Hierarchy in somatic mutations arising during genomic evolution and progression of follicular lymphoma

Michael R. Green, Andrew J. Gentles, Ramesh V. Nair, Jonathan M. Irish, Shingo Kihira, Chih Long Liu, Itai Kela, Erik S. Hopmans, June H. Myklebust, Hanlee Ji, Sylvia K. Plevritis, Ronald Levy, Ash A. Alizadeh

Research output: Contribution to journalArticle

168 Scopus citations

Abstract

Follicular lymphoma (FL) is currently incurable using conventional chemotherapy or immunotherapy regimes, compelling new strategies. Advances in high-throughput sequencing technologies that can reveal oncogenic pathways have stimulated interest in tailoring therapies toward actionable somatic mutations. However, for mutation-directed therapies to be most effective, the mutations must be uniformly present in evolved tumor cells as well as in the self-renewing tumor-cell precursors. Here, we show striking intratumoral clonal diversity within FL tumors in the representation of mutations in the majority of genes as revealed by whole exome sequencing of subpopulations. This diversity captures a clonal hierarchy, resolved using immunoglobulin somatic mutations and IGH-BCL2 translocations as a frame of reference and by comparing diagnosis and relapse tumor pairs, allowing us to distinguish early versus late genetic eventsduring lymphomagenesis. We provide evidence that IGHBCL2 translocations and CREBBP mutations are early events, whereas MLL2 and TNFRSF14 mutations probably represent late events during disease evolution. These observations provide insight into which of the genetic lesions represent suitable candidates for targeted therapies.

Original languageEnglish (US)
Pages (from-to)1604-1611
Number of pages8
JournalBlood
Volume121
Issue number9
DOIs
StatePublished - Feb 28 2013

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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    Green, M. R., Gentles, A. J., Nair, R. V., Irish, J. M., Kihira, S., Liu, C. L., Kela, I., Hopmans, E. S., Myklebust, J. H., Ji, H., Plevritis, S. K., Levy, R., & Alizadeh, A. A. (2013). Hierarchy in somatic mutations arising during genomic evolution and progression of follicular lymphoma. Blood, 121(9), 1604-1611. https://doi.org/10.1182/blood-2012-09-457283