ETV6 Is the Target of Chromosome 12P Deletions in T(12;21) Childhood Acute Lymphocytic Leukemia
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Leukemia (1997) 11, 1459–1464 1997 Stockton Press All rights reserved 0887-6924/97 $12.00 ETV6 is the target of chromosome 12p deletions in t(12;21) childhood acute lymphocytic leukemia H Cave´ 1, V Cacheux2, S Raynaud3, G Brunie1, M Bakkus4, P Cochaux5, C Preudhomme6, JL Laı¨7, E Vilmer8 and B Grandchamp1,9 1Laboratoire de Biochimie Ge´ne´tique, 2Laboratoire de Biologie du De´veloppement, 8Service d’He´matologie, Hoˆpital Robert Debre´, Paris; 3Laboratoire de Ge´ne´tique Mole´culaire des Cancers Humains, CNRS URA 1462, Nice, France; 4Faculte´ de Me´decine VUB, Bruxelles; 5Universite´ libre de Bruxelles, De´partement de Ge´ne´tique Me´dicale, Hopital Erasme, Bruxelles, Belgium; 6Institut de recherche sur le cancer, Lille; 7Laboratoire de cytoge´ne´tique, CHRU, Lille; and 9INSERM U409, Faculte´ de Me´decine Xavier Bichat, Paris, France The presence of ETV6 deletions was investigated in 215 chil- of t(5;12)10 and was subsequently found to be fused to a dren with acute lymphoblastic leukemia (ALL) using the loss number of different partners as a result of various leukemia- of heterozygosity (LOH) approach. We used four intragenic or 11–13 juxtagenic microsatellite markers to detect allelic deletions. In associated translocations. In pediatric B lineage ALL, this series of unselected patients, LOH of ETV6 markers was t(12;21)(p13;q22), which leads to the formation of a ETV6- found in 23% of cases (6% of T-ALL and 26% of B lineage ALL) AML1 fusion gene on the der(21) chromosome,14,15 is found confirming that chromosome 12p12-13 deletions represent a with a high frequency (16–28%).16–18 Interestingly, we have major genetic alteration in childhood ALL, frequently missed by previously shown that t(12;21) and deletions of the non-trans- cytogenetic analysis. The presence of a t(12;21)(p13;q22) was located chromosome 12 were frequently associated in these studied by RT-PCR and/or FISH in a total of 134 patients (125 B lineage ALL, nine T-ALL) including 42 cases with LOH. Thirty- children and we found an intragenic deletion of ETV6 in one four out of 44 patients (77%) for whom a t(12;21) was observed patient with a t(12;21) suggesting that ETV6 was the target of displayed LOH of the ETV6 markers. When associated with a the deletions. In our initial series, 14 out of 16 patients with t(12;21), ETV6 is very likely to be the target of deletions as indi- t(12;21) had lost the non-translocated allele of ETV6.6 These cated by the detection of intragenic deletions in three patients. results contrast with those of other studies using Southern blot Although deletion of ETV6 and t(12;21) were associated in most analysis that reported a much lower frequency of ETV6 patients, in eight cases (six B lineage and two T-ALL) LOH was 16,17 detected at the ETV6 locus without ETV6-AML1 hybrid RNA. deletions in patients with a t(12;21). Besides, while FISH studies conducted in five of these eight patients con- t(12;21) is specifically found in children with B lineage ALL, firmed the absence of translocation involving ETV6. In such 12p deletions have also been detected in patients with other patients, the other allele of ETV6 could be disrupted by either types of malignancies19 including T-ALL,20 and it is unclear a small deletion, a point mutation, or an epigenetic modification whether or not ETV6 is the target of 12p deletions in all cases and it will be of interest to study the structure and expression or in a specific subset of patients. Indeed, a recent study of of the remaining allele of ETV6 in these cases. Alternatively, a tumor suppressor gene located close to ETV6 and CDKN1B LOH for 12p markers in childhood ALL suggested that ETV6 could be the target of deletions. might not be the target of all 12p deletions, since a second Keywords: ETV6; ETV6-AML1; t(12;21); loss of heterozygosity; region of deletion that did not include ETV6 was found near deletion; acute lymphoblastic leukemia CDKN1B.4 The aims of the present study were to establish the frequency of ETV6 deletions in a large series of children with B and T lineage ALL, to determine the occurence of small Introduction deletions involving specifically ETV6 that may incriminate this gene as the target gene of the deletions, and to correlate the Abnormalities of the short arm of chromosome 12 are quite presence of these deletions with the presence of t(12;21). We common in various hematological malignancies including used four intragenic or juxtagenic microsatellite markers to acute myeloid leukemia, myelodysplastic syndrome, myelo- detect allelic deletions of ETV6, and the t(12;21) translocation proliferative disease and acute lymphoblastic leukemia (ALL).1 was sought by FISH and/or RT-PCR of the ETV6-AML1 Chromosome 12p