La leucémie à tricholeucocytes (ou HCL pour Hairy Cell Leukemia) est un syndrôme lymphoprolifératif B rare du sujet âgé, caractérisé par une infiltration médullaire et splénique de cellules présentant des protrusions cytoplasmiques. Des thérapies de première ligne efficaces existent contre ce cancer et l’intérêt de la recherche biomédicale dans ce domaine réside désormais dans le développement de nouvelles molécules actives contre les cellules leucémiques réfractaires aux traitements de référence. Parmi les voies de signalisation dérégulées dans l’HCL, celle des Rho-GTPases influe sur les phénomènes de croissance cellulaire et d’organisation du cytosquelette d’actine, perturbés dans les tricholeucocytes. Les travaux précédemment menés au laboratoire ont montré la sous-expression dans l’HCL d’une Rho-GTPase atypique, RhoH, dont l’expression ectopique dans un modèle cellulaire d’HCL atténue la progression tumorale. Afin de déterminer les cibles moléculaires de RhoH dans cette leucémie, une étude transcriptomique a été réalisée et a montré la sous-expression du marqueur de surface CD38 lorsque RhoH est surexprimée.Plus qu’un marqueur de différenciation lymphocytaire, CD38 est une molécule à effets pléïotropiques (à la fois récepteur, enzyme et protéine d’adhérence cellulaire), importante dans le développement des lymphocytes B. CD38 a également été décrit comme un marqueur délétère dans la leucémie lymphoïde chronique et représente une cible thérapeutique dans le myélome multiple. Bien qu’exprimé par un tiers des patients porteurs de l’HCL, son rôle dans cette leucémie restait jusqu’alors inconnu.Les travaux présentés dans cette thèse décrivent, d’une part, l’étude de la régulation du gène CD38 par RhoH dans l’HCL, et d’autre part, l’impact de la protéine CD38 dans la progression de cette leucémie. Des données préliminaires sur l’activité de fragments de promoteur du gène CD38 semblent indiquer un rôle du facteur de transcription Smad1 dans la régulation de ce gène par RhoH. Grâce à une technique de genome editing, nous avons produit deux lignées cellulaires HCL knock out pour le gène CD38. Ces modèles nous ont permis de déterminer que CD38 promeut la survie ainsi que l’adhésion à l’endothélium des cellules HCL, et modifie également leurs propriétés migratoires in vitro. Nous avons également observé que CD38 favorisait la progression tumorale dans un modèle murin de xénogreffe de ces lignées cellulaires. Enfin, des données produites par nos collaborateurs ont montré que CD38 est un marqueur de mauvais pronostic pour la rechute des patients atteints d’HCL et qu’il constitue une cible thérapeutique potentielle pour les 30% de patients qui l’expriment.Mimer l’effet de RhoH dans l’HCL à des fins thérapeutiques s’avèrerait délicat. Le ciblage de CD38 semble donc une alternative de choix. En effet, la sous-expression de RhoH dans l’HCL favorise l’expression de cette protéine, dont l’effet est délétère pour les patients puisqu’elle participe à la progression de la leucémie. Les anticorps monoclonaux thérapeutiques dirigés contre CD38 étant déjà utilisés en clinique pour traiter d’autres leucémies, ce travail ouvre la voie à l’extension de leur utilisation dans le traitement de l’HCL réfractaire, pour les patients qui l’expriment. / Hairy Cell Leukemia (HCL) is a B-lymphoproliferative disorder of the elderly, which is characterized by medullar and splenic homing of “hairy” cells bearing cytoplasmic protrusions. Efficient first-line therapies against this cancer do exist and the real challenge in biomedical research is now to develop new molecules targeting leukemic cells which are resistant to these first-line treatments. Among some deregulated signaling pathways that have been described in HCL, Rho-GTPases are noteworthy, mediating proliferation and reorganization of actin cytoskeleton, being both disrupted in hairy cells. Former works from our laboratory have shown the underexpression in HCL cells of an atypical Rho-GTPase called RhoH, which reconstitution decreased malignant progression in both in vitro and in vivo models of HCL. In order to determine the molecular targets of RhoH, a microarray study was performed that showed underexpression of the cell surface marker CD38 while RhoH is overexpressed.Not only a differentiation marker of lymphocytes, CD38 is a pleiotropic molecule (being at the same time a receptor, an enzyme and an adhesion protein), which is important in B-cell development. It is also known as a bad prognosis marker in chronic lymphocytic leukemia and a therapeutic target in multiple myeloma. Its role in Hairy Cell Leukemia has not been studied yet, despite its expression in one third of HCL patients.The work presented in this thesis deals with, on the one hand, the study of the regulation of CD38 gene by RhoH in HCL, on the other hand, the impact of CD38 protein on HCL progression. Preliminary data seem to indicate a potential role of Smad1 transcription factor in this mechanism of regulation of CD38 by RhoH. Thanks to genome editing technology, we produced two HCL cell lines knock out for the CD38 gene. These models allowed us to prove that CD38 enhances hairy cells survival and adhesion to endothelium, and modulates their migratory features in vitro. We also showed that CD38 promotes disease progression in vivo in an HCL xenograft mouse model. Finally, data from our collaborators indicated that CD38 is a bad prognosis marker for HCL relapses and could be a potential therapeutic target.Mimicking RhoH effects for therapeutic purposes would be somewhat tricky. Targeting CD38 seems an interesting alternative, as RhoH underexpression favours CD38 expression, which is deleterious for patients by enhancing malignant progression. As therapeutic monoclonal antibodies targeting CD38 are already used in clinics to treat other leukemias, this work brings the evidence of their potential usefulness against refractory HCL cases expressing this marker.

