The genomic basis of childhood T-lineage acute lymphoblastic leukaemia

T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour 1 that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation 2 , 3 . Here we report an integrated analysis of genome and...

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Published in:Nature (London) Vol. 632; no. 8027; pp. 1082 - 1091
Main Authors: Pölönen, Petri, Di Giacomo, Danika, Seffernick, Anna Eames, Elsayed, Abdelrahman, Kimura, Shunsuke, Benini, Francesca, Montefiori, Lindsey E., Wood, Brent L., Xu, Jason, Chen, Changya, Cheng, Zhongshan, Newman, Haley, Myers, Jason, Iacobucci, Ilaria, Li, Elizabeth, Sussman, Jonathan, Hedges, Dale, Hui, Yawei, Diorio, Caroline, Uppuluri, Lahari, Frank, David, Fan, Yiping, Chang, Yunchao, Meshinchi, Soheil, Ries, Rhonda, Shraim, Rawan, Li, Alexander, Bernt, Kathrin M., Devidas, Meenakshi, Winter, Stuart S., Dunsmore, Kimberly P., Inaba, Hiroto, Carroll, William L., Ramirez, Nilsa C., Phillips, Aaron H., Kriwacki, Richard W., Yang, Jun J., Vincent, Tiffaney L., Zhao, Yaqi, Ghate, Pankaj S., Wang, Jian, Reilly, Colleen, Zhou, Xin, Sanders, Mathijs A., Takita, Junko, Kato, Motohiro, Takasugi, Nao, Chang, Bill H., Press, Richard D., Loh, Mignon, Rampersaud, Evadnie, Raetz, Elizabeth, Hunger, Stephen P., Tan, Kai, Chang, Ti-Cheng, Wu, Gang, Pounds, Stanley B., Mullighan, Charles G., Teachey, David T.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 29.08.2024
Nature Publishing Group
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ISSN:0028-0836, 1476-4687, 1476-4687
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Abstract T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour 1 that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation 2 , 3 . Here we report an integrated analysis of genome and transcriptome sequencing of tumour and remission samples from more than 1,300 uniformly treated children with T-ALL, coupled with epigenomic and single-cell analyses of malignant and normal T cell precursors. This approach identified 15 subtypes with distinct genomic drivers, gene expression patterns, developmental states and outcomes. Analyses of chromatin topology revealed multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific manner, thereby demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically described, high-risk entity of early T cell precursor ALL is superseded by a broader category of ‘early T cell precursor-like’ leukaemia. This category has a variable immunophenotype and diverse genomic alterations of a core set of genes that encode regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease. Comprehensive genomic and transcriptomics analyses of more than 1,300 cases of childhood T-lineage acute lymphoblastic leukaemia identify 15 distinct subtypes that are associated with specific outcomes.
AbstractList T-lineage acute lymphoblastic leukemia (T-ALL) is a high-risk tumor1 that has eluded comprehensive genomic characterization, in part due to the high frequency of non-coding genomic alterations resulting in oncogene deregulation2,3. Here we report integrated analysis of genome and transcriptome sequencing of tumor and remission samples from over 1300 uniformly treated children with T-ALL, coupled with epigenomic and single cell analysis of malignant and normal T cell precursors. This identified 15 subtypes with distinct genomic drivers, gene expression, developmental state and outcome. Analysis of chromatin topology elucidated multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific fashion, demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically-described, high-risk entity of early T-cell precursor ALL is superseded by a broader category of “ETP-like” leukemia with variable immunophenotype and diverse genomic alterations of a core set of genes encoding regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease.
T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation . Here we report an integrated analysis of genome and transcriptome sequencing of tumour and remission samples from more than 1,300 uniformly treated children with T-ALL, coupled with epigenomic and single-cell analyses of malignant and normal T cell precursors. This approach identified 15 subtypes with distinct genomic drivers, gene expression patterns, developmental states and outcomes. Analyses of chromatin topology revealed multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific manner, thereby demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically described, high-risk entity of early T cell precursor ALL is superseded by a broader category of 'early T cell precursor-like' leukaemia. This category has a variable immunophenotype and diverse genomic alterations of a core set of genes that encode regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease.
T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour 1 that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation 2 , 3 . Here we report an integrated analysis of genome and transcriptome sequencing of tumour and remission samples from more than 1,300 uniformly treated children with T-ALL, coupled with epigenomic and single-cell analyses of malignant and normal T cell precursors. This approach identified 15 subtypes with distinct genomic drivers, gene expression patterns, developmental states and outcomes. Analyses of chromatin topology revealed multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific manner, thereby demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically described, high-risk entity of early T cell precursor ALL is superseded by a broader category of ‘early T cell precursor-like’ leukaemia. This category has a variable immunophenotype and diverse genomic alterations of a core set of genes that encode regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease. Comprehensive genomic and transcriptomics analyses of more than 1,300 cases of childhood T-lineage acute lymphoblastic leukaemia identify 15 distinct subtypes that are associated with specific outcomes.
