Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment with the potential for cure in patients with myelodysplastic neoplasm (MDS). Nevertheless, disease relapse is the main cause of treatment failure. Due to the rarity of childhood MDS (cMDS), there are few studies sh...

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Main Authors: Elaiza Almeida Antônio de Kós, Viviane Lamim Lovatel, Rita de Cássia Barbosa Tavares, Gerson Moura Ferreira, Bernadete Evangelho Gomes, Ana Paula Silva Bueno, Elaine Sobral da Costa, Teresa de Souza Fernandez
Format: Article
Language:English
Published: PAGEPress Publications 2024-04-01
Series:Mediterranean Journal of Hematology and Infectious Diseases
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Online Access:https://www.mjhid.org/mjhid/article/view/5682
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author Elaiza Almeida Antônio de Kós
Viviane Lamim Lovatel
Rita de Cássia Barbosa Tavares
Gerson Moura Ferreira
Bernadete Evangelho Gomes
Ana Paula Silva Bueno
Elaine Sobral da Costa
Teresa de Souza Fernandez
author_facet Elaiza Almeida Antônio de Kós
Viviane Lamim Lovatel
Rita de Cássia Barbosa Tavares
Gerson Moura Ferreira
Bernadete Evangelho Gomes
Ana Paula Silva Bueno
Elaine Sobral da Costa
Teresa de Souza Fernandez
author_sort Elaiza Almeida Antônio de Kós
collection DOAJ
description Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment with the potential for cure in patients with myelodysplastic neoplasm (MDS). Nevertheless, disease relapse is the main cause of treatment failure. Due to the rarity of childhood MDS (cMDS), there are few studies showing the impact of cytogenetic alterations and genetic variants on outcomes of allo-HSCT, mainly focusing on clonal chromosomal evolution (CCE) during relapse post-transplant. Here, we describe a 3-year-old boy with cMDS-IB, who evolved to MDS/AML. At diagnosis, the patient showed a complex karyotype with chromosomal abnormalities not yet reported together in the same clone, and likely a pathogenic variant in the ETV6 gene. The patient was treated with HLA-matched sibling HSCT, but unfortunately relapsed after HSCT with clonal cytogenetic evolution. This unfavorable outcome suggests that the treatment of pediatric MDS associated with predictive factors of poor prognosis, such as complex karyotype and ETV6 variant remains a challenge.
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issn 2035-3006
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publishDate 2024-04-01
publisher PAGEPress Publications
record_format Article
series Mediterranean Journal of Hematology and Infectious Diseases
spelling doaj-art-35a2a57270254a2da2abf82e8dbdcd822025-08-20T02:44:39ZengPAGEPress PublicationsMediterranean Journal of Hematology and Infectious Diseases2035-30062024-04-0116110.4084/MJHID.2024.040Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment Elaiza Almeida Antônio de Kós 0https://orcid.org/0000-0002-6953-4284Viviane Lamim Lovatel 1https://orcid.org/0000-0001-8493-5855Rita de Cássia Barbosa Tavares 2https://orcid.org/0000-0002-9050-7918Gerson Moura Ferreira 3https://orcid.org/0000-0002-3467-2580Bernadete Evangelho Gomes4Ana Paula Silva Bueno5https://orcid.org/0000-0003-0167-2258Elaine Sobral da Costa 6https://orcid.org/0000-0002-5340-5816Teresa de Souza Fernandez7Cytogenetic Laboratory, Cell and Gene Therapy Program, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, BrazilCytogenetic Laboratory, Cell and Gene Therapy Program, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, BrazilOutpatient Department, Bone Marrow Transplantation Center, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, BrazilStem Cell Laboratory, Instituto Nacional de Câncer, Rio de Janeiro, RJ, BrazilImmunology Laboratory, Cell and Gene Therapy Program, Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, BrazilInstituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, BrazilInstituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, BrazilBone Marrow Transplantation Center, National Cancer Institute (INCA), Rio de Janeiro, RJ, Brazil. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment with the potential for cure in patients with myelodysplastic neoplasm (MDS). Nevertheless, disease relapse is the main cause of treatment failure. Due to the rarity of childhood MDS (cMDS), there are few studies showing the impact of cytogenetic alterations and genetic variants on outcomes of allo-HSCT, mainly focusing on clonal chromosomal evolution (CCE) during relapse post-transplant. Here, we describe a 3-year-old boy with cMDS-IB, who evolved to MDS/AML. At diagnosis, the patient showed a complex karyotype with chromosomal abnormalities not yet reported together in the same clone, and likely a pathogenic variant in the ETV6 gene. The patient was treated with HLA-matched sibling HSCT, but unfortunately relapsed after HSCT with clonal cytogenetic evolution. This unfavorable outcome suggests that the treatment of pediatric MDS associated with predictive factors of poor prognosis, such as complex karyotype and ETV6 variant remains a challenge. https://www.mjhid.org/mjhid/article/view/5682childhood myelodysplastic neoplasmcomplex karyotypeETV6 varianthematopoietic stem cell transplantationrelapseclonal cytogenetic evolution
spellingShingle Elaiza Almeida Antônio de Kós
Viviane Lamim Lovatel
Rita de Cássia Barbosa Tavares
Gerson Moura Ferreira
Bernadete Evangelho Gomes
Ana Paula Silva Bueno
Elaine Sobral da Costa
Teresa de Souza Fernandez
Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
Mediterranean Journal of Hematology and Infectious Diseases
childhood myelodysplastic neoplasm
complex karyotype
ETV6 variant
hematopoietic stem cell transplantation
relapse
clonal cytogenetic evolution
title Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
title_full Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
title_fullStr Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
title_full_unstemmed Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
title_short Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
title_sort outcome of allogeneic hematopoietic stem cell transplantation in a child with myelodysplastic neoplasm with complex karyotype and etv6 variant challenges in treatment
topic childhood myelodysplastic neoplasm
complex karyotype
ETV6 variant
hematopoietic stem cell transplantation
relapse
clonal cytogenetic evolution
url https://www.mjhid.org/mjhid/article/view/5682
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