Utility of Next Generation Sequencing in the Workup and Diagnosis of Myeloproliferative neoplasm in the Peripheral Blood: A single institution experience

Abstract Introduction/Objective In patients with suspicion of Myeloproliferative neoplasm (MPN) and negative for BCR-ABL1, NCCN guideline currently recommends two molecular workup pathways in peripheral blood: 1) a multi-step reflex mutation testing algorithm including JAK2 V617F, CALR, MPL, JAK2 exon12 or 2) a multigene Next Generation Sequencing (NGS) panel that includes at least JAK2, CALR and MPL genes. Here we report the clinical utilization and impact of a NGS based MPN diagnosis assay. Methods/Case Report Total of 690 consecutive cases at Geisinger between 2019 and 2021 were included in this study. Patient’s CBC showed chronic cytosis in either single or multi-lineage myelopoiesis and was clinically suspicious for MPNs. For BCR-ABL1 negative cases, NGS based MPN diagnostic assay was performed, which include the four disease defining genes recommended by NCCN guideline: JAK2, CALR, MPL, CSF3R as well as three additional genes NRAS, PPM1D and TP53. Variants are classified in to four tiers based on their level of clinical significance. Results (if a Case Study enter NA) Among all cases tested, 25 out of 690 cases (3.6%) were positive for BCR-ABL1 transcript. 20.9% (139 out of 665 BCR-ABL1 negative cases) had at least one variant detected, which included 73 variants in Tier I category (11.0%), 6 variants in Tier II (0.9%), 57 variants in Tier III (8.6%) and 3 variants in Tier IV(0.5%). Among all disease defining mutations, JAK2 V617F was the most commonly detected mutation (59 cases and 8.8%), followed by CALR indel mutations (13 cases and 2.0%). In addition, double variants were detected in total 7 cases (1.0%). Conclusion Comparing to the conventional multi-step sequential workup for MPN diagnosis, the multi-gene NGS panel provides a cost-effective and time- saving solution. When detected concurrently with the disease defining mutations, NRAS, PPM1D and TP53 could provide not only additional prognostic information but also may suggest pending progression in myeloproliferative neoplasms.

Download Full-text

Validation of variants using cost effective highresolution melting (HRM) analysis predicted from target re-sequencing in Eucalyptus

Acta Botanica Croatica ◽

10.37427/botcro-2020-019 ◽

2020 ◽

Vol 79 (2) ◽

pp. 105-113

Author(s):

Abdul Bari Muneera Parveen ◽

Divya Lakshmanan ◽

Modhumita Ghosh Dasgupta

Keyword(s):

Next Generation Sequencing ◽

Large Scale ◽

Sequence Data ◽

Cost Effective ◽

Nucleotide Polymorphisms ◽

Next Generation ◽

Time Saving ◽

Hrm Analysis ◽

The Cost ◽

Generation Sequencing

The advent of next-generation sequencing has facilitated large-scale discovery and mapping of genomic variants for high-throughput genotyping. Several research groups working in tree species are presently employing next generation sequencing (NGS) platforms for marker discovery, since it is a cost effective and time saving strategy. However, most trees lack a chromosome level genome map and validation of variants for downstream application becomes obligatory. The cost associated with identifying potential variants from the enormous amount of sequence data is a major limitation. In the present study, high resolution melting (HRM) analysis was optimized for rapid validation of single nucleotide polymorphisms (SNPs), insertions or deletions (InDels) and simple sequence repeats (SSRs) predicted from exome sequencing of parents and hybrids of Eucalyptus tereticornis Sm. ? Eucalyptus grandis Hill ex Maiden generated from controlled hybridization. The cost per data point was less than 0.5 USD, providing great flexibility in terms of cost and sensitivity, when compared to other validation methods. The sensitivity of this technology in variant detection can be extended to other applications including Bar-HRM for species authentication and TILLING for detection of mutants.

