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<meta name="description" content="The genetic basis of hypodiploid acute lymphoblastic leukemia (ALL), a subtype of ALL characterized by aneuploidy and poor outcome, is unknown. Genomic profiling of 124 hypodiploid ALL cases, including whole-genome and exome sequencing of 40 cases, identified two subtypes that differ in the severity …"><meta name="keywords" content="pmid:23334668, PMC3919793, doi:10.1038/ng.2532, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov&#x27;t, Linda Holmfeldt, Lei Wei, Charles G Mullighan, Aneuploidy*, Animals, Base Sequence, Cell Line, Tumor, Chromosome Aberrations*, Gene Expression Regulation, Neoplastic, Haploidy, Humans, Ikaros Transcription Factor / genetics, Ikaros Transcription Factor / metabolism, Mice, Molecular Sequence Data, Mutation*, Phosphatidylinositol 3-Kinases / genetics, Phosphatidylinositol 3-Kinases / metabolism, Precursor Cell Lymphoblastic Leukemia-Lymphoma / genetics*, Precursor Cell Lymphoblastic Leukemia-Lymphoma / metabolism, Precursor Cell Lymphoblastic Leukemia-Lymphoma / pathology, Retinoblastoma Protein / genetics, Retinoblastoma Protein / metabolism, Signal Transduction, Transplantation, Heterologous, Treatment Outcome, Tumor Suppressor Protein p53 / genetics, Tumor Suppressor Protein p53 / metabolism, PubMed Abstract, NIH, NLM, NCBI, National Institutes of Health, National Center for Biotechnology Information, National Library of Medicine, MEDLINE"><meta name="robots" content="index,nofollow,noarchive"><meta property="og:title" content="The genomic landscape of hypodiploid acute lymphoblastic leukemia - PubMed"><meta property="og:url" content="https://pubmed.ncbi.nlm.nih.gov/23334668/"><meta property="og:description" content="The genetic basis of hypodiploid acute lymphoblastic leukemia (ALL), a subtype of ALL characterized by aneuploidy and poor outcome, is unknown. Genomic profiling of 124 hypodiploid ALL cases, including whole-genome and exome sequencing of 40 cases, identified two subtypes that differ in the severity …"><meta property="og:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:image:secure_url" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg"><meta property="og:type" content="website"><meta property="og:site_name" content="PubMed"><meta name="twitter:domain" content="pubmed.ncbi.nlm.nih.gov"><meta name="twitter:card" content="summary_large_image"><meta name="twitter:title" content="The genomic landscape of hypodiploid acute lymphoblastic leukemia - PubMed"><meta name="twitter:url" content="https://pubmed.ncbi.nlm.nih.gov/23334668/"><meta name="twitter:description" content="The genetic basis of hypodiploid acute lymphoblastic leukemia (ALL), a subtype of ALL characterized by aneuploidy and poor outcome, is unknown. Genomic profiling of 124 hypodiploid ALL cases, including whole-genome and exome sequencing of 40 cases, identified two subtypes that differ in the severity …"><meta name="twitter:image" content="https://cdn.ncbi.nlm.nih.gov/pubmed/persistent/pubmed-meta-image-v2.jpg">
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<input type="hidden" name="email-subject-hash" value="ce1a806d9bab59b40cc502b6dcd06c57d6f3885ddf1ff9641a1ec7742d108316"/>
</div>
<div class="action-panel-control-wrap">
<label for="email-to" class="action-panel-label required-field-asterisk">
To:
</label>
<input type="email" aria-label="Recipient Email Address" placeholder="email@example.com" id="email-to" class="email-to" pattern="^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+\.[a-zA-Z0-9-.]+$" maxlength="100" required>
</div>
<div class="action-panel-control-wrap">
<label for="email-from" class="action-panel-label">
From:
</label>
<input type="email" aria-label="Sender Email Address" placeholder="email@example.com" id="email-from" class="email-from" pattern="^[a-zA-Z0-9_.+-]+@[a-zA-Z0-9-]+\.[a-zA-Z0-9-.]+$" maxlength="256">
</div>
<div class="action-panel-control-wrap">
<label for="email-citation-format" class="action-panel-label">
Format:
</label>
<select id="email-citation-format" name="citation-format" class="action-panel-selector email-citation-format">
<option selected="selected" value="summary">Summary</option>
<option value="summary-text">Summary (text)</option>
<option value="abstract">Abstract</option>
<option value="abstract-text">Abstract (text)</option>
</select>
</div>
<div class="include-supplemental-container">
<input type="checkbox" aria-label="Include MeSH and other data" name="include-supplemental" id="email-include-supplemental" class="email-include-supplemental">
<label for="email-include-supplemental" class="email-include-supplemental-label">MeSH and other data</label>
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<div class="form-field recaptcha ">
<div class="g-recaptcha" id="id-recaptcha" data-sitekey="6LfsWHMdAAAAAClKbtOpjQ2pMjgsGxvv7NdZW9uI"></div>
</div>
<div id="captcha-error-message" class="usa-input-error-message captcha-validation-message" role="alert"></div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Sending..."
