Publications by authors named "Nicolas Fiorelli"

Systematic studies of germ line genetic predisposition to myeloid neoplasms in adult patients are still limited. In this work, we performed germ line and somatic targeted sequencing in a cohort of adult patients with hypoplastic bone marrow (BM) to study germ line predisposition variants and their clinical correlates. The study population included 402 consecutive adult patients investigated for unexplained cytopenia and reduced age-adjusted BM cellularity.

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Background: Systemic mastocytosis (SM) encompasses a heterogeneous group of clonal disorders characterized by abnormal expansion of mast cells (MCs). Beyond KIT and other genes recurrently mutated in myeloid neoplasms, several genetic variants have been described as predisposing to the development of the disease and influencing its clinical phenotype. Increased copy number variants of the TPSAB1 gene were identified as a cause of nonclonal elevated tryptasemia and defined as hereditary α-tryptasemia (HαT).

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Mast cell leukemia (MCL) is a rare subtype of systemic mastocytosis defined by ≥20% mast cells (MC) on a bone marrow aspirate. We evaluated 92 patients with MCL from the European Competence Network on Mastocytosis registry. Thirty-one (34%) patients had a diagnosis of MCL with an associated hematologic neoplasm (MCL-AHN).

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Mastocytosis encompasses a subset of rare diseases, characterized by the presence and accumulation of abnormal neoplastic MC in various organ systems, including skin, bone marrow, spleen and gastrointestinal tract. Clinical manifestations are highly heterogeneous, as they result from both MC mediator release and MC organ infiltration. Both pregnancy, a lifetime dominated by huge physiological changes, and labor can provide triggers that could induce worsening of mastocytosis symptoms.

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Article Synopsis
  • Clonal cytopenia of undetermined significance (CCUS) is linked to a higher risk of developing myeloid neoplasms, and a study of various patient cohorts revealed that about 30% of individuals with idiopathic cytopenia carry genetic mutations associated with CCUS.
  • The presence of clonal hematopoiesis (CH) was found in nearly 20% of non-anemic individuals and around 28% of those with unexplained anemia, with distinct mutation patterns indicating differing levels of disease progression risk.
  • Two main mutation clusters were identified, with one showing isolated DNMT3A mutations and the other characteristic combinatorial patterns, impacting both overall survival rates and the likelihood of progression to myeloid ne
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