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luDepartment of Molecular Biology and Genetics, Faculty of Science, Bilkent University, 06533 Ankara, Turkey [M. D. R., T. Ö., B. C., H. Ö., M. Ö.]; Department of Pediatrics, Hacettepe University School of Medicine, 06100 Ankara, Turkey [M. T., A. G.]; Department of Internal Medicine, Ankara University School of Medicine, 06100 Ankara, Turkey [Ö. U., H. Ç.]; and Departments of Pediatrics and Internal Medicine, Çukurova University School of Medicine, 01330 Adana, Turkey [A. T., E. E.]
Heterozygous germ-line mutations in the DNA mismatch repair genes lead to hereditary nonpolyposis colorectal cancer. The disease susceptibility of individuals who constitutionally lack both wild-type alleles is unknown. We have identified three offspring in a hereditary nonpolyposis colorectal cancer family who developed hematological malignancy at a very early age, and at least two of them displayed signs of neurofibromatosis type 1 (NF1). DNA sequence analysis and allele-specific amplification in two siblings revealed a homozygous MLH1 mutation (C676T
Arg226Stop). Thus, a homozygous germ-line MLH1 mutation and consequent mismatch repair deficiency results in a mutator phenotype characterized by leukemia and/or lymphoma associated with neurofibromatosis type 1.
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