ABSTRACT
As with most genetic cancer predisposition syndromes, inherited susceptibility to myelodysplastic syndrome (MDS) and acute leukemia (AL) is likely to be more common than previously appreciated. As next-generation sequencing technologies become integrated into clinical practice, we anticipate that the number of cases of familial MDS/AL identified will increase. Although the existence of syndromes predisposing to MDS/AL has been known for some time, clinical guidelines for the screening and management of suspected or confirmed cases do not exist. Based on our collective experience caring for families with these syndromes, we propose recommendations for genetic counseling, testing, and clinical management. We welcome discussion about these proposals and hope that they will catalyze an ongoing dialog leading to optimal medical and psychosocial care for these patients.
Subject(s)
Myelodysplastic Syndromes/diagnosis , Myelodysplastic Syndromes/therapy , Disease Susceptibility , Family , Genetic Counseling , Genetic Testing , Humans , Leukemia/diagnosis , Leukemia/genetics , Myelodysplastic Syndromes/genetics , Practice Guidelines as TopicSubject(s)
Blood Donors , DNA Mutational Analysis , Hematopoietic Stem Cell Transplantation , Leukemia/genetics , Myelodysplastic Syndromes/genetics , Thrombocytopenia/genetics , Acute Disease , Blood Donors/statistics & numerical data , Blood Grouping and Crossmatching , Case-Control Studies , Cohort Studies , Family , Genetic Predisposition to Disease , Humans , Leukemia/therapy , Mutation/physiology , Myelodysplastic Syndromes/therapy , Telomerase/genetics , Telomerase/physiology , Thrombocytopenia/bloodABSTRACT
Ikaros is a hematopoietic cell-specific zinc finger DNA binding protein that plays an important role in lymphocyte development. Genetic disruption of Ikaros results in T-cell transformation. Ikaros null mice develop leukemia with 100% penetrance. It has been hypothesized that Ikaros controls gene expression through its association with chromatin remodeling complexes. The development of leukemia in Ikaros null mice suggests that Ikaros has the characteristics of a tumor suppressor gene. In this report, we show that the introduction of Ikaros into an established mouse Ikaros null T leukemia cell line leads to growth arrest at the G0/G1 stage of the cell cycle. This arrest is associated with up-regulation of the cell cycle-dependent kinase inhibitor p27kip1, the induction of expression of T-cell differentiation markers, and a global and specific increase in histone H3 acetylation status. These studies provide strong evidence that Ikaros possesses the properties of a bona fide tumor suppressor gene for the T-cell lineage and offer insight into the mechanism of Ikaros's tumor suppressive activity.
