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@ARTICLE{Erlacher:278591,
author = {M. Erlacher$^*$ and F. Andresen and M. Sukova and J. Stary
and B. De Moerloose and J. v. d. W. T. Bosch and M. Dworzak
and M. G. Seidel and S. Polychronopoulou and R. Beier and C.
M. Kratz and M. Nathrath and M. C. Frühwald and G. Göhring
and A. K. Bergmann and C. Mayerhofer and D. Lebrecht and S.
Ramamoorthy and A. Yoshimi and B. Strahm and M. W. Wlodarski
and C. M. Niemeyer$^*$},
title = {{S}pontaneous remission and loss of monosomy 7: a window of
opportunity for young children with {SAMD}9{L} syndrome.},
journal = {Haematologica},
volume = {109},
number = {2},
issn = {0390-6078},
address = {Pavia},
publisher = {Ferrata Storti Foundation},
reportid = {DKFZ-2023-01672},
pages = {422-430},
year = {2024},
note = {2024 Feb 1;109(2):422-430},
abstract = {Monosomy 7 is the most common cytogenetic abnormality in
pediatric myelodysplastic syndrome (MDS) and associated with
a high risk of disease progression. However, in young
children, spontaneous loss of monosomy 7 with concomitant
hematologic recovery has been described, especially in the
presence of germline mutations in SAMD9 and SAMD9L genes.
Here, we report on our experience of close surveillance
instead of upfront hematopoietic stem cell transplantation
(HSCT) in seven patients diagnosed with SAMD9L syndrome and
monosomy 7 at a median age of 0.6 years (0.4-2.9). Within 14
months from diagnosis, three children experienced
spontaneous hematological remission accompanied by a
decrease in monosomy 7 clone size. Subclones with somatic
SAMD9L mutations in cis were identified in five patients,
three of whom attained hematological remission. Two patients
acquired RUNX1 and EZH2 mutations during the observation
period, of whom one progressed to MDS with excess of blasts
(MDS-EB). Four patients underwent allogeneic HSCT at a
median time of 26 months (14-40) from diagnosis for MDS-EB,
necrotizing granulomatous lymphadenitis, persistent monosomy
7, and severe neutropenia. At last follow-up, six patients
were alive, while one passed away due to transplant-related
causes. These data confirm previous observations that
monosomy 7 can be transient in young children with SAMD9L
syndrome. However, they also indicate that delaying HSCT
poses a substantial risk of severe infection and disease
progression. Finally, surveillance of patients with SAMD9L
syndrome and monosomy 7 is critical to define the evolving
genetic landscape and to determine the appropriate timing of
HSCT.},
cin = {FR01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37584291},
doi = {10.3324/haematol.2023.283591},
url = {https://inrepo02.dkfz.de/record/278591},
}