Genetic basis for iMCD-TAFRO

Authors

Department

Pathology

Document Type

Article

Publication Title

Oncogene

Abstract

TAFRO syndrome, a clinical subtype of idiopathic multicentric Castleman disease (iMCD), consists of a constellation of symptoms/signs including thrombocytopenia, anasarca, fever, reticulin fibrosis/renal dysfunction, and organomegaly. The etiology of iMCD-TAFRO and the basis for cytokine hypersecretion commonly seen in iMCD-TAFRO patients has not been elucidated. Here, we identified a somatic MEK2 mutation and a germline RUNX1 mutation in two patients with iMCD-TAFRO, respectively. The MEK2 mutation, which has been identified previously in solid tumor and histiocytosis patients, caused hyperactivated MAP kinase signaling, conferred IL-3 hypersensitivity and sensitized the cells to various MEK inhibitors. The RUNX1 mutation abolished the transcriptional activity of wild-type RUNX1 and functioned as a dominant negative form of RUNX1, resulting in enhanced self-renewal activity in hematopoietic stem/progenitor cells. Interestingly, ERK was heavily activated in both patients, highlighting a potential role for activation of MAPK signaling in iMCD-TAFRO pathogenesis and a rationale for exploring inhibition of the MAPK pathway as a therapy for iMCD-TAFRO. Moreover, these data suggest that iMCD-TAFRO might share pathogenetic features with clonal inflammatory disorders bearing MEK and RUNX1 mutations such as histiocytoses and myeloid neoplasms.

First Page

3218

Last Page

3225

DOI

10.1038/s41388-020-1204-9

Volume

39

Issue

15

Publication Date

4-1-2020

Medical Subject Headings

Adult; Castleman Disease (genetics, pathology); Child, Preschool; Core Binding Factor Alpha 2 Subunit (genetics); DNA Mutational Analysis; Humans; Lymph Nodes (pathology); MAP Kinase Kinase 2 (genetics); MAP Kinase Signaling System (genetics); Male; Young Adult

PubMed ID

32051554

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