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Ak B, Güngör Ö, Karaca E, Durmaz B, Bozer DS, Töbü M, Akın H. A complex t(15;22;17)(q22;q11.2;q21) variant of APL. Cancer Genet 2024; 286-287:48-51. [PMID: 39111247 DOI: 10.1016/j.cancergen.2024.07.003] [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: 09/18/2023] [Revised: 05/13/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024]
Abstract
The present study described an extremely rare case of acute promyelocytic leukemia (APL) characterized by a complex three‑way (15;22;17)(q22;q11.2;q21) translocation. Acute promyelocytic leukemia (APL) is a specific subtype of acute myeloid leukemia with distinctive clinical and therapeutic characteristics. Besides being characterized by the t(15;17)(q22;q12) translocation, this subtype is also notable for its response to all-trans-retinoic acid (ATRA) treatment. APL is highly responsive to a combination of ATRA and chemotherapeutic agents, achieving over 90 % complete remission rates and over 80 % long-term remission rates. In this case, a 79-year-old male patient presented with complaints of weakness, fatigue, and petechial rash, with no other significant medical history except for diabetes mellitus and hypertension. Conventional cytogenetic methods, dual-color dual-fusion, and dual-color break-apart fluorescent in situ hybridization techniques together identified the t(15;22;17) translocation. RT-PCR analysis was performed for expression of PML/RARA fusion transcripts. The patient, diagnosed with APL, exhibited a complete response to all-trans retinoic acid (ATRA) and idarubicin treatment. In this paper, we present the second documented case of t(15;22;17) and explore the remarkable remission observed following treatment with All-Trans Retinoic Acid (ATRA).
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MESH Headings
- Humans
- Male
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/drug therapy
- Aged
- Translocation, Genetic
- Chromosomes, Human, Pair 17/genetics
- Tretinoin/therapeutic use
- Chromosomes, Human, Pair 15/genetics
- Chromosomes, Human, Pair 22/genetics
- In Situ Hybridization, Fluorescence
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Affiliation(s)
- Bilgesu Ak
- Ege University Hospital, Department of Medical Genetics, Izmir 35100, Turkey.
| | - Özge Güngör
- Ege University Hospital, Department of Medical Genetics, Izmir 35100, Turkey
| | - Emin Karaca
- Ege University Hospital, Department of Medical Genetics, Izmir 35100, Turkey
| | - Burak Durmaz
- Ege University Hospital, Department of Medical Genetics, Izmir 35100, Turkey
| | - Denis S Bozer
- Ege University Hospital, Department of Hematology, Izmir 35100, Turkey
| | - Mahmut Töbü
- Ege University Hospital, Department of Hematology, Izmir 35100, Turkey
| | - Haluk Akın
- Ege University Hospital, Department of Medical Genetics, Izmir 35100, Turkey
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2
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Bi X, Li C, Shang M, Han B, Li H, Sun L, Lin Y, Yang S. The first case of six-way complex translocation of t(4;7;9;22;8;14) in a patient with chronic myeloid leukemia. J Hematop 2024; 17:97-101. [PMID: 38492169 DOI: 10.1007/s12308-024-00577-8] [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: 11/14/2023] [Accepted: 02/29/2024] [Indexed: 03/18/2024] Open
Abstract
In chronic myeloid leukemia (CML), patients exhibit the t(9;22)(q34.1;q11.2) translocation, resulting in the formation of a Philadelphia chromosome (Ph). However, a subset of CML patients display variant complex translocations, characterized by three-way, four-way, and five-way translocations, which have been occasionally associated with a poor prognosis. This case report presents the first case of a t(9;22) variant six-way complex translocation in CML. The R banding chromosome karyotyping technique was used to obtain preliminary karyotyping results, and the multi-probe FISH technique was used to assist in the verification of chromosome results. Both FISH and PCR proved the existence of fusion genes. A 45-year-old male patient admitted to our hospital due to elevated WBC and anemia. Bone marrow smears revealed a significant proliferation of mature granulocytes, accompanied by an increase in eosinophils and basophils. Karyotype analysis indicated abnormalities in six chromosomes, including 4, 7, 8, 9, 14, and 22. Further analysis using FISH technology demonstrated the presence of the BCR::ABL1 fusion gene, as well as the mapping of the BCR (22q11), MYC (8q24), IGH (14q32), D4S163 (4q35.1), and D7S486 (7q31) genes to new chromosomes. Ultimately, the karyotype findings were described as t(4;7;9;22;8;14)(q27;q22;q34;q11;q22;q12). PCR showed that BCR::ABL1 was p210. After treatment with imatinib for 4 months, the patient achieved complete cytogenetic response (CCyR) and early molecular response (EMR). This is the first report of complex chromosomal karyotype involving six-way translocation in CML; the combination of chromosome analysis and FISH techniques is an effective strategy in determining the karyotype result.
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MESH Headings
- Humans
- Translocation, Genetic/genetics
- Male
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Middle Aged
- Karyotyping/methods
- In Situ Hybridization, Fluorescence
- Chromosomes, Human, Pair 22/genetics
- Imatinib Mesylate/therapeutic use
- Fusion Proteins, bcr-abl/genetics
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Affiliation(s)
- Xiaoyu Bi
- Department of Cytogenetics, Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-Aided Hematopathology Diagnosis, 5 Xinghua No.3 Branch Road, Tianjin, China
| | - Chao Li
- Department of Hematology, Nanyang Central Hospital, Nanyang, Henan, China
| | - Miao Shang
- Department of Hematology, Nanyang Central Hospital, Nanyang, Henan, China
| | - Bingbing Han
- Department of Cytogenetics, Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-Aided Hematopathology Diagnosis, 5 Xinghua No.3 Branch Road, Tianjin, China
| | - Hongyu Li
- Department of Cytogenetics, Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-Aided Hematopathology Diagnosis, 5 Xinghua No.3 Branch Road, Tianjin, China
| | - Lidan Sun
- Department of Cytogenetics, Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-Aided Hematopathology Diagnosis, 5 Xinghua No.3 Branch Road, Tianjin, China
| | - Yani Lin
- Department of Cytogenetics, Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-Aided Hematopathology Diagnosis, 5 Xinghua No.3 Branch Road, Tianjin, China.
| | - Shaobin Yang
- Department of Cytogenetics, Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-Aided Hematopathology Diagnosis, 5 Xinghua No.3 Branch Road, Tianjin, China.
