Atypical chronic myeloid leukemia (aCML)[1] is a type of leukemia. It is a heterogeneous disorder belonging to the group of myelodysplastic/myeloproliferative (MDS/MPN) syndromes.

In aCML many clinical features (splenomegaly, myeloid predominance in the bone marrow with some dysplastic features but without a differentiation block) and laboratory abnormalities (myeloid proliferation, low leukocyte alkaline phosphatase values) suggest the diagnosis of chronic myelogenous leukemia (CML). However the lack of the pathognomonic Philadelphia chromosome[2] and of the resulting BCR-ABL1 fusion point to a different pathogenetic process. Since no specific recurrent genomic or karyotypic abnormalities have been identified in aCML, the molecular pathogenesis of this disease has remained elusive and the outcome dismal (median survival 37 months)[3] with no improvement over the last 20 years. This sharply contrasts with the outcome for CML, for which the prognosis was dramatically improved by the development of imatinib as a specific inhibitor of the BCR-ABL protein and in particular for CML.[4][5][6][7]

In 2012 SETBP1 was identified as a novel oncogene in aCML; specific somatic mutations of this gene were discovered in people with aCML and related diseases. These mutations, which are identical to the ones present in SGS as germline mutations, impair the degradation of SETBP1 and therefore cause increased cellular levels of the protein.[8]

References

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  1. ^ Vardiman, James W.; Thiele, Jüergen; Arber, Daniel A.; Brunning, Richard D.; Borowitz, Michael J.; Porwit, Anna; Harris, Nancy Lee; Le Beau, Michelle M.; Hellström-Lindberg, Eva; Tefferi, Ayalew; Bloomfield, Clara D. (July 30, 2009). "The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes". Blood. 114 (5). American Society of Hematology: 937–951. doi:10.1182/blood-2009-03-209262. ISSN 0006-4971.
  2. ^ Nowell, Peter C.; Hungerford, David A. (1960). "A minute chromosome in human chronic granulocytic leukemia" (PDF). Science. 142: 1497. Retrieved 24 October 2023.
  3. ^ Kurzrock, Razelle; Bueso-Ramos, Carlos E.; Kantarjian, Hagop; Freireich, Emil; Tucker, Susan L.; Siciliano, Michael; Pilat, Susan; Talpaz, Moshe (June 1, 2001). "BCR Rearrangement–Negative Chronic Myelogenous Leukemia Revisited". Journal of Clinical Oncology. 19 (11). American Society of Clinical Oncology (ASCO): 2915–2926. doi:10.1200/jco.2001.19.11.2915. ISSN 0732-183X.
  4. ^ Druker, Brian J.; Talpaz, Moshe; Resta, Debra J.; Peng, Bin; Buchdunger, Elisabeth; Ford, John M.; Lydon, Nicholas B.; Kantarjian, Hagop; Capdeville, Renaud; Ohno-Jones, Sayuri; Sawyers, Charles L. (April 5, 2001). "Efficacy and Safety of a Specific Inhibitor of the BCR-ABL Tyrosine Kinase in Chronic Myeloid Leukemia". New England Journal of Medicine. 344 (14). Massachusetts Medical Society: 1031–1037. doi:10.1056/nejm200104053441401. ISSN 0028-4793.
  5. ^ Rebora, P.; Czene, K.; Antolini, L.; Passerini, C. G.; Reilly, M.; Valsecchi, M. G. (September 22, 2010). "Are Chronic Myeloid Leukemia Patients More at Risk for Second Malignancies? A Population-based Study". American Journal of Epidemiology. 172 (9). Oxford University Press (OUP): 1028–1033. doi:10.1093/aje/kwq262. ISSN 0002-9262.
  6. ^ Gambacorti-Passerini, Carlo; Antolini, Laura; Mahon, François-Xavier; Guilhot, Francois; Deininger, Michael; Fava, Carmen; Nagler, Arnon; Della Casa, Chiara Maria; Morra, Enrica; Abruzzese, Elisabetta; D’Emilio, Anna; Stagno, Fabio; le Coutre, Philipp; Hurtado-Monroy, Rafael; Santini, Valeria; Martino, Bruno; Pane, Fabrizio; Piccin, Andrea; Giraldo, Pilar; Assouline, Sarit; Durosinmi, Muheez A.; Leeksma, Onno; Pogliani, Enrico Maria; Puttini, Miriam; Jang, Eunjung; Reiffers, Josy; Valsecchi, Maria Grazia; Kim, Dong-Wook (March 21, 2011). "Multicenter Independent Assessment of Outcomes in Chronic Myeloid Leukemia Patients Treated With Imatinib". JNCI: Journal of the National Cancer Institute. 103 (7). Oxford University Press (OUP): 553–561. doi:10.1093/jnci/djr060. ISSN 1460-2105.
  7. ^ Goldman, John M. (2010). "Chronic Myeloid Leukemia: A Historical Perspective". Seminars in Hematology. 47 (4). Elsevier BV: 302–311. doi:10.1053/j.seminhematol.2010.07.001. ISSN 0037-1963.
  8. ^ Piazza, Rocco; Valletta, Simona; Winkelmann, Nils; Redaelli, Sara; Spinelli, Roberta; Pirola, Alessandra; Antolini, Laura; Mologni, Luca; Donadoni, Carla; Papaemmanuil, Elli; Schnittger, Susanne; Kim, Dong-Wook; Boultwood, Jacqueline; Rossi, Fabio; Gaipa, Giuseppe; De Martini, Greta P; di Celle, Paola Francia; Jang, Hyun Gyung; Fantin, Valeria; Bignell, Graham R; Magistroni, Vera; Haferlach, Torsten; Pogliani, Enrico Maria; Campbell, Peter J; Chase, Andrew J; Tapper, William J; Cross, Nicholas C P; Gambacorti-Passerini, Carlo (December 9, 2012). "Recurrent SETBP1 mutations in atypical chronic myeloid leukemia". Nature Genetics. 45 (1). Springer Science and Business Media LLC: 18–24. doi:10.1038/ng.2495. ISSN 1061-4036. PMC 3588142.