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BRIEF RESEARCH REPORT article

Front. Oncol.

Sec. Molecular and Cellular Oncology

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1605369

Raw lacquer -associated familial chr onic myelomonocytic leukemia with multi-hit TET2 mutations

Provisionally accepted
Yang ZhangYang Zhang1Yujiao LuoYujiao Luo2,3Hongling PengHongling Peng2,3Yafei YinYafei Yin4*Guangsen ZhangGuangsen Zhang3*
  • 1Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
  • 2Second Xiangya Hospital, Central South University, Changsha, China
  • 3Department of Hematology, Second Xiangya Hospital, Central South University, Changsha, Anhui Province, China
  • 4Changsha Central Hospital, Changsha, Hunan Province, China

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Background: To explore the potential association between long-term exposure to raw lacquer and the development of chronic myelomonocytic leukemia (CMML). Methods: We analyzed the clinical and hematological characteristics of an elderly couple with CMML. Whole-exon sequencing (WES) was performed to identify relevant gene variants, with a focus on TET2 mutation status. Results: Two unrelated CMML patients within the same family, both with over 40 years of raw lacquer exposure, developed CMML. WES revealed both patients harbored multi-hit TET2 gene mutations and lacked ASXL1 mutations. Both demonstrated relative sensitivity to hydroxyurea or hypomethylating agent (HMA) therapy. Unaffected family members lacked significant raw lacquer exposure. Conclusions: Long-term exposure to raw lacquer may be associated with the onset of familial CMML. CMML patients with multi-hit TET2 mutations in the absence of ASXL1 mutations may have a favorable prognosis.

Keywords: Raw lacquer, chronic myelomonocytic leukemia, familial, TET2 mutation, Runx1, N-ras

Received: 03 Apr 2025; Accepted: 30 Jul 2025.

Copyright: © 2025 Zhang, Luo, Peng, Yin and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Yafei Yin, Changsha Central Hospital, Changsha, 410004, Hunan Province, China
Guangsen Zhang, Department of Hematology, Second Xiangya Hospital, Central South University, Changsha, Anhui Province, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material