FATHER SATURNINO URIOS UNIVERSITY

San Francisco St. Butuan City 8600, Region XIII Caraga,

Philippines
Nursing Program

EVIDENCE-BASED READING

Title/ Topic
The significance of PTEN and AKT aberrations in pediatric T-cell acute lymphoblastic leukemia

Research Findings
PTEN and AKT E17K mutations were found in 13% and 2% of the patients, respectively.
Inadvertently, defective PTEN-splicing was discovered. There were patients who lacked PTEN
protein but did not have exon-, splice-, or promoter mutations or hypermethylation. PTEN/AKT
mutations were more common in TAL- or LMO-rearranged leukemia but almost non-existent in
TLX3-rearranged patients (P=0.03), the opposite of what was observed for NOTCH1-activating
mutations. The majority of PTEN/AKT mutant patients lacked NOTCH1-activating mutations
(P=0.006) or had weak NOTCH1-activating mutations (P=0.011), resulting in low intracellular
NOTCH1, cMYC, and MUSASHI levels. Patients with T-cell leukemia who did not have PTEN/AKT
or NOTCH1 activating mutations fared well, with a cumulative incidence of relapse of only 8%
versus 35% for PTEN/AKT and/or NOTCH1-activated patients (P=0.005).

Conclusion
PI3K/AKT pathway aberrations are present in 18% of pediatric T-cell acute lymphoblastic
leukemia patients. Absence of strong NOTCH1-activating mutations in these cases may explain
cellular insensitivity to γ-secretase inhibitors.

Analysis
Despite improved treatment outcome, children with T-cell acute lymphoblastic leukemia (T-
ALL) have a higher relapse risk than children with B-lineage ALL. The study affects the nursing
profession by emphasizing comfort and miniziming the adverse adverse effects of
chemotherapy, promote preservation of veins, manage complications, and provide teaching
and psychological support.

Reference
Zuurbier, L., Petricoin, E. F., Vuerhard, M. J., Calvert, V., Kooi, C., Buijs-Gladdines, J. G. C. A.
M., Smits, W. K., Sonneveld, E., Veerman, A. J. P., Kamps, W. A., Horstmann, M.,
Pieters, R., & Meijerink, J. P. P. (2012, September). The significance of PTEN and
Akt Aberrations in pediatric T-Cell Acute Lymphoblastic Leukemia. Haematologica.
Retrieved May 7, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3436243/