Monitoring chronic lymphocytic leukemia progression by whole genome sequencing reveals heterogeneous clonal evolution patterns

被引:255
作者
Schuh, Anna [1 ]
Becq, Jennifer [2 ]
Humphray, Sean [2 ]
Alexa, Adrian [2 ]
Burns, Adam
Clifford, Ruth
Feller, Stephan M. [3 ]
Grocock, Russell [2 ]
Henderson, Shirley
Khrebtukova, Irina [4 ]
Kingsbury, Zoya [2 ]
Luo, Shujun [4 ]
McBride, David [2 ]
Murray, Lisa [2 ]
Menju, Toshi [3 ,5 ]
Timbs, Adele
Ross, Mark [2 ]
Taylor, Jenny
Bentley, David [2 ]
机构
[1] Univ Oxford, Oxford NIHR Biomed Res Ctr, Mol Diagnost Lab, Oxford OX3 9DS, England
[2] Illumina Cambridge Ltd, Saffron Walden, Essex, England
[3] Univ Oxford, Biol Syst Architecture Grp, Dept Oncol, Weatherall Inst Mol Med, Oxford OX3 9DS, England
[4] Illumina Inc, Hayward, CA USA
[5] Kyoto Univ, Dept Thorac Surg, Grad Sch Med, Kyoto, Japan
关键词
ADJUVANT CHEMOTHERAPY; SOMATIC MUTATIONS; CANCER; FLUDARABINE; CYCLOPHOSPHAMIDE; IDENTIFICATION; TRASTUZUMAB; SIGNATURES; RITUXIMAB; CATALOG;
D O I
10.1182/blood-2012-05-433540
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Chronic lymphocytic leukemia is characterized by relapse after treatment and chemotherapy resistance. Similarly, in other malignancies leukemia cells accumulate mutations during growth, forming heterogeneous cell populations that are subject to Darwinian selection and may respond differentially to treatment. There is therefore a clinical need to monitor changes in the subclonal composition of cancers during disease progression. Here, we use whole-genome sequencing to track subclonal heterogeneity in 3 chronic lymphocytic leukemia patients subjected to repeated cycles of therapy. We reveal different somatic mutation profiles in each patient and use these to establish probable hierarchical patterns of subclonal evolution, to identify subclones that decline or expand over time, and to detect founder mutations. We show that clonal evolution patterns are heterogeneous in individual patients. We conclude that genome sequencing is a powerful and sensitive approach to monitor disease progression repeatedly at the molecular level. If applied to future clinical trials, this approach might eventually influence treatment strategies as a tool to individualize and direct cancer treatment. (Blood. 2012; 120(20): 4191-4196)
引用
收藏
页码:4191 / 4196
页数:6
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