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Blood, 15 April 2001, Vol. 97, No. 8, pp. 2434-2439
NEOPLASIA
Activating mutation of D835 within the activation loop of FLT3
in human hematologic malignancies
Yukiya Yamamoto,
Hitoshi Kiyoi,
Yasuyuki Nakano,
Ritsuro Suzuki,
Yoshihisa Kodera,
Shuichi Miyawaki,
Norio Asou,
Kazutaka Kuriyama,
Fumiharu Yagasaki,
Chihiro Shimazaki,
Hideki Akiyama,
Kenji Saito,
Miki Nishimura,
Toshiko Motoji,
Katsuji Shinagawa,
Akihiro Takeshita,
Hidehiko Saito,
Ryuzo Ueda,
Ryuzo Ohno, and
Tomoki Naoe
From the Department of Infectious Diseases and the
First Department of Internal Medicine, Nagoya University School of
Medicine; Division of Molecular Medicine, Aichi Cancer Center; the
Department of Medicine, Japanese Red Cross Nagoya First Hospital;
Second Department of Internal Medicine, Nagoya City University School
of Medicine, Nagoya, Japan; Department of Medicine, Saiseikai Maebashi
Hospital, Maebashi, Japan; Second Department of Internal Medicine,
Kumamoto University School of Medicine, Kumamoto, Japan; Department of
Hematology, Atomic Disease Institute, Nagasaki University School of
Medicine, Nagasaki, Japan; First Department of Internal Medicine,
Saitama Medical School, Saitama, Japan; Second Department of Medicine,
Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of
Hematology, Tokyo Metropolitan Komagome Hospital; Department of
Hematology, Tokyo Women's Medical University, Tokyo, Japan; Department
of Hematology, Dokkyo University School of Medicine, Tochigi, Japan;
Second Department of Internal Medicine, Chiba University School of
Medicine, Chiba, Japan; Second Department of Medicine, Okayama
University School of Medicine, Okayama, Japan; and Department of
Medicine III, Hamamatsu University School of Medicine, Hamamatsu,
Japan.
Mutations of receptor tyrosine kinases are implicated in the
constitutive activation and development of human malignancy. An
internal tandem duplication (ITD) of the juxtamembrane (JM) domain-coding sequence of the FLT3 gene (FLT3/ITD) is found
in 20% of patients with acute myeloid leukemia (AML) and is strongly associated with leukocytosis and a poor prognosis. On the other hand,
mutations of the c-KIT gene, which have been found in mast cell leukemia and AML, are clustered in 2 distinct regions, the JM
domain and D816 within the activation loop. This study was designed to
analyze the mutation of D835 of FLT3, which corresponds to D816 of
c-KIT, in a large series of human hematologic malignancies. Several
kinds of missense mutations were found in 30 of the 429 (7.0%) AML
cases, 1 of the 29 (3.4%) myelodysplastic syndrome (MDS) cases, and 1 of the 36 (2.8%) acute lymphocytic leukemia patients. The D835Y
mutation was most frequently found (22 of the 32 D835 mutations),
followed by the D835V (5), and D835H (1), D835E (1), and D835N (1)
mutations. Of note is that D835 mutations occurred independently of
FLT3/ITD. An analysis in the 201 patients newly diagnosed with AML
(excluding M3) revealed that, in contrast to the FLT3/ITD mutation
(n = 46), D835 mutations (n = 8) were not significantly related to
the leukocytosis, but tended to worsen disease-free survival. All
D835-mutant FLT3 were constitutively tyrosine-phosphorylated and
transformed 32D cells, suggesting these mutations were constitutively
active. These results demonstrate that the FLT3 gene is the
target most frequently mutated to become constitutively active in AML.

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S. Knapper, A. K. Burnett, T. Littlewood, W. J. Kell, S. Agrawal, R. Chopra, R. Clark, M. J. Levis, and D. Small
A phase 2 trial of the FLT3 inhibitor lestaurtinib (CEP701) as first-line treatment for older patients with acute myeloid leukemia not considered fit for intensive chemotherapy
Blood,
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[Abstract]
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S. Knapper, K. I. Mills, A. F. Gilkes, S. J. Austin, V. Walsh, and A. K. Burnett
The effects of lestaurtinib (CEP701) and PKC412 on primary AML blasts: the induction of cytotoxicity varies with dependence on FLT3 signaling in both FLT3-mutated and wild-type cases
Blood,
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[Abstract]
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T. Ikezoe, C. Nishioka, T. Tasaka, Y. Yang, N. Komatsu, K. Togitani, H. P. Koeffler, and H. Taguchi
The antitumor effects of sunitinib (formerly SU11248) against a variety of human hematologic malignancies: enhancement of growth inhibition via inhibition of mammalian target of rapamycin signaling.
