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Query: EC:2.7.10.1 (
ERK
)
95,504
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
In 20 patients with myeloid malignancies and isolated trisomy 11 an internal tandem duplication of the
MLL
and
FLT3
genes was observed in 41% and 31% of the cases, respectively; 80% of the FLT3+ cases showed
MLL
self-fusion. Concomitant presence of
MLL
and
FLT3
anomalies could be relevant in determining the poor outcome of patients with acute myeloid leukemia with trisomy 11.
...
PMID:Trisomy 11 in myeloid malignancies is associated with internal tandem duplication of both MLL and FLT3 genes. 1571 May 85
Acute promyelocytic leukemia (APL) with t(15;17) appears in two phenotypes: AML M3, with abnormal promyelocytes showing heavy granulation and bundles of Auer rods, and AML M3 variant (M3v), with non- or hypogranular cytoplasm and a bilobed nucleus. We investigated the global gene expression profiles of 35 APL patients (19 AML M3, 16 AML M3v) by using high-density DNA-oligonucleotide microarrays. First, an unsupervised approach clearly separated APL samples from other AMLs characterized genetically as t(8;21) (n = 35), inv(16) (n = 35), or t(11q23)/
MLL
(n = 35) or as having a normal karyotype (n = 50). Second, we found genes with functional relevance for blood coagulation that were differentially expressed between APL and other AMLs. Furthermore, a supervised pairwise comparison between M3 and M3v revealed differential expression of genes that encode for biological functions and pathways such as granulation and maturation of hematologic cells, explaining morphologic and clinical differences. Discrimination between M3 and M3v based on gene signatures showed a median classification accuracy of 90% by use of 10-fold CV and support vector machines. Additional molecular mutations such as
FLT3
-LM, which were significantly more frequent in M3v than in M3 (P < 0.0001), may partly contribute to the different phenotypes. However, linear regression analysis demonstrated that genes differentially expressed between M3 and M3v did not correlate with
FLT3
-LM.
...
PMID:AML M3 and AML M3 variant each have a distinct gene expression signature but also share patterns different from other genetically defined AML subtypes. 1575 Oct 46
Recently, somatic mutations of the nucleophosmin gene (NPM1), which alter the subcellular localization of the product, have been reported in acute myeloid leukemia (AML). We analyzed the clinical significance of NPM1 mutations in comparison with cytogenetics,
FLT3
, NRAS, and TP53 mutations, and a partial tandem duplication of the
MLL
gene (
MLL
-TD) in 257 patients with AML. We found NPM1 mutations, including 4 novel sequence variants, in 64 of 257 (24.9%) patients. NPM1 mutations were associated with normal karyotype and with internal tandem duplication (ITD) and D835 mutations in
FLT3
, but not with other mutations. In 190 patients without the M3 French-American-British (FAB) subtype who were treated with the protocol of the Japan Adult Leukemia Study Group, multivariate analyses showed that the NPM1 mutation was a favorable factor for achieving complete remission but was associated with a high relapse rate. Sequential analysis using 39 paired samples obtained at diagnosis and relapse showed that NPM1 mutations were lost at relapse in 2 of the 17 patients who had NPM1 mutations at diagnosis. These results suggest that the NPM1 mutation is not necessarily an early event during leukemogenesis or that leukemia clones with NPM1 mutations are sensitive to chemotherapy.
...
PMID:Clinical characteristics and prognostic implications of NPM1 mutations in acute myeloid leukemia. 1599 85
In the present study 170 newly diagnosed acute promyelocytic leukaemia patients (M3: n = 121; M3v: n = 49) were molecularly characterised with respect to PML breakpoint and additional molecular mutations. In total, 83 patients were positive for bcr1 (49%), five for bcr2 (3%) and 82 for bcr3 (48%). Bcr3 was more frequent in M3v (65.3%) compared with M3 (41.3%) (P = 0.005). Cases with bcr3 showed a significantly higher white blood cell count (median: 3.65 x 10(9)/l vs. 1.59 x 10(9)/l, P = 0.003), as well as a higher PML-RARAABL expression ratio (14.8% vs. 72.7%, P < 0.005) compared with bcr1.
FLT3
-length-mutations were detected more frequently together with bcr3 compared with bcr1 (56.5% vs. 19.4%, P < 0.001) and in M3v compared with M3 (64.5% vs. 24.1%, P < 0.005).
FLT3
tyrosine kinase mutations were found in eight cases (6.4%) and were distributed equally within the total group. Analysis for further mutations revealed no
MLL
-PTD and
KIT
mutations and only two cases of 99 analysed (2%) with NRAS mutations.
FLT3
-mutations were detected in 62 of 139 cases (44.6%) and associated with a significant lower overall survival (P = 0.0339). In addition, cases with bcr3 showed a tendency for a worse event-free survival (P = 0.0795) compared with the bcr1 group.
...
