Clinical significance of SF3B1 mutations in myelodysplastic syndromes and myelodysplastic/myeloproliferative neoplasms

Luca Malcovati, Elli Papaemmanuil, David T. Bowen, Jacqueline Boultwood, Matteo G. Della Porta, Cristiana Pascutto, Erica Travaglino, Michael J. Groves, Anna L. Godfrey, Ilaria Ambaglio, Anna Galli, Matteo C. Da Via, Simona Conte, Sudhir Tauro, Norene Keenan, Ann Hyslop, Jonathan Hinton, Laura J. Mudie, James S. Wainscoat, P. Andrew FutrealMichael R. Stratton, Peter J. Campbell, Eva Hellstrom-Lindberg, Mario Cazzola, Assoc Italiana Ricerca Canc Grp, Int Canc Genome Consortium

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    Abstract

    In a previous study, we identified somatic mutations of SF3B1, a gene encoding a core component of RNA splicing machinery, in patients with myelodysplastic syndrome (MDS). Here, we define the clinical significance of these mutations in MDS and myelodysplastic/myeloproliferative neoplasms (MDS/MPN). The coding exons of SF3B1 were screened using massively parallel pyrosequencing in patients with MDS, MDS/MPN, or acute myeloid leukemia (AML) evolving from MDS. Somatic mutations of SF3B1 were found in 150 of 533 (28.1%) patients with MDS, 16 of 83 (19.3%) with MDS/MPN, and 2 of 38 (5.3%) with AML. There was a significant association of SF3B1 mutations with the presence of ring sideroblasts (P < .001) and of mutant allele burden with their proportion (P = .002). The mutant gene had a positive predictive value for ring sideroblasts of 97.7% (95% confidence interval, 93.5%-99.5%). In multivariate analysis including established risk factors, SF3B1 mutations were found to be independently associated with better overall survival (hazard ratio = 0.15, P = .025) and lower risk of evolution into AML (hazard ratio = 0.33, P = .049). The close association between SF3B1 mutations and disease phenotype with ring sideroblasts across MDS and MDS/MPN is consistent with a causal relationship. Furthermore, SF3B1 mutations are independent predictors of favorable clinical outcome, and their incorporation into stratification systems might improve risk assessment in MDS. (Blood. 2011;118(24):6239-6246)

    Original languageEnglish
    Pages (from-to)6239-6246
    Number of pages8
    JournalBlood
    Volume118
    Issue number24
    DOIs
    Publication statusPublished - 8 Dec 2011

    Keywords

    • PROGNOSTIC SCORING SYSTEM
    • WORLD-HEALTH-ORGANIZATION
    • RING SIDEROBLASTS
    • MYELOID NEOPLASMS
    • HUMAN 5Q-SYNDROME
    • CD34(+) CELLS
    • ANEMIA
    • CLASSIFICATION
    • GENE
    • TET2

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