Detection of AML-specific TP53 mutations in bone marrow–derived mesenchymal stromal cells cultured under hypoxia conditions

  • Marian Müller
  • Ricarda Graf
  • Karl Kashofer
  • Susanne Macher
  • Albert Wölfler
  • Armin Zebisch
  • Andelko Hrzenjak
  • Ellen Heitzer
  • Heinz SillEmail author
Open Access
Letter to the Editor

Dear Editor,

TP53 mutations are early events in the pathogenesis of acute myeloid leukemia (AML) and TP53-mutated AML has recently been classified as a distinct subentity [1, 2, 3]. An increasing number of reports postulate that the bone marrow (BM) microenvironment of patients with myeloid malignancies contributes to both leukemogenesis and therapeutic resistance [4]. As disease-specific, somatic aberrations have been reported in cells of the BM microenvironment in these disorders [5, 6], we hypothesized that BM-derived mesenchymal stromal cells (BM-MSCs) are also affected by leukemia-specific mutations in patients with TP53-mutated AML.

The study was approved by the ethics committee of the Medical University of Graz, Austria, and written informed consent was obtained from all patients. Diagnostic, vitally frozen BM specimens from 13 AML patients with somatic TP53 mutations were used for BM-MSC culture (Supplementary Table 1) [7]. One specimen from a patient with Li-Fraumeni-syndrome suffering from therapy-related AML served as a positive control. In accordance with previous reports, these leukemia specimens revealed a complex karyotype (12/14; 86%) and a paucity of cooperating gene mutations (median, 1; range, 0–3) [3]. As outlined in detail in the “Supplementary Methods,” ex vivo culture of mononuclear BM cells was performed under low oxygen conditions (3% pO2 and 5% CO2 at 37 °C) with the addition of human platelet lysate. Adherent cells representing BM-MSCs were cultivated up to a maximum of 4 passages. To obtain pure cell populations, they were further subjected to cell sorting by FACS (FACSAria, BD) using the human monoclonal antibodies CD 73, CD105 (Bioscience), CD90 (Biolegend), and CD34 (Biolegend), CD45, CD14, and HLA-DR (all Beckman Coulter), respectively. In addition, their adipogenic, chondrogenic, and osteogenic differentiation capacity as a characteristic feature of BM-MSCs was demonstrated (Supplementary Fig. 1) [8]. Patient-specific TP53 and cooperating mutations were analyzed in both AML and purified BM-MCS specimens, using the error corrected, high-resolution “Safe-Sequencing System” method as described previously [1, 3]. In AML specimens, somatic TP53 and cooperating mutations were found at variant allele frequencies (VAFs) between 1.5 and 91.2%. In purified BM-MSCs, the leukemia-specific TP53 mutation was detected in 2/13 patients (15%) at VAFs of 0.2% each and confirmed using biological replicates (0.2% and 0.1%, respectively) (Fig. 1). However, apart from one single nucleotide polymorphism in TET2 (c.100C > T, p.L34F [rs111948941], sample #7479), no leukemia-specific, cooperating mutation was detected in BM-MSCs in any of the specimens analyzed (Supplementary Table 2).
Fig. 1

Variant allele frequencies (VAFs) from primary leukemia specimens and purified bone marrow–derived mesenchymal stromal cells (BM-MSCs) from patients with TP53-mutated acute myeloid leukemia (AML). The BM-MSC specimen with a VAF of 47.1% was derived from a patient with Li-Fraumeni syndrome suffering from therapy-related AML serving as a positive control

The detection of somatic, leukemia–specific TP53 mutations in BM-MSCs of AML patients may indicate that these mutations have arisen in common mesodermal ancestors of hematopoietic stem and progenitor cells and BM-MSCs [9]. It further supports the concept of TP53 mutations being early events of acute myeloid leukemogenesis. The demonstration of BM-MSCs affected by leukemia-specific mutations—albeit at low VAFs—might also have practical implications as these cell types are increasingly used as a source of germline, control DNA [10]. Future work will focus on the functional role of the bone marrow microenvironment in this distinct AML subentity.