T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour1 that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation2,3. Here we report an integrated analysis of genome and transcriptome sequencing of tumour and remission samples from more than 1,300 uniformly treated children with T-ALL, coupled with epigenomic and single-cell analyses of malignant and normal T cell precursors. This approach identified 15 subtypes with distinct genomic drivers, gene expression patterns, developmental states and outcomes. Analyses of chromatin topology revealed multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific manner, thereby demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically described, high-risk entity of early T cell precursor ALL is superseded by a broader category of 'early T cell precursor-like' leukaemia. This category has a variable immunophenotype and diverse genomic alterations of a core set of genes that encode regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease.T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour1 that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation2,3. Here we report an integrated analysis of genome and transcriptome sequencing of tumour and remission samples from more than 1,300 uniformly treated children with T-ALL, coupled with epigenomic and single-cell analyses of malignant and normal T cell precursors. This approach identified 15 subtypes with distinct genomic drivers, gene expression patterns, developmental states and outcomes. Analyses of chromatin topology revealed multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific manner, thereby demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically described, high-risk entity of early T cell precursor ALL is superseded by a broader category of 'early T cell precursor-like' leukaemia. This category has a variable immunophenotype and diverse genomic alterations of a core set of genes that encode regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease.
T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour1 that has eluded comprehensive genomic characterization, which is partly due to the high frequency of noncoding genomic alterations that result in oncogene deregulation2,3. Here we report an integrated analysis of genome and transcriptome sequencing of tumour and remission samples from more than 1,300 uniformly treated children with T-ALL, coupled with epigenomic and single-cell analyses of malignant and normal T cell precursors. This approach identified 15 subtypes with distinct genomic drivers, gene expression patterns, developmental states and outcomes. Analyses of chromatin topology revealed multiple mechanisms of enhancer deregulation that involve enhancers and genes in a subtype-specific manner, thereby demonstrating widespread involvement of the noncoding genome. We show that the immunophenotypically described, high-risk entity of early T cell precursor ALL is superseded by a broader category of'early T cell precursor-like' leukaemia. This category has a variable immunophenotype and diverse genomic alterations of a core set of genes that encode regulators of hematopoietic stem cell development. Using multivariable outcome models, we show that genetic subtypes, driver and concomitant genetic alterations independently predict treatment failure and survival. These findings provide a roadmap for the classification, risk stratification and mechanistic understanding of this disease.
Author Myers, Jason
Teachey, David T.
Benini, Francesca
Reilly, Colleen
Press, Richard D.
Sussman, Jonathan
Chang, Bill H.
Tan, Kai
Fan, Yiping
Shraim, Rawan
Wu, Gang
Montefiori, Lindsey E.
Ramirez, Nilsa C.
Bernt, Kathrin M.
Winter, Stuart S.
Mullighan, Charles G.
Kato, Motohiro
Phillips, Aaron H.
Zhou, Xin
Takasugi, Nao
Rampersaud, Evadnie
Chen, Changya
Yang, Jun J.
Inaba, Hiroto
Hunger, Stephen P.
Loh, Mignon
Pölönen, Petri
Li, Elizabeth
Uppuluri, Lahari
Wood, Brent L.
Sanders, Mathijs A.
Chang, Yunchao
Devidas, Meenakshi
Raetz, Elizabeth
Chang, Ti-Cheng
Cheng, Zhongshan
Carroll, William L.
Seffernick, Anna Eames
Newman, Haley
Li, Alexander
Iacobucci, Ilaria
Vincent, Tiffaney L.
Wang, Jian
Elsayed, Abdelrahman
Kimura, Shunsuke
Dunsmore, Kimberly P.
Pounds, Stanley B.
Diorio, Caroline
Meshinchi, Soheil
Di Giacomo, Danika
Hui, Yawei
Ries, Rhonda
Ghate, Pankaj S.
Frank, David
Takita, Junko
Zhao, Yaqi
Xu, Jason
Kriwacki, Richard W.
