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A transcriptomic continuum of differentiation arrest identifies myeloid interface acute leukemias with poor prognosis.

Accepted version
Peer-reviewed

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Authors

Bond, Jonathan 
Krzywon, Aleksandra 
Roumier, Christophe 
Roggy, Anne 

Abstract

Classification of acute lymphoblastic and myeloid leukemias (ALL and AML) remains heavily based on phenotypic resemblance to normal hematopoietic precursors. This framework can provide diagnostic challenges for immunophenotypically heterogeneous immature leukemias, and ignores recent advances in understanding of developmental multipotency of diverse normal hematopoietic progenitor populations that are identified by transcriptional signatures. We performed transcriptional analyses of a large series of acute myeloid and lymphoid leukemias and detected significant overlap in gene expression between cases in different diagnostic categories. Bioinformatic classification of leukemias along a continuum of hematopoietic differentiation identified leukemias at the myeloid/T-lymphoid interface, which shared gene expression programs with a series of multi or oligopotent hematopoietic progenitor populations, including the most immature CD34+CD1a-CD7- subset of early thymic precursors. Within these interface acute leukemias (IALs), transcriptional resemblance to early lymphoid progenitor populations and biphenotypic leukemias was more evident in cases originally diagnosed as AML, rather than T-ALL. Further prognostic analyses revealed that expression of IAL transcriptional programs significantly correlated with poor outcome in independent AML patient cohorts. Our results suggest that traditional binary approaches to acute leukemia categorization are reductive, and that identification of IALs could allow better treatment allocation and evaluation of therapeutic options.

Description

Keywords

Biomarkers, Tumor, Cell Differentiation, Computational Biology, Humans, Leukemia, Biphenotypic, Acute, Leukemia, Myeloid, Acute, Precursor Cell Lymphoblastic Leukemia-Lymphoma, Prognosis, Survival Rate, Transcriptome

Journal Title

Leukemia

Conference Name

Journal ISSN

0887-6924
1476-5551

Volume Title

35

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Wellcome Trust (107630/Z/15/Z)
European Hematology Association (EHA)
Medical Research Council (MC_PC_12009)
Wellcome Trust (203151/Z/16/Z)
Medical Research Council (MC_PC_17230)
The Necker laboratory was supported by the Association Laurette Fugain, La ligue contre le Cancer and the INCa 2007 (DM/FC/sl/RT07) and CARAMELE Translational Research and PhD programs and INCa/AP-HP genetic Plateforme de Ressources Biologiques (PRB). Certain AL samples were collected within the MILE program (55). JB was supported by a Kay Kendall Leukaemia Fund Intermediate Research Fellowship and by the National Children’s Research Centre, Children’s Health Ireland at Crumlin, Dublin. Work in the Laurenti laboratory in Cambridge was supported by a Wellcome/Royal Society Sir Henry Dale Fellowship to EL, the European Hematology Association, BBSRC and by core funding from Wellcome and MRC to the Wellcome-MRC Cambridge Stem Cell Institute. AK was funded by a National Science Centre, Poland research grant (2017/01/X/ST6/01329).