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[Abstract]
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C. Thiede, S. Koch, E. Creutzig, C. Steudel, T. Illmer, M. Schaich, G. Ehninger, and for the Deutsche Studieninitiative Leukamie (DSIL)
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Blood,
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[Abstract]
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O. Piloto, B. Nguyen, D. Huso, K.-T. Kim, Y. Li, L. Witte, D. J. Hicklin, P. Brown, and D. Small
IMC-EB10, an Anti-FLT3 Monoclonal Antibody, Prolongs Survival and Reduces Nonobese Diabetic/Severe Combined Immunodeficient Engraftment of Some Acute Lymphoblastic Leukemia Cell Lines and Primary Leukemic Samples.
Cancer Res.,
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[Abstract]
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D. L. Stirewalt, K. J. Kopecky, S. Meshinchi, J. H. Engel, E. L. Pogosova-Agadjanyan, J. Linsley, M. L. Slovak, C. L. Willman, and J. P. Radich
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Blood,
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R. Cairoli, A. Beghini, G. Grillo, G. Nadali, F. Elice, C. B. Ripamonti, P. Colapietro, M. Nichelatti, L. Pezzetti, M. Lunghi, et al.
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[Abstract]
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C. Reindl, K. Bagrintseva, S. Vempati, S. Schnittger, J. W. Ellwart, K. Wenig, K.-P. Hopfner, W. Hiddemann, and K. Spiekermann
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Blood,
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A. Shimada, T. Taki, K. Tabuchi, A. Tawa, K. Horibe, M. Tsuchida, R. Hanada, I. Tsukimoto, and Y. Hayashi
KIT mutations, and not FLT3 internal tandem duplication, are strongly associated with a poor prognosis in pediatric acute myeloid leukemia with t(8;21): a study of the Japanese Childhood AML Cooperative Study Group
Blood,
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H. S. Radomska, D. S. Basseres, R. Zheng, P. Zhang, T. Dayaram, Y. Yamamoto, D. W. Sternberg, N. Lokker, N. A. Giese, S. K. Bohlander, et al.
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F. Heidel, F. K. Solem, F. Breitenbuecher, D. B. Lipka, S. Kasper, M. H. Thiede, C. Brandts, H. Serve, J. Roesel, F. Giles, et al.
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X. Lu, R. Levine, W. Tong, G. Wernig, Y. Pikman, S. Zarnegar, D. G. Gilliland, and H. Lodish
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P. Van Vlierberghe, J. P. P. Meijerink, R. W. Stam, W. van der Smissen, E. R. van Wering, H. B. Beverloo, and R. Pieters
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R. E. Gale, R. Hills, A. R. Pizzey, P. D. Kottaridis, D. Swirsky, A. F. Gilkes, E. Nugent, K. I. Mills, K. Wheatley, E. Solomon, et al.
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C. H. Brandts, B. Sargin, M. Rode, C. Biermann, B. Lindtner, J. Schwable, H. Buerger, C. Muller-Tidow, C. Choudhary, M. McMahon, et al.
Constitutive Activation of Akt by Flt3 Internal Tandem Duplications Is Necessary for Increased Survival, Proliferation, and Myeloid Transformation
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T. Suzuki, H. Kiyoi, K. Ozeki, A. Tomita, S. Yamaji, R. Suzuki, Y. Kodera, S. Miyawaki, N. Asou, K. Kuriyama, et al.
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R. W. Stam, M. L. den Boer, P. Schneider, P. Nollau, M. Horstmann, H. B. Beverloo, E. van der Voort, M. G. Valsecchi, P. de Lorenzo, S. E. Sallan, et al.
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D. T. Bowen, M. E. Frew, R. Hills, R. E. Gale, K. Wheatley, M. J. Groves, S. E. Langabeer, P. D. Kottaridis, A. V. Moorman, A. K. Burnett, et al.
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S. Frohling, C. Scholl, D. G. Gilliland, and R. L. Levine
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X. Yang, L. Liu, D. Sternberg, L. Tang, I. Galinsky, D. DeAngelo, and R. Stone
The FLT3 Internal Tandem Duplication Mutation Prevents Apoptosis in Interleukin-3-Deprived BaF3 Cells Due to Protein Kinase A and Ribosomal S6 Kinase 1-Mediated BAD Phosphorylation at Serine 112
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D. E. Lopes de Menezes, J. Peng, E. N. Garrett, S. G. Louie, S. H. Lee, M. Wiesmann, Y. Tang, L. Shephard, C. Goldbeck, Y. Oei, et al.
