title: The new frontier of epigenetic heterogeneity in B-cell neoplasms.
abstract: OBJECTIVE
  There is mounting evidence that heterogeneity of the epigenome is a feature of many cancers, including B-cell lymphomas, and presents important clinical implications. The purpose of this review is to explain the biological and clinical relevance of this epigenetic phenomenon in B-cell neoplasms.
  
  
  RESULTS
  Here, we summarize new findings demonstrating that B-cell lymphomas display increased DNA methylation heterogeneity compared to their normal counterparts. This plasticity of cytosine methylation manifests both as intertumor and intratumor heterogeneity and is associated with worse prognosis and poor clinical outcome in lymphoma patients. Recent studies of different subtypes of B-cell lymphomas have revealed that epigenetic aberrations and heterogeneous cytosine methylation patterning are common features of all neoplasms derived from B-lymphocytes, irrespective of maturation stage. With regard to mechanisms driving this process, recent reports suggest that cytosine methylation heterogeneity arises through passive and active processes. One factor implicated in active generation of cytosine methylation heterogeneity is activation-induced cytidine deaminase, which mediates DNA methylation changes and introduces epigenetic heterogeneity in normal germinal center B cells, the cells of origin of mature B-cell neoplasms such as diffuse large B-cell lymphoma and follicular lymphoma.
  
  
  CONCLUSIONS
  Understanding the scope and mechanism of epigenetic heterogeneity in cancer is of paramount importance to our understanding of clonal plasticity and treatment responses in B-cell lymphomas.
authors.affiliation: aDivisions of Hematology and Medical Oncology, Department of Medicine bDepartments of Physiology and Biophysics, Institute for Computational Biomedicine, Weill Cornell Medicine cDepartment of Pathology, Mount Sinai School of Medicine, New York, New York, USA.
authors.forename: Pilar M
authors.initials: PM
authors.lastname: Dominguez
authors.forename: Matt
authors.initials: M
authors.lastname: Teater
authors.forename: Rita
authors.initials: R
authors.lastname: Shaknovich
mesh_terms: D000818:Animals; D019175:DNA Methylation; D044127:Epigenesis, Genetic; D015972:Gene Expression Regulation, Neoplastic; D018740:Genetic Heterogeneity; D018858:Germinal Center / Q000378:metabolism; D006801:Humans; D015448:Leukemia, B-Cell / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism; D015398:Signal Transduction