data-ga-category="save_share"
data-ga-action="email"
data-ga-label="send">
Send email
</button>
<button class="action-panel-cancel"
aria-label="Close 'Email citations' panel"
ref="linksrc=close_email_panel"
aria-controls="email-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="email"
data-ga-label="cancel">
Cancel
</button>
</div>
<input type="hidden" name="email-search-details" value="" />
<input type="hidden" name="email-search-details-hash" value="0e42663a6c3bd85498fcb88798998fed7bfdc45d457db35281e41afe13cc0524" />
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<div id="collections-action-panel"
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aria-hidden="true"
data-collections-open-panel-enabled="false"
data-collections-open-panel-url-hash="#open-collections-panel">
<div class="inner-wrap">
<h3 class="action-panel-heading">
Add to Collections
</h3>
<form id="collections-action-panel-form"
class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-existing-collections-url="/list-existing-collections/"
data-add-to-existing-collection-url="/add-to-existing-collection/"
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data-get-article-ids-by-search-url="/get-article-ids-by-search/"
data-myncbi-max-collection-name-length="100"
data-add-to-collection-max-amount="1000"
data-collections-root-url="https://www.ncbi.nlm.nih.gov/myncbi/collections/">
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<div class="choice-group" role="radiogroup">
<ul class="radio-group-items">
<li>
<input type="radio"
id="collections-action-panel-new"
class="collections-new"
name="collections"
value="new"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="collections_radio_new">
<label for="collections-action-panel-new">Create a new collection</label>
</li>
<li>
<input type="radio"
id="collections-action-panel-existing"
class="collections-existing"
name="collections"
value="existing"
checked="true"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="collections_radio_existing">
<label for="collections-action-panel-existing">Add to an existing collection</label>
</li>
</ul>
</div>
<div class="controls-wrapper">
<div class="action-panel-control-wrap new-collections-controls">
<label for="collections-action-panel-add-to-new" class="action-panel-label required-field-asterisk">
Name your collection:
</label>
<input
type="text"
name="add-to-new-collection"
id="collections-action-panel-add-to-new"
class="collections-action-add-to-new"
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/"
maxlength="100"
data-ga-category="save_share"
data-ga-action="create_collection"
data-ga-label="non_favorties_collection">
<div class="collections-new-name-too-long usa-input-error-message selection-validation-message">
Name must be less than 100 characters
</div>
</div>
<div class="action-panel-control-wrap existing-collections-controls">
<label for="collections-action-panel-add-to-existing" class="action-panel-label">
Choose a collection:
</label>
<select id="collections-action-panel-add-to-existing"
class="action-panel-selector collections-action-add-to-existing"
data-ga-category="save_share"
data-ga-action="select_collection"
data-ga-label="($('#collections-action-add-to-existing').val() === 'Favorites') ? 'Favorites' : 'non_favorites_collection'">
</select>
<div class="collections-retry-load-on-error usa-input-error-message selection-validation-message">
Unable to load your collection due to an error<br>
<a href="#">Please try again</a>
</div>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Adding..."
