2015
DOI: 10.1038/ni.3160
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Mechanisms of clonal evolution in childhood acute lymphoblastic leukemia

Abstract: Childhood acute lymphoblastic leukemia can often be retraced to a pre-leukemic clone carrying a prenatal genetic lesion. Postnatally acquired mutations then drive clonal evolution towards overt leukemia. RAG1-RAG2 and AID enzymes, the diversifiers of immunoglobulin genes, are strictly segregated to early and late stages of B-lymphopoiesis, respectively. Here, we identified small pre-BII cells as a natural subset of increased genetic vulnerability owing to concurrent activation of these enzymes. Consistent with… Show more

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Cited by 180 publications
(213 citation statements)
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“…Another group recently identified a pre-B-cell population with concurrent expression of recombination activating genes and AID, providing additional support for the possibility that the t(c-MYC;Ig) translocation could occur early in development. 41 Biased, or stereotyped, usage of particular IGHV genes was observed in BL tumors, suggesting that BL progenitors carrying particular Ig genes preferentially differentiate into the memory B-cell compartment. Thus, BL progenitors are preferentially selected based on their BCR, and likely their antigenic specificity.…”
Section: Discussionmentioning
confidence: 99%
“…Another group recently identified a pre-B-cell population with concurrent expression of recombination activating genes and AID, providing additional support for the possibility that the t(c-MYC;Ig) translocation could occur early in development. 41 Biased, or stereotyped, usage of particular IGHV genes was observed in BL tumors, suggesting that BL progenitors carrying particular Ig genes preferentially differentiate into the memory B-cell compartment. Thus, BL progenitors are preferentially selected based on their BCR, and likely their antigenic specificity.…”
Section: Discussionmentioning
confidence: 99%
“…Infection exposure was the first suggested cause for childhood ETV6-RUNX1 pB-ALL and remains one of the strongest candidates (3). Moreover, in vitro inflammatory and infection stimuli are known to increase RAG expression, which is relevant for the clonal evolution of human ETV6-RUNX1 pB-ALL (42)(43)(44). However, the role of infection in the conversion of the ETV6-RUNX1 preleukemic clone into pB-ALL remains unknown.…”
Section: Infection Exposure Induces Pb-all In Sca1-etv6-runx1 Micementioning
confidence: 99%
“…Although the majority of patients may be cured by the currently available therapeutic regimens, novel treatments are urgently required for the 20% of patients who experience relapse (1). The prevalence of BCP ALL may result, in part, from the fact that transformation generally occurs in cells arrested at the B-cell receptor checkpoint, a stage of differentiation associated with a balance between proliferation and recombination-activating gene-mediated DNA rearrangement (2)(3)(4). The stromal cytokine interleukin (IL)-7 serves an important role during this highly ordered process of differentiation, proliferation and somatic recombination (5-7).…”
Section: Introductionmentioning
confidence: 99%