This work was supported by “Anna-Maurer Fund” and the Austria Science Fund FWF (P 31430-B26).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2019_3680_MOESM1_ESM.docx (332 kb)
ESM 1 (DOCX 331 kb)


  1. 1.
    Lal R, Lind K, Heitzer E, Ulz P, Aubell K, Kashofer K, Middeke JM, Thiede C, Schulz E, Rosenberger A, Hofer S, Feilhauer B, Rinner B, Svendova V, Schimek MG, Rucker FG, Hoefler G, Dohner K, Zebisch A, Wolfler A, Sill H (2017) Somatic TP53 mutations characterize preleukemic stem cells in acute myeloid leukemia. Blood. 129(18):2587–2591CrossRefGoogle Scholar
  2. 2.
    Papaemmanuil E, Gerstung M, Bullinger L, Gaidzik VI, Paschka P, Roberts ND, Potter NE, Heuser M, Thol F, Bolli N, Gundem G, Van Loo P, Martincorena I, Ganly P, Mudie L, McLaren S, O’Meara S, Raine K, Jones DR, Teague JW, Butler AP, Greaves MF, Ganser A, Dohner K, Schlenk RF, Dohner H, Campbell PJ (2016) Genomic classification and prognosis in acute myeloid leukemia. N Engl J Med 374(23):2209–2221CrossRefGoogle Scholar
  3. 3.
    Prochazka KT, Pregartner G, Rucker FG, Heitzer E, Pabst G, Wolfler A, Zebisch A, Berghold A, Dohner K, Sill H (2019) Clinical implications of subclonal TP53 mutations in acute myeloid leukemia. Haematologica. 104(3):516–523CrossRefGoogle Scholar
  4. 4.
    Morrison SJ, Scadden DT (2014) The bone marrow niche for haematopoietic stem cells. Nature. 505(7483):327–334CrossRefGoogle Scholar
  5. 5.
    Garcia-Montero AC, Jara-Acevedo M, Alvarez-Twose I, Teodosio C, Sanchez-Munoz L, Muniz C, Munoz-Gonzalez JI, Mayado A, Matito A, Caldas C, Morgado JM, Escribano L, Orfao A (2016) KIT D816V-mutated bone marrow mesenchymal stem cells in indolent systemic mastocytosis are associated with disease progression. Blood. 127(6):761–768CrossRefGoogle Scholar
  6. 6.
    Azuma K, Umezu T, Imanishi S, Asano M, Yoshizawa S, Katagiri S, Ohyashiki K, Ohyashiki JH (2017) Genetic variations of bone marrow mesenchymal stromal cells derived from acute leukemia and myelodysplastic syndrome by targeted deep sequencing. Leuk Res 62:23–28CrossRefGoogle Scholar
  7. 7.
    Olipitz W, Hopfinger G, Aguiar RC, Gunsilius E, Girschikofsky M, Bodner C, Hiden K, Linkesch W, Hoefler G, Sill H (2002) Defective DNA-mismatch repair: a potential mediator of leukemogenic susceptibility in therapy-related myelodysplasia and leukemia. Genes Chromosom Cancer 34(2):243–248CrossRefGoogle Scholar
  8. 8.
    Dominici M, Le Blanc K, Mueller I, Slaper-Cortenbach I, Marini F, Krause D, Deans R, Keating A, Prockop D, Horwitz E (2006) Minimal criteria for defining multipotent mesenchymal stromal cells. The International Society for Cellular Therapy position statement. Cytotherapy. 8(4):315–317CrossRefGoogle Scholar
  9. 9.
    Ratajczak MZ (2015) A novel view of the adult bone marrow stem cell hierarchy and stem cell trafficking. Leukemia. 29(4):776–782CrossRefGoogle Scholar
  10. 10.
    Mujahed H, Jansson M, Bengtzen S, Lehamnn S (2017) Bone marrow stroma cells derived from mononuclear cells at diagnosis as a source of germline control DNA for determination of somatic mutations in acute myeloid leukemia. Blood Cancer J 7(10):e616CrossRefGoogle Scholar

Copyright information

© The Author(s) 2019

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  • Marian Müller
    • 1
  • Ricarda Graf
    • 2
  • Karl Kashofer
    • 3
  • Susanne Macher
    • 4
  • Albert Wölfler
    • 1
  • Armin Zebisch
    • 1
  • Andelko Hrzenjak
    • 5
    • 6
  • Ellen Heitzer
    • 2
  • Heinz Sill
    • 1
    Email author
  1. 1.Division of HematologyMedical University of GrazGrazAustria
  2. 2.Institute of Human Genetics, Diagnostic and Research Center for Molecular BiomedicineMedical University of GrazGrazAustria
  3. 3.Institute of PathologyMedical University of GrazGrazAustria
  4. 4.Department for Blood Group Serology and Transfusion MedicineMedical University of GrazGrazAustria
  5. 5.Division of PulmonologyMedical University of GrazGrazAustria
  6. 6.Ludwig Boltzmann Institute for Lung Vascular ResearchGrazAustria

Personalised recommendations