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2. Clinical, molecular, and prognostic correlates of number, type, and functional localization of TET2 mutations in chronic myelomonocytic leukemia (CMML)—a study of 1084 patients

Author

Coltro, Giacomo, Mangaonkar, Abhishek A., Lasho, Terra L., Finke, Christy M., Pophali, Prateek, Carr, Ryan, Gangat, Naseema, Binder, Moritz, Pardanani, Animesh, Fernandez-Zapico, Martin, Robertson, Keith D., Bosi, Alberto, Droin, Nathalie, Vannucchi, Alessandro M., Tefferi, Ayalew, Hunter, Anthony, Padron, Eric, Solary, Eric, and Patnaik, Mrinal M.

Published
2020
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4. Cancer of Unknown Primary: When Imaging, Pathology, and Molecular Biology Do Not Match.

Author

Juarez-Vignon Whaley, Juan Jose, Pophali, Prateek, Chornenkyy, Yevgen, and Peters, Mary Linton

Subjects
*CANCER of unknown primary origin, *MOLECULAR biology, *PATHOLOGY, *GERM cell tumors, *IMMUNOSTAINING, *LUNG cancer
Abstract

Introduction: Cancers of unknown primary are aggressive and rare malignancies with a complex diagnosis and management. Here we present a case in which imaging, pathology, and molecular biology did not match for a specific tumor site and the importance of a multidisciplinary team for these complicated cases. Case Presentation: A man in his 70s with strong smoking history under workup for suspicion of metastatic lung cancer underwent lung mass biopsy. Immunohistochemical stains corresponded to hepatocellular/cholangiocarcinoma or germ cell tumor; however, dedicated liver and testicular studies including imaging and iscochrome 12p FISH were negative. Additionally, somatic variant profiling was not specific for any malignancy nor targetable variants. Given the pattern of disease, risk factors, and patient history, the patient received treatment for lung adenocarcinoma (carboplatin, pemetrexed, and pembrolizumab). The patient had a drastic improvement in dyspnea, weight gain, and was able to return to work. Conclusion: This report describes a case in which immunohistochemistry and molecular profiling did not identify the tissue of origin and highlights the importance of a multidisciplinary team to reach a diagnosis and guide treatment without delaying patient care in patients with these diagnoses. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Clinicopathologic characteristics, prognostication and treatment outcomes for myelodysplastic/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U): Mayo Clinic-Moffitt Cancer Center study of 135 consecutive patients

Author

Mangaonkar, Abhishek A., Swoboda, David M., Coltro, Giacomo, Lasho, Terra L., Novotny, Paul J., Pophali, Prateek, Carr, Ryan M., Binder, Moritz, Finke, Christy M., Gangat, Naseema, Al-Kali, Aref, Begna, Kebede H., Reichard, Kaaren K., Ketterling, Rhett P., Al Ali, Najla H., Vafaii, Pardis, Zhang, Ling, Padron, Eric, Talati, Chetasi, and Patnaik, Mrinal M.

Published
2020
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8. Increased mortality among smokers with myelodysplastic syndrome (MDS).

Author

Zavras, Phaedon D., primary, Pophali, Prateek, additional, Shastri, Aditi, additional, Bachier-Rodriguez, Lizamarie, additional, Sica, Alejandro R., additional, Goldfinger, Mendel, additional, Kornblum, Noah, additional, Braunschweig, Ira, additional, Verma, Amit K., additional, and Mantzaris, Ioannis, additional

Published
2021
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12. Splenectomy in patients with chronic myelomonocytic leukemia: Indications, histopathological findings and clinical outcomes in a single institutional series of 39 patients

Author

Pophali, Prateek, Horna, Pedro, Lasho, Terra L., Finke, Christy M., Ketterling, Rhett P., Gangat, Naseema, Nagorney, David, Tefferi, Ayalew, and Patnaik, Mrinal M.

