Combined mutation of C/EBPa and GATA-2 induce bi-lineage acute erythroid leukemia through transformation of a neomorphic neutrophil-erythroid progenitor [10x RNA-seq]

Acute erythroid leukemia (AEL) most commonly involves transformation of both the myeloid and erythroid lineages. However, the mutations that cause AEL and the nature of the transformed cell that sustains the bi-lineage leukemia phenotype remain unknown. We here show that combined bi-alleCD45.2+LKFcgRII/III+CD55- C/EBPa and GATA-2 zinc finger 1 (ZnF1) mutations are sufficient to induce bi-lineage AEL, and that the leukemia-initiating cell has a Lin–Sca-1–c-Kit+CD150–FcyRII/III+ surface phenotype, consistent with a committed myeloid progenitor. However, we find that in the presence of bi-alleCD45.2+LKFcgRII/III+CD55- C/EBPa mutation this cell population acquires ectopic erythroid gene expression and lineage potential, leading to the formation of neomorphic neutrophil-erythroid lineage progenitors, which upon transformation generate the bi-lineage leukemia-initiating cell. These results identify C/EBPa and GATA-2 ZnF1 mutations as causative of AEL, and demonstrate that transcriptional reprogramming by a leukemia-initiating mutation can re-define the lineage output of the resulting leukemia-initiating cells The design for the 10x sort was: 8700 Lin-CD71+CD235a+ and 8700 Lin-CD71-CD235a- single cells were sorted from two human AEL samples and 15000 Lin-CD45. 1-GFP- single cells were sorted from two KLG-E mice. Libraries were preparing using the chromium single cell 3’ reagent kits v2 (10x Genomics, California USA) according to manufacturer’s protocol.