T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive malignancy of thymocytes that is diagnosed in children, adolescents and adults. Although originally associated with high relapse rates, the prognosis of T-ALL has gradually improved with the introduction of intensified chemotherapy, with cure rates in modern protocols reaching over 80% in children and about 50% in adults with this disease. However, the outcome of T-ALL patients with primary resistant or relapsed leukemia remains poor. Therefore, current research efforts are focused on the search for targets for the development of more effective and less toxic antileukemic drugs, which will likely require a greater degree of specificity and an improved understanding of the molecular events that lead to the disease.
In contrast to the wealth of information on gene expression profiles and genetic alterations in T-ALL, information on the DNA methylome is relatively scarce. Indeed, only very few studies have reported on genome-wide DNA methylation patterns in human T-ALL and none of these reports have directly compared, using the same technological platform, T-ALLs with different subsets of normal T cells as their putative cell-of-origin. Therefore, it has been largely unclear if the DNA methylome of human T-ALLs is uniformly perturbed as compared to normal T cells. Furthermore, the molecular mechanisms that drive aberrant DNA methylation profiles in T-ALL have remained unknown so far.
In this research project, we have been able to show that human T-ALLs acquire their aberrant DNA methylation signature as a result of their replicative history, cell-of-origin and leukemia-specific gene expression profile that is driven by patient-specific genetic abnormalities. This epigenetic history of T-cell transformation can be traced back by using 3 main categories of CpG islands or Open Sea CpG sites which show differential methylation between normal and malignant T cells. Notably, these novel insights pave the way towards novel or improved epigenetic therapies for the treatment of human leukemia.