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 Blood, 1 May 2004, Vol. 103, No. 9, pp. 3544-3546.
Prepublished online as a Blood First Edition Paper on December 11, 2003; DOI 10.1182/blood-2003-07-2441.

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NEOPLASIA
Brief report

FLT3 mutations in childhood acute lymphoblastic leukemia

Scott A. Armstrong, Meghann E. Mabon, Lewis B. Silverman, Aihong Li, John G. Gribben, Edward A. Fox, Stephen E. Sallan, and Stanley J. Korsmeyer

From the Departments of Pediatric Oncology, Adult Oncology and Cancer Immunology and AIDS, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA; Division of Hematology/Oncology, Children's Hospital, Boston, MA; and the Howard Hughes Medical Institute, Boston, MA.

Activating mutations of the FLT3 receptor tyrosine kinase are common in acute myelogenous leukemia (AML) but are rare in adult acute lymphoblastic leukemia (ALL). We have recently shown that FLT3 is highly expressed and often mutated in ALLs with rearrangement of the mixed lineage leukemia (MLL) gene on chromosome 11q23. Because hyperdiploid ALL samples also show high-level expression of FLT3, we searched for the presence of FLT3 mutations in leukemic blasts from 71 patients with ALL. The data show that approximately 25% (6 of 25) of hyperdiploid ALL samples possess FLT3 mutations, whereas only 1 of 29 TEL/AML1-rearranged samples harbored mutations (P = .04, Fisher exact test). Three mutations are novel in-frame deletions within a 7-amino acid region of the receptor juxtamembrane domain. Finally, 3 samples from patients whose disease would relapse harbored FLT3 mutations. These data suggest that patients with hyperdiploid or relapsed ALL might be considered candidates for therapy with newly described small-molecule FLT3 inhibitors. (Blood. 2004;103: 3544-3546)


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