A single-cell atlas of large B cell lymphomas reveals distinct malignant archetypes predictive of clinical outcomes

Large B cell lymphomas (LBCLs) exhibit significant heterogeneity which leads to disparate treatment response, with up to 40% of patients developing refractory disease or relapsing within the first two years. To understand the cellular and molecular basis of this heterogeneity, we performed single-cell RNA-seq, BCR-seq, and TCR-seq on LBCL tumor biopsies, generating an atlas of 63 LBCL cases, mostly classified as diffuse LBCL, not otherwise specified (DLBCL NOS). We identified five conserved transcriptional archetypes of malignant B cells that co-occur within individual tumors, with varying proportions across patients. Notably, high abundance of Archetype 4, characterized by memory B cell features and quiescence markers, correlated with poor event-free survival following standard immunochemotherapy, a finding which was validated in independent cohorts through deconvolution of bulk RNA-seq data. Our study provides a novel framework for patient stratification based on the quantification of malignant cellular states, with implications for precision therapy of LBCLs.

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Journal
Blood
Published
2026-09-17
DOI
https://doi.org/10.1182/blood.2026033056
Primary Topic
Single-cell and spatial transcriptomics
Type
article
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article

A single-cell atlas of large B cell lymphomas reveals distinct malignant archetypes predictive of clinical outcomes

Kerstin Wenzl, Sahil Seth, Gabriel Brisou, Sandrine Roulland et al.
Blood
Single-cell and spatial transcriptomics
article

A single-cell atlas of large B cell lymphomas reveals distinct malignant archetypes predictive of clinical outcomes

Kerstin Wenzl, Sahil Seth, Gabriel Brisou, Sandrine Roulland, Philippe Gaulard, Laura K. Hilton, Pierre Milpied, Xubin Li, Pauline Gravelle, C. Chris Huang, Caroline Huber, Sabrina Baaklini, Corinne Haïoun, Matthew E. Stokes, Anita K. Gandhi, Romain Fenouil, Michael R. Green, Lionel Spinelli, Marine Pujol, Laurine Gil, Noushin Mossadegh‐Keller, María Ortiz Estévez, Romane Trombetta, Benjamin Rivière, Ryan D. Morin, Peggy Cuillière-Dartigues, Kostiantyn Dreval, Laila Dahbi, Jean‐Marc Navarro, Bertrand Escalière, Francisco Llamas Gutierrez, Camille Barthelemy, Alexandre Sarrabay, Rahat Hasan, Camille Laurent, François Lemonnier, Céline Pangault, Mark Isaac Kaplan, Fabrice Jardin, Bertrand Nadel
article en

Abstract

Large B cell lymphomas (LBCLs) exhibit significant heterogeneity which leads to disparate treatment response, with up to 40% of patients developing refractory disease or relapsing within the first two years. To understand the cellular and molecular basis of this heterogeneity, we performed single-cell RNA-seq, BCR-seq, and TCR-seq on LBCL tumor biopsies, generating an atlas of 63 LBCL cases, mostly classified as diffuse LBCL, not otherwise specified (DLBCL NOS). We identified five conserved transcriptional archetypes of malignant B cells that co-occur within individual tumors, with varying proportions across patients. Notably, high abundance of Archetype 4, characterized by memory B cell features and quiescence markers, correlated with poor event-free survival following standard immunochemotherapy, a finding which was validated in independent cohorts through deconvolution of bulk RNA-seq data. Our study provides a novel framework for patient stratification based on the quantification of malignant cellular states, with implications for precision therapy of LBCLs.

Blood
Centre National de la Recherche Scientifique (FR), The University of Texas MD Anderson Cancer Center (US), Inserm (FR), Bristol-Myers Squibb (Germany) (DE), Université Paris-Est Créteil (FR), Institut Gustave Roussy (FR), Centre de Recherches en Cancérologie de Toulouse (FR), Bristol-Myers Squibb (United States) (US), Assistance Publique – Hôpitaux de Paris (FR), Institut universitaire du cancer de Toulouse Oncopole (FR), Hôpital Gui de Chauliac (FR), Hôpital Pontchaillou (FR), Hôpitaux Universitaires Henri-Mondor (FR), Bristol-Myers Squibb (Sweden) (SE), Laboratoire National Henri Becquerel (FR), Centre d’Immunologie de Marseille-Luminy (FR), Lymphoma Study Association (FR), Institut Paoli-Calmettes (FR), Centre Hospitalier Universitaire de Rennes (FR), Université de Rennes (FR), Université de Rouen Normandie (FR)
No poverty
Openalex Percentile: Top 19%
Single-cell and spatial transcriptomics
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