Acute Myeloid Leukemia Clinical Trial
Official title:
Screening Gene Mutations in Myeloid Cancers by Next Generation Sequencing to Improve Treatment Results
Genetic mutations have closely linked to the pathogenesis and prognostication of myeloid cancers. In addition, a number of molecularly targeted agents have been developed in recent years. With the advent of next generation sequencing (NGS), we now are able to detect a wide range of mutations more rapidly, accurately, and economically. In this study, the investigators will use NGS to screen and analyze myeloid-associated gene mutations in the participants, and aim to build up the mutational landscapes of the various myeloid cancers, and investigate how these mutations are linked to clinical outcome.
Genetic mutations have closely linked to the pathogenesis and prognostication of myeloid
cancers (including acute myeloid leukemia, myelodysplastic syndromes, and myeloproliferative
neoplasms). In recent years, a number of novel therapeutic agents targeting various genetic
mutations have been developed. For instance, patients with FLT3-ITD and IDH2 mutations have
been shown to derive benefits from midostaurin and enasidenib, respectively. Furthermore, the
TP53-mutated patients once categorized in the very high risk group, have been found to
respond favorably to the hypomethylating agent, decitabine. Detecting a wide array of cancer
mutations nowadays by the traditional Sanger method has become not only time-consuming but
also not as cost-effective. With the advent of next generation sequencing (NGS), we now are
able to detect a panel gene mutations more rapidly, accurately, and economically.
In this study, the investigators will screen and analyze myeloid-associated gene mutations in
participants with myeloid cancers, with an in-house designed targeted NGS panel. The total
nucleic acid from patients' blood or bone marrow specimens will be extracted, and then
subjected to the library preparation procedure based on multiplex PCR amplification.
Sequencing will be performed on Illumina MiSeq sequencer, and the results will be analyzed
using our in-house developed bioinformatic workflow. Briefly, the sequenced reads will be
aligned to human reference genome hg19 with BWA-mem, and somatic mutations called with
Mutect2. The variants will be annotated via SnpEff with RefSeq, dbSNP, 1000 Genome Project,
COSMIC and ClinVar databases. The investigators aim to build up the mutational landscapes of
the above mentioned myeloid cancers, and investigate how these mutations are linked to
clinical outcome.
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