1 6673 86 USE OF COMPUTER TV MORPHODENSITOMETRY TO STUDY EPIGENETIC CHANGES IN BLOOD LYMPHOCYTES FROM CHILDREN AFFECTED BY LOW-DOSE IRRADIATION. A NOVEL METHOD, COMPUTER TV MORPHODENSITOMETRY, WAS USED TO EVALUATE THE EFFECTS OF LOW-DOSE IRRADIATION ON PERIPHERAL BLOOD LYMPHOCYTES FROM CHILDREN AFFECTED BY THE CHERNOBYL DISASTER. THIS METHOD USES DIGITIZED IMAGES TO DETECT AND MEASURE CHANGES IN CHROMATIN SHAPE AND DENSITY AND TO PRODUCE TWO-DIMENSIONAL AND THREE-DIMENSIONAL PICTURES. IMAGES CAN THEN BE STORED TO CREATE A VIDEO ARCHIVE. THIS METHOD IS SENSITIVE ENOUGH TO OBSERVE SUBTLE CHANGES IN CHROMATIN STRUCTURE THAT PREVIOUSLY COULD BE DETECTED ONLY BY MORE DETAILED MOLECULAR ANALYSES. IN THIS STUDY, LYMPHOCYTE INTERPHASE NUCLEI IN DNA-STAINED BLOOD SMEARS FROM CHILDREN SUBJECTED TO CHRONIC LOW-DOSE IRRADIATION WERE EXAMINED BY COMPUTER TV MORPHODENSITOMETRY. PRELIMINARY DATA INDICATE THAT CIRCULATING LYMPHOCYTES FROM CHILDREN EXPOSED TO RADIATION MAY CONTAIN SIGNIFICANT ALTERATIONS IN THE STRUCTURE AND/OR DENSITY OF NUCLEAR CHROMATIN. 1997 2 6847 22 [MOLECULAR DIAGNOSIS OF CHRONIC MYELOPROLIFERATIVE DISEASES AND MYELODYSPLASTIC SYNDROMES]. HISTOMORPHOLOGICAL EVALUATION OF BONE MARROW TREPHINES AND SMEARS REPRESENTS THE MAJOR APPROACH TO DIAGNOSE THE CHRONIC MYELOPROLIFERATIVE DISEASES (CMPD) AND THE MYELODYSPLASTIC SYNDROMES (MDS). HOWEVER, RISING INSIGHTS INTO MOLECULAR PATHOGENESIS OF HUMAN DISEASES STRENGTHEN THE ATTEMPT OF PATHOLOGISTS TO DEFINE AND TO DETECT UNDERLYING DEFECTS BEYOND THE MICROSCOPE. SINCE DISCOVERY OF THE PHILADELPHIA CHROMOSOME IN CHRONIC MYELOID LEUKEMIA AS THE FIRST SPECIFIC MOLECULAR ABNORMALITY EVER DETECTED IN A HUMAN NEOPLASIA THE GAIN OF KNOWLEDGE OF MOLECULAR PATHOMECHANISMS IN PHILADELPHIA CHROMOSOME NEGATIVE (PH-) CMPD WAS RATHER SPARSE. A DECISIVE BREAKTHROUGH IN PH CMPD WAS THE FINDING OF JAK2 (V617F) DERIVED FROM A SOMATIC POINT MUTATION IN THE MAJORITY OF PATIENTS WITH POLYCYTHEMIA VERA (P.VERA) AND HALF OF PATIENTS WITH ESSENTIAL THROMBOCYTHEMIA (ET) AND PRIMARY MYELOFIBROSIS (PMF). IT THEREFORE CAN NOT BE OVERESTIMATED THAT DETECTION OF JAK2 (V617F) IN A SUSPECTIVE MYELOPROLIFERATION NOW ENABLES A CLEARCUT DISCRIMINATION OF A TRUE PH CMPD FROM A REACTIVE STATE, E.G. P.VERA FROM REACTIVE ERYTHROCYTOSIS. INTERESTINGLY, A BASIC PRINCIPLE OF MOLECULAR DEFECTS DEMONSTRABLE IN CMPD AND RELATED DISORDERS SEEMS TO BE THE INVOLVEMENT OF GENES WITH KINASE ACTIVITIES. SOME OF THOSE GENES WILL BE DISCUSSED IN MORE DETAIL. IN PRIMARY MDS, KARYOTYPING VIA CLASSICAL CYTOGENETICS IS THE PREDOMINANT MOLECULAR APPROACH TO ESTIMATE PROGNOSIS, E.G. -Y, DEL(5Q) AND DEL(20Q) REPRESENT FAVOURABLE ANOMALIES. INDEED, IN 5Q- SYNDROMES KARYOTYPING ENABLES DEFINITE SUBTYPING AND ALLOWS CLINICIANS AND PATIENTS TO EXPECT A GOOD PROGNOSIS. UNTIL NOW, DOZENS OF MOLECULAR ABNORMALITIES SUCH AS MUTATIONS IN AML1, FLT3 AND RAS AS WELL AS EPIGENETIC ALTERATIONS OF GENES HAVE BEEN IDENTIFIED TO VARIOUS DEGREES IN MDS SUBTYPES. SOME OF THEM SEEM TO BE INVOLVED IN DISEASE INITIATION ("MASTER EVENT") AND OTHERS MIGHT INDICATE DISEASE PROGRESSION. HOWEVER, EVEN THOUGH USEFUL FOR FURTHER DISSECTION OF MOLECULAR PATHOMECHANISMS THE MAJORITY OF ABERRATIONS CURRENTLY DOES NOT SERVE AS POTENT MARKERS IN THE DAILY ROUTINE. NEVERTHELESS, IN CMPD AND MDS THE IMPORTANCE OF MOLECULAR ANALYSES FOR DIAGNOSIS, ESTIMATION OF PROGNOSIS, AND DISEASE MONITORING WILL FURTHER INCREASE IN A FORESEEABLE PERIOD OF TIME. 2007 3 5841 26 STRUCTURAL CHROMATIN ALTERATIONS IN PERIPHERAL BLOOD LEUKOCYTES OF ALCOHOL-DEPENDENT INDIVIDUALS DURING DETOXIFICATION THERAPY. BACKGROUND/AIM: THE AIM OF THIS STUDY WAS TO INVESTIGATE THE STATE OF CHROMATIN CONDENSATION IN PERIPHERAL BLOOD LEUKOCYTES OF ALCOHOLICS, DURING THE EARLY DETOXIFICATION PERIOD, IN ORDER TO HIGHLIGHT STRUCTURAL MODIFICATIONS, INDICATING EPIGENETIC MECHANISMS REGULATED BY ALCOHOL. MATERIALS AND METHODS: BLOOD SAMPLES WERE OBTAINED FROM ALCOHOLIC PATIENTS, WHO WERE ADMITTED FOR DETOXIFICATION ON AN INPATIENT BASIS, AND FROM HEALTHY CONTROLS. THE LEVEL OF CONDENSED HETEROCHROMATIN AND DE-CONDENSED EUCHROMATIN WERE DETECTED THROUGH THE RATIO OF LYSINE TO ARGININE RESIDUES, BY THE APPLICATION OF THE AMMONIACAL SILVER REACTION (ASR) STAINING ON LEUKOCYTE PELLETS, AND THROUGH IMMUNOHISTOCHEMICAL LOCALIZATION OF HISTONE H1 ON PERIPHERAL BLOOD SMEARS. RESULTS: LYMPHOCYTES AND NEUTROPHILS WITH RELAXED DE-CONDENSED CHROMATIN WERE FOUND, INDICATING A MORE REACTIVE GENOME IN ALCOHOLICS, EVEN AT THE STAGE OF DETOXIFICATION. CONCLUSION: THE RESULTS UNDERLINE THE IMPORTANCE OF CHROMATIN STRUCTURE OF LEUKOCYTES AS A SENSITIVE, PERIPHERAL, BIOLOGICAL MARKER FOR EPIGENETIC STUDIES IN LIVING CHRONIC ALCOHOLICS. 