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Feasibility to use whole-genome sequencing as a sole diagnostic method to detect genomic aberrations in pediatric B-cell acute lymphoblastic leukemia

Rezayee, Fatemah ; Eisfeldt, Jesper ; Skaftason, Aron ; Öfverholm, Ingegerd ; Sayyab, Shumaila ; Syvänen, Ann Christine ; Maqbool, Khurram ; Lilljebjörn, Henrik LU orcid ; Johansson, Bertil LU and Olsson-Arvidsson, Linda LU , et al. (2023) In Frontiers in Oncology 13.
Abstract

Introduction: The suitability of whole-genome sequencing (WGS) as the sole method to detect clinically relevant genomic aberrations in B-cell acute lymphoblastic leukemia (ALL) was investigated with the aim of replacing current diagnostic methods. Methods: For this purpose, we assessed the analytical performance of 150 bp paired-end WGS (90x leukemia/30x germline). A set of 88 retrospective B-cell ALL samples were selected to represent established ALL subgroups as well as ALL lacking stratifying markers by standard-of-care (SoC), so-called B-other ALL. Results: Both the analysis of paired leukemia/germline (L/N)(n=64) as well as leukemia-only (L-only)(n=88) detected all types of aberrations mandatory in the current ALLTogether trial... (More)

Introduction: The suitability of whole-genome sequencing (WGS) as the sole method to detect clinically relevant genomic aberrations in B-cell acute lymphoblastic leukemia (ALL) was investigated with the aim of replacing current diagnostic methods. Methods: For this purpose, we assessed the analytical performance of 150 bp paired-end WGS (90x leukemia/30x germline). A set of 88 retrospective B-cell ALL samples were selected to represent established ALL subgroups as well as ALL lacking stratifying markers by standard-of-care (SoC), so-called B-other ALL. Results: Both the analysis of paired leukemia/germline (L/N)(n=64) as well as leukemia-only (L-only)(n=88) detected all types of aberrations mandatory in the current ALLTogether trial protocol, i.e., aneuploidies, structural variants, and focal copy-number aberrations. Moreover, comparison to SoC revealed 100% concordance and that all patients had been assigned to the correct genetic subgroup using both approaches. Notably, WGS could allocate 35 out of 39 B-other ALL samples to one of the emerging genetic subgroups considered in the most recent classifications of ALL. We further investigated the impact of high (90x; n=58) vs low (30x; n=30) coverage on the diagnostic yield and observed an equally perfect concordance with SoC; low coverage detected all relevant lesions. Discussion: The filtration of the WGS findings with a short list of genes recurrently rearranged in ALL was instrumental to extract the clinically relevant information efficiently. Nonetheless, the detection of DUX4 rearrangements required an additional customized analysis, due to multiple copies of this gene embedded in the highly repetitive D4Z4 region. We conclude that the diagnostic performance of WGS as the standalone method was remarkable and allowed detection of all clinically relevant genomic events in the diagnostic setting of B-cell ALL.

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type
Contribution to journal
publication status
published
subject
keywords
B-cell acute lymphoblastic leukemia, class-defining genetic lesions, diagnostic validation, genomic aberrations, whole-genome sequencing
in
Frontiers in Oncology
volume
13
article number
1217712
publisher
Frontiers Media S. A.
external identifiers
  • pmid:37664045
  • scopus:85169622251
ISSN
2234-943X
DOI
10.3389/fonc.2023.1217712
language
English
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yes
id
cb0b12de-ee55-4f73-8313-f034c26b0b9c
date added to LUP
2023-11-06 15:17:13
date last changed
2024-04-19 03:41:17
@article{cb0b12de-ee55-4f73-8313-f034c26b0b9c,
  abstract     = {{<p>Introduction: The suitability of whole-genome sequencing (WGS) as the sole method to detect clinically relevant genomic aberrations in B-cell acute lymphoblastic leukemia (ALL) was investigated with the aim of replacing current diagnostic methods. Methods: For this purpose, we assessed the analytical performance of 150 bp paired-end WGS (90x leukemia/30x germline). A set of 88 retrospective B-cell ALL samples were selected to represent established ALL subgroups as well as ALL lacking stratifying markers by standard-of-care (SoC), so-called B-other ALL. Results: Both the analysis of paired leukemia/germline (L/N)(n=64) as well as leukemia-only (L-only)(n=88) detected all types of aberrations mandatory in the current ALLTogether trial protocol, i.e., aneuploidies, structural variants, and focal copy-number aberrations. Moreover, comparison to SoC revealed 100% concordance and that all patients had been assigned to the correct genetic subgroup using both approaches. Notably, WGS could allocate 35 out of 39 B-other ALL samples to one of the emerging genetic subgroups considered in the most recent classifications of ALL. We further investigated the impact of high (90x; n=58) vs low (30x; n=30) coverage on the diagnostic yield and observed an equally perfect concordance with SoC; low coverage detected all relevant lesions. Discussion: The filtration of the WGS findings with a short list of genes recurrently rearranged in ALL was instrumental to extract the clinically relevant information efficiently. Nonetheless, the detection of DUX4 rearrangements required an additional customized analysis, due to multiple copies of this gene embedded in the highly repetitive D4Z4 region. We conclude that the diagnostic performance of WGS as the standalone method was remarkable and allowed detection of all clinically relevant genomic events in the diagnostic setting of B-cell ALL.</p>}},
  author       = {{Rezayee, Fatemah and Eisfeldt, Jesper and Skaftason, Aron and Öfverholm, Ingegerd and Sayyab, Shumaila and Syvänen, Ann Christine and Maqbool, Khurram and Lilljebjörn, Henrik and Johansson, Bertil and Olsson-Arvidsson, Linda and Pietras, Christina Orsmark and Staffas, Anna and Palmqvist, Lars and Fioretos, Thoas and Cavelier, Lucia and Fogelstrand, Linda and Nordlund, Jessica and Wirta, Valtteri and Rosenquist, Richard and Barbany, Gisela}},
  issn         = {{2234-943X}},
  keywords     = {{B-cell acute lymphoblastic leukemia; class-defining genetic lesions; diagnostic validation; genomic aberrations; whole-genome sequencing}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Oncology}},
  title        = {{Feasibility to use whole-genome sequencing as a sole diagnostic method to detect genomic aberrations in pediatric B-cell acute lymphoblastic leukemia}},
  url          = {{http://dx.doi.org/10.3389/fonc.2023.1217712}},
  doi          = {{10.3389/fonc.2023.1217712}},
  volume       = {{13}},
  year         = {{2023}},
}