Clustering of aberrations to specific chromosomes in human neoplasms. III. Incidence and geographic distribution of chromosome aberrations in 856 cases

An 8-kilobase abl RNA transcript in chronic myelogenous leukemia

Chronic myelogenous leukemia (CML) is a clonal hematologic malignancy characterized by a reciprocal translocation between chromosomes 9 and 22 [t(9;22)] in greater than 90% of cases. This translocation results in a short chromosome 22, termed the Philadelphia (Ph1 or 22q-) chromosome. Recently, the cellular oncogenes abl and sis were mapped to human chromosomes 9 and 22, respectively. Moreover, abl was shown to be translocated from chromosome 9 to 22 and sis from chromosome 22 to 9 in CML patients with t(9;22). These findings raised the possibility that one or both of these oncogenes is activated and directly involved in the development of the disease. We analyzed expression of the abl and sis oncogenes in leukemic cells from CML patients with t(9;22). We found that sis is not expressed but that abl is transcribed into an 8-kilobase RNA. This abl RNA is also present in two leukemic cell lines (EM2 and K562), which were derived from CML patients and contain the t(9;22). This 8-kilobase RNA is not detected in normal cells, in other human leukemias without t(9;22), or in human cell lines that lack t(9;22). The consistent presence of this abl RNA transcript in CML with t(9;22) suggests that it is a consequence of abl translocation and that it plays a role in the development of this leukemia.

Translocation 1;19--a new cytogenetic abnormality in acute lymphocytic leukemia

A study of the chromosomes of 125 consecutive patients with acute lymphocytic leukemia (ALL) showed the same translocation between chromosomes #1 and #19 in 5 patients. In 4 of the 5, the t(1;19)(q21;q13) was present at diagnosis. The fifth patient, who had Philadelphia chromosome positive (Ph1+) ALL, developed t(1;19) in first relapse. Trisomy 1q was involved in 2 of the 5 patients; 3 patients had additional abnormalities. All patients had low white cell counts at presentation (less than 35 X 10(9)/L), and the 4 patients tested had common ALL antigen (CALLA) positive leukemic blast cells. All achieved complete remission, including the Ph1+ ALL patient in first relapse, and survival times ranged from 4 to 21+ mo from the time the t(1;19) first appeared. Our data suggest that t(1;19) is a previously unrecognized nonrandom structural abnormality in ALL that is also found in other lymphoid malignancies. Unlike the other specific translocations, it is not associated with a poor prognosis.

Restricted number of chromosomal regions implicated in aetiology of human cancer and leukaemia

It has been known since the days of Boveri that neoplasia is associated with chromosomal aberration. The introduction, some 10 years ago, of chromosome banding techniques provided the impetus for the description of an immense number of such aberrations, and for the localization to individual chromosome bands of the breaks underlying the aberrations. Hypothetically, the breaks should comprise two essentially different kinds: primary breaks that are actively involved in the malignant development, and secondary breaks, coincidental to this process. In the search for a possible method to identify primary breaks in human cancer, I selected from the catalogue of chromosome aberrations now available those cases that had one single structural aberration as their sole deviation from normality. I report here that the breakpoints thus specified affect a surprisingly limited number of chromosomal regions, and conclude that these regions contain genes of prime importance to cancer development.

Prognostic importance of cytogenetic abnormalities in patients with chronic lymphocytic leukemia

Chronic lymphocytic leukemia is recognized as having a variable prognosis, but its staging has depended exclusively on anatomical sites of involvement and the presence or absence of anemia and thrombocytopenia. The recent availability of techniques permitting cytogenetic analysis of malignant B lymphocytes led us to examine the karyotypic abnormalities in chronic lymphocytic leukemia and to correlate them with clinical stage, progression of disease, and survival. Of 53 patients with metaphases adequate for study who were followed for a minimum of one year, 21 (40 per cent) had abnormal karyotypes, of which trisomy 12 was the most frequent (25 per cent). Abnormal karyotypes were found to be significant correlates of advanced clinical stage (P less than 0.005) and of shortened survival (P less than 0.05). We conclude that cytogenetic analysis provides useful clinical and prognostic information in patients with chronic lymphocytic leukemia.

Investigations on karyotype evolution in patients with chronic myeloid leukemia (CML)

In an attempt to relate karyotype evolution to clinical and hematological data serial chromosomal analyses were performed in 31 patients with chronic myeloid leukemia (CML), both in chronic and acute phases. Our results in Philadelphia chromosome (Ph1)-positive CML are in line with karyotype profiles described in the literature. In addition, we report on chromosomal findings in 4 cases of Ph1-negative disease, one presenting with an iso17q chromosome in the positive CML. The same chromosomal abnormality was observed in a small population of Ph1-negative cells present in one of two patients with mixed Ph1-positive/Ph1-negative CML. The first case of a female patient with the loss of a sex chromosome in Ph1-positive cells is reported. Two patients with unusually long and mild chronic phases despite the presence of trisomy 8 in their karyotypes are described. Our findings suggest that the order of appearance of additional chromosomal changes of CML is of prognostic significance for the progression and the clinical picture of the disease.