2014 4 4553 19 MUTATIONAL LANDSCAPE OF CHRONIC MYELOMONOCYTIC LEUKEMIA IN CHINESE PATIENTS. BACKGROUND: CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML) IS A RARE AND HETEROGENEOUS HEMATOLOGICAL MALIGNANCY. IT HAS BEEN SHOWN THAT THE MOLECULAR ABNORMALITIES SUCH AS ASXL1, TET2, SETBP1, AND SRSF2 MUTATIONS ARE COMMON IN CAUCASIAN POPULATION. METHODS: WE RETROSPECTIVELY ANALYZED 178 CHINESE CMML PATIENTS. THE TARGETED NEXT GENERATION SEQUENCING (NGS) WAS USED TO EVALUATE 114 GENE VARIATIONS, AND THE PROGNOSTIC FACTORS FOR OS WERE DETERMINED BY COX REGRESSION ANALYSIS. RESULTS: THE CMML PATIENTS SHOWED A UNIQUE MUTATIONAL SPECTRUM, INCLUDING TET2 (36.5%), NRAS (31.5%), ASXL1 (28.7%), SRSF2 (24.7%), AND RUNX1 (21.9%). OF THE 102 PATIENTS WITH CLONAL ANALYSIS, THE ANCESTRAL EVENTS PREFERENTIALLY OCCURRED IN TET2 (18.5%), SPLICING FACTORS (16.5%), RAS (14.0%), AND ASXL1 (7.8%), AND THE SUBCLONAL GENES WERE MAINLY ASXL1, TET2, AND RAS. IN ADDITION, THE SECONDARY ACUTE MYELOID LEUKEMIA (SAML) TRANSFORMED FROM CMML OFTEN HAD MUTATIONS IN DNMT3A, ETV6, FLT3, AND NPM1, WHILE THE PRIMARY AML (PAML) DEMONSTRATED MORE MUTATIONS IN CEBPA, DNMT3A, FLT3, IDH1/2, NPM1, AND WT1. IT WAS OF NOTE THAT A SERIES OF CLONES WERE EMERGED DURING THE PROGRESSION FROM CMML TO AML, INCLUDING DNMT3A, FLT3, AND NPM1. BY UNIVARIATE ANALYSIS, ASXL1 MUTATION, INTERMEDIATE- AND HIGH-RISK CYTOGENETIC ABNORMALITY, CMML-SPECIFIC PROGNOSTIC SCORING SYSTEM (CPSS) STRATIFICATIONS (INTERMEDIATE-2 AND HIGH GROUP), AND TREATMENT OPTIONS (BEST SUPPORTIVE CARE) PREDICTED FOR WORSE OS. MULTIVARIATE ANALYSIS REVEALED A SIMILAR OUTCOME. CONCLUSIONS: THE COMMON MUTATIONS IN CHINESE CMML PATIENTS INCLUDED EPIGENETIC MODIFIERS (TET2 AND ASXL1), SIGNALING TRANSDUCTION PATHWAY COMPONENTS (NRAS), AND SPLICING FACTOR (SRSF2). THE CMML PATIENTS WITH DNMT3A, ETV6, FLT3, AND NPM1 MUTATIONS TENDED TO PROGRESS TO SAML. ASXL1 MUTATION AND THERAPEUTIC MODALITIES WERE INDEPENDENT PROGNOSTIC FACTORS FOR CMML. 2022 5 472 17 ARRAY COMPARATIVE GENOMIC HYBRIDIZATION AND SEQUENCING OF 23 GENES IN 80 PATIENTS WITH MYELOFIBROSIS AT CHRONIC OR ACUTE PHASE. MYELOFIBROSIS IS A MYELOPROLIFERATIVE NEOPLASM THAT OCCURS DE NOVO (PRIMARY MYELOFIBROSIS) OR RESULTS FROM THE PROGRESSION OF POLYCYTHEMIA VERA OR ESSENTIAL THROMBOCYTEMIA (HEREAFTER DESIGNATED AS SECONDARY MYELOFIBROSIS OR POST-POLYCYTHEMIA VERA/ ESSENTIAL THROMBOCYTHEMIA MYELOFIBROSIS). TO PROGRESS IN THE UNDERSTANDING OF MYELOFIBROSIS AND TO FIND MOLECULAR PROGNOSTIC MARKERS WE STUDIED 104 SAMPLES OF PRIMARY AND SECONDARY MYELOFIBROSIS AT CHRONIC (N=68) AND ACUTE PHASES (N=12) FROM 80 PATIENTS, BY USING ARRAY-COMPARATIVE GENOMIC HYBRIDIZATION AND SEQUENCING OF 23 GENES (ASXL1, BMI1, CBL, DNMT3A, EZH2, IDH1/2, JAK2, K/NRAS, LNK, MPL, NF1, PPP1R16B, PTPN11, RCOR1, SF3B1, SOCS2, SRSF2, SUZ12, TET2, TP53, TRPS1). WE FOUND COPY NUMBER ABERRATIONS IN 54% OF SAMPLES, OFTEN INVOLVING GENES WITH A KNOWN OR POTENTIAL ROLE IN LEUKEMOGENESIS. WE SHOW THAT CASES CARRYING A DEL(20Q), DEL(17) OR DEL(12P) EVOLVE IN ACUTE MYELOID LEUKEMIA (P=0.03). WE FOUND THAT 88% OF THE CASES WERE MUTATED, MAINLY IN SIGNALING PATHWAY (JAK2 69%, NF1 6%) AND EPIGENETIC GENES (ASXL1 26%, TET2 14%, EZH2 8%). OVERALL SURVIVAL WAS POOR IN PATIENTS WITH MORE THAN ONE MUTATION (P=0.001) AND IN PATIENTS WITH JAK2/ASXL1 MUTATIONS (P=0.02). OUR STUDY HIGHLIGHTS THE HETEROGENEITY OF MYELOFIBROSIS, AND POINTS TO SEVERAL INTERESTING COPY NUMBER ABERRATIONS AND GENES WITH DIAGNOSTIC AND PROGNOSTIC IMPACT. 