Undifferentiated leukemia of infancy with t(11:17) chromosomal rearrangement coexpressing myeloid and B cell restricted antigens

Umiel, Tehila; Nadler, Lee M.; Cohen, Ian J.; Levine, H; Stark, Batia; Mammon, Zipora; Dzaldetti, Mier; Rechavi, Gideon; Simoni, Frida Brok; Katzir, Nurit; Ramot, Bracha; Zaizov, Rina

doi:10.1002/1097-0142(19870315)59:6<1143::aid-cncr2820590618>3.0.co;2-j

Cited by 13 publications

(1 citation statement)

References 45 publications

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“…There have been other patients with leukemia with mixed-Iineage characteristics described with abnormalities of chromosome 17 [21,22,29] or 14 [7], but we are not aware of any other described lineage switches or AMLLs associated with abnormalities of both chromosome 14 and 17. It is interesting to speculate, considering our patient's course, that the 14q + , 17p + may be a chromosomal aberration associated with a progenitor cell that underwent malignant transformation.…”

Section: Discussionmentioning

confidence: 79%

Undifferentiated Acute Leukemia and Lineage Infidelity (Difficulties in Classification and Management)

DeLaat¹,

Files²,

Lampkin³

et al. 1989

Journal of Pediatric Hematology/Oncology

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The acute leukemias have been considered to represent a clonal expansion of a malignant transformed hematopoietic progenitor cell with adherence to either the myeloid or lymphoid lineage-"lineage fidelity.'' Lineage fidelity has been challenged by the demonstration of lineage switching or mixed-lineage leukemias. We describe a 7 year old male who presented with undifferentiated acute leukemia and nasopharyngeal and cervical masses. His blasts had the morphologic appearance of myeloblasts (FAB MI) and were positive solely for the myeloid antigen CD15. He entered a complete remission (CR) with acute nonlymphocytic leukemia therapy. At first relapse he had evidence of mixed-lineage leukemia with 6-cell lymphoid and myeloid phenotypes. He again relapsed from a second CR with Burkitt-cell leukemia. Cytogenetic findings showed a consistent 14q + ,17p+ abnormality in the blasts and nasopharyngeal mass. The t(8;14) associated with Burkitt's lymphoma was found in the mass tissue only following passage in the nude mouse.Our patient demonstrates that limitations still exist in our ability to classify acute leukemia. That leukemic transformation occurred in a multipotential progenitor cell leading to undifferentiated leukemia at diagnosis andlor that chemotherapy can influence the genetic programs of leukemic cells leading to the evidence of mixed-lineage leukemia and lineage switching is supported.

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Section: Discussionmentioning

confidence: 79%

Undifferentiated Acute Leukemia and Lineage Infidelity (Difficulties in Classification and Management)

DeLaat¹,

Files²,

Lampkin³

et al. 1989

Journal of Pediatric Hematology/Oncology

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Biologic and cytogenetic characteristics of leukemia in infants

Stark¹,

Vogel²,

Cohen³

et al. 1989

Cancer

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Clinical features, leukemic cell characterization, chromosomal findings, and treatment outcome were analyzed in a retrospective study of 30 cases with acute leukemia of infancy, 24 infants with acute lymphoblastic leukemia (ALL), and six cases with acute nonlymphoblastic leukemia (ANLL). Extensive bulky disease with organomegaly, central nervous system (CNS), and skin involvement were prominent features at diagnosis with a higher frequency in ANLL as compared to ALL. Four of six ANLL patients were classified as monocytic or myelomonocytic. In the ALL group nine of 24 (36%) were non-L1 morphology and six of 17 (33%) were common ALL antigen (CALLA) negative, the majority of them (five of six) were included in the non-L1 group. Immunophenotyping revealed four cases with early B-cell (three patients: Ia+B4+, and one patient: Ia+) and two cases with T-cell. Mixed lineage leukemia was found in five infants. Heavy chain immunoglobulin gene rearrangement was present in six cases tested, two CALLA+, two with Ia+B4+, and two were undifferentiated mixed lineage leukemia. Chromosomal aberrations were detected in ten of 18 patients, mostly in ANLL and CALLA negative ALL. Translocations were detected in six patients, involving 4q21-23 and 11q23 in three and two cases, respectively. The probability of five-year DFS were 27% for the whole group. The worst prognosis was observed in infants younger than 6 months of age, in whom the leukemia cell characteristics was compatible with stem cell: ANLL, very early pre-B, or undifferentiated mixed type. The chromosomal aberrations found in all cases included translocation with the seemingly nonrandom breakpoints at 4q21 and 11q23, and breakpoints that corresponded to known fragile sites. This finding may be suggestive of an underlying genetic predisposition associated with the poor prognosis of leukemia of infancy.

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Infant leukemia: An analysis of nine chinese patients

Chuu¹,

Tien²,

Lin³

et al. 1990

American J Hematol

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A study was made of the cellular and molecular characteristics of nine Chinese infants, consecutively presenting with acute leukemia. Five cases were acute lymphoblastic leukemia (ALL); four were acute nonlymphoblastic leukemia (ANLL). Hyperleukocytosis, hepatosplenomegaly, and poor response to conventional therapy were common features, and CNS involvement was detected at diagnosis in three cases. The blast cells from all five cases with ALL expressed early B-cell markers, i.e., HLA-DR+, CD19+, but CD10-. Terminal deoxynucleotidyl transferase (TdT) was present in blasts from four of the five cases and periodic acid-Schiff staining in blasts from two patients only. The leukemic cells of one patient also showed positive nonspecific esterase activity and expressed myeloid-associated antigens CD33 (My9), CD11 (OkM1), and CD14 (My4 and Mo2). Molecular analysis of leukemic cell DNA from this and two other patients showed rearrangement of the immunoglobulin (Ig) heavy-chain genes, but without any evidence of kappa light-chain gene rearrangement. T-cell receptor (TCR) genes remained in the germline configuration in these cases. Cytogenetic analysis showed translocation t(4;11) (q21;q23) in all four cases studied. In the group of ANLL, three cases belonged to the M4 and one to the M2 subtype. Chromosomal abnormality involving 11q23 was also detected in two patients: t(11;17)(q23;q11) and del(11)(q14q23) in each case respectively. Neither Ig nor TCR gene rearrangement was present in blast cells from patients with ANLL. The data indicate that chromosomal rearrangement of band 11q23 was quite common in Chinese infants with either form of leukemia, a finding that may have pathogenetic implications.

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Undifferentiated leukemia of infancy with t(11:17) chromosomal rearrangement coexpressing myeloid and B cell restricted antigens

Cited by 13 publications

References 45 publications

Undifferentiated Acute Leukemia and Lineage Infidelity (Difficulties in Classification and Management)

Undifferentiated Acute Leukemia and Lineage Infidelity (Difficulties in Classification and Management)

Biologic and cytogenetic characteristics of leukemia in infants

Infant leukemia: An analysis of nine chinese patients

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