Acid phosphatase-producing androgen-independent subline of rat prostatic adenocarcinoma (Dunning R3327 tumor) in cell culture

Establishment of a cell line derived from the androgen-independent subline of rat prostatic adenocarcinoma (Dunning R3327 tumor) is reported. Cells of this line produced acid phosphatase. When the cultured cells were transplanted to Copenhagen rats, solid tumors were formed. Histologically, the tumor consisted of spindle-shaped, large and bizarre polygonal cells; this feature was almost identical to that of the original tumor. Chromosomes were in the triploid range with seven frequently appearing marker chromosomes.

Karyotypic abnormalities of squamous cell carcinoma of the oral cavity

The karyotypic abnormalities in 18 squamous cell carcinomas of the oral cavity were studied in unbanded chromosomes on direct preparations of the tumor material. The chromosome counts revealed a great variability in the number of chromosomes per cell of each tumor, the range being from 31 to 148 in all cases studied. The modal population of cells was diploid in five cases, triploid in eight cases, tetraploid and pentaploid in one case each. Reduction of the number of chromosomes was more consistently observed in groups A and B, frequently involving chromosome No 1 and increases in groups C, D, E, F and G. Markers were frequently present, the most common being an almost metacentric chromosome of the size of the chromosomes of Group C.

The heterogeneity of the 5q--chromosome marker in refractory anemia

A patient presenting with an unusual case of refactory anemia is described in whom acquired markers originating from chromosomes No. 5 and 8 are identified by G- and sequential C-banding. Comparison with various published illustrations of chromosome No. 5 deletions in this general broad category of disease raises the possibility that karyotypic misclassification in cases of absent or substandard banding (typical of bone marrow) may help to explain the considerable variation in size and morphology of the 5q--marker.

A summary of cytogenetic studies on 534 cases of chronic myelocytic leukemia in Japan

Cytogenetic and clinical data on 534 patients with chronic myelocytic leukemia (CML) were collected from 10 institutions in Japan. The results of the analysis of the data were in substantial accord with those of the First International Workshop on Chromosomes in Leukemia and other published data, but certain differences were noted in the frequency of Philadelphia chromosome (Ph1)-negative cases, unusual and complex Ph1 translocations, and additional chromosome changes. Some of the findings are discussed with respect to the origin of unusual and complex Ph1 translocations, the relationship between chromosome abnormalities and survival, and geographic differences in chromosome abnormalities.

Cellular heterogeneity in a tissue culture cell line derived from a human bladder carcinoma

To study heterogeneity in a cell line derived from a human bladder carcinoma (EJ), 7 clones were isolated at low passage and examined for differences in culture behaviour, ability to grow in agar and tumorigenicity in nude mice. The parent EJ line had several distinct chromosome populations (both diploid and tetraploid), grew in agar and produced tumours in nude mice. Three of the clones had pseudodiploid modes and 4 had either hypo- or hypertetraploid modes. The 7 clones had 5 marker chromosomes in common but the combination of other marker chromosomes made each clone unique. No significant difference was found between the clones in the in vitro growth rate although analysis of in vitro culture behaviour showed heterogeneity in the pattern of cell movement on plastic substratum. Three clones were composed of static cells, one clone had very mobile cells; the other clones had rates of movement intermediate between the two. Differences were also found in the packing density of the cloned cells and in the cell size. All 7 clones grew in agar but heterogeneity was seen between the clones as shown by widely varying colony-forming efficiencies (0.5-13%). One clone had a high colony-forming ability in agar but failed to produce tumours in nude mice. The other clones were tumorigenic regardless of colony-forming efficiency in agar. Specific chromosome abnormalities were found to be associated with growth in agar and tumorigenicity but not with the growth pattern or the rate of movement of the cloned cells in culture.

Chronic myelogenous leukemia with a Philadelphia chromosome resulting from a complex translocation (2; 9; 22), following an undifferentiated acute leukemia

This case report concerns a patient with acute leukemia considered at diagnosis to be undifferentiated. Unfortunately, because of the failure of the culture, a cytogenetic evaluation was not possible at that stage. A full remission was induced, but 17 months after the onset of the disease the patient developed chronic myelogenous leukemia. The karyotypes prepared at that time and during the follow-up revealed the presence of a Philadelphia chromosome (Ph1) in all examined cells. This Ph1 resulted from a complex translocation involving chromosomes No. 2, 9, and 22.

