<i>BRAF</i> Mutations in Patients with Myeloid Neoplasms: A Cancer Center Multigene Next-Generation Sequencing Analysis Experience

oleh: Fei Fei, Caitlin Caporale, Lisa Chang, Barbara K. Fortini, Haris Ali, Diana Bell, Anthony Stein, Guido Marcucci, Milhan Telatar, Michelle Afkhami

Format: Article
Diterbitkan: MDPI AG 2024-05-01

Deskripsi

<i>BRAF</i> mutations are rare in myeloid neoplasms and are reported to be associated with poor treatment outcomes. The purpose of our study is to characterize <i>BRAF</i> mutations in myeloid neoplasms using a next-generation sequencing (NGS) panel based on the experiences of a single cancer center. We conducted a retrospective review of patients with myeloid neoplasms who underwent the HopeSeq studies between January 2018 and September 2023. A total of 14 patients with myeloid neoplasms carrying <i>BRAF</i> mutations were included in our cohort. The clinical, pathological, and molecular features of these patients were investigated. Our study indicates that <i>BRAF</i> mutations are rare in myeloid neoplasms, constituting only 0.53% (14/2632) of all myeloid neoplasm cases, with the most common <i>BRAF</i> mutation being <i>BRAF</i> V600E (4/14; 28.6%). Interestingly, we observed that six out of seven patients with acute myeloid leukemia (AML) exhibited AML with monocytic differentiation, and all the patients with AML exhibited an extremely poor prognosis compared to those without <i>BRAF</i> mutations. <i>TET2</i> (5/14; 35.7%), <i>ASXL1</i> (4/14; 28.6%), and <i>JAK2</i> (4/14; 28.6%) were the three most frequently co-mutated genes in these patients. Moreover, we noted concurrent <i>KMT2A</i> gene rearrangement with <i>BRAF</i> mutations in three patients with AML (3/7; 42.9%). Our study suggests that although <i>BRAF</i> mutations are rare in myeloid neoplasms, they play a crucial role in the pathogenesis of specific AML subtypes. Furthermore, RAS pathway alterations, including <i>BRAF</i> mutations, are associated with <i>KMT2A</i> gene rearrangement in AML. However, these findings warrant further validation in larger studies.