Original Article

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Blood Res 2018; 53(3):

Published online September 28, 2018

https://doi.org/10.5045/br.2018.53.3.240

© The Korean Society of Hematology

Spectrum of mitochondrial genome instability and implication of mitochondrial haplogroups in Korean patients with acute myeloid leukemia

Hye Ran Kim1,#, Min-Gu Kang2,#, Young Eun Lee3,4, Bo Ram Na3,4, Min Seo Noh3,4, Seung Hyun Yang3,4, Jong-Hee Shin3, and Myun-Geun Shin3,4,5*

1College of Korean Medicine, Dongshin University, Naju, Korea.

2Department of Laboratory Medicine, Gwangyang Sarang General Hospital, Gwangyang, Korea.

3Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.

4Brain Korea 21 Plus Project, Chonnam National University Medical School, Gwangju, Korea.

5Environmental Health Center for Childhood Leukemia and Cancer, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.

Correspondence to : Correspondence to Myun-Geun Shin, M.D., Ph.D. Department of Laboratory Medicine, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeonnam 58128, Korea. mgshin@chonnam.ac.kr

Received: July 26, 2018; Revised: August 1, 2018; Accepted: August 5, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Mitochondrial DNA (mtDNA) mutations may regulate the progression and chemosensitivity of leukemia. Few studies regarding mitochondrial aberrations and haplogroups in acute myeloid leukemia (AML) and their clinical impacts have been reported. Therefore, we focused on the mtDNA length heteroplasmies minisatellite instability (MSI), copy number alterations, and distribution of mitochondrial haplogroups in Korean patients with AML.

Methods

This study investigated 74 adult patients with AML and 70 controls to evaluate mtDNA sequence alterations, MSI, mtDNA copy number, haplogroups, and their clinical implications. The hypervariable (HV) control regions (HV1 and HV2), tRNAleu1gene, and cytochrome b gene of mtDNA were analyzed. Two mtDNA minisatellite markers, 16189 poly-C (16184CCCCCTCCCC16193, 5CT4C) and 303 poly-C (303CCCCCCCTCCCCC315, 7CT5C), were used to examine the mtDNA MSI.

Results

In AML, most mtDNA sequence variants were single nucleotide substitutions, but there were no significant differences compared to those in controls. The number of mtMSI patterns increased in AML. The mean mtDNA copy number of AML patients increased approximately 9-fold compared to that of controls (P<0.0001). Haplogroup D4 was found in AML with a higher frequency compared to that in controls (31.0% vs. 15.7%, P=0.046). None of the aforementioned factors showed significant impacts on the outcomes.

Conclusion

AML cells disclosed more heterogeneous patterns with the mtMSI markers and had increased mtDNA copy numbers. These findings implicate mitochondrial genome instability in primary AML cells. Therefore, mtDNA haplogroup D4 might be associated with AML risk among Koreans.

Keywords AML, Mitochondrial genome, Instability, Haplogroup, Outcome

Article

Original Article

Blood Res 2018; 53(3): 240-249

Published online September 28, 2018 https://doi.org/10.5045/br.2018.53.3.240

Copyright © The Korean Society of Hematology.

Spectrum of mitochondrial genome instability and implication of mitochondrial haplogroups in Korean patients with acute myeloid leukemia

Hye Ran Kim1,#, Min-Gu Kang2,#, Young Eun Lee3,4, Bo Ram Na3,4, Min Seo Noh3,4, Seung Hyun Yang3,4, Jong-Hee Shin3, and Myun-Geun Shin3,4,5*

1College of Korean Medicine, Dongshin University, Naju, Korea.

2Department of Laboratory Medicine, Gwangyang Sarang General Hospital, Gwangyang, Korea.

3Department of Laboratory Medicine, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.

4Brain Korea 21 Plus Project, Chonnam National University Medical School, Gwangju, Korea.

5Environmental Health Center for Childhood Leukemia and Cancer, Chonnam National University Medical School and Chonnam National University Hwasun Hospital, Hwasun, Korea.

