Theranostics 2022; 12(4):1715-1729. doi:10.7150/thno.54453 This issue

Research Paper

Comprehensive characterization of the epigenetic landscape in Multiple Myeloma

Elina Alaterre1,2, Sara Ovejero1,2, Laurie Herviou1,2, Hugues de Boussac3, Giorgio Papadopoulos2, Marta Kulis4,5, Stéphanie Boireau1,2, Nicolas Robert1,2, Guilhem Requirand1,2, Angélique Bruyer3, Guillaume Cartron6,7,8, Laure Vincent6, Anne Marie Martinez2, José Ignacio Martin-Subero4,5,9,10, Giacomo Cavalli2, Jerome Moreaux1,2,7,11✉

1. Department of Biological Hematology, CHU Montpellier, Montpellier, France.
2. Institute of Human Genetics, UMR 9002 CNRS-UM, Montpellier, France.
3. Diag2Tec, Montpellier, France.
4. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
5. Centro de Investigación Biomédica en Red de Cáncer, CIBERONC, Madrid, Spain.
6. Clinical Hematology. CHU Montpellier, Montpellier, France.
7. University of Montpellier, UFR Medicine, Montpellier, France.
8. UMR-CNRS 5535, Institut de Génétique Moléculaire de Montpellier, 34090 Montpellier, France.
9. Departament de Fonaments Clinics, Facultat de Medicina, Universitat de Barcelona, Barcelona, Spain.
10. Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain.
11. Institut Universitaire de France (IUF).

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Alaterre E, Ovejero S, Herviou L, de Boussac H, Papadopoulos G, Kulis M, Boireau S, Robert N, Requirand G, Bruyer A, Cartron G, Vincent L, Martinez AM, Martin-Subero JI, Cavalli G, Moreaux J. Comprehensive characterization of the epigenetic landscape in Multiple Myeloma. Theranostics 2022; 12(4):1715-1729. doi:10.7150/thno.54453. Available from

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Graphic abstract

Background: Human multiple myeloma (MM) cell lines (HMCLs) have been widely used to understand the molecular processes that drive MM biology. Epigenetic modifications are involved in MM development, progression, and drug resistance. A comprehensive characterization of the epigenetic landscape of MM would advance our understanding of MM pathophysiology and may attempt to identify new therapeutic targets.

Methods: We performed chromatin immunoprecipitation sequencing to analyze histone mark changes (H3K4me1, H3K4me3, H3K9me3, H3K27ac, H3K27me3 and H3K36me3) on 16 HMCLs.

Results: Differential analysis of histone modification profiles highlighted links between histone modifications and cytogenetic abnormalities or recurrent mutations. Using histone modifications associated to enhancer regions, we identified super-enhancers (SE) associated with genes involved in MM biology. We also identified promoters of genes enriched in H3K9me3 and H3K27me3 repressive marks associated to potential tumor suppressor functions. The prognostic value of genes associated with repressive domains and SE was used to build two distinct scores identifying high-risk MM patients in two independent cohorts (CoMMpass cohort; n = 674 and Montpellier cohort; n = 69). Finally, we explored H3K4me3 marks comparing drug-resistant and -sensitive HMCLs to identify regions involved in drug resistance. From these data, we developed epigenetic biomarkers based on the H3K4me3 modification predicting MM cell response to lenalidomide and histone deacetylase inhibitors (HDACi).

Conclusions: The epigenetic landscape of MM cells represents a unique resource for future biological studies. Furthermore, risk-scores based on SE and repressive regions together with epigenetic biomarkers of drug response could represent new tools for precision medicine in MM.

Keywords: Epigenetics, Multiple myeloma, Histone modifications, Therapeutic target, Precision medicine