Alterations in the Transcriptional Programs of Myeloma Cells and the Microenvironment during Extramedullary Progression Affect Proliferation and Immune Evasion.
Daeun Ryu, Seok Jin Kim, Yourae Hong, Areum Jo, Nayoung Kim, Hee-Jin Kim, Hae-Ock Lee, Kihyun Kim, Woong-Yang Park
Author Information
Daeun Ryu: Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.
Seok Jin Kim: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yourae Hong: Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.
Areum Jo: Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.
Nayoung Kim: Samsung Genome Institute, Samsung Medical Center, Seoul, Korea.
Hee-Jin Kim: Department of Laboratory Medicine and Genetics, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hae-Ock Lee: Samsung Genome Institute, Samsung Medical Center, Seoul, Korea. woongyang@skku.edu haeock.lee@samsung.com kihyunk.kim@samsung.com.
Kihyun Kim: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. woongyang@skku.edu haeock.lee@samsung.com kihyunk.kim@samsung.com.
Woong-Yang Park: Samsung Genome Institute, Samsung Medical Center, Seoul, Korea. woongyang@skku.edu haeock.lee@samsung.com kihyunk.kim@samsung.com. ORCID
PURPOSE: In multiple myeloma, extramedullary progression is associated with treatment resistance and a high mortality rate. To understand the molecular mechanisms controlling the devastating progression of myeloma, we applied single-cell RNA-sequencing (RNA-seq) to myeloma in the bone marrow and myelomatous pleural effusions or ascites. EXPERIMENTAL DESIGN: Bone marrow or extramedullary myeloma samples were collected from 15 patients and subjected to single-cell RNA-seq. The single-cell transcriptome data of malignant plasma cells and the surrounding immune microenvironment were analyzed. RESULTS: Comparisons of single-cell transcriptomes revealed the systematic activation of proliferation, antigen presentation, proteasomes, glycolysis, and oxidative phosphorylation pathways in extramedullary myeloma cells. The myeloma cells expressed multiple combinations of growth factors and receptors, suggesting autonomous and pleiotropic growth potential at the single-cell level. Comparisons of the tumor microenvironment revealed the presence of cytotoxic T lymphocytes and natural killer (NK) cells in both the bone marrow and extramedullary ascites, demonstrating a gene-expression phenotype indicative of functional compromise. In parallel, isolated myeloma cells persistently expressed class I MHC molecules and upregulated inhibitory molecules for cytotoxic T and NK cells. CONCLUSIONS: These data suggest that myeloma cells are equipped with specialized immune evasion mechanisms in cytotoxic microenvironments. Taken together, single-cell transcriptome analysis revealed transcriptional programs associated with aggressive myeloma progression that support autonomous cell proliferation and immune evasion.