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3
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Han B, Jing Y, Bi X, Lin Y, Li H, Li H, Ru K, Yang S. t(2;2;21;8)(p21;q37;q22;q22), a novel four-way complex translocation involving variant t(8;21) in case of acute myeloid leukemia : A case report and literature review. Cancer Genet 2024; 284-285:1-4. [PMID: 38460349 DOI: 10.1016/j.cancergen.2024.03.003] [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: 03/19/2023] [Revised: 08/25/2023] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
Chromosomal translocation serves as a crucial diagnostic marker in the classification of acute myeloid leukemia. Among the most prevalent cytogenetic abnormalities is t(8;21)(q22;q22), typically associated with the FAB subtype AML-M2. On occasion, alternative forms of t(8;21) have been observed. This report presents a case of AML with RUNX1::RUNX1T1, wherein the karyotype revealed t(2;2;21;8)(p21;q37;q22;q22), representing the first instance of a variant t(8;21) involving both chromosomes 2. The combination of routine karyotype analysis and fluorescence in situ hybridization proves to be an effective method for identifying complex translocations of t(8;21).
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MESH Headings
- Humans
- Translocation, Genetic
- Leukemia, Myeloid, Acute/genetics
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 8/genetics
- Core Binding Factor Alpha 2 Subunit/genetics
- In Situ Hybridization, Fluorescence
- Male
- Chromosomes, Human, Pair 2/genetics
- RUNX1 Translocation Partner 1 Protein/genetics
- Karyotyping
- Female
- Adult
- Oncogene Proteins, Fusion/genetics
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Affiliation(s)
- Bingbing Han
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China
| | - Yu Jing
- Department of Haematology, The Fifth Medical centre of Chinese PLA General Hospital, Beijing, China
| | - Xiaoyu Bi
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China
| | - Yani Lin
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China
| | - Huilan Li
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China
| | - Hongyu Li
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China
| | - Kun Ru
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China; Department of Pathology and Lab Medicine, Shandong Cancer Hospital, Jinan, Shandong, China
| | - Shaobin Yang
- Sino-US Diagnostics Lab, Tianjin Enterprise Key Laboratory of Al-aided Hematopathology Diagnosis, 5 Xinghua No.3 branch road, Tianjin, China.
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4
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Kim DH. A three‑way complex translocation of (15;15;17)(q24;q14;q21) involving two breakpoints on chromosome 15 in acute promyelocytic leukemia: A case report. Oncol Lett 2023; 26:309. [PMID: 37332331 PMCID: PMC10272972 DOI: 10.3892/ol.2023.13895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
The present study described an extremely rare case of acute promyelocytic leukemia (APL) characterized by a complex three-way (15;15;17)(q24;q14;q21) translocation. It was identified in a 59-year-old male through karyotype, molecular, and fluorescence in situ hybridization (FISH) analyses. The third translocation breakpoint 15q14 was identified on the same chromosome 15 that also contained the classical t(15;17)(q24;q21) and may have evolved from the classical t(15;17) clone, as indicated by interphase FISH analysis. A complex translocation involving two breakpoints on the same chromosome is extremely rare, such that this case can provide insights into complex translocations in APL.
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Affiliation(s)
- Do-Hoon Kim
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, North Gyeongsang 42601, Republic of Korea
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5
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Grant BJ, Tang Z, Toruner GA, Mahdi A, Bigham L, Dong J, Musunuru T, Mallick J, Lyapichev KA. A rare case of complex variant translocation of t(9;22;16)(q34;q11.2;q24) in a newly diagnosed patient with chronic myeloid leukemia. Leuk Res Rep 2022; 18:100351. [PMID: 36176359 PMCID: PMC9513261 DOI: 10.1016/j.lrr.2022.100351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 09/19/2022] [Indexed: 11/07/2022] Open
Abstract
Complex Philadelphia chromosome translocations. Variability of chromosomal translocations may impact treatment. Genomic analysis is integral for molecular characterization of CML.
Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm associated with the dysregulated production of myeloid cells. The Philadelphia chromosome (Ph), t(9;22)(q34;q11), is a hallmark of the disease and found in 90–95% of diagnosed CML patients. The balanced, reciprocal translocation places the genes BCR and ABL1, next to each other, resulting in an increase of kinase activity. Additional cases involve complex variants, including translocation events involving an additional chromosome with the creation of the Ph chromosome. A rare three-way Ph chromosome complex variant, t(9;22;16)(q34;q11.2;q24), was identified in a 40-year-old female who presented with visual changes and leukocytosis. Cytogenetic analysis by G-banding revealed the presence of a three-way translocation involving the long arms of chromosomes 9, 22, and 16. Fluorescence in situ hybridization with a dual-color fusion probe confirmed the presence of the BCR::ABL1 fusion.
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6
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Asif M, Hussain A, Wali A, Ahmed N, Ali I, Iqbal Z, Amir M, Shafiq M, Rasool M. Molecular, Cytogenetic, and Hematological Analysis of Chronic Myeloid Leukemia Patients and Discovery of Two Novel Translocations. Anal Cell Pathol (Amst) 2021; 2021:4909012. [PMID: 34422550 PMCID: PMC8378985 DOI: 10.1155/2021/4909012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022] Open
Abstract
Chronic myeloid leukemia (CML) is a disease of hematopoietic stem cells and is caused by the balanced translocations among the long arms of chromosomes 9 and 22, which are called the Philadelphia (Ph) chromosome. In this study, 131 CML patients were enrolled. Complete blood cell count was performed at the time of diagnosis for all the patients. Cytogenetic (karyotyping) examination using bone marrow samples was conducted on 76 CML patients for the confirmation of Ph-positive (9;22)(q34;q11) standard translocation, complex variant translocation, and additional chromosome abnormalities. FISH was performed on 38 patients for diagnostic purposes and on 39 patients for monitoring purposes. Twenty-two samples of CML patients were evaluated by reverse transcriptase PCR and real-time PCR for the patients who failed to respond against imatinib mesylate. In this study, 72 (54.96%) were males and 59 (45.03%) were females with a median age of 38.5 years. CBC values in the diagnosis process showed that 75 patients had high values of WBC being >100 × 103/μl, while 71 (58.01) patients exhibited reduced values of hemoglobin, i.e., <10.00 mg/dl, and high values of PLTs > 100 were observed in 40 (30.53%) patients. Cytogenetic results show that standard translocation was developed in 63 (82.89%), development of complex variant translocations in 4 (5.32%), additional chromosomal abnormalities (ACAs) in 3 (3.94%), and ACAs together with complex variant translocations in 1 (1.31%) patient. At the time of diagnosis, 61 (92.95%) patients were in the chronic phase, 4 (5.63%) were in the accelerated phase, and only 1 (1.40%) was in the blast crisis. Out of twenty-two patients, only 6 CML patients who were shifted from imatinib mesylate to nilotinib showed BCR-ABL-positive amplification. However, only 7 out of twenty-one patients exhibit BCR-ABL gene values ≥ 1 after three months of follow-up when analyzed by the quantitative real-time PCR. In conclusion, we found a novel five-way translocation 46XX,t(1;2;2;17;9;22)(p36.3,q21;q11.2,q21,q34,q11.2) and a novel four-way complex variant translocation 48XY,+8(8;17)(9;22),+der(22)(q11.2;q23)(q34;q11.2) in the accelerated phase.
