Immunoglobulin (IG) gene repertoire restrictions strongly support antigen selection in the pathogenesis of chronic lymphocytic leukemia (CLL). Given the emerging multifarious interactions between CLL and bystander T cells, we sought to determine whether antigen(s) are also selecting T cells in CLL. We performed a large-scale, next-generation sequencing (NGS) study of the T-cell repertoire, focusing on major stereotyped subsets representing CLL subgroups with undisputed antigenic drive, but also included patients carrying non-subset IG rearrangements to seek for T-cell immunogenetic signatures ubiquitous in CLL. Considering the inherent limitations of NGS, we deployed bioinformatics algorithms for qualitative curation of T-cell receptor rearrangements, and included multiple types of controls. Overall, we document the clonal architecture of the T-cell repertoire in CLL. These T-cell clones persist and further expand overtime, and can be shared by different patients, most especially patients belonging to the same stereotyped subset. Notably, these shared clonotypes appear to be disease-specific, as they are found in neither public databases nor healthy controls. Altogether, these findings indicate that antigen drive likely underlies T-cell expansions in CLL and may be acting in a CLL subset-specific context. Whether these are the same antigens interacting with the malignant clone or tumor-derived antigens remains to be elucidated.

CEITEC Masaryk University and University Hospital Brno Brno Czech Republic

Department of Immunology Genetics and Pathology Rudbeck Laboratory Uppsala University Uppsala Sweden

Hematology Department and HCT Unit G Papanicolaou Hospital Thessaloniki Greece

Immunology and National Tissue Typing Center General Hospital of Athens 'G Gennimatas' Athens Thessaloniki Greece

Institute of Applied Biosciences CERTH Thessaloniki Greece

Laboratory of Medical Informatics Medical School Aristotle University of Thessaloniki Thessaloniki Greece

Medical School University of Crete Heraklion Greece

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