PMID:Impact of FLT3 mutations and promyelocytic leukaemia-breakpoint on clinical characteristics and prognosis in acute promyelocytic leukaemia. 1602 47
17-allylamino-17-demethoxygeldanamycin (17-AAG), an inhibitor of the molecular chaperone heat shock protein 90, results in cell type-specific inhibition of proliferation of leukemic cells. GTP14564 is a tyrosine kinase inhibitor actively against
FLT3
. The current study evaluated the single and combined effects of 17-AAG and GTP14564, and the role of
FLT3
in their inhibitory effects. The importance of
FLT3
mutations was demonstrated using small interfering RNA (siRNA) targeted to
FLT3
. Similar to
FLT3
siRNA, GTP14564 inhibited
FLT3
internal tandem duplication (ITD) cells (MV4;11) and
FLT3
amplified wild-type cells (SEMK2-M1), but not wild-type
FLT3
cells (RS4;11). However, when RS4;11 cells were stimulated with
FLT3
-ligand, phosphorylation of STAT5 and GTP14564 inhibition were observed. Responses to GTP14564 in all cell types were directly related to the level of STAT5 phosphorylation in the cells. We observed synergistic effects of combined 17-AAG and GTP14564 in cell lines with
FLT3
-ITD and amplified wild-type
FLT3
. Combined treatment with 17-AAG and GTP14564 reduced the levels of p-
FLT3
and p-STAT5, enhanced G0/G1 arrest and apoptosis in
FLT3
-ITD and amplified wild-type
FLT3
. The combination of 17-AAG with
FLT3
kinase inhibitors can enhance targeted therapy in leukemias with
FLT3
mutations, such as
MLL
fusion gene leukemias.
...
PMID:Human leukemias with mutated FLT3 kinase are synergistically sensitive to FLT3 and Hsp90 inhibitors: the key role of the STAT5 signal transduction pathway. 1603 64
Nucleophosmin (NPM1) exon-12 gene mutations are the hallmark of a large acute myelogenous leukemia (AML) subgroup with normal karyotype, but their prognostic value in this AML subset has not yet been determined. We screened 401 AML patients with normal karyotype treated within the German AML Cooperative Group Protocol 99 (AMLCG99) study for NPM1 mutations. Results were related with partial tandem duplications within the
MLL
gene (MLL-PTD), Fms-like tyrosine kinase 3-length mutations (FLT3-LM), the tyrosine kinase domain of
FLT3
(FLT3-TKD), NRAS,
KIT
, and CEBPA mutations and with clinical characteristics and outcome. NPM1 mutations were detected in 212 (52.9%) of 401 patients. Fourteen mutations, including 8 new variants, were identified. NPM1-mutated cases associated frequently with
FLT3
mutations but rarely with other mutations. The NPM1-mutated group had a higher complete remission (CR) rate (70.5% vs 54.7%, P = .003), a trend to a longer overall survival (OS; median 1012 vs 549 days, P = .076), and significantly longer event-free survival (EFS; median 428 vs 336 days; P = .012). The favorable impact of NPM1 mutations on OS and EFS clearly emerged in the large group (264 [66.8%] of 395 cases) of normal-karyotype AML without
FLT3
-LM. This positive effect was lost in the presence of a concomitant
FLT3
-LM, since survival of the NPM1+/
FLT3
-LM+ double positive was similar to NPM1-/
FLT3
-LM+ cases. In conclusion, this study demonstrates that NPM1+/
FLT3
-LM- mutations are an independent predictor for a favorable outcome in AML with normal karyotype.
...
PMID:Nucleophosmin gene mutations are predictors of favorable prognosis in acute myelogenous leukemia with a normal karyotype. 1607 67
Partial tandem (PTD) and internal tandem duplications (ITD) of the
MLL
or
FLT3
genes respectively, have been demonstrated in acute myeloid leukemia (AML). While occurrence of each of these PTD/ITD seem to confer an unfavorable prognosis, the literature contains only sparse information of the occurrence and the prognosis of simultaneous PTD/ITD of these genes. We have therefore attempted to determine the presence and its consequence in AML and with the further aim of characterizing such patients with respect to other genetic aberrations and to prototype variables in this disease. We analyzed blast cells from 250 adult patients treated at the same institution during a 15-year period for
FLT3
ITD and
MLL
PTD and the duplications were found in 24% and 4%, respectively. The four co-duplicated cases (2%) did not differ with respect to sex, age, FAB-type, or immunophenotype, promoter methylation of p15, E-cadherin (CDH1), Estrogen receptor, MDR1, expression of apoptosis-related or multidrug resistance-related genes, though a trend toward decreased gene expression of MDR1 was observed. Two of the patients had a normal karyotypic analysis, while the remaining two showed aberrations in chromosome 11, one with trisomy 11 and the other with a der (11). The extensive molecular characterization of
FLT3
/
MLL
coduplicated patients presented here indicates that, even though they do not differ molecularly from the groups of patients with single ITDs, their prognosis and overall survival is universally poor. More patients are needed to determine whether coduplication has independent clinical implications compared to patients with single ITD/PTD.
