Researchers have described how the most common gene mutation found in acute myeloid leukemia starts the process of cancer development and how it can cooperate with a well-defined group of other mutations to cause full-blown leukemia. The researchers suggest that three critical steps are required to transform normal blood cells into leukemic ones, each subverting a different cellular process. By charting the route towards cancer, the study identifies processes that might serve as targets for new treatments to halt the cancer's development in its tracks and even reverse it. Acute myeloid leukemia is a rare but devastating disease, which can take hold in a matter of just days or weeks. Every year, 2,000 adults in the UK are diagnosed with acute myeloid leukaemia: only about three in ten adults survive for five years. In recent years researchers have identified a number of genes involved in the development of acute myeloid leukemia. The most common is NPM1, a gene with many known functions. The new research shows that mutation in NPM1 is a key event in the development of a large proportion of cases of acute myeloid leukemia and that it exerts its effect by helping cells to self-renew, a process that can be thought of as the first step towards leukemia. The team also identified two subsequent events that are required to cooperate with NPM1 to drive cells to become cancerous. The new work was published online on March 27, 2011, in Nature Genetics. "We have used targeted gene disruption to look at the way acute myeloid leukemia develops in mice," says Dr George Vassiliou, Consultant Haematologist, cancer researcher and first author on the study from the Wellcome Trust Sanger Institute, "and have found critical steps that take place when the cancer develops.
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