Biomaterial Database

Clonal evolution mechanisms in NT5C2 mutant-relapsed acute lymphoblastic leukaemia. 2018

Gannie Tzoneva, and Chelsea L Dieck, and Koichi Oshima, and Alberto Ambesi-Impiombato, and Marta Sánchez-Martín, and Chioma J Madubata, and Hossein Khiabanian, and Jiangyan Yu, and Esme Waanders, and Ilaria Iacobucci, and Maria Luisa Sulis, and Motohiro Kato, and Katsuyoshi Koh, and Maddalena Paganin, and Giuseppe Basso, and Julie M Gastier-Foster, and Mignon L Loh, and Renate Kirschner-Schwabe, and Charles G Mullighan, and Raul Rabadan, and Adolfo A Ferrando

Institute for Cancer Genetics, Columbia University, New York, New York 10032, USA.

Relapsed acute lymphoblastic leukaemia (ALL) is associated with resistance to chemotherapy and poor prognosis. Gain-of-function mutations in the 5'-nucleotidase, cytosolic II (NT5C2) gene induce resistance to 6-mercaptopurine and are selectively present in relapsed ALL. Yet, the mechanisms involved in NT5C2 mutation-driven clonal evolution during the initiation of leukaemia, disease progression and relapse remain unknown. Here we use a conditional-and-inducible leukaemia model to demonstrate that expression of NT5C2(R367Q), a highly prevalent relapsed-ALL NT5C2 mutation, induces resistance to chemotherapy with 6-mercaptopurine at the cost of impaired leukaemia cell growth and leukaemia-initiating cell activity. The loss-of-fitness phenotype of NT5C2+/R367Q mutant cells is associated with excess export of purines to the extracellular space and depletion of the intracellular purine-nucleotide pool. Consequently, blocking guanosine synthesis by inhibition of inosine-5'-monophosphate dehydrogenase (IMPDH) induced increased cytotoxicity against NT5C2-mutant leukaemia lymphoblasts. These results identify the fitness cost of NT5C2 mutation and resistance to chemotherapy as key evolutionary drivers that shape clonal evolution in relapsed ALL and support a role for IMPDH inhibition in the treatment of ALL.

UI	MeSH Term	Description	Entries
D007168	IMP Dehydrogenase	An enzyme that catalyzes the dehydrogenation of inosine 5'-phosphate to xanthosine 5'-phosphate in the presence of NAD. EC 1.1.1.205.	Inosinic Acid Dehydrogenase,Inosine-5-Monophosphate Dehydrogenase,Acid Dehydrogenase, Inosinic,Dehydrogenase, IMP,Dehydrogenase, Inosine-5-Monophosphate,Dehydrogenase, Inosinic Acid,Inosine 5 Monophosphate Dehydrogenase
D008297	Male		Males
D009154	Mutation	Any detectable and heritable change in the genetic material that causes a change in the GENOTYPE and which is transmitted to daughter cells and to succeeding generations.	Mutations
D011687	Purines	A series of heterocyclic compounds that are variously substituted in nature and are known also as purine bases. They include ADENINE and GUANINE, constituents of nucleic acids, as well as many alkaloids such as CAFFEINE and THEOPHYLLINE. Uric acid is the metabolic end product of purine metabolism.
D012008	Recurrence	The return of a sign, symptom, or disease after a remission.	Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D004195	Disease Models, Animal	Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases.	Animal Disease Model,Animal Disease Models,Disease Model, Animal
D005260	Female		Females
D006151	Guanosine	A purine nucleoside that has guanine linked by its N9 nitrogen to the C1 carbon of ribose. It is a component of ribonucleic acid and its nucleotides play important roles in metabolism. (From Dorland, 28th ed)
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000073659	Gain of Function Mutation	A mutation that results in an increase in a gene's activity or in acquiring a new molecular function or a new pattern of gene expression.	Activation Mutation,Activation Mutations,Mutation, Activation,Mutations, Activation