Analyse épigénétique intégrative pour identifier de nouveaux biomarqueurs dans la leucémie myéloïde aiguë causée par des translocations chromosomiques de type KMT2A

Leukemia is a form of cancer that affects blood cells. Depending on the affected cell lineage and the rate at which the cancer grows, leukemia can be myeloid or lymphoid, or acute or chronic, respectively. In children, they are often characterized by the presence of chromosomal translocations, in particular involving the KMT2A gene. The biological impact of these gene fusions, known to be epigenetic disruptors, is still poorly understood.  To study the consequences of the presence of gene fusions involving KMT2A, we have developed a human leukemia model. The model consists of transducing hematopoietic stem and progenitor cells (CD34+) from a single healthy donor with a retrovirus bearing an oncogenic fusion. These cells are injected into immunodeficient mice to produce acute myeloid or lymphoid leukemia after a few weeks. By using this model, we aim to define genes that are epigenetically regulated and essential in the process of leukemogenesis mediated by KMT2A gene fusions.  The first part of this thesis characterized the genetic and epigenetic changes at each step of leukemogenesis caused by KMT2A-MLLT3 gene fusion. We investigated epigenetic changes such as DNA methylation (Methyl-seq), histone marks (ChIP-seq), and chromatin accessibility (ATAC-seq) and correlated these with expression changes (RNA-seq). We observed that acute myeloid leukemias exhibit a profound hypomethylation phenotype while expression changes after addition of the fusion highlighted the loss of stem cell associated genes and alterations in other genes implicated in leukemogenesis such as S100A8/9 in the early stages of leukemic transformation. Our ATAC-seq data showed that there were relatively few changes specific to acute myeloid leukemia and that the vast majority corresponded to open chromatin regions and clusters of transcription factors previously seen in other types of blood cells. Examination of ChIP-seq data for active histone marks revealed that leukemia specific expression of the chemokine CCL23 can enable autocrine signalling through its cognate receptor, CCR1. Our results suggest that KMT2A-MLLT3 induces minimal changes in the epigenome while co-opting the normal transcriptional machinery to drive leukemogenesis.  The second part of this thesis focuses on KMT2A-MLLT4 gene fusion, another chromosomal translocation for which the vital prognosis of patients is known to be worse than that of patients carrying the KMT2A-MLLT3 fusion. The extension of our model to the KMT2A-MLLT4 fusion allows us to apply the same approaches and to characterize the genetic and epigenetic differences between these two different leukemias. We were able to observe a dramatic decrease in the expression level of a group of genes involved in ribosomal and translational processes. Furthermore, PROM1 (CD133) acts as a potential biomarker candidate which might be used to make the distinction between these two leukemias. LPL gene might play a role in leukemogenesis mediated by KMT2A-MLLT4 gene fusion.  In conclusion, studying the mechanisms at each stage of leukemic development has provided us with a better understanding of the epigenetic changes involved in the process of leukemogenesis mediated by KMT2A rearrangements. A better characterization of the pathophysiology of leukemia could make it possible to eventually develop more targeted therapeutic treatments.

Keyphrases: KMT2A-MLLT3, KMT2A-MLLT4, RNA-seq, ChIP-seq, Methyl-seq, ATAC-seq, Leukemia, Epigenetics, DNA methylation, Histone marks, Chromatin, Transcription factors