1. Single-cell multiomics analysis of chronic myeloid leukemia links cellular heterogeneity to therapy response.
- Author
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Warfvinge R, Geironson Ulfsson L, Dhapola P, Safi F, Sommarin M, Soneji S, Hjorth-Hansen H, Mustjoki S, Richter J, Thakur RK, and Karlsson G
- Subjects
- Humans, Neoplastic Stem Cells metabolism, Neoplastic Stem Cells drug effects, Neoplastic Stem Cells pathology, Retrospective Studies, Male, Female, Gene Expression Profiling, Middle Aged, Multiomics, Leukemia, Myelogenous, Chronic, BCR-ABL Positive drug therapy, Leukemia, Myelogenous, Chronic, BCR-ABL Positive genetics, Leukemia, Myelogenous, Chronic, BCR-ABL Positive pathology, Single-Cell Analysis methods, Protein Kinase Inhibitors pharmacology, Protein Kinase Inhibitors therapeutic use
- Abstract
The advent of tyrosine kinase inhibitors (TKIs) as treatment of chronic myeloid leukemia (CML) is a paradigm in molecularly targeted cancer therapy. Nonetheless, TKI-insensitive leukemia stem cells (LSCs) persist in most patients even after years of treatment and are imperative for disease progression as well as recurrence during treatment-free remission (TFR). Here, we have generated high-resolution single-cell multiomics maps from CML patients at diagnosis, retrospectively stratified by BCR::ABL1
IS (%) following 12 months of TKI therapy. Simultaneous measurement of global gene expression profiles together with >40 surface markers from the same cells revealed that each patient harbored a unique composition of stem and progenitor cells at diagnosis. The patients with treatment failure after 12 months of therapy had a markedly higher abundance of molecularly defined primitive cells at diagnosis compared to the optimal responders. The multiomic feature landscape enabled visualization of the primitive fraction as a mixture of molecularly distinct BCR::ABL1+ LSCs and BCR::ABL1- hematopoietic stem cells (HSCs) in variable ratio across patients, and guided their prospective isolation by a combination of CD26 and CD35 cell surface markers. We for the first time show that BCR::ABL1+ LSCs and BCR::ABL1- HSCs can be distinctly separated as CD26+ CD35- and CD26- CD35+ , respectively. In addition, we found the ratio of LSC/HSC to be higher in patients with prospective treatment failure compared to optimal responders, at diagnosis as well as following 3 months of TKI therapy. Collectively, this data builds a framework for understanding therapy response and adapting treatment by devising strategies to extinguish or suppress TKI-insensitive LSCs., Competing Interests: RW, LG, FS, MS, SS, RT No competing interests declared, PD, GK Is a board member and has equity in Nygen Analytics AB, HH Received honoraria from Pfizer, Novartis, BMS, and Incyte, SM Received honoraria and research funding from BMS, research funding from Novartis, Janpix, and honoraria from Dren Bio, JR Received honoraria and research funding from Novartis and Bristol-Myers Squibb (BMS) and honoraria from Ariad, (© 2023, Warfvinge et al.)- Published
- 2024
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