Human chromosome analysis in 24 cases of primary carcinoma of the large intestine: contribution of the G-banding technique

As in the haemopathies, the application of cytogenetics to epithelial cancers could aid in the study of their pathogenesis evaluation. In this context we performed chromosome analyses on a series of human colo-rectal cancers. The technique was consistently reliable since the modal number of chromosomes could be determined in all 24 cases. In 22, karyotypes could also be established. Each tumour was characterized by a single cell clone in 21 cases and by a mosaic of 2 populations in 3 cases. Numerical anomalies were not due to chance: they enabled near-diploid (11 cases), near-triploid (9 cases), mosaic (3 cases) and highly polyploid (1 case) cancers to be distinguished. Supernumerary chromosomes were primarily in groups C and F. The most frequent markers before denaturation techniques were No 2q +, No F and minutes. Each time double-minutes were observed (5 cases), they were in invasive cancers (B and C Dukes classification). Cells were generally diploid in non-invasive cancers with fewer quantitative and structural anomalies. Tumour cytogenetics were related to the histological type and localization in the colon, as well as to the local and metastatic spread.

Application of the micronucleus test to exfoliated cells of high cancer risk groups: tobacco chewers

Powdered tobacco (Khaini tobacco) with the addition of lime is commonly used by the residents of Bihar, India. The tobacco/lime mixture is usually placed on the inner side of the lower lip within the gingivolabial groove. About 42% of the users keep it at the front, the rest move the tobacco towards the left or right side within the oral cavity. Carcinomas (so-called "Khaini cancers") develop mainly at the site where the tobacco is in close contact with the mucosa. Scrapings of the mucosa were taken at sites where the tobacco is kept, then smears were prepared, stained with the Feulgen reaction and fast green, and screened for micronuclei which indicate the occurrence of chromosome aberrations in the dividing cell population of the basal layer. An elevated frequency of cells with micronuclei was found in the oral mucosa of all 27 examined Khaini tobacco users (Munda and Santal tribes) compared to that of non-chewers of similar ethnic background and dietary habits. The induction of micronucleated mucosa cells seems to be due to genotoxic agents released from the tobacco/lime mixture. In vitro, an aqueous extract of the Khaini tobacco elicits chromosome aberrations and micronuclei in cultured human fibroblasts and Chinese hamster ovary (CHO) cells. No chromosome-damaging effect was observed following the application of lime or calcium hydroxide (Ca(OH)2). The micronucleus test on exfoliated cells can provide evidence of carcinogen exposure in the tissue from which cancers will develop. This approach combines all the advantages of in vitro short-term tests for genotoxic and carcinogenic agents with those of using an intact organism with all its defence mechanisms.

Characterization of a new chromosomal marker for acute lymphoblastic leukemia from a long-term cell line

A bone marrow aspirate from a child with acute lymphoblastic leukemia (ALL) at first relapse was used to establish cell line # 697. The cultured line and marrow aspirates taken at initial diagnosis and first relapse were examined and compared. Similarities in all patterns evaluated confirmed the leukemic origin of the line. Morphologically, the cells were typically lymphoblastic. Cytochemically, they were slightly acid phosphatase-positive and negative for peroxidase, ASD chloroacetate esterase, and nonspecific esterase. Immunologically, they were found positive for common-ALL antigen (CALLA), Ia-associated antigen, terminal deoxynucleotidyl transferase (TdT), and cytoplasmic IgM (cIgM) and slightly positive for surface IgM (sIgM). Testing for Epstein-Barr virus (EBV) capsid antigen was also positive. Cytogenetic evaluations performed on initial, relapse, and cell line specimens each revealed the presence of a pseudodiploid cell line characterized by a consistent marker chromosome. GTG-, QFQ-, and RF-banding identified the marker as being derived from a translocation involving chromosomes #7 and #19: t(7;19) (q11;q13). Iso 7q, -5, -9, and +2 were also found in significant association with the marker and were viewed as demonstrating continued karyotypic evolution within the cell line. From these data, cell line #697 has been classified as a leukemic line of B-cell lineage in a transitional stage between pre-B and mature B cells.

Statistical analysis of cytogenetic abnormalities in human cancer cells

It is sometimes difficult to evaluate reports of "nonrandom" chromosome involvement in certain malignant diseases, since the "random" or expected distribution is seldom defined. Therefore, we have developed methods for the statistical analysis of cytogenetic abnormalities in human cancer cells with modal karyotypes in the diploid range (35-57 chromosomes). For this analysis, it is assumed that the expected gain or loss of each chromosome will occur with equal probability and structural abnormalities will involve each chromosome in proportion to its size. To perform this analysis, the total number of numerical and structural abnormalities is determined from the modal karyotypes of a series of histologically related tumors. The maximum expected values are determined by computer simulation for different levels of significance. Then the distributions of observed and expected abnormalities of each type are compared to identify nonrandom involvement. Preferential gain or loss is analyzed for each of the 24 different chromosomes, and preferential structural rearrangement is determined for each of the 48 chromosome arms. We have analyzed two series of karyotypic data to demonstrate the utility of this method. The rationale for the assumptions made as well as alternative approaches are discussed.

