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. 2021 Oct 21;138(16):1391–1405. doi: 10.1182/blood.2021010858

Table 1.

Integration sites within the malignant CAR T cells and their effect on expression of surrounding genes in patient 2

Insert mapping Genomic context and RNA sequencing
Chromosome Insert site* Strand Transcriptional shadow, kbp Gene same strand within shadow§ Observed Log2 FC, malignancy CPM vs ProductCPM In silico evidence of functional product#
chr1 26c145c520 + 18 FAM110D 7.01 FAM110D
chr1 53c455c616 + 25 DMRTB1 12.20
chr1 154c760c298 + 50
chr1 184c030c856 + 60 TSEN15 0.66
chr1 208c989c499 450
chr1 214c453c094 + 40
chr2 57c195c660 + 50
chr2 62c309c188 40
chr3 99c637c483 + 100 COL8A1 9.72 COL8A1
chr3 111c596c609 + 0
chr5 49c702c91 + 120 LINC01020 8.00
chr6 12c023c195 + 120 HIVEP1 2.98 HIVEP1
chr6 35c678c292 + 50 ARMC12 2.99
chr6 90c251c539 50 BACH2 −0.17
chr6 111c857c020 100 FYN 3.14 FYN
chr6 141c455c746 + 40
chr7 7c259c055 + 110 LOC101927354 5.93
chr7 83c404c188 + 50
chr7 143c289c731 + 0
chr8 70c401c154 100 NCOA2 1.05
chr9 36c557c687 + 100 MELK 1.30
chr10 108c310c155 1000 LINC01435*** 11.07
chr12 57c836c644 + 100
chr21 19c588c904 + 100

Insertion sites within the genome, size of transcriptional shadow, and impact on exonic expression of surrounding genes are shown. CAR19 insertions in the malignancy were detected by μ insertion analysis and confirmed on whole-genome sequencing by searching alignment files for paired-end split reads between the CAR19 “contig” and regions of the autosomes, excluding calls that did not indicate a full-length insertion of CAR19. Transcriptional shadow was directly visualized using the Integrative Genomics Viewer - Broad Institute. Expression of genes within the transcriptional shadow and on the same strand was evaluated based on total exon counts, and functional impact of intronic insertion sites was estimated by determining whether missing exons interrupted the ORF based on gene annotation. If open reading frame interruption was seen, in silico translation of the spliced product was performed (expasy.org) and compared with the wild-type (WT) protein sequence (www.ebi.ac.uk/Tools/msa/clustalo/). If the resultant sequence retained the WT sequence (in-frame deletion), functional domains (uniprot.org) were evaluated to estimate the likelihood of the altered product retaining activity.

chr, chromosome; FC, fold change; MalignancyCPM, counts per million in malignant T cells; ProductCPM, counts per million in CD4 CAR T cells from the product.

*

Insert site indicates the nucleotide position of the insert on the chromosome.

Strand (+ or −) indicates the orientation of the transgene.

Transcriptional shadow indicates the presence and length of transcriptional readthrough seen in kilobase pairs as directly visualized in IGV.

§

Gene same strand within shadow indicates the name of genes potentially impacted by the transcriptional readthrough seen.

Observed Log2FC is the total increase in transcription within the gene affected by the transcriptional shadow including exonic, intronic, and out-of-frame sequences compared with the CAR T-cell product expressed as log2 fold change.

#

In silico evidence of functional product indicates genes with increased functional protein compared with the CAR T-cell product based on splicing analysis.

**

LINC01435* is long noncoding RNA not associated with malignancy.