C.G.M. spoke at an Affymetrix symposium in 2007.

Monday, December 10, 2007 7:30 AM

Session Info:  Simultaneous Session: Molecular Signatures in ALL and AML (7:30 a.m.-9:00 a.m.)