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 Blood, 1 January 2008, Vol. 111, No. 1, pp. 376-378.
Prepublished online as a Blood First Edition Paper on September 27, 2007; DOI 10.1182/blood-2007-02-074690.

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NEOPLASIA

Brief Report

NOTCH1 mutation can be an early, prenatal genetic event in T-ALL

Minenori Eguchi-Ishimae1, Mariko Eguchi1, Helena Kempski2, and Mel Greaves1

1 Section of Haemato-Oncology, Institute of Cancer Research, London; and 2 Molecular Haematology and Cancer Biology Unit, Institute of Child Health, London, United Kingdom

NOTCH1 mutations are common in T-lineage acute lymphoblastic leukemia (T-ALL). Twin studies and retrospective screening of neonatal blood spots provide evidence that fusion genes and other chromosomal abnormalities associated with pediatric leukemias can originate prenatally. Whether this is also the case for NOTCH1 mutations is unknown. Eleven cases of T-ALL were screened for NOTCH1 mutations and 4 (36%) had mutations in either the heterodimerization (HD) or proline glutamic acid/serine/threonine (PEST) domains. Of these 4, 3 could be amplified by mutation-specific polymerase chain reaction primers. In one of these 3, with the highest sensitivity, NOTCH1 mutation was detected in neonatal blood spots. In this patient, the blood spot was negative for SIL-TAL1 fusion, present concomitant with NOTCH1 mutation, in the diagnostic sample. We conclude that NOTCH1 can be an early or initiating event in T-ALL arising prenatally, to be complemented by a postnatal SIL-TAL1 fusion.


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