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Blood, 5 November 2009, Vol. 114, No. 19, pp. 4197-4208.
Prepublished online as a Blood First Edition Paper on September 4, 2009; DOI 10.1182/blood-2008-12-190934.


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MYELOID NEOPLASIA

E3 ligase–defective Cbl mutants lead to a generalized mastocytosis and myeloproliferative disease

Srinivasa Rao Bandi1,2,*, Christian Brandts1,2,*, Marion Rensinghoff1, Rebekka Grundler3, Lara Tickenbrock1,4, Gabriele Köhler5, Justus Duyster3, Wolfgang E. Berdel1, Carsten Müller-Tidow1, Hubert Serve1,2, on behalf of the Study Alliance Leukemias, and Bülent Sargin1

1 Department of Medicine, Hematology and Oncology and the Interdisciplinary Center for Clinical Research, University Hospital Muenster, Muenster; 2 Department of Medicine, Hematology/Oncology, Goethe University, Frankfurt am Main; 3 Department of Internal Medicine III, Klinikum Rechts der Isar, Technical University of Munich, Munich; 4 University of Applied Science, Hochschule Hamm-Lippstadt, Hamm; and 5 Gerhard Domagk Institute of Pathology, University of Münster, Münster, Germany

Somatic mutations of Kit have been found in leukemias and gastrointestinal stromal tumors. The proto-oncogene c-Cbl negatively regulates Kit and Flt3 by its E3 ligase activity and acts as a scaffold. We recently identified the first c-Cbl mutation in human disease in an acute myeloid leukemia patient, called Cbl-R420Q. Here we analyzed the role of Cbl mutants on Kit-mediated transformation. Coexpression of Cbl-R420Q or Cbl-70Z with Kit induced cytokine-independent proliferation, survival, and clonogenic growth. Primary murine bone marrow retrovirally transduced with c-Cbl mutants and transplanted into mice led to a generalized mastocytosis, a myeloproliferative disease, and myeloid leukemia. Overexpression of these Cbl mutants inhibited stem cell factor (SCF)–induced ubiquitination and internalization of Kit. Both Cbl mutants enhanced the basal activation of Akt and prolonged the ligand-dependent activation. Importantly, transformation was observed also with kinase-dead forms of Kit and Flt3 in the presence of Cbl-70Z, but not in the absence of Kit or Flt3, suggesting a mechanism dependent on receptor tyrosine kinases, but independent of their kinase activity. Instead, transformation depends on the Src family kinase Fyn, as c-Cbl coimmunoprecipitated with Fyn and inhibition abolished transformation. These findings may explain primary resistance to tyrosine kinase inhibitors targeted at receptor tyrosine kinases.


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