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Blood, 1 August 2008, Vol. 112, No. 3, pp. 733-740.
Prepublished online as a Blood First Edition Paper on April 14, 2008; DOI 10.1182/blood-2007-12-130096.


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NEOPLASIA

NOTCH1 extracellular juxtamembrane expansion mutations in T-ALL

Maria Luisa Sulis1,2, Odette Williams2, Teresa Palomero2,3, Valeria Tosello2, Sasikala Pallikuppam2, Pedro J. Real2, Kelly Barnes2, Linda Zuurbier4, Jules P. Meijerink4, and Adolfo A. Ferrando13

1 Division of Pediatric Oncology, Department of Pediatrics; 2 Institute for Cancer Genetics; and 3 Department of Pathology, Columbia University Medical Center, New York, NY; and 4 Department of Pediatric Oncology/Hematology, Erasmus Medical Center (MC) Sophia Children's Hospital, Rotterdam, The Netherlands

Heterodimerization domain (HD) mutations in NOTCH1 induce ligand-independent activation of the receptor and contribute to the pathogenesis of one-third of human T-cell lymphoblastic leukemias (T-ALLs). Here we report a novel class of activating mutations in NOTCH1 leading to aberrant activation of NOTCH1 signaling in T-cell lymphoblasts. These so-called juxtamembrane expansion (JME) alleles consist of internal duplication insertions in the vicinity of exon 28 of the NOTCH1 gene encoding the extracellular juxtamembrane region of the receptor. Notably, structure-function analysis of leukemia-derived and synthetic JME mutants demonstrated that the aberrant activation of NOTCH1 signaling is dependent on the number of residues introduced in the extracellular juxtamembrane region of the receptor and not on the specific amino acid sequence of these insertions. JME NOTCH1 mutants are effectively blocked by {gamma}-secretase inhibitors and require an intact metalloprotease cleavage site for activation. Overall, these results show a novel mechanism of NOTCH1 activation in T-ALL and provide further insight on the mechanisms that control the activation of NOTCH1 signaling.


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