Epigenetic allele diversity is linked to inferior prognosis in acute myeloid leukemia (AML). However, the source of epiallele heterogeneity in AML is unknown. Herein we analyzed epiallele diversity in a genetically and clinically annotated AML cohort. Notably, AML driver mutations linked to transcription factors and favorable outcome are associated with epigenetic destabilization in a defi ned set of susceptible loci. In contrast, AML subtypes linked to inferior prognosis manifest greater abundance and highly stochastic epiallele patterning. We report an epiallele outcome classifi er supporting the link between epigenetic diversity and treatment failure. Mouse models with TET2 or IDH2 mutations show that epiallele diversity is especially strongly induced by IDH mutations, precedes transformation to AML, and is enhanced by cooperation between somatic mutations. Furthermore, epiallele complexity was partially reversed by epigenetic therapies in AML driven by TET2 / IDH2 , suggesting that epigenetic therapy might function in part by reducing population complexity and fi tness of AMLs.

doi.org/10.1158/2159-8290.Cd-19-0897, hdl.handle.net/1765/134753
Cancer Discovery
Rotterdam Institute of Law and Economics

S. Li (Sheng), Chen, Xiao Wen, J. Wang (Jiahui), Meydan, Cem, Glass, Jacob L., Shih, A., … Melnick, A. (2020). Somatic Mutations Drive Specific, but Reversible, Epigenetic Heterogeneity States in AML. Cancer Discovery, 10(12), 1934–1949. doi:10.1158/2159-8290.Cd-19-0897