Comparative analysis of high-resolution chromosome techniques for leukemic bone marrows

High-resolution direct and synchronization culture techniques for chromosome analysis of leukemic bone marrow cells can now be utilized. In this article, three different techniques are quantitatively compared for their consistency in successful cytogenetic analysis, reliability in the detection of clones with chromosomal abnormalities, and usefulness for the precise delineation of break points involved in structural chromosomal rearrangements. Bone marrow samples from 15 consecutive patients with acute nonlymphocytic leukemia (ANLL) were studied using an improved direct technique, amethopterin cell synchronization with thymidine release, and amethopterin cell synchronization with bromodeoxyuridine (BrdU) release. The results obtained with the amethopterin cell synchronization technique and thymidine release suggest that it should be the method of choice in the detection of chromosome defects in bone marrow of patients with ANLL.

Significance of a (4;11) translocation in acute lymphoblastic leukemia

This report describes a case of null cell congenital acute lymphoblastic leukemia associated with a (4;11) translocation. This chromosome abnormality is associated with acute lymphoblastic leukemia and probably more specifically with congenital acute lymphoblastic leukemia. A review of the literature is presented.

Karyotype analysis in acute nonlymphocytic leukemia (ANLL): comparison with ethnic group, age, morphology, and survival

The karyotype, leukemia cell morphology (FAB classification), ethnic group, age, sex, and survival were compared in 60 patients with acute nonlymphocytic leukemia (ANLL), to determine their diagnostic and prognostic significance. An ethnic age difference was observed; a significantly greater number of black patients were children. The majority of children were males. A higher frequency of chromosome abnormalities was detected in children, yet they survived longer than adults. A specific, significant association between a (8; 21) karyotype and M2-ANLL was confirmed; four of ten patients with M2-ANLL showed this translocation. The more mature morphology of M2-ANLL was associated with a longer survival irrespective of karyotype, ethnic group, and age. The specificity of t(15; 17) in M3-ANLL and nonrandom monosomy 7 in preleukemic children was confirmed. Patients, particularly adults, with normal karyotypes tended to survive longer than those with abnormal karyotypes. The patient's age and the differentiative capacity of the leukemic cell appear to be as important as the karyotype in determining survival. The nonrandom association of certain chromosome aberrations in ANLL appears to be worldwide.

Abnormalities of chromosome #13 in retinoblastomas from individuals with normal constitutional karyotypes

Constitutional chromosome abnormalities have been associated with retinoblastoma, Wilm's tumor, and a familial form of renal carcinoma. For each tumor type, the particular chromosome segment involved in the observed rearrangements is different: in retinoblastoma, that segment is band q14 on chromosome #13. We now present evidence that in retinoblastoma, structural abnormalities involving the particular chromosome segment identified in the constitutional cases can also occur in the tumors of individuals with normal constitutional karyotypes. Six cases with retinoblastoma in one or both eyes were analyzed; deletions/rearrangements involving 13q14 were found in the tumor cell karyotypes of five of the six. These observations suggest that changes in a gene or genes at a common site (13q14) play a role in tumorigenesis in all forms of retinoblastoma, sporadic as well as heritable.

Human large-bowel cancer: correlation of clinical and histopathological features with banded chromosomes

Clinical and histopathological features were correlated with cytogenetic banding studies on direct preparations from 31 large-bowel tumors. An interesting relationship between the site and the karyotypes of the tumors was observed. There appears to be a progressive increase in chromosomal number and/or structural rearrangement as one progresses from proximal to distal large bowel. We suggest that these observations may be related to differences in function and micro-environment within different areas of the colon. Although it is not known what factors favor cytogenetic variability and instability on the left side or the presence of fewer abnormalities on the right side of the colon, it is evident that clonal karyotypic evolution may be important in the progression of large-bowel cancer. The brevity of follow-up precludes conclusions regarding the influence of karyotype on survival.

Ph1 -positive CML associated with megakaryocytic hyperplasia and thrombocythemia and an abnormality of chromosome no. 3

A patient with Philadelphia (Ph1) chromosome positive chronic myelocytic leukemia is described, who had in blast crisis in addition an abnormality of chromosome No. 3; ins(3; 3)(q26; q21q26). This abnormality might be connected with hyperplasia of megakaryocytes and thrombocythemia, as recently reported in patients with acute leukemia. In the initial phase of the disease our patient had also thrombocythemia, hyperplasia of megakaryocytes with morphological abnormalities. Furthermore, when blast cells were culture in diffusion chambers, differentiation into several cell lines occurred but not into megakaryopoiesis. It is, therefore, concluded that the involved band on chromosome No. 3 might contain the locus which controls megakaryocytic proliferation and platelet production but additional factors seem to be required for their expression.

