ダウン症児における白血病進化過程を解明(Unravelling the evolution of leukemia in children with Down Syndrome)

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2026-04-23 ゲーテ大学

独フランクフルト大学の研究チームは、ダウン症候群の小児に発症する白血病の進化過程を解明した。ゲノム解析により、白血病は単一の変異ではなく、複数段階の遺伝的変化が蓄積して発症することが判明。特に胎児期からすでに前駆細胞に異常が生じ、その後の追加変異によって病気へ進行する仕組みが示された。また、一部の変異は治療抵抗性や再発リスクに関与する可能性も指摘された。これにより、発症前段階の早期検出や個別化治療の開発に重要な手がかりが提供される。ダウン症候群に特有の生物学的背景と白血病発症の関係理解を深め、将来的な予防・治療戦略の高度化に貢献する成果である。

ダウン症児における白血病進化過程を解明(Unravelling the evolution of leukemia in children with Down Syndrome)
Blood of a child with Down syndrome who is suffering from transient myeloproliferative syndrome (TAM). Under the microscope, similar to leukemia, almost exclusively the purple-stained immature precursors of white blood cells (blasts) can be seen. Photo: Jan-Henning Klusmann, Universitätsmedizin Frankfurt © Jan-Henning Klusmann

<関連情報>

ダウン症候群の骨髄性白血病における単一細胞転写進化 Single cell transcriptional evolution of myeloid leukemia of Down syndrome

Mi K. Trinh,Konstantin Schuschel,Hasan Issa,Rebecca Thomas,Conor Parks,Agnes Oszlanczi,Toochi Ogbonnah,Di Zhou,Lira Mamanova,Elena Prigmore,Emilia R. Robertson,Angus Hodder,Anna Wenger,Nathaniel D. Anderson,Holly J. Whitfield,Taryn D. Treger,José Gonçalves-Dias,Karin Straathof,David O’Connor,Matthew D. Young,Laura Jardine,Stuart Adams,Jan-Henning Klusmann,Jack Bartram & Sam Behjati
Nature Communications  Published:23 April 2026
DOI:https://doi.org/10.1038/s41467-026-71707-2

Abstract

Children with Down syndrome have a 150-fold increased risk of developing myeloid leukaemia (ML-DS). Unusually for a childhood leukaemia, ML-DS arises from a preleukaemic state, termed transient abnormal myelopoiesis (TAM), via a conserved sequence of mutations. Here, we examine the relationship between the genetic and transcriptional evolution of ML-DS from natural variation; a rich collection of primary patient samples and foetal tissues with a range of constitutional karyotypes. We distil transcriptional consequences of each genetic step in ML-DS evolution, utilising single-cell mRNA sequencing, complemented by phylogenetic analyses in progressive disease. We find that transcriptional changes induced by the TAM-defining GATA1 mutations are retained in, and account for most of the ML-DS transcriptome. The GATA1 transcriptome pervades all stages of ML-DS, including progressive disease that had undergone genetic evolution. Our approach delineates the transcriptional evolution of ML-DS and provides an analytical blueprint for distiling consequences of mutations within their pathophysiological context.

医療・健康
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