Download Full-text

Clinical Use of Next-Generation Sequencing in the Diagnosis of Wilson’s Disease

Gastroenterology Research and Practice ◽

10.1155/2016/4548039 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

Dániel Németh ◽

Kristóf Árvai ◽

Péter Horváth ◽

János Pál Kósa ◽

Bálint Tobiás ◽

...

Keyword(s):

Next Generation Sequencing ◽

Sanger Sequencing ◽

Wilson’S Disease ◽

Cost Effective ◽

Wilson's Disease ◽

Clinical Use ◽

Next Generation ◽

Time Saving ◽

Cost Effective Method ◽

Generation Sequencing

Objective. Wilson’s disease is a disorder of copper metabolism which is fatal without treatment. The great number of disease-causingATP7Bgene mutations and the variable clinical presentation of WD may cause a real diagnostic challenge. The emergence of next-generation sequencing provides a time-saving, cost-effective method for full sequencing of the wholeATP7Bgene compared to the traditional Sanger sequencing. This is the first report on the clinical use of NGS to examineATP7Bgene.Materials and Methods. We used Ion Torrent Personal Genome Machine in four heterozygous patients for the identification of the other mutations and also in two patients with no known mutation. One patient with acute on chronic liver failure was a candidate for acute liver transplantation. The results were validated by Sanger sequencing.Results. In each case, the diagnosis of Wilson’s disease was confirmed by identifying the mutations in both alleles within 48 hours. One novel mutation (p.Ala1270Ile) was found beyond the eight other known ones. The rapid detection of the mutations made possible the prompt diagnosis of WD in a patient with acute liver failure.Conclusions. According to our results we found next-generation sequencing a very useful, reliable, time-saving, and cost-effective method for diagnosing Wilson’s disease in selected cases.

Download Full-text

Next-generation sequencing in the clinical genetic screening of patients with pheochromocytoma and paraganglioma

Endocrine Connections ◽

10.1530/ec-13-0009 ◽

2013 ◽

Vol 2 (2) ◽

pp. 104-111 ◽

Cited By ~ 32

Author(s):

Joakim Crona ◽

Alberto Delgado Verdugo ◽

Dan Granberg ◽

Staffan Welin ◽

Peter Stålberg ◽

...

Keyword(s):

Next Generation Sequencing ◽

Genetic Screening ◽

Bioinformatics Analysis ◽

Cost Effective ◽

Susceptibility Genes ◽

Next Generation ◽

Clinical Genetic ◽

Cost Effective Method ◽

Agilent Sureselect ◽

Generation Sequencing

BackgroundRecent findings have shown that up to 60% of pheochromocytomas (PCCs) and paragangliomas (PGLs) are caused by germline or somatic mutations in one of the 11 hitherto known susceptibility genes: SDHA, SDHB, SDHC, SDHD, SDHAF2, VHL, HIF2A (EPAS1), RET, NF1, TMEM127 and MAX. This list of genes is constantly growing and the 11 genes together consist of 144 exons. A genetic screening test is extensively time consuming and expensive. Hence, we introduce next-generation sequencing (NGS) as a time-efficient and cost-effective alternative.MethodsTumour lesions from three patients with apparently sporadic PCC were subjected to whole exome sequencing utilizing Agilent Sureselect target enrichment system and Illumina Hi seq platform. Bioinformatics analysis was performed in-house using commercially available software. Variants in PCC and PGL susceptibility genes were identified.ResultsWe have identified 16 unique genetic variants in PCC susceptibility loci in three different PCC, spending less than a 30-min hands-on, in-house time. Two patients had one unique variant each that was classified as probably and possibly pathogenic: NF1 Arg304Ter and RET Tyr791Phe. The RET variant was verified by Sanger sequencing.ConclusionsNGS can serve as a fast and cost-effective method in the clinical genetic screening of PCC. The bioinformatics analysis may be performed without expert skills. We identified process optimization, characterization of unknown variants and determination of additive effects of multiple variants as key issues to be addressed by future studies.

Download Full-text

The genetic analysis of Chinese patients with clonal cytopenias using targeted next-generation sequencing

Molecular Cytogenetics ◽

10.1186/s13039-021-00572-z ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Lijuan Zhang ◽

YuYe Shi ◽

Yue Chen ◽

Shandong Tao ◽

Wenting Shi ◽

...

