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image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Genes Chromosomes an...arrow_drop_down
image/svg+xml Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao Closed Access logo, derived from PLoS Open Access logo. This version with transparent background. http://commons.wikimedia.org/wiki/File:Closed_Access_logo_transparent.svg Jakob Voss, based on art designer at PLoS, modified by Wikipedia users Nina and Beao
Genes Chromosomes and Cancer
Article . 2022 . Peer-reviewed
License: Wiley Online Library User Agreement
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N‐terminus DUX4‐immunohistochemistry is a reliable methodology for the diagnosis of DUX4‐fused B‐lymphoblastic leukemia/lymphoma (N‐terminus DUX4 IHC for DUX4‐fused B‐ALL)

Authors: Bradford J. Siegele; Anat O. Stemmer‐Rachamimov; Henrik Lilljebjorn; Thoas Fioretos; Amanda C. Winters; Paola Dal Cin; Amy Treece; +2 Authors

N‐terminus DUX4‐immunohistochemistry is a reliable methodology for the diagnosis of DUX4‐fused B‐lymphoblastic leukemia/lymphoma (N‐terminus DUX4 IHC for DUX4‐fused B‐ALL)

Abstract

AbstractB‐lymphoblastic leukemia/lymphoma (B‐ALL) is the most common pediatric malignancy and the most commonly diagnosed adult lymphoblastic leukemia. Recent advances have broadened the spectrum of B‐ALL, with DUX4 gene fusions implicated in a subclass occurring in adolescents and young adults and harboring a favorable prognosis. DUX4 fusions have been challenging to identify. We aimed to determine whether expression of the DUX4 oncoprotein, as detected by targeted immunohistochemistry, might serve as a surrogate for molecular detection of DUX4 fusions in B‐ALL. A cohort of investigational B‐ALLs was generated with enrichment for DUX4 fusions by the inclusion of cases with characteristic demographic features and immunophenotypic properties. B‐ALLs with mutually exclusive cytogenetics were collected. Immunohistochemical staining by a monoclonal antibody raised against the N‐terminus of the DUX4 protein was performed. N‐DUX4 immunohistochemistry demonstrated strong, crisp nuclear staining in blasts of seven investigational cases, six of which had nucleic acid material available for molecular evaluation. Five of these cases demonstrated RNA‐seq DUX4‐fusion positivity. One N‐DUX4 immunohistochemistry positive case lacked a definitive DUX4‐fusion by RNA‐seq, though demonstrated a gene expression profile characteristic of DUX4‐rearranged B‐ALLs, a CD2+ immunophenotype, and a lack of staining by C‐terminus DUX4 antibody immunohistochemistry. At least 83.3% [5/6] positive predictive value. N‐DUX4 immunohistochemistry was negative in blasts of three RNA‐seq DUX4‐fusion‐negative cases (3/3; 100% negative predictive value). B‐ALLs with mutually exclusive cytogenetic profiles were all N‐DUX4 negative (0/10, specificity 100%). N‐DUX4 immunohistochemistry is reliable for the distinction of DUX4‐rearranged B‐ALLs from other B‐ALLs. We recommend its use for subclassification of B‐ALLs in adolescents and young adults and in B‐ALLs that remain “not otherwise specified.”

Keywords

Adolescent, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Burkitt Lymphoma, Immunohistochemistry, Immunophenotyping, Young Adult, Humans, Gene Fusion, Child

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
10
Top 10%
Average
Top 10%
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