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Blood, 1 January 2002, Vol. 99, No. 1, pp. 15-23
PLENARY PAPER
The AML1-ETO fusion protein promotes the expansion of
human hematopoietic stem cells
James C. Mulloy,
Jörg Cammenga,
Karen L. MacKenzie,
Francisco J. Berguido,
Malcolm A. S. Moore, and
Stephen D. Nimer
From the Laboratory of Molecular Hematopoiesis,
Sloan-Kettering Institute; the Division of Hematologic Oncology,
Memorial Sloan-Kettering Cancer Center; and the Laboratory of
Developmental Hematopoiesis, Cell Biology Program, Sloan-Kettering
Institute, New York, NY.
The acute myelogenous leukemia-1 (AML1)-ETO
fusion protein is generated by the t(8;21), which is found in 40% of
AMLs of the French-American-British M2 subtype. AML1-ETO
interferes with the function of the AML1 (RUNX1, CBFA2) transcription
factor in a dominant-negative fashion and represses transcription by
binding its consensus DNA-binding site and via protein-protein
interactions with other transcription factors. AML1 activity is
critical for the development of definitive hematopoiesis, and
haploinsufficiency of AML1 has been linked to a propensity to develop
AML. Murine experiments suggest that AML1-ETO expression may not be
sufficient for leukemogenesis; however, like the BCR-ABL isoforms, the
cellular background in which these fusion proteins are expressed may be critical to the phenotype observed. Retroviral gene transfer was used to examine the effect of AML1-ETO on the in vitro behavior of human hematopoietic stem and progenitor cells. Following
transduction of CD34+ cells, stem and progenitor cells were
quantified in clonogenic assays, cytokine-driven expansion cultures,
and long-term stromal cocultures. Expression of AML1-ETO inhibited
colony formation by committed progenitors, but enhanced the growth of
stem cells (cobblestone area-forming cells), resulting in a profound
survival advantage of transduced over nontransduced cells.
AML1-ETO-expressing cells retained progenitor activity and continued
to express CD34 throughout the 5-week long-term culture. Thus, AML1-ETO
enhances the self-renewal of pluripotent stem cells, the physiological target of many acute myeloid leukemias.

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