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Blood, 28 May 2009, Vol. 113, No. 22, pp. 5583-5587. Prepublished online as a Blood First Edition Paper on April 8, 2009; DOI 10.1182/blood-2008-07-168260.
MYELOID NEOPLASIA High frequency of RUNX1 biallelic alteration in acute myeloid leukemia secondary to familial platelet disorder1 Department of Hematology, Biology and Pathology Center, Centre Hospitalier Régional Universitaire (CHRU) of Lille, Lille; 2 Cancer Research Institute, JP Aubert Center, Inserm U-837, Team 3, Lille; 3 North-West Canceropole, Rouen; 4 Department of Genetic Oncology, Paoli Calmettes Institute, Marseille; 5 Department of Medical Genetics, Jeanne de Flandres Hospital, CHRU of Lille, Lille; 6 Department of Adult Hematology, Saint-Louis Hospital, Paris; 7 Department of Clinical Hematology, La Pitié-Salpétrière Hospital, Paris; 8 Department of Pediatric Onco-Hematology, Debrousse Hospital, Lyon; 9 Hematology Laboratory, CHRU of Reims, Reims; and 10 Department of Pediatric Hematology, Robert Debré Hospital, Paris, France Familial platelet disorder (FPD), a rare autosomal dominant disorder characterized by quantitative and qualitative platelet abnormalities, is considered as a model of genetic predisposition to acute myeloid leukemia (AML). So far, monoallelic RUNX1 germline mutations have been found in 19 of 20 families with reported FPD, and the analysis of blast cells from only 5 patients at acute leukemia (AL) stage has shown no additional RUNX1 abnormality. Here, we performed RUNX1 analysis at constitutional and somatic levels in 8 persons with FPD who developed AL from 4 independent families. In addition to the germline RUNX1 mutation, we identified a second RUNX1 alteration in 6 AML cases (acquired point mutations in 4 cases and duplication of the altered RUNX1 allele associated with acquired trisomy 21 in 2 other cases). Although haploinsufficiency of RUNX1 causes FPD, our findings suggest that a second genetic event involving RUNX1 is often associated with progression to AML.
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