1. Recurrent fusions in PLAGL1 define a distinct subset of pediatric-type supratentorial ependymoma
- Author
-
Nada Jabado, Ofelia Cruz, David W. Ellison, Patricia Kohlhof-Meinecke, Ruf, Konstantin Okonechnikov, Martin Sill, Wolf Mueller, Matija Snuderl, Sebastian Brandner, Patrick N. Harter, Daniel Schrimpf, Philipp Sievers, Michal Zapotocky, Dominik Sturm, Andrey Korshunov, Noreen Akhtar, Pieter Wesseling, Ichimura K, Marcel Kool, Kranendonk Meg, Christian Mawrin, Guido Reifenberger, Cinzia Lavarino, Pascale Varlet, Henneken Sc, Deimling Av, Christina Blume, Hildegard Dohmen, Till Acker, Rudi Beschorner, Kendra K Maaß, Felix Sahm, Kenneth Aldape, Kristian W. Pajtler, Wolfgang Wick, Mark R. Gilbert, Leonille Schweizer, David E. Reuss, Jones Dtw, Stefan M. Pfister, Stefan Rutkowski, Pouget C, Ulrich Schüller, Damian Stichel, Richard Grundy, Ales Vicha, Zied Abdullaev, Mélanie Pagès, Terri S. Armstrong, Henning B. Boldt, Mariona Suñol, Lenka Krskova, Julia Benzel, and David Capper
- Subjects
Ependymoma ,Pathology ,medicine.medical_specialty ,business.industry ,Biology ,medicine.disease ,Pleomorphic adenoma ,OLIG2 ,Text mining ,DNA methylation ,medicine ,Genomic imprinting ,business ,EP300 ,Gene - Abstract
Ependymomas encompass a heterogeneous group of central nervous system (CNS) neoplasms that occur along the entire neuroaxis. In recent years, extensive (epi-)genomic profiling efforts have identified several molecular groups of ependymoma that are characterized by distinct molecular alterations and/or patterns. Based on unsupervised visualization of a large cohort of genome-wide DNA methylation data, we identified a highly distinct group of pediatric-type tumors (n = 40) forming a cluster separate from all established CNS tumor types, of which a high proportion were histopathologically diagnosed as ependymoma. RNA sequencing revealed recurrent fusions involving the pleomorphic adenoma gene-like 1 (PLAGL1) gene in 19 of 20 of the samples analyzed, with the most common fusion being EWSR1:PLAGL1 (n = 13). Five tumors showed a PLAGL1:FOXO1 fusion and one a PLAGL1:EP300 fusion. High transcript levels of PLAGL1 were noted in these tumors, with concurrent overexpression of the imprinted genes H19 and IGF2, which are regulated by PLAGL1. Histopathological review of cases with sufficient material (n = 16) demonstrated a broad morphological spectrum of largely ependymoma-like tumors. Immunohistochemically, tumors were GFAP-positive and OLIG2- and SOX10-negative. In 3/16 of the cases, a dot-like positivity for EMA was detected. Consistent with other fusion-positive ependymal groups, all tumors in our series were located in the supratentorial compartment. Median age of the patients at the time of diagnosis was 6.2 years. Analysis of time to progression or recurrence revealed survival times comparable to those of patients with ZFTA:RELA-fused ependymoma. In summary, our findings suggest the existence of a novel group of supratentorial ependymomas that are characterized by recurrent PLAGL1 fusions and enriched for pediatric patients.
- Published
- 2021