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  • Actionable perturbations of...
    Schrader, A; Crispatzu, G; Oberbeck, S; Mayer, P; Pützer, S; von Jan, J; Vasyutina, E; Warner, K; Weit, N; Pflug, N; Braun, T; Andersson, E I; Yadav, B; Riabinska, A; Maurer, B; Ventura Ferreira, M S; Beier, F; Altmüller, J; Lanasa, M; Herling, C D; Haferlach, T; Stilgenbauer, S; Hopfinger, G; Peifer, M; Brümmendorf, T H; Nürnberg, P; Elenitoba-Johnson, K S J; Zha, S; Hallek, M; Moriggl, R; Reinhardt, H C; Stern, M-H; Mustjoki, S; Newrzela, S; Frommolt, P; Herling, M

    Nature communications, 02/2018, Volume: 9, Issue: 1
    Journal Article

    T-cell prolymphocytic leukemia (T-PLL) is a rare and poor-prognostic mature T-cell malignancy. Here we integrated large-scale profiling data of alterations in gene expression, allelic copy number (CN), and nucleotide sequences in 111 well-characterized patients. Besides prominent signatures of T-cell activation and prevalent clonal variants, we also identify novel hot-spots for CN variability, fusion molecules, alternative transcripts, and progression-associated dynamics. The overall lesional spectrum of T-PLL is mainly annotated to axes of DNA damage responses, T-cell receptor/cytokine signaling, and histone modulation. We formulate a multi-dimensional model of T-PLL pathogenesis centered around a unique combination of TCL1 overexpression with damaging ATM aberrations as initiating core lesions. The effects imposed by TCL1 cooperate with compromised ATM toward a leukemogenic phenotype of impaired DNA damage processing. Dysfunctional ATM appears inefficient in alleviating elevated redox burdens and telomere attrition and in evoking a p53-dependent apoptotic response to genotoxic insults. As non-genotoxic strategies, synergistic combinations of p53 reactivators and deacetylase inhibitors reinstate such cell death execution.