2014 6 5984 16 TET2, DNMT3A, IDH1, AND JAK2 MUTATION IN MYELOPROLIFERATIVE NEOPLASMS IN SOUTHERN IRAN. BACKGROUND: FIVE EPIGENETIC REGULATOR MUTATIONS ARE CONSIDERED IN MYELOPROLIFERATIVE NEOPLASMS (MPN) THAT HAVE PROGNOSTIC AND THERAPEUTIC VALUES. OBJECTIVE: WE AIMED TO EVALUATE THESE MUTATIONS IN MPNS AMONG THE IRANIAN POPULATION. METHODS: WE SELECTED 5 MUTATIONS IN 4 EPIGENETIC REGULATORY GENES [TET2, DNMT3A, IDH1 (RS147001633&RS121913499), AND JAK2)] AND EVALUATED 130 PATIENTS WITH MPNS INCLUDING 78 PHILADELPHIA CHROMOSOME NEGATIVE (49 ETS, 20 PVS, AND 9 PMFS) AND 52 PHILADELPHIA CHROMOSOME-POSITIVE PATIENTS AS WELL AS 51 HEALTHY CONTROLS. RESULTS: EIGHT PATIENTS (6.5%) CARRIED THE DNMT3A MUTATION, 35 (27%) WERE POSITIVE FOR TET2 MUTATION AND 64 (49.3%) HAD THE JAK2V617F MUTATION. IN THE HEALTHY CONTROLS, 16 (31.4%) CASES HAD THE TET2 MUTATION (15 HETEROZYGOTE + 1 HOMOZYGOTE) AND ONE HAD HETEROZYGOTE JAK2 MUTATION. THERE WAS NO STATISTICALLY SIGNIFICANT DIFFERENCE BETWEEN PATIENT GROUPS FOR ANY OF THESE MUTATIONS, EXCEPT FOR JAK2. THE JAK2 MUTATION RATE WAS 18 (90%), 25 (51%), 7 (77.8%), 14 (26.9%) IN POLYCYTHEMIA VERA, ESSENTIAL THROMBOCYTHEMIA, PRIMARY MYELOFIBROSIS, AND CHRONIC MYELOCYTIC LEUKEMIA, RESPECTIVELY. PATIENTS AGED 60 AND OLDER WERE MORE LIKELY TO CARRY THE TET2 MUTATION (23% VS. 39% IN YOUNGER AND OLDER THAN 60 YEARS OLD INDIVIDUALS, P=0.025). IDH1 WAS NOT DETECTED AT ALL AND PV HAD THE HIGHEST TET2 MUTATION 7(35%). TWO PMF PATIENTS HAD A HISTORY OF BONE MARROW TRANSPLANTATION THAT WERE NEGATIVE FOR IDH1AND DNMT3A AND ONE WAS POSITIVE FOR TET2 MUTATION. CONCLUSION: IN THE NORMAL IRANIAN POPULATION, THE HETEROZYGOTE FORM OF TET2 MUTATION IS SIGNIFICANT, ESPECIALLY IN THE ELDERLY. NO ASSOCIATION WAS FOUND BETWEEN JAK2 AND TET2 MUTATIONS. BOTH OF THEM ARE MORE PREVALENT IN THE AGE GROUP OF 60 YEARS AND OLDER. DNMT3A MUTATION HAS A LOW PREVALENCE AND OCCURS IN BOTH POSITIVE AND NEGATIVE MPNS. 2021 7 3520 20 IGLV3-21R110 IDENTIFIES AN AGGRESSIVE BIOLOGICAL SUBTYPE OF CHRONIC LYMPHOCYTIC LEUKEMIA WITH INTERMEDIATE EPIGENETICS. B-CELL RECEPTOR (BCR) SIGNALING IS CRUCIAL FOR CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) BIOLOGY. IGLV3-21-EXPRESSING B CELLS MAY ACQUIRE A SINGLE POINT MUTATION (R110) THAT TRIGGERS AUTONOMOUS BCR SIGNALING, CONFERRING AGGRESSIVE BEHAVIOR. EPIGENETIC STUDIES HAVE DEFINED 3 CLL SUBTYPES BASED ON METHYLATION SIGNATURES REMINISCENT OF NAIVE-LIKE (N-CLL), INTERMEDIATE (I-CLL), AND MEMORY-LIKE (M-CLL) B CELLS WITH DIFFERENT BIOLOGICAL FEATURES. I-CLL CARRIES A BORDERLINE IGHV MUTATIONAL LOAD AND SIGNIFICANTLY HIGHER USE OF IGHV3-21/IGLV3-21. TO DETERMINE THE CLINICAL AND BIOLOGICAL FEATURES OF IGLV3-21R110 CLL AND ITS RELATIONSHIP TO THESE EPIGENETIC SUBTYPES, WE CHARACTERIZED THE IMMUNOGLOBULIN GENE OF 584 CLL CASES USING WHOLE-GENOME/EXOME AND RNA SEQUENCING. IGLV3-21R110 WAS DETECTED IN 6.5% OF CASES: 30 (38%) OF 79 I-CLLS, 5 (1.7%) OF 291 M-CLLS, AND 1 (0.5%) OF 189 N-CLLS. ALL STEREOTYPE SUBSET 2 CASES CARRIED IGLV3-21R110, WHEREAS 62% OF IGLV3-21R110 I-CLL CASES HAD NONSTEREOTYPED BCR IMMUNOGLOBULINS. IGLV3-21R110 I-CLL HAD A SIGNIFICANTLY HIGHER NUMBER OF SF3B1 AND ATM MUTATIONS AND TOTAL NUMBER OF DRIVER ALTERATIONS. HOWEVER, THE R110 MUTATION WAS THE SOLE ALTERATION IN 1 I-CLL AND WAS ACCOMPANIED ONLY BY DEL(13Q) IN 3. ALTHOUGH IGHV MUTATIONAL STATUS VARIED, IGLV3-21R110 I-CLL TRANSCRIPTOMICALLY RESEMBLED N-CLL/UNMUTATED IGHV CLL WITH A SPECIFIC SIGNATURE INCLUDING WNT5A/B OVEREXPRESSION. IN CONTRAST, I-CLL LACKING IGLV3-21R110 MIRRORED M-CLL/MUTATED IGHV. PATIENTS WITH IGLV3-21R110 I-CLL HAD A SHORT TIME TO FIRST TREATMENT AND OVERALL SURVIVAL SIMILAR TO THOSE OF N-CLL/UNMUTATED IGHV PATIENTS, WHEREAS PATIENTS WITH NON-IGLV3-21R110 I-CLL HAD A GOOD PROGNOSIS SIMILAR TO THAT OF PATIENTS WITH M-CLL/MUTATED IGHV. IGLV3-21R110 DEFINES A CLL SUBGROUP WITH SPECIFIC BIOLOGICAL FEATURES AND AN UNFAVORABLE PROGNOSIS INDEPENDENT OF IGHV MUTATIONAL STATUS AND EPIGENETIC SUBTYPE. 2021 8 2877 20 FUNCTIONAL STATE OF NEUTROPHIC GRANULOCYTES' GENOME OF THE PERIPHERAL BLOOD IN PATIENTS WITH CHRONIC HEPATITIS C WITH CONCOMITANT DIABETES MELLITUS TYPE II. OBJECTIVE: THE AIM: TO DETERMINE CHANGES OF FSG OF NEUTROPHILIC GRANULOCYTES OF PERIPHERAL BLOOD (NGPB) OF PATIENTS WITH CHC WITH CONCOMITANT DM-2. PATIENTS AND METHODS: MATERIALS AND METHODS: WE'VE EXAMINED 180 PATIENTS WITH CHC: 160 WITH CONCOMITANT DIABETES MELLITUS AND 20 ONES WITHOUT IT. THE NGPB GENOME WAS STUDIED USING CYTOGENETIC METHOD. THERE WERE ANALYZED 100 INTERPHASE NGPB NUCLEI IN THE PREPARATION, STRUCTURAL CHARACTERISTICS WERE EVALUATED ACCORDING TO INDICES: CHROMATIZATION (IC), NUCLEOLAR (IN), PATHOLOGICALLY ALTERED NUCLEI (PAN), MICRONUCLEI (MNI). RESULTS: RESULTS: VIOLATIONS OF FSG OF NGPBWERE FOUND ACCORDING TO ALL INDICES IN PATIENTS WITH CHC, THEY WERE MORE PRONOUNCED IN PATIENTS WITH CONCOMITANT DM-2. CONCLUSION: CONCLUSIONS: FSG NGPB IS MORE DISORDERED IN CHC WITH CONCOMITANT DM-2. THE REDUCTION OF IC IN CHC WITH CONCOMITANT DM-2 IS MORE PRONOUNCED IN MEN. REDUCTION OF IN IN PATIENTS WITH CHC WITH AND WITHOUT DM-2 IS A MARKER OF VIOLATIONS OF THE SECOND STAGE OF REALIZATION OF HEREDITARY INFORMATION. THE TENDENCY TO CHANGE THE COMPONENTS OF THE CYTOGENETIC STATUS OF ALL EXAMINED PATIENTS DUE TO THE FREQUENCY OF MNI WAS DETERMINED. 2020 9 1062 14 CLINICAL SIGNIFICANCE OF DNA METHYLATION IN CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS: RESULTS FROM 3 UK CLINICAL TRIALS. CHRONIC LYMPHOCYTIC LEUKEMIA PATIENTS WITH MUTATED IMMUNOGLOBULIN HEAVY-CHAIN GENES (IGHV-M), PARTICULARLY THOSE LACKING POOR-RISK GENOMIC LESIONS, OFTEN RESPOND WELL TO CHEMOIMMUNOTHERAPY (CIT). DNA METHYLATION PROFILING CAN SUBDIVIDE EARLY-STAGE PATIENTS INTO NAIVE B-CELL-LIKE CLL (N-CLL), MEMORY B-CELL-LIKE CLL (M-CLL), AND INTERMEDIATE CLL (I-CLL), WITH DIFFERING TIMES TO FIRST TREATMENT AND OVERALL SURVIVAL. HOWEVER, WHETHER DNA METHYLATION CAN IDENTIFY PATIENTS DESTINED TO RESPOND FAVORABLY TO CIT HAS NOT BEEN ASCERTAINED. WE CLASSIFIED TREATMENT-NAIVE PATIENTS (N = 605) FROM 3 UK CHEMO AND CIT CLINICAL TRIALS INTO THE 3 EPIGENETIC SUBGROUPS, USING PYROSEQUENCING AND MICROARRAY ANALYSIS, AND PERFORMED EXPANSIVE SURVIVAL ANALYSIS. THE N-CLL, I-CLL, AND M-CLL SIGNATURES WERE FOUND IN 80% (N = 245/305), 17% (53/305), AND 2% (7/305) OF IGHV-UNMUTATED (IGHV-U) CASES, RESPECTIVELY, AND IN 9%, (19/216), 50% (108/216), AND 41% (89/216) OF IGHV-M CASES, RESPECTIVELY. MULTIVARIATE COX PROPORTIONAL ANALYSIS IDENTIFIED M-CLL AS AN INDEPENDENT PROGNOSTIC FACTOR FOR OVERALL SURVIVAL (HAZARD RATIO [HR], 0.46; 95% CONFIDENCE INTERVAL [CI], 0.24-0.87; P = .018) IN CLL4, AND FOR PROGRESSION-FREE SURVIVAL (HR, 0.25; 95% CI, 0.10-0.57; P = .002) IN ARCTIC AND ADMIRE PATIENTS. THE ANALYSIS OF EPIGENETIC SUBGROUPS IN PATIENTS ENTERED INTO 3 FIRST-LINE UK CLL TRIALS IDENTIFIES M-CLL AS AN INDEPENDENT MARKER OF PROLONGED SURVIVAL AND MAY AID IN THE IDENTIFICATION OF PATIENTS DESTINED TO DEMONSTRATE PROLONGED SURVIVAL AFTER CIT. 2019 10 1100 16 COMBINATION OF MYELOPROLIFERATIVE NEOPLASM DRIVER GENE ACTIVATION WITH MUTATIONS OF SPLICE FACTOR OR EPIGENETIC MODIFIER GENES INCREASES RISK OF RAPID BLASTIC PROGRESSION. OBJECTIVES: MYELOPROLIFERATIVE NEOPLASMS (MPN) COMPRISING POLYCYTHEMIA VERA (PV), ESSENTIAL THROMBOCYTHEMIA (ET) AND PRIMARY MYELOFIBROSIS (PMF) FOLLOW A BI-PHASIC COURSE OF DISEASE WITH FIBROTIC AND/OR BLASTIC PROGRESSION. AT PRESENTATION IN THE CHRONIC PHASE, CURRENTLY THERE ARE ONLY INSUFFICIENT TOOLS TO PREDICT THE RISK OF PROGRESSION IN INDIVIDUAL CASES. METHODS: IN THIS STUDY, CHRONIC PHASE MPN (16 PMF, 11 PV, AND 11 MPN UNCLASSIFIED) WITH BLASTIC TRANSFORMATION DURING COURSE OF DISEASE (N = 38, MEDIAN FOLLOW-UP 5.3 YEARS) WERE ANALYZED BY HIGH-THROUGHPUT SEQUENCING. MPN CASES WITH A COMPARABLE FOLLOW-UP PERIOD AND WITHOUT EVIDENCE OF BLAST INCREASE SERVED AS CONTROL (N = 63, MEDIAN FOLLOW-UP 5.8 YEARS). RESULTS: FREQUENT ARCH/CHIP-ASSOCIATED MUTATIONS (TET2, ASXL1, DNMT3A) FOUND AT PRESENTATION WERE NOT SIGNIFICANTLY ASSOCIATED WITH BLASTIC TRANSFORMATION. BY CONTRAST, MUTATIONS OF SRSF2, U2AF1, AND IDH1/2 AT FIRST PRESENTATION WERE FREQUENTLY OBSERVED IN THE PROGRESSION COHORT (13/38, 34.2%) AND WERE COMPLETELY MISSING IN THE CONTROL GROUP WITHOUT BLAST TRANSFORMATION DURING FOLLOW-UP (P = .0007 FOR SRSF2; P = .0063 FOR U2AF1 AND IDH1/2). CONCLUSION: UNLIKE FREQUENT ARCH/CHIP ALTERATIONS (TET2, ASXL1, DNMT3A), MUTATIONS IN SRSF2, IDH1/2, AND U2AF1 WHEN MANIFEST ALREADY AT FIRST PRESENTATION PROVIDE AN INDEPENDENT RISK FACTOR FOR RAPID BLAST TRANSFORMATION OF MPN. 2021 11 3168 17 GTPASE REGULATOR ASSOCIATED WITH THE FOCAL ADHESION KINASE (GRAF) TRANSCRIPT WAS DOWN-REGULATED IN PATIENTS WITH MYELOID MALIGNANCIES. BACKGROUND: GTPASE REGULATOR ASSOCIATED WITH THE FOCAL ADHESION KINASE (GRAF), A PUTATIVE TUMOR SUPPRESSOR GENE, IS FOUND INACTIVATED IN HEMATOPOIETIC MALIGNANCIES BY EITHER GENETIC OR EPIGENETIC ABNORMALITIES. HOWEVER, THE