2019 Fiscal Year Research-status Report
Genomic Profiling of Childhood Acute Leukemia in North of Iraq
| Project/Area Number |
18K07295
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| Research Institution | Shinshu University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
奥野 友介 名古屋大学, 医学部附属病院, 病院講師 (00725533)
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Keywords | FTA / ALL / NGS / RAS / Iraq |
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| Outline of Annual Research Achievements |
Dried blood spot-derived DNA was proved successful for the molecular diagnosis of hematological malignancies. As genetic analysis is not yet available in Iraq, we proceed with the genetic evaluation of Iraqi childhood acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML), using next generation sequencing (NGS). Since April 2018, we collected 99 cases of ALL, AML and acute undifferentiated leukemia (AUL), from 4 centers in Iraq, including 2 hospitals in the Northern Iraq (Sulaymaniyah and Duhok), as well as one in Baghdad and one from Basra. Out of 99 cases, 67 had paired samples (at diagnosis and at remission), including 54, 11 and 2 cases of ALL, AML and AUL, respectively. The rest 32 cases were either not sufficient in regard to DNA concentration (n=3), died before reaching remission (n=10), transferred to be treated outside Iraq (n=2), abandon therapy (n=8), or pending the next samples (n=9). Whole exome sequencing using Flinders Technology Associates (FTA)-derived DNA was satisfactory in terms of sequencing coverage, sensitivity, and error rate. The spectrum of somatic mutations was comparable to other countries, with a higher RAS-mutation frequency in ALL (13/40, 32.5%), in agreement with our previous report. We presented the progress in our data (since 2016) in the 81st Japanese Society of Hematology in Tokyo 2019 (October 11-13, 2019). Our work was planned to be presented at the 19th annual Japan Iraq Medical Network (JIM-NET) meeting in Iraq (April 3-4, 2020), (but the meeting was canceled due to COVID-19 Pandemic).
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| Current Status of Research Progress |
Current Status of Research Progress
3: Progress in research has been slightly delayed.
Reason
We updated the ethical approval IRB for the study from the medical institutes in Japan, including Shinshu University School of Medicine and Nagoya University Graduate School of Medicine, in addition to Ministry of Health in Iraq. The DNA extraction is carried on in Shinshu University, and next generation sequencing is done in Nagoya University. The FTA cards collection was going on smoothly until February 2020, when the coronavirus pandemic started. Curfew was applied in Iraq by March 2020. We are collaborating with the doctors in the centers that collect the samples, but the collection is struggling currently because of the emergency status of the pandemic. As we need to collect paired sequential samples (Day 0 upon diagnosis and Day 30 or more upon remission), currently we have many cases with D0 only, and the second FTA samples were either collected and stocked in the centers in Iraq or not done yet. The transferal of samples from Iraq to Japan is also in trouble. In addition, ordering materials in Japan, became troublesome, due to coronavirus pandemic.
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| Strategy for Future Research Activity |
Our plan is to include another 15-20 cases of childhood acute leukemia from Mosul also as well as from Baghdad and Sulaymaniyah, because they are receiving bulk of cases in Iraq. Of note, Mosul the second biggest city in Iraq, was occupied by (Islamic State of Iraq and Syria) ISIS, so we could not include cases from Mosul previously. We already have sent FTA cards to Mosul and arranged with the doctors there. However, the recent coronavirus pandemic is expected to result in delay of samples collection. We submitted our updated work results to 2 conferences: the 82nd Japanese Society of Hematology in Kyoto (October 9-11, 2020), and the 52nd International Society of Pediatric Oncology (SIOP), in Canada (October 14-17, 2020). On the other hand, we are writing a paper currently to publish our results. We also got another fund to support the NGS analysis owing to the high coast.
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| Causes of Carryover |
Our plan is to include another 15-20 cases of childhood acute leukemia from Mosul, as well as Baghdad and Sulaymaniyah. FTA cards were already sent to Mosul. However, the recent event of corona pandemic is expected to result in a delay in sample collection from Iraq. The reason for the remained amount of money unused for last year (234,408円), was because the travel to Nagoya in February was canceled. In addition, a planned trip to Iraq in March was canceled due to Corona situation, and thus, the orders for DNA extraction materials were canceled too. DHL will be used to transfer FTA samples.
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Research Products
(3 results)
