A novelRUNX1mutation with ANKRD26 dysregulation is related to thrombocytopenia in a sporadic form of myelodysplastic syndrome

Aging is associated with a higher risk of developing malignant diseases, including myelodysplastic syndromes, clonal disorders characterised by chronic cytopenias (anaemia, neutropenia and thrombocytopenia) and abnormal cellular maturation. Myelodysplastic syndromes arising in older subjects are influenced by combinations of acquired somatic genetic lesions driving evolution from clonal haematopoiesis to myelodysplastic syndromes and from myelodysplastic syndromes to acute leukaemia. A different pattern of mutations has been identified in a small subset of myelodysplastic syndromes arising in young patients with familial syndromes. In particular, dysregulation ofANKRD26, RUNX1andETV6genes plays a role in familial thrombocytopenia with predisposition to myelodysplastic syndromes and acute leukaemia. Whether these genes affect thrombopoiesis in sporadic myelodysplastic syndrome with thrombocytopenia is still undefined. Thirty-one myelodysplastic syndromes subjects and 27 controls subjects were investigated. Genomic DNA was used for mutation screening (ETV6,RUNX1, 5 ' UTRANKRD26genes). Functional studies were performed in the MEG-01-akaryoblastic cell line. We found four novel variants ofRUNX1gene, all in elderly myelodysplastic syndromes subjects with thrombocytopenia. Functional studies of the variant p.Pro103Arg showed no changes in RUNX1 expression, but the variant was associated with deregulated high transcriptional activity ofANKRD26in MEG-01 cells. RUNX1 variant p.Pro103Arg was also associated with increased viability and reduced apoptosis of MEG-01, as well as impaired platelet production. Our findings are consistent with dysregulation ofANKRD26inRUNX1haploinsufficiency. Lack of repression ofANKRD26expression may contribute to thrombocytopenia of subjects with sporadic myelodysplastic syndromes.

Automated summary

Aging is associated with a higher risk of developing malignant diseases, and myelodysplastic syndromes in older subjects are influenced by genetic mutations in genes like RUNX1 and ANKRD26, potentially leading to thrombocytopenia and impaired platelet production.