<p>B cell lymphomas and leukemias are heterogeneous tumors with different cellular origins. Analysis of immunoglobulin (Ig) genes enables insight into the B cell progenitor, as Ig somatic hypermutation correlates with antigen-related B cell transit through the germinal center (GC). Also, restricted Ig variable heavy chain (V_H) gene repertoires in B cell malignancies could imply antigen selection during tumorigenesis. The length of telomeres has been shown to differ between GC B cells and pre/post-GC B cells, possibly representing an alternative angle to investigate B cell tumor origin. </p><p>Mantle cell lymphoma (MCL), previously postulated to derive from a naïve, pre-GC B cell, was shown to have an Ig-mutated subset (18/110 MCLs, 16%), suggestive of divergent cellular origin and GC exposure. Another subset of MCL (16/110, 15%), characterized by V_H3-21/V_λ3-19 gene usage, alludes to a role for antigen(s) in pathogenesis, also possible for hairy cell leukemia (HCL) in which the V_H3-30 gene (6/32, 19%) was overused. HCL consisted mainly of Ig-mutated cases (27/32, 84%) with low level intraclonal heterogeneity, contrasting with the proposed post-GC origin, for both Ig-mutated and Ig-unmutated HCLs. For MCL and HCL, derivation from naïve or memory marginal zone B cells which may acquire mutations without GC transit are tempting speculations, but currently little is known about this alternative immunological pathway. Heavily mutated Ig genes without intraclonal heterogeneity were demonstrated in lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia (13/14, 93%), confirming that the precursor cell was transformed after GC affinity maturation. Telomere length analysis within 304 B cell tumors revealed variable lengths; shortest in the Ig-unmutated subset of chronic lymphocytic leukemia, longest in the GC-like subtype of diffuse large B cell lymphoma, and homogeneous in MCL regardless of Ig mutation status. However, telomere length is complex with regard to GC-related origin.</p><p>In summary, this thesis has provided grounds for speculation that antigens play a role in MCL and HCL pathogenesis, although the potential antigens involved are currently unknown. It has also enabled a more informed postulation about the cellular origin of B cell tumors, which will ultimately enhance understanding of the biological background of the diseases. </p>

B cell lymphomas and leukemias are heterogeneous tumors with different cellular origins. Analysis of immunoglobulin (Ig) genes enables insight into the B cell progenitor, as Ig somatic hypermutation correlates with antigen-related B cell transit through the germinal center (GC). Also, restricted Ig variable heavy chain (VH) gene repertoires in B cell malignancies could imply antigen selection during tumorigenesis. The length of telomeres has been shown to differ between GC B cells and pre/post-GC B cells, possibly representing an alternative angle to investigate B cell tumor origin. Mantle cell lymphoma (MCL), previously postulated to derive from a naïve, pre-GC B cell, was shown to have an Ig-mutated subset (18/110 MCLs, 16%), suggestive of divergent cellular origin and GC exposure. Another subset of MCL (16/110, 15%), characterized by VH3-21/Vλ3-19 gene usage, alludes to a role for antigen(s) in pathogenesis, also possible for hairy cell leukemia (HCL) in which the VH3-30 gene (6/32, 19%) was overused. HCL consisted mainly of Ig-mutated cases (27/32, 84%) with low level intraclonal heterogeneity, contrasting with the proposed post-GC origin, for both Ig-mutated and Ig-unmutated HCLs. For MCL and HCL, derivation from naïve or memory marginal zone B cells which may acquire mutations without GC transit are tempting speculations, but currently little is known about this alternative immunological pathway. Heavily mutated Ig genes without intraclonal heterogeneity were demonstrated in lymphoplasmacytic lymphoma/Waldenström’s macroglobulinemia (13/14, 93%), confirming that the precursor cell was transformed after GC affinity maturation. Telomere length analysis within 304 B cell tumors revealed variable lengths; shortest in the Ig-unmutated subset of chronic lymphocytic leukemia, longest in the GC-like subtype of diffuse large B cell lymphoma, and homogeneous in MCL regardless of Ig mutation status. However, telomere length is complex with regard to GC-related origin. In summary, this thesis has provided grounds for speculation that antigens play a role in MCL and HCL pathogenesis, although the potential antigens involved are currently unknown. It has also enabled a more informed postulation about the cellular origin of B cell tumors, which will ultimately enhance understanding of the biological background of the diseases.

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 5 uppsatser.