Background Nucleophosmin (NPM), a nucleocytoplasmic shuttlingprotein with prominent nucleolar localization, regulates theARF-p53 tumor-suppressor pathway. Translocations involving theNPM gene cause cytoplasmic dislocation of the NPM protein.
Methods We used immunohistochemical methods to study the subcellularlocalization of NPM in bone marrowbiopsy specimens from591 patients with primary acute myelogenous leukemia (AML).We then correlated the presence of cytoplasmic NPM with clinicaland biologic features of the disease.
Results Cytoplasmic NPM was detected in 208 (35.2 percent) ofthe 591 specimens from patients with primary AML but not in135 secondary AML specimens or in 980 hematopoietic or extrahematopoieticneoplasms other than AML. It was associated with a wide spectrumof morphologic subtypes of the disease, a normal karyotype,and responsiveness to induction chemotherapy, but not with recurrentgenetic abnormalities. There was a high frequency of FLT3 internaltandem duplications and absence of CD34 and CD133 in AML specimenswith a normal karyotype and cytoplasmic dislocation of NPM,but not in those in which the protein was restricted to thenucleus. AML specimens with cytoplasmic NPM carried mutationsof the NPM gene that were predicted to alter the protein atits C-terminal; this mutant gene caused cytoplasmic localizationof NPM in transfected cells.
Conclusions Cytoplasmic NPM is a characteristic feature of alarge subgroup of patients with AML who have a normal karyotype,NPM gene mutations, and responsiveness to induction chemotherapy.
Source Information
From the Institute of Hematology (B.F., C.M., E.T., R.R., L.P., R.L.S., A.S., B.B., R.P., A.P., M.F.M.) and the Department of Biochemistry and Molecular Biotechnology (V.P.), University of Perugia, Perugia, Italy; the European Institute of Oncology, Milan, Italy (M.A., E.C., N.M., P.-G.P.); the Institute for Cancer Genetics, Columbia University, New York (L.P.); the Institute of Hematology, University La Sapienza, Rome (D.D., F.M.); the Institute of Hematology, University of Foggia, Foggia, Italy (A.L.); the Gruppo Italiano Malattie Ematologiche dell'Adulto (GIMEMA) Data Center, Rome (M.V., P.F.); the Division of Internal Medicine and Hematology, Ospedale S. Luigi, Orbassano-Turin, Italy (G.S.); and the Department of Biopathology, University of Tor Vergata, Rome (F.L.-C.). Drs. Tiacci, Alcalay, and Rosati contributed equally to this article.
Address reprint requests to Dr. Falini at the Institute of Hematology, Policlinico Monteluce, 06122 Perugia, Italy, or at faliniem{at}unipg.it.
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(2007). Alternative BCR/ABL Splice Variants in Philadelphia Chromosome-Positive Leukemias Result in Novel Tumor-Specific Fusion Proteins that May Represent Potential Targets for Immunotherapy Approaches. Cancer Res.
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Li, J., Sejas, D. P., Burma, S., Chen, D. J., Pang, Q.
(2007). Nucleophosmin suppresses oncogene-induced apoptosis and senescence and enhances oncogenic cooperation in cells with genomic instability. Carcinogenesis
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Falini, B., Nicoletti, I., Bolli, N., Martelli, M. P., Liso, A., Gorello, P., Mandelli, F., Mecucci, C., Martelli, M. F.
(2007). Translocations and mutations involving the nucleophosmin (NPM1) gene in lymphomas and leukemias. haematol
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Suh, K. S., Crutchley, J. M., Koochek, A., Ryscavage, A., Bhat, K., Tanaka, T., Oshima, A., Fitzgerald, P., Yuspa, S. H.
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Pasqualucci, L., Liso, A., Martelli, M. P., Bolli, N., Pacini, R., Tabarrini, A., Carini, M., Bigerna, B., Pucciarini, A., Mannucci, R., Nicoletti, I., Tiacci, E., Meloni, G., Specchia, G., Cantore, N., Di Raimondo, F., Pileri, S., Mecucci, C., Mandelli, F., Martelli, M. F., Falini, B.
(2006). Mutated nucleophosmin detects clonal multilineage involvement in acute myeloid leukemia: impact on WHO classification. Blood
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Garcia, M. A., Gil, J., Ventoso, I., Guerra, S., Domingo, E., Rivas, C., Esteban, M.
(2006). Impact of Protein Kinase PKR in Cell Biology: from Antiviral to Antiproliferative Action. Microbiol. Mol. Biol. Rev.