EXPRESSION LEVEL OF GRAF GENE HAS NOT YET BEEN STUDIED IN LEUKEMIA. THE AIM OF THIS STUDY WAS TO INVESTIGATE THE EXPRESSION LEVEL OF GRAF GENE IN THOSE PATIENTS WITH MYELOID MALIGNANCIES INCLUDING ACUTE MYELOID LEUKEMIA (AML), MYELODYSPLASTIC SYNDROME (MDS) AND CHRONIC MYELOID LEUKEMIA (CML). METHODS: THE EXPRESSION LEVELS OF GRAF TRANSCRIPT WERE DETERMINED IN 94 PATIENTS USING REAL-TIME QUANTITATIVE PCR (RQ-PCR). CLINICAL AND LABORATORY DATA OF THESE PATIENTS WERE COLLECTED AND ANALYZED. RESULTS: THE SIGNIFICANTLY DECREASED LEVEL OF GRAF TRANSCRIPT WAS OBSERVED IN THREE MYELOID MALIGNANCIES COMPARED TO CONTROLS. WITHIN AML, THERE WAS NO DIFFERENCE IN THE LEVEL OF GRAF TRANSCRIPT AMONG DIFFERENT FAB SUBTYPES (P > 0.05). DIFFERENCE WAS NOT OBSERVED IN THE AMOUNT OF GRAF MRNA BETWEEN CML AT CHRONIC PHASE AND CONTROLS. AS CML PROGRESSED, GRAF TRANSCRIPT SIGNIFICANTLY DECREASED. IN MDS, THREE CASES WITH 5Q DELETION HAD LOWER GRAF TRANSCRIPT THAN FOUR WITHOUT 5Q DELETION (MEDIAN 0.76 VS 2.99) (P > 0.05). CONCLUSION: OUR RESULTS DEMONSTRATE THAT THE GRAF TRANSCRIPT IS DECREASED IN MYELOID MALIGNANCIES. 2010 12 1083 20 CNL AND ACML SHOULD BE CONSIDERED AS A SINGLE ENTITY BASED ON MOLECULAR PROFILES AND OUTCOMES. CHRONIC NEUTROPHILIC LEUKEMIA (CNL) AND ATYPICAL CHRONIC MYELOID LEUKEMIA (ACML) ARE RARE MYELOID DISORDERS THAT ARE CHALLENGING WITH REGARD TO DIAGNOSIS AND CLINICAL MANAGEMENT. TO STUDY THE SIMILARITIES AND DIFFERENCES BETWEEN THESE DISORDERS, WE UNDERTOOK A MULTICENTER INTERNATIONAL STUDY OF ONE OF THE LARGEST CASE SERIES (CNL, N = 24; ACML, N = 37 CASES, RESPECTIVELY), FOCUSING ON THE CLINICAL AND MUTATIONAL PROFILES (N = 53 WITH MOLECULAR DATA) OF THESE DISEASES. WE FOUND NO DIFFERENCES IN CLINICAL PRESENTATIONS OR OUTCOMES OF BOTH ENTITIES. AS PREVIOUSLY DESCRIBED, BOTH CNL AND ACML SHARE A COMPLEX MUTATIONAL PROFILE WITH MUTATIONS IN GENES INVOLVED IN EPIGENETIC REGULATION, SPLICING, AND SIGNALING PATHWAYS. APART FROM CSF3R, ONLY EZH2 AND TET2 WERE DIFFERENTIALLY MUTATED BETWEEN THEM. THE MOLECULAR PROFILES SUPPORT THE NOTION OF CNL AND ACML BEING A CONTINUUM OF THE SAME DISEASE THAT MAY FIT BEST WITHIN THE MYELODYSPLASTIC/MYELOPROLIFERATIVE NEOPLASMS. WE IDENTIFIED 4 HIGH-RISK MUTATED GENES, SPECIFICALLY CEBPA (BETA = 2.26, HAZARD RATIO [HR] = 9.54, P = .003), EZH2 (BETA = 1.12, HR = 3.062, P = .009), NRAS (BETA = 1.29, HR = 3.63, P = .048), AND U2AF1 (BETA = 1.75, HR = 5.74, P = .013) USING MULTIVARIATE ANALYSIS. OUR FINDINGS UNDERSCORE THE RELEVANCE OF MOLECULAR-RISK CLASSIFICATION IN CNL/ACML AS WELL AS THE IMPORTANCE OF CSF3R MUTATIONS IN THESE DISEASES. 2023 13 6769 17 ["EDUCATION" IN AN AGE OF INCREASING EQUALITY--A PATH TOWARDS 'OCHLOCRACY"?]. A PHILOSOPHICAL AND SCIENTIFIC ANALYSIS OF HOW THE CONCEPT OF EQUALITY HAS DEVELOPED FROM BIOLOGICAL, POLITICAL, SOCIOLOGICAL, SOCIAL, ECONOMIC AND--NOT LEAST--CULTURAL POINTS OF VIEW. THE FOCUS HERE IS ON THE GERMAN CHRONIC SHORTAGE OF EDUCATIONAL FACILITIES CONTINUING FOR DECADES, A CULTURAL REVOLUTION WITHOUT ANY FORESEEABLE END. THESE REFLECTIONS ENCOMPASS A PERIOD OF AROUND TWO AND A HALF MILLENNIA, BEGINNING WITH THE ANCIENT GREEK STATE PHILOSOPHY, REACHING INTO OUR EPOCH OF ADVANCED GLOBALISATION WITH MOMENTOUS CHANGES IN WESTERN SOCIAL WELFARE STATES. IN CONSIDERATION OF A BIOCHEMICAL AND INTRINSIC INDIVIDUALITY BASED ON GENETIC AND EPI-GENETIC FACTORS, EQUAL OPPORTUNITIES ARE AN UNLIKELY PREREQUISITE IN EVOLUTION. WITH REGARD TO FREE EDUCATION, EQUALITY CAN ONLY BE A STARTING POINT SINCE, DUE TO INDIVIDUAL DIFFERENCES, EGALITARIAN AIMS OF EDUCATION WITHIN A "GROUP UNIVERSITY" CAN NEVER OPEN UP EQUALLY GOOD CHANCES TO EVERYBODY. BECAUSE OF A MISUNDERSTANDING OF EQUALITY, THE STUDENT REVOLT IN 1968 BROUGHT FORTH AN EGALITARIAN REMODELING OF SCHOOL AND UNIVERSITY CAREERS ACCOMPANIED BY A LEVELING, AMONG OTHER THINGS A "UNIVERSITY OF EDUCATION FOR THE MASSES". INSTEAD OF "EDUCATIONAL KNOWLEDGE" BASED ON SCIENTIFIC NATURE, AN EDUCATION TOWARDS VOCATIONAL KNOWLEDGE AND REGULATION OF STUDIES TOOK PLACE. AT PRESENT, A SOCIALISTIC REVERSAL OF THE SCHOOL SYSTEM AIMED AT LEARNING TOGETHER IN ,COMMUNITY SCHOOLS" UNTIL THE 10TH GRADE IS IN PROGRESS. THE UNITY OF (PURE) RESEARCH AND TEACHING NO LONGER EXISTS. THE CHANGE IN THE SYSTEM SUPPORTED BY A WELFARE STATE WILL HAVE CONSEQUENCES IN WORLDWIDE COMPETITION. THE FINAL POINT OF THE CULTURAL REVOLUTION, FOLLOWING HISTORICAL EXAMPLES, COULD BE THE EMERGENCE OF A DEGENERATE FORM OF DEMOCRACY: OCHLOCRACY. 