Correspondence to:Correspondence to Myun-Geun Shin, M.D., Ph.D. Department of Laboratory Medicine, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeonnam 58128, Korea. mgshin@chonnam.ac.kr

Received: July 26, 2018; Revised: August 1, 2018; Accepted: August 5, 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Mitochondrial DNA (mtDNA) mutations may regulate the progression and chemosensitivity of leukemia. Few studies regarding mitochondrial aberrations and haplogroups in acute myeloid leukemia (AML) and their clinical impacts have been reported. Therefore, we focused on the mtDNA length heteroplasmies minisatellite instability (MSI), copy number alterations, and distribution of mitochondrial haplogroups in Korean patients with AML.

Methods

This study investigated 74 adult patients with AML and 70 controls to evaluate mtDNA sequence alterations, MSI, mtDNA copy number, haplogroups, and their clinical implications. The hypervariable (HV) control regions (HV1 and HV2), tRNAleu1gene, and cytochrome b gene of mtDNA were analyzed. Two mtDNA minisatellite markers, 16189 poly-C (16184CCCCCTCCCC16193, 5CT4C) and 303 poly-C (303CCCCCCCTCCCCC315, 7CT5C), were used to examine the mtDNA MSI.

Results

In AML, most mtDNA sequence variants were single nucleotide substitutions, but there were no significant differences compared to those in controls. The number of mtMSI patterns increased in AML. The mean mtDNA copy number of AML patients increased approximately 9-fold compared to that of controls (P<0.0001). Haplogroup D4 was found in AML with a higher frequency compared to that in controls (31.0% vs. 15.7%, P=0.046). None of the aforementioned factors showed significant impacts on the outcomes.

Conclusion

AML cells disclosed more heterogeneous patterns with the mtMSI markers and had increased mtDNA copy numbers. These findings implicate mitochondrial genome instability in primary AML cells. Therefore, mtDNA haplogroup D4 might be associated with AML risk among Koreans.

Keywords: AML, Mitochondrial genome, Instability, Haplogroup, Outcome

Fig 1.

Figure 1.

Representative sequencing chromatograms revealing mtDNA mutations in tRNAleu1 gene (AML No.112 patient) and CYTB gene (AML No.50 patient) as nonsynonymous mutations. (A) mtDNA tRNAleu1 gene mutation-affected amino acid change (Ala→Thr) for AML patient No.112. (B) mtDNA CYTB gene mutation-affected amino acid change (Ala→Thr) for AML patient No.50.

Blood Research 2018; 53: 240-249https://doi.org/10.5045/br.2018.53.3.240

Fig 2.

Figure 2.

Gene scan analysis of poly C-stretch region at nucleotide position (np) 303–315, 16184–16193, and 514–515(CA)5 repeats. (A) The mtDNA D-loop HV2 (303 poly-C) region. Capillary electropherogram of the np 303 poly-C region from AML patient No.123 showed 9CT6C as a C insertion type. (B) The mtDNA D-loop HV1 (16189 poly-C) region. Capillary electropherogram of np 16184–16193 poly-C region from samples of AML No.29 patient also disclosed the profile of several mtDNA types (heteroplasmic mutations). (C) The mtDNA D-loop HV2 514–515(CA)5 repeats region. Gene scan analysis of CA repeats starting at np 514 (AML No.27 patient) also disclosed heteroplasmic mutations, which suggest the coexistence of wildtype and mutant mtDNA in the same patient.

Blood Research 2018; 53: 240-249https://doi.org/10.5045/br.2018.53.3.240
Primers for the mtDNA control region PCR, direct sequencing, and gene scan.

Abbreviations: bp, base pair; CYTB, cytochrome b; F, Forward; Kb, kilo base; np, nucleotide position; R, Reverse; tRNAleu1, tRNA leucine1..


Characteristics of the patients enrolled in this study.

Abbreviations: FAB, French-American-British; N, number; WBC, white blood cells..


Distribution of mtDNA minisatellite instability of hypervariable regions in AML patients.

a)Newly appeared patterns in AML patients involved in this study compared to normal controls of the previous study [6]..


Cox regression analyses of outcome data.

Abbreviations: CI, confidence interval; EFS, event-free survival; OS, overall survival..


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