North american Burkitt-type ALL with a variant translocation t(8;22)

Simultaneous occurrence of t(14;18) and t(8;22) common acute lymphoblastic leukemia

A young male patient progressed rapidly from localized abdominal lymph node enlargement to overt acute lymphoblastic leukemia. Despite aggressive treatment, he died of progressive CNS leukemia 5 months after initial presentation. At diagnosis, karyotypic analysis of an abdominal lymph node revealed the coexistence of t(14;18) (q32;q21), specific for follicular lymphoma, and t(8;22) (q24;q11), a variant Burkitt translocation. Such cases might be considered as a model for a general mechanism of tumor progression with cascade-like involvement of oncogenes.

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.

Epidemiology of the childhood acute leukemias

Epidemiologic studies of the childhood leukemias have provided information relevant to several aspects of the care and follow-up of these children. The observations made regarding in utero radiation and ALL risk have certainly curtailed the use of routine obstetric diagnostic radiographs; observations regarding the association between birth weight, fetal loss, and other gestational events provide added enthusiasm for further research into basic biologic events occurring during fetal development; and the genetic patterns of disease supply critical information for genetic counseling and follow-up of affected patients and families. Additionally, the continued epidemiologic surveillance of children with cancer serves to form the foundation from which we will assess any future changes in childhood cancer incidence or pattern. Although not discussed here, the epidemiology of late effects, including second malignancies, reproductive function, and neuropsychologic functioning will assume a more prominent role as more children survive ALL and move into adulthood. While analytic studies have yet to yield an association as strong as the lung cancer/cigarette association in adults, future research designed to isolate biologically homogeneous disease populations for study may lead us to new and important associations. The continued cooperation of large pediatric oncology groups and private physicians is crucial as these future investigations are undertaken.

The significance of cytogenetic findings of erythroid colonies derived from a Ph+ ALL patient: fundamental differences between Ph+ ALL and blastic phase CML

Cytogenetic analysis was performed on colonies from erythroid burst-forming units (BFU-E) derived from bone marrow (BM) cells of a Ph-positive acute lymphocytic leukemia (Ph+ ALL) patient. A normal diploid karyotype was revealed in all 15 metaphases that could be analyzed in the erythroid colonies. Previous cytogenetic analyses of erythroid colonies obtained from BM cells of patients with Ph+ chronic myelogenous leukemia (CML) revealed that Ph-positive karyotypes were predominant in all 11 cases. Two of them were also examined in blastic phase (BP) and showed 100% Ph+ cells in BFU-E-derived colonies. The present findings suggest that the leukemic process of Ph+ ALL does not involve the erythroid series, which is in contrast to the involvement in CML. This is considered to be a fundamental difference between Ph+ ALL and the blastic phase of CML (BP CML). Clinically, cytogenetic analysis of erythroid colonies from BM cells may constitute a valuable approach for the differential diagnosis between Ph+ ALL and the BP of Ph+ CML.

Cytogenetic study in six Spanish patients with Burkitt's lymphoma

A cytogenetic study carried out on affected tissues of six children with Burkitt's lymphoma revealed five cases with a typical translocation (8q-; 14q+) and one with a variant t(2p-; 8q+). Additional cytogenetic variations were present in three cases. One had two acrocentric marker chromosomes comprised of material from chromosome #1 (1q21----q44) translocated to the Y gonosome. The other two cases had a cytogenetic alteration of chromosome #12. Cytogenetic studies carried out systematically in Burkitt's lymphoma could be a great help in possibly establishing differences in the biologic and clinical aspects of cases presenting with the t(8;14) versus cases with variant translocations, as this would allow for classification of these patients into groups which, at present, cannot be differentiated using other diagnostic methods.

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.

Mapping of the human Blym-1 transforming gene activated in Burkitt lymphomas to chromosome 1

Blym-1, a transforming gene detected by transfection of NIH 3T3 cells with DNA from Burkitt lymphomas, was mapped to the short arm of chromosome 1 (1p32) by chromosomal in situ hybridization. The Blym-1 gene was not physically linked to the cellular myc oncogene or to any of the immunoglobulin gene loci implicated in the characteristic chromosomal translocations in Burkitt lymphoma.

Kappa and lambda immunoglobulin expression associated with abnormalities of chromosomes #2 and #22 in lymphoma and leukemia

The types of surface immunoglobulins on Burkitt lymphoma (BL) cells correlate with the specific chromosomes that are altered in the tumor. For example, BL with a t(2;8) translocation expresses kappa (kappa) light chains, whereas BL with a t(8;22) translocation expresses lambda (lambda) light immunoglobulin chains; these correspond with the locations of the kappa chain genes on chromosome #2 and the lambda chain genes on chromosome #22, respectively (1-5). In order to explain this close correlation between specific translocations and light chain expression in BL and BL-type acute lymphocytic leukemia (ALL) (L3 type), Hecht et al. [6] proposed the concept of position effect, which is reviewed herein.

Non-T, non-B acute lymphoblastic leukemia (L3) with t(8;22) and two 14q+ chromosomes

A patient with L3 leukemia is reported whose leukemic cells were characterized cytogenetically by a duplication of the long arm segment 1q25 leads to q42, trisomy for chromosome 7, t(8;22)(q24;q11), and two 14q+ chromosomes. Immunologic marker analysis revealed the leukemic cells to be of the non-T, non-B ("null") type. This observation, when considered in conjunction with a previous report of heterogeneity in cell lineages of L3 leukemias, raises the possibility of some lymphoid neoplasms arising in stem cells.

Chromosome studies in stimulated lymphocytes of B-cell chronic lymphocytic leukemias

Using a sister chromatid differentiation technique, cell cycle study of stimulated lymphocytes of B-cell chronic lymphocytic leukemia (B-CLL) revealed their cell cycle progression to be similar to that of normal lymphocytes stimulated by T-cell and various polyclonal B-cell activators (PBA). The chromosome constitutions of stimulated lymphocytes in 62 patients with B-CLL were examined using PBA such as Epstein-Barr virus (EBV) and lipopolysaccharide W from E. coli 055:B5 (LPS). Of the 20 patients with abnormal clones, 11 patients had trisomy 12; other less common abnormalities were trisomy 1, 6q-, i(7q), 14q+, trisomy 16, trisomy 18, reciprocal translocations, and marker chromosomes of unknown origin. These findings indicate that trisomy 12 may be a unique and common karyotypic change in B-CLL. The fact that 3 out of 4 patients with marker chromosomes showed stage IV disease may indicate that a clone with a marker is a predictor of an unfavourable prognosis. The near correlation between trisomy 12 and kappa chains existed (0.05 less than p less than 0.10). Trisomy 12 was seen in all 5 patients with monoclonal paraprotein.