Activation of Hedgehog signaling associates with early disease progression in chronic lymphocytic leukemia
2019
Targeted sequencing of 103 leukemia-associated genes in leukemia cells from 841 treatment-naive patients with
chronic lymphocytic leukemia(CLL) identified 89 (11%) patients have CLL cells with mutations in genes encoding proteins that putatively are involved in
Hedgehog(Hh) signaling. Consistent with this, we found that there was a significant association between the presence of these mutations and the expression of
GLI1(Chi square test P + . Patients with
GLI1+ CLL cells had a shorter median treatment free survival (TFS) than patients with CLL cells lacking expression of
GLI1independent of
IGHVmutation status. We found that GANT61, a small molecule that can inhibit
GLI1, was highly cytotoxic for
GLI1+ CLL cells relative to that of CLL cells without
GLI1. Collectively, this study shows that a large proportion of patients have CLL cells with activated Hh-signaling, which is associated with early disease progression and enhanced sensitivity to inhibition of
GLI1.
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