data-pinger-ignore
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="add">
Add
</button>
<button class="action-panel-cancel"
aria-label="Close 'Add to Collections' panel"
ref="linksrc=close_collections_panel"
aria-controls="collections-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="collections"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="bibliography-action-panel"
class="bibliography-action-panel action-panel in-progress-dots-panel"
aria-hidden="true"
data-bibliography-open-panel-enabled="false"
data-bibliography-open-panel-url-hash="#open-bibliography-panel">
<div class="inner-wrap">
<h3 class="action-panel-heading">
Add to My Bibliography
</h3>
<form id="bibliography-action-panel-form"
class="bibliography-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-add-to-bibliography-max-amount="100"
data-add-to-bibliography-batch-size="10"
data-bibliography-delegates-url="/list-bibliography-delegates/"
data-add-to-bibliography-url="/add-to-bibliography/"
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<div class="action-panel-control-wrap bibliographies-controls">
<div class="choice-group">
<ul class="bibliographies-action-add radio-group-items">
<li>
<input name="bibliography" id="my-bibliography" class="my-bibliography" type="radio" checked/>
<label for="my-bibliography">My Bibliography</label>
</li>
</ul>
</div>
</div>
<div class="bibliographies-retry-load-on-error usa-input-error-message selection-validation-message">
Unable to load your delegates due to an error<br>
<a href="#">Please try again</a>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Adding..."
data-pinger-ignore>
Add
</button>
<button class="action-panel-cancel"
aria-label="Close 'Add to bibliography' panel"
ref="linksrc=close_bibliography_panel"
aria-controls="bibliography-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="mybib"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="saved-search-action-panel" class="saved-search-action-panel action-panel " aria-hidden="true"
data-saved-search-open-panel-enabled="false"
data-saved-search-open-panel-url-hash="#open-saved-search-panel">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Your saved search
</h2>
<form id="saved-search-action-panel-form"
class="saved-search-action-panel-form action-panel-content action-form"
data-create-saved-search-url="/create-saved-search/"
data-try-search-terms-url="/try-search-term/"
data-saved-search-root-url="https://www.ncbi.nlm.nih.gov/myncbi/searches/">
<input type="hidden" name="csrfmiddlewaretoken" value="CsRyZeGXCV68EH8a3UnzsywiraILXcSkTfBDC49jcwTCy8e0Gd0BWG2WZeqXQNqE">
<div class="action-panel-control-wrap">
<label for="saved-search-name" class="action-panel-label saved-search-name-label required-field-asterisk">
Name of saved search:
</label>
<input maxlength="200"
type="text"
name="saved-search-name"
id="saved-search-name"
class="saved-search-name"
value=""
required
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/">
</div>
<div class="action-panel-control-wrap">
<label for="saved-search-term" class="action-panel-label required-field-asterisk">
Search terms:
</label>
<textarea name="saved-search-term" id="saved-search-term" class="saved-search-term" required></textarea>
</div>
<div class="test-search-term-wrap">
<a href="#" class="try-search-term">Test search terms</a>
</div>
<div class="choice-group action-panel-extra-margin-top">
<span class="action-panel-label" id="fieldset-label">
Would you like email updates of new search results?
