D. Piffaretti, I. Romano, J. Marquez de Almeida, M. Salehi, H. Javanmard Khameneh, R. Moia, A. Bruscaggin, F. Jauk, S. Bocchetta, A. Condoluci, G. Forestieri, M. C. Pirosa, L. Terzi di Bergamo, S. Schär, A. Zenobi, A. Stathis, S. Monticelli, G. Gaidano, G. Guarda, D. Rossi
{"title":"CLONAL HEMATOPOIESIS IN DIFFUSE LARGE B-CELL LYMPHOMA","authors":"D. Piffaretti, I. Romano, J. Marquez de Almeida, M. Salehi, H. Javanmard Khameneh, R. Moia, A. Bruscaggin, F. Jauk, S. Bocchetta, A. Condoluci, G. Forestieri, M. C. Pirosa, L. Terzi di Bergamo, S. Schär, A. Zenobi, A. Stathis, S. Monticelli, G. Gaidano, G. Guarda, D. Rossi","doi":"10.1002/hon.70093_60","DOIUrl":null,"url":null,"abstract":"<p>D. Piffaretti and I. Romano equally contributing authors.</p><p><b>Introduction:</b> Clonal Hematopoiesis (CH) may promote diffuse large B-cell lymphoma (DLBCL) in two ways: by seeding mutations in the B-cells progenitors, potentially contributing to malignant transformation. Alternatively, lymphoma may be promoted by the clonal and pro-inflammatory tumor microenvironment derived from CH. In this study we aimed to determine: (i) CH prevalence in newly diagnosed DLBCL; (ii) clinical impact of CH; (iii) correlation between CH and DLBCL genetic lesions; (iv) co-occurrence frequency of DLBCL driver and CH mutations at the single cell level; (v) enrichment of CH in cells of the lymphoma microenvironment compared to blood.</p><p><b>Methods:</b> Patients (<i>n</i> = 387) from the IOSI-EMA003 and SAKK38/19 trials were analyzed. CH mutations were identified in genomic DNA using a myeloid panel, while a lymphoid panel detected DLBCL mutations, somatic copy number abnormalities, and <i>BCL6</i> fusions in plasma cfDNA. Multiomic scDNA-seq and immunophenotyping of paired peripheral blood (PB) or bone marrow (BM) and disaggregated lymph nodes of 6 patients were performed. A custom Tapestri (MissionBio) panel targeted CH mutations and barcoded the dominant DLBCL clone by covering trunk oncogene mutations, enabling simultaneous genotyping and phenotyping of B cells, T cell subtypes, and myeloid cells. To assess whether CH-bearing myeloid cells support DLBCL in vitro: (i) BM cells from <i>Tet2</i> knockout (KO) and control mice were differentiated into macrophages and co-cultured with a <i>Tp53</i> KO murine B-cell lymphoma line; (ii) biallelic <i>TET2-</i>KO human THP1 monocytic cells, were differentiated into macrophages and co-cultured with DLBCL cell lines. Additionally, lymphoma-prone <i>Klf2</i><sup><i>fl/fl</i></sup><i>/Notch2IC</i><sup><i>fl/+</i></sup><i>/Cd19Cre</i><sup><i>+/</i>−</sup>/<i>Cd</i>45<i>.2</i><sup>+/+</sup> oncogenic and <i>Cd19Cre</i><sup><i>+/</i>−</sup>/<i>Cd45.2</i><sup>+/−</sup> control mice were adoptively transplanted with BM cells from <i>Tet</i>2<sup>+/+</sup>, <i>Tet</i>2<sup>+/−</sup>, and <i>Tet2</i><sup>−/−</sup> C57BL/6 <i>Cd45.1</i><sup>+/−</sup> mice without conditioning.</p><p><b>Results:</b> The analysis was done including patients per the CONSORT diagram (Figure 1A). CH mutations (VAF > 1%) were found in 38% of patients, primarily in <i>DNMT3A</i> and <i>TET2</i>, and correlated with age (Figure 1B). However, CH showed no association with features of lymphoma aggressiveness (clinical stage, B-symptoms, IPI) or DLBCL subtypes (cell of origin, C1-C5). Cox analyses (univariate/multivariate, adjusted for IPI), revealed no impact of CH on progression-free survival or lymphoma-specific survival. In vitro, lymphoma cell survival was limitedly affected by <i>TET2</i> status in macrophages. Engraftment in control mice mirrored the typical load of CH in humans (∼1% PB leukocytes at 3 months), whereas <i>Tet</i>2<sup>+/−</sup> and <i>Tet</i>2<sup>−/−</sup> cells failed to engraft in the lymphoma-prone <i>Klf2l</i><sup><i>fl/fl</i></sup><i>/Notch2IC</i><sup><i>fl/+</i></sup><i>/Cd19Cre</i><sup><i>+/</i>−</sup>/<i>Cd45.2</i><sup><i>+/+</i></sup> mice, suggesting elimination of <i>Tet2</i>-deficient cells in an oncogenic setting. Single-cell analysis showed no co-occurrence of CH and DLBCL mutations, and CH-derived cells were not enriched in the lymphoma microenvironment.</p><p><b>Conclusions:</b> CH mutations likely have a limited role in DLBCL promotion.</p><p><b>Research</b> <b>funding declaration:</b> The study was supported by ISREC Foundation, Helmut Horten Foundation, ETH Zurich Lymphoma Challenge.</p><p><b>Keywords:</b> tumor biology and heterogeneity; aggressive B-cell non-Hodgkin lymphoma; diagnostic and prognostic biomarkers</p><p>No potential sources of conflict of interest.</p>","PeriodicalId":12882,"journal":{"name":"Hematological Oncology","volume":"43 S3","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hon.70093_60","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematological Oncology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/hon.70093_60","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
