CSNK1E sustains stemlike drug persistence in diffuse large B-cell lymphoma

X Xiang Li M Mengke Liu Q Qing Shi (1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China) Z Zhi-Shan Du (1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China) D Di Fu Y Ying Fang L Liang-Juan Zhao (1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China) Y Yuting Dai M Mu-Chen Zhang (1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China) F Fan Zhang Y Yan Zhao H Hong-Mei Yi (2Department of Pathology, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China) Y Yang He S Shu Cheng P Peng-Peng Xu (1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China) L Li Wang (The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital Zhengzhou China) J Jiahao Chen (Spin-X Institute, School of Chemistry and Chemical Engineering, School of Biomedical Sciences and Engineering, Guangdong-Hong Kong-Macao Joint Laboratory of Optoelectronic and Magnetic Functional Materials, State Key Laboratory of Luminescent Materials and Devices) W Wei-Li Zhao (1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China)

Abstract

Abstract Relapsed or refractory (R/R) disease occurs in up to 40% of patients with diffuse large B-cell lymphoma (DLBCL) following first-line immunochemotherapy. However, the molecular mechanisms underlying drug persistence remain incompletely defined. In this study, we performed single-cell RNA and B-cell receptor sequencing on paired diagnostic and R/R samples from 8 patients who were either treatment-refractory or relapsed after remission, and validated our findings in 3 independent patient cohorts. We found that drug-persistent cells exhibited a transcriptional profile indicative of a less-differentiated state and adopted a memory B-cell–like program with enhanced stemlike properties, which correlated with unfavorable clinical outcomes across multiple DLBCL cohorts. Functionally, drug-persistent cells showed significantly increased in vitro clonogenicity and in vivo tumor-initiating capacity. Mechanistically, the WNT signaling regulator casein kinase 1ɛ (CSNK1E) was upregulated in these stemlike drug-persistent cells, in part through the activation of the A proliferation-inducing ligand (APRIL)–TNFRSF13B axis. Notably, CSNK1E inhibition impaired the growth and tumor-initiating capacity of drug-persistent cells and potentiated the efficacy of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)–based treatment, both in vitro and in vivo. Together, our study reveals the stemlike transcriptional and functional properties of drug-persistent cells, and identifies CSNK1E as a critical mediator and therapeutic vulnerability that may improve the efficacy of standard immunochemotherapy in DLBCL.

Article Details

Journal Blood
Volume / Issue Vol. 147, Issue 22
Published May 28, 2026
Pages 2633-2647
ISSN 0006-4971
Publisher Elsevier BV

Journal Info

Blood

Elsevier BV

ISSN: 0006-4971 Health Sciences

Authors (18)

X

Xiang Li

M

Mengke Liu

Q

Qing Shi

1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China

Z

Zhi-Shan Du

1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China

D

Di Fu

Y

Ying Fang

L

Liang-Juan Zhao

1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China

Y

Yuting Dai

M

Mu-Chen Zhang

1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China

F

Fan Zhang

Y

Yan Zhao

H

Hong-Mei Yi

2Department of Pathology, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China

Y

Yang He

S

Shu Cheng

P

Peng-Peng Xu

1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China

L

Li Wang

The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital Zhengzhou China

J

Jiahao Chen

Spin-X Institute, School of Chemistry and Chemical Engineering, School of Biomedical Sciences and Engineering, Guangdong-Hong Kong-Macao Joint Laboratory of Optoelectronic and Magnetic Functional Materials, State Key Laboratory of Luminescent Materials and Devices

W

Wei-Li Zhao

1Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China