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Publication : De novo activating mutations drive clonal evolution and enhance clonal fitness in KMT2A-rearranged leukemia.

First Author  Hyrenius-Wittsten A Year  2018
Journal  Nat Commun Volume  9
Issue  1 Pages  1770
PubMed ID  29720585 Mgi Jnum  J:262915
Mgi Id  MGI:6161023 Doi  10.1038/s41467-018-04180-1
Citation  Hyrenius-Wittsten A, et al. (2018) De novo activating mutations drive clonal evolution and enhance clonal fitness in KMT2A-rearranged leukemia. Nat Commun 9(1):1770
abstractText  Activating signaling mutations are common in acute leukemia with KMT2A (previously MLL) rearrangements (KMT2A-R). These mutations are often subclonal and their biological impact remains unclear. Using a retroviral acute myeloid mouse leukemia model, we demonstrate that FLT3 (ITD) , FLT3 (N676K) , and NRAS (G12D) accelerate KMT2A-MLLT3 leukemia onset. Further, also subclonal FLT3 (N676K) mutations accelerate disease, possibly by providing stimulatory factors. Herein, we show that one such factor, MIF, promotes survival of mouse KMT2A-MLLT3 leukemia initiating cells. We identify acquired de novo mutations in Braf, Cbl, Kras, and Ptpn11 in KMT2A-MLLT3 leukemia cells that favored clonal expansion. During clonal evolution, we observe serial genetic changes at the Kras (G12D) locus, consistent with a strong selective advantage of additional Kras (G12D) . KMT2A-MLLT3 leukemias with signaling mutations enforce Myc and Myb transcriptional modules. Our results provide new insight into the biology of KMT2A-R leukemia with subclonal signaling mutations and highlight the importance of activated signaling as a contributing driver.
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