2012 14 5246 16 PROGNOSTIC SCORE INCLUDING GENE MUTATIONS IN CHRONIC MYELOMONOCYTIC LEUKEMIA. PURPOSE: SEVERAL PROGNOSTIC SCORING SYSTEMS HAVE BEEN PROPOSED FOR CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML), A DISEASE IN WHICH SOME GENE MUTATIONS-INCLUDING ASXL1-HAVE BEEN ASSOCIATED WITH POOR PROGNOSIS IN UNIVARIABLE ANALYSES. WE DEVELOPED AND VALIDATED A PROGNOSTIC SCORE FOR OVERALL SURVIVAL (OS) BASED ON MUTATIONAL STATUS AND STANDARD CLINICAL VARIABLES. PATIENTS AND METHODS: WE GENOTYPED ASXL1 AND UP TO 18 OTHER GENES INCLUDING EPIGENETIC (TET2, EZH2, IDH1, IDH2, DNMT3A), SPLICING (SF3B1, SRSF2, ZRSF2, U2AF1), TRANSCRIPTION (RUNX1, NPM1, TP53), AND SIGNALING (NRAS, KRAS, CBL, JAK2, FLT3) REGULATORS IN 312 PATIENTS WITH CMML. GENOTYPES AND CLINICAL VARIABLES WERE INCLUDED IN A MULTIVARIABLE COX MODEL OF OS VALIDATED BY BOOTSTRAPPING. A SCORING SYSTEM WAS DEVELOPED USING REGRESSION COEFFICIENTS FROM THIS MODEL. RESULTS: ASXL1 MUTATIONS (P < .0001) AND, TO A LESSER EXTENT, SRSF2 (P = .03), CBL (P = .003), AND IDH2 (P = .03) MUTATIONS PREDICTED INFERIOR OS IN UNIVARIABLE ANALYSIS. THE RETAINED INDEPENDENT PROGNOSTIC FACTORS INCLUDED ASXL1 MUTATIONS, AGE OLDER THAN 65 YEARS, WBC COUNT GREATER THAN 15 X10(9)/L, PLATELET COUNT LESS THAN 100 X10(9)/L, AND ANEMIA (HEMOGLOBIN < 10 G/DL IN FEMALE PATIENTS, < 11G/DL IN MALE PATIENTS). THE RESULTING FIVE-PARAMETER PROGNOSTIC SCORE DELINEATED THREE GROUPS OF PATIENTS WITH MEDIAN OS NOT REACHED, 38.5 MONTHS, AND 14.4 MONTHS, RESPECTIVELY (P < .0001), AND WAS VALIDATED IN AN INDEPENDENT COHORT OF 165 PATIENTS (P < .0001). CONCLUSION: A NEW PROGNOSTIC SCORE INCLUDING ASXL1 STATUS, AGE, HEMOGLOBIN, WBC, AND PLATELET COUNTS DEFINES THREE GROUPS OF CMML PATIENTS WITH DISTINCT OUTCOMES. BASED ON CONCORDANCE ANALYSIS, THIS SCORE APPEARS MORE DISCRIMINATIVE THAN THOSE BASED SOLELY ON CLINICAL PARAMETERS. 2013 15 4554 13 MUTATIONAL PROFILING IN MYELOFIBROSIS: IMPLICATIONS FOR MANAGEMENT. MUTATIONAL PROFILING, USUALLY BY TARGETED NEXT-GENERATION SEQUENCING, IS INCREASINGLY PERFORMED ON PATIENTS WITH MYELOPROLIFERATIVE NEOPLASM-ASSOCIATED MYELOFIBROSIS (MF), WHETHER PRIMARY (PMF) OR POST-POLYCYTHEMIA VERA/ESSENTIAL THROMBOCYTHEMIA (POST-PV/ET MF). "DRIVER" MUTATIONS IN JAK2, MPL AND INDELS IN CALR UNDERLIE THE VAST MAJORITY OF CASES OF PMF AND POST-ET MF; THE REMAINDER ( APPROXIMATELY 10%) LACK IDENTIFIABLE DRIVER MUTATIONS, BUT OTHER CLONAL MARKERS ARE USUALLY DETECTABLE. NEARLY ALL PATIENTS WITH POST-PV MF CARRY ACTIVATING JAK2 MUTATIONS. IN BOTH PMF AND POST-ET MF, TYPE 1/-LIKE CALR MUTATIONS CONFER A FAVORABLE PROGNOSIS. SINCE BOTH TYPE 1/-LIKE AND TYPE 2/-LIKE CALR MUTATIONS HAVE ESSENTIALLY THE SAME FUNCTIONAL CONSEQUENCE, THIS IS A SUBJECT OF INTENSE RESEARCH. ADDITIONAL, "NON-DRIVER" MUTATIONS, MOSTLY AFFECTING GENES ENCODING EPIGENETIC MODIFIERS OR SPLICEOSOME COMPONENTS, E.G., ASXL1, EZH2, TET2, DNMT3A, SRSF2 AND U2AF1, ARE FREQUENTLY FOUND; SOME OF THESE ARE ASSOCIATED WITH INFERIOR SURVIVAL AND HAVE BEEN INCORPORATED INTO PROGNOSTIC MODELS. SOME MUTATIONS, E.G., IDH1/2, ARE RELATIVELY INFREQUENT IN CHRONIC PHASE BUT ARE SUBSTANTIALLY MORE COMMON IN BLAST PHASE, AND ARE NOW THERAPEUTICALLY TARGETABLE. WHILE MUTATIONAL INFORMATION DOES NOT CURRENTLY INFLUENCE CHOICE OF DRUG THERAPY IN CHRONIC-PHASE MF, THE PRESENCE OF A "HIGH MOLECULAR RISK" GENOTYPE IS NOW ROUTINELY TAKEN INTO ACCOUNT FOR TRANSPLANT DECISION-MAKING. 2020 16 5911 17 TARGETED NEXT-GENERATION SEQUENCING IN MYELODYSPLASTIC SYNDROME AND CHRONIC MYELOMONOCYTIC LEUKEMIA AIDS DIAGNOSIS IN CHALLENGING CASES AND IDENTIFIES FREQUENT SPLICEOSOME MUTATIONS IN TRANSFORMED ACUTE MYELOID LEUKEMIA. OBJECTIVES: OPTIMAL INTEGRATION OF NEXT-GENERATION SEQUENCING (NGS) INTO CLINICAL PRACTICE IN HEMATOLOGIC MALIGNANCIES REMAINS UNCLEAR. WE EVALUATE THE UTILITY OF NGS IN MYELOID MALIGNANCIES. METHODS: A 42-GENE PANEL WAS USED TO SEQUENCE 109 CASES OF MYELODYSPLASTIC SYNDROME (MDS, N = 38), CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML, N = 14), MYELOPROLIFERATIVE NEOPLASM (MPN, N = 24), AND MDS AND/OR MPN TRANSFORMED TO ACUTE