January 2018 | Eanáir 2018

Major Research Development in Juvenile Myelomonocytic Leukaemia

Fri, 12 January 18 18:14

Professor Owen Smith, UCD Professor of Paediatric and Adolescent Medicine and Consultant Paediatric Haematologist at Our Lady’s Children’s Hospital, Crumlin, is part of an international team that has made a breakthrough in juvenile myelomonocytic leukaemia (JMML).

The study, published in Nature Communications, shows for the first time, that JMML can be broken into three subgroups with unique molecular and clinical characteristics, through analysis of DNA methylation. Based on high, intermediate or low methylation, differences in the underlying mutations, and significantly, in the prognosis of the disease have been identified.  High methylation is associated with a poor clinical outcome, low methylation with a good outcome.

JMML is an aggressive myeloproliferative cancer of early childhood characterized by mutations activating RAS signaling.  Without adequate treatment, survival for most children with JMML is less than 1 year. Treatment involves stem cell transplantation, and even with this, the 5 year event-free survival still reaches only about 50%.  Current established clinical and genetic markers do not differentiate the clinical and biological heterogeneity of this disease.

This study is a huge advance in the care of children with this type of cancer; providing a method to predict the disease outcome, and to stratify risk of relapse. From this, future work in the mechanisms underlying the DNA methylation in this disease, will potentially lead to new avenues of treatment.

The research is supported by the National Children’s Research Centre at Our Lady’s Children’s Hospital Crumlin.

Article Reference

RAS-pathway mutation patterns define epigenetic subclasses in juvenile myelomonocytic leukemia.

Lipka DB, Witte T, Toth R, Yang J, Wiesenfarth M, Nöllke P, Fischer A, Brocks D, Gu Z, Park J, Strahm B, Wlodarski M, Yoshimi A, Claus R, Lübbert M, Busch H, Boerries M, Hartmann M, Schönung M, Kilik U, Langstein J, Wierzbinska JA, Pabst C, Garg S, Catalá A, De Moerloose B, Dworzak M, Hasle H, Locatelli F, Masetti R, Schmugge M, Smith O, Stary J, Ussowicz M, van den Heuvel-Eibrink MM, Assenov Y, Schlesner M, Niemeyer C, Flotho C, Plass C.

Nat Commun. 2017 Dec 19;8(1):2126. doi: 10.1038/s41467-017-02177-w.  PMID: 29259247

Adapted from an Article by the National Children's Research Centre.