Abstract:
:Clonal heterogeneity and evolution has major implications for disease progression and relapse in acute myeloid leukemia (AML). To model clonal dynamics in vivo, we serially transplanted 23 AML cases to immunodeficient mice and followed clonal composition for up to 15 months by whole-exome sequencing of 84 xenografts across two generations. We demonstrate vast changes in clonality that both progress and reverse over time, and define five patterns of clonal dynamics: Monoclonal, Stable, Loss, Expansion and Burst. We also show that subclonal expansion in vivo correlates with a more adverse prognosis. Furthermore, clonal expansion enabled detection of very rare clones with AML driver mutations that were undetectable by sequencing at diagnosis, demonstrating that the vast majority of AML cases harbor multiple clones already at diagnosis. Finally, the rise and fall of related clones enabled deconstruction of the complex evolutionary hierarchies of the clones that compete to shape AML over time.
journal_name
Nat Communjournal_title
Nature communicationsauthors
Sandén C,Lilljebjörn H,Orsmark Pietras C,Henningsson R,Saba KH,Landberg N,Thorsson H,von Palffy S,Peña-Martinez P,Högberg C,Rissler M,Gisselsson D,Lazarevic V,Juliusson G,Ågerstam H,Fioretos Tdoi
10.1038/s41467-019-14106-0subject
Has Abstractpub_date
2020-02-05 00:00:00pages
579issue
1issn
2041-1723pii
10.1038/s41467-019-14106-0journal_volume
11pub_type
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