Evolution and impact of subclonal mutations in chronic lymphocytic leukemia.

Evolution and impact of subclonal mutations in chronic lymphocytic leukemia.
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慢性淋巴细胞白血病亚克隆突变的演变和影响。

DOI:
10.1016/j.cell.2013.01.019
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发表时间:
2013-02-14
期刊:
影响因子:
64.5
通讯作者:
Wu CJ
Wu CJ
中科院分区:
生物学1区
文献类型:
--
作者:
Landau DA;Carter SL;Stojanov P;McKenna A;Stevenson K;Lawrence MS;Sougnez C;Stewart C;Sivachenko A;Wang L;Wan Y;Zhang W;Shukla SA;Vartanov A;Fernandes SM;Saksena G;Cibulskis K;Tesar B;Gabriel S;Hacohen N;Meyerson M;Lander ES;Neuberg D;Brown JR;Getz G;Wu CJ

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克隆演变是癌症进展和复发的关键特征。我们研究了149例慢性淋巴细胞白血病(CLL)病例的肿瘤内异质性,通过整合全外显子组序列和拷贝数来测量携带每个体细胞突变的癌细胞比例。我们确定驱动突变主要是克隆的(例如,MYD 88、12三体和del(13 q))或亚克隆(例如,SF3B1,TP53),对应于CLL演变中的早期和晚期事件。我们在两个时间点从18名患者中采集白血病细胞样本。12例接受化疗的CLL病例中有10例(但6例未接受治疗的病例中仅1例)经历了克隆进化,主要涉及具有驱动突变的亚克隆(例如,SF3B1,TP53),随时间推移而扩大。此外,亚克隆驱动突变的存在是疾病快速进展的独立风险因素。因此,我们的研究揭示了慢性淋巴细胞白血病的克隆进化模式,提供了其逐步转变的见解,并将亚克隆的存在与不良临床结果联系起来。
Clonal evolution is a key feature of cancer progression and relapse. We studied intratumoral heterogeneity in 149 chronic lymphocytic leukemia (CLL) cases by integrating whole-exome sequence and copy number to measure the fraction of cancer cells harboring each somatic mutation. We identified driver mutations as predominantly clonal (e.g., MYD88, trisomy 12 and del(13q)) or subclonal (e.g., SF3B1, TP53), corresponding to earlier and later events in CLL evolution. We sampled leukemia cells from 18 patients at two timepoints. Ten of 12 CLL cases treated with chemotherapy (but only 1 of 6 without treatment) underwent clonal evolution, predominantly involving subclones with driver mutations (e.g., SF3B1, TP53) that expanded over time. Furthermore, presence of a subclonal driver mutation was an independent risk factor for rapid disease progression. Our study thus uncovers patterns of clonal evolution in CLL, providing insights into its stepwise transformation, and links the presence of subclones with adverse clinical outcome.
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