...
PMID:Delineation and molecular characterization of acute myeloid leukemia patients with coduplication of FLT3 and MLL. 1610 73
Bruton's tyrosine kinase (BTK) deficiency results in a differentiation block at the pre-B cell stage. Likewise, acute lymphoblastic leukemia cells are typically arrested at early stages of B cell development. We therefore investigated BTK function in B cell precursor leukemia cells carrying a BCR-ABL1, E2A-PBX1,
MLL
-AF4, TEL-AML1, or TEL-
PDGFRB
gene rearrangement. Although somatic mutations of the BTK gene are rare in B cell precursor leukemia cells, we identified kinase-deficient splice variants of BTK throughout all leukemia subtypes. Unlike infant leukemia cells carrying an
MLL
-AF4 gene rearrangement, where expression of full-length BTK was detectable in only four of eight primary cases, in leukemia cells harboring other fusion genes full-length BTK was typically coexpressed with kinase-deficient variants. As shown by overexpression experiments, kinase-deficient splice variants can act as a dominant-negative BTK in that they suppress BTK-dependent differentiation and pre-B cell receptor responsiveness of the leukemia cells. On the other hand, induced expression of full-length BTK rendered the leukemia cells particularly sensitive to apoptosis. Comparing BTK expression in surviving or preapoptotic leukemia cells after 10-Gy gamma radiation, we observed selective survival of leukemia cells that exhibit expression of dominant-negative BTK forms. These findings indicate that lack of BTK expression or expression of dominant-negative splice variants in B cell precursor leukemia cells can (i) inhibit differentiation beyond the pre-B cell stage and (ii) protect from radiation-induced apoptosis.
...
PMID:Deficiency of Bruton's tyrosine kinase in B cell precursor leukemia cells. 1614 23
FLT3
is a class III receptor tyrosine kinase together with
KIT
,
FMS
and
PDGFR
.
FLT3
mutations were first reported as internal tandem duplication (
FLT3
/ITD) of the juxtamembrane domain-coding sequence, and subsequently as a missense mutation of D835 (
FLT3
/KDM) within a kinase domain. Furthermore, point mutations, deletions, and insertions in the codons surrounding D835 have also been found.
FLT3
/ITD and
FLT3
/KDM occur in 15% to 35% and 5% to 10%, respectively, of patients with AML.
FLT3
mutations are, therefore, the most frequent genetic alterations so far reported in AML. Several large-scale studies have confirmed that
FLT3
/ITD is strongly associated with leukocytosis and a poor prognosis. Although the clinical significance of
FLT3
/KDM is controversial, the meta-analysis suggests its adverse effect on the outcome.
FLT3
/ITD is far less common in patients with ALL, whereas
FLT3
/KDM is recurrently found in patients with ALL, especially in those harboring an
MLL
gene rearrangement or hyperdiploidy. The overexpression of
FLT3
transcripts has been demonstrated in a pro-portion of the AML patients without
FLT3
mutations, which are associated with a poor prognosis for overall survival. Routine screening of
FLT3
mutations is recommended to stratify the patients into distinct risk groups, while the optimal treatment strategy for patients with
FLT3
mutations should be further evaluated.
...
PMID:Clinical significance of FLT3 in leukemia. 1614 37
Genetic and molecular techniques have provided increasing insights into the biology of acute myeloid leukemia (AML). These investigations showed that AML is not a homogeneous disease but a heterogeneous group of biologically different subentities. These subentities are currently primarily defined by cytogenetics by which three main subgroups can be discriminated: AML with balanced translocations, AML with unbalanced aberrations and AML without cytogenetically detectable aberrations. Within the latter group molecular alterations are identified in more than half of cases such as NPM mutations,
FLT3
mutations,
MLL
duplications and mutations of CEBP-alpha. The clinical meaning of these findings is illustrated by substantial differences in response to therapy and long-term outcome. As demonstrated by the recent multicenter trial of the German AML Cooperative Group (AMLCG) and other studies intensification of induction therapy may improve the results in distinct subtypes but fails to do so in others. Therefore, new strategies need to be explored which incorporate the knowledge about the biology of AML to develop biology adapted treatment strategies. This process has just begun and is predominantly determined by the availability of new agents and their evaluation in clinical phase I and II studies. A variety of targets are currently explored and some trials have yielded promising results already. The step towards a biology adapted treatment of AML is long and requires the combined efforts of researchers, clinicians and the pharmaceutical industry. The first steps towards this goal have been taken and give rise to the hope for more effective and more specific therapies of AML.
...
PMID:Towards a pathogenesis-oriented therapy of acute myeloid leukemia. 1620 31
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