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Blood, Vol. 95 No. 6 (March 15), 2000:
pp. 2132-2137
Granulocyte colony-stimulating factor receptor mutations in severe
congenital neutropenia transforming to acute myelogenous leukemia
confer resistance to apoptosis and enhance cell survival
Melissa G. Hunter and
Belinda R. Avalos
From the Molecular, Cellular, and Developmental Biology Program and
the Bone Marrow Transplantation Program, The Ohio State University,
Arthur G. James Cancer Hospital & Research Institute, Columbus, OH.
Patients with severe congenital neutropenia (SCN) are at increased
risk for the development of acute myelogenous leukemia (AML). In the
subset of patients with SCN that progresses to AML, acquired mutations
in the receptor for granulocyte colony-stimulating factor (G-CSF) have
been detected that result in the expression of truncated forms of the
G-CSF receptor (G-CSFR) protein. G-CSFR truncation mutants from these
patients trans-duce hyperproliferative growth responses. In this paper,
we show that the most frequently isolated mutant G-CSFR form from
patients with SCN/AML ( 716) confers resistance to apoptosis and
prolongs cell survival through a mechanism involving Akt, a downstream
target of PI3-kinase. G-CSF stimulation of cells expressing the G-CSFR
truncation mutant induces sustained activation of Akt and prolonged
phosphorylation of the pro-apoptotic protein Bad, resulting in enhanced
cell survival. Extension of cell survival allowing for sufficient time
for the acquisition of additional oncogenic events may represent an
important mechanism by which G-CSFR mutations contribute to
leukemogenesis. These data provide further insight into the
pathophysiologic contribution of G-CSFR mutations to AML.

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