Abstract

Follicular Lymphoma an Epigenetic Addicted Cancer

Jude Fitzgibbon, Professor, Queen Mary University Of London

Follicular lymphoma is the most common indolent non-Hodgkin’s lym¬phoma and remains a significant clinical burden. Although these tumours are chemo-sensitive, the disease is incurable, with many patients experiencing a relapsing remitting clinical course. Our centre have developed one of the largest series of sequential tumour biopsies worldwide and this has allowed us to trace the acquisition of genetic changes in these tumours over time. We have uncovered a highly complex pattern of tumour evolution, consistent with the existence of a common progenitor B cell population (Fitzgibbon Monoto J Clinical Oncology 2011) from which each new episode of disease is thought to arise and have employed an in-depth characterization and chronicling of the underlying genetic events using Next Generation Sequencing (NGS) tools. These experiments are informing new precision approaches to care centring on H3K4 and K27 chromatin marks, and based around activating mutations in the histone methyltransferase, EZH2 and KMT2D (Bodor et al., Blood 2013; Okosun et al., Nature Genetics 2014, 2015).