Abstract
Neurofibromatosis type 1 (NF1) affects 1/3,000–4,000 individuals worldwide and is caused by the inactivation of the NF1 tumour suppressor gene which encodes the protein neurofibromin. Consistent with Knudson’s two-hit hypothesis, NF1 patients harbouring a heterozygous germline NF1 mutation develop several NF1-associated tumours upon somatic inactivation of the second (wild-type) NF1 allele. Although the identification of somatic mutations in NF1 patients has always been problematic on account of the extensive cellular heterogeneity manifested by neurofibromas, their classification is a prerequisite for understanding the complex molecular mechanisms underlying NF1 tumorigenesis. Here, we have performed a meta-analysis of known somatic NF1 mutations identified in a range of NF1-associated neoplasms including peripheral nerve sheath tumours (neurofibromas), malignant peripheral nerve sheath tumours (MPNSTs), astrocytomas, gastrointestinal stromal tumours, gastric carcinoid, juvenile myelomonocytic leukaemia, glomus tumours, neuroblastomas, breast cancer and phaeochromocytomas. Comparison of the frequencies of the different types of somatic NF1 mutation so far observed with those of their previously reported germline counterparts reveals significant differences (p = 0.00014), with the somatic mutational spectrum being characterised by a greater proportion of nonsense mutations and a smaller proportion of splice-site mutations. Finally, C>T and G>A changes in CpG and CpHpG oligonucleotides resulting in missense/nonsense mutations in the NF1 gene were significantly overrepresented in the soma as compared to the germline (p = 0.007).
Some of the unpublished mutations in Supplementary Table 2 of Laycock-van Spyk et al. (2011) have now been published by Thomas et al. (2012a, b).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ars E, Kruyer H, Gaona A, Casquero P et al (1998) A clinical variant of neurofibromatosis type 1: familial spinal neurofibromatosis with a frameshift mutation in the NF1 gene. Am J Hum Genet 62:834–841
Ballester R, Marchuk D, Boguski M, Saulino A et al (1990) The NF1 locus encodes a protein functionally related to mammalian GAP and yeast IRA proteins. Cell 63:851–859
Bandipalliam P (2005) Syndrome of early onset colon cancers, hematologic malignancies & features of neurofibromatosis in HNPCC families with homozygous mismatch repair gene mutations. Fam Cancer 4:323–333
Bausch B, Borozdin W, Mautner VF, Hoffmann MM et al (2007) Germline NF1 mutational spectra and loss-of-heterozygosity analyses in patients with pheochromocytoma and neurofibromatosis type 1. J Clin Endocrinol Metab 92:2784–2792
Beert E, Brems H, Daniëls B, De Wever I, Van Calenbergh F, Schoenaers J, Debiec-Rychter M, Gevaert O, De Raedt T, Van Den Bruel A, de Ravel T, Cichowski K, Kluwe L, Mautner V, Sciot R, Legius E (2011) Atypical neurofibromas in neurofibromatosis type 1 are premalignant tumors. Genes Chromosomes Cancer 50:1021–1032
Bennett E, Thomas N, Upadhyaya M (2009) Neurofibromatosis type 1: its association with the Ras/MAPK pathway syndromes. J Paediatr Neurol 7:105–115
Benz MR, Czernin J, Dry SM, Tap WD et al (2010) Quantitative F18-fluorodeoxyglucose positron emission tomography accurately characterizes peripheral nerve sheath tumors as malignant or benign. Cancer 116:451–458
Bien E, Stachowicz-Stencel T, Sierota D, Polczynska K, Szolkiewicz A, Stefanowicz J, Adamkiewicz-Drozynska E, Czauderna P, Kosiak W, Dubaniewicz-Wybieralska M, Izycka-Swieszewska E, Balcerska A (2007) Sarcomas in children with neurofibromatosis type 1-poor prognosis despite aggressive combined therapy in four patients treated in a single oncological institution. Childs Nerv Syst 23:1147–1153
