Genome-Wide Profiling of Endothelial Progenitor Cells in Multiple Myeloma: Overlaps with Myeloma Tumor Cells and Common Cancer Gene-Pathways.
Authors: Braunstein Marc J. , Carrasco Daniel R. , Campagne Fabien , Mukherjee Piali , Sukhdeo Kumar , Protopopov Alexei , Anderson Kenneth C. , Batuman Olcay A. 
Published: April 2020

Abstract
Background: In multiple myeloma (MM), bone-marrow-derived endothelial progenitor cells (EPCs) contribute to tumor neoangiogenesis, and their levels covary with tumor mass and prognosis. Recent X-chromosome inactivation studies showed that EPCs are clonally restricted in MM. In addition, high-resolution array comparative genomic hybridization (aCGH) found that the genomes of EPCs and MM cells display similar chromosomal gains and losses in the same patient. In this study, we performed an integrative analysis of EPCs and tumor cells by genome-wide expression profiling, and applied a bioinformatics approach that leverages gene expression data from cancer datasets to mine MM gene pathways common to multiple tumor tissues and likely involved in MM pathogenesis.
Methods: Confluent EPCs (&gt;98% vWF/CD133/KDR+ and CD38−) were outgrown from 22 untreated MM patients’ bone marrow aspirates by adherence to laminin. The fractions enriched for tumor cells were &gt;50% CD38+. For gene expression profiling, total RNA from EPCs, MM cells, and control HUVECs were hybridized to cDNA microarrays, and comparisons were made by analysis of variance.
Results: Two sets of EPC gene profiles were of particular interest. The first contained genes that differ significantly between EPCs and HUVEC, but not between EPCs and tumor (Profile 1). We hypothesize that this profile is a consequence of the clonal identity previously reported between EPCs and tumor, and that a subset of these genes is largely responsible for MM progression. The second set of important EPC genes are differentially regulated compared both to HUVECs and to tumor cells (Profile 2). These genes may represent the profile of EPCs that are clonally diverse from tumor cells but nevertheless display common gene expression patterns with other cancers. Profile 2 genes may also represent genes that confer a predisposition to clonal transformation of EPCs. When genes in Profile 1 and Profile 2 were overlapped with published lists of cancer biomarkers, significant similarities (P&lt;.05) were apparent. The largest overlaps were observed with the HM200 gene list, a list composed of 200 genes most consistently differentially expressed in human/mouse cancers (Campagne and Skrabanek, BMC Bioinformatics 2006). More than 80% of genes in either EPC profile have not been previously characterized in MM, but have been identified as cancer biomarkers in other cancer studies. These genes will be presented and discussed in the context of MM. Current studies are aimed at integrating Profile 1 and Profile 2 genes in each patient with chromosomal copy number abnormalities (CNAs) found in EPCs, and also with clinical stage and disease severity, in order to elucidate the pathogenic information that the profiles hold.
Conclusions: The genomes of EPCs display ranges of overlap with tumor cells in MM, evidenced by gene expression profiles with varying similarity to those found in MM tumor cells. More importantly, MM EPC gene expression profiles, in contrast to normal endothelial cells, contain cancer biomarker genes in tumors not yet associated with MM. Results strongly support the concept that EPCs are an integral part of the neoplastic process in MM.