Subjects
Male, Palliative Care, Leukemia, Myelomonocytic, Chronic, Survival Analysis, Article, Time-to-Treatment, Treatment Outcome, hemic and lymphatic diseases, Cause of Death, Splenectomy, Humans, Female, Aged, Retrospective Studies, Splenic Diseases
Abstract

In a 28-year period, 39 (7%) patients with chronic myelomonocytic leukemia (CMML) (median age 66 years, 64% male) underwent a splenectomy at our institution. Primary indications for splenectomy were refractory thrombocytopenia (36%), progressive spleen related symptoms (33%), emergent splenectomy for splenic rupture (21%), refractory anemia (8%), and prior to allogeneic stem cell transplant (3%). Eleven (28%) patients had anemia at the time of splenectomy, of which 3 (27%) were autoimmune. The median time to splenectomy from CMML diagnosis was 6 months (0-40); perioperative morbidity and mortality rates were 43% and 13%, while the median postsplenectomy survival was 25 months (11-38). Durable remission in spleen related symptoms, thrombocytopenia, complications from splenic rupture, and anemia were achieved in 85%, 50%, 62%, and 21% of patients, respectively. Perioperative morbidity (n = 30) included infections/sepsis in 6 (20%), intraabdominal bleeding in 4 (13%), venous thromboembolism (VTE) in 3 (10%), and acute lung injury in 2 (7%) patients. The median duration of hospital stay was 6 days (1-25), with 5 deaths occurring secondary to respiratory failure (n = 2), multiorgan dysfunction (n = 2) and hemorrhagic shock (n = 1). There was no difference in overall survival between CMML patients that underwent splenectomy, in comparison to those that did not. Unlike in myelofibrosis, portal hypertension was not an indication for splenectomy and no patients developed post-splenectomy thrombocytosis. In conclusion, apart from being a lifesaving emergent modality in the event of splenic rupture, splenectomy has an important palliative role in patients with CMML, with significant and durable improvements in spleen related symptoms and refractory cytopenias.

Published
2018

13. Clinical, molecular, and prognostic correlates of number, type, and functional localization of TET2 mutations in chronic myelomonocytic leukemia (CMML)—a study of 1084 patients

Author

Coltro, Giacomo, primary, Mangaonkar, Abhishek A., additional, Lasho, Terra L., additional, Finke, Christy M., additional, Pophali, Prateek, additional, Carr, Ryan, additional, Gangat, Naseema, additional, Binder, Moritz, additional, Pardanani, Animesh, additional, Fernandez-Zapico, Martin, additional, Robertson, Keith D., additional, Bosi, Alberto, additional, Droin, Nathalie, additional, Vannucchi, Alessandro M., additional, Tefferi, Ayalew, additional, Hunter, Anthony, additional, Padron, Eric, additional, Solary, Eric, additional, and Patnaik, Mrinal M., additional

Published
2019
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14. Clinicopathologic characteristics, prognostication and treatment outcomes for myelodysplastic/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U): Mayo Clinic-Moffitt Cancer Center study of 135 consecutive patients

Author

Mangaonkar, Abhishek A., primary, Swoboda, David M., additional, Coltro, Giacomo, additional, Lasho, Terra L., additional, Novotny, Paul J., additional, Pophali, Prateek, additional, Carr, Ryan M., additional, Binder, Moritz, additional, Finke, Christy M., additional, Gangat, Naseema, additional, Al-Kali, Aref, additional, Begna, Kebede H., additional, Reichard, Kaaren K., additional, Ketterling, Rhett P., additional, Al Ali, Najla H., additional, Vafaii, Pardis, additional, Zhang, Ling, additional, Padron, Eric, additional, Talati, Chetasi, additional, and Patnaik, Mrinal M., additional

Published
2019
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15. Suboptimal response rates to hypomethylating agent therapy in chronic myelomonocytic leukemia; a single institutional study of 121 patients

Author

Coston, Tucker, primary, Pophali, Prateek, additional, Vallapureddy, Rangit, additional, Lasho, Terra L., additional, Finke, Christy M., additional, Ketterling, Rhett P., additional, Carr, Ryan, additional, Binder, Moritz, additional, Mangaonkar, Abhishek A., additional, Gangat, Naseema, additional, Al‐Kali, Aref, additional, Litzow, Mark, additional, Zblewski, Darci, additional, Pardanani, Animesh, additional, Tefferi, Ayalew, additional, and Patnaik, Mrinal M., additional

