Remission clone in acute myeloid leukemia shows growth advantage after chemotherapy but is distinct from leukemic clone

Abstract We previously published an AML case study where we tracked the dynamics of somatic mutations over 9 years. Interestingly, we observed a group of mutations that expanded during remission, which we named "remission clone". To investigate the nature of the remission clone, we performed flow cytometry-based cell sorting followed by ultra-deep sequencing. The remission clone repeatedly expanded after chemotherapeutic cycles and was suppressed during relapse in the myeloid lineage (multipotent hematopoietic stem, progenitor, and myeloid cells). On the other hand, the remission clone was consistently observed in lymphoid lineages (B- and T-cells) regardless of the disease state. When transfected to HEK-293 cell line, NR2C2 (A93V) mutant showed a growth advantage (all p