Published online 4 July 2008
Haematologica, Vol 93, Issue 9, 1398-1401 doi:10.3324/haematol.12945
Copyright © 2008 by Ferrata Storti Foundation
t(3;11)(q12;p15)/NUP98-LOC348801 fusion transcript in acute myeloid leukemia
Paolo Gorello1,
Lucia Brandimarte1,
Roberta La Starza1,
Valentina Pierini1,
Loredana Bury1,
Roberto Rosati1,
Massimo F. Martelli1,
Peter Vandenberghe2,
Iwona Wlodarska2,
Cristina Mecucci1
1 IbiT Foundation, Fondazione IRCCS Biotecnologie nel Trapianto, Hematology, University of Perugia, Perugia, Italy
2 Center for Human Genetics, University of Leuven, Leuven, Belgium
Correspondence: Cristina Mecucci, University of Perugia, IBiT Foundation, Fondazione IRCCS Biotecnologie nel Trapianto, Policlinico Monteluce, via Brunamonti 51, 06122 Perugia, Italy. E-mail:crimecux{at}unipg.it

ABSTRACT
In a case of acute myeloid leukemia we report molecular cytogenetic
findings of a t(3;11)(q12;p15), characterized as a new NUP98
translocation rearranging with
LOC348801 at chromosome 3.
NUP98 involvement was detected by fluorescence
in situ hybridization.
3-RACE-PCR showed nucleotide 1718 (exon 13) of NUP98
was fused in-frame with nucleotide 1248 (exon 2) of
LOC348801.
RT-PCR and cloning experiments detected two in-frame spliced
NUP98-LOC348801 transcripts and the reciprocal
LOC348801-NUP98.
A highly specific double-color double-fusion FISH assay reliably
detects
NUP98-LOC348801.
Key words: acute myeloid leukemia, NUP98, translocation partners.

Introduction
Chromosome translocations are recurrent features in hematologic
malignancies. In primary and therapy-related acute myeloid leukemia
(AML) and in T-cell acute lymphoblastic leukemia (T-ALL), the
NUP98 gene, a member of the nucleoporin gene family which maps
to chromosome 11p15.5, is a frequent target in chromosomal translocations.
To date, 22 diverse
NUP98 partners with different characteristics
have been described and grouped into homeobox and non-homeobox
genes.
1–5 Here we characterize for the first time fusion
of
NUP98 and
LOC348801 in a case of primary acute myeloid leukemia
(AML) with t(3;11)(q12;p15).

Design and Methods
Case report
A 28 year-old man was referred because of fatigue, fever and
bleeding. Clinical examination revealed petechia, enlarged liver,
spleen and lymph nodes. The peripheral blood count was: Hb 9.1
gr/dL, PLT 30
x10
9/L, WBC 86.4
x10
9/L with 41% blasts. Acute myeloid
leukemia M2, according to the FAB classification, was diagnosed
on bone marrow. The karyotype was: 46,XY,t(3;11)(q12;p15). The
patient achieved hematologic remission after chemotherapy with
the HOVON protocol.
6 He relapsed seven months later. Second-line
therapy with cytosine arabinoside and mitoxantrone failed. He
died 23 months after diagnosis.
Fluorescence in situ hybridization (FISH)
Interphase break-apart FISH assay was performed with clone RP11-348A20 spanning the 5 region and exons 1–27 of NUP98/11p15, and clone CTD-3234F16 spanning the rest of NUP98 and flanking its 3 region.7 Once the new NUP98 partner was identified at 3q12, we designed a specific double-color, double-fusion FISH assay by combining RP11-348A20/CTD-3234F16 for NUP98 (in green) with RP11-683B14, encompassing LOC348801 (in red).
3-RACE- and RT-PCR
Total RNA was extracted by Trizol (Invitrogen) from the patients cryopreserved bone marrow cells and 1µg was reverse transcribed using 3-RACE kit (Invitrogen). cDNA was amplified in semi-nested PCR (Expand extra long PCR system; Roche Applied Science, Penzberg, Germany) using NUP_1083_1106F (exon 8) as the first gene specific primer, NUP_1400_1419F (exon 11) as the second and AUAP (Abridged Universal Amplification Primer, Invitrogen) as reverse primer in both steps. The PCR product was sub-cloned into the pGEM-T easy vector (Promega), sequenced and analyzed using the BLAST program (NCBI, http://www.ncbi.nim.nih.gov/) and BLAT Genome Search (http://genome.ucsc.edu/cgi-bin/hgBlat) programs.
To confirm the NUP98-LOC348801 fusion transcript we performed RT-PCR experiments using primers NUP_1284_1303F (exon 10) and LOC_1843_1824R (exon 4 ) for the first amplification round and primers NUP_1400_1419F (exon 11) and LOC_1787_1768_R (exon 4) for the second.
Primers LOC_1171_1190F (exon 1) and NUP1861_1843R (exon 14) for the first round and primers LOC_1219_1238F (exon 1) and NUP1861_1843R (exon 14) for the second were used to search for the reciprocal fusion transcript.