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MESH Headings
- Adolescent
- Adult
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/genetics
- Drug Substitution
- Female
- Humans
- Imatinib Mesylate/therapeutic use
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Philadelphia Chromosome
- Protein Kinase Inhibitors/therapeutic use
- Pyrimidines/therapeutic use
- Translocation, Genetic
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Muhammad Asif
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
- Office of Research Innovation and Commercialization, BUITEMS, Quetta, Pakistan
| | - Abrar Hussain
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
| | - Abdul Wali
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
| | - Nazeer Ahmed
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
| | - Irfan Ali
- Centre of Agricultural Biochemistry and Biotechnology, Agriculture University of Faisalabad, Pakistan
| | - Zafar Iqbal
- Clinical Laboratory Sciences Program, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences/KAIMRC/SSBMT, National Guard Health Affairs, King Abdulaziz Medical City, Al-Ahsa, Saudi Arabia
| | - Muhammad Amir
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
| | - Muhammad Shafiq
- Department of Biotechnology, University of Sialkot, Pakistan
| | - Mahmood Rasool
- Center of Excellence in Genomic Medicine Research, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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7
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Torii Y, Nanjo K, Toubai T, Hosokawa M, Sato R, Yamada A, Aizawa K, Himuro M, Ito S, Yamamoto M, Magenau J, Wilcox R, Ishizawa K. A unique three-way Philadelphia chromosome variant t(4;9;22)(q21;q34;q11.2) in a newly diagnosed patient with chronic phase chronic myeloid leukemia: a case report and review of the literature. J Med Case Rep 2021; 15:285. [PMID: 34030730 PMCID: PMC8146239 DOI: 10.1186/s13256-021-02885-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 04/28/2021] [Indexed: 12/04/2022] Open
Abstract
Background Chronic myeloid leukemia is a hematologic malignancy associated with the fusion of two genes: BCR and ABL1. This fusion results from a translocation between chromosomes 9 and 22, which is called the Philadelphia chromosome. Although the Philadelphia chromosome is present in more than 90% of patients with chronic myeloid leukemia, 5–8% of patients with chronic myeloid leukemia show complex variant translocations. Herein, we report a unique case of a three-way translocation variant in chronic phase chronic myeloid leukemia. Case presentation A 40-year-old Asian male who presented with leukocytosis was diagnosed with chronic phase chronic myeloid leukemia. Cytogenetic karyotyping analysis showed 46,XY,t(4;9;22)(q21;q34;q11.2). He was treated with bosutinib and then changed to dasatinib because of intolerance, and MR4.5 (BCR-ABL/ABL ≦ 0.0032%, international scale) was achieved after 17 months of continuous treatment. Conclusion This was the 14th case of t(4;9;22), in particular, a new variant Ph translocation involved in chromosome 4q21 and the first successful case treated with tyrosine kinase inhibitors in the world. We summarize previous case reports regarding three-way variant chromosome translocation, t(4;9;22) and discuss how this rare translocation is linked to prognosis.
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Affiliation(s)
- Yuka Torii
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Kana Nanjo
- Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tomomi Toubai
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Masashi Hosokawa
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Ryo Sato
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Akane Yamada
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Keiko Aizawa
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Masahito Himuro
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Satoshi Ito
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Masakazu Yamamoto
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - John Magenau
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ryan Wilcox
- Department of Internal Medicine, Division of Hematology and Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Kenichi Ishizawa
- Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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8
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Tang Z, Toruner GA, Tang G, Cameron Yin C, Wang W, Hu S, Thakral B, Wang SA, Miranda RN, Khoury JD, Medeiros LJ. Chronic myeloid leukemia with insertion-derived BCR-ABL1 fusion: redefining complex chromosomal abnormalities by correlation of FISH and karyotype predicts prognosis. Mod Pathol 2020; 33:2035-2045. [PMID: 32404952 DOI: 10.1038/s41379-020-0564-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 12/29/2022]
Abstract
Chromosomal insertion-derived BCR-ABL1 fusion is rare and mostly cryptic in chronic myeloid leukemia (CML). Most of these cases present a normal karyotype, and their risk and/or prognostic category are uncertain. We searched our database and identified 41 CML patients (20 M/21 F, median age: 47 years, range 12-78 years) with insertion-derived BCR-ABL1 confirmed by various FISH techniques: 31 in chronic phase, 1 in accelerated phase, and 9 in blast phase at time of diagnosis. Conventional cytogenetics analysis showed a normal karyotype (n = 19); abnormal karyotype with morphologically normal chromosomes 9 and 22 (n = 5); apparent ins(9;22) (n = 2) and abnormal karyotype with apparent abnormal chromosomes 9, der(9) and/or 22, der(22) (n = 15). The locations of insertion-derived BCR-ABL1 were identified on chromosome 22 (68.3%), 9 (29.3%), and 19 (2.4%). Complex chromosomal abnormalities were often overlooked by conventional cytogenetics but identified by FISH tests in many cases. After a median follow-up of 58 months (range 1-242 months), 11 patients died, and 3 lost contact, while the others achieved different cytogenetic/molecular responses. The locations of BCR-ABL1 (der(22) vs. non-der(22)) and the karyotype results (complex karyotype vs. noncomplex karyotype) by conventional cytogenetics were not associated with overall survival in this cohort. However, redefining the complexity of chromosomal abnormality by correlating karyotype and FISH findings, CML cases with simple chromosomal abnormalities had a more favorable overall survival than that with complex chromosomal abnormalities. We conclude that insertion-derived BCR-ABL1 fusions often involve complex chromosomal abnormalities which are overlooked by conventional cytogenetics, but can be identified by one or more FISH tests. We also suggest that the traditional cytogenetic response criteria may not apply in these patients, and the complexity of chromosomal abnormalities redefined by correlating karyotype and FISH findings can plays a role in stratifying patients into more suitable risk groups for predicting prognosis. (Word count: 292).
