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Blood, 1 January 2002, Vol. 99, No. 1, pp. 310-318

NEOPLASIA

FLT3 internal tandem duplication mutations associated with human acute myeloid leukemias induce myeloproliferative disease in a murine bone marrow transplant model

Louise M. Kelly, Qing Liu, Jeffrey L. Kutok, Ifor R. Williams, Christina L. Boulton, and D. Gary Gilliland

From the Division of Hematology/Oncology, Department of Pathology, Brigham and Women's Hospital, and the Howard Hughes Medical Institute, Harvard Medical School, Boston, MA; and Department of Pathology, Emory University, Atlanta, GA.

FLT3 receptor tyrosine kinase is expressed on lymphoid and myeloid progenitors in the hematopoietic system. Activating mutations in FLT3 have been identified in approximately 30% of patients with acute myelogenous leukemia, making it one of the most common mutations observed in this disease. Frequently, the mutation is an in-frame internal tandem duplication (ITD) in the juxtamembrane region that results in constitutive activation of FLT3, and confers interleukin-3 (IL-3)-independent growth to Ba/F3 and 32D cells. FLT3-ITD mutants were cloned from primary human leukemia samples and assayed for transformation of primary hematopoietic cells using a murine bone marrow transplantation assay. FLT3-ITDs induced an oligoclonal myeloproliferative disorder in mice, characterized by splenomegaly and leukocytosis. The myeloproliferative phenotype, which was associated with extramedullary hematopoiesis in the spleen and liver, was confirmed by histopathologic and flow cytometric analysis. The disease latency of 40 to 60 days with FLT3-ITDs contrasted with wild-type FLT3 and enhanced green fluorescent protein (EGFP) controls, which did not develop hematologic disease (> 200 days). These results demonstrate that FLT3-ITD mutant proteins are sufficient to induce a myeloproliferative disorder, but are insufficient to recapitulate the AML phenotype observed in humans. Additional mutations that impair hematopoietic differentiation may be required for the development of FLT3-ITD-associated acute myeloid leukemias. This model system should be useful to assess the contribution of additional cooperating mutations and to evaluate specific FLT3 inhibitors in vivo.

© 2002 by The American Society of Hematology.
 

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L. C. Platanias
SMRT interactions, repression, and Flt3-ITD
Blood, June 15, 2004; 103(12): 4382 - 4382.
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S. Takahashi, M. J. McConnell, H. Harigae, M. Kaku, T. Sasaki, A. M. Melnick, and J. D. Licht
The Flt3 internal tandem duplication mutant inhibits the function of transcriptional repressors by blocking interactions with SMRT
Blood, June 15, 2004; 103(12): 4650 - 4658.
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D. T. Le, N. Kong, Y. Zhu, J. O. Lauchle, A. Aiyigari, B. S. Braun, E. Wang, S. C. Kogan, M. M. Le Beau, L. Parada, et al.
Somatic inactivation of Nf1 in hematopoietic cells results in a progressive myeloproliferative disorder
Blood, June 1, 2004; 103(11): 4243 - 4250.
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Cancer Res.Home page
P. George, P. Bali, P. Cohen, J. Tao, F. Guo, C. Sigua, A. Vishvanath, W. Fiskus, A. Scuto, S. Annavarapu, et al.
Cotreatment with 17-Allylamino-Demethoxygeldanamycin and FLT-3 Kinase Inhibitor PKC412 Is Highly Effective against Human Acute Myelogenous Leukemia Cells with Mutant FLT-3
Cancer Res., May 15, 2004; 64(10): 3645 - 3652.
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B. D. Smith, M. Levis, M. Beran, F. Giles, H. Kantarjian, K. Berg, K. M. Murphy, T. Dauses, J. Allebach, and D. Small
Single-agent CEP-701, a novel FLT3 inhibitor, shows biologic and clinical activity in patients with relapsed or refractory acute myeloid leukemia
Blood, May 15, 2004; 103(10): 3669 - 3676.
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K. Bagrintseva, R. Schwab, T. M. Kohl, S. Schnittger, S. Eichenlaub, J. W. Ellwart, W. Hiddemann, and K. Spiekermann
Mutations in the tyrosine kinase domain of FLT3 define a new molecular mechanism of acquired drug resistance to PTK inhibitors in FLT3-ITD-transformed hematopoietic cells
Blood, March 15, 2004; 103(6): 2266 - 2275.
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R. Zheng, A. D. Friedman, M. Levis, L. Li, E. G. Weir, and D. Small
Internal tandem duplication mutation of FLT3 blocks myeloid differentiation through suppression of C/EBP{alpha} expression
Blood, March 1, 2004; 103(5): 1883 - 1890.
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T. Taketani, T. Taki, K. Sugita, Y. Furuichi, E. Ishii, R. Hanada, M. Tsuchida, K. Sugita, K. Ida, and Y. Hayashi
FLT3 mutations in the activation loop of tyrosine kinase domain are frequently found in infant ALL with MLL rearrangements and pediatric ALL with hyperdiploidy
Blood, February 1, 2004; 103(3): 1085 - 1088.
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Proc. Natl. Acad. Sci. USAHome page
B. S. Braun, D. A. Tuveson, N. Kong, D. T. Le, S. C. Kogan, J. Rozmus, M. M. Le Beau, T. E. Jacks, and K. M. Shannon
Somatic activation of oncogenic Kras in hematopoietic cells initiates a rapidly fatal myeloproliferative disorder
PNAS, January 13, 2004; 101(2): 597 - 602.
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ASH Education BookHome page
D. G. Gilliland, C. T. Jordan, and C. A. Felix
The Molecular Basis of Leukemia
Hematology, January 1, 2004; 2004(1): 80 - 97.
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Clin. Cancer Res.Home page
A.-M. O'Farrell, J. M. Foran, W. Fiedler, H. Serve, R. L. Paquette, M. A. Cooper, H. A. Yuen, S. G. Louie, H. Kim, S. Nicholas, et al.
An Innovative Phase I Clinical Study Demonstrates Inhibition of FLT3 Phosphorylation by SU11248 in Acute Myeloid Leukemia Patients
Clin. Cancer Res., November 15, 2003; 9(15): 5465 - 5476.
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C. M. Zwaan, S. Meshinchi, J. P. Radich, A. J. P. Veerman, D. R. Huismans, L. Munske, M. Podleschny, K. Hahlen, R. Pieters, M. Zimmermann, et al.
FLT3 internal tandem duplication in 234 children with acute myeloid leukemia: prognostic significance and relation to cellular drug resistance
Blood, October 1, 2003; 102(7): 2387 - 2394.
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Proc. Natl. Acad. Sci. USAHome page
S. Wong, J. McLaughlin, D. Cheng, K. Shannon, L. Robb, and O. N. Witte
IL-3 receptor signaling is dispensable for BCR-ABL-induced myeloproliferative disease
PNAS, September 30, 2003; 100(20): 11630 - 11635.
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J. Biol. Chem.Home page
K. Murata, H. Kumagai, T. Kawashima, K. Tamitsu, M. Irie, H. Nakajima, S. Suzu, M. Shibuya, S. Kamihira, T. Nosaka, et al.
Selective Cytotoxic Mechanism of GTP-14564, a Novel Tyrosine Kinase Inhibitor in Leukemia Cells Expressing a Constitutively Active Fms-like Tyrosine Kinase 3 (FLT3)
J. Biol. Chem., August 29, 2003; 278(35): 32892 - 32898.
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M. M. Le Beau, E. M. Davis, B. Patel, V. T. Phan, J. Sohal, and S. C. Kogan
Recurring chromosomal abnormalities in leukemia in PML-RARA transgenic mice identify cooperating events and genetic pathways to acute promyelocytic leukemia
Blood, August 1, 2003; 102(3): 1072 - 1074.
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JEMHome page
H. Karsunky, M. Merad, A. Cozzio, I. L. Weissman, and M. G. Manz
Flt3 Ligand Regulates Dendritic Cell Development from Flt3+ Lymphoid and Myeloid-committed Progenitors to Flt3+ Dendritic Cells In Vivo
J. Exp. Med., July 21, 2003; 198(2): 305 - 313.
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R. Grundler, C. Thiede, C. Miething, C. Steudel, C. Peschel, and J. Duyster
Sensitivity toward tyrosine kinase inhibitors varies between different activating mutations of the FLT3 receptor
Blood, July 15, 2003; 102(2): 646 - 651.
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Clin. Cancer Res.Home page
K. Spiekermann, K. Bagrintseva, R. Schwab, K. Schmieja, and W. Hiddemann
Overexpression and Constitutive Activation of FLT3 Induces STAT5 Activation in Primary Acute Myeloid Leukemia Blast Cells
Clin. Cancer Res., June 1, 2003; 9(6): 2140 - 2150.
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A.-M. O'Farrell, T. J. Abrams, H. A. Yuen, T. J. Ngai, S. G. Louie, K. W. H. Yee, L. M. Wong, W. Hong, L. B. Lee, A. Town, et al.
SU11248 is a novel FLT3 tyrosine kinase inhibitor with potent activity in vitro and in vivo
Blood, May 1, 2003; 101(9): 3597 - 3605.
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M. Mizuki, J. Schwable, C. Steur, C. Choudhary, S. Agrawal, B. Sargin, B. Steffen, I. Matsumura, Y. Kanakura, F. D. Bohmer, et al.
Suppression of myeloid transcription factors and induction of STAT response genes by AML-specific Flt3 mutations
Blood, April 15, 2003; 101(8): 3164 - 3173.
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J. Sohal, V. T. Phan, P. V. Chan, E. M. Davis, B. Patel, L. M. Kelly, T. J. Abrams, A. M. O'Farrell, D. G. Gilliland, M. M. Le Beau, et al.
A model of APL with FLT3 mutation is responsive to retinoic acid and a receptor tyrosine kinase inhibitor, SU11657
Blood, April 15, 2003; 101(8): 3188 - 3197.
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K. Spiekermann, R. J. Dirschinger, R. Schwab, K. Bagrintseva, F. Faber, C. Buske, S. Schnittger, L. M. Kelly, D. G. Gilliland, and W. Hiddemann
The protein tyrosine kinase inhibitor SU5614 inhibits FLT3 and induces growth arrest and apoptosis in AML-derived cell lines expressing a constitutively activated FLT3
Blood, February 15, 2003; 101(4): 1494 - 1504.
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Clin. Cancer Res.Home page
F. Ravandi, M. Talpaz, and Z. Estrov
Modulation of Cellular Signaling Pathways: Prospects for Targeted Therapy in Hematological Malignancies
Clin. Cancer Res., February 1, 2003; 9(2): 535 - 550.
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ASH Education BookHome page
B. Lowenberg, J. D. Griffin, and M. S. Tallman
Acute Myeloid Leukemia and Acute Promyelocytic Leukemia
Hematology, January 1, 2003; 2003(1): 82 - 101.
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Proc. Natl. Acad. Sci. USAHome page
Z. Qian, A. A. Fernald, L. A. Godley, R. A. Larson, and M. M. Le Beau
Expression profiling of CD34+ hematopoietic stem/ progenitor cells reveals distinct subtypes of therapy-related acute myeloid leukemia
PNAS, November 12, 2002; 99(23): 14925 - 14930.
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K. Spiekermann, K. Bagrintseva, C. Schoch, T. Haferlach, W. Hiddemann, and S. Schnittger
A new and recurrent activating length mutation in exon 20 of the FLT3 gene in acute myeloid leukemia
Blood, October 16, 2002; 100(9): 3423 - 3425.
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K. W. H. Yee, A. M. O'Farrell, B. D. Smolich, J. M. Cherrington, G. McMahon, C. L. Wait, L. S. McGreevey, D. J. Griffith, and M. C. Heinrich
SU5416 and SU5614 inhibit kinase activity of wild-type and mutant FLT3 receptor tyrosine kinase
Blood, September 26, 2002; 100(8): 2941 - 2949.
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D. G. Gilliland and J. D. Griffin
The roles of FLT3 in hematopoiesis and leukemia
Blood, August 13, 2002; 100(5): 1532 - 1542.
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F. M. Abu-Duhier, A. C. Goodeve, G. A. Wilson, R. S. Carr, I. R. Peake, and J. T. Reilly
FLT3 internal tandem duplication mutations are rare in agnogenic myeloid metaplasia
Blood, June 17, 2002; 100(1): 364 - 364.
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Clin. Cancer Res.Home page
D. G. B. Leonard, L. B. Travis, K. Addya, G. M. Dores, E. J. Holowaty, K. Bergfeldt, D. Malkin, B. A. Kohler, C. F. Lynch, T. Wiklund, et al.
p53 Mutations in Leukemia and Myelodysplastic Syndrome after Ovarian Cancer
Clin. Cancer Res., May 1, 2002; 8(5): 973 - 985.
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