Brems H, Park C, Maertens O, Pemov A et al (2009) Glomus tumors in neurofibromatosis type 1: genetic functional, and clinical evidence of a novel association. Cancer Res 69:7393–7401
Brennan C, Momota H, Hambardzumyan D, Ozawa T et al (2009) Glioblastoma subclasses can be defined by activity among signal transduction pathways and associated genomic alterations. PLoS One 4:e7752
Burnichon N, Vescovo L, Amar L, Libé R, de Reynies A, Venisse A, Jouanno E, Laurendeau I, Parfait B, Bertherat J, Plouin PF, Jeunemaitre X, Favier J, Gimenez-Roqueplo AP (2011) Integrative genomic analysis reveals somatic mutations in pheochromocytoma and paraganglioma. Hum Mol Genet 20:3974–3985
Carroll SL, Ratner N (2008) How does the Schwann cell lineage form tumors in NF1? Glia 56(14):1590–1605
Chen JM, Cooper DN, Ferec C, Kehrer-Sawatzki H et al (2010) Genomic rearrangements in inherited disease and cancer. Semin Cancer Biol 20:222–233
Cichowski K, Jacks T (2001) NF1 tumor suppressor gene function: narrowing the GAP. Cell 104:593–604
Cichowski K, Shih T, Schmitt E, Santiago S et al (1999) Mouse models of tumor development in neurofibromatosis type 1. Science 286:2172–2176
De Raedt T, Brems H, Wolkenstein P, Vidaud D et al (2003) Elevated risk for MPNST in NF1 microdeletion patients. Am J Hum Genet 72:1288–1292
Ding L, Getz G, Wheeler D, Mardis E et al (2008) Somatic mutations affect key pathways in lung adenocarcinoma. Nature 455:1069–1075
Ducatman B, Scheithauer B, Piepgras D, Reiman H et al (1986) Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases. Cancer 57:2006–2021
Dugoff L, Sujansky E (1996) Neurofibromatosis type 1 and pregnancy. Am J Med Genet 66:7–10
Dworkin AM, Ridd K, Bautista D, Allain DC et al (2010) Germline variation controls the architecture of somatic alterations in tumors. PLoS Genet 6:e1001136
Easton DF, Ponder MA, Huson SM, Ponder BA (1993) An analysis of variation in expression of neurofibromatosis (NF) type 1 (NF1): evidence for modifying genes. Am J Hum Genet 53:305–313
Eisenbarth I, Beyer K, Krone W, Assum G (2000) Toward a survey of somatic mutation of the NF1 gene in benign neurofibromas of patients with neurofibromatosis type 1. Am J Hum Genet 66:393–401
Evans D, Baser M, McGaughran J, Sharif S et al (2002) Malignant peripheral nerve sheath tumours in neurofibromatosis 1. J Med Genet 39:311–314
Flotho C, Steinemann D, Mullighan C, Neale G et al (2007) Genome-wide single-nucleotide polymorphism analysis in juvenile myelomonocytic leukemia identifies uniparental disomy surrounding the NF1 locus in cases associated with neurofibromatosis but not in cases with mutant RAS or PTPN11. Oncogene 26:5816–5821
Friedman JM, Arbiser J, Epstein JA, Gutmann DH, Huot SJ, Lin AE, McManus B, Korf BR (2002) Cardiovascular disease in neurofibromatosis 1: report of the NF1 Cardiovascular Task Force. Genet Med 4:105–111
Garcia-Linares C, Fernandez-Rodriguez J, Terribas E, Mercade J et al (2011) Dissecting loss of heterozygosity (LOH) in neurofibromatosis type 1-associated neurofibromas: importance of copy neutral LOH. Hum Mutat 32:78–90
Gerlinger M, Rowan AJ, Horswell S, Math M, Larkin J, Endesfelder D et al (2012) Intratumour heterogeneity and branched evolution revealed by multiregion sequencing. N Engl J Med 366:883–892
Gregorian C, Nakashima J, Dry S, Nghiemphu P et al (2009) PTEN dosage is essential for neurofibroma development and malignant transformation. Proc Natl Acad Sci USA 106:19479–19484
Gutmann DH, Cole JL, Stone WJ, Ponder BA, Collins FS (1994) Loss of neurofibromin in adrenal gland tumors from patients with neurofibromatosis type I. Genes Chromosomes Cancer 10:55–58
Gutmann DH, Geist RT, Rose K, Wallin G, Moley JF (1995) Loss of neurofibromatosis type I (NF1) gene expression in pheochromocytomas from patients without NF1. Genes Chromosomes Cancer 13(2):104–109
