A 14q+ chromosome in a B-cell acute lymphocytic leukemia and in a luekemic non-endemic Burkitt lymphoma

Chromosomal abnormalities in adult non-endemic Burkitt's lymphoma and leukemia: 22 new reports and a review of 148 cases from the literature

Tumour cell karyotypes from patients with Burkitt lymphoma (BL) or Burkitt's type leukemia (ALL3) were studied for correlation with survival, bone marrow and cerebral spinal fluid involvement (CSF), human immunodeficiency virus (HIV) serology, and for recurrent cytogenetic abnormalities. The records of 22 patients with BL from our institution and of 148 cases of BL and ALL3 reported in the literature with karyotypes were evaluated for clinical and cytological features. Overall survival was only 28 per cent and 88 per cent of deaths occurred within the first nine months after diagnosis. Those who survived at least 18 months were unlikely to relapse. Age and gender did not significantly affect survival. Patients presenting with advanced Ann Arbor stage, bone marrow or CSF involvement had lower survival rates. The association of translocations involving chromosome band 8q24 with this disease is confirmed. Sixty-two per cent of karyotypes had t(8;14)(q24;q32) translocations; the recognized variant translocations t(8;22)(q24;q11) and t(2;8)(p12;q24) affected 12 per cent and 9 per cent respectively. Seventeen per cent had abnormal karyotypes but no classic translocation. Patients with variant translocations had the poorest survival rates, and those with the classic t(8;14)(q24;q32) did the best. Despite a small sample size, the variant translocation t(8;22)(q24;q11) appeared to occur at an increased frequency in the patients with AIDS. In the entire group, recurrent involvement of chromosome regions 1q2, 6q11-14 and 17p1 suggests that alteration of genes at these loci, B Cell Growth Factor (BCGF) at 1q2 and p53 on 17p, may contribute to the development and progression of this tumour. Similarly, the frequent trisomies of chromosomes 7, 8, 12 and 18 may indicate an effect on tumour cell growth due to increased gene dosage. Trisomy 12 was found in eight tumours, five from patients with AIDS, suggesting that chromosome 12 has a site or gene whose allelic dosage is selected for in AIDS related lymphoma cells. Cytogenetic studies of adult Burkitt lymphoma and leukemia suggest several likely loci for gene alterations that in conjunction with myc translocations can lead to tumorigenesis.

Secondary nonrandom chromosomal abnormalities of band 13q34 in Burkitt lymphoma-leukemia

Clonal abnormalities of the long arm of chromosome 13 were detected in 9 of 54 patients with Burkitt lymphoma-leukemia. All abnormalities involved band 13q34, in three patients as t(1;13). The 13q34 abnormalities are thus the second most frequent secondary chromosomal abnormalities, after those of chromosome I, in these lymphoid proliferations.

The molecular genetics of human non-Hodgkin's lymphoma

There is increasing evidence to implicate oncogenes in the etiology of Burkitt's and non-Burkitt's non-Hodgkin's lymphoma. Some of these oncogenes have been identified because of their location at common breakpoints, some because they have been found by transfection assays to be activated, and some because they have been shown to be expressed in non-Hodgkin's lymphomas. So far there is no consistent pattern of involvement between specific oncogenes and specific subtypes of non-Hodgkin's lymphoma. This may be because more than one oncogene is necessary for transformation.

Chromosome 1 aberrations in cancer

Evidence for chromosome #1 involvement in structural rearrangements in cancer is reviewed. There have been adequate studies of cancer at most of the common sites, and at all of these, nonrandom chromosome #1 involvement has been demonstrated. In general, a variety of changes is encountered, irrespective of the site; most commonly, however, the changes result in the duplication of long arm material. It seems that these nonrandom changes, which tend to occur at a relatively late stage, may contribute to the progression of all forms of cancer. However, a small number of chromosome #1 aberrations are also now known, which may represent specific and possibly initiating changes in particular forms of cancer. These include short arm deletions in neuroblastoma and translocations in leukemias and myelodysplasia.

The human T-cell leukemias: clinical, cytomorphologic, immunophenotypic, and genotypic characteristics

The distribution of the conventional lymphoid cell markers on T lymphocytes and the principal panels of monoclonal antibodies used to recognize distinctive T-lymphocyte-associated differentiation antigens are discussed. These reagents have been used to probe the early and late stages of T-cell differentiation, and a hypothetical schema of T-cell differentiation has been constructed. Application of these reagents to the investigation of neoplastic T cells has resulted in the determination of the subset of origin and the stage of differentiation of the neoplastic cells in T-cell-derived lymphoproliferative malignancies. Recent advances in molecular biology have made possible the Southern blot hybridization analysis of DNA extracted from neoplastic T cells for patterns of T-cell-receptor gene rearrangements. Examination of these patterns in benign and malignant T and non-T cell has provided the basis for the use of T-cell-receptor gene rearrangements as specific genetic markers of T-cell lineage, clonality, and differentiation. These and other advances have resulted in the delineation of a new category of T-cell neoplasia, the adult T-cell leukemia/lymphoma syndrome. They have also demonstrated that the majority of clinically indolent neoplasms composed of large granular lymphocytes in so-called T gamma-lymphoproliferative disease are monoclonal proliferations. Further phenotypic, functional, and genotypic analyses of the T-cell malignancies should provide better understanding of T-lymphocyte differentiation and heterogeneity. Such studies should also lead to better clinicopathologic correlations and greater understanding of the basis for the clinical diversity of the T-cell-derived lymphoproliferative malignancies.

Phenotypic and karyotypic properties of hyperdiploid acute lymphoblastic leukaemia of childhood

The DNA/cell content was measured by flow cytometry in samples obtained from 98 unselected children with acute lymphocytic leukaemia (ALL) at diagnosis. The frequency of anomalies in modal DNA content was compared to that encountered in acute childhood non-lymphocytic leukaemia (ANLL) and disseminated non-Hodgkin's lymphoma (NHL). In ALL the most frequent (35%) aberration in DNA content was an increase by 20% relative to the modal value of normal white blood cells. This subcategory, referred to as hyperdiploid ALL (HD-ALL), was characterized by a close association with the expression of the c-ALL surface marker (20/20 patients) and characteristic numerical chromosome changes, including tri- or tetrasomy of chromosome 21. Moreover, patients with hyperdiploid ALL had a much lower peripheral leucocyte count (P = 0.001) than those with diploid disease and a varying proportion of their leukaemic cells existed in the peripheral blood as morphologically normal lymphocytes expressing the c-ALL antigen. Within the standard risk category, patients with HD-ALL had a longer disease-free survival than those with diploid disease (P = 0.058). It is concluded that routine analysis by flow cytometry can conveniently and consistently detect ALL patients with hyperdiploid chromosome numbers. Hyperdiploid ALL constitutes a fairly large subtype of childhood ALL with specific biological and karyotypic properties, possibly associated with favourable prognosis.

Does multisomy of chromosome 1q confer a proliferative advantage in B-cell acute lymphoblastic leukemia?

Two patients fulfilled the clinical and hematologic criteria for B-cell acute lymphoblastic leukemia: the malignant cells had L3 morphology, bore B-cell markers, and carried the specific t(8;14) translocation. The leukemic cells of one patient were tetrasomic for 1q, and those of the other patient showed several separate cell lines with complete or partial trisomy of 1q. In the latter patient it appeared that a break close to the heterochromatin of 1q produced an unstable chromosome end which formed associations with the telomeres of at least seven other chromosomes. It is suggested that multisomy of 1q gives tumor cells a proliferative advantage and is secondary to the basic neoplastic event.

Karyotype evolution in B-cell lymphoid malignancy with an 8;14 translocation

To evaluate the significance of karyotypic evolution of tumor cells with an 8;14 translocation [t(8;14)(q24;q32)], we examined the clinicopathologic features and immunologic phenotypes of nine Japanese patients with various types of B-cell malignancy with the translocation. All these patients had structural rearrangements of the long arm of chromosome No. I (Iq) in a stem line or the subline of tumor cells with a t(8;14). The rearrangements were composed of a translocation involving Iq with other chromosomes and a tandem duplication of Iq, and they were exclusively associated with a partial trisomy for Iq. Two patients with diffuse large-cell lymphoma, whose tumor cells did not express surface immunoglobulins (s-Ig), had the Iq translocation in their highly complex karyotypes. Tumor cells from the other seven patients expressed s-Ig and the karyotypes were relatively simple. Among these patients, the Iq translocation was found in two patients with Burkitt's lymphoma, and the Iq duplication were observed in a stem line or the sublines from four patients with Burkitt's lymphoma-leukemia and one each with small non-cleaved-cell or diffuse large-cell lymphoma. Except for one patient in the stage of IE, these patients had a poor prognosis because of the clinical conversion of extranodal metastases in the earlier disease phase. These findings are compatible with those of Western patients with a t(8;14). Therefore, tumor cells marked primarily with a t(8;14) could have "major routes" in the karyotypic evolution, for which potentials should be recognized as clinical risk factors, and the morphologic presentation and the expression of surface immunoglobulins may be associated with the process of karyotypic evolution.

Adult T-cell leukemia. Chromosome analysis of 15 cases

Chromosome studies was conducted on 15 patients with adult T-cell leukemia. Cells with chromosomal abnormality were seen in 14 of the 15 patients. The modal chromosome number was near diploid range in all the patients. The most common abnormality was 14q+ marker chromosome and partial deletion of the long arm of chromosome 6, i.e., 6q-, which were seen in eight and seven cases, respectively. Donor chromosomes involved in the 14q+ marker chromosome varies, i.e., Yq, #5p, #5q, #9q, #10q or #12q, except for two patients whose donor chromosome origins were unable to determine. The break point in 14q+ marker chromosome was band at q32. The 6q- chromosome was due to a deletion in one patient and interstitial deletion in six patients. A 14q- chromosome having break point at q24 was found in one patient and duplication of Yq chromosome in two patients. In addition, four patients showed a 5q- chromosome or a 9q- chromosome which was due to a translocation or deletion. The significance of these chromosome abnormalities was discussed.

Burkitt cell leukemia with abnormality of chromosome No. 1

A case of L3 (Burkitt cell) leukemia with chromosome 1 abnormality but no detectable abnormalities of chromosomes 8 or 14 is reported. This is the first time that L3 leukemia has been shown to be associated with a primary abnormality of chromosome 1. The implications of these findings relative to the development of B-cell ALL and the role of chromosome 1 in human neoplasia is discussed.

Translocation (11;14) in B-cell lymphoproliferative disorders

A number of chromosomes other than chromosome No. 8 participate in formation of the 14q+ marker in lymphoproliferative disorders. Among them is chromosome No. 11 which appears to be important because its break points are constant; it is also possibly significant because of its participation in cytogenetic alterations in B-cell disorders.

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.

Cytogenetic studies on Burkitt's lymphoma-leukemia

Chromosome studies on 26 cases of Burkitt's cell malignancy are reported, including 7 lymphomas and 19 acute lymphocytic leukemias. A specific translocation was found in 26 of the patients: 20 t(8;14), 4 t(8;22), and 1 t(2;8). In one other case only 2 mitoses out of 59 were found to have a probable t(8;22) translocation. Additional chromosomal abnormalities were found in 15 of the patients, irrespective of whether they had or had not been treated before cytogenetic investigation. The most remarkable was a partial duplication of chromosome 1q. The presence of additional chromosomal abnormalities together with a specific translocation allows a distinction to be made between specific and secondary chromosome anomalies. The implications of the two types of aberrations for research into the molecular mechanisms of malignancy are discussed.

Childhood acute lymphoblastic leukemia associated with an unusual 8;14 translocation

An 8;14 chromosome translocation with the break points t(8;14(q11;q32) is described in bone marrow cells of a patient with null cell terminal deoxynucleotidyl transferase (TdT)-positive acute lymphoblastic leukemia. The patient, who is dysmorphic and mentally retarded, ha a normal 46,XY constitutional chromosome karyotype. A review of the more usual cytogenetic findings in this type of leukemia and a comparison of B-cell lymphoproliferative cytogenetic associations are presented.

Cytogenetic studies on four cases of non-endemic Burkitt lymphoma

Cytogenetic studies carried out on four children with non-endemic Burkitt lymphoma showed: 1) Two with the typical translocation t(8;14)(q24;q23); 2) one with a variant t(2;8)(p11;q24); and 3) one with apparently normal chromosomes 8 and 14. Additional chromosomal variation was present in all four patients. Two were shown to have a duplication of part of the long arm of chromosome 1 (1q23 leads to 1q32 and 1q23 leads to 1q42). Epstein Barr virus studies on two patients showed that one was positive and the other negative. A comparison of these results with other non-endemic cases in the literature has been made revealing a wider range of chromosomal variation than has been hitherto reported for endemic cases. The finding that chromosome 8 is also involved in the variant translocations in Burkitt lymphoma suggests that its changes may contribute more to the tumour development than the than the 14q+.

Cytogenetic studies on African Burkitt's lymphoma cell lines: t(8;14), t(2;8) and t(8;22) translocations

Cytogenetic studies on ten African Epstein-Barr virus (EBV) positive Burkitt's lymphoma (BL) cell lines were performed. The usual translocation t(8;14) (q24;q32) was found in five of them, a deletion del(8) (q24 leads to qter) in another one, while four variants were observed, two of these having a t(2;8) (p12;q24) translocation and two a t(8;22) (q24;q11) translocation. Other chromosome abnormalities were seen in seven of the cell lines, but these varied from one cell line to another. Thus, variant translocations, such as we describe here, are found in endemic BL cases. Two of these variants are identical to those previously identified in BL from nonendemic areas. The common chromosome abnormality of these BL cell lines was a rearrangement of the 8q24 band. The role of this constant cytogenetic change remains to be elucidated.

Studies of banded chromosomes in patients with acute lymphocytic leukemia, including one patient with the Burkitt-type (L3)

Studies on banded chromosomes of 10 patients with acute lymphocytic leukemia (ALL) are reported. The group is small but quite representative. 60% of the patients had a clonal abnormality: a Philadelphia chromosome and chromosome #7 abnormalities were seen in one patient; a marked hypodiploid clone (32 chromosomes) and its duplicate was seen in another; hyperploidy of 49 chromosomes (+4 +17 +21) was seen in a third patient, and 3 patients were found to have a 6q-abnormality. One of these patients had an L3, Burkitt-type of ALL. A translocation t(8;14) has frequently been found in this type of ALL. The findings confirm the nonrandomness of particular cytogenetic abnormalities in ALL and the possibility of the existence of different aberrations in apparently identical clinical entities.