</span>
<fieldset id="saved-search-alert" aria-describedby="fieldset-label">
<legend class="usa-sr-only">Saved Search Alert Radio Buttons</legend>
<ul class="radio-group-items">
<li>
<input type="radio" id="saved-search-alert-yes" class="saved-search-alert-yes" name="saved-search-alert" value="yes" checked>
<label for="saved-search-alert-yes" class="action-panel-label">Yes</label>
</li>
<li>
<input aria-label="No radio input" type="radio" id="saved-search-alert-no" class="saved-search-alert-no" name="saved-search-alert" value="no">
<label for="saved-search-alert-no" class="action-panel-label">No</label>
</li>
</ul>
</fieldset>
</div>
<div class="alert-schedule-wrap">
<div class="action-panel-control-wrap">
<label class="action-panel-label">
Email:
</label>
<span aria-label="Email address" id="saved-search-email" class="action-panel-label"><span class="action-panel-label-bold"></span> (<a class="myncbi-account-settings" href="https://www.ncbi.nlm.nih.gov/account/settings/">change</a>)</span>
</div>
<div class="action-panel-control-wrap action-panel-extra-margin-top">
<label for="saved-search-frequency" class="action-panel-label">
Frequency:
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<select id="saved-search-frequency" class="no-border-panel-selector saved-search-frequency">
<option value="monthly">Monthly</option>
<option value="weekly">Weekly</option>
<option value="daily">Daily</option>
</select>
</div>
<div class="action-panel-control-wrap saved-search-monthly-additional">
<label for="saved-search-monthly-on-day" class="action-panel-label">
Which day?
</label>
<select id="saved-search-monthly-on-day" class="no-border-panel-selector">
<option value="Sunday">The first Sunday</option>
<option value="Monday">The first Monday</option>
<option value="Tuesday">The first Tuesday</option>
<option value="Wednesday">The first Wednesday</option>
<option value="Thursday">The first Thursday</option>
<option value="Friday">The first Friday</option>
<option value="Saturday">The first Saturday</option>
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<div class="action-panel-control-wrap saved-search-weekly-additional">
<label for="saved-search-weekly-on-day" class="action-panel-label">
Which day?
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<select id="saved-search-weekly-on-day" class="no-border-panel-selector saved-search-weekly-on-day">
<option value="Sunday">Sunday</option>
<option value="Monday">Monday</option>
<option value="Tuesday">Tuesday</option>
<option value="Wednesday">Wednesday</option>
<option value="Thursday">Thursday</option>
<option value="Friday">Friday</option>
<option value="Saturday">Saturday</option>
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</div>
<div class="action-panel-control-wrap">
<label for="saved-search-report" class="action-panel-label">
Report format:
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<option value="DocSum">Summary</option>
<option value="DocSumText">Summary (text)</option>
<option value="Abstract">Abstract</option>
<option value="AbstractText">Abstract (text)</option>
<option value="MEDLINE">PubMed</option>
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</div>
<div class="action-panel-control-wrap">
<label for="saved-search-amount" class="action-panel-label">
Send at most:
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<option value="5" selected>5 items</option>
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</div>
<div>
<input type="checkbox" id="saved-search-send-if-no-result" class="saved-search-send-if-no-result" name="saved-search-send-if-no-result">
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Send even when there aren't any new results
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<div class="action-panel-control-wrap option-text-in-email-wrap">
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Optional text in email:
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<textarea name="saved-search-email-text"
id="saved-search-email-text"
class="saved-search-email-text"></textarea>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Saving..."
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="save">
Save
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<button class="action-panel-cancel"
aria-label="Close 'Your saved search' panel"
ref="linksrc=close_saved_search_panel"
aria-controls="saved-search-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
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</div>
<div id="citation-manager-action-panel" class="citation-manager-action-panel action-panel" aria-hidden="true">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Create a file for external citation management software
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class="action-panel-content action-form"
action="/results-export-ids/"
data-by-search-action="/results-export-search-data/"
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<input name="results-format" type="hidden" value="pubmed"/>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Sending..."