Gutmann D, Donahoe J, Brown T, James C et al (2000) Loss of neurofibromatosis 1 (NF1) gene expression in NF1-associated pilocytic astrocytomas. Neuropathol Appl Neurobiol 26:361–367
Gutmann D, James C, Poyhonen M, Louis D et al (2003) Molecular analysis of astrocytomas presenting after age 10 in individuals with NF1. Neurology 61:1397–1400
Haferlach C, Dicker F, Kohlmann A, Schindela S et al (2010) AML with CBFB-MYH11 rearrangement demonstrate RAS pathway alterations in 92% of all cases including a high frequency of NF1 deletions. Leukemia 24:1065–1069
Hölzel M, Huang S, Koster J, Ora I et al (2010) NF1 is a tumor suppressor in neuroblastoma that determines retinoic acid response and disease outcome. Cell 142:218–229
Huson S, Harper P, Compston D (1988) von Recklinghausen neurofibromatosis. A clinical and population study in south-east Wales. Brain 111(Pt 6):1355–1381
Ivanov D, Hamby SE, Stenson PD, Phillips AD et al (2011) Comparative analysis of germline and somatic microlesion mutational spectra in 17 human tumor suppressor genes. Hum Mutat 32:620–632
John A, Ruggieri M, Ferner R, Upadhyaya M (2000) A search for evidence of somatic mutations in the NF1 gene. J Med Genet 37:44–49
Joseph N, Mosher J, Buchstaller J, Snider P et al (2008) The loss of Nf1 transiently promotes self-renewal but not tumorigenesis by neural crest stem cells. Cancer Cell 13:129–140
Kehrer-Sawatzki H (2008) Structure of the NF1 gene region and mechanisms underlying gross NF1 deletions. In: Kaufmann D (ed) Neurofibromatoses. Karger, Basel, pp 46–62
Kehrer-Sawatzki H, Cooper DN (2008) Mosaicism in sporadic neurofibromatosis type 1: variations on a theme common to other hereditary cancer syndromes? J Med Genet 45:622–631
Knudson AJ (1971) Mutation and cancer: statistical study of retinoblastoma. Proc Natl Acad Sci USA 68:820–823
Kourea H, Orlow I, Scheithauer B, Cordon-Cardo C et al (1999) Deletions of the INK4A gene occur in malignant peripheral nerve sheath tumors but not in neurofibromas. Am J Pathol 155:1855–1860
Kushner BH, Hajdu SI, Helson L (1985) Synchronous neuroblastoma and von Recklinghausen’s disease: a review of the literature. J Clin Oncol 3:117–120
Lamlum H, Ilyas M, Rowan A, Clark S et al (1999) The type of somatic mutation at APC in familial adenomatous polyposis is determined by the site of the germline mutation: a new facet to Knudson’s ‘two-hit’ hypothesis. Nat Med 5:1071–1075
Lammert M, Friedman JM, Kluwe L, Mautner VF (2005) Prevalence of neurofibromatosis 1 in German children at elementary school enrollment. Arch Dermatol 141:71–74
Laycock-van Spyk S, Thomas N, Cooper DN, Upadhyaya M (2011) Neurofibromatosis type 1-associated tumours: their somatic mutational spectrum and pathogenesis. Hum Genomics 5:623–690
Le L, Shipman T, Burns D, Parada L (2009) Cell of origin and microenvironment contribution for NF1-associated dermal neurofibromas. Cell Stem Cell 4:453–463
Lee J, Wang J, Torbenson M, Lu Y et al (2010) Loss of SDHB and NF1 genes in a malignant phyllodes tumor of the breast as detected by oligo-array comparative genomic hybridization. Cancer Genet Cytogenet 196:179–183
Legius E, Dierick H, Wu R, Hall B et al (1994) TP53 mutations are frequent in malignant NF1 tumors. Genes Chromosomes Cancer 10:250–255
Listernick R, Charrow J, Greenwald M, Mets M (1994) Natural history of optic pathway tumors in children with neurofibromatosis type 1: a longitudinal study. J Pediatr 125:63–66
Maertens O, Prenen H, Debiec-Rychter M, Wozniak A et al (2006) Molecular pathogenesis of multiple gastrointestinal stromal tumors in NF1 patients. Hum Mol Genet 15:1015–1023
Mantripragada K, Spurlock G, Kluwe L, Chuzhanova N et al (2008) High-resolution DNA copy number profiling of malignant peripheral nerve sheath tumors using targeted microarray-based comparative genomic hybridization. Clin Cancer Res 14:1015–1024
