Cancer can be defined as an abnormal proliferation of cells that defy the normal regulatory controls observed by normal cells. Recently, histone deacetylation therapies have been attempted in the treatment of certain cancers [reviewed by Delcuve et al. (2009)]. Specifically, the FDA has approved histone deacetylation (HDAC) inhibitors for the treatment of cutaneous T-cell lymphoma. Explain why histone acetylation might be associated with cancer and what the rationale is for the use of HDAC inhibitors in the treatment of certain forms of cancer.
Table of contents
- 1. Introduction to Genetics51m
- 2. Mendel's Laws of Inheritance3h 37m
- 3. Extensions to Mendelian Inheritance2h 41m
- 4. Genetic Mapping and Linkage2h 28m
- 5. Genetics of Bacteria and Viruses1h 21m
- 6. Chromosomal Variation1h 48m
- 7. DNA and Chromosome Structure56m
- 8. DNA Replication1h 10m
- 9. Mitosis and Meiosis1h 34m
- 10. Transcription1h 0m
- 11. Translation58m
- 12. Gene Regulation in Prokaryotes1h 19m
- 13. Gene Regulation in Eukaryotes44m
- 14. Genetic Control of Development44m
- 15. Genomes and Genomics1h 50m
- 16. Transposable Elements47m
- 17. Mutation, Repair, and Recombination1h 6m
- 18. Molecular Genetic Tools19m
- 19. Cancer Genetics29m
- 20. Quantitative Genetics1h 26m
- 21. Population Genetics50m
- 22. Evolutionary Genetics29m
19. Cancer Genetics
Cancer Mutations
Problem 26
Textbook Question
A study by Bose and colleagues (1998). Blood 92:3362-3367] and a previous study by Biernaux and others (1996). Bone Marrow Transplant 17:(Suppl. 3) S45–S47] showed that BCR-ABL fusion gene transcripts can be detected in 25 to 30 percent of healthy adults who do not develop chronic myelogenous leukemia (CML). Explain how these individuals can carry a fusion gene that is transcriptionally active and yet does not develop CML.

1
Understand the concept of the BCR-ABL fusion gene: The BCR-ABL fusion gene is formed by a translocation between chromosome 9 and chromosome 22, creating the Philadelphia chromosome. This fusion gene encodes a constitutively active tyrosine kinase that is associated with chronic myelogenous leukemia (CML).
Recognize the significance of transcriptional activity: The detection of BCR-ABL fusion gene transcripts in healthy individuals indicates that the gene is transcriptionally active, meaning it is being expressed and producing RNA. However, transcriptional activity alone does not guarantee the development of CML.
Consider the role of additional genetic or environmental factors: The development of CML typically requires more than just the presence of the BCR-ABL fusion gene. Additional mutations, epigenetic changes, or environmental factors may be necessary to trigger the progression to leukemia.
Explore the concept of cellular regulation: Healthy individuals may have mechanisms in place that regulate the activity of the BCR-ABL protein or prevent its oncogenic effects. For example, immune surveillance or cellular repair systems might counteract the potential damage caused by the fusion protein.
Understand the difference between presence and disease manifestation: The presence of the BCR-ABL fusion gene in healthy individuals does not necessarily mean they will develop CML. It is possible for the gene to exist without leading to uncontrolled cell proliferation, highlighting the complexity of cancer development and the interplay of multiple factors.

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Key Concepts
Here are the essential concepts you must grasp in order to answer the question correctly.
BCR-ABL Fusion Gene
The BCR-ABL fusion gene is a result of a chromosomal translocation between the BCR gene on chromosome 22 and the ABL gene on chromosome 9. This fusion creates a hybrid gene that encodes a constitutively active tyrosine kinase, which is implicated in the pathogenesis of chronic myelogenous leukemia (CML). However, the presence of this fusion gene alone does not guarantee the development of CML, as other genetic and environmental factors also play significant roles.
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Transcriptional Activity
Transcriptional activity refers to the process by which a gene's DNA sequence is transcribed into messenger RNA (mRNA), which can then be translated into proteins. In the case of the BCR-ABL fusion gene, even in healthy individuals, the gene can be transcribed, leading to the production of the fusion protein. However, the expression levels and regulatory mechanisms of this gene can vary, which may prevent the onset of CML in some carriers.
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Genetic and Environmental Factors
The development of diseases like CML is influenced by a combination of genetic predispositions and environmental factors. While the presence of the BCR-ABL fusion gene is a critical factor, other mutations, epigenetic changes, and external influences (such as exposure to certain chemicals or radiation) can determine whether an individual will develop CML. Thus, healthy individuals with the fusion gene may not exhibit the disease due to the absence of these additional risk factors.
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