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Blood, 23 April 2009, Vol. 113, No. 17, pp. 4074-4077.
Prepublished online as a Blood First Edition Paper on May 15, 2008; DOI 10.1182/blood-2007-11-125476.


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MYELOID NEOPLASIA

Brief Report

Identification of a novel type of ITD mutations located in nonjuxtamembrane domains of the FLT3 tyrosine kinase receptor

Frank Breitenbuecher1,2, Susanne Schnittger3, Rebekka Grundler4, Boyka Markova1, Birgit Carius1, Alexandra Brecht1, Justus Duyster4, Torsten Haferlach3, Christoph Huber1, and Thomas Fischer1

1 3rd Medical Department, Johannes Gutenberg University, Mainz; 2 Department of Medicine (Cancer Research), West German Cancer Center, University Hospital Essen, Essen; 3 MLL-Munich Leukemia Laboratory, Munich; and 4 Technical University of Munich, Munich, Germany

In acute myeloid leukemia (AML), internal tandem duplications (ITDs) of the juxtamembrane (JM) of FLT3 have been shown to play a crucial role in driving proliferation and survival of the leukemic clone. Here, we report the identification of FLT3_ITD mutations located in non-JM domains of the FLT3-receptor. This novel type of FLT3_ITD mutation was found in 216 of 753 (28.7%) of unselected FLT3_ITD-positive AML cases. An FLT3 receptor harbouring a prototypic non-JM ITD (FLT3_ITD627E) mediated constitutive phosphorylation of FLT3 and of STAT5, suggesting that non-JM ITDs confer constitutive activation of the receptor. FLT3_ITD627E induced transformation of hematopoietic 32D cells and led to a lethal myeloproliferative disease in a syngeneic mouse model. Our results indicate that a significant proportion of activating FLT3_ITD mutations is not confined to the JM domain of FLT3. Further studies are warranted to define the biologic and clinical characteristics of non-JM ITDs.


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