data-ga-category="save_share"
data-ga-action="citation_manager"
data-ga-label="save">
Create file
</button>
<button class="action-panel-cancel"
aria-label="Close 'Send citations to citation manager' panel"
ref="linksrc=close_citation_manager_panel"
aria-controls="citation-manager-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="citation_manager"
data-ga-label="cancel">
Cancel
</button>
</div>
</form>
</div>
</div>
<div id="rss-action-panel" class="rss-action-panel action-panel " aria-hidden="true">
<div class="inner-wrap">
<h2 class="action-panel-heading">
Your RSS Feed
</h2>
<form id="rss-action-panel-form"
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<div class="action-panel-control-wrap">
<label for="rss-name" class="action-panel-label required-field-asterisk">
Name of RSS Feed:
</label>
<input maxlength="200"
placeholder="Name"
type="text"
name="rss-name"
id="rss-name"
class="rss-name"
value=''
required
pattern="[^&quot;&amp;=&lt;&gt;\/]*" title="The following characters are not allowed in the Name field: &quot;&amp;=&lt;&gt;/">
</div>
<div class="rss-limit-wrap">
<div class="action-panel-control-wrap action-panel-extra-margin-top">
<label for="rss-limit" class="action-panel-label">
Number of items displayed:
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<option value="5">5</option>
<option value="10">10</option>
<option value="15" selected="selected">15</option>
<option value="20">20</option>
<option value="50">50</option>
<option value="100">100</option>
</select>
</div>
</div>
<div class="action-panel-actions">
<button class="action-panel-submit"
type="submit"
data-loading-label="Creating..."
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="save">
Create RSS
</button>
<button class="action-panel-cancel"
aria-label="Close 'Your RSS' panel"
ref="linksrc=close_rss_panel"
aria-controls="rss-action-panel"
aria-expanded="false"
data-ga-category="save_share"
data-ga-action="alert"
data-ga-label="cancel">
Cancel
</button>
</div>
<div class="action-panel-control-wrap rss-link-copy-wrap">
<label for="rss-link" class="usa-sr-only">RSS Link</label>
<input placeholder="Your RSS Feed Link" type="text" name="rss-link" id="rss-link" class="rss-link" title="RSS Link">
<button
type="button"
disabled
class="rss-link-copy-button disabled"
data-ga-category="save_share"
data-ga-action="rss"
data-ga-label="copy">
Copy
</button>
</div>
</form>
</div>
</div>
</div>
</div>
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Full text links
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<a class="link-item
dialog-focus"
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Full text links
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<div class="actions-buttons sidebar"><h3 class="title">Actions</h3><div class="inner-wrap"><button class="citation-button citation-dialog-trigger"
aria-label="Open dialog with citation text in different styles"
data-ga-category="save_share"
data-ga-action="cite"
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aria-label="Save article in MyNCBI collections."
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data-ga-action="click"
data-ga-label="collections_button"
data-collections-open-dialog-enabled="false"
data-collections-open-dialog-url="https://account.ncbi.nlm.nih.gov/?back_url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F23334668%2F%23open-collections-dialog"
data-in-collections="false"><span class="button-label">Collections</span></button><div class="overlay" role="dialog"><div id="collections-action-dialog"
class="dialog collections-dialog"
aria-hidden="true"><div class="title">Add to Collections</div><div class="collections-action-panel action-panel"><form id="collections-action-dialog-form"
class="collections-action-panel-form action-panel-content action-form action-panel-smaller-selectors"
data-existing-collections-url="/list-existing-collections/"
data-add-to-existing-collection-url="/add-to-existing-collection/"
data-create-and-add-to-new-collection-url="/create-and-add-to-new-collection/"
data-myncbi-max-collection-name-length="100"
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id="collections-action-dialog-new"
class="collections-new"
name="collections"
value="new"
data-ga-category="collections_button"
data-ga-action="click"
data-ga-label="collections_radio_new"><label for="collections-action-dialog-new">Create a new collection</label></li><li><input type="radio"
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name="collections"
value="existing"
checked="true"
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The genomic landscape of hypodiploid acute lymphoblastic leukemia
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The genetic basis of hypodiploid acute lymphoblastic leukemia (ALL), a subtype of ALL characterized by aneuploidy and poor outcome, is unknown. Genomic profiling of 124 hypodiploid ALL cases, including whole-genome and exome sequencing of 40 cases, identified two subtypes that differ in the severity of aneuploidy, transcriptional profiles and submicroscopic genetic alterations. Near-haploid ALL with 24-31 chromosomes harbor alterations targeting receptor tyrosine kinase signaling and Ras signaling (71%) and the lymphoid transcription factor gene IKZF3 (encoding AIOLOS; 13%). In contrast, low-hypodiploid ALL with 32-39 chromosomes are characterized by alterations in TP53 (91.2%) that are commonly present in nontumor cells, IKZF2 (encoding HELIOS; 53%) and RB1 (41%). Both near-haploid and low-hypodiploid leukemic cells show activation of Ras-signaling and phosphoinositide 3-kinase (PI3K)-signaling pathways and are sensitive to PI3K inhibitors, indicating that these drugs should be explored as a new therapeutic strategy for this aggressive form of leukemia.
