CLONAL HEMATOPOIESIS IN DIFFUSE LARGE B-CELL LYMPHOMA

IF 3.3 4区 医学 Q2 HEMATOLOGY
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
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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. 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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.

Research funding 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

No potential sources of conflict of interest.

Abstract Image

弥漫大b细胞淋巴瘤的克隆造血
D. Piffaretti和I. Romano是同等贡献的作者。克隆造血(CH)可能通过两种方式促进弥漫性大b细胞淋巴瘤(DLBCL):通过在b细胞祖细胞中播种突变,潜在地促进恶性转化。或者,来自CH的克隆性和促炎性肿瘤微环境可能促进淋巴瘤的发生。在本研究中,我们旨在确定:(i)新诊断的DLBCL中CH的患病率;(ii) CH的临床影响;(iii) CH与DLBCL遗传病变的相关性;(iv) DLBCL驱动和CH突变在单细胞水平上的共现频率;(v)与血液相比,淋巴瘤微环境细胞中CH的富集。方法:对来自isi - ema003和SAKK38/19试验的患者(n = 387)进行分析。髓系检测在基因组DNA中发现CH突变,而淋巴系检测在血浆cfDNA中发现DLBCL突变、体细胞拷贝数异常和BCL6融合。对6例患者的配对外周血(PB)或骨髓(BM)及散结淋巴结进行多组scDNA-seq和免疫表型分析。定制的tapstri (MissionBio)面板针对CH突变,并通过覆盖主干癌基因突变对显性DLBCL克隆进行条形码,从而实现B细胞,T细胞亚型和骨髓细胞的同时基因分型和表型。为了评估携带ch的骨髓细胞是否支持体外DLBCL: (i) Tet2敲除(KO)小鼠和对照小鼠的BM细胞分化为巨噬细胞,并与Tp53 KO小鼠b细胞淋巴瘤系共培养;(ii)双等位基因TET2-KO人THP1单核细胞,分化为巨噬细胞,与DLBCL细胞系共培养。此外,将易发淋巴瘤的Klf2fl/fl/Notch2ICfl/+/Cd19Cre+/−/Cd45.2+/+致癌小鼠和Cd19Cre+/−/Cd45.2+/−对照小鼠,不加条件地移植来自Tet2+/+、Tet2+/−和Tet2−/−C57BL/6 Cd45.1+/−小鼠的BM细胞。结果:根据CONSORT图(图1A)对患者进行了分析。CH突变(VAF >;1%)在38%的患者中发现,主要发生在DNMT3A和TET2,并且与年龄相关(图1B)。然而,CH与淋巴瘤侵袭性特征(临床分期、b症状、IPI)或DLBCL亚型(起源细胞C1-C5)无关。Cox分析(单因素/多因素,经IPI调整)显示,CH对无进展生存期或淋巴瘤特异性生存期没有影响。在体外,巨噬细胞中TET2状态对淋巴瘤细胞存活的影响有限。对照小鼠的移植反映了人类CH的典型负荷(3个月时约1%的PB白细胞),而Tet2+/−和Tet2−/−细胞未能移植到易患淋巴瘤的Klf2lfl/fl/Notch2ICfl/+/Cd19Cre+/−/Cd45.2+/+小鼠中,这表明在致癌环境中消除了Tet2缺陷细胞。单细胞分析显示,CH和DLBCL突变未同时发生,CH来源的细胞在淋巴瘤微环境中不富集。结论:CH突变在DLBCL促进中可能作用有限。研究经费声明:本研究得到了ISREC基金会、Helmut Horten基金会、苏黎世联邦理工学院淋巴瘤挑战赛的支持。关键词:肿瘤生物学及异质性;侵袭性b细胞非霍奇金淋巴瘤;无潜在的利益冲突来源。
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来源期刊
Hematological Oncology
Hematological Oncology 医学-血液学
CiteScore
4.20
自引率
6.10%
发文量
147
审稿时长
>12 weeks
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: -Clinical practice and management of hematological neoplasia, including: acute and chronic leukemias, malignant lymphomas, myeloproliferative disorders -Diagnostic investigations, including imaging and laboratory assays -Epidemiology, pathology and pathobiology of hematological neoplasia of hematological diseases -Therapeutic issues including Phase 1, 2 or 3 trials as well as allogeneic and autologous stem cell transplantation studies -Aspects of the cell biology, molecular biology, molecular genetics and cytogenetics of normal or diseased hematopoeisis and lymphopoiesis, including stem cells and cytokines and other regulatory systems. Concise, topical review material is welcomed, especially if it makes new concepts and ideas accessible to a wider community. Proposals for review material may be discussed with the Editor-in-Chief. Collections of case material and case reports will be considered only if they have broader scientific or clinical relevance.
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