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Blood, 1 August 2002, Vol. 100, No. 3, pp. 998-1007
NEOPLASIA
Heterozygous PU.1 mutations are associated with acute
myeloid leukemia
Beatrice U. Mueller,
Thomas Pabst,
Motomi Osato,
Norio Asou,
Lisa M. Johansen,
Mark D. Minden,
Gerhard Behre,
Wolfgang Hiddemann,
Yoshiaki Ito, and
Daniel G. Tenen
From the Harvard Institutes of Medicine,
Harvard Medical School, Boston, MA; the Department of Internal
Medicine, Kumamoto University, Japan; the Department of Viral Oncology,
Institute for Virus Research, Kyoto University, Kyoto, Japan; the
Department of Medicine and Medical Biophysics, University of Toronto,
Canada; the Department of Medicine III, Grosshadern, Clinical
Cooperative Group Acute Myeloid Leukemia of the National Research
Center for Environment and Health (GSF), Munich, Germany.
The transcription factor PU.1 is required for normal blood cell
development. PU.1 regulates the expression of a number of crucial
myeloid genes, such as the macrophage colony-stimulating factor
(M-CSF) receptor, the granulocyte colony-stimulating factor (G-CSF) receptor, and the granulocyte-macrophage colony-stimulating factor (GM-CSF) receptor. Myeloid cells derived from
PU.1 / mice are blocked at the earliest stage of myeloid
differentiation, similar to the blast cells that are the hallmark of
human acute myeloid leukemia (AML). These facts led us to hypothesize
that molecular abnormalities involving the PU.1 gene could
contribute to the development of AML. We identified 10 mutant alleles
of the PU.1 gene in 9 of 126 AML patients. The PU.1 mutations comprised 5 deletions affecting the DNA-binding domain, and 5 point mutations in
1) the DNA-binding domain (2 patients), 2) the PEST domain (2 patients), and 3) the transactivation domain (one patient). DNA binding
to and transactivation of the M-CSF receptor promoter, a direct PU.1
target gene, were deficient in the 7 PU.1 mutants that affected the
DNA-binding domain. In addition, these mutations decreased the ability
of PU.1 to synergize with PU.1-interacting proteins such as AML1 or
c-Jun in the activation of PU.1 target genes. This is the first report
of mutations in the PU.1 gene in human neoplasia and suggests that
disruption of PU.1 function contributes to the block in differentiation
found in AML patients.

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