Published
2019
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17. Clinical Correlates, Prognostic Impact and Survival Outcomes in Chronic Myelomonocytic Leukemia Patients with Myeloproliferative Neoplasm Associated-Driver Mutations

Author

Pophali, Prateek, primary, Lasho, Terra L., additional, Finke, Christy, additional, Horna, Pedro, additional, Ketterling, Rhett P., additional, Gangat, Naseema, additional, Begna, Kebede H., additional, Mangaonkar, Abhishek A., additional, Pardanani, Animesh, additional, Tefferi, Ayalew, additional, and Patnaik, Mrinal M., additional

Published
2018
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18. Splenectomy in patients with chronic myelomonocytic leukemia: Indications, histopathological findings and clinical outcomes in a single institutional series of thirty-nine patients

Author

Pophali, Prateek, primary, Horna, Pedro, additional, Lasho, Terra L., additional, Finke, Christy M., additional, Ketterling, Rhett P., additional, Gangat, Naseema, additional, Nagorney, David, additional, Tefferi, Ayalew, additional, and Patnaik, Mrinal M., additional

Published
2018
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19. Clinical, molecular, and prognostic correlates of number, type, and functional localization of TET2mutations in chronic myelomonocytic leukemia (CMML)—a study of 1084 patients

Author

Coltro, Giacomo, Mangaonkar, Abhishek A., Lasho, Terra L., Finke, Christy M., Pophali, Prateek, Carr, Ryan, Gangat, Naseema, Binder, Moritz, Pardanani, Animesh, Fernandez-Zapico, Martin, Robertson, Keith D., Bosi, Alberto, Droin, Nathalie, Vannucchi, Alessandro M., Tefferi, Ayalew, Hunter, Anthony, Padron, Eric, Solary, Eric, and Patnaik, Mrinal M.

Abstract

Loss-of-function TET2mutations (TET2MT) are frequent early clonal events in myeloid neoplasms and are thought to confer a fitness advantage to hematopoietic precursors. This large, multi-institutional study (n= 1084), investigated the TET2mutational landscape and prognostic implications of the number, type, and location of TET2MTand the epistatic relationship with other somatic events in chronic myelomonocytic leukemia (CMML). Nine hundred and forty-two TET2MTwere identified in 604 (56%) patients, of which 710 (75%) were predicted to be truncating (involving the catalytic domain). Three hundred and sixteen (29%) patients had ≥1 TET2MT, with 28%, 1%, and 0.2% harboring 2, 3, and 5 mutations, respectively. In comparison to TET2WT, TET2MTpatients were older in age, more likely to have dysplastic CMML, a higher number of co-occurring mutations, and lower-risk stratification. Importantly, TET2MTwere associated with a survival advantage (49 vs. 30 months, p< 0.0001), especially in the context of multiple TET2MT(≥2; 57 months, p< 0.001), and truncating TET2MT(51 months, p< 0.001). In addition, the adverse prognostic impact of ASXL1MTwas partially mitigated by concurrent TET2MT, with the ASXL1WT/TET2MTgenotype having better outcomes and resulting in further risk stratification of ASXL1inclusive CMML prognostic models, in comparison to ASXL1MTalone.

Published
2020
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20. Clinical correlates, prognostic impact and survival outcomes in chronic myelomonocytic leukemia patients with the JAK2 V617F mutation.

Author

Patnaik MM, Pophali PA, Lasho TL, Finke CM, Horna P, Ketterling RP, Gangat N, Mangaonkar AA, Pardanani A, and Tefferi A

Subjects
Biomarkers, Biomarkers, Tumor, Female, Genetic Testing, Humans, Leukemia, Myelomonocytic, Chronic diagnosis, Leukemia, Myelomonocytic, Chronic mortality, Male, Neoplasm Staging, Prognosis, Survival Analysis, Alleles, Amino Acid Substitution, Janus Kinase 2 genetics, Leukemia, Myelomonocytic, Chronic genetics, Mutation
Published
2019
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