Recurrent Mutations Found In Acute Monocytic Leukemia by Exomes Sequencing

Abstract 2490

Acute monocytic leukemia, the M5 subtype of acute myeloid leukemia (AML-M5), is a distinct group with characteristic clinical features and has been reported to have a poor prognosis. A subset of AML-M5 is associated with various chromosomal translocations involving the MLL locus at 11q23, while mutations are also reported in genes such as NPM1, FLT3, NRAS at different frequencies in this disease. However, these genetic changes occur only in a part of AML-M5 patients and some of them lack specificity due to the presence in other AML subtypes. To address the important genetic and molecular factors for the pathogenesis of M5 in a comprehensive manner, we sequenced exomes from nine AML-M5 initial bone marrow (BM) samples and matched control samples. We identified 64 somatic mutations within the coding sequences of 61 genes including 57 point mutations and 7 insertions or deletions (indels), among which 17 genes had at least 2 cases of mutations in 100 validated AML-M5 BM samples. We tested a part of these gene mutations in different subtypes of AML and found that some mutations are restricted to AML-M5 and AML-M4 (acute myelomonocytic leukemia) with more than 15% and 10% frequency, respectively. Thus, by systemic sequencing of exomes from a group of AML-M5 cases, we discovered recurring mutations that may play an essential role in the pathogenesis of AML with monocytic features.The prognostic significance of the mutations will be present in details.