Genetic and phenotypic attributes of splenic marginal zone lymphoma.

TitleGenetic and phenotypic attributes of splenic marginal zone lymphoma.
Publication TypeJournal Article
Year of Publication2022
AuthorsBonfiglio F, Bruscaggin A, Guidetti F, di Bergamo LTerzi, Faderl M, Spina V, Condoluci A, Bonomini L, Forestieri G, Koch R, Piffaretti D, Pini K, Pirosa MCristina, Cittone MGiulia, Arribas A, Lucioni M, Ghilardi G, Wu W, Arcaini L, Baptista MJoao, Bastidas G, Beà S, Boldorini R, Broccoli A, Buehler MMatteo, Canzonieri V, Cascione L, Ceriani L, Cogliatti S, Corradini P, Derenzini E, Devizzi L, Dietrich S, Elia ARita, Facchetti F, Gaidano G, Garcia JFernando, Gerber B, Ghia P, da Silva MGomes, Gritti G, Guidetti A, Hitz F, Inghirami G, Ladetto M, Lopez-Guillermo A, Lucchini E, Maiorana A, Marasca R, Matutes E, Meignin V, Merli M, Moccia A, Mollejo M, Montalban C, Novak U, Oscier DGraham, Passamonti F, Piazza F, Pizzolitto S, Rambaldi A, Sabattini E, Salles G, Santambrogio E, Scarfò L, Stathis A, Stussi G, Geyer JT, Tapia G, Tarella C, Thieblemont C, Tousseyn T, Tucci A, Vanini G, Visco C, Vitolo U, Walewska R, Zaja F, Zenz T, Zinzani PLuigi, Khiabanian H, Calcinotto A, Bertoni F, Bhagat G, Campo E, de Leval L, Dirnhofer S, Pileri SA, Piris MA, Traverse-Glehen A, Tzankov A, Paulli M, Ponzoni M, Mazzucchelli L, Cavalli F, Zucca E, Rossi D
JournalBlood
Volume139
Issue5
Pagination732-747
Date Published2022 Feb 03
ISSN1528-0020
KeywordsAged, Animals, Chromosome Aberrations, Female, Humans, Immunophenotyping, Lymphoma, B-Cell, Marginal Zone, Male, Mice, Middle Aged, Multigene Family, Mutation, Spleen, Splenic Neoplasms, Transcriptome, Tumor Microenvironment
Abstract

Splenic marginal zone B-cell lymphoma (SMZL) is a heterogeneous clinico-biological entity. The clinical course is variable, multiple genes are mutated with no unifying mechanism, and essential regulatory pathways and surrounding microenvironments are diverse. We sought to clarify the heterogeneity of SMZL by resolving different subgroups and their underlying genomic abnormalities, pathway signatures, and microenvironment compositions to uncover biomarkers and therapeutic vulnerabilities. We studied 303 SMZL spleen samples collected through the IELSG46 multicenter international study (NCT02945319) by using a multiplatform approach. We carried out genetic and phenotypic analyses, defined self-organized signatures, validated the findings in independent primary tumor metadata and in genetically modified mouse models, and determined correlations with outcome data. We identified 2 prominent genetic clusters in SMZL, termed NNK (58% of cases, harboring NF-κB, NOTCH, and KLF2 modules) and DMT (32% of cases, with DNA-damage response, MAPK, and TLR modules). Genetic aberrations in multiple genes as well as cytogenetic and immunogenetic features distinguished NNK- from DMT-SMZLs. These genetic clusters not only have distinct underpinning biology, as judged by differences in gene-expression signatures, but also different outcomes, with inferior survival in NNK-SMZLs. Digital cytometry and in situ profiling segregated 2 basic types of SMZL immune microenvironments termed immune-suppressive SMZL (50% of cases, associated with inflammatory cells and immune checkpoint activation) and immune-silent SMZL (50% of cases, associated with an immune-excluded phenotype) with distinct mutational and clinical connotations. In summary, we propose a nosology of SMZL that can implement its classification and also aid in the development of rationally targeted treatments.

DOI10.1182/blood.2021012386
Alternate JournalBlood
PubMed ID34653238
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