D. Piffaretti and I. Romano equally contributing authors.
Introduction: Clonal Hematopoiesis (CH) may promote diffuse large B-cell lymphoma (DLBCL) in two ways: by seeding mutations in the B-cells progenitors, potentially contributing to malignant transformation. Alternatively, lymphoma may be promoted by the clonal and pro-inflammatory tumor microenvironment derived from CH. In this study we aimed to determine: (i) CH prevalence in newly diagnosed DLBCL; (ii) clinical impact of CH; (iii) correlation between CH and DLBCL genetic lesions; (iv) co-occurrence frequency of DLBCL driver and CH mutations at the single cell level; (v) enrichment of CH in cells of the lymphoma microenvironment compared to blood.
Methods: Patients (n = 387) from the IOSI-EMA003 and SAKK38/19 trials were analyzed. CH mutations were identified in genomic DNA using a myeloid panel, while a lymphoid panel detected DLBCL mutations, somatic copy number abnormalities, and BCL6 fusions in plasma cfDNA. Multiomic scDNA-seq and immunophenotyping of paired peripheral blood (PB) or bone marrow (BM) and disaggregated lymph nodes of 6 patients were performed. A custom Tapestri (MissionBio) panel targeted CH mutations and barcoded the dominant DLBCL clone by covering trunk oncogene mutations, enabling simultaneous genotyping and phenotyping of B cells, T cell subtypes, and myeloid cells. To assess whether CH-bearing myeloid cells support DLBCL in vitro: (i) BM cells from Tet2 knockout (KO) and control mice were differentiated into macrophages and co-cultured with a Tp53 KO murine B-cell lymphoma line; (ii) biallelic TET2-KO human THP1 monocytic cells, were differentiated into macrophages and co-cultured with DLBCL cell lines. Additionally, lymphoma-prone Klf2fl/fl/Notch2ICfl/+/Cd19Cre+/−/Cd45.2+/+ oncogenic and Cd19Cre+/−/Cd45.2+/− control mice were adoptively transplanted with BM cells from Tet2+/+, Tet2+/−, and Tet2−/− C57BL/6 Cd45.1+/− mice without conditioning.
Results: The analysis was done including patients per the CONSORT diagram (Figure 1A). CH mutations (VAF > 1%) were found in 38% of patients, primarily in DNMT3A and TET2, and correlated with age (Figure 1B). However, CH showed no association with features of lymphoma aggressiveness (clinical stage, B-symptoms, IPI) or DLBCL subtypes (cell of origin, C1-C5). Cox analyses (univariate/multivariate, adjusted for IPI), revealed no impact of CH on progression-free survival or lymphoma-specific survival. In vitro, lymphoma cell survival was limitedly affected by TET2 status in macrophages. Engraftment in control mice mirrored the typical load of CH in humans (∼1% PB leukocytes at 3 months), whereas Tet2+/− and Tet2−/− cells failed to engraft in the lymphoma-prone Klf2lfl/fl/Notch2ICfl/+/Cd19Cre+/−/Cd45.2+/+ mice, suggesting elimination of Tet2-deficient cells in an oncogenic setting. Single-cell analysis showed no co-occurrence of CH and DLBCL mutations, and CH-derived cells were not enriched in the lymphoma microenvironment.
Conclusions: CH mutations likely have a limited role in DLBCL promotion.
Researchfunding declaration: The study was supported by ISREC Foundation, Helmut Horten Foundation, ETH Zurich Lymphoma Challenge.
Keywords: tumor biology and heterogeneity; aggressive B-cell non-Hodgkin lymphoma; diagnostic and prognostic biomarkers
期刊介绍:
Hematological Oncology considers for publication articles dealing with experimental and clinical aspects of neoplastic diseases of the hemopoietic and lymphoid systems and relevant related matters. Translational studies applying basic science to clinical issues are particularly welcomed. Manuscripts dealing with the following areas are encouraged:
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