TY - JOUR
T1 - Single-cell heterogeneity in Sézary syndrome.
AU - Buus, Terkild Brink
AU - Willerslev-Olsen, Andreas
AU - Fredholm, Simon Mayland
AU - Blümel, Edda
AU - Nastasi, Claudia
AU - Gluud, Maria
AU - Hu, Tengpeng
AU - Lindahl, Lise M.
AU - Iversen, Lars
AU - Fogh, Hanne
AU - Gniadecki, Robert
AU - Litvinov, Ivan V.
AU - Persson, Jenny L.
AU - Bonefeld, Charlotte Menne
AU - Geisler, Carsten
AU - Christensen, Jan Pravsgaard
AU - Krejsgaard, Thorbjørn Frej
AU - Litman, Thomas
AU - Andersen, Anders Woetmann
AU - Ødum, Niels
PY - 2018/8/28
Y1 - 2018/8/28
N2 - Sézary syndrome (SS) is an aggressive leukemic variant of cutaneous T-cell lymphoma (CTCL) with a median life expectancy of less than 4 years. Although initial treatment responses are often good, the vast majority of patients with SS fail to respond to ongoing therapy. We hypothesize that malignant T cells are highly heterogeneous and harbor subpopulations of SS cells that are both sensitive and resistant to treatment. Here, we investigate the presence of single-cell heterogeneity and resistance to histone deacetylase inhibitors (HDACi) within primary malignant T cells from patients with SS. Using single-cell RNA sequencing and flow cytometry, we find that malignant T cells from all investigated patients with SS display a high degree of single-cell heterogeneity at both the mRNA and protein levels. We show that this heterogeneity divides the malignant cells into distinct subpopulations that can be isolated by their expression of different surface antigens. Finally, we show that treatment with HDACi (suberanilohydroxamic acid and romidepsin) selectively eliminates some subpopulations while leaving other subpopulations largely unaffected. In conclusion, we show that patients with SS display a high degree of single-cell heterogeneity within the malignant T-cell population, and that distinct subpopulations of malignant T cells carry HDACi resistance. Our data point to the importance of understanding the heterogeneous nature of malignant SS cells in each individual patient to design combinational and new therapies to counter drug resistance and treatment failure.
AB - Sézary syndrome (SS) is an aggressive leukemic variant of cutaneous T-cell lymphoma (CTCL) with a median life expectancy of less than 4 years. Although initial treatment responses are often good, the vast majority of patients with SS fail to respond to ongoing therapy. We hypothesize that malignant T cells are highly heterogeneous and harbor subpopulations of SS cells that are both sensitive and resistant to treatment. Here, we investigate the presence of single-cell heterogeneity and resistance to histone deacetylase inhibitors (HDACi) within primary malignant T cells from patients with SS. Using single-cell RNA sequencing and flow cytometry, we find that malignant T cells from all investigated patients with SS display a high degree of single-cell heterogeneity at both the mRNA and protein levels. We show that this heterogeneity divides the malignant cells into distinct subpopulations that can be isolated by their expression of different surface antigens. Finally, we show that treatment with HDACi (suberanilohydroxamic acid and romidepsin) selectively eliminates some subpopulations while leaving other subpopulations largely unaffected. In conclusion, we show that patients with SS display a high degree of single-cell heterogeneity within the malignant T-cell population, and that distinct subpopulations of malignant T cells carry HDACi resistance. Our data point to the importance of understanding the heterogeneous nature of malignant SS cells in each individual patient to design combinational and new therapies to counter drug resistance and treatment failure.
U2 - 10.1182/bloodadvances.2018022608
DO - 10.1182/bloodadvances.2018022608
M3 - Journal article
C2 - 30139925
SN - 2473-9529
VL - 2
SP - 2115
EP - 2126
JO - Blood advances
JF - Blood advances
IS - 16
ER -