机构:[1]Capital Med Univ, Beijing Tongren Hosp, Dept Hematol, Beijing 100730, Peoples R China临床科室血液内科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[2]Naval Med Univ, Shanghai Changzheng Hosp, Myeloma & Lymphoma Ctr, Dept Hematol, Shanghai 200003, Peoples R China[3]Sun Yat Sen Univ, Collaborat Innovat Ctr Canc Med, State Key Lab Oncol South China, Canc Ctr, Guangzhou 510060, Guangdong, Peoples R China[4]Guangxi Med Univ, Clin Res Ctr, Affiliated Hosp 2, Nanning 530007, Guangxi, Peoples R China[5]Guangxi Med Univ, Intens Care Unit, Affiliated Hosp 2, Nanning 530007, Guangxi, Peoples R China[6]YuanDong Int Acad Life Sci, Dept Basic Sci, Hong Kong 999077, Peoples R China[7]YuanDong Int Acad Life Sci, Expt Ctr BIOQGene, Hong Kong 999077, Peoples R China
Background Multiple myeloma (MM) is a heterogeneous disease with different patterns of clonal evolution and a complex tumor microenvironment, representing a challenge for clinicians and pathologists to understand and dissect the contribution and impact of polyclonality on tumor progression. Methods In this study, we established a global cell ecological landscape of the bone marrow (BM) from MM patients, combining single-cell RNA sequencing and single-molecule long-read genome sequencing data. Results The malignant mutation event was localized to the tumor cell clusters with shared mutation of ANK1 and IFITM2 in all malignant subpopulations of all MM patients. Therefore, these two variants occur in the early stage of malignant clonal origin to mediate the malignant transformation of proplasmacytes or plasmacytes to MM cells. Tumor cell stemness index score and pseudo-sequential clonal evolution analysis can be used to divide the evolution model of MM into two clonal origins: types I and IX. Notably, clonal evolution and the tumor microenvironment showed an interactive relationship, in which the evolution process is not only selected by but also reacts to the microenvironment; thus, vesicle secretion enriches immune cells with malignant-labeled mRNA for depletion. Interestingly, microenvironmental modification exhibited significant heterogeneity among patients. Conclusions This characterization of the malignant clonal evolution pattern of MM at the single-cell level provides a theoretical basis and scientific evidence for a personalized precision therapy strategy and further development of a potential new adjuvant strategy combining epigenetic agent and immune checkpoint blockade.
基金:
National Natural Science Foundation of China [81873450, 82170181]; Beijing Municipal Administration of Hospitals' Youth Program [QMS20200201]