Keyword(s):

Next Generation Sequencing ◽

Myelodysplastic Syndromes ◽

Rna Splicing ◽

Myeloproliferative Neoplasms ◽

Chinese Patients ◽

Newly Diagnosed ◽

Next Generation ◽

Targeted Next Generation Sequencing ◽

Significant Difference ◽

Generation Sequencing

Abstract Background Clonal hematopoiesis (CH) can be found in various myeloid neoplasms (MN), such as myelodysplastic syndromes (MDS), myelodysplastic syndromes/myeloproliferative neoplasms (MDS/MPN), also in pre-MDS conditions. Methods Cytogenetics is an independent prognostic factor in MDS, and fluorescence in-situ hybridization (FISH) can be used as an adjunct to karyotype analysis. In the past 5 years, only 35 of 100 newly diagnosed MDS and MDS/MPN patients were identified abnormalities, who underwent the FISH panel. In addition, we examined a cohort of 51 cytopenic patients suspected MDS or MDS/MPN with a 20-gene next generation sequencing (NGS), including 35 newly diagnosed MN patients and 16 clonal cytopenias of undetermined significance (CCUS) patients. Results Compared with the CCUS group, the MN group had higher male ratio (22/13 vs 10/6), cytogenetics abnormalities rate (41.4% vs 21.4%) and frequency of a series of mutations, such as ASXL1 (28.6% vs 25%), U2AF1 (25.7% vs 25%), RUNX1 (20% vs 0.0%); also, higher adverse mutations proportion (75% vs 85.2%), and double or multiple mutations (54.3% vs 43.75%). There were 7 MN patients and 4 CCUS patients who experienced cardio-cerebrovascular embolism events demonstrated a significant difference between the two groups (25% vs 20%). Ten of the 11 patients had somatic mutations, half had DNA methylation, while the other half had RNA splicing. Additionally, six patients had disease transformation, and four patients had mutated U2AF1, including two CCUS cases and two MDS-EB cases. Following up to January 2021, there was no significant difference in over survival between the CCUS and MN groups. Conclusion NGS facilitates the diagnosis of unexplained cytopenias. The monitoring and management of CCUS is necessary, also cardio-cerebrovascular embolism events in patients with CH need attention in the clinical practice.

Download Full-text

PB2197 NEXT-GENERATION SEQUENCING IN CLINICAL PRACTICE: MOLECULAR EVENTS AND COURSE OF MYELOPROLIFERATIVE NEOPLASMS

HemaSphere ◽

10.1097/01.hs9.0000567268.25156.c8 ◽

2019 ◽

Vol 3 (S1) ◽

pp. 985

Author(s):

L. Poluskina ◽

V. Shuvaev ◽

M. Fominykh ◽

E. Efremova ◽

E. Motyko ◽

...

Keyword(s):

Clinical Practice ◽

Next Generation Sequencing ◽

Myeloproliferative Neoplasms ◽

Next Generation ◽

Molecular Events ◽

Generation Sequencing

Download Full-text

Next-Generation Sequencing Mutational Landscape and Clinical Features of Chinese Adults with Myeloproliferative Neoplasms

10.21203/rs.3.rs-483741/v1 ◽

2021 ◽

Author(s):

Shuna Luo ◽

Zanzan Wang ◽

Xiaofei Xu ◽

Lan Zhang ◽

Shengjie Wang ◽

...