Mautner VF, Kluwe L, Friedrich RE, Roehl AC et al (2010) Clinical characterisation of 29 neurofibromatosis type-1 patients with molecularly ascertained 1.4 Mb type-1 NF1 deletions. J Med Genet 47:623–630
McCaughan J, Holloway S, Davidson R, Lam W (2007) Further evidence of the increased risk for malignant peripheral nerve sheath tumour from a Scottish cohort of patients with neurofibromatosis type 1. J Med Genet 44:463–466
McGillicuddy LT, Fromm JA, Hollstein PE, Kubek S et al (2009) Proteasomal and genetic inactivation of the NF1 tumor suppressor in gliomagenesis. Cancer Cell 16:44–54
McLaughlin ME, Jacks T (2003) Progesterone receptor expression in neurofibromas. Cancer Res 63:752–755
Menon A, Anderson K, Riccardi V, Chung R et al (1990) Chromosome 17p deletions and p53 gene mutations associated with the formation of malignant neurofibrosarcomas in von Recklinghausen neurofibromatosis. Proc Natl Acad Sci USA 87:5435–5439
Miettinen M, Fetsch J, Sobin L, Lasota J (2006) Gastrointestinal stromal tumors in patients with neurofibromatosis 1: a clinicopathologic and molecular genetic study of 45 cases. Am J Surg Pathol 30:90–96
Nielsen G, Stemmer-Rachamimov A, Ino Y, Moller M et al (1999) Malignant transformation of neurofibromas in neurofibromatosis 1 is associated with CDKN2A/p16 inactivation. Am J Pathol 155:1879–1884
Padmanabhan A, Lee JS, Ismat FA, Lu MM, Lawson ND, Kanki JP, Look AT, Epstein JA (2009) Cardiac and vascular functions of the zebrafish orthologues of the type I neurofibromatosis gene NFI. Proc Natl Acad Sci USA 106:22305–22310
Pao W, Girard N (2011) New driver mutations in non-small-cell lung cancer. Lancet Oncol 12:175–180
Parsons DW, Jones S, Zhang X, Lin JC et al (2008) An integrated genomic analysis of human glioblastoma multiforme. Science 321:1807–1812
Pasmant E, Vidaud D, Harrison M, Upadhyaya M (2010) Different sized somatic NF1 locus rearrangements in neurofibromatosis 1-associated malignant peripheral nerve sheath tumors. J Neurooncol 102:341–346
Poyhonen M, Leisti E, Kytölä S, Leisti J (1997) Hereditary spinal neurofibromatosis: a rare form of NF1? J Med Genet 34:184–187
Pulst SM, Riccardi VM, Fain P, Korenberg JR (1991) Familial spinal neurofibromatosis: clinical and DNA linkage analysis. Neurology 41:1923–1927
Roehl AC, Mussotter T, Cooper DN, Kluwe L, Wimmer K, Högel J, Zetzmann M, Vogt J, Mautner VF, Kehrer-Sawatzki H (2012) Tissue-specific differences in the proportion of mosaic large NF1 deletions are suggestive of a selective growth advantage of hematopoietic del(+/−) stem cells. Hum Mutat 33:541–550
Roth T, Ramamurthy P, Muir D, Wallace M et al (2008) Influence of hormones and hormone metabolites on the growth of Schwann cells derived from embryonic stem cells and on tumor cell lines expressing variable levels of neurofibromin. Dev Dyn 237:513–524
Sangha N, Wu R, Kuick R, Powers S et al (2008) Neurofibromin 1 (NF1) defects are common in human ovarian serous carcinomas and co-occur with TP53 mutations. Neoplasia 10:1362–1372
Sawada S, Florell S, Purandare S, Ota M et al (1996) Identification of NF1 mutations in both alleles of a dermal neurofibroma. Nat Genet 14:110–112
Serra E, Rosenbaum T, Winner U, Aledo R et al (2000) Schwann cells harbor the somatic NF1 mutation in neurofibromas: evidence of two different Schwann cell subpopulations. Hum Mol Genet 9:3055–3064
Serra E, Rosenbaum T, Nadal M, Winner U et al (2001) Mitotic recombination effects homozygosity for NF1 germline mutations in neurofibromas. Nat Genet 28:294–296
Sharif S, Moran A, Huson SM, Iddenden R, Shenton A, Howard E, Evans DG (2007) Women with neurofibromatosis 1 are at a moderately increased risk of developing breast cancer and should be considered for early screening. J Med Genet 44:481–484
