The coding genome of splenic marginal zone lymphoma: activation of NOTCH2 and other pathways regulating marginal zone development

D Rossi, V Trifonov, M Fangazio… - Journal of Experimental …, 2012 - rupress.org
D Rossi, V Trifonov, M Fangazio, A Bruscaggin, S Rasi, V Spina, S Monti, T Vaisitti, F Arruga…
Journal of Experimental Medicine, 2012rupress.org
Splenic marginal zone lymphoma (SMZL) is a B cell malignancy of unknown pathogenesis,
and thus an orphan of targeted therapies. By integrating whole-exome sequencing and copy-
number analysis, we show that the SMZL exome carries at least 30 nonsilent gene
alterations. Mutations in NOTCH2, a gene required for marginal-zone (MZ) B cell
development, represent the most frequent lesion in SMZL, accounting for∼ 20% of cases.
All NOTCH2 mutations are predicted to cause impaired degradation of the NOTCH2 protein …
Splenic marginal zone lymphoma (SMZL) is a B cell malignancy of unknown pathogenesis, and thus an orphan of targeted therapies. By integrating whole-exome sequencing and copy-number analysis, we show that the SMZL exome carries at least 30 nonsilent gene alterations. Mutations in NOTCH2, a gene required for marginal-zone (MZ) B cell development, represent the most frequent lesion in SMZL, accounting for ∼20% of cases. All NOTCH2 mutations are predicted to cause impaired degradation of the NOTCH2 protein by eliminating the C-terminal PEST domain, which is required for proteasomal recruitment. Among indolent B cell lymphoproliferative disorders, NOTCH2 mutations are restricted to SMZL, thus representing a potential diagnostic marker for this lymphoma type. In addition to NOTCH2, other modulators or members of the NOTCH pathway are recurrently targeted by genetic lesions in SMZL; these include NOTCH1, SPEN, and DTX1. We also noted mutations in other signaling pathways normally involved in MZ B cell development, suggesting that deregulation of MZ B cell development pathways plays a role in the pathogenesis of ∼60% SMZL. These findings have direct implications for the treatment of SMZL patients, given the availability of drugs that can target NOTCH, NF-κB, and other pathways deregulated in this disease.
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