Distinct evolution and dynamics of epigenetic and genetic heterogeneity in acute myeloid leukemia

Sheng Li, Francine E. Garrett-Bakelman, Stephen S. Chung, Mathijs A. Sanders, Todd Hricik, Franck Rapaport, Jay Patel, Richard Dillon, Priyanka Vijay, Anna L. Brown, Alexander E. Perl, Joy Cannon, Lars Bullinger, Selina Luger, Michael Becker, Ian D. Lewis, Luen Bik To, Ruud Delwel, Bob Löwenberg, Hartmut DöhnerKonstanze Döhner, Monica L. Guzman, Duane C. Hassane, Gail J. Roboz, David Grimwade, Peter J.M. Valk, Richard J. D'Andrea, Martin Carroll, Christopher Y. Park, Donna Neuberg, Ross Levine, Ari M. Melnick, Christopher E. Mason

Research output: Contribution to journalArticlepeer-review

253 Scopus citations


Genetic heterogeneity contributes to clinical outcome and progression of most tumors, but little is known about allelic diversity for epigenetic compartments, and almost no data exist for acute myeloid leukemia (AML). We examined epigenetic heterogeneity as assessed by cytosine methylation within defined genomic loci with four CpGs (epialleles), somatic mutations, and transcriptomes of AML patient samples at serial time points. We observed that epigenetic allele burden is linked to inferior outcome and varies considerably during disease progression. Epigenetic and genetic allelic burden and patterning followed different patterns and kinetics during disease progression. We observed a subset of AMLs with high epiallele and low somatic mutation burden at diagnosis, a subset with high somatic mutation and lower epiallele burdens at diagnosis, and a subset with a mixed profile, suggesting distinct modes of tumor heterogeneity. Genes linked to promoter-associated epiallele shifts during tumor progression showed increased single-cell transcriptional variance and differential expression, suggesting functional impact on gene regulation. Thus, genetic and epigenetic heterogeneity can occur with distinct kinetics likely to affect the biological and clinical features of tumors.

Original languageEnglish (US)
Pages (from-to)792-799
Number of pages8
JournalNature medicine
Issue number7
StatePublished - Jul 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)


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