ID

45784

Description

Principal Investigator: Catherine Wu, MD, Dana Farber Cancer Institute, Boston, MA, USA MeSH: Leukemia, Lymphocytic, Chronic, B-Cell https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/study.cgi?study_id=phs001091 We analyzed clonal evolution in serial samples from five CLL patients who became resistant to the Bruton's tyrosine kinase (BTK) inhibitor ibrutinib, using whole-exome and deep targeted sequencing. We observe a BTK-C481S mutation in one of five patients, and multiple PLCG2 mutations in a second patient. The other patients had an expansion of clones harboring del(8p) carrying additional driver mutations (EP300, MLL2, EIF2A), with one patient developing trans-differentiation into CD19-negative histiocytic sarcoma. We calculated the growth kinetics of ibrutinib-resistant subclones and estimated the size of the resistant clones at treatment initiation, which we validated by droplet-microfluidic technology. Haplo-insufficiency of TRAIL-R, a consequence of del(8p), led to TRAIL insensitivity which may contribute to development of ibrutinib resistance. These findings demonstrate that ibrutinib therapy has the potential to lead to clonal selection and expansion of rare cell populations already present at the time of treatment initiation. They also provide insight into the heterogeneity of genetic changes associated with ibrutinib resistance, previously attributed solely to mutations in BTK and related pathway molecules.

Link

dbGaP-study=phs001091

Keywords

  1. 6/21/23 6/21/23 - Chiara Middel
Copyright Holder

Catherine Wu, MD, Dana Farber Cancer Institute, Boston, MA, USA

Uploaded on

June 21, 2023

DOI

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License

Creative Commons BY 4.0

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dbGaP phs001091 Clonal Evolution in Patients with Chronic Lymphocytic Leukemia

This subject phenotype table contains subject IDs, gender, age, primary disease, mutational status of the IgHV genes, and chromosomal alterations as identified by FISH.

pht006065
Description

pht006065

Alias
UMLS CUI [1,1]
C3846158
Unique Participant Identifier
Description

SUBJID

Data type

string

Alias
UMLS CUI [1,1]
C2348585
Participant's gender as Male or Female
Description

Gender

Data type

string

Alias
UMLS CUI [1,1]
C0079399
Age of patient
Description

Age

Data type

string

Measurement units
  • years
Alias
UMLS CUI [1,1]
C0001779
years
Primary disease state of patient
Description

Primary Disease

Data type

string

Alias
UMLS CUI [1,1]
C0205225
UMLS CUI [1,2]
C0012634
UMLS CUI [1,3]
C0449438
Mutational status of the Immunoglobulin Heavy Chain Variable Region Genes (IgHV)
Description

IgHV

Data type

text

Alias
UMLS CUI [1,1]
C0026882
UMLS CUI [1,2]
C0449438
UMLS CUI [1,3]
C4321381
UMLS CUI [1,4]
C0017337
Chromosomal alterations as identified by Fluorescence in situ Hybridization (FISH)
Description

FISH

Data type

string

Alias
UMLS CUI [1,1]
C0008625
UMLS CUI [1,2]
C0205396
UMLS CUI [1,3]
C0162789

Similar models

This subject phenotype table contains subject IDs, gender, age, primary disease, mutational status of the IgHV genes, and chromosomal alterations as identified by FISH.

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
pht006065
C3846158 (UMLS CUI [1,1])
SUBJID
Item
Unique Participant Identifier
string
C2348585 (UMLS CUI [1,1])
Item
Participant's gender as Male or Female
string
C0079399 (UMLS CUI [1,1])
Code List
Participant's gender as Male or Female
CL Item
Female (Female)
C0086287 (UMLS CUI [1,1])
CL Item
Male (Male)
C0086582 (UMLS CUI [1,1])
Age
Item
Age of patient
string
C0001779 (UMLS CUI [1,1])
Item
Primary disease state of patient
string
C0205225 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0449438 (UMLS CUI [1,3])
Code List
Primary disease state of patient
CL Item
Chronic Lymphocytic Leukemia (Chronic Lymphocytic Leukemia)
Item
Mutational status of the Immunoglobulin Heavy Chain Variable Region Genes (IgHV)
text
C0026882 (UMLS CUI [1,1])
C0449438 (UMLS CUI [1,2])
C4321381 (UMLS CUI [1,3])
C0017337 (UMLS CUI [1,4])
Code List
Mutational status of the Immunoglobulin Heavy Chain Variable Region Genes (IgHV)
CL Item
Unknown (1)
CL Item
Unmutated (2)
Item
Chromosomal alterations as identified by Fluorescence in situ Hybridization (FISH)
string
C0008625 (UMLS CUI [1,1])
C0205396 (UMLS CUI [1,2])
C0162789 (UMLS CUI [1,3])
Code List
Chromosomal alterations as identified by Fluorescence in situ Hybridization (FISH)
CL Item
del 11q (del 11q)
CL Item
del 13q, del 11q (del 13q, del 11q)
CL Item
del 17p, del 13q (del 17p, del 13q)
CL Item
del 17p, del 13q, del 11q (del 17p, del 13q, del 11q)
CL Item
del 17p, del 13q, trisomy 12 (del 17p, del 13q, trisomy 12)

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