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Affiliation(s)
- Zhenya Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Gokce A Toruner
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Wei Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Beenu Thakral
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Roberto N Miranda
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, 77030, USA
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9
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RNA-Binding Proteins in Acute Leukemias. Int J Mol Sci 2020; 21:ijms21103409. [PMID: 32408494 PMCID: PMC7279408 DOI: 10.3390/ijms21103409] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 12/12/2022] Open
Abstract
Acute leukemias are genetic diseases caused by translocations or mutations, which dysregulate hematopoiesis towards malignant transformation. However, the molecular mode of action is highly versatile and ranges from direct transcriptional to post-transcriptional control, which includes RNA-binding proteins (RBPs) as crucial regulators of cell fate. RBPs coordinate RNA dynamics, including subcellular localization, translational efficiency and metabolism, by binding to their target messenger RNAs (mRNAs), thereby controlling the expression of the encoded proteins. In view of the growing interest in these regulators, this review summarizes recent research regarding the most influential RBPs relevant in acute leukemias in particular. The reported RBPs, either dysregulated or as components of fusion proteins, are described with respect to their functional domains, the pathways they affect, and clinical aspects associated with their dysregulation or altered functions.
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10
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A unique case of complex variant translocation of t(6;9;22)(p22;q34;q11.2), der(19) in a newly diagnosed patient with chronic myeloid leukemia. Cancer Genet 2019; 237:78-81. [PMID: 31447069 DOI: 10.1016/j.cancergen.2019.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 05/11/2019] [Accepted: 06/11/2019] [Indexed: 11/20/2022]
Abstract
Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by the dysregulated production and uncontrolled proliferation of myeloid neoplastic cells. CML is associated with the fusion of BCR (on chromosome 22) and ABL1 (on chromosome 9) resulting in the BCR-ABL1 fusion gene. The translocation of chromosomes (9;22)(q34;p15) is present in almost 90-95% of patients with CML and only 5-8% CML patients have established variant complex translocation due to the participation of one or more chromosomes other than 9 and 22 chromosome. In the present study, a unique case of a pH chromosome-positive CML is reported with a new variant pH translocation involving three chromosomal aberrations 6p22, 9q34, 22q11.2 and derivation 19 which has not been described previously. The complex variant translocation with pH chromosome was 46,XY,t(6;9;22)(p22:q34;q11.2), der(19)[48]/46,XY[2] in this newly diagnosed CML patient. Additional cytogenetic anomalies may be seen in patients which are not controlled by the tyrosine kinase inhibitor in CML patients or in accelerated/blastic phase. In this case, the patient' treatment was switched to dasatinib because the IS-NCN could not be controlled with imatinib. In conclusion, complex translocations in unusual locations of the BCR / ABL gene appear to indicate a poor prognosis.
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Shu Y, Yang W, Zhang X, Xu X. Recurrent chronic myeloid leukemia with t (9;22;16) (q34; q11; p13) treated by nilotinib: A case report. Medicine (Baltimore) 2018; 97:e12875. [PMID: 30335005 PMCID: PMC6211866 DOI: 10.1097/md.0000000000012875] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Variant Philadelphia chromosome translocations involving chromosomes other than chromosomes 9 and 22 have been reported in 5% to 10% of patients with chronic myeloid leukemia (CML). Here, a case of CML with a t (9, 22, 16) (q34; q11; p13) translocation, which has never been described, is reported. PATIENT CONCERNS A 59-year-old female with dry cough, referred to our hospital, exhibited hepatosplenomegaly, high basophil count, and high platelet count at admission without any other known chronic diseases. DIAGNOSES The patient was diagnosed with CML with the translocation t (9;22;16) (q34; q11; p13). The patient was treated with imatinib, a first-generation tyrosine kinase inhibitor (TKI), discontinuously, achieving a complete hematological response for 7 years. Since November 8, 2017, the patient had recurrent fever, and her platelet count rose to 1422 × 10/L. Subsequently, the E279K mutation in the BCR-ABL kinase region was detected. OUTCOMES According to a previous report, this mutation confers sensitivity to nilotinib, a second-generation TKI. In the end, the patient received treatment with nilotinib and showed a complete hematological response. LESSONS The present study reports a rare case of CML with Ph chromosome and a t (9;22;16) (q34; q11; p13) translocation. For such cases about CML with variant Philadelphia chromosome translocations or BCR-ABL kinase region mutation, TKI may still be valuable.
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MESH Headings
- Antineoplastic Agents/administration & dosage
- Chromosomes, Human, 16-18/genetics
- Chromosomes, Human, Pair 22/genetics
- Chromosomes, Human, Pair 9/genetics
- Female
- Humans
- Imatinib Mesylate/administration & dosage
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Middle Aged
- Mutation
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/genetics
- Philadelphia Chromosome
- Pyrimidines/administration & dosage
- Translocation, Genetic/genetics
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Asif M, Hussain A, Wali A, Ahmad N, Sajjad N, Amir M, Ali I, Pushparaj PN, Rasool M. A rare case of three-way complex variant translocation in chronic myeloid leukemia t(6;9;22)(p21;q34;q11): A case report. Biomed Rep 2017; 7:377-379. [PMID: 29085635 DOI: 10.3892/br.2017.967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/20/2017] [Indexed: 11/05/2022] Open
Abstract
Philadelphia (Ph)-positive chromosome or Ph translocation has been recognized in 90-95 chronic myeloid leukemia (CML) cases worldwide. However, only 5-8% CML patients show complex variant translocations. In the present study, hematological tests for a 47-year-old female CML patient were performed to determine the hemoglobin, platelets and total leukocyte values. A FISH test was carried out to recognize the BCR/ABL gene fusion, and a cytogenetic analysis was performed. The hematological results showed an increase in WBC (414000/mm3) and a decrease in hemoglobin (8.9 mg/dl), indicating the anemic condition in the CML patient. Furthermore, cytogenetic karyotyping results showed 46,XX,t(6;9;22)(p21;q34;q11) and positive for Ph chromosome. In conclusion, in the present study, we report a rare three-way complex variant translocation in a CML patient.
