Mutagenic impact and evolutionary influence of radiotherapy in hematologic malignancies

Benjamin T. Diamond; Dhanvantri Chahar; Michael David Jain; Alexandra Maria Poos; Michael A. Durante; Bachisio Ziccheddu; Marcella Kaddoura; Marios Papadimitriou; Kylee H. Maclachlan; Tomas Jelinek; Faith E. Davies; Nicholas B. Figura; Gareth John Morgan; Elias Mai; Katja Christina Weisel; Roland R. Fenk; Marc Steffen Raab; Saad Z. Usmani; Ola Landgren; Frederick Lundry Locke; Hartmut Goldschmidt; Jonathan Harry Schatz; Niels Weinhold; Francesco Maura

doi:10.1101/2024.11.15.623836

GenomicsbioRxivNov 15, 2024

Preprint

Mutagenic impact and evolutionary influence of radiotherapy in hematologic malignancies

Benjamin T. Diamond iD, Dhanvantri Chahar iD, Michael David Jain iD, Alexandra Maria Poos iD, Michael A. Durante iD, Bachisio Ziccheddu iD, Marcella Kaddoura iD, Marios Papadimitriou iD, Kylee H. Maclachlan iD, Tomas Jelinek iD, Faith E. Davies iD, Nicholas B. Figura iD, Gareth John Morgan iD, Elias Mai, Katja Christina Weisel iD, Roland R. Fenk iD, Marc Steffen Raab iD, Saad Z. Usmani iD, Ola Landgren iD, Frederick Lundry Locke iD, Hartmut Goldschmidt iD, Jonathan Harry Schatz iD, Niels Weinhold iD, Francesco Maura iD

Abstract

Ionizing radiotherapy (RT) is a widely used palliative and curative treatment strategy for malignancies. In solid tumors, RT-induced double strand breaks lead to the accumulation of indels, and their repair by non-homologous end-joining has been linked to the ID8 mutational signature in resistant cells. However, the extent of RT-induced DNA damage in hematologic malignancies and its impact on their evolution and interplay with commonly used chemotherapies has not yet been explored. Here, we interrogated 580 whole genome sequencing (WGS) from patients with large B-cell lymphoma, multiple myeloma, and myeloid neoplasms and identified ID8 only in relapsed disease. Yet, it was detected after exposure to both RT and mutagenic chemotherapy (i.e., platinum). Using WGS of single-cell colonies derived from treated lymphoma cells, we revealed a dose-response relationship between RT and platinum and ID8. Finally, using ID8 as a genomic barcode we demonstrate that a single RT-resistant cell may seed systemic relapse.

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