title: Backtracking RAS mutations in high hyperdiploid childhood acute lymphoblastic leukemia.
abstract: High hyperdiploidy is the single largest subtype of childhood acute lymphoblastic leukemia (ALL) and is defined by the presence of 51-68 chromosomes in a karyotype. The 5 or more extra chromosomes characterizing this subtype are known to occur in a single mitotic event, prenatally. We screened for RAS mutations among 517 acute childhood leukemias (including 437 lymphocytic, of which 393 were B-cell subtypes) and found mutations in 30% of high hyperdiploids compared to only 10% of leukemias of other subtypes (P<0.0001). We assessed whether KRAS mutations occurred before birth using a PCR-restriction enzyme-mediated Taqman quantitative PCR reaction, and found no evidence for prenatal KRAS mutations in 14 patients tested. While RAS mutations were previously associated with prior chemical exposures in childhood and adult leukemias, in this study RAS-mutated cases were not significantly associated with parental smoking when compared to study controls. IGH rearrangements were backtracked in three RAS-positive patients (which were negative for KRAS mutation at birth) and found to be evident before birth, confirming a prenatal origin for the leukemia clone. We posit a natural history for hyperdiploid leukemia in which prenatal mitotic catastrophe is followed by a postnatal RAS mutation to produce the leukemic cell phenotype.
authors.affiliation: Laboratory for Molecular Epidemiology, Department of Epidemiology and Biostatistics, and Helen Diller Comprehensive Cancer Center, University of California San Francisco, CA 94158, USA. joe.wiemels@ucsf.edu
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Wiemels
authors.forename: Michelle
authors.initials: M
authors.lastname: Kang
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Chang
authors.forename: Lily
authors.initials: L
authors.lastname: Zheng
authors.forename: Carina
authors.initials: C
authors.lastname: Kouyoumji
authors.forename: Luoping
authors.initials: L
authors.lastname: Zhang
authors.forename: Martyn T
authors.initials: MT
authors.lastname: Smith
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Scelo
authors.forename: Catherine
authors.initials: C
authors.lastname: Metayer
authors.forename: Patricia
authors.initials: P
authors.lastname: Buffler
authors.forename: John K
authors.initials: JK
authors.lastname: Wiencke
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D002869:Chromosome Aberrations; D005260:Female; D006801:Humans; D008297:Male; D011003:Ploidies; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics*; D011518:Proto-Oncogene Proteins / Q000235:genetics*; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins / Q000235:genetics*
chemical_list: C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins