Cancer Biology Graduate Program, Stanford University School of Medicine, Stanford, United States.
Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, United States.
Elife. 2024 Apr 22;13:e93019. doi: 10.7554/eLife.93019.
Relapse of acute myeloid leukemia (AML) is highly aggressive and often treatment refractory. We analyzed previously published AML relapse cohorts and found that 40% of relapses occur without changes in driver mutations, suggesting that non-genetic mechanisms drive relapse in a large proportion of cases. We therefore characterized epigenetic patterns of AML relapse using 26 matched diagnosis-relapse samples with ATAC-seq. This analysis identified a relapse-specific chromatin accessibility signature for mutationally stable AML, suggesting that AML undergoes epigenetic evolution at relapse independent of mutational changes. Analysis of leukemia stem cell (LSC) chromatin changes at relapse indicated that this leukemic compartment underwent significantly less epigenetic evolution than non-LSCs, while epigenetic changes in non-LSCs reflected overall evolution of the bulk leukemia. Finally, we used single-cell ATAC-seq paired with mitochondrial sequencing (mtscATAC) to map clones from diagnosis into relapse along with their epigenetic features. We found that distinct mitochondrially-defined clones exhibit more similar chromatin accessibility at relapse relative to diagnosis, demonstrating convergent epigenetic evolution in relapsed AML. These results demonstrate that epigenetic evolution is a feature of relapsed AML and that convergent epigenetic evolution can occur following treatment with induction chemotherapy.
急性髓系白血病 (AML) 的复发具有高度侵袭性,且通常对治疗具有耐药性。我们分析了先前发表的 AML 复发队列,发现 40%的复发病例在驱动基因突变没有改变的情况下发生,这表明在很大比例的病例中,非遗传机制驱动了复发。因此,我们使用 26 对匹配的诊断-复发样本进行了 ATAC-seq 分析,以研究 AML 复发的表观遗传模式。这项分析确定了突变稳定 AML 的复发特异性染色质可及性特征,表明 AML 在复发时会发生独立于基因突变的表观遗传进化。在复发时分析白血病干细胞 (LSC) 染色质变化表明,与非 LSCs 相比,这个白血病细胞群经历的表观遗传变化要少得多,而非 LSCs 的表观遗传变化反映了白血病整体的进化。最后,我们使用单细胞 ATAC-seq 与线粒体测序 (mtscATAC) 将诊断时的克隆与它们的表观遗传特征一起映射到复发中。我们发现,与诊断时相比,具有明显线粒体定义的克隆在复发时表现出更相似的染色质可及性,这表明复发 AML 中存在趋同的表观遗传进化。这些结果表明,表观遗传进化是复发 AML 的一个特征,并且在诱导化疗治疗后可以发生趋同的表观遗传进化。
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