Karyotype consistency in human colorectal carcinoma cell lines established in vitro

Karyotypes of nine human colorectal cell lines deposited with the ATCC were studied by trypsin-Giemsa banding. CCL 229,230,231 and 235 (Modal chromosome number, Sm, was 49, 68, 47, and 40, respectively) belong in the stable type that is characterized by karyotypes consisting mostly of normal chromosomes and stable markers. CCL 228, 234, and 238 (Sm=55,79, and 70 respectively) belong in the unstable type that has karyotypes consisting of numerous markers in addition to normal chromosomes and stable markers. The remaining intermediate type (CCL 233 and 237, Sm = 60 and 64, respectively) has karyotypic characteristics between the above two types usually with two or less unstable markers per cell. The stable markers (together with normal chromosomes) are constitutive components of a cell genome and are common to most cells within the same cultured population. Unstable markers, which generally constitute only a small portion of the total chromosome complement are the likely cause of karyotypic variations between cells and often are produced by balanced inter- or intrachromosome changes, or both. Consequently, total chromosome length per cell genome is remarkably consistent within a cell population, and karyotypes between cells, such as from four stable lines, are profoundly stable and mostly identical. Chromosome deletions and interhomologue exchanges (including isochromosomes) had the highest incidences among both stable and unstable markers. The complex markers occurred relatively infrequently. There were neither common markers nor unique chromosome breakages common to all of these established cell lines. However, chromosomes No. 7 and 1 had the highest incidence (15 and 12, respectively) of structural modifications resulting in the formation of stable markers (82 total exchanges in nine cell lines), and chromosomes No. 7 and 2 were involved at high incidence (21 and 15, respectively) in the formation of both stable and unstable markers (181 total exchanges). Moreover, No. 7 is overrepresented in eight of nine lines. The significance of chromosome changes involving No. 7 in this as well as other tumor pathotypes is briefly discussed.

Chromosomal rearrangement and carcinogenesis

All carcinogens that have been thoroughly tested have been found to induce some kind of chromosomal rearrangement. Chromosomal rearrangements are associated with a variety of human and rodent cancers and are associated, with in vitro cell transformation. The DNA from non-malignant cells can transform other non-malignant cells under conditions that may involve chromosomal rearrangement. These findings support the view that chromosomal rearrangement can be a step in carcinogenesis. Available evidence indicates that carcinogens can act to induce chromosomal rearrangement by creating or revealing sites on DNA for recombination, or by inducing or activating cellular systems resulting in a stimulation of recombination. Chromosomal rearrangement may affect carcinogenesis by altering gene expression. Perhaps by allowing the activation of cellular cancer genes.

An analysis of chromosome findings in non-Hodgkin's lymphomas

Banding studies were done on tissues from tumors excised from 22 Japanese patients with non-Hodgkin's lymphomas. All tumors were found to be associated with aneuploidy. The chromosome abnormalities were diverse, with each chromosome type being involved in these abnormalities. Terminal deletions, derivative chromosomes as a result of unbalanced or nonreciprocal translocations, and markers of totally or partially unknown origin accounted for the majority of the structural abnormalities. Balanced reciprocal translocations were seen only occasionally. The 14q+, 6q-, partial trisomy of 1q, 11q+, 18q+, and 19q+ abnormalities were seen in more than two patients. The incidence of a missing sex chromosome was significantly higher than that of autosomes, but no particular other karyotypic abnormality seemed to be associated with the event. All six patients whose chromosomes could be totally characterized were in complete remission. Patients with one or more markers of unknown either totally or partially origin, had a median survival of only 8 months (p less than 0.01). Five of the former six patients showed a nodular histology. Fifteen of the latter 16 patients had a diffuse histology, with 13 of the 15 having diffuse histiocytic lymphoma. The median survival of 9.5 months for the 14 with only abnormal metaphases in the lymphatic tissues (AA-group) was shorter than the 26+ months for the seven patients with both normal and abnormal metaphases (AN-group). Thus certain aspects of chromosomal changes appear to correlate with histology and/or prognosis in non-Hodgkin's lymphomas.

Patient with acute B-cell leukemia of Burkitt's type (L3) and marker chromosomes including an (8;14) translocation

A 20-year-old man with acute B-cell leukemia of Burkitt's type (L3) presenting unusual début symptoms with jaw involvement is reported. The leukemic cells revealed chromosomal abnormalities including four marker chromosomes [1q+, 6q-, t(8;14)].

