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Prepublished online as a Blood First Edition Paper on April 30, 2002; DOI 10.1182/blood-2002-02-0382.

Submitted February 5, 2002
Accepted April 10, 2002
ATM mutations are associated with inactivation of the ARF-TP53 tumor suppressor pathway in diffuse large B-cell lymphoma
Kirsten Gronbaek, Jesper Worm, Elisabeth Ralfkiaer, Vibeke Ahrenkiel, Peter Hokland, and Per Guldberg*
Department of Tumor Cell Biology, Institute of Cancer Biology, Copenhagen, Denmark
Department of Pathology, Rigshospitalet, Copenhagen, Denmark; Department of Pathology, Herlev University Hospital, Copenhagen, Denmark
Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
* Corresponding author; email: perg{at}cancer.dk.
The ATM serine-threonine kinase plays a central role in the cellular response to DNA damage. Germ-line mutations in the ATM gene cause ataxia-telangiectasia (A-T), a multisystem disorder associated with predisposition to lymphoma and acute leukemia. Moreover, somatic ATM mutations have been identified in T-cell prolymphocytic leukemia, mantle cell lymphoma, and B-cell chronic lymphocytic leukemia. In this study, the entire ATM coding sequence was examined in genomic DNA from 120 lymphoid neoplasms. Novel mutations and mutations implicated in cancer and/or A-T were found in 9 of 45 diffuse large B-cell lymphomas (DLBCL), 2 of 24 follicular lymphomas, and 1 of 27 adult acute lymphoblastic leukemias, whereas no such mutations were detected among 24 peripheral T-cell lymphomas. The mutational spectrum consisted of 2 nonsense mutations, 1 mutation affecting RNA splicing, and 10 missense variants. Most of these mutations were associated with loss or mutation of the paired ATM allele, consistent with biallelic inactivation of ATM. Seven of the 9 DLBCLs with ATM mutations also carried TP53 mutations and/or deletions of the ARF gene (P = 0.003). The ATM 735C>T substitution previously considered a rare normal variant was found to be 5.6 times more frequent in DLBCL than in random individuals (P = 0.026), suggesting that it may predispose to B-cell lymphoma. Our data suggest that ATM mutations contribute to the development of DLBCL, and that ATM and the ARF-p53 tumor suppressor pathway may cooperate in the pathogenesis of this malignancy.

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