title: Clonal evolution in B-lineage acute lymphoblastic leukemia by contemporaneous VH-VH gene replacements and VH-DJH gene rearrangements.
abstract: B-cell acute lymphoblastic leukemia (B-ALL), more frequently than any other B-lineage neoplasm, exhibits oligoclonal Ig heavy chain (IgH) gene rearrangement in 15% to 43% of all cases studied. To study the molecular processes that promote multiple IgH rearrangements, a comprehensive sequence analysis of a B-ALL case was performed in which seven clonal IgH gene rearrangements were identified. The genetic profiles suggested that a single leukemic progenitor clone evolved into several subclones through dual processes of variable (VH) to preexisting diversity-joining (DJH) gene segment rearrangement and VH to VH gene replacement. Predominant IgH-V usage and the uniquely rearranged clonotype-specific VHDJH region gene sequences were identified using a novel DNA-based gene amplification strategy. Polymerase chain reaction (PCR) was directed by an IgH-J generic primer and a complement of family-specific IgH-V primers that defined the major B-cell IgH-V gene usage. Clonality of rearranged VHDJH bands was substantiated by high resolution denaturant gel electrophoretic analysis. Sequence patterns of the amplified VHDJH fragments segregated into two groups defined by common DJH sequences. Partial N region homology at the VHD junction as well as shared DJH sequences firmly established VH to VHDJH gene replacement as a mechanism generating clonal evolution in one group. In the second subset, oligoclonality was propagated by independent VH gene rearrangements to a common DJH precursor. The contributions of all clonal Ig-VHDJH repertoires for each group was approximately 50% and reflected a symmetric distribution of leukemic subclones generated by either process. Thus, oligoclonal rearrangements evolved by two independent, yet seemingly contemporaneous molecular genetic mechanisms. All seven clones displayed nonfunctional Ig-VHDJH recombinations. These observations may have relevance to the recombinatorial opportunities available during normal B-cell maturation.
authors.affiliation: Department of Neurology, Roswell Park Cancer Institute, Buffalo, NY 14263 USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Choi
authors.forename: S J
authors.initials: SJ
authors.lastname: Greenberg
authors.forename: T L
authors.initials: TL
authors.lastname: Du
authors.forename: P M
authors.initials: PM
authors.lastname: Ward
authors.forename: P M
authors.initials: PM
authors.lastname: Overturf
authors.forename: M L
authors.initials: ML
authors.lastname: Brecher
authors.forename: M
authors.initials: M
authors.lastname: Ballow
mesh_terms: D001483:Base Sequence; D001853:Bone Marrow / Q000473:pathology; D019070:Cell Lineage; D002675:Child, Preschool; D002999:Clone Cells / Q000473:pathology*; D004254:DNA Nucleotidyltransferases / Q000378:metabolism; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D015326:Gene Rearrangement, B-Lymphocyte, Heavy Chain; D005803:Genes, Immunoglobulin; D006801:Humans; D007135:Immunoglobulin Variable Region / Q000235:genetics; D008969:Molecular Sequence Data; D009363:Neoplasm Proteins / Q000235:genetics* / Q000378:metabolism; D014411:Neoplastic Stem Cells / Q000473:pathology*; D016133:Polymerase Chain Reaction; D045567:VDJ Recombinases
chemical_list: D004273:DNA, Neoplasm; D007135:Immunoglobulin Variable Region; D009363:Neoplasm Proteins; D004254:DNA Nucleotidyltransferases; D045567:VDJ Recombinases