Abstract A44: The role of PHF6 in maintaining pre-B cell commitment in B-cell acute lymphoblastic leukemia

Loss of function mutations in the plant homeodomain factor 6 (PHF6) are responsible for the Borjeson–Forssman–Lehmann syndrome, a familial X-linked intellectual disability disorder, and are observed in approximately 20% of adult T-cell acute lymphoblastic leukemias (T-ALLs) and 3% of adult acute myeloid leukemias (AMLs). However, mutations in B-cell lineage malignancies are notably absent. Interestingly, our recent work has uncovered PHF6 as a positive growth regulator in B-cell acute lymphoblastic leukemia (B-ALL) through a genome-scale in vivo loss-of-function screen. To identify the molecular mechanism by which PHF6 acts to promote B-ALL growth in vivo, we utilized CRISPR-Cas9 to delete Phf6 in murine B-ALL cells. Transplantation of Phf6 knockout cells ( Phf6 KO ) into immunocompetent syngeneic recipients significantly extends disease latency and survival, therefore validating PHF6 as a bona fide positive growth regulator of B-ALL in vivo . Strikingly, these mice develop lymphoma-like disease with complete penetrance, characterized by significantly enlarged lymph nodes, decreased disease burden in the spleen and increased expression of the canonical T-cell marker CD4, suggesting that Phf6 KO B-ALL cells transdifferentiated to cells resembling those of the T-cell lineage. To dissect the mechanism by which PHF6 regulates this lineage decision, we carried out a combination of RNA sequencing and chromatin immunoprecipitation (ChIP) analyses in Phf6 WT and Phf6 KO cells. RNA sequencing analysis revealed many differentially expressed genes in Phf6 KO B-ALL cells , including gene sets involved in pathways important for B-cell development. ChIP-sequencing analysis of PHF6 and several histone marks (H3K27Ac, H3K27me3, H3K4me3) in Phf6 WT B-ALL cells revealed that PHF6 and H3K27Ac signals co-localize close to the transcription start site of a significant proportion of differentially expressed genes. Transcription factor binding motif analysis revealed significant enrichment for several well-described master regulators of B-cell development, including PU.1, EGR-1, EBF-1, NF-κB and TCF3/TCF12. Notably, a number of these predicted transcription factors co-immunoprecipitated with PHF6 in Phf6 WT B-ALL cells. These findings reveal an essential role for PHF6 in the maintenance of B-cell identity in B-ALL by activating, directly or indirectly, genes that are crucial for B-cell lineage commitment. Collectively, these results indicate that loss-of-function of PHF6 in B-ALL leads to transdifferentiation to the T-cell lineage, potentially explaining the apparent absence of PHF6 mutations in human B cell-lineage malignancies. Citation Format: Yadira M. Soto-Feliciano, Jordan ME Bartlebaugh, Yunpeng Liu, Francisco J. Sanchez-Rivera, Abraham S. Weintraub, Arjun Bhutkar, Tyler E. Jacks, Richard A. Young, Michael T. Hemann. The role of PHF6 in maintaining pre-B cell commitment in B-cell acute lymphoblastic leukemia. [abstract]. In: Proceedings of the AACR Special Conference on Chromatin and Epigenetics in Cancer; Sep 24-27, 2015; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2016;76(2 Suppl):Abstract nr A44.