Targetable genetic alterations of TCF4 (E2-2) drive immunoglobulin expression in diffuse large B cell lymphoma

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The activated B cell (ABC-like) subtype of diffuse large B cell lymphoma (DLBCL) is characterized by chronic activation of signaling initiated by immunoglobulin m (IgM). By analyzing the DNA copy number profiles of 1000 DLBCL tumors, we identified gains of 18q21.2 as the most frequent genetic alteration in ABC-like DLBCL. Using integrative analysis of matched gene expression profiling data, we found that the TCF4 (E2-2) transcription factor gene was the target of these alterations. Overexpression of TCF4 in ABC-like DLBCL cell lines led to its occupancy on immunoglobulin (IGHM) and MYC gene enhancers and increased expression of these genes at the transcript and protein levels. Inhibition of TCF4 activity with dominant-negative constructs was synthetically lethal to ABC-like DLBCL cell lines harboring TCF4 DNA copy gains, highlighting these gains as an attractive potential therapeutic target. Furthermore, the TCF4 gene was one of the top BRD4-regulated genes in DLBCL cell lines. BET proteolysistargeting chimera (PROTAC) ARV771 extinguished TCF4, MYC, and IgM expression and killed ABC-like DLBCL cells in vitro. In DLBCL xenograft models, ARV771 treatment reduced tumor growth and prolonged survival. This work highlights a genetic mechanism for promoting immunoglobulin signaling in ABC-like DLBCL and provides a functional rationale for the use of BET inhibitors in this disease.


  • Neeraj Jain
  • Keenan Hartert
  • Saber Tadros
  • Warren Fiskus
  • Ondrej Havranek
  • Man Chun John Ma
  • Alyssa Bouska
  • Tayla Heavican
  • Dhiraj Kumar
  • Qing Deng
  • Dalia Moore
  • Christine Pak
  • Chih Long Liu
  • Andrew J. Gentles
  • Elena Hartmann
  • Robert Kridel
  • Karin Ekstrom Smedby
  • Richard Rosenquist
  • Randy D. Gascoyne
  • Andreas Rosenwald
  • Filippo Giancotti
  • Sattva S. Neelapu
  • Jason Westin
  • Julie M. Vose
  • Matthew A. Lunning
  • Timothy Greiner
  • Scott Rodig
  • Javeed Iqbal
  • Ash A. Alizadeh
  • R. Eric Davis
  • Kapil Bhalla
  • Michael R. Green
External organisations
  • University of Texas
  • University of Nebraska Medical Center
  • Stanford University
  • Julius Maximilian University of Würzburg
  • University of Toronto
  • Karolinska University Hospital
  • British Columbia Cancer Agency
  • Brigham and Women's Hospital, Boston
  • Harvard Medical School
  • Karolinska Institutet
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cell and Molecular Biology
  • Medical Biotechnology
Original languageEnglish
Article numbereaav5599
JournalScience Translational Medicine
Issue number497
Publication statusPublished - 2019 Jun 19
Publication categoryResearch