alterations consist of both deletions and chimeric transcript. translocations. Recent studies using microsatellite markers have shown that loss of heterozygosity (LOH) in the chromo- somal region 12p12-13 is found in 20–40% of cases in child- Patients and methods hood ALL.2–4 This suggested that a tumor suppressor gene (TSG) might be located in this region whose inactivation Patients would participate in leukemogenesis.5 LOH mapping and FISH analysis indicated that, in the majority of patients, the We studied 215 children (aged 3 months to 15 years) with deletion contained two genes, the CDKN1B gene (previously ALL (183 B lineage ALL, 32 T-ALL). Eight of these children named KIP1) and the ETS-variant gene 6 (ETV6, previously were studied both at diagnosis and at marrow relapse. Chil- named TEL).3,4,6–9 CDKN1B encodes the cyclin-dependent dren were consecutively diagnosed and unselected, except kinase inhibitor p27 that is a regulator of the cell cycle and that inclusion required the presence of at least 70% of blasts therefore a candidate TSG, but several studies concluded that in marrow at the time of diagnosis or relapse (13 children the remaining allele of this gene is not mutated in patients have been excluded because of a low percentage of blasts in with one deleted allele.3,4 ETV6 was cloned at the breakpoint marrow). ALL were classified on the basis of lymphoid mor- phologic appearance and immunophenotype as assessed by flow cytometry. ALL were defined as belonging to the T lin- Correspondence: H Cave´, Laboratoire de Biochimie Ge´ne´tique, Hoˆpi- eage based on the presence of at least two of the T cell anti- tal Robert Debre´, 48 boulevard Se´rurier, 75019 Paris, France gens CD2, CD5 and CD7. The diagnosis of B precursor ALL Received 20 March 1997; accepted 17 June 1997 was based on the expression of B cell-associated antigens ETV6 deletions in childhood B lineage ALL H Cave´ et al 1460 (CD19+, CD22±, CD10±) and the lack of surface membrane lows: 10 s denaturation at 94°C, 10 s annealing extension at immunoglobulins (Ig). Informed consent was obtained from 68°C. Amplification was controlled by electrophoresis in 2% the patients, their parents, or both, as appropriate. agarose and ethidium bromide staining. ETV6-AML1 and AML1-ETV6 PCR gave rise to a 103 bp and a 199 bp fragment, respectively. The quality of the cDNAs was checked by ampli- Preparation of mononuclear cell lysates fying a 155 bp sequence of the porphobilinogene deaminase cDNA using primers P-PBGD (5′-AGCGGAGCCATG- Bone marrow (BM) was collected on EDTA before induction TCTGGTAACGGCAATG-3′)and N-PBGD (5′-AGGCCAGGG- therapy and during clinical remission between 6 and 24 TACGAGGCTTTCAATGTTG-3′) under the same PCR con- months of therapy according to the EORTC 58 881 follow- ditions as described above but with an annealing extension up protocol. Mononuclear cells were separated by gradient temperature of 60°C. centrifugation over Ficoll (Lymphoprep; Pharmacia, Uppsala, Specificity of the amplification was tested by Southern blot Sweden), washed in 0.9% NaCl, counted, and aliquots of cells hybridization to radio-labeled junctional probes for ETV6- were stored at −80°C. Erythrocytes were lysed by resus- AML1 (5′-AGAATAGCAGAATGCATACT-3′).15 pending the cells in a solution containing 10 mm Tris-HCl (pH 7.5), 1% Triton-100 (Sigma, St Louis, MO, USA), 5 mm MgCl2 and 0.32 mm saccharose. After centrifugation, mono- Results nuclear cells were lysed in a buffer containing 0.45% Tween 20 (Difco, Detroit, MI, USA), 1.45% Nonidet P40 (Sigma), Frequency of monoallelic ETV6 deletion in childhood 2.5 mm MgCl2 and 10 mm Tris-HCl (pH 7.5) and incubated ALL for 2 h at 60°C in the presence of 1 mg/ml proteinase K. Vol- umes were adjusted to obtain 6 ng of DNA per ml of lysate. The presence of allelic deletions of ETV6 was investigated in After a 10-min incubation at 95°C, the lysates were stored at 215 children with ALL using the LOH approach. Partial results −20°C until analysis. concerning 66 of these children (including 16 with LOH) have been previously reported.6 The polymorphic markers used for this screening were D12S1697, D12S89, CA159A7 and Search for loss of heterozygosity D12S98. Markers D12S89 and CA159A7 are located within the ETV6 gene. D12S89 has been previously shown to map Seven simple tandem repeat (STR) markers were used that immediately upstream of exon 2 while CA159A7 maps in the span the chromosome bands 12p12-13. These markers are 5′ region of exon 1B.21 D12S1697 is located 7 kb upstream ordered from telomere to centromere: D12S1697, D12S89, of exon 1A of ETV6, and D12S98 is about 50 kb downstream CA159A7, D12S98, D12S1581, D12S1580 and D12S320.3,21 of exon 8.21 Loss of heterozygosity was evidenced by comparison of Percentages of LOH observed for each marker are reported allelic patterns of amplified DNA on the diagnosis sample in Table 1.