MYELOID LEUKEMIA (AML, N = 33). RESULTS: AT LEAST ONE PATHOGENIC MUTATION WAS IDENTIFIED IN 74% OF CASES OF MDS, 100% OF CMMLS, AND 96% OF MPNS. IN CONTRAST, ONLY 47% OF CASES OF MDS (18/38) AND 7% (1/14) OF CMMLS EXHIBITED ABNORMAL CYTOGENETICS. IN DIAGNOSTICALLY DIFFICULT CASES OF MDS OR CMML WITH NORMAL CYTOGENETICS, NGS IDENTIFIED A PATHOGENIC MUTATION AND WAS CRITICAL IN ESTABLISHING THE CORRECT DIAGNOSIS. SPLICEOSOMAL GENES AND EPIGENETIC MODIFIERS WERE FREQUENTLY MUTATED. SPLICEOSOME MUTATIONS WERE ALSO FREQUENTLY DETECTED IN AML ARISING FROM MDS, CMML, OR MPN (39%) COMPARED WITH THE REPORTED RATE IN DE NOVO AML (7%-14%). CONCLUSIONS: IN DIFFICULT CASES OF MDS OR MPN, NGS FACILITATES DIAGNOSIS BY DETECTION OF GENE MUTATIONS TO CONFIRM CLONALITY, AND AMLS EVOLVING FROM MDS OR MPN CARRY FREQUENT MUTATIONS IN SPLICEOSOMAL GENES. 2016 17 3484 24 IDENTIFICATION OF CHROMATIN REMODELING GENES ARID4A AND ARID4B AS LEUKEMIA SUPPRESSOR GENES. BACKGROUND: LEUKEMIA EVOLVES THROUGH A MULTISTEP PROCESS FROM PREMALIGNANCY TO MALIGNANCY. EPIGENETIC ALTERATIONS, INCLUDING HISTONE MODIFICATIONS, HAVE BEEN PROPOSED TO PLAY AN IMPORTANT ROLE IN TUMORIGENESIS. THE INVOLVEMENT OF TWO CHROMATIN REMODELING GENES, RETINOBLASTOMA-BINDING PROTEIN 1 (RBBP1/ARID4A) AND RBBP1-LIKE 1 (RBBP1L1/ARID4B), IN LEUKEMOGENESIS WAS NOT CHARACTERIZED. METHODS: THE LEUKEMIC PHENOTYPE OF MICE DEFICIENT FOR ARID4A WITH OR WITHOUT HAPLOINSUFFICIENCY FOR ARID4B WAS INVESTIGATED BY SERIALLY MONITORING COMPLETE BLOOD COUNTS TOGETHER WITH MICROSCOPIC HISTOLOGIC ANALYSIS AND FLOW CYTOMETRIC ANALYSIS OF BONE MARROW AND SPLEEN FROM THE ARID4A(-/-) MICE OR ARID4A(-/-)ARID4B(+/-) MICE. REGULATION IN BONE MARROW CELLS OF DOWNSTREAM GENES IMPORTANT FOR NORMAL HEMATOPOIESIS WAS ANALYZED BY REVERSE TRANSCRIPTION-POLYMERASE CHAIN REACTION. GENOTYPIC EFFECTS ON HISTONE MODIFICATIONS WERE EXAMINED BY WESTERN BLOTTING AND IMMUNOFLUORESCENCE ANALYSIS. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: YOUNG (2-5 MONTHS OLD) ARID4A-DEFICIENT MICE HAD INEFFECTIVE BLOOD CELL PRODUCTION IN ALL HEMATOPOIETIC LINEAGES. BEYOND 5 MONTHS OF AGE, THE ARID4A(-/-) MICE MANIFESTED MONOCYTOSIS, ACCOMPANIED BY SEVERE ANEMIA AND THROMBOCYTOPENIA. THESE SICK ARID4A(-/-) MICE SHOWED BONE MARROW FAILURE WITH MYELOFIBROSIS ASSOCIATED WITH SPLENOMEGALY AND HEPATOMEGALY. FIVE OF 42 ARID4A(-/-) MICE AND 10 OF 12 ARID4A(-/-)ARID4B(+/-) MICE PROGRESSED TO ACUTE MYELOID LEUKEMIA (AML) AND HAD RAPID FURTHER INCREASES OF LEUKOCYTE COUNTS. EXPRESSION OF HOX GENES (HOXB3, HOXB5, HOXB6, AND HOXB8) WAS DECREASED IN ARID4A-DEFICIENT BONE MARROW CELLS WITH OR WITHOUT ARID4B HAPLOINSUFFICIENCY, AND FOXP3 EXPRESSION WAS REDUCED IN ARID4A(-/-)ARID4B(+/-) BONE MARROW. INCREASES OF HISTONE TRIMETHYLATION OF H3K4, H3K9, AND H4K20 (FOLD INCREASES IN TRIMETHYLATION = 32, 95% CONFIDENCE INTERVAL [CI] = 27 TO 32; 45, 95% CI = 41 TO 49; AND 2.2, 95% CI = 1.7 TO 2.7, RESPECTIVELY) WERE OBSERVED IN THE BONE MARROW OF ARID4A-DEFICIENT MICE. CONCLUSIONS: ARID4A-DEFICIENT MICE INITIALLY DISPLAY INEFFECTIVE HEMATOPOIESIS, FOLLOWED BY TRANSITION TO CHRONIC MYELOMONOCYTIC LEUKEMIA (CMML)-LIKE MYELODYSPLASTIC/MYELOPROLIFERATIVE DISORDER, AND THEN TRANSFORMATION TO AML. THE DISEASE PROCESSES IN THE ARID4A-DEFICIENT MICE ARE VERY SIMILAR TO THE COURSE OF EVENTS IN HUMANS WITH CMML AND AML. THIS MOUSE MODEL HAS THE POTENTIAL TO FURNISH ADDITIONAL INSIGHTS INTO THE ROLE OF EPIGENETIC ALTERATIONS IN LEUKEMOGENESIS, AND IT MAY BE USEFUL IN DEVELOPING NOVEL PHARMACOLOGICAL APPROACHES TO TREATMENT OF PRELEUKEMIC AND LEUKEMIC STATES. 2008 18 5665 18 SF3B1, RUNX1 AND TP53 MUTATIONS SIGNIFICANTLY IMPACT THE OUTCOME OF PATIENTS WITH LOWER-RISK MYELODYSPLASTIC SYNDROME. INTRODUCTION: PROGNOSIS OF PATIENTS WITH MYELODYSPLASTIC SYNDROME (MDS), PARTICULARLY THE GROUP WITH LOWER-RISK DISEASE (LR-MDS) IS VERY HETEROGENEOUS. SEVERAL STUDIES HAVE DESCRIBED THE PROGNOSTIC VALUE OF RECURRENT SOMATIC MUTATIONS IN MDS INCLUDING ALL RISK CATEGORIES. RECENTLY, THE INCORPORATION OF GENOMIC DATA TO CLINICAL PARAMETERS DEFINED THE NEW MOLECULAR INTERNATIONAL PROGNOSTIC SCORING SYSTEM (IPSS-M). MATERIALS AND METHODS: IN THIS STUDY, WE EVALUATED THE IMPACT OF MOLECULAR PROFILE IN A SERIES OF 181 PATIENTS WITH LR-MDS AND NON-PROLIFERATIVE CHRONIC MYELOMONOCYTIC LEUKEMIA. RESULTS: EPIGENETIC REGULATORS (TET2, ASXL1) AND SPLICING (SF3B1) WERE THE MOST RECURRENT MUTATED PATHWAYS. IN UNIVARIATE ANALYSIS, RUNX1 OR TP53 MUTATIONS CORRELATED WITH LOWER MEDIAN OVERALL SURVIVAL (OS). IN CONTRAST, SF3B1 MUTATION WAS ASSOCIATED WITH PROLONGED MEDIAN OS [95 MONTHS (95% IC, 32-157) VS. 33 MONTHS (95% CI, 19-46) IN UNMUTATED PATIENTS (P < 0.01)]. IN A MULTIVARIATE COX REGRESSION MODEL, RUNX1 MUTATIONS INDEPENDENTLY ASSOCIATED WITH SHORTER OS, WHILE SF3B1 MUTATION RETAINED ITS FAVORABLE IMPACT ON OUTCOME (HR: 0.24, 95% CI, 0.1-0.5; P = 0.001). IN ADDITION, TP53 OR RUNX1 MUTATIONS WERE IDENTIFIED AS PREDICTIVE COVARIATES FOR THE PROBABILITY OF LEUKEMIC PROGRESSION (P < 0.001). CONCLUSION: INCORPORATION OF MOLECULAR TESTING IN LR-MDS IDENTIFIED A SUBSET OF PATIENTS WITH EXPECTED POORER OUTCOME, EITHER DUE TO LOWER SURVIVAL OR PROBABILITY OF LEUKEMIC PROGRESSION. 2022 19 409 16 ANALYSIS OF GENES ENCODING EPIGENETIC REGULATORS IN MYELOPROLIFERATIVE NEOPLASMS: COEXISTENCE OF A NOVEL SETBP1 MUTATION IN A PATIENT WITH A P.V617F JAK2 POSITIVE MYELOFIBROSIS. IN RECENT YEARS IT HAS BEEN SHOWN THAT THE CAUSES OF CHRONIC MYELOPROLIFERATIVE NEOPLASMS (MPNS) ARE MORE COMPLEX THAN A SIMPLE SIGNALING ABERRATION AND MANY OTHER MUTATED GENES AFFECTING DIFFERENT CELL PROCESSES HAVE BEEN DESCRIBED. FOR INSTANCE, MUTATIONS IN GENES ENCODING EPIGENETIC REGULATORS ARE MORE FREQUENT THAN EXPECTED. ONE OF THE LATEST GENES DESCRIBED AS MUTATED IS SET BINDING PROTEIN 1 (SETBP1). IN SILICO TOOLS HAVE REVEALED THAT THERE ARE SEVERAL HUMAN SETBP1 PARALOGOUS TO NUCLEAR RECEPTOR BINDING SET DOMAIN PROTEIN 1 (NSD1), NSD2 AND NSD3, FOR EXAMPLE, WHICH ARE ALSO INVOLVED IN THE DEVELOPMENT OF OTHER HEMATOLOGICAL MALIGNANCIES. THEREFORE, THE PRESENT STUDY ANALYZED THE MUTATIONAL STATUS OF NSD1, NSD2, NSD3 AND SETBP1 IN BCR-ABL1 NEGATIVE MPNS WITH OR WITHOUT JANUS KINASE 2 (JAK2) P.V617F MUTATION. THE PRESENT STUDY REVEALED THAT THE NSD GENES ARE NOT FREQUENTLY MUTATED IN MPNS. HOWEVER, A NOVEL SETBP1 MUTATION WAS IDENTIFIED IN A PATIENT WITH P.V617F JAK2 POSITIVE PRIMARY MYELOFIBROSIS. THESE RESULTS PROVIDE FURTHER INSIGHT INTO THE GENETIC COMPLEXITY OF MPNS. 2019 20 4465 22 MOLECULAR MECHANISMS OF POSTTRAUMATIC STRESS DISORDER (PTSD) AS A BASIS FOR INDIVIDUALIZED AND PERSONALIZED THERAPY: RATIONALE, DESIGN AND METHODS OF THE SOUTH EASTERN EUROPE (SEE)-PTSD STUDY. POSTTRAUMATIC STRESS DISORDER (PTSD) IS A MAJOR HEALTH PROBLEM IN SOUTH EASTERN EUROPE (SEE). AVAILABLE TREATMENT OPTIONS ARE NOT EFFICIENT ENOUGH AND THE COURSE IS OFTEN CHRONIC. LITTLE IS KNOWN ABOUT MOLECULAR MEDIATORS AND MODERATORS OF PATHOGENESIS AND THERAPY. GENETIC AND EPIGENETIC VARIATION MAY BE ONE CENTRAL MOLECULAR MECHANISM. WE THEREFORE ESTABLISHED A CONSORTIUM COMBINING CLINICAL EXPERTISE ON PTSD FROM SEE COUNTRIES BOSNIA-HERZEGOVINA (SARAJEVO, TUZLA AND MOSTAR), KOSOVO (PRISHTINA) AND CROATIA (ZAGREB) WITH GENETIC AND EPIGENETIC COMPETENCE FROM GERMANY (WURZBURG) IN 2011 WITHIN THE FRAMEWORK OF THE DAAD (DEUTSCHER AKADEMISCHER AUSTAUSCHDIENST)-FUNDED STABILITY PACT FOR SOUTH EASTERN EUROPE. AFTER OBTAINING ETHICAL VOTES AND PERFORMING RATER TRAININGS AS WELL AS TRAINING IN DNA EXTRACTION FROM EDTA BLOOD BETWEEN 2011 AND 2013, WE RECRUITED 747 INDIVIDUALS WHO HAD EXPERIENCED WAR-RELATED TRAUMA IN THE SEE CONFLICTS BETWEEN 1991 AND 1999. 236 PARTICIPANTS HAD CURRENT PTSD, 161 LIFETIME PTSD AND 350 DID NOT HAVE AND NEVER HAD PTSD. DEMOGRAPHIC AND CLINICAL DATA ARE CURRENTLY MERGED TOGETHER WITH GENETIC AND EPIGENETIC DATA IN A SINGLE DATABASE TO ALLOW FOR A COMPREHENSIVE ANALYSIS OF THE ROLE OF GENETIC AND EPIGENETIC VARIATION IN THE PATHOGENESIS AND THERAPY OF PTSD. ANALYSES WILL BE DONE TO A GREAT DEGREE BY PHD STUDENTS FROM PARTICIPATING SEE CENTERS WHO IN ADDITION TO PARTICIPATION IN THE PROJECT HAD AN OPPORTUNITY TO TAKE PART IN SPRING AND SUMMER SCHOOLS OF THE DFG (DEUTSCHE FORSCHUNGSGEMEINSCHAFT) FUNDED RESEARCH TRAINING GROUP (RTG) 1253 AND THUS MEET PHD STUDENTS FROM GERMANY AND OTHER COUNTRIES WE ARE CONFIDENT THAT OUR PROJECT WILL NOT ONLY CONTRIBUTE TO A BETTER UNDERSTANDING OF GENETIC AND EPIGENETIC MECHANISMS OF PTSD AS A BASIS FOR FUTURE INDIVIDUALIZED AND PERSONALIZED THERAPIES, BUT ALSO TO THE ACADEMIC DEVELOPMENT OF SOUTH EASTERN EUROPE. 2016