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Leukemia in severe congenital neutropenia: defective proteolysis suggests new pathways to malignancy and opportunities for therapy.

Abstract
Severe congenital neutropenia (SCN), a heterogeneous disorder that includes Kostmann syndrome, predisposes to myelodysplasia and acute myelogenous leukemia. Recently identified heterozygous mutations in the gene ELA2, encoding neutrophil elastase on human chromosome 19pter, account for the majority of autosomal dominant cases of SCN, including those demonstrating neoplastic progression. The involvement of the serine protease neutrophil elastase, localized to the granules of neutrophils and monocytes, implies an unexpected role for proteolytic regulation of hematopoiesis. Continued elucidation of the clinical features, molecular genetics, and biochemistry is likely to provide insight into novel pathways of leukemia induction with attendant prospects for new avenues of therapy.
AuthorsMarshall Horwitz, Feng-Qian Li, Dalila Albani, Zhijun Duan, Richard E Person, Kimberly Meade-White, Kathleen F Benson
JournalCancer investigation (Cancer Invest) Vol. 21 Issue 4 Pg. 579-87 ( 2003) ISSN: 0735-7907 [Print] England
PMID14533448 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Review)
Chemical References
  • Proteins
  • Leukocyte Elastase
Topics
  • Diagnosis, Differential
  • Hematopoiesis
  • Humans
  • Leukemia, Myeloid, Acute (etiology, genetics, physiopathology)
  • Leukocyte Elastase (genetics, pharmacology)
  • Neural Tube Defects (etiology, genetics, physiopathology)
  • Neutropenia (congenital, physiopathology)
  • Proteins (metabolism)
  • Risk Factors

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