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Targeted deep sequencing reveals clonal and subclonal mutational signatures in Adult T-cell leukemia/lymphoma and defines an unfavorable indolent subtype.
靶向深度测序揭示了成人 T 细胞白血病/淋巴瘤的克隆和亚克隆突变标签,并定义了一种不利的惰性亚型。
- 影响因子:6.08
- DOI:10.1038/s41375-020-0900-3
- 作者列表:"Marçais A","Lhermitte L","Artesi M","Laurent C","Durkin K","Hahaut V","Rosewick N","Suarez F","Sibon D","Cheminant M","Avettand-Fenoel V","Bruneau J","Georges M","Pique C","Van den Broeke A","Asnafi V","Hermine O
- 发表时间:2020-06-17
Abstract
:Adult T-cell leukemia/lymphoma (ATL) carries a poor prognosis even in indolent subtypes. We performed targeted deep sequencing combined with mapping of HTLV-1 proviral integration sites of 61 ATL patients of African and Caribbean origin. This revealed mutations mainly affecting TCR/NF-kB (74%), T-cell trafficking (46%), immune escape (29%), and cell cycle (26%) related pathways, consistent with the genomic landscape previously reported in a large Japanese cohort. To examine the evolution of mutational signatures upon disease progression while tracking the viral integration architecture of the malignant clone, we carried out a longitudinal study of patients who either relapsed or progressed from an indolent to an aggressive subtype. Serial analysis of relapsing patients identified several patterns of clonal evolution. In progressing patients, the longitudinal study revealed NF-kB/NFAT mutations at progression that were present at a subclonal level at diagnosis (allelic frequency < 5%). Moreover, the presence in indolent subtypes of mutations affecting the TCR/NF-kB pathway, whether clonal or subclonal, was associated with significantly shorter time to progression and overall survival. Our observations reveal the clonal dynamics of ATL mutational signatures at relapse and during progression. Our study defines a new subgroup of indolent ATLs characterized by a mutational signature at high risk of transformation.
摘要
: 成人 T 细胞白血病/淋巴瘤 (ATL) 即使在惰性亚型中也具有不良预后。我们对 61 例非洲和加勒比地区 ATL 患者进行了靶向深度测序结合 HTLV-1 前病毒整合位点的定位。这揭示了主要影响 TCR/NF-kB (74%) 、 T 细胞运输 (46%) 、免疫逃逸 (29%) 和细胞周期 (26%) 相关通路的突变。与以前在一个大型日本队列中报道的基因组景观一致。在跟踪恶性克隆的病毒整合架构的同时,检查疾病进展时突变标记的演变,我们对复发或从惰性向侵袭性亚型进展的患者进行了一项纵向研究。复发患者的系列分析确定了几种克隆进化模式。在进展患者中,纵向研究发现进展时 NF-kB/NFAT 突变存在于诊断时的亚克隆水平 (等位基因频率 <5%)。此外,影响 TCR/NF-kB 通路的惰性突变亚型的存在,无论是克隆性的还是亚克隆性的,与显著较短的进展时间和总生存期相关。我们的观察结果揭示了 ATL 突变标签在复发和进展期间的克隆动力学。我们的研究定义了一个新的惰性 ATLs 亚组,其特征是具有转化高风险的突变特征。
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