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Affiliation(s)
- Muhammad Asif
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Abrar Hussain
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Abdul Wali
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Nazeer Ahmad
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Naheed Sajjad
- Department of Biotechnology, Sardar Bahadur Khan Women's University, Quetta 87500, Pakistan
| | - Muhammad Amir
- Department of Biotechnology, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta 87300, Pakistan
| | - Irfan Ali
- Akhuwat Faisalabad Institute of Research Science and Technology, Faisalabad 38000, Pakistan
| | - Peter Natesan Pushparaj
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
| | - Mahmood Rasool
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah 21589, Kingdom of Saudi Arabia
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Molica M, Massaro F, Breccia M. Diagnostic and prognostic cytogenetics of chronic myeloid leukaemia: an update. Expert Rev Mol Diagn 2017; 17:1001-1008. [PMID: 28930482 DOI: 10.1080/14737159.2017.1383156] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Despite the advent of molecular assessment, banding cytogenetics and fluorescence in situ hybridization (FISH) still have a significant role in diagnostic and prognostic approaches to chronic myeloid leukaemia (CML). Area covered: At diagnosis and during treatment with tyrosine kinase inhibitors (TKIs), cytogenetics is used to detect the Philadelphia chromosome, with its typical translocation t(9;22)(q34;q11.2), and any additional or other chromosomal aberrations (ACAs and OCAs) that may arise in 5-10% of cases, the latter associated to transformation of the disease in blast phases. In this review, the potential role of banding cytogenetics and FISH is discussed through a review of published papers on the prognostic impact of these tools in CML treatment and monitoring. Expert commentary: Cytogenetic techniques, including banding cytogenetics and FISH, continue to maintain a crucial role in CML monitoring. At diagnosis and after 3 months of therapy, banding cytogenetics will continue to be an essential test to perform, but it will become redundant after the achievement of a major molecular response (MMR) assessed with molecular techniques. FISH analysis maintains its usefulness in monitoring the response to TKIs only in special situations.
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Affiliation(s)
- Matteo Molica
- a Hematology, Department of Cellular Biotechnologies and Hematology , Sapienza University , Rome , Italy
| | - Fulvio Massaro
- a Hematology, Department of Cellular Biotechnologies and Hematology , Sapienza University , Rome , Italy
| | - Massimo Breccia
- a Hematology, Department of Cellular Biotechnologies and Hematology , Sapienza University , Rome , Italy
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14
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Role of complexity of variant Philadelphia chromosome in chronic myeloid leukemia in the era of tyrosine kinase inhibitor therapy. Ann Hematol 2016; 96:501-504. [PMID: 27915425 DOI: 10.1007/s00277-016-2892-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 11/27/2016] [Indexed: 02/03/2023]
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Asif M, Hussain A, Rasool M. A rare case of a three way complex variant positive Philadelphia translocation involving chromosome (9;11;22)(q34;p15;q11) in chronic myeloid leukemia: A case report. Oncol Lett 2016; 12:1986-1988. [PMID: 27602125 DOI: 10.3892/ol.2016.4821] [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: 01/31/2015] [Accepted: 12/02/2015] [Indexed: 11/05/2022] Open
Abstract
The t(9;22)(q34;q11) translocation is present in 90-95% of patients with chronic myeloid leukemia (CML). Variant complex translocations have been observed in 5-8% of CML patients, in which a third chromosome other than (9;22) is involved. Imatinib mesylate is the first line breakpoint cluster region-Abelson gene (BCR/ABL)-targeted oral therapy for CML, and may produce a complete response in 70-80% of CML patients in the chronic phase. In the present study, a bone marrow sample was used for conventional cytogenetic analysis, and the fluorescence in situ hybridization (FISH) test was used for BCR/ABL gene detection. A hematological analysis was also performed to determine the white blood cell (WBC) count, red blood cell count, hemoglobin levels, packed and mean cell volumes, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and platelet values of the patient. The hematological analysis of the patient indicated the increased WBC of 186.5×103 cells/µl, and decreased hemoglobin levels of 11.1 g/dl. The FISH test revealed that 67% cells demonstrated BCR/ABL gene translocation. The patient was treated with 400 mg imatinib mesylate daily, and was monitored at various intervals over a 6-month period. The present study reports the rare case of a patient that demonstrates a three-way Philadelphia chromosome-positive translocation involving 46XY,t(9;11;22)(q34;p15;q11)[10], alongside CML in the chronic phase. The translocation was analyzed using cytogenetic and FISH tests.
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Affiliation(s)
- Muhammad Asif
- Department of Biotechnology and Informatics, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta, Balochistan 87300, Pakistan; Office of Research Innovation and Commercialization, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta, Balochistan 87300, Pakistan
| | - Abrar Hussain
- Department of Biotechnology and Informatics, Balochistan University of Information Technology, Engineering and Management Sciences, Quetta, Balochistan 87300, Pakistan
| | - Mahmood Rasool
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Makkah 21589, Saudi Arabia
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Chen L, Wu Y, You Y, Xiao M, Yao Y, Li W. A novel e8a2 BCR-ABL1 intronic fusion through insertion of a chromosome 22 BCR gene fragment into chromosome 9 in an atypical Philadelphia (Ph) chromosome chronic myeloid leukemia patient. Leuk Lymphoma 2016; 57:2930-2933. [PMID: 27118564 DOI: 10.3109/10428194.2016.1173211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Lifeng Chen
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Yaohui Wu
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Yong You
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Min Xiao
- b Department of Hematology , Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
| | - Ye Yao
- c Department of Radiation Oncology and Medical Oncology , Zhongnan Hospital, Wuhan University , Wuhan , Hubei Province , P.R. China.,d Hubei Cancer Clinical Study Center, Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital , Wuhan University , Wuhan , Hubei Province , P.R. China
| | - Weiming Li
- a Department of Hematology , Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei Province , P.R. China
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Bennour A, Saad A, Sennana H. Chronic myeloid leukemia: Relevance of cytogenetic and molecular assays. Crit Rev Oncol Hematol 2015; 97:263-74. [PMID: 26412717 DOI: 10.1016/j.critrevonc.2015.08.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Revised: 07/07/2015] [Accepted: 08/24/2015] [Indexed: 12/12/2022] Open
Abstract
Chronic myeloid leukemia (CML) is the prototype cytogenetic malignancy. Even before the development of basic G- and R-banding techniques, CML was found to be associated with a persistent chromosomal abnormality, the Philadelphia (Ph) chromosome. Banding technology later showed the marker chromosome to be a translocation between the breakpoint cluster region (BCR) on chromosome 22q11.2 and the Abelson proto-oncogene (ABL) on chromosome 9q34. Further advances in cytogenetic and molecular biology have also contributed to the understanding, diagnosis, and treatment of CML. Fluorescent in situ hybridization (FISH) has revealed cryptic translocations in most cases of Ph-negative CML. Additional rare chromosomal variant translocations have been discovered as well. The understanding of cytogenetic and molecular physiopathology of CML has led to the use of tyrosine kinase inhibitors as treatment for this disease with spectacular success. Over the 40 years since being identified as the first cytogenetic disease, CML has become the greatest success in translating the basic science of oncology into the treatment of patients with cancer. In this review we will not only summarize the biology of CML, recent progress in the delineation of mechanisms and treatment strategies, but also we will discuss the laboratory tools used for diagnosing CML, for monitoring during treatment and for revealing point mutations and additional chromosomal abnormalities. In doing so, we will describe in detail our individual research on CML, identifying why and how these tests were performed to help to explain CML subgroups and clinical significance of additional chromosomal abnormalities.