CHIR-258: A Potent Inhibitor of FLT3 Kinase in Experimental Tumor Xenograft Models of Human Acute Myelogenous Leukemia
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D. S. Krause and R. A. Van Etten
Tyrosine Kinases as Targets for Cancer Therapy
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C. Choudhary, J. Schwable, C. Brandts, L. Tickenbrock, B. Sargin, T. Kindler, T. Fischer, W. E. Berdel, C. Muller-Tidow, and H. Serve
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R. Grundler, C. Miething, C. Thiede, C. Peschel, and J. Duyster
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K. Bagrintseva, S. Geisenhof, R. Kern, S. Eichenlaub, C. Reindl, J. W. Ellwart, W. Hiddemann, and K. Spiekermann
FLT3-ITD-TKD dual mutants associated with AML confer resistance to FLT3 PTK inhibitors and cytotoxic agents by overexpression of Bcl-x(L)
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[Abstract]
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L. Tickenbrock, J. Schwable, M. Wiedehage, B. Steffen, B. Sargin, C. Choudhary, C. Brandts, W. E. Berdel, C. Muller-Tidow, and H. Serve
Flt3 tandem duplication mutations cooperate with Wnt signaling in leukemic signal transduction
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D. K. Walters, E. P. Stoffregen, M. C. Heinrich, M. W. Deininger, and B. J. Druker
RNAi-induced down-regulation of FLT3 expression in AML cell lines increases sensitivity to MLN518
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C. Recher, O. Beyne-Rauzy, C. Demur, G. Chicanne, C. Dos Santos, V. M.-D. Mas, D. Benzaquen, G. Laurent, F. Huguet, and B. Payrastre
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J. Schwable, C. Choudhary, C. Thiede, L. Tickenbrock, B. Sargin, C. Steur, M. Rehage, A. Rudat, C. Brandts, W. E. Berdel, et al.
RGS2 is an important target gene of Flt3-ITD mutations in AML and functions in myeloid differentiation and leukemic transformation
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P. Chen, M. Levis, P. Brown, K.-T. Kim, J. Allebach, and D. Small
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O. Piloto, M. Levis, D. Huso, Y. Li, H. Li, M.-N. Wang, R. Bassi, P. Balderes, D. L. Ludwig, L. Witte, et al.
Inhibitory Anti-FLT3 Antibodies Are Capable of Mediating Antibody-Dependent Cell-Mediated Cytotoxicity and Reducing Engraftment of Acute Myelogenous Leukemia Blasts in Nonobese Diabetic/Severe Combined Immunodeficient Mice
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W. Fiedler, H. Serve, H. Dohner, M. Schwittay, O. G. Ottmann, A.-M. O'Farrell, C. L. Bello, R. Allred, W. C. Manning, J. M. Cherrington, et al.
A phase 1 study of SU11248 in the treatment of patients with refractory or resistant acute myeloid leukemia (AML) or not amenable to conventional therapy for the disease
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P. Brown, M. Levis, S. Shurtleff, D. Campana, J. Downing, and D. Small
FLT3 inhibition selectively kills childhood acute lymphoblastic leukemia cells with high levels of FLT3 expression
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M. Wadleigh, D. J. DeAngelo, J. D. Griffin, and R. M. Stone
After chronic myelogenous leukemia: tyrosine kinase inhibitors in other hematologic malignancies
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R. M. Stone, D. J. DeAngelo, V. Klimek, I. Galinsky, E. Estey, S. D. Nimer, W. Grandin, D. Lebwohl, Y. Wang, P. Cohen, et al.
Patients with acute myeloid leukemia and an activating mutation in FLT3 respond to a small-molecule FLT3 tyrosine kinase inhibitor, PKC412
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K. Y. Chung, G. Morrone, J. J. Schuringa, B. Wong, D. C. Dorn, and M. A. S. Moore
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T. Kindler, F. Breitenbuecher, S. Kasper, E. Estey, F. Giles, E. Feldman, G. Ehninger, G. Schiller, V. Klimek, S. D. Nimer, et al.
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K. W. H. Yee, M. Schittenhelm, A.-M. O'Farrell, A. R. Town, L. McGreevey, T. Bainbridge, J. M. Cherrington, and M. C. Heinrich
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J. J. Clark, J. Cools, D. P. Curley, J.-C. Yu, N. A. Lokker, N. A. Giese, and D. G. Gilliland
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F. Chiara, M.-J. Goumans, H. Forsberg, A. Ahgren, A. Rasola, P. Aspenstrom, C. Wernstedt, C. Hellberg, C.-H. Heldin, and R. Heuchel
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P. Brown, S. Meshinchi, M. Levis, T. A. Alonzo, R. Gerbing, B. Lange, R. Arceci, and D. Small
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J. Jiang, J. G. Paez, J. C. Lee, R. Bo, R. M. Stone, D. J. DeAngelo, I. Galinsky, B. M. Wolpin, A. Jonasova, P. Herman, et al.
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M. Levis, R. Pham, B. D. Smith, and D. Small
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R. Luthra and L. J. Medeiros
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J. Chen, I. R. Williams, J. L. Kutok, N. Duclos, E. Anastasiadou, S. C. Masters, H. Fu, and D. G. Gilliland
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E. J. C. Rombouts, B. Pavic, B. Lowenberg, and R. E. Ploemacher
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E. Paietta, A. A. Ferrando, D. Neuberg, J. M. Bennett, J. Racevskis, H. Lazarus, G. Dewald, J. M. Rowe, P. H. Wiernik, M. S. Tallman, et al.
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