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<p> Figure 1. Mutation spectrum of whole genome… </p>
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<p> Figure 1. Mutation spectrum of whole genome sequenced hypodiploid ALL </p>
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<div class="figure-caption-contents"><b> a </b> , Circos plots of…</div>
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Figure 1. Mutation spectrum of whole genome sequenced hypodiploid ALL
</strong>
<div class="figure-caption-contents"><b>a</b>, Circos plots of representative near haploid (top left), masked near haploid (top right), low hypodiploid (bottom left) and masked low hypodiploid (bottom right) cases. Depicted are structural genetic variants, including DNA copy number alterations, intra- and inter-chromosomal translocations, and sequence alterations. <b>b</b>, Whole genome sequenced cases are depicted from left to right. Colored bars represent number of specific lesions identified in each case as indicated. Masked hypodiploid cases here refer to cases with either a pure doubled hypodiploid clone or cases harboring a doubled clone constituting at least 30%.</div>
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<p> Figure 2. Genome-wide DNA copy number alterations… </p>
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<p> Figure 2. Genome-wide DNA copy number alterations and gene expression profiling of hypodiploid ALL </p>
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<div class="figure-caption-contents"><b> a… </b></div>
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<figcaption id="figure-caption-1" class="figure-caption-full figure-caption-text" itemtype="http://schema.org/ImageObject" itemprop="description">
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Figure 2. Genome-wide DNA copy number alterations and gene expression profiling of hypodiploid ALL
</strong>
<div class="figure-caption-contents"><b>a</b>, Log<sub>2</sub> ratio DNA copy number heatmap showing SNP 6.0 microarray data for the tumor samples from the pediatric hypodiploid ALL cohort. Chromosomes 122, X and Y are depicted from top to bottom, and individual samples are shown from left to right. An asterisk (*) indicates tumor samples with less than 70% blasts. LH, low hypodiploid. Blue indicates loss of genetic material and red, gain. Dicentric chromosomes most frequently involved chromosome arms 9p, and either 12p or 20q, and were predominantly observed in near diploid karyotypes. Copy-neutral loss-of-heterozygosity was observed of diploid chromosomes in masked hypodiploid cases (Supplementary Table 10 and Supplementary Fig. 2) consistent with duplication of the hypodiploid clone. <b>b</b>, Left panel: Unsupervised principal component analysis (PCA) of gene expression data from all hypodiploid ALL cases with available high quality RNA (N=94). PCA analysis using 1000 representative probesets selected by <i>k</i> means distinguishes near haploid/masked near haploid, low hypodiploid/masked low hypodiploid and near diploid subgroups. Right panel: Weighted Pair-Group Method with Arithmetic mean hierarchical clustering analysis performed using the 10,000 most variable probesets. Masked hypodiploid cases here refer to cases with a doubled hypodiploid clone constituting at least 30%.</div>
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<p> Figure 3. Recurrent alterations of Ras- and… </p>
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<p> Figure 3. Recurrent alterations of Ras- and RTK signaling in near haploid ALL </p>
</strong>
<div class="figure-caption-contents"><b> a </b> ,…</div>
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Figure 3. Recurrent alterations of Ras- and RTK signaling in near haploid ALL
</strong>
