1
|
Hofer KD, Bühler MM, Roncador M, Rechsteiner M, Maggio EM, Tchinda J, Schanz U, Haralambieva E, Widmer CC. Mutational patterns in therapy-related acute lymphoblastic leukemia subgroups: one step closer to unveiling the genetic odyssey. Leuk Lymphoma 2024; 65:808-815. [PMID: 38385617 DOI: 10.1080/10428194.2024.2315171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
There is increasing evidence that therapy-related acute lymphoblastic leukemia (trALL) resulting from chemo- and/or radiotherapy represents a distinct entity. However, apart from KMT2A rearrangements, which have been repeatedly reported in this subgroup, the relevance of other aberrations remains controversial due to divergent study results and sparse molecular analyses. Within our ALL patient cohort, 15% (n = 19/131) met the criteria for trALL with a high proportion of Ph + and KMT2A rearrangements. On the molecular level, the most frequently observed mutation was KMT2D, followed by CDKN2A, KRAS and DNMT3A. No TP53 mutation was detected. Outcome was particularly poor in Ph + trALL compared to Ph+ de novo ALL, which seemed to be mitigated by allogeneic stem cell transplantation. Our findings further define trALL as a distinct entity but highlight the need for further molecular genome sequencing of somatic and germline variants to advance our understanding of trALL.
Collapse
Affiliation(s)
- Kevin D Hofer
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Marco M Bühler
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Marco Roncador
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Markus Rechsteiner
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Ewerton M Maggio
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Joëlle Tchinda
- Oncology Laboratory, University Children's Hospital Zurich, Switzerland
| | - Urs Schanz
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
| | - Eugenia Haralambieva
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - Corinne C Widmer
- Department of Medical Oncology and Hematology, University Hospital Zurich, Switzerland
- Division of Hematology, University Hospital Basel, Switzerland
| |
Collapse
|
2
|
Lee HY, Park CJ, Ahn A, Lee MY, Cho YU, Jang S, Seo EJ, Lee KH, Lee JH. Two Rare Cases of Therapy-Related Acute Lymphoblastic Leukemia in Patients With Plasma Cell Myeloma. Ann Lab Med 2019; 39:496-498. [PMID: 31037870 PMCID: PMC6502952 DOI: 10.3343/alm.2019.39.5.496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/07/2019] [Accepted: 03/29/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hye Young Lee
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Chan Jeoung Park
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
| | - Ari Ahn
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Min Yung Lee
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Young Uk Cho
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Seongsoo Jang
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Eul Ju Seo
- Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Kyoo Hyung Lee
- Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| | - Je Hwan Lee
- Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
| |
Collapse
|
3
|
Parekh V, Peker D. Clinicopathologic and cytogenetic characterization of therapy-related acute T lymphoblastic leukemia in adult population. Leuk Lymphoma 2015; 57:1460-2. [PMID: 26585442 DOI: 10.3109/10428194.2015.1083564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Vishwas Parekh
- a Department of Pathology , University of Alabama at Birmingham , Birmingham , AL , USA
| | - Deniz Peker
- a Department of Pathology , University of Alabama at Birmingham , Birmingham , AL , USA
| |
Collapse
|
4
|
Matnani R, Parekh V, Borate U, Brazelton J, Reddy V, Peker D. Therapy-related B-lymphoblastic leukemia associated with Philadelphia chromosome and MLL rearrangement: Single institution experience and the review of the literature. Pathol Int 2015; 65:536-40. [PMID: 26259760 DOI: 10.1111/pin.12337] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 07/09/2015] [Indexed: 11/26/2022]
Abstract
Therapy related acute lymphoblastic leukemia (t-ALL) of B cell origin is rare and constitutes approximately 2% of all ALL. Previously compiled data on the complete cytogenetic analysis of 48 t-B-ALL cases suggested that MLL rearrangement at 11q23 gene locus is the most common abnormality. Philadelphia chromosome (Ph) and a normal karyotype were reported as the second and third most common karyotypes, respectively. We investigated cytogenetic karyotypes of six t-B-ALL cases with a pre-B cell immunophenotype. Ph + t-B-ALL was noted in four of six patients previously treated with radiation and/or chemotherapy. In addition, one case demonstrated MLL rearrangement at 11q23 locus while one case demonstrated normal cytogenetic karyotype. Five of the six t-B-ALL patients had persistent leukemia following initiation of chemotherapy for secondary leukemia with survival ranging from 10 to 21 months. To our knowledge, only fourteen patients with Ph + t-B-ALL have been described in the literature. In the current study, three of four cases with Ph + t-B-ALL were associated with treated breast carcinoma while one patient was treated for Hodgkin lymphoma. All four patients had undergone radiation therapy. The results may indicate a plausible association between Ph+t-B-ALL and prior radiation exposure.
Collapse
Affiliation(s)
- Rahul Matnani
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vishwas Parekh
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Uma Borate
- Department of Medicine, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jason Brazelton
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vishnu Reddy
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Deniz Peker
- Department of Pathology, Division of Hematology & Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
5
|
Bang JI, Lee ES, Kim TS, Kim SK. Unexpected Second Primary Malignancies Detected by F-18 FDG PET/CT During Follow-up for Primary Malignancy: Two Case Reports. Nucl Med Mol Imaging 2014; 49:65-8. [PMID: 25767625 DOI: 10.1007/s13139-014-0302-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 10/13/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022] Open
Abstract
As the survival rate of cancer patients has increased over the last few decades, the risk of cancer survivors developing second primary malignancies has gained attention. We report two rare cases of second primary hematologic malignancy detected by (18)F-fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) during follow-up for primary solid malignancies. Acute lymphoblastic leukemia developed in a breast cancer patient and non-Hodgkin lymphoma in an anal cancer patient. F-18 FDG PET/CT findings led to the diagnosis of unexpected second primary hematologic malignancy in cancer survivors in these two cases.
