State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
Department of Systems Biology, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Monrovia, California, USA.
J Clin Invest. 2022 Feb 1;132(3). doi: 10.1172/JCI153283.
Mantle cell lymphoma (MCL) is a phenotypically and genetically heterogeneous malignancy in which the genetic alterations determining clinical indications are not fully understood. Here, we performed a comprehensive whole-exome sequencing analysis of 152 primary samples derived from 134 MCL patients, including longitudinal samples from 16 patients and matched RNA-Seq data from 48 samples. We classified MCL into 4 robust clusters (C1-C4). C1 featured mutated immunoglobulin heavy variable (IGHV), CCND1 mutation, amp(11q13), and active B cell receptor (BCR) signaling. C2 was enriched with del(11q)/ATM mutations and upregulation of NF-κB and DNA repair pathways. C3 was characterized by mutations in SP140, NOTCH1, and NSD2, with downregulation of BCR signaling and MYC targets. C4 harbored del(17p)/TP53 mutations, del(13q), and del(9p), and active MYC pathway and hyperproliferation signatures. Patients in these 4 clusters had distinct outcomes (5-year overall survival [OS] rates for C1-C4 were 100%, 56.7%, 48.7%, and 14.2%, respectively). We also inferred the temporal order of genetic events and studied clonal evolution of 16 patients before treatment and at progression/relapse. Eleven of these samples showed drastic clonal evolution that was associated with inferior survival, while the other samples showed modest or no evolution. Our study thus identifies genetic subsets that clinically define this malignancy and delineates clonal evolution patterns and their impact on clinical outcomes.
套细胞淋巴瘤(Mantle cell lymphoma,MCL)是一种表型和基因异质性恶性肿瘤,其决定临床指征的遗传改变尚未完全阐明。在此,我们对 134 例 MCL 患者的 152 个原发样本进行了全面的外显子组测序分析,其中包括 16 例患者的纵向样本和 48 例样本的匹配 RNA-Seq 数据。我们将 MCL 分为 4 个稳健的聚类(C1-C4)。C1 特征为免疫球蛋白重链可变区(IGHV)突变、CCND1 突变、amp(11q13)和活跃的 B 细胞受体(BCR)信号。C2 富含 del(11q)/ATM 突变和 NF-κB 和 DNA 修复途径的上调。C3 的特征是 SP140、NOTCH1 和 NSD2 突变,BCR 信号和 MYC 靶标下调。C4 具有 del(17p)/TP53 突变、del(13q)和 del(9p),以及活跃的 MYC 途径和过度增殖特征。这 4 个聚类的患者具有不同的结局(C1-C4 的 5 年总生存率分别为 100%、56.7%、48.7%和 14.2%)。我们还推断了遗传事件的时间顺序,并研究了 16 例患者治疗前和进展/复发时的克隆进化。这些样本中的 11 个显示出剧烈的克隆进化,与生存不良相关,而其他样本显示出适度或没有进化。因此,我们的研究确定了临床上定义这种恶性肿瘤的遗传亚群,并描绘了克隆进化模式及其对临床结局的影响。