Abstract Chronic lymphocytic leukemia risk variants are associated with alteration of epigenetic state in regulatory regions The vast majority of disease-associated single-nucleotide polymorphisms (SNPs) identified by genome-wide association studies (GWASs) reside in noncoding genomic regions. Functional impact of noncoding casual variants on target gene expression often involves regulatory mechanisms, typically through altering local chromatin accessibility, histone modifications, transcription factor (TF) binding affinity and chromatin interactions. In chronic lymphocytic leukemia (CLL), we and others have identified 41 GWAS risk variants, whose mechanism of action in CLL etiology remains largely unknown. In this study, we aim to decipher the regulatory potential of these variants and to better understand the mechanisms contributing to dysregulation of genes implicated in CLL pathogenesis. We performed ChIP-seq for H3K4me3, H3K4me1, H3K27ac and H3K27me3 in CLL. In addition, we also analyzed over 250 public ChIP-seq, ATAC-seq, DNase-seq, FAIRE-seq, and chromatin interaction data in CLL, B cells and/or lymphoblastoid cell lines. Comparing the 41 index SNPs and the nearby SNPs they associated with in linkage disequilibrium (R2 at least 0.5 in the EUR ethnic group in 1000 Genomes Project) to the above epigenetic data sets revealed overlaps with regulatory regions in 38 of the risk loci, with 28 of the loci overlapping super-enhancers. We used two approaches to elucidate the mechanisms of potential SNP causality. First, we used GATK UnifiedGenotyper to infer genotype for the SNPs that overlapped open chromatin regions and ChIP-seq peaks, by which evidence of imbalance between reference and alternative allele was identified at heterozygous sites. Second, for SNPs located within open chromatin regions or ChIP-seq peaks, we used FIMO program to scan the 100bp sequences centered on the SNPs for significant matches (p=1e-05) to the position weight matrices in five TF binding motif databases; SNPs that had TF motifs altered by the alternative alleles were retained. Together, these two approaches revealed evidence for allele imbalance or TF binding motif alterations at 36 of the 38 CLL risk loci, suggesting the generality of epigenetic regulation in CLL pathogenesis. Further analysis of chromatin interaction, gene expression and expression quantitative trait loci data will likely link the casual SNPs to their target genes. Citation Format: Huihuang Yan, Shulan Tian, Geffen Kleinstern, Susan Slager. Chronic lymphocytic leukemia risk variants are associated with alteration of epigenetic states in regulatory regions [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1221.