Hedges, Dale
AuthorAffiliation 16 Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN, USA
6 Children’s Hospital Los Angeles, Laboratory Medicine, Los Angeles, CA, USA
20 Department of Structural Biology, St. Jude Children’s Research Hospital, Memphis, TN, USA
7 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
18 Department of Pediatrics and Pathology, Perlmutter Cancer Center, NYU Langone Health, New York, NY, USA
21 Department of Microbiology, Immunology and Biochemistry, University of Tennessee Health Sciences Center, Memphis, TN, USA
1 Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
3 Department of Biostatistics, St. Jude Children’s Research Hospital, Memphis, TN, USA
22 Department of Pharmaceutical Sciences, St. Jude Children’s Research Hospital, Memphis, TN, USA
23 Department of Computational Biology, St. Jude Children’s Research Hospital, Memphis, TN, USA
12 Fred Hutchinson Cancer Research Center, Clinical Research Division, Seattle,
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  fullname: Mullighan, Charles G.
  email: charles.mullighan@stjude.org
  organization: Department of Pathology, St Jude Children’s Research Hospital
– sequence: 59
  givenname: David T.
  orcidid: 0000-0001-7373-8987
  surname: Teachey
  fullname: Teachey, David T.
  email: teacheyd@chop.edu
  organization: Perelman School of Medicine, University of Pennsylvania, Division of Oncology and Center for Childhood Cancer Research, Children’s Hospital of Philadelphia, Department of Pediatrics and the Center for Childhood Cancer Research, Children’s Hospital of Philadelphia
BackLink https://www.ncbi.nlm.nih.gov/pubmed/39143224$$D View this record in MEDLINE/PubMed
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Equal contribution
M.L., E.R., S.P.H., J.J.Y., M.D., H.I., S.W., K.D., W.L.C, N.C.R, K.B., C.D., L.U., D.F., S.M., R.R., A.L., T.L.V., P.S.G., M.A.S., J.T., M.K., N.T., B.H.C., R.D.P., Y.Z., provided patient samples and collected data. P.P., Z.C., J.M, Y.H., Y.F., D.H., E.R, preprocessed data. P.P., T.C.C, G.W., H.N., R.S., analyzed genomic data. P.P., A.E.S., A.E, S.B.P. performed statistical analysis. P.P., J.X., C.C., E.L., J.S., A.L., K.T analyzed single cell RNA data. P.P., J.W., C.R., X.Z., generated cloud-based visualizations. R.R., S.M., T.V isolated DNA/RNA, J.X., C.C, performed single cell library preparation and sequencing, D.D.G. and L.E.M. performed HiCHIP and ATACseq, R.D.P. performed targeted amplicon sequencing, F.B., S.K., performed long read sequencing, S.K. engineered MED12 knock-out cells, Y.C. performed western blotting, F.B., I.I., S.K., performed luciferase report assays. B.L.W analyzed flow cytometry data. P.P., C.G.M., D.T.T. designed the study and wrote the manuscript.
Author Contributions
ORCID 0000-0003-3583-7727
0000-0002-1871-1850
0000-0002-2158-467X
0000-0002-1099-3478
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Snippet T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour 1 that has eluded comprehensive genomic characterization, which is partly due to the high...
T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour that has eluded comprehensive genomic characterization, which is partly due to the high...
T-lineage acute lymphoblastic leukaemia (T-ALL) is a high-risk tumour1 that has eluded comprehensive genomic characterization, which is partly due to the high...
T-lineage acute lymphoblastic leukemia (T-ALL) is a high-risk tumor1 that has eluded comprehensive genomic characterization, in part due to the high frequency...
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StartPage 1082
SubjectTerms 38
38/91
45
631/114/2401
631/67/1990/283/2125
631/67/68
631/67/69
Acute lymphoblastic leukemia
Cell culture
Child
Childhood
Children
Chromatin
Chromatin - genetics
Chromatin - metabolism
Deregulation
Enhancer Elements, Genetic - genetics
Enhancers
Epigenomics
Female
Gene expression
Gene Expression Regulation, Leukemic
Gene sequencing
Genes
Genetic diversity
Genome, Human - genetics
Genomes
Genomic analysis
Genomics
Hematopoietic stem cells
Humanities and Social Sciences
Humans
Leukemia
Lymphocytes
Lymphocytes T
Male
Medical prognosis
multidisciplinary
Mutation
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - genetics
Precursor T-Cell Lymphoblastic Leukemia-Lymphoma - pathology
Precursors
Remission
Science
Science (multidisciplinary)
Single-Cell Analysis
Stem cells
T cell receptors
T-Lymphocytes - cytology
T-Lymphocytes - pathology
Topology
Transcriptome - genetics
Transcriptomes
Title The genomic basis of childhood T-lineage acute lymphoblastic leukaemia
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https://pubmed.ncbi.nlm.nih.gov/PMC11611067
Volume 632
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