title: ATM gene deletion in patients with adult acute lymphoblastic leukemia.
abstract: BACKGROUND
  Loss of heterozygosity (LOH) at the ATM gene (mutated in ataxia telangiectasia [AT] patients) and ATM protein deficiency occur in 14% and 34%, respectively, of patients with chronic lymphocytic leukemia (CLL). ATM protein deficiency also is associated with aggressive disease and worse patient survival. Considering the aberrations in the ATM gene in CLL and the high rate of incidence of lymphoid neoplasias in AT patients, the authors investigated its incidence rate and significance in patients with adult acute lymphoblastic leukemia (ALL).
  
  
  METHODS
  Samples from 36 adults with ALL were analyzed for LOH and homozygous deletion (HD) using a panel of three microsatellite markers located at the ATM gene (D11S2179), the MLL gene (D11S1356), and the BCL1 gene (D11S987) loci. These markers are located within the 11q13-q23 locus.
  
  
  RESULTS
  Of the 36 informative cases, 10 (28%) showed deletions (7 LOH and 3 HDs) at the D11S2179 marker. In two patients, the deletions were extended to the MLL gene locus. These deletions were submicroscopic because only 3% (1 of 36) of patients showed abnormalities involving 11q23 using cytogenetic studies. The authors also estimated the levels of ATM protein in 15 ALL patients and 12 healthy volunteers by radioimmunoassay. The ATM protein levels in cases with LOH at the ATM gene were between 15-50% of those from normal bone marrow. In contrast to CLL patients, patients with LOH or HD at the ATM gene locus showed better survival compared with patients without ATM gene deletions (P = 0.003).
  
  
  CONCLUSIONS
  LOH of the ATM gene and protein deficiency are common in adult ALL, are not demonstrated at the cytogenetic level, and are associated with a favorable prognosis. The authors speculate that ATM deficiency may increase the sensitivity of leukemic blasts to the chemotherapy used during induction and after disease remission in patients with adult ALL. The relatively high frequency of deletion of the D11S2179 marker compared with the D11S1356 marker suggests that ATM is the target gene of the deletion at the 11q23 locus, and that such deletions may play a role in the pathogenesis of ALL.
authors.affiliation: Section of Hematopathology, Division of Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030-4095, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Haidar
authors.forename: H
authors.initials: H
authors.lastname: Kantarjian
authors.forename: T
authors.initials: T
authors.lastname: Manshouri
authors.forename: C Y
authors.initials: CY
authors.lastname: Chang
authors.forename: S
authors.initials: S
authors.lastname: O'Brien
authors.forename: E
authors.initials: E
authors.lastname: Freireich
authors.forename: M
authors.initials: M
authors.lastname: Keating
authors.forename: M
authors.initials: M
authors.lastname: Albitar
mesh_terms: D000328:Adult; D001260:Ataxia Telangiectasia / Q000235:genetics*; D064007:Ataxia Telangiectasia Mutated Proteins; D015153:Blotting, Western; D018797:Cell Cycle Proteins; D002880:Chromosomes, Human, Pair 11; D004268:DNA-Binding Proteins; D004586:Electrophoresis; D005260:Female; D017353:Gene Deletion; D006579:Heterozygote; D006801:Humans; D019656:Loss of Heterozygosity; D008297:Male; D018895:Microsatellite Repeats; D016133:Polymerase Chain Reaction; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000401:mortality; D011379:Prognosis; D017346:Protein Serine-Threonine Kinases / Q000032:analysis; D011863:Radioimmunoassay; D015996:Survival Rate; D025521:Tumor Suppressor Proteins
chemical_list: D018797:Cell Cycle Proteins; D004268:DNA-Binding Proteins; D025521:Tumor Suppressor Proteins; C576324:ATM protein, human; D064007:Ataxia Telangiectasia Mutated Proteins; D017346:Protein Serine-Threonine Kinases