Casitas B-cell lymphoma (Cbl)-family E3 ubiquitin ligases are negative regulators of tyrosine kinase signaling. Recent work has revealed a critical role of Cbl in the maintenance of hematopoietic stem cell (HSC) homeostasis, and mutations in CBL have been identified in myeloid malignancies. Here we show that, in contrast to Cbl or Cbl-b single-deficient mice, concurrent loss of Cbl and Cbl-b in the HSC compartment leads to an early-onset lethal myeloproliferative disease in mice. Cbl, Cbl-b double-deficient bone marrow cells are hypersensitive to cytokines, and show altered biochemical response to thrombopoietin. Thus, Cbl and Cbl-b play redundant but essential roles in HSC regulation, whose breakdown leads to hematological abnormalities that phenocopy crucial aspects of mutant Cbl-driven human myeloid malignancies.ubiquitin ligase | leukemia M embers of the Casitas B-cell lymphoma (Cbl) protein family are critical negative regulators of protein tyrosine kinase (PTK)-mediated signal transduction pathways (1-3). An N-terminal tyrosine kinase binding (TKB) domain, composed of a four-helical bundle, a calcium-binding EF hand, and a variant SH2 domain, mediates specific docking of Cbl proteins on activated PTKs (and some nonkinase components of PTK signaling pathways) through cognate phosphotyrosine-containing motifs. A short linker region and a RING finger domain immediately C-terminal to the TKB domain mediate interaction with E2 ubiquitin-conjugating enzymes and are essential for E3 activity of Cbl proteins.In the past few years, several groups have reported mutations of the CBL gene in a subset of patients with myeloid neoplasms (4-13). A large proportion of CBL mutations is associated with myelodysplastic syndrome/myeloproliferative disorder (MDS/ MPD), a heterogeneous group of hematopoietic malignancies characterized by deregulated hematopoiesis and a high propensity to develop acute myeloid leukemia (AML). Strikingly, CBL mutations have been identified in more than 10% of patients with juvenile myelomonocytic leukemia (JMML), a pediatric subtype of MDS/MPD with excessive proliferation of myelomonocytic cells and hypersensitivity to granulocyte-macrophage colony-stimulating factor (GM-CSF). In both adult and pediatric cases, a majority of the CBL mutations cluster within the linker and RING finger domains. Interestingly, only rare CBLB mutations have been detected in these studies, although not all studies have looked for such mutations.Why mutations in CBL are specifically associated with MDS/ MPD and how these mutations produce the disease are of obvious interest. A recent study has demonstrated that Cbl protein functions to limit the size of the hematopoietic stem cell (HSC) compartment, and that Cbl-null mice show an expansion of HSCs with an enhanced ability to mediate long-term bone marrow repopulation (14). However, Cbl-null animals develop only mild, nonlethal MPD, indicating that other factors are involved. A unique feature of patient-derived CBL mutations is their frequent association with uniparenta...