OnkoSight AdvancedTM Virtual Karyotyping in CLL and Plasma Cell Myeloma

OnkoSight Advanced NGS panels for Chronic Lymphoid Neoplasms and Plasma Cell Myeloma offer enhanced capabilities, enabling simultaneous detection of somatic gene mutations and genome-wide copy number alterations (CNAs), ranging from single-gene changes to entire chromosome aberrations.

Copy number alterations (CNAs) are a structural genetic variation (>50 bp) that involves a gain or loss of DNA segments.

  • Approximately 80% of chronic lymphocytic leukemia (CLL) carries somatically acquired recurrent genomic copy number aberrations, including gains of entire chromosomes (e.g., trisomy 12) and losses of various lengths at 13q14 (RB1), 11q (ATM), and 17p (TP53).
  • Multiple myeloma is characterized by high genetic heterogeneity. Development of chromosomal hyperdiploidy can be observed in up to half of patients with multiple myeloma and is considered a favorable prognostic factor.

CNA assessments are included in OnkoSight Advanced CLL and multiple myeloma panels [Fig.1]*.  This important feature can inform the presence of large-scale, whole chromosome, chromosome arm, large deletion, or large gain in a sample. Traditionally, such analysis has been restricted to fluorescent in-situ hybridization (FISH), chromosomal metaphase karyotyping, and microarray.

In some instances, a normal cytogenetic result in lymphoid neoplasms, such as CLL/SLL and MM, maybe a false-negative due to lack of clonal growth of neoplastic cells. Adding CNA information alongside SNV analysis enables the detection of chromosomal gains and losses that enhance diagnostic accuracy, prognostic assessments, and therapeutic stratification in CLL and MM cases, empowering healthcare professionals to make informed decisions.

Fig.1 Genome-Wide Distribution of CNV and SNV

Test Information

TH55-7 PB/BM
TJ93-4 FFPE

ATM
 BCL2
 BCL6
 BIRC3
 BRAF
 BTK
 CARD11
 CD79B
 CDKN2A
 CREBBP
 CXCR4
 DNMT3A
 EP300
 EZH2
 IDH1
 IDH2
 IKZF1
 IRF4
 JAK1
 JAK3
 KMT2D
 KRAS
 MAP2K1
 MEF2B
 MYC
 MYD88
 NOTCH1
 NOTCH2
 NRAS
 PIK3CA
 PIK3CG
 PLCG2
 PTPRD
 RHOA
 SETD2
 SF3B1
 STAT3
 STAT5B
 TET2
 TNFRSF14
 TP53

TL67-3 PB/BM
TL68-1 FFPE

AKT1
 AKT2
 AKT3
 ATM
 ATR
 B2M
 BIRC3
 BRAF
 CCND1
 CDK4
 CDKN1B
 CDKN2A
 CXCR4
 CYLD
 DIS3
 DNMT3A
 EGFR
 FAM46C
 FGFR3
 FUBP1
 IDH1
 IDH2
 IGF1R
 IKZF1
 IRF4
 JAK2
 KDM6A
 KRAS
 MAX
 MYC
 MYD88
 NF1
 NFKBIA
 NOTCH1
 NRAS
 PIK3CA
 PIK3CG
 PIK3R1
 PIK3R2
 PIM1
 PRDM1
 PSMB8
 PTPN11
 RB1
 STAT3
 TERT
 TET2
 TGFBR2
 TP53
 TRAF2

Healthcare providers should only order panels if each gene or test in the panel is medically necessary.

*The Cancer Genomics Laboratory at GenPath® will require samples with >50% tumor content to run the copy number alteration algorithm. Normal findings will not be reported. The Genome-wide Distribution of CNV and SNV sections in CLL and Multiple Myeloma reports will appear only when an alteration is detected.

Download a sample report here.

References:

1. Ouillette P, Malek S. (2013) Acquired genomic copy number aberrations in CLL. Adv Exp Med Biol. 792:47-86. doi: 10.1007/978-1-4614-8051-8_3. PMID: 24014292.

2. Sessa M, Cavazzini F, Cavallari M, Rigolin GM, Cuneo A. A Tangle of Genomic Aberrations Drives Multiple Myeloma and Correlates with Clinical Aggressiveness of the Disease: A Comprehensive Review from a Biological Perspective to Clinical Trial Results. Genes (Basel). 2020 Dec 3;11(12):1453. doi: 10.3390/genes11121453. PMID: 33287156; PMCID: PMC7761770.