Sharif S, Upadhyaya M, Ferner R, Majounie E, Shenton A, Baser M, Thakker N, Evans DG (2011) A molecular analysis of individuals with neurofibromatosis type 1 (NF1) and optic pathway gliomas (OPGs), and an assessment of genotype-phenotype correlations. J Med Genet 48:256–260
Spurlock G, Griffiths S, Uff J, Upadhyaya M (2007) Somatic alterations of the NF1 gene in an NF1 individual with multiple benign tumours (internal and external) and malignant tumour types. Fam Cancer 6:463–471
Spurlock G, Knight SJ, Thomas N, Kiehl TR, Guha A, Upadhyaya M (2010) Molecular evolution of a neurofibroma to malignant peripheral nerve sheath tumor (MPNST) in an NF1 patient: correlation between histopathological, clinical and molecular findings. J Cancer Res Clin Oncol 136:1869–1880
Staser K, Yang FC, Clapp DW (2012) Pathogenesis of plexiform neurofibroma: tumor-stromal/hematopoietic interactions in tumor progression. Annu Rev Pathol 7:469–495
Steinemann D, Arning L, Praulich I, Stuhrmann M et al (2010) Mitotic recombination and compound-heterozygous mutations are predominant NF1-inactivating mechanisms in children with juvenile myelomonocytic leukemia and neurofibromatosis type 1. Haematologica 95:320–323
Stenson PD, Ball E, Howells K, Phillips A et al (2008) Human Gene Mutation Database: towards a comprehensive central mutation database. J Med Genet 45:124–126
Stephens K, Weaver M, Leppig K, Maruyama K et al (2006) Interstitial uniparental isodisomy at clustered breakpoint intervals is a frequent mechanism of NF1 inactivation in myeloid malignancies. Blood 108:1684–1689
Stewart W, Traynor JP, Cooke A, Griffiths S et al (2007a) Gastric carcinoid: germline and somatic mutation of the neurofibromatosis type 1 gene. Fam Cancer 6:147–152
Stewart D, Corless C, Rubin B, Heinrich M et al (2007b) Mitotic recombination as evidence of alternative pathogenesis of gastrointestinal stromal tumours in neurofibromatosis type 1. J Med Genet 44:e61
Stewart DR, Pemov A, Van Loo P, Beert E, Brems H, Sciot R, Claes K, Pak E, Dutra A, Richard Lee CC, Legius E (2012) Mitotic recombination of chromosome arm 17q as a cause of loss of heterozygosity of NF1 in neurofibromatosis type 1-associated glomus tumors. Genes Chromosomes Cancer 51:429–437
Stiller C, Chessells J, Fitchett M (1994) Neurofibromatosis and childhood leukaemia/lymphoma: a population-based UKCCSG study. Br J Cancer 70:969–972
Stratton MR (2011) Exploring the genomes of cancer cells: progress and promise. Science 331:1553–1558
Sugimoto Y, Muramatsu H, Makishima H, Prince C et al (2009) Spectrum of molecular defects in juvenile myelomonocytic leukaemia includes ASXL1 mutations. Br J Haematol 150:83–87
Sung L, Anderson JR, Arndt C, Raney RB, Meyer WH, Pappo AS (2004) Neurofibromatosis in children with rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma study IV. J Pediatr 144:666–668
The I, Murthy AE, Hannigan GE, Jacoby LB, Menon AG, Gusella JF, Bernards A (1993) Neurofibromatosis type 1 gene mutations in neuroblastoma. Nat Genet 3:62–66
Thomas L, Kluwe L, Chuzhanova N, Mautner V et al (2010) Analysis of NF1 somatic mutations in cutaneous neurofibromas from patients with high tumor burden. Neurogenetics 11:391–400
Thomas L, Spurlock G, Eudall C, Thomas NS, Mort M, Hamby SE, Chuzhanova N, Brems H, Legius E, Cooper DN, Upadhyaya M (2012a) Exploring the somatic NF1 mutational spectrum associated with NF1 cutaneous neurofibromas. Eur J Hum Genet 20(4):411–419
Thomas L, Mautner VF, Cooper D, Upadhyaya M (2012) Molecular heterogeneity in malignant peripheral nerve sheath tumors (MPNSTs) associated with neurofibromatosis type 1 (NF1). Hum Genomics 6:18
Upadhyaya M (2008) NF1 gene structure and NF1 genotype/phenotype correlations. In: Kaufmann D (ed) Neurofibromatoses. Karger, Basel, pp 46–62