<div class="figure-caption-contents"><b>a</b>, Protein domain plot of NF1 depicting identified alterations. The recurrent exon 1535 deletion in <i>NF1</i> is indicated by a double-headed arrow. <b>b</b>, SNP 6.0 microarray heatmap showing deletions in <i>NF1.</i> Blue indicates DNA loss. Cases with simultaneous <i>NF1</i> deletion and sequence mutation are indicated by a Y. Masked hypodiploid cases here include all cases harboring a doubled clone constituting at least 30%. mNH, masked near haploid; LH, low hypodiploid; mLH, masked low hypodiploid. <b>c</b>, The genomic breakpoints for the <i>NF1</i> deletions cluster in two regions. The individual breakpoints are indicated by arrows. The 5-break (upper panel) is most frequently present in intron 14, and the 3-break (lower panel) in intron 35. Immediately internal to the 5- and 3-breakpoints are putative, partially conserved RAG heptamer recombination signal sequences (RSS) present, and an insertion of a variable number of non-consensus nucleotides in between the two breakpoints were seen for all these cases. <b>d</b>, RT-PCR on cases harboring an <i>NF1</i> exon 1535 deletion, using forward and reverse primers complementary to regions in <i>NF1</i> exons 14 and 36, respectively, rendering a 648 bp fragment. <b>eh</b>, Protein domain- and alteration plots for other Ras- and RTK signaling related genes recurrently targeted by sequence mutations in hypodiploid ALL, including <i>NRAS, KRAS, FLT3</i> and <i>PTPN11</i> (schematic of MAPK1 can be found in Supplementary Fig. 4). Blue line indicates alterations present also in non-tumor cells.</div>
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<p> Figure 4. Frequent mutations in <i> TP53 </i> in… </p>
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<p> Figure 4. Frequent mutations in <i> TP53 </i> in low hypodiploid ALL </p>
</strong>
<div class="figure-caption-contents"><b> ab </b> , Protein domain plots…</div>
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Figure 4. Frequent mutations in <i>TP53</i> in low hypodiploid ALL
</strong>
<div class="figure-caption-contents"><b>ab</b>, Protein domain plots of p53 with alterations identified in (<b>a</b>) pediatric hypodiploid ALL and (<b>b</b>) adult ALL. Known LFS alterations are indicated in red. Alterations present in non-tumor cells are indicated by blue lines. Arrows indicate alterations identified in adult low hypodiploid cases in <b>b. c</b>, Pedigree of a family with an inherited <i>TP53</i> mutation. N, number of siblings. <b>d</b>, Electropherograms showing the inherited <i>TP53</i> g.13886delG mutation (resulting in p.G302fs) in the proband (child; leukemic bone marrow (top) and normal skin biopsy(middle)) and father (lower panel). Wild-type (Wt) DNA and amino acid (aa) sequences (seq) are depicted at the top of the panel. Δ indicates the deleted nucleotide. <b>e</b>, Histologic examination of tumor from the probands father indicated a diagnosis of glioblastoma. Poorly differentiated glial cells are admixed with sparse cells showing an astrocytic phenotype. Many neoplastic cells are GFAP-immunopositive, and all express the mutant <i>TP53</i> and <i>IDH1</i> (p.Arg132His) gene products. Scale bar corresponds to 50 microns. HE, hematoxylin and eosin. <b>f</b>, Immunoblot of p53 on primary hypodiploid ALL samples harboring either wild-type <i>TP53</i> or a <i>TP53</i> missense mutation as indicated. <b>g</b>, Flow cytometric analysis of spleen samples from xenografted mice and NALM-16 detecting p53 levels. Only cells positive for human CD45 and CD19 were analyzed. Known nonsense and missense alterations in p53 are indicated. BM, bone marrow.</div>
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<p> Figure 5. Recurrent deletions of the IKAROS… </p>
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<p> Figure 5. Recurrent deletions of the IKAROS family genes IKZF2 (HELIOS) and IKZF3 (AIOLOS) </p>
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<div class="figure-caption-contents"><b> ac… </b></div>
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Figure 5. Recurrent deletions of the IKAROS family genes IKZF2 (HELIOS) and IKZF3 (AIOLOS)
