
 
        
         
		SCIENTIFIC PROGRAMME 
 SESSION I  
 THE GENOMIC AND  
 EPIGENOMIC LANDSCAPE  
 OF CLL AND CLINICAL  
 CONSEQUENCES 
 SESSION II 
 THE ROLE OF BCR  
 ACTIVATION AND  
 SIGNALLING FOR CLL 
 SESSION III 
 THERAPEUTIC OPTIONS  
 FOR CLL 
 SESSION IV 
 LONG TERM FOLLOW  
 UP OF CLINICAL TRIALS  
 VERSUS REAL WORLD  
 DATA (OUTSIDE CLINICAL  
 TRIALS DATA-OCT) 
 SESSION V 
 THE INCREASING ROLE  
 OF THE LEUKAEMIC  
 MICROENVIRONMENT 
 SESSION VI 
 THERAPEUTIC OPTIONS 2 :  
 THE USE OF CELLULAR  
 AND NON-CELLULAR  
 IMMUNOTHERAPIES IN  
 CLL 
 SESSION VII 
 EFFICACY THROUGH  
 SAFETY 
 SESSION VIII 
 CLONAL HETEROGENEITY,  
 CLONAL EVOLUTION AND  
 MECHANISMS OF DRUG  
 RESISTANCE 
 SESSION IX 
 CONTRASTING  
 THERAPEUTIC CONCEPTS 
 SELECTED ABSTRACTS  
 FOR AN ORAL  
 PRESENTATION 
 SELECTED ABSTRACTS  
 FOR A POSTER  
 PRESENTATION 
 FACULTY DISCLOSURES 
 SHANK1 AS A PREDICTIVE, DIAGNOSTIC AND PROGNOSTIC METHYLATION  
 BIOMARKER AND A POSSIBLE FUNCTIONAL PLAYER IN CHRONIC LYMPHOCYTIC  
 LEUKEMIA  
   
 Eleonora Loi1, Loredana Moi1, Antonio Fadda1, Giannina Satta2, Mariagrazia Zucca3, Sonia Sanna3, Shadi  
 Amini Nia2, Giuseppina Cabras4, Marina Padoan5, Corrado Magnani5, Lucia Miligi6, Sara Piro6, Davide  
 Gentilini7,8,  Maria  Grazia  Ennas3,  Melissa  C  Southey9,10,  Graham  G  Giles11,12,  Nicole  Wong  Doo11,13,  
 Pierluigi Cocco2 and Patrizia Zavattari3  
   
 (1)Department  of  Biomedical  Sciences,  Unit  of  Biology  and  Genetics,  University  of  Cagliari,  Cagliari,  
 Italy,  (2)Department  of  Medical  Sciences  and  Public  Health,  Occupational  Health  Unit,  University  of  
 Cagliari,  Cagliari,  Italy,  (3)Department  of  Biomedical  Sciences,  Cytomorphology  Unit,  University  of  
 Cagliari,  Cagliari,  Italy,  (4)Unit  of  Hematology,  A.  Businco  Oncology  Hospital,  Cagliari,  Italy,  
 (5)Department of Medical Sciences, Unit of Medical Statistics and Cancer Epidemiology, University of  
 Eastern  Piedmont,  Novara,  Italy,  (6)Institute  of  Oncology  Studies  and  Prevention,  Florence,  Italy,  
 (7)Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy, (8)Bioinformatics and  
 Statistical Genomics Unit, Istituto Auxologico Italiano IRCCS, Cusano Milanino, Milan, Italy, (9)Precision  
 Medicine, Monash University, Melbourne, Melbourne, Australia, (10)Department of Clinical Pathology,  
 The University of Melbourne, Melbourne, Australia, (11)Cancer Epidemiology and Intelligence Division,  
 Cancer  Council  Victoria,  Melbourne,  Australia,  (12)Centre  for  Epidemiology  &  Biostatistics,  The  
 University of Melbourne, Melbourne, Australia, (13)Concord Hospital Clinical School, The University of  
 Sydney, Sydney, Australia   
   
 Objectives :  
 Chronic lymphocytic leukemia (CLL) is characterized by the clonal expansion of malignant B  
 cells.  
 Biomarkers able to diagnose CLL in the early phases of the disease and to predict its clinical  
 course are urgently needed. Methylation alterations are early events in tumorigenesis and  
 represent powerful cancer biomarkers.  
 The main aim of this study was to identify differential methylation patterns between CLL and  
 healthy individuals to employ as potential biomarkers for CLL early diagnosis and prognosis.  
 Moreover, the correlation between methylation and gene expression was investigated.  
   
 Methods : A genome-wide methylation analysis of 18 CLL cases and six normal controls was  
 performed  by  Illumina  Infinium  HumanMethylation450  BeadChips.  Raw  methylation  data  
 were analysed by RnBeads and absolute lymphocyte count data was added as a covariate in  
 the limma analysis. Methylation of the most altered CpG island (CGI), associated with SHANK1  
 gene, was validated using publicly available methylation data of a large cohort including 139  
 CLL and 20 controls. Methylation data of 438 samples of mature B-cell neoplasms (MBCN),  
 including 82 CLL and small lymphocytic lymphoma (SLL) cases, collected years before diagnosis  
 and  438  controls  were  analysed  to  investigate  whether  the  selected  CGI  could  undergo  
 methylation  changes  prior  to  the  clinical  manifestation  of  the  disease.  SHANK1  gene  
 expression analysis was performed in 27 CLL and 16 healthy controls by qRT-PCR.  
   
 Results :  Differential  methylation  analysis  between  CLL  and  healthy  controls  allowed  the  
 identification of several CGIs altered in CLL. A CGI located in SHANK1 gene body showed the  
 highest  differential  methylation  value  (Δβ=  0.29)  in  our  experimental  cohort.  SHANK1  
 displayed statistically significant lower levels in CLL samples compared to healthy controls.  
 Hypermethylation of this CGI was successfully replicated in a larger CLL dataset. A positive  
 correlation  between  SHANK1  methylation  levels  and  absolute  lymphocyte  counts,  in  
 particular  CD19+  B  cells,  was  detected  in  CLL  patients.  A  statistically  significant  gain  of  
 SHANK1-associated  CGI  methylation  was  detected  in  blood  samples  of  82  CLL  and  SLL  
 collected years before diagnosis compared to matched controls as well as in 438 MBCNs.