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Affiliation(s)
- Ayda Bennour
- Department of Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia.
| | - Ali Saad
- Department of Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia
| | - Halima Sennana
- Department of Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia
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18
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Brahmbhatt MM, Trivedi PJ, Patel DM, Shukla SN, Patel PS. Location of the BCR/ABL Fusion Genes on Both Chromosomes 9 in Ph Negative Young CML Patients: An Indian Experience. Indian J Hematol Blood Transfus 2014; 30:241-6. [PMID: 25435721 DOI: 10.1007/s12288-013-0316-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 12/17/2013] [Indexed: 10/25/2022] Open
Abstract
The BCR/ABL gene rearrangement is cytogenetically visualized in most chronic myeloid leukemia (CML) cases. About 5-10 % of CML patients lack its cytogenetic evidence, however, shows BCR/ABL fusion by molecular methods. We describe two CML patients with Philadelphia (Ph) negative (-ve) and BCR/ABL positive by fluorescence in situ hybridization (FISH). Both the cases were in chronic phase at diagnosis. Conventional cytogenetics and different FISH assays were adopted using BCR/ABL probes. Home-brew FISH assay using bacterial artificial clone (BAC) for BAC-CTA/bk 299D3 for chromosomal region 22q13.31-q13.32 was performed in case 1. Both the patients were Ph-ve. In first case, dual color dual fusion (DCDF)-FISH studies revealed 1 Red (R) 2 Green (G) 1 Fusion (F) signal pattern in 80 % of cells indicating BCR/ABL fusion signals on chromosomes 9 instead of Ph and 2G2F signal pattern in 20 % of cells indicating two BCR/ABL fusions on both chromosomes 9q34 on presentation. In second case, FISH studies revealed the 1R1G1F signal pattern indicating BCR/ABL fusion signals on chromosomes 9 instead of Ph in 100 % of cells at presentation. During follow-up, both the patients exhibited 2G2F signal pattern indicating two BCR/ABL fusions on both chromosomes 9q34, which indicated a clonal evolution in 100 % cells. Both the patients did not achieve therapeutic response. Relocation of BCR/ABL fusion sequence on sites other than 22q11 represents a rare type of variant Ph, the present study highlights the hot spots involved in CML pathogenesis and signifies their implications in Ph-ve BCR/ABL positive CML. This study demonstrated the genetic heterogeneity of this subgroup of CML and strongly emphasized the role of metaphase FISH, especially in Ph-ve CML cases, as it detects variations of the classical t(9;22).
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Affiliation(s)
- Manisha M Brahmbhatt
- Cell Biology Division, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad, 380016 Gujarat India
| | - Pina J Trivedi
- Cell Biology Division, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad, 380016 Gujarat India
| | - Dharmesh M Patel
- Cell Biology Division, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad, 380016 Gujarat India
| | - Shilin N Shukla
- Medical Oncology Department, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad, 380016 India
| | - Prabhudas S Patel
- Cell Biology Division, The Gujarat Cancer & Research Institute, Asarwa, Ahmedabad, 380016 Gujarat India
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Yokota S, Nakamura Y, Bessho M. A novel five-way translocation t(7;11;9;22;9)(q22;q13;q34;q11.2;q34) involving Ph chromosome in a patient of chronic myeloid leukemia: a case report. Mol Cytogenet 2012; 5:20. [PMID: 22548843 PMCID: PMC3407734 DOI: 10.1186/1755-8166-5-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 05/01/2012] [Indexed: 11/10/2022] Open
Abstract
About 5-10 % of chronic myelogenous leukemia (CML) patients show variant Philadelphia (Ph) translocations. The formation mechanisms and clinical significance of variant Ph translocations remain unclear. We report a CML case with a novel five-way complex translocation. Although the result of initial G-banding was 46,XY,t(7;11;9)(q22;q13;q34),t(9;22)(q34;q11.2), fluorescence in situ hybridization (FISH) demonstrated t(7;11;9;22;9)(q22;q13;q34;q11.2;q34) consisting of sequential rearrangements involving five chromosomes. The patient was successfully treated by imatinib and obtained a major molecular response. To our knowledge, this is the tenth CML case with a complicated Ph translocation involving five chromosomes and the third one treated by imatinib. Good response with imatinib therapy suggested that a single-event rearrangement was involved in the chromosomal changes.
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Affiliation(s)
- Sho Yokota
- Department of Hematology, Saitama Medical University Hospital, 38 Moro-Hongo, Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
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Bennour A, Bellâaj H, Ben Youssef Y, Elloumi M, Khelif A, Saad A, Sennana H. Molecular cytogenetic characterization of Philadelphia-negative rearrangements in chronic myeloid leukemia patients. J Cancer Res Clin Oncol 2011; 137:1329-36. [PMID: 21739181 DOI: 10.1007/s00432-011-1002-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 06/27/2011] [Indexed: 01/13/2023]
Abstract
BACKGROUND The BCR/ABL gene rearrangement is generated by a reciprocal translocation t(9;22)(q34;q11) in chronic myeloid leukemia (CML) patients. In most cases, it is cytogenetically visualized by the Philadelphia (Ph) chromosome. About 5-10% of CML patients lack cytogenetic evidence of the Ph translocation but show BCR/ABL fusion by fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR). Deletions around the breakpoints on derivative chromosome 9 including 5'ABL and 3'BCR sequences occur in 10-15% of Ph-positive CML patients and are thought to have prognostic significance. METHODS We explored cryptic rearrangements involving chromosomes 9 and 22 in 3 CML patients with an apparently normal bone marrow karyotypes using multiplex RT-PCR and FISH with commercial and home-brew probes. RESULTS The BCR/ABL fusion transcripts were detected by RT-PCR. Using commercial FISH probes, the BCR/ABL fusion gene was found on chromosome 22 in two patients and on chromosome 9 in one patient. Consecutive FISH assays clarified the mechanism of the masked Ph chromosome: in the 3 patients, Ph rearrangement resulted from double mechanism consisting in standard translocation t(9;22)(q34;q11) followed by a second reversed translocation t(9;22)(q34;q11). One patient achieved major cytogenetic response after 6 months of imatinib therapy, and one patient had successful bone marrow transplant. CONCLUSIONS In this study, we have characterized three Ph-negative CML patients with cryptic BCR/ABL rearrangement generated after an uncommon mechanism involving two sequential translocations and confirm that the BCR/ABL hybrid gene may be located on other sites than 22q11. Ph-negative CML patients with BCR/ABL fusion gene have the same prognosis as patients with classical t(9;22).
