High frequency of clonal hematopoiesis in Erdheim-Chester disease
Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral bl...
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Published in | Blood Vol. 137; no. 4; pp. 485 - 492 |
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Main Authors | , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
28.01.2021
American Society of Hematology |
Subjects | |
Online Access | Get full text |
ISSN | 0006-4971 1528-0020 1528-0020 |
DOI | 10.1182/blood.2020005101 |
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Abstract | Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38− BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD.
•ECD patients have a very high frequency of clonal hematopoiesis and concomitant overt myeloid malignancies.•ECD patients with clonal hematopoiesis are older and have more frequent retroperitoneal involvement and BRAFV600E mutations.
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AbstractList | ECD patients have a very high frequency of clonal hematopoiesis and concomitant overt myeloid malignancies.
ECD patients with clonal hematopoiesis are older and have more frequent retroperitoneal involvement and
BRAF
V600E mutations.
Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of
BRAF
V600E
mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were
TET2
,
ASXL1
,
DNMT3A
, and
NRAS
. ECD patients with clonal hematopoiesis were more likely to be older (
P
< .0001), have retroperitoneal involvement (
P
= .02), and harbor a
BRAF
V600E
mutation (
P
= .049) than those without clonal hematopoiesis. The presence of the
TET2
mutation was associated with a
BRAF
V600E
mutation in tissue ECD lesions (
P
= .0006) and
TET2
-mutant ECD patients were more likely to have vascular involvement than
TET2
wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34
+
CD38
−
BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD. Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38− BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD. •ECD patients have a very high frequency of clonal hematopoiesis and concomitant overt myeloid malignancies.•ECD patients with clonal hematopoiesis are older and have more frequent retroperitoneal involvement and BRAFV600E mutations. [Display omitted] Abstract Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38− BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD. Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38− BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD. Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38- BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD. Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38- BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD.Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent retroperitoneal involvement) and a high frequency of BRAFV600E mutations. Although ECD is not commonly recognized to have overt peripheral blood (PB) or bone marrow (BM) disease, we recently identified that ECD patients have a high frequency of a concomitant myeloid malignancy. We thus conducted a systematic clinical and molecular analysis of the BM from 120 ECD patients. Surprisingly, 42.5% of ECD patients (51 of 120) had clonal hematopoiesis whereas 15.8% of patients (19 of 120) developed an overt hematologic malignancy (nearly all of which were a myeloid neoplasm). The most frequently mutated genes in BM were TET2, ASXL1, DNMT3A, and NRAS. ECD patients with clonal hematopoiesis were more likely to be older (P < .0001), have retroperitoneal involvement (P = .02), and harbor a BRAFV600E mutation (P = .049) than those without clonal hematopoiesis. The presence of the TET2 mutation was associated with a BRAFV600E mutation in tissue ECD lesions (P = .0006) and TET2-mutant ECD patients were more likely to have vascular involvement than TET2 wild-type ECD patients. Clonal hematopoiesis mutations in ECD were detected in cells derived from CD34+CD38- BM progenitors and PB monocytes but less frequently present in PB B and T lymphocytes. These data identify a heretofore unrecognized high frequency of clonal hematopoiesis in ECD patients, reaffirm the development of additional high risk of myeloid neoplasms in ECD, and provide evidence of a BM-based precursor cell of origin for many patients with ECD. |
Author | Cohen Aubart, Fleur Hélias-Rodzewicz, Zofia Della-Valle, Véronique Abdel-Wahab, Omar Haroche, Julien Charlotte, Frédéric Roos-Weil, Damien Amoura, Zahir Duployez, Nicolas Nguyen-Khac, Florence Donadieu, Jean Emile, Jean-François Maloum, Karim Lhote, Raphael Bernard, Olivier Poulain, Stéphanie Armand, Marine Marceau-Renaut, Alice |
AuthorAffiliation | 5 Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER), UMR-S 1277, Centre Hospitalier Universitaire (CHU) Lille, INSERM, Centre National de la Recherche Scientifique (CNRS), Université de Lille, Lille, France 10 Service d’Hématologie Pédiatrique, Hôpital Trousseau, AP-HP, Paris, France; and 4 Institut de Recherche Contre le Cancer de Lille, Unité Mixte de Recherche (UMR) 9020, and 1 Service de Médecine Interne 2, Centre National de Référence Histiocytoses, and 6 EA4340, Université Versailles-Saint Quentin, Versailles, France 12 Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 11 Human Oncology and Pathogenesis Program and 2 Service d’Hématologie, Hôpital de la Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France 9 Service d’Hématologie Biologique, Hôpital de la Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France 3 Gustave Roussy, Unité 1170, INSERM, Villejuif, France 7 Départ |
AuthorAffiliation_xml | – name: 8 Service d’Anatomopathologie and – name: 9 Service d’Hématologie Biologique, Hôpital de la Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France – name: 6 EA4340, Université Versailles-Saint Quentin, Versailles, France – name: 2 Service d’Hématologie, Hôpital de la Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France – name: 10 Service d’Hématologie Pédiatrique, Hôpital Trousseau, AP-HP, Paris, France; and – name: 12 Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY – name: 11 Human Oncology and Pathogenesis Program and – name: 5 Cancer Heterogeneity, Plasticity and Resistance to Therapies (CANTHER), UMR-S 1277, Centre Hospitalier Universitaire (CHU) Lille, INSERM, Centre National de la Recherche Scientifique (CNRS), Université de Lille, Lille, France – name: 4 Institut de Recherche Contre le Cancer de Lille, Unité Mixte de Recherche (UMR) 9020, and – name: 7 Département de Pathologie, Hôpital Ambroise Paré, AP-HP, Boulogne, France – name: 1 Service de Médecine Interne 2, Centre National de Référence Histiocytoses, and – name: 3 Gustave Roussy, Unité 1170, INSERM, Villejuif, France |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33067622$$D View this record in MEDLINE/PubMed https://hal.science/hal-03994724$$DView record in HAL |
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28;137(4):434-436 |
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Snippet | Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular, frequent... Abstract Erdheim-Chester disease (ECD) is a clonal hematopoietic disorder characterized by the accumulation of foamy histiocytes within organs (in particular,... ECD patients have a very high frequency of clonal hematopoiesis and concomitant overt myeloid malignancies. ECD patients with clonal hematopoiesis are older... |
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SubjectTerms | Abnormal Karyotype Adult Age Factors Aged Bone Marrow - pathology Cell Transformation, Neoplastic - genetics Clonal Hematopoiesis - genetics Dioxygenases Disease Progression DNA-Binding Proteins - genetics Erdheim-Chester Disease - genetics Erdheim-Chester Disease - physiopathology Exons - genetics Female Genes, Neoplasm Hematopoiesis and Stem Cells Humans Immunology Leukemia, Myeloid - genetics Life Sciences Male Middle Aged Multiple Myeloma - genetics Mutation Myelodysplastic Syndromes - genetics Neoplasm Proteins - genetics Neoplastic Stem Cells - pathology Organ Specificity Proto-Oncogene Proteins - genetics Proto-Oncogene Proteins B-raf - genetics |
Title | High frequency of clonal hematopoiesis in Erdheim-Chester disease |
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