Genetic Disorders with Predisposition to Paediatric Haematopoietic Malignancies—A Review

Abstract

The view of paediatric cancer as a genetic disease arises as genetic research develops. Germline mutations in cancer predisposition genes have been identified in about 10% of children. Paediatric cancers are characterized by heterogeneity in the types of genetic alterations that drive tumourigenesis. Interactions between germline and somatic mutations are a key determinant of cancer development. In 40% of patients, the family history does not predict the presence of inherited cancer predisposition syndromes and many cases go undetected. Paediatricians should be aware of specific symptoms, which highlight the need of evaluation for cancer syndromes. The quickest possible identification of such syndromes is of key importance, due to the possibility of early detection of neoplasms, followed by presymptomatic genetic testing of relatives, implementation of appropriate clinical procedures (e.g., avoiding radiotherapy), prophylactic surgical resection of organs at risk, or searching for donors of hematopoietic stem cells. Targetable driver mutations and corresponding signalling pathways provide a novel precision medicine strategy.Therefore, there is a need for multi-disciplinary cooperation between a paediatrician, an oncologist, a geneticist, and a psychologist during the surveillance of families with an increased cancer risk. This review aimed to emphasize the role of cancer-predisposition gene diagnostics in the genetic surveillance and medical care in paediatric oncology.

Germline Variants and Characteristic Features of Hereditary Hematological Malignancy Syndrome

“…Second-hit variants (especially deletions) in ETV6 are common in ETV6-RUNX1 rearranged leukemias [ 171 ]. In addition, somatic rearrangements with RUNX1 are observed in a quarter of ALL patients [ 172 ]. Studies using umbilical cord blood from healthy newborns have shown that ETV6-RUNX1 translocations can occur in more than 1% of the healthy population [ 173 ].…”

Germline Variants and Characteristic Features of Hereditary Hematological Malignancy Syndrome

“…Second-hit variants (especially deletions) in ETV6 are common in ETV6-RUNX1 rearranged leukemias [104]. In addition, somatic rearrangements with RUNX1 are observed in a quarter of ALL patients [105]. Studies using umbilical cord blood from healthy newborns have shown that ETV6-RUNX1 translocations can occur in more than 1% of the healthy population [106].…”