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Prepublished online as a Blood First Edition Paper on September 5, 2002; DOI 10.1182/blood-2002-04-1010.

Submitted April 3, 2002
Accepted August 21, 2002
Implications of somatic mutations in the AML1 gene in radiation-associated and therapy-related myelodysplastic syndrome/acute myeloid leukemia
Hironori Harada*, Yuka Harada, Hideo Tanaka, Akiro Kimura, and Toshiya Inaba
Department of Molecular Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
Department of Molecular Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan; Department of Hematology/Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
Department of Hematology/Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
* Corresponding author; email: herf1{at}hiroshima-u.ac.jp.
Somatically-acquired point mutations of AML1/RUNX1 gene have been recently identified in rare cases of acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Moreover, germline mutations of AML1 were found in an autosomal dominant disease, familial platelet disorder with predisposition to AML (FPD/AML), suggesting that AML1 mutants, as well as AML1 chimeras contribute to the transformation of hematopoietic progenitors. In this report, we showed that AML1 point mutations were found in 6 (46%) of 13 MDS patients among atomic bomb (A-bomb) survivors in Hiroshima. Unlike acute or chronic leukemia patients among A-bomb survivors, MDS patients exposed relatively low dose radiation and developed the disease after long latency period. AML1 mutations were also found in 5 (38%) of 13 therapy-related AML/MDS patients, who were treated with alkylating agents with or without local radiation therapy. In contrast, frequency of AML1 mutation in sporadic MDS patients was 2.7% (2/74). Among AML1 mutations identified in this study, truncated-type mutants lost DNA-binding potential and trans-activation activity. All missense mutations with one exception (G42R) lacked DNA-binding ability and downregulated the trans-activation potential of wild type AML1 in a dominant-negative fashion. The G42R mutation that was shared by two patients, bound DNA even more avidly than wild type AML1 and enhanced the trans-activation potential of normal AML1. These results suggest that AML1 point mutations are related to low dose radiation or alkylating agents and play a role distinct from that of leukemogenic chimeras as a result of chromosomal translocations caused by sublethal radiation or topoisomerase II inhibitors.

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