Myeloid Malignancies: Recognizing the Risk of Germline Predisposition and Supporting Patients and Families

There is increasing recognition of the role of inheritance in myeloid malignancies. Differentiating germline from somatic variants in a hematologic malignancy is challenging but important. Oncology nurses need to be knowledgeable about the germline risk associated with myeloid malignancies; the inherited risk is well established and has implications for affected individuals as well as family members who may be at risk for malignancy themselves or who are being evaluated to serve as a related donor for allogeneic hematopoietic stem cell transplantation.

AT A GLANCE

• Germline predisposition in myeloid malignancies has the potential to affect risk identification, disease management, and allogeneic stem cell donor selection.
• It is essential to sample nonhematopoietic tissue to distinguish somatic variants from germline; this typically requires a skin biopsy for fibroblast culture and DNA extraction.
• Oncology nurses must be aware of germline predisposition in myeloid malignancies and collect a thorough family and personal history, including nonmalignant history (e.g., bleeding disorders), so that appropriate and timely referral to a genetics expert can occur for individuals and families.