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Affiliation(s)
- Ayda Bennour
- Department of Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse, Tunisia.
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Vigil CE, Wang SA, Cortes JE, Bueso-Ramos C, Verstovsek S, Shinder R, Chen SS, Katz RL, Khanna A, Esmaeli B, Manning JT, You MJ, Miranda RN. Dasatinib-responsive mast cell neoplasms as initial presentation of chronic myelogenous leukemia in blast phase. J Clin Oncol 2011; 29:e514-6. [PMID: 21464405 PMCID: PMC4874210 DOI: 10.1200/jco.2010.34.1610] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Carlos E. Vigil
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sa A. Wang
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jorge E. Cortes
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | - Roman Shinder
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Su S. Chen
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Ruth L. Katz
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Abha Khanna
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Bita Esmaeli
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - John T. Manning
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - M. James You
- The University of Texas MD Anderson Cancer Center, Houston, TX
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De Braekeleer E, Douet-Guilbert N, Rowe D, Bown N, Morel F, Berthou C, Férec C, De Braekeleer M. ABL1 fusion genes in hematological malignancies: a review. Eur J Haematol 2011; 86:361-71. [PMID: 21435002 DOI: 10.1111/j.1600-0609.2011.01586.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Chromosomal rearrangements involving the ABL1 gene, leading to a BCR-ABL1 fusion gene, have been mainly associated with chronic myeloid leukemia and B-cell acute lymphoblastic leukemia (ALL). At present, six other genes have been shown to fuse to ABL1. The kinase domain of ABL1 is retained in all chimeric proteins that are also composed of the N-terminal part of the partner protein that often includes a coiled-coil or a helix-loop-helix domain. These latter domains allow oligomerization of the protein that is required for tyrosine kinase activation, cytoskeletal localization, and neoplastic transformation. Fusion genes that have a break in intron 1 or 2 (BCR-ABL1, ETV6-ABL1, ZMIZ1-ABL1, EML1-ABL1, and NUP214-ABL1) have transforming activity, although NUP214-ABL1 requires amplification to be efficient. The NUP214-ABL1 gene is the second most prevalent fusion gene involving ABL1 in malignant hemopathies, with a frequency of 5% in T-cell ALL. Both fusion genes (SFPQ-ABL1 and RCSD1-ABL1) characterized by a break in intron 4 of ABL1 are associated with B-cell ALL, as the chimeric proteins lacked the SH2 domain of ABL1. Screening for ABL1 chimeric genes could be performed in patients with ALL, more particularly in those with T-cell ALL because ABL1 modulates T-cell development and plays a role in cytoskeletal remodeling processes in T cells.
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Affiliation(s)
- Etienne De Braekeleer
- Université de Brest, Faculté de Médecine et des Sciences de la Santé, Brest Institut National de la Santé et de la Recherche Médicale (INSERM), Brest CHRU Brest, Hôpital Morvan, Service de Cytogénétique, Cytologie et Biologie de la Reproduction, Brest, France
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Manabe M, Yoshii Y, Mukai S, Sakamoto E, Kanashima H, Inoue T, Teshima H. A Rare t(9;22;16)(q34;q11;q24) Translocation in Chronic Myeloid Leukemia for Which Imatinib Mesylate Was Effective: A Case Report. LEUKEMIA RESEARCH AND TREATMENT 2011; 2011:592519. [PMID: 23213545 PMCID: PMC3505916 DOI: 10.4061/2011/592519] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Revised: 04/20/2011] [Accepted: 05/15/2011] [Indexed: 11/20/2022]
Abstract
The t(9;22)(q34;q11) translocation is found in about 90% of chronic myeloid leukemia (CML) patients. About 5-10% of CML patients have complex variant translocations involving a third chromosome in addition to chromosomes 9 and 22. Herein, we describe a CML-chronic phase male with a complex translocation involving chromosome 16, t(9;22;16)(q34;q11;q24). First, he was treated with interferon-alpha and intermittent hydroxyurea, but only a partial cytogenetic response was attained. Subsequently, the patient was treated with imatinib mesylate because of an additional chromosome abnormality, trisomy 8. A major molecular response was obtained after one year's imatinib therapy, and the follow-up chromosomal analysis performed 4 years and 3 months after the initiation of imatinib therapy displayed a normal karyotype of 46,XY.
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Affiliation(s)
- Masahiro Manabe
- Department of Hematology, Osaka City General Hospital, 2-13-22 Miyakojimahondori, Miyakojima-Ku, Osaka 534-0021, Japan ; Department of Hematology, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-Ku, Osaka 545-8585, Japan
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Morris CM. Chronic myeloid leukemia: cytogenetic methods and applications for diagnosis and treatment. Methods Mol Biol 2011; 730:33-61. [PMID: 21431633 DOI: 10.1007/978-1-61779-074-4_4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Chronic myeloid leukemia (CML) is a clonal myeloproliferative disease caused by recombination between the BCR gene on chromosome 22 and the ABL1 gene on chromosome 9. This rearrangement generates the BCR-ABL1 fusion gene that characterizes leukemic cells in all CML cases. In about 90% of cases, the BCR-ABL1 rearrangement is manifest cytogenetically by the Philadelphia (Ph) chromosome, a derivative of the reciprocal translocation t(9;22)(q34;q11.2). For the remaining cases, recombination may be more complex, involving BCR, ABL1, and genomic sites on one or more other chromosomal regions, or it may occur cryptically within an apparently normal karyotype. Detection of the Ph and associated t(9;22) translocation is a recognized clinical hallmark for CML diagnosis. The disease has a natural multistep pathogenesis, and during chronic phase CML, the t(9;22) or complex variant is usually the sole abnormality. In 60-80% of cases, additional cytogenetic changes appear and often forecast progression to an accelerated disease phase or a terminal blast crisis. Because new frontline therapies such as imatinib specifically target the abnormal protein product of the BCR-ABL1 fusion gene to eliminate BCR-ABL1 positive cells, there is a new reliance on the cytogenetic evaluation of bone marrow cells at diagnosis, then at regular posttreatment intervals. Combined with other parameters, presence or absence of Ph-positive cells in the bone marrow is a powerful early indicator for clinical risk stratification. Cytogenetic changes detected at any stage during treatment, including in the BCR-ABL1-negative cells, may also provide useful prognostic information. Laboratory methods detailed here extend from initial collection of peripheral blood or bone marrow samples through cell culture with or without synchronization, metaphase or interphase harvest, hypotonic treatment and fixation, slide preparation for G-banding or fluorescent in situ hybridization (FISH), and final interpretation.