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Marzac, C., Teyssandier, I., Calendini, O., Perrot, J.-Y., Faussat, A.-M., Tang, R., Casadevall, N., Marie, J.-P., Legrand, O.
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Heuser, M., Beutel, G., Krauter, J., Dohner, K., von Neuhoff, N., Schlegelberger, B., Ganser, A.
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Falini, B., Martelli, M. P., Bolli, N., Bonasso, R., Ghia, E., Pallotta, M. T., Diverio, D., Nicoletti, I., Pacini, R., Tabarrini, A., Galletti, B. V., Mannucci, R., Roti, G., Rosati, R., Specchia, G., Liso, A., Tiacci, E., Alcalay, M., Luzi, L., Volorio, S., Bernard, L., Guarini, A., Amadori, S., Mandelli, F., Pane, F., Lo-Coco, F., Saglio, G., Pelicci, P.-G., Martelli, M. F., Mecucci, C., for the GIMEMA Acute Leukemia Working Party,
(2006). Immunohistochemistry predicts nucleophosmin (NPM) mutations in acute myeloid leukemia. Blood
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Chen, W., Rassidakis, G. Z., Li, J., Routbort, M., Jones, D., Kantarjian, H., Medeiros, L. J., Bueso-Ramos, C. E.
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Wilson, C. S., Davidson, G. S., Martin, S. B., Andries, E., Potter, J., Harvey, R., Ar, K., Xu, Y., Kopecky, K. J., Ankerst, D. P., Gundacker, H., Slovak, M. L., Mosquera-Caro, M., Chen, I-M., Stirewalt, D. L., Murphy, M., Schultz, F. A., Kang, H., Wang, X., Radich, J. P., Appelbaum, F. R., Atlas, S. R., Godwin, J., Willman, C. L.
(2006). Gene expression profiling of adult acute myeloid leukemia identifies novel biologic clusters for risk classification and outcome prediction. Blood
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Cathelin, S., Rebe, C., Haddaoui, L., Simioni, N., Verdier, F., Fontenay, M., Launay, S., Mayeux, P., Solary, E.
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Li, J., Sejas, D. P., Rani, R., Koretsky, T., Bagby, G. C., Pang, Q.
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Monzo, M., Brunet, S., Urbano-Ispizua, A., Navarro, A., Perea, G., Esteve, J., Artells, R., Granell, M., Berlanga, J., Ribera, J. M., Bueno, J., Llorente, A., Guardia, R., Tormo, M., Torres, P., Nomdedeu, J. F., Montserrat, E., Sierra, J., for CETLAM,
(2006). Genomic polymorphisms provide prognostic information in intermediate-risk acute myeloblastic leukemia. Blood
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Dohner, K., Dohner, H.
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Falini, B., Bolli, N., Shan, J., Martelli, M. P., Liso, A., Pucciarini, A., Bigerna, B., Pasqualucci, L., Mannucci, R., Rosati, R., Gorello, P., Diverio, D., Roti, G., Tiacci, E., Cazzaniga, G., Biondi, A., Schnittger, S., Haferlach, T., Hiddemann, W., Martelli, M. F., Gu, W., Mecucci, C., Nicoletti, I.
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Grimm, T., Holzel, M., Rohrmoser, M., Harasim, T., Malamoussi, A., Gruber-Eber, A., Kremmer, E., Eick, D.
(2006). Dominant-negative Pes1 mutants inhibit ribosomal RNA processing and cell proliferation via incorporation into the PeBoW-complex. Nucleic Acids Res
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Thiede, C., Koch, S., Creutzig, E., Steudel, C., Illmer, T., Schaich, M., Ehninger, G., for the Deutsche Studieninitiative Leukamie (DSIL),
(2006). Prevalence and prognostic impact of NPM1 mutations in 1485 adult patients with acute myeloid leukemia (AML). Blood
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Roti, G., Rosati, R., Bonasso, R., Gorello, P., Diverio, D., Martelli, M. F., Falini, B., Mecucci, C., for the Gruppo Italiano Malattie Ematologiche dell,
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Colombo, E., Martinelli, P., Zamponi, R., Shing, D. C., Bonetti, P., Luzi, L., Volorio, S., Bernard, L., Pruneri, G., Alcalay, M., Pelicci, P. G.
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Chou, W.-C., Tang, J.-L., Lin, L.-I., Yao, M., Tsay, W., Chen, C.-Y., Wu, S.-J., Huang, C.-F., Chiou, R.-J., Tseng, M.-H., Lin, D.-T., Lin, K.-H., Chen, Y.-C., Tien, H.-F.
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