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<div class="figure-caption-contents"><b>ac</b>, SNP 6.0 microarray heatmaps (left panel) and schematics (right panel) of the alterations identified in the IKAROS family members <i>IKZF1</i> (IKAROS, <b>a</b>), <i>IKZF2</i> (HELIOS, <b>b</b>) and <i>IKZF3</i> (AIOLOS, <b>c</b>). Blue indicates loss of DNA in the heatmaps. One <i>IKZF1</i> altered case harbors a simultaneous deletion and sequence mutation, indicated by a Y in the left hand panel of <b>a. d</b>, Immunoblot analysis on primary hypodiploid ALL patient samples using the antibodies sc-9866 detecting HELIOS (left), and sc-101982 detecting AIOLOS (right). Deletions in the respective gene are indicated by “+” and lack thereof by “−”.</div>
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<p> Figure 6. Recurring mutations in hypodiploid ALL </p>
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<p> Figure 6. Recurring mutations in hypodiploid ALL </p>
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<div class="figure-caption-contents"><b> a </b> , Data are shown for the entire…</div>
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Figure 6. Recurring mutations in hypodiploid ALL
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<div class="figure-caption-contents"><b>a</b>, Data are shown for the entire hypodiploid ALL cohort split up in the near haploid (including masked near haploid cases), low hypodiploid (and masked low hypodiploid) and near diploid subgroups. <b>b</b>, Data matrix as above, but only including genes involved in histone modification identified in samples sequenced by either whole genome- or exome sequencing. SV, structural variation; Indel, insertion/deletion mutation; SNV, single nucleotide variation; Age, Age at diagnosis; Ind. failure, Induction treatment failure; NGS, next-generation sequencing; WGS, whole genome sequencing; WES, whole exome sequencing; GEP, gene expression profiling.</div>
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<p> Figure 7. Activation of Ras signaling </p>
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<p> Figure 7. Activation of Ras signaling </p>
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<div class="figure-caption-contents"><b> ab </b> , Flow cytometric analyses of spleen samples from…</div>
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Figure 7. Activation of Ras signaling
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<div class="figure-caption-contents"><b>ab</b>, Flow cytometric analyses of spleen samples from xenografted mice and the near haploid cell line NALM-16 detecting pERK (<b>a</b>) and pS6 (<b>b</b>)levels. Only cells positive for human CD45 were analyzed. *Cases with a known mutation in the Ras signaling pathway. <i>IKZF2</i> and <i>IKZF3</i> deletions are indicated by “+” and lack thereof by “−”. <b>c</b>, Immunoblot showing levels of Ras-GTP as assessed by a Raf-Ras binding domain bead pulldown assay in low hypodiploid and near haploid ALL xenograft samples and NALM-16. Presence of Ras pathway (pwy) and <i>IKZF2</i> alterations are indicated by “+”. <b>de</b>, Detection of pERK (<b>d</b>) and pS6 (<b>e</b>) in non-stimulated NALM-16 with and without treatment with the PI3K inhibitor GDC-0941 (0.7uM) and the PI3K/mTOR inhibitor BEZ235 (0.3uM) for 1 hour. The drug concentrations correspond to the respective IC<sub>50</sub> value gained from proliferation assays on NALM-16 (Supplementary Table 23). <b>f</b>, <i>ex vivo</i> proliferation assay on near haploid (upper, SJHYPO037-X2) and low hypodiploid (lower, SJHYPO077-X1) xenograft cells harboring the indicated mutations (Supplementary Table 12). BM, bone marrow; NH, near haploid; LH, low hypodiploid.</div>
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MLPA and DNA index improve the molecular diagnosis of childhood B-cell acute lymphoblastic leukemia.
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Related information
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Gene
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