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Affiliation(s)
- Christine M Morris
- Cancer Genetics Research Group, Department of Pathology, University of Otago Christchurch School of Medicine and Health Services, Christchurch, New Zealand.
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25
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Bakshi SR, Patel BP, Brahmbhatt MM, Trivedi PJ, Gajjar SB, Iyer RR, Parikh EH, Shukla SN, Shah PM. Complex karyotype with a masked Philadelphia translocation and variant BCR-ABL fusion in CML. ACTA ACUST UNITED AC 2009; 189:142-3. [PMID: 19215799 DOI: 10.1016/j.cancergencyto.2008.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
MESH Headings
- Adult
- Chromosome Aberrations
- Chromosomes, Human, Pair 10
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 9
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Philadelphia Chromosome
- Protein Isoforms/genetics
- RNA, Messenger, Stored/genetics
- Translocation, Genetic
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Affiliation(s)
- Sonal R Bakshi
- Cell Biology Division, Division of Research, The Gujarat Cancer Society, Department of Cancer Biology, NCH Campus, Asarwa, Ahmedabad-380016, India
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26
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Torres L, Lisboa S, Cerveira N, Lopes JM, Lopes C, Teixeira MR. Cryptic chromosome rearrangement resulting in SYT-SSX2 fusion gene in a monophasic synovial sarcoma. ACTA ACUST UNITED AC 2008; 187:45-9. [DOI: 10.1016/j.cancergencyto.2008.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Revised: 07/14/2008] [Accepted: 07/23/2008] [Indexed: 10/21/2022]
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27
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A novel five-way chromosomal translocation observed in chronic myelogenous leukemia. ACTA ACUST UNITED AC 2008; 183:69-71. [DOI: 10.1016/j.cancergencyto.2008.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2007] [Revised: 01/29/2008] [Accepted: 02/06/2008] [Indexed: 11/19/2022]
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28
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Bennour A, Sennana H, Laatiri MA, Khelif A, Saad A. A masked BCR/ABL rearrangement in a case of chronic myeloid leukemia with translocation t(3;9)(p14;q34). ACTA ACUST UNITED AC 2008; 181:72-4. [DOI: 10.1016/j.cancergencyto.2007.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2007] [Revised: 11/19/2007] [Accepted: 11/20/2007] [Indexed: 10/22/2022]
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29
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Confirmation of a novel recurrent association: BCR-ABL t(9;22) and t(19;21). ACTA ACUST UNITED AC 2007; 179:127-31. [DOI: 10.1016/j.cancergencyto.2007.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2007] [Accepted: 08/14/2007] [Indexed: 11/23/2022]
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30
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Valle L, Fernández V, Pérez-Pons C, Sánchez FG, Benítez J, Urioste M. Generation of the BCR/ABL fusion gene in a Philadelphia chromosome-negative chronic myeloid leukaemia: insertion of 5.6 Mb of 9q34 into the BCR region of chromosome 22. Hematol Oncol 2006; 24:86-8. [PMID: 16598834 DOI: 10.1002/hon.775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This report describes a chronic myelogenous leukaemia patient with an apparently normal bone marrow karyotype but BCR/ABL fusion-gene-positive. Commercial FISH probes showed an atypical pattern and the BCR/ABL fusion transcript was detected by RT-PCR, but not the reciprocal ABL/BCR. Consecutive FISH assays clarified the mechanism of the masked Ph. The ABL gene and the following 5.6-5.7 Mb of 9q are inserted into the BCR region of chromosome 22. There is no transference of 22q material to chromosome 9 or to any other chromosomes. Clinical features and evolution of the patient are similar to those cases with classic Ph chromosome.
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Affiliation(s)
- Laura Valle
- Familial Cancer Unit, Human Cancer Genetics Program, Centro Nacional de Investigaciones Oncológicas, Madrid, Spain.
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31
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Babicka L, Zemanova Z, Pavlistova L, Brezinova J, Ransdorfova S, Houskova L, Moravcova J, Klamova H, Michalova K. Complex chromosomal rearrangements in patients with chronic myeloid leukemia. ACTA ACUST UNITED AC 2006; 168:22-9. [PMID: 16772117 DOI: 10.1016/j.cancergencyto.2005.11.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2005] [Revised: 11/14/2005] [Accepted: 11/23/2005] [Indexed: 11/29/2022]
Abstract
During progression of chronic myeloid leukemia (CML) from the chronic to the accelerated phase and/or blast crisis, clonal evolution with nonrandom secondary aberrations such as +8, +Ph, i(17q), +19, -Y, +21, +17, and -7 is frequently observed. Complex chromosomal rearrangements (CCR) are rather rare, and the significance and frequency of different anomalies are poorly understood. The aim of this study was to determine the chromosomes and chromosomal regions which are involved in CCR during progression of the disease and the frequency of nonrandom changes. Conventional cytogenetics, FISH, and multicolor FISH (mFISH) were used to study karyotypes of 18 CML patients with CCR ascertained by G-banding. Most often involved in CCR were chromosomes 2 (x6); 3, 7, and 17 (x5); 1 and 4 (x4); and 5, 6, 11, and 12 (x3); regions 1q, 2q, 5q, 7p, and 17p; and breakpoints 17p11.2 (x3) and 7p15 (x2). There were no recurrent complex translocations. The present findings demonstrate the very high instability of the genome of malignant cells at the chromosomal level. Precise determination of breakpoints involved in CCR can give new dimension to the understanding of genetic mechanisms which play role in progression of malignant disease.
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Affiliation(s)
- Libuse Babicka
- Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General Faculty Hospital and 1st Medical Faculty, Charles University, U Nemocnice 2, 128 08 Prague 2, Prague, Czech Republic.
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32
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Gebhart E. Double minutes, cytogenetic equivalents of gene amplification, in human neoplasia - a review. Clin Transl Oncol 2006; 7:477-85. [PMID: 16373058 DOI: 10.1007/bf02717000] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Double minutes are tiny spherical chromatin bodies of a few mega-base pairs of size which are found occasionally in hematopoietic neoplasia and more or less often in human solid tumors. They have been associated with worse prognosis and poor outcome of the malignancies where present. With the beginning era of molecular cytogenetics they could be defined as cytogenetic equivalents of amplified DNA sequences. The identification of involved chromosomal segments and their molecular nature led to the development of molecular genetic techniques for a rapid and reliable detection of prognostically important oncogene amplifications in human tumors and,as a consequence, to gene-targeted therapy.
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Affiliation(s)
- Erich Gebhart
- Institute of Human Genetics, University of Erlangen-Nürnberg, Germany.
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33
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Cerveira N, Torres L, Ribeiro FR, Henrique R, Pinto A, Bizarro S, Ferreira AM, Lopes C, Teixