medgenМедицинская генетикаMedical Genetics2073-7998Publishing House «Genius Media» LLC10.25557/2073-7998.2024.07.15-23medgen-2505Research ArticleНАУЧНЫЙ ОБЗОРREVIEWОсобенности клональной эволюции при остром миелоидном лейкозеFeatures of clonal evolution in acute myeloid leukemiaМусатоваВ. В.MusatovaV. V.

Мусатова Виктория Владимировна

115522, г. Москва, ул. Москворечье, д. 1

Victoria V. Musatova

1 Moskvorechie st., Moscow, 115522

shkarupo@mail.ruЕфремоваА. В.EfremovaA. V.

115522, г. Москва, ул. Москворечье, д. 1

1 Moskvorechie st., Moscow, 115522

ФГБНУ Медико-генетический научный центр имени академика Н.П.БочковаРоссияResearch Centre for Medical GeneticsRussian Federation2024101020242371523Copyright © Мусатова В.В., Ефремова А.В., 20242024Мусатова В.В., Ефремова А.В.Musatova V.V., Efremova A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medgen-journal.ru/jour/article/view/2505

Освещена вариабельность мутационного профиля и клональной эволюции острого миелоидного лейкоза (ОМЛ) от момента постановки диагноза до рецидива c акцентом на ОМЛ у детей. Молекулярные изменения, ассоциированные с возрастом, определяют терапевтические подходы, которые, в свою очередь, влияют на процессы рецидивирования. Обсуждается два основных механизма рецидивирования: прогрессия доминантного аллеля драйверной мутации и эволюция клонального состава, инициируемая схемами химиотерапии. Представлена оценка вклада эпигенетических механизмов в прогрессию опухоли как способа формирования химиорезистентности и эволюционно устойчивых клонов, а также роль аберрантного метилирования как самостоятельного функционального механизма с учётом изменения мутационного спектра рецидивирующей опухоли. 

The work highlights the variability of the mutational profile and clonal evolution of AML from diagnosis to relapse, with an emphasis on pediatric AML. The significance of molecular changes associated with age determines therapeutic approaches, which, in turn, influence the processes of relapse. Two main mechanisms of relapse are discussed: progression of the dominant allele of the driver mutation and evolution of clonal composition initiated by chemotherapy regimens. The contribution of epigenetic mechanisms in tumor progression as a way of forming chemoresistance and evolutionarily stable clones is assessed. As well as the role of aberrant methylation as an independent functional mechanism, taking into account the change in the mutational spectrum of a recurrent tumor.

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The authors declare that there are no conflicts of interest present.