Progenitor B-1 B-cell acute lymphoblastic leukemia is associated with collaborative mutations in 3 critical pathways by Sheryl M. Gough, Liat Goldberg,

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Progenitor B-1 B-cell acute lymphoblastic leukemia is associated with collaborative mutations in 3 critical pathways by Sheryl M. Gough, Liat Goldberg, Marbin Pineda, Robert L. Walker, Yuelin J. Zhu, Sven Bilke, Yang Jo Chung, Joseph Dufraine, Subhadip Kundu, Elad Jacoby, Terry J. Fry, Susanna Fischer, Renate Panzer-Grümayer, Paul S. Meltzer, and Peter D. Aplan BloodAdv Volume 1(20):1749-1759 September 12, 2017 © 2017 by The American Society of Hematology

Sheryl M. Gough et al. Blood Adv 2017;1:1749-1759 © 2017 by The American Society of Hematology

A subset of NP23 mice develop a CD19+ B220− leukemia. A subset of NP23 mice develop a CD19+B220−leukemia. (A) Schematic of the NP23 transgene. Vav 5′ and 3′ regulatory elements are indicated in red, the NUP98 portion of the transgene is gray, and the PHF23 portion is black, with the PHD domain indicated with crosshatches. (B) Schematic of murine bone marrow (BM) B-lymphopoietic differentiation stages, adapted from Hardy and Hayakawa.20 (C) Flow cytometry profile of I2 mouse BM, spleen, and lymph node, stained with the indicated antibodies. (D) Immunohistochemical staining of I2 BM with B220 antibody. (E) Representative flow cytometry profiles of BM, spleen, lymph node (LyNode), and thymus from NP-23 B-lineage ALL 752 using CD19 and B220 antibodies. (F) Hematoxylin and eosin (H&E), B220, and CD3 immunohistochemistry of infiltrated 752 spleen compared with a wild-type (WT) control. (G) B220/CD19 cell populations in additional pro–B-1 ALL samples. Analysis shown is of tissues with the highest purity of malignant cells: 633 BM, 724 BM, 758 BM, 1450 BM, 1533 LyNode, and 1534 BM. CLP, common lymphoid progenitor; Fr, fraction; HSC, hematopoietic stem cell; MLP, multilineage progenitor. Sheryl M. Gough et al. Blood Adv 2017;1:1749-1759 © 2017 by The American Society of Hematology

NP23 B-lineage ALLs display features consistent with pro–B-1 cells. NP23 B-lineage ALLs display features consistent with pro–B-1 cells. (A) NP23 ALL sample 752 stained with indicated antibodies. (B) Samples 752, 758, and 1533 stained with AA4.1 and IL7Ra. LyNode, lymph node. Sheryl M. Gough et al. Blood Adv 2017;1:1749-1759 © 2017 by The American Society of Hematology

NP23 B-lineage leukemia gene signature is enriched in fetal liver fraction BC and pro–B-1 cells. NP23 B-lineage leukemia gene signature is enriched in fetal liver fraction BC and pro–B-1 cells. (A) Heat map shows clustering of 106 NP23 leukemia core genes (>2-fold upregulated in NP23 B-lineage leukemias) in expression array data from isolated B-cell populations (GSE15907). Fetal liver (FL) fraction (Fr) BC profile is boxed in red; bone marrow (BM) fraction BC profile is boxed in blue. (B) GSEA plot showing enrichment of NP23 leukemia core upregulated genes in FL Fr BC compared with BM Fr BC (GSE15907). (C) Enrichment of NP23 leukemia core upregulated genes in pro–B-1 vs pro–B-2 cells23 (GSE81411). FDR, false-discovery rate; LN, lymph node; MLN, mesenteric LN; NES, normalized enrichment score; PC, peritoneal cavity; SP, spleen. Sheryl M. Gough et al. Blood Adv 2017;1:1749-1759 © 2017 by The American Society of Hematology

Bcor mutations in NP23 pro–B-1 ALL Bcor mutations in NP23 pro–B-1 ALL. (A) Schematic of mouse Bcor transcript (Bcor-001; ENSMUST00000115513), exons 1 to 15. Bcor mutations in NP23 pro–B-1 ALL. (A) Schematic of mouse Bcor transcript (Bcor-001; ENSMUST00000115513), exons 1 to 15. Black upper-case text is exon 8 coding sequence. Underlined sequence indicates PCR primers. An internal alternative exon 8 splice acceptor site is indicated (|). The Bcor 11-bp palindromic mutational hotspot is shown in red. (B) Bcor exon 8 mutations at the exon 8 hotspot; indels shown in red capital letters. (C) WT and 724 pro–B-1 ALL sequence across the mutational hotspot (underlined). Red arrow indicates site of CC dinucleotide insertion. (D) 724 messenger RNA expression (lower panel). Red arrows indicate CC dinucleotide insertion. Predicted amino acid sequence is indicated (upper panel). (E) Schematic of the mouse Bcor protein and mutation sites (arrowheads). Sheryl M. Gough et al. Blood Adv 2017;1:1749-1759 © 2017 by The American Society of Hematology

NP23 pro–B-1 ALL gene signature is enriched in pediatric ALL with CRLF2 rearrangements. NP23 pro–B-1 ALL gene signature is enriched in pediatric ALL with CRLF2 rearrangements. (A) Hierarchical clustering of RNA-seq samples showing that NP23 pro–B-1 ALL expression profile is distinct from that of murine pre–B-2 ALL (taken from Eμ-RET and E2A-PBX mice). (B) GSEA plot showing enrichment of NP23 pro–B-1 ALL gene signature in pediatric ALL carrying CRLF2 rearrangements (GSE26281). The gene signature was generated by comparing NP23 pro–B-1 ALL with mouse pre–B-2 ALL (FPKM FC>2). Sheryl M. Gough et al. Blood Adv 2017;1:1749-1759 © 2017 by The American Society of Hematology