Chronic T-cell leukemias. II. Cytogenetic studies

Chromosome abnormalities were documented in the PHA-stimulated lymphoid cells from 10 patients with chronic T-cell leukemias (6 T-PLL, 3 T-CLL and 1 T-LCL). One or more marker chromosomes were present in most metaphases in every case of T-PLL but they were different in each case. Structural abnormalities were also observed in T-CLL and T-LCL but less consistently. Chromosomes involved in marker formation in two or more cases were: Nos. 2, 7, 8, 9, 11 and 16. The karyotype was hypodiploid in five cases and hyperdiploid in two. Chromosomes Nos. 2 and 8 were the most frequently involved in structural and numerical abnormalities: Nos. 8 in 2 T-CLL and the 6 T-PLL and No. 2 in 1 T-CLL, 1 T-LCL and 5 T-PLL. Abnormalities of chromosome No. 2 are rare in human neoplastic disease but may be common in T-lymphoproliferative disorders. The differences between T-PLL and T-CLL reported here may have some bearing on the clinical features. T-PLL, characterised in all cases by clonal abnormalities, has an aggressive clinical course. In contrast, T-CLL with less consistent karyotypic changes has a protracted and benign clinical evolution.

Cytogenetic studies in adult acute leukemias

Thirty-six patients with acute leukemia (31 with AML, 5 with ALL) were classified by FAB criteria, and their bone marrow cells were analyzed cytogenetically with G-banding. Chromosomal abnormalities were found in 16 patients (44%). The most common abnormality was an 8;21 translocation, accounting for 19.4% of all AML patients, that was restricted to patients with M2. In 29 treated AML patients, those with an 8;21 translocation [t(8;21) patients] showed a higher complete remission rate (83%) and a longer median survival (10.7 months) than did other patients with AML; patients with only abnormal metaphases (AA patients) had the lowest complete remission rate (33%) and shortest median survival (2.7 months). There was no difference in the remission rate and survival between patients with only normal metaphases (N patients) and patients with abnormal metaphases (A patients). Three out of five patients with ALL had karyotypic abnormalities; the Philadelphia (Ph1) chromosome was found in one case.

Chromosome studies in a case of monoblastic leukemia

Chromosome analysis of a direct bone marrow preparation from a patient with acute, undifferentiated monoblastic leukemia showed a predominant clone of 51,XX,+6,+8,+4,+19,+21,11q+, along with a chromosomally normal clone. Studies with cytofluorometry confirmed the two populations of cells with different DNA content.

9;22;15 complex translocation in Ph1 chromosome positive CML revealed by Giemsa-11 procedure in apparent lymphoid cells of blastic crisis

A Ph1 chromosome positive chronic myeloid leukemia patient whose chronic phase lasted 7.5 years experienced a blastic transformation originating in the spleen. The spleen was infiltrated with undifferentiated blast cells that on cytogenetic analysis had a hyperdiploid karyotype and were Ph1 chromosome positive. The blast cells were negative for PAS, peroxidase. Sudan black and esterase stains. They were non-T, non-B with TdT activity. Remission was achieved in response to prednisone, vincristine, and adriamycin. Ph1 positive cells were present with cells responding to PHA stimulation throughout the course of the disease. A Giemsa-11 staining procedure male possible the ascertainment of a No. 9 translocation chromosome in blastic crisis cells that had also been present in Ph1 chromosome positive cells early in the disease. The presence of this translocation initially in myeloid cells and subsequently in apparent lymphoid cell types suggests the origin of this patient's leukemia as a pluripotential stem cell.

Chromosome pattern, occupation, and clinical features in patients with acute nonlymphocytic leukemia

Chromosome banding pattern of bone marrow cells, cell morphology according to the FAB classification, and clinical finding were compared in two groups of adult patients with acute nonlymphocytic leukemia (ANLL): 52 patients occupationally exposed to chemical solvents, insecticides, or petrol products, and 110 patients with no history of occupational exposure to potential mutagenic/carcinogenic agents. Striking differences were found between the two groups: (1) Clonal chromosomal aberrations were present in 75% of exposed patients compared with only 32% in the nonexposed group. (2) Of the patients exposed to solvents and insecticides 92% had abnormal chromosomes, whereas only 29% of patients exposed to petrol products showed abnormalities; in the total material 10/13 exposed patients with normal chromosomes were exposed to petrol products. (3) The relationship between chromosomal abnormality and exposure was evident in both females and males. However, only 29% of women with an abnormal karyotype were exposed, whereas 70% of males with an abnormal karyotype were exposed. (4) The incidence of certain characteristic karyotypic abnormalities, i.e., -5/5q-, 7/7q-, +8, +21, t(8;21), and t(9;22), were decidedly more common in exposed than in nonexposed patients. At least one of these changes were present in 92% of exposed patients with aberrations, whereas in the nonexposed group the incidence was only 60%. (5) The monocytic varieties of ANLL (M4 + M5) were more common in the nonexposed patients, whereas erythroleukemia (M6) was more common in the exposed group. The predominance of abnormal karyotypes in the exposed compared to the nonexposed patients was similar in leukemia types M1 + M2 and in M4 + M5. (6) There was no difference in survival time between the two groups and the same correlation was obvious in both exposed and nonexposed patients: patients who had only abnormal metaphases had poorer prognosis than those with normal bone marrow metaphases only (6 vs 1.5 months). This correlation was obvious in patients classified as acute myeloid leukemia (AML) as well as in the monocytic varieties of ANLL.

A 14q+ chromosome in a malignant lymphoma in a patient with Down's syndrome

A 17-year-old Japanese boy with Down's syndrome developed leukemic lymphosarcoma; histology of a lymph node biopsy revealed a malignant lymphoma, of the poorly differentiated lymphocytic (ML-PDL) or possibly lymphoblastic type (ML-LB). The Giemsa-banding technique for chromosome analysis revealed the karyotype of the lymphoma cells to be 47, XY, + 21, 14q+. A chromosome study of PHA-stimulated lymphocytes showed a 21-trisomic pattern, i.e., 47, XY, + 21. The 14q+ marker was a product of a translocation in which the long arm of chromosome No. 8 (probable break at band q11) was translocated to the long arm of a No. 14 at band q32, which is a region usually affected in various types of lymphomas. Two normal No.8 chromosomes were present. Thus, the lymphoma cells were partially trisomic for chromosome No. 8.

Chromosomal banding patterns in human large bowel cancer

Cytogenetic banding studies were performed on direct preparations from 31 large bowel tumors. Twenty-eight of these were from primary sites and three from metastases. Some distinctive patterns were observed. The 31 tumors were separable into four groups: (1) Tumors with normal karyotypes (three cases); (2) tumors with simple gains of chromosomes (three cases); (3) tumors with gains, losses and structural aberrations (ten cases). Groups 1, 2 and 3 were all in the diploid range; and (4) tumors with hypotriploid-hypotetraploid karyotypes (15 cases). Non-random gains of several chromosomes, especially No. 8 and non-random losses of No. 17 were seen in this series. Thirteen cases had sex chromosome abnormalities. The most prominent structural abnormalities involved chromosomes No. 1 and No. 5. Marker chromosomes were sometimes absent, but when present ranged from simple translocations to the most complex rearrangements. Doubling of chromosome and/or marker chromosomes were prominent in Group 4. Double minutes were seen in all three metastatic tumors and three primary cancers. Premature chromosome condensation was observed in three cases in the hypotriploid-hypotetraploid group.

Chromosome #14 markers in two Epstein-Barr virus (EBV)-transformed lymphoblastoid cell lines of normal origin differ from the Burkitt lymphoma (BL)-associated 14q+ marker

Two among ten Epstein-Barr Virus (EBV)-transformed lymphoblastoid cell lines contained a 14q+ marker in a low frequency of the cells (2 and 9%). By means of "mesome-prosome" analysis of the G-band patterns of these markers; it was established that the additional chromosome segments of these two 14q+ markers came from chromosomes #3 and #5, respectively, and not from chromosome #8 as in the 14q+ marker of Burkitt lymphoma. Chromosome #8 was not involved at all in any changes in the ten lymphoblastoid cell lines studied.

Karyotypic patterns and their clinical significance in polycythemia vera

We studied a series of 34 polycythemia vera (PV) patients to determine the incidence of chromosome abnormalities and their relationship to leukemic transformation. Metaphase chromosomes from bone marrow or unstimulated peripheral blood were examined with conventional stain and, in 20 patients, also with banding techniques. The overall incidence of clonal abnormalities in first samples was 44% (15 of 34 patients), with a higher incidence in patients who had received prior therapy. The most frequent abnormalities were long-arm deletion of No. 5 (5q-; four patients), gain of all or most of a No. 8 (five patients), gain of all or most of a No. 9 (four patients), and long-arm deletion of No. 20 (three patients); these sometimes occurred in combination. Some of the PV patients who had cytogenetic abnormalities early in the disease have had long survivals without developing leukemia. For example, one patient has been 48,XX,+8,+9 in sequential samples obtained over the last 15 years. Five patients developed acute myeloblastic leukemia (AML); each had a complex chromosomal pattern. Two of these five patients were cytogenetically normal during the polycythemic phase; the change in karyotype occurred with the leukemic transformation. Three AML patients were studied only in the leukemic phase. Three AML patients had a 5q-, and a fourth showed loss of a B-group chromosome. Evolutionary changes in the karyotype during the disease course and the occurrence of a 5q- appear to be associated with a terminal phase of PV.

Characterization of a complex Philadelphia translocation (1p-;9q+;22q-) by gene mapping

Human-Chinese hamster somatic cell hybrids were obtained using circulating leucocytes from a chronic myeloid leukaemia (CML) patients carrying a complex Philadelphia ((Ph1) translocation (1p-;9q+;22q-). Hybrid clones which showed segregation of the translocation chromosomes were studied. The chromosome 22 markers ACO2, ARSA, and NAGA segregated with the 1p- derivative; and the chromosome 1 markers UMPK, PGD, and ENO1 segregated with the 9q+ derivative. Hence, molecular evidence has been obtained for the translocation of the distal part of 22q to chromosome 1 and for the translocation of the distal part of 1p to chromosome 9. No conclusions could be drawn either about translocation of chromosome 9 material or about a possible difference in breakpoint in chromosome 22 when compared with six cases of 9;22 translocations similarly studied and previously reported. In addition, a more precise mapping of PGM1 was obtained, the gene being proximal to UMPK and the breakpoint in 1p32.

Chromosome changes in human chronic lymphocytic leukemia

Karyotypes were studied in B- and T-lymphocyte cultures from 66 patients with B-cell CLL and two patients wtih T-cell CLL. Thirty-one of the B-cell cases had not been treated for their disease; 35 had received radiotherapy, corticosteroids, or cytostatic drugs. Only one of the untreated patients had a clone with an abnormal karyotype. This was present in all her mitotic cells found in cultures containing lipopolysaccharide B (LPS, a B-cell mitogen) and 10% of those in cultures with pokeweed mitogen (PWM, a T- and B-cell mitogen). The karyotype of this clone was 46,XX,t(6;7),t(7;13),t(11;14). Four of the treated patients had clones with specific chromosome changes. These were 47,XY,+12 in 10% of leukoagglutinin (LA, T-cell mitogen) and protein A (PA, T- and B-cell mitogen) cultures in one case; 47,XX,+12,del(14) in 80% of LPS cultures and in all spontaneously dividing cells in another case; 46,XY,t(6;20) in all LPS cultures in another; and 46,XX,t(1;8) in all PA cultures in another. Both structural and numerical nonclonal chromosome aberrations (9%) were found in 24% of the different cultures of cells from untreated patients, and in 15% of the cells in 20% of the different cultures in the patient who had received treatment. Both patients with T-cell CLL had receive) in all PA cultures in another. Both structural and numerical nonclonal chromosome aberrations (9%) were found in 24% of the different cultures of cells from untreated patients, and in 15% of the cells in 20% of the different cultures in the patient who had received treatment. Both patients with T-cell CLL had receive) in all PA cultures in another. Both structural and numerical nonclonal chromosome aberrations (9%) were found in 24% of the different cultures of cells from untreated patients, and in 15% of the cells in 20% of the different cultures in the patient who had received treatment. Both patients with T-cell CLL had received treatment for their disease, and had a normal karyotype in all cultures.

All patients with acute nonlymphocytic leukemia may have a chromosomal defect

Previous studies of banded marrow chromosomes suggest that half the patients with acute nonlymphocytic leukemia (ANLL) have normal karyotypes. To determine whether high-resolution chromosome analysis could detect additional abnormalities, we studied marrow from 26 patients with ANLL, using methotrexate cell synchronization as well as a direct technique. In 24 patients, including 18 who were untreated, adequate mitoses were obtained. All demonstrated clonal chromosomal abnormalities, which involved a balanced translocation in 11 cases, a complete or partial monosomy in 10, and a trisomy in six. Previously reported recurring defects in ANLL were identified, including t(15;17) in two cases, -7 in two cases, and +8 in three cases. In addition, a new specific abnormality involving band 11q23 was noted in one patient with acute monocytic leukemia and in two with myelomonocytic leukemia. Our results suggest that most, if not all, patients with ANLL have chromosomal changes, and that our new technique may allow more precise identification of subtypes of ANLL with characteristic clinical and hematologic features.

Specific fine chromosomal defects in cancer: an overview

More than 2 tumors have been found to have a specific chromosomal abnormality. In acute nonlymphocytic and acute lymphocytic leukemia, subgroups have also been identified with consistent chromosomal defects and different prognoses and responses to treatment. With the recent advent of high resolution chromosome technology, it appears possible that most malignant tumors will be found to have a chromosomal defect. This has recently been observed in acute nonlymphocytic leukemias. These findings and the availability of new solid tumor techniques make it possible to predict that study of chromosomes in cancer will become a useful if not essential tool in the subclassification and understanding of the etiology of neoplasias.

Chromosomes and cancer: new nomenclature and future directions

The recent advent of high resolution chromosome techniques for the study of neoplasia has conceivably expanded the scope of cancer cytogenetics, making feasible the detection of chromosomal defects in most neoplasias. Because of the usefulness of the new technology, the Standard Chromosome Nomenclature has been extended to give a unified numbering system to the fine bands observed and to maintain a simple system for the description of previously undetectable defects and the more precise delineation of chromosomal rearrangements.