Table 1 Genetic and clinical characteristics of the 12 patients with myeoid malignancies carrying putative somatic UBA1 variants.

From: Novel causative variants of VEXAS in UBA1 detected through whole genome transcriptome sequencing in a large cohort of hematological malignancies

Patient_ID

Age

Sex

Diagnosis

UBA1 Variant

VAF [%]

Vacuole

Co-mutation

Karyotype

Hematological history (age)

Possible immunodysregulation (age)

P1

77

male

aCML

M41L

12

NA

NRAS (12%)

46,XY[20]

clinically diagnosed with CML (65); CML diagnosis revised to aCML due to negative BCR::ABL1 [*](75); splenomegaly (circa 40 cm)

none recorded

P2

82

male

MDS-MLD

M41T

76

NA

none

46,XY[20]

ESA/transfusion-requring anemia

none recorded

P3

76

male

MSD-RS-SLD

M41T

11

yes

SF3B1 (31%), JAK2 (14%), ZRSR2 (4%)

46,XY[20]

thrombocytosis

none recorded

P4

50

male

MDS-MLD

M41T

80

NA

none

46,XY,t(2;11)(p21;q23)[13]/46,XY [7]

NA

unspecified autoimmune disease under immunosuppresion

P5

84

male

MDS-MLD

M41V

55

yes

none

46,XY,der(1)t(1;2)(p34;q24),der(2)t(1;2)(p36;q24)[7]/46,idem,del5(q14q34)[3]/46,XY[10]

transfusion-requring anemia, pancytopenia

polyneuropathy, latent hyperthyroidism

P6

76

male

MDS-RS-MLD

Y55H

41

yes

SRSF2 (50%)

46,XY[20]

[*]MGUS; pancytopenia; anemia treated with 30 mg prednisone/transfusion, successfully discontinued (79)

none recorded

I894F

37

P7

66

male

CLL

R182H

0

yes

 

46,XY, del(11)(q21q23)[4]/46,XY[16]

[*]CLL treated with fludarabine, cyclophosphamide, rituximab (64-65) in CR (66); pancytopenia(65); treated with azacitidine (66)

Pneumocystis pneumonia (65/66), CMV reactivation (65/66)

t-MDS/MDS-EB2

57

NRAS (35%), TP53 (98%)

44,XY,der(3;21)(q10;q10),-7[20]

P8

68

male

MDS-MLD

A478S

53

NA

none

45,X,-Y [18]/46,XY[2]

primary cutaneous large cell anaplastic T cell lymphoma in the head and neck treated with resection [*] and radiation (68-70); MDS no treatment until age 70

hyperthyroidism

P9

69

male

CML

E597A

0

NA

BCR::ABL1 (IS 0.034)

46,XY,t(7;18)(q11,q23)[7]/46,XY[2]

ET (61) treated with anagrelide; CML [*1] treated with imatinib (67); anemia due to secondary MF (69); transfusion-dependent Coombs-positive anemia (69); 12% blasts with increased borderline monocyte/blasts in PB [*2] (69)

monoblast infiltration in the skin (69), steroid-resistant fever (69)

MPN

75

NRAS (50%), BCR::ABL1 (IS 0.006)

46,XY,t(7;18)(q11,q23)[20]

P10

67

male

MDS-RS-MLD

S621C

90

yes

FLT3-ITD (39%), RUNX1 (69%), SRSF2 (39%)

47,XY, + 21[19]/46,XY[1]

steroid-treated hemolytic anemia[*] (67); 9 cycles of azacitidine against MDS (67); decitabine switch (68), 33% blasts in PB, suggesting secondary AML (68); transfusion-dependent anemia

azacitidine injection site reaction (67), antibiotic-resistant broncoscopy-negative pulmonary infiltrate post fungal infection (68)

P11

73

male

MDS-MLD

P749L

10

NA

none

47,XX, + X[20]

chronic hemolytic anemia requiring ESA/transfusion

hyperthyroidism treated with nuclear medicine (74)

P12

63

male

MDS-RS-SLD

P1014L/canonical splice site

7

NA

SF3B1 (49%), TET2 (16%)

46,XY[20]

autoimmune anemia treated with steroids (62-, tapered and reinitiated), azathioprine[*] (62–63), mycophenol-mofetil (63–74), and rituximab (63, 74), ESA/multiple transfusion (62-)

anti-parietal cell antibody positive gastritis with polyclonal hypergammaglobulinemia and elevated complements (56), IgG4-associated nephritis (58/histology 68), interstitial pneumotitis (62), leiomyosarcoma (71), diverse skin tumors (74)

  1. [*] indicates the time point the sequencing was performed.
  2. MDS-MLD MDS with multi-lineage dysplasia, MDS-RS-MLD MDS with ring sideroblasts and multi-lineage dysplasia, CLL chronic lymphocytic leukemia, t-MDS therapy-related MDS, MDS-EB MDS with excess blast, CML chronic myeloid leukemia, MPN myeloproliferative neoplasms, MDS-RS-SLD MDS with ring sideroblasts and single-lineage dysplasia, aCML atypical CML, ESA Erythropoiesis-stimulating agent, NA not available, MGUS monoclonal gammopathy of undetermined significance, CR complete remission, ET essential thrombocythemia, MF myelofibrosis, PB peripheral blood, AML acute myeloid leukemia.