Publications
Nature immunologySep 2022 DOI:
10.1038/s41590-022-01314-y

NUDT21 limits CD19 levels through alternative mRNA polyadenylation in B cell acute lymphoblastic leukemia

Witkowski, Matthew T; Lee, Soobeom; Wang, Eric; Lee, Anna K; Talbot, Alexis; Ma, Chao; Tsopoulidis, Nikolaos; Brumbaugh, Justin; Zhao, Yaqi; Roberts, Kathryn G; Hogg, Simon J; Nomikou, Sofia; Ghebrechristos, Yohana E; Thandapani, Palaniraja; Mullighan, Charles G; Hochedlinger, Konrad; Chen, Weiqiang; Abdel-Wahab, Omar; Eyquem, Justin; Aifantis, Iannis
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Abstract
B cell progenitor acute lymphoblastic leukemia (B-ALL) treatment has been revolutionized by T cell-based immunotherapies-including chimeric antigen receptor T cell therapy (CAR-T) and the bispecific T cell engager therapeutic, blinatumomab-targeting surface glycoprotein CD19. Unfortunately, many patients with B-ALL will fail immunotherapy due to 'antigen escape'-the loss or absence of leukemic CD19 targeted by anti-leukemic T cells. In the present study, we utilized a genome-wide CRISPR-Cas9 screening approach to identify modulators of CD19 abundance on human B-ALL blasts. These studies identified a critical role for the transcriptional activator ZNF143 in CD19 promoter activation. Conversely, the RNA-binding protein, NUDT21, limited expression of CD19 by regulating CD19 messenger RNA polyadenylation and stability. NUDT21 deletion in B-ALL cells increased the expression of CD19 and the sensitivity to CD19-specific CAR-T and blinatumomab. In human B-ALL patients treated with CAR-T and blinatumomab, upregulation of NUDT21 mRNA coincided with CD19 loss at disease relapse. Together, these studies identify new CD19 modulators in human B-ALL.
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