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N-ras gene point mutations in childhood acute lymphocytic leukemia
correlate with a poor prognosis
M Lubbert, J Mirro , CW Miller, J Kahan, G Isaac, G Kitchingman, R Mertelsmann, F Herrmann, F McCormick and HP Koeffler
UCLA Department of Medicine.
Ras genes can be altered by point mutations at critical portions of their
coding regions to acquire transforming ability in vitro. These point
mutations have been detected in a variety of human malignancies. However,
their relevance for the clinical and biologic behavior of the subgroups of
patients exhibiting these mutations in unclear. We analyzed 100 patients
with childhood acute lymphocytic leukemias (ALLs) for point mutations of
exons 1 and 2 of all three ras genes (H-ras, K- ras, and N-ras) by
polymerase chain reaction and a combination of oligonucleotide
hybridization and direct DNA sequencing. A 6% incidence of N-ras gene
mutations was detected, all of which occurred at different nucleotides of
codons 12 or 13 of N-ras. When correlating presence of ras mutations with
the clinical and biologic features and the clinical outcome of these cases,
a significantly higher risk for hematologic relapse (P = .01) and a trend
toward a lower rate of complete remission (P = .07) was noted. The two
groups did not differ in any of the known high-risk factors of ALL. These
results suggest that presence of an N-ras mutation in children with ALL may
be an independent predictor for worse clinical outcome and therefore may
have therapeutic implications; further studies to confirm these findings
are required because of the small number of patients with N-ras mutations.
Volume 75,
Issue 5,
pp. 1163-1169,
03/01/1990
Copyright © 1990 by The American Society of Hematology
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