MYD88

Genetic findings for MYD88 in Waldenström's Macroglobulinemia

Variants (1)

VariantTypeFrequencySignificance
L265P (somatic)somatic>90% (up to 100% by AS-PCR)Defining molecular hallmark of WM. Gain-of-function mutation causing constitutive Myddosome assembly, BTK activation, and NF-kB-driven B-cell survival. Discovered by Treon et al. 2012 via whole-genome sequencing.

Clinical implications

L265P (somatic)

Predicts favourable response to ibrutinib. MYD88 wild-type patients have shorter survival and poor BTK inhibitor response. Required for molecular diagnosis per ECWM consensus.

Also found in: Schnitzler syndrome (~30%), IgM-MGUS (~47%), DLBCL (ABC subtype) (~29%), Splenic marginal zone lymphoma (~6%)

Related molecules

MYD88established

Central oncogenic driver (TLR/IL-1R adaptor)L265P gain-of-function in >90%

Related hypotheses

MYD88 L265P is the founding mutation driving constitutive NF-κB and BTK signaling in WM

90
leading·85 studies

A two-hit model where MYD88 L265P provides the founding event and secondary mutations (CXCR4, ARID1A, TP53) shape disease phenotype

75
leading·30 studies