Upadhyaya M (2010) Neurofibromatosis type 1 (NF1): diagnosis and recent advances. Expert Opin Med Genet 4:307–322
Upadhyaya M (2011) Genetic basis of tumorigenesis in NF1 malignant peripheral nerve sheath tumors. Front Biosci 16:937–951
Upadhyaya M, Han S, Consoli C et al (2004) Characterization of the somatic mutational spectrum of the neurofibromatosis type 1 (NF1) gene in neurofibromatosis patients with benign and malignant tumors. Hum Mutat 23:134–146
Upadhyaya M, Spurlock G, Majounie E, Griffiths S et al (2006) The heterogeneous nature of germline mutations in NF1 patients with malignant peripheral serve sheath tumours (MPNSTs). Hum Mutat 27:716
Upadhyaya M, Huson S, Davies M, Thomas N et al (2007) An absence of cutaneous neurofibromas associated with a 3-bp inframe deletion in exon 17 of the NF1 gene (c.2970-2972 delAAT): evidence of a clinically significant NF1 genotype-phenotype correlation. Am J Hum Genet 80:140–151
Upadhyaya M, Kluwe L, Spurlock G, Monem B et al (2008a) Germline and somatic NF1 gene mutation spectrum in NF1-associated malignant peripheral nerve sheath tumors (MPNSTs). Hum Mutat 29:74–82
Upadhyaya M, Spurlock G, Monem B, Thomas N et al (2008b) Germline and somatic NF1 gene mutations in plexiform neurofibromas. Hum Mutat 29:E103–E111
Upadhyaya M, Spurlock G, Kluwe L, Chuzhanova N et al (2009) The spectrum of somatic and germline NF1 mutations in NF1 patients with spinal neurofibromas. Neurogenetics 10:251–263
Upadhyaya M, Spurlock G, Thomas L, Thomas NS, Richards M, Mautner VF, Cooper DN, Guha A, Yan J (2012) Microarray-based copy number analysis of neurofibromatosis type-1 (NF1)-associated malignant peripheral nerve sheath tumours (MPNSTs) reveals a role for Rho-GTPase pathway genes in NF1 tumorigenesis. Hum Mutat. 33:763–776
Vogel K, Klesse L, Velasco-Miguel S, Meyers K et al (1999) Mouse tumor model for neurofibromatosis type 1. Science 286:2176–2179
Walker L, Thompson D, Easton D, Ponder B, Ponder M, Frayling I, Baralle D (2006) A prospective study of neurofibromatosis type1 cancer incidence in the UK. Br J Cancer 95:233–238
Wiest V, Eisenbarth I, Schmegner C, Krone W et al (2003) Somatic NF1 mutation spectra in a family with neurofibromatosis type 1: toward a theory of genetic modifiers. Hum Mutat 22:423–427
Wimmer K, Etzler J (2008) Constitutional mismatch repair-deficiency syndrome: have we so far seen only the tip of an iceberg? Hum Genet 124:105–122
Wu J, Williams J, Rizvi T, Kordich J et al (2008) Plexiform and dermal neurofibromas and pigmentation are caused by Nf1 loss in desert hedgehog-expressing cells. Cancer Cell 13:105–116
Yang FC, Ingram DA, Chen S, Zhu Y et al (2008) Nf1-dependent tumors require a microenvironment containing Nf1+/− and c-kit-dependent bone marrow. Cell 135:437–448
Yoshimi A, Kojima S, Hirano N (2010) Juvenile myelomonocytic leukemia: epidemiology etiopathogenesis, diagnosis, and management considerations. Paediatr Drugs 12:11–21
Zheng H, Chang L, Patel N, Yang J, Lowe L et al (2008) Induction of abnormal proliferation by nonmyelinating Schwann cells triggers neurofibroma formation. Cancer Cell 13:117–128
Zhu Y, Ghosh P, Charnay P, Burns D et al (2002) Neurofibromas in NF1: Schwann cell origin and role of tumor environment. Science 296:920–922
Acknowledgements
We are grateful to all our NF1 patients and their families for their support.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Upadhyaya, M., Chuzhanova, N., Cooper, D.N. (2012). The Somatic Mutational Spectrum of the NF1 Gene. In: Upadhyaya, M., Cooper, D. (eds) Neurofibromatosis Type 1. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32864-0_15
Download citation
DOI: https://doi.org/10.1007/978-3-642-32864-0_15
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-32863-3
Online ISBN: 978-3-642-32864-0
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)