Abstract
Neurofibromatosis type 1 (NF1) is a common autosomal dominant cancer predisposition syndrome that is caused by germ line mutations in the NF1 tumor suppressor gene. Children with NF1 are at greatly increased risk of developing myeloid malignancies, particularly an aggressive myeloproliferative neoplasm called juvenile myelomonocytic leukemia (JMML). The association between NF1 and JMML prompted the discovery of NF1 as a bona fide tumor suppressor gene in hematopoietic cells whose loss plays a key role in tumorigenesis through increased Ras output. This link also led to the discovery of JMML as fundamentally a disease of hyperactive Ras. Although anecdotal data suggest that patients with NF1 are at increased risk of developing leukemia after receiving genotoxins to treat another primary cancer, adults with NF1 are not predisposed to spontaneously develop hematologic cancers for unknown reasons. With the advent of new technologies for genome-wide analysis, NF1 is emerging as an important tumor suppressor in sporadic cancers, including acute myeloid leukemia. Studies in animal models have shown that Nf1 inactivation initiates myeloid leukemia in vivo and are suggesting new therapeutic strategies for treating JMML and other hematologic cancers. In this chapter, we address the role of NF1 mutations in hematologic cancers and emphasize recent advances in the field, therapeutic options, unanswered questions, and future directions.
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Acknowledgments
The work from our laboratory presented in this chapter was funded, in part, by the US Army Neurofibromatosis Research Program (Project DAMD17-02-1-0638), by NIH grants CA72614 and U0184221, and by the Children’s Tumor Foundation. T.C. is the recipient of a fellowship from the St. Baldrick’s Foundation, and K.S. is an American Cancer Society research professor.
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Chang, T., Shannon, K. (2012). NF1 Mutations in Hematologic Cancers. In: Upadhyaya, M., Cooper, D. (eds) Neurofibromatosis Type 1. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32864-0_30
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