Bioinformatic tools for detecting germline copy number changes in acute lymphoblastic leukemia patients

Acute lymphoblastic leukemia (ALL) is a hematological malignancy that is characterized by uncontrolled proliferation and blocked maturation of lymphoid progenitor cells. It is divided into B- and T-cell types both of which have multiple subtypes defined by different somatic genetic changes. Also, germline predisposition has been found to play an important role in multiple hematological malignancies and several germline variants that contribute to the ALL risk have already been identified in pediatric and familial settings. There are only few studies including adult ALL patients but thanks to the findings in acute myeloid leukemia, where they found the germline predisposition to consider also adult patients, there is now more interest in studying adult patients. The prognosis of adult ALL patients is much worse compared to pediatric patients and many are still lacking clear genetic markers for diagnosis. Thus, identifying genetic lesions affecting ALL development is important in order to improve treatments and prognosis. Germline studies can provide additional insight on the predisposition and development of ALL when there are no clear somatic biomarkers. Single nucleotide variants are usually of interest when identifying biomarkers from the genome, but also structural variants can be studied. Their coverage on the genome is higher than that of single nucleotide variants which makes them suitable candidates to explore association with prognosis. Copy number changes can be detected from next generation sequencing data although the detection specificity and sensitivity vary a lot between different software. Current approach is to identify the most likely regions with copy number change by using multiple tools and to later validate the findings experimentally. In this thesis the copy number changes in germline samples of 41 adult ALL patients were analyzed using ExomeDepth, CODEX2 and CNVkit