Keyword(s):

Next Generation Sequencing ◽

Comprehensive Evaluation ◽

Myeloproliferative Neoplasms ◽

Primary Myelofibrosis ◽

Next Generation ◽

Chinese Adults ◽

Leukocyte Counts ◽

Next Generation Sequencing Ngs ◽

Generation Sequencing

Abstract Background: Myeloproliferative neoplasms (MPNs) include three classical subtypes: polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). Since prefibrotic primary myelofibrosis (pre-PMF) was recognized as a separate entity in the 2016 revised classification of MPN, it has been a subject of debate among experts due to its indefinite diagnosis. However, pre-PMF usually has a distinct outcome compared with either ET or overt PMF. In this study, we examined the clinical, haematologic, genetic, and prognostic differences among pre-PMF, ET, and overt PMF.Methods: We retrospectively reviewed the clinical parameters, haematologic information, and genetic mutations of patients who were diagnosed with pre-PMF, ET, and overt PMF according to the WHO 2016 criteria using next-generation sequencing (NGS).Results: Pre-PMF patients exhibited higher leukocyte counts, higher LDH values, a higher frequency of splenomegaly, and a higher incidence of hypertension than ET patients. On the other hand, pre-PMF patients had higher platelet counts and haemoglobin levels than overt PMF patients. Molecular analysis revealed that the frequency of EP300 mutations was significantly increased in pre-PMF patients compared with ET and overt PMF patients. In terms of outcome, male sex, along with symptoms including MPN-10, anaemia, thrombocytopenia, and KMT2A and CUX1 mutations, indicated a poor prognosis for PMF patients.Conclusion: The results of this study indicated that comprehensive evaluation of BM features, clinical phenotypes, haematologic parameters, and molecular profiles is needed for the accurate diagnosis and treatment of ET, pre-PMF, and overt PMF patients.

Download Full-text

A rare atypical chronic myeloid leukemia BCR-ABL1 negative with concomitant JAK2 V617F and SETBP1 mutations: a case report and literature review

Therapeutic Advances in Hematology ◽

10.1177/2040620720927105 ◽

2020 ◽

Vol 11 ◽

pp. 204062072092710

Author(s):

Tianqi Gao ◽

Changhui Yu ◽

Si Xia ◽

Ting Liang ◽

Xuekui Gu ◽

...

Keyword(s):

Bone Marrow ◽

Targeted Therapy ◽

Next Generation Sequencing ◽

Myeloid Leukemia ◽

Jak2 V617f ◽

Next Generation ◽

Bone Marrow Fibrosis ◽

Atypical Chronic Myeloid Leukemia ◽

Generation Sequencing ◽

Marrow Fibrosis

Atypical chronic myeloid leukemia (aCML) BCR-ABL1 negative is a rare myelodysplastic syndromes/myeloproliferative neoplasm (MDS/MPN) for which no standard treatment currently exists. The advent of next-generation sequencing has allowed our understanding of the molecular pathogenesis of aCML to be expanded and has made it possible for clinicians to more accurately differentiate aCML from similar MDS/MPN overlap syndrome and MPN counterparts, as MPN-associated driver mutations in JAK2, CALR, or MPL are typically absent in aCML. A 55-year old male with main complaints of weight loss and fatigue for more than half a year and night sweats for more than 2 months was admitted to our hospital. Further examination revealed increased white blood cells, splenomegaly, and grade 1 bone marrow fibrosis with JAK2 V617F, which supported a preliminary diagnosis of pre-primary marrow fibrosis. However, in addition to JAK2 V617F (51.00%), next-generation sequencing also detected SETBP1 D868N (46.00%), ASXL1 G645fs (36.09%), and SRSF2 P95_R102del (33.56%) mutations. According to the 2016 World Health Organization diagnostic criteria, the patient was ultimately diagnosed with rare aCML with concomitant JAK2 V617F and SETBP1 mutations. The patient received targeted therapy of ruxolitinib for 5 months and subsequently an additional four courses of combined hypomethylating therapy. The patient exhibited an optimal response, with decreased spleen volume by approximately 35% after therapy and improved symptom scores after therapy. In diagnosing primary bone marrow fibrosis, attention should be paid to the identification of MDS/MPN. In addition to basic cell morphology, mutational analysis using next-generation sequencing plays an increasingly important role in the differential diagnosis. aCML with concomitant JAK2 V617F and SETBP1 mutations has been rarely reported, and targeted therapy for mutated JAK2 may benefit patients, especially those not suitable recipients of hematopoietic stem cell transplants.

Download Full-text