Dissemin is shutting down on January 1st, 2025

Published in

Wiley, Hematological Oncology, S2(39), 2021

DOI: 10.1002/hon.43_2879

American Society of Hematology, Blood, 5(139), p. 732-747, 2022

DOI: 10.1182/blood.2021012386

Links

Tools

Export citation

Search in Google Scholar

Genetic and phenotypic attributes of splenic marginal zone lymphoma

Journal article published in 2022 by Ferdinando Bonfiglio ORCID, Lodovico Terzi di Bergamo, Alessio Bruscaggin, Lodovico Terzi di Bergamo, Francesca Guidetti, Martin Richard Faderl ORCID, Valeria Spina, Adalgisa Condoluci, Luisella Bonomini, Gabriela Forestieri, Ricardo Koch, Deborah Piffaretti, Katia Pini, Maria Cristina Pirosa ORCID, Micol Giulia Cittone ORCID and other authors.
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

Full text: Download

Green circle
Preprint: archiving allowed
Orange circle
Postprint: archiving restricted
Red circle
Published version: archiving forbidden
Data provided by SHERPA/RoMEO

Abstract

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 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.