Results and Discussion
In this first case of primary AML with t(3;11)(q12;p15) characterized
by
NUP98-LOC348801 fusion, the 5-region of
NUP98 gene
encoding GLFG repeats motifs and the GLEBS-like motif was fused
in-frame with the 3-region of
LOC348801 gene (
Figure 1).
The reciprocal
LOC348801-NUP98 fusion transcript was also present.
LOC348801 is the 23
rd gene to be described as a
NUP98 fusion
partner. It maps to chromosome 3q12.2 and contains four exons
encoding for a protein with 178 aminoacids still lacking functional
characterization.
The interphase break-apart FISH assay indicated
NUP98 was involved
in t(3;11)(q12;p15) (
data not shown). Our 3-RACE-PCR
experiments showed that nucleotide 1718 (exon 13) of
NUP98 was
fused in-frame with nucleotide 1248 (exon 2) of
LOC348801 (
Figure 1).
The genomic breakpoints appeared to fall within intron 13 of
NUP98 and intron 1 of
LOC348801. Double-color double-fusion
FISH which gave one green signal, one red signal, and two fusion
signals (
Figure 2), further confirmed the reciprocal translocation
t(3;11)(q12;p15) produced the
NUP98-LOC348801 fusion gene.
Interestingly, in
LOC348801 nucleotide 1248 is located 33 nucleotides
upstream to the ATG start codon (1281–1283) (
Figure 1).
Thus, the predicted protein fuses the
NUP98 FG repeat motifs
and GLEBS-like motif to the entire
LOC348801 through an 11 bridging
peptide translated from non-coding sequence at the start of
LOC348801 exon 2. RT-PCR and cloning experiments detected two
in-frame alternatively spliced transcripts. Isoform 1 had
NUP98 exon 12, upstream to the breakpoint region while in isoform
2 it was eliminated by alternative splicing (
Figure 1). Alternative
splicing mechanisms were reported in other
NUP98 fusions.
8–12 In mammalians splicing physiologically produces
NUP98 or the
NUP98-NUP96 mRNA which encodes a precursor protein of 186 kDa.
The precursor is then proteolytically cleaved to produce NUP98
and NUP96 proteins.
8,13 Interestingly, in several oncogenes
aberrant and alternative splicing defects may underlie susceptibility
to tumor development and progression.
14,15 Our case emphasizes
that alternative splicing is a frequent event in
NUP98 leukemic
recombinations.
In this patient, a reciprocal LOC348801-NUP98 fusion transcript was also found as nucleotide 1247 (exon 1) of LOC348801 was fused with nucleotide 1719 (exon 14) of NUP98 (data not shown). Reciprocal fusion transcripts were reported in NUP98 translocations with different partners. However, since fusion with a partner may or may not produce the reciprocal transcripts generation does not seem to depend upon the characteristics of the partner gene.16–18 Whatever the mechanism, any possible biological and clinical significance of different NUP98 fusion isoforms and/or reciprocal transcripts is still not understood.
To date, t(3;11)(q12;p15) has been reported in two females, one with myelodysplastic syndrome and the other with T-ALL. In both cases NUP98 involvement was proven but partner(s) were not characterized.1 In another case of primary T-ALL/AML a t(3;11) recombination, which cytogenetically resembled translocation of our patient, was really a 3q translocation/inversion in which NUP98 recombined with the IQCG gene at 3q29.4
In conclusion NUP98, like MLL, is another promiscuous genes, that rearranges with many partners. In MLL-leukemia the translocation partner may influence clinical and phenotype features.19 Here we describe a new recombination between NUP98 and LOC348801 at 3q12 resulting in two in-frame spliced products and a reciprocal transcript. In our view, molecular characterization of new partners is a step towards a better understanding of the pathogenesis and mechanism of NUP98-positive leukemias. The highly specific double-color double-fusion FISH we set up for the NUP98-LOC348801 fusion provides the differential diagnosis between NUP98-IQCG and NUP98-LOC348801 and rapidly confirms genomic rearrangements, particularly in the event of ambiguous results with conventional cytogenetics.

Acknowledgments
the authors wish to thank Dr. Geraldine Boyd for assistance
in the preparation of the manuscript. Funding: AIRC (Associazione
Italiana Ricerca sul Cancro), MIUR (Ministero per l'Istruzione,
l'Università e la Ricerca Scientifica); Fondazione Cassa
di Risparmio, Perugia, Italy, FIRB, Italy and Associazione "Sergio
Luciani", Fabriano, Italy. IAP (Interuniversity Attraction Poles,
University of Leuven, Belgium) B.C. is supported by a grant
from FIRC (Fondazione Italiana Ricerca sul Cancro). BAC clones
were kindly provided by Dr Mariano Rocchi (DAPEG Sez. di Genetica,
University of Bari, Italy).

Footnotes
PG and LB shared authorship.
Authorship and Disclosures
PG: designed molecular studies and wrote the paper; LB: performed molecular studies and sequencing analyses; RLS: designed FISH studies and wrote the paper; VP: selected DNA clones and performed FISH experiments; LB: performed molecular studies and sequencing analyses; RR: supervised molecular studies; MFM: supervised clinical and experimental findings; PV: performed cytogenetic analysis and was involved in the management of the patient; IW: performed FISH experiments and provided clinical data; CM: was responsible for the conception and supervision of the study.
The authors reported no potential conflicts of interest.
Received for publication February 20, 2008.
Revision received March 19, 2008.
Accepted for publication April 10, 2008.

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