Collapse
Affiliation(s)
- Ji-In Bang
- Department of Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi 410-769 Republic of Korea
| | - Eun Seong Lee
- Department of Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi 410-769 Republic of Korea
| | - Tae-Sung Kim
- Department of Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi 410-769 Republic of Korea
| | - Seok-Ki Kim
- Department of Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi 410-769 Republic of Korea
| |
Collapse
|
6
|
Cho JH, Hur M, Moon HW, Yun YM, Ko YS, Kim WS, Lee MH. Therapy-related acute leukemia with mixed phenotype and t(9;22)(q32;q11.2): a case report and review of the literature. Hum Pathol 2011; 43:605-9. [PMID: 22036054 DOI: 10.1016/j.humpath.2011.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 06/07/2011] [Accepted: 07/13/2011] [Indexed: 01/28/2023]
Abstract
Therapy-related acute leukemia showing mixed phenotype is extremely rare. We report a 49-year-old woman who presented with palpable masses in her neck and back. She had received systemic chemotherapy (adriamycin and cisplatin) and radiotherapy for endometrial adenocarcinoma 7 years before. Her peripheral blood and bone marrow showed increased blasts, which coexpressed myeloid (CD13, CD33, and myeloperoxidase) and B-lymphoid antigens (CD19 and CD79a). Cytogenetic analysis showed a karyotype of 46,XX,dup(1)(q21q32),add(5)(q33),t(9;22)(q34;q11.2)[12]/47,idem,+der(22)t(9;22)[8], and BCR/ABL1 rearrangement was detected. Leukemic infiltration was also confirmed in her back mass. After induction chemotherapy with idarubicin, cytarabine, and imatinib, she achieved complete remission. Only 2 cases of therapy-related acute leukemia with mixed phenotype have been reported so far: one with hyperploidy and the other with t(1;21)(p36;q22). To the best of our knowledge, this is the first case of therapy-related acute leukemia with mixed phenotype and t(9;22) as well as extramedullary leukemic infiltrations.
Collapse
Affiliation(s)
- Jin-Hee Cho
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul 143-729, Korea
| | | | | | | | | | | | | |
Collapse
|
7
|
Motlló C, Manuel Sancho J, García O, Granada I, Millá F, Ribera JM. Leucemias agudas secundarias a tratamiento con quimioterapia y/o radioterapia: estudio de 23 pacientes. Med Clin (Barc) 2011; 137:449-52. [DOI: 10.1016/j.medcli.2010.09.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 09/10/2010] [Accepted: 09/14/2010] [Indexed: 10/18/2022]
|
8
|
Tazi I, Nafil H, Mahmal L, Elomrani A, Khouchani M, Tahri A, Hda N. A case of therapy-related acute lymphoblastic leukemia with t(9;22)(q34;q11.2) following treatment of breast cancer. Leuk Res 2011; 35:e58. [PMID: 21247633 DOI: 10.1016/j.leukres.2010.12.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 12/24/2010] [Accepted: 12/31/2010] [Indexed: 10/18/2022]
|
9
|
Cho J, Hur M, Moon HW, Yun YM, Lee CH, Lee HG. A case of therapy-related ALL with MLL gene rearrangement following treatment of breast cancer. Korean J Lab Med 2010; 30:255-9. [PMID: 20603585 DOI: 10.3343/kjlm.2010.30.3.255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
ALL with MLL gene rearrangement secondary to chemotherapy has been rarely reported. We report a case of therapy-related ALL (t-ALL) with MLL gene rearrangement in a patient who had undergone treatment for breast cancer. A 60-yr-old woman with breast cancer underwent breast-conserving surgery followed by 6 cycles of adjuvant chemotherapy (cyclophosphamide, epirubicin, and fluorouracil) and radiation therapy (dose, 5,040 cGy to the left breast and a 1,000 cGy boost to the tumor bed). A follow-up examination performed 14 months after the chemotherapy revealed no evidence of breast malignancy. However, the patient's complete blood cell count indicated acute leukemia: white blood cell count, 174.1 x 10(9)/L with 88% blasts; Hb level, 12.5 g/dL; and platelet count, 103.0 x 10(9)/L. Examination of the bone marrow aspirate smear revealed a high percentage of blasts (85.1% of all nucleated cells); the blasts showed a pro-B immunophenotype and were positive for CD19, CD79a, HLA-DR, CD34, and terminal deoxynucleotidyl transferase (TdT). Cytogenetic and FISH analyses revealed t(4;11)(q21;q23) and MLL gene rearrangement, respectively. The patient received induction chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone and achieved complete remission. Following consolidation chemotherapy, she underwent allogenic peripheral blood stem cell transplantation and has been clinically stable. To our knowledge, this is the first reported case of t-ALL with MLL gene rearrangement following treatment of breast cancer in Korea.
Collapse
Affiliation(s)
- Jinhee Cho
- Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
10
|
Benzene as a cause of lymphoproliferative disorders. Chem Biol Interact 2010; 184:147-50. [DOI: 10.1016/j.cbi.2009.12.021] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Revised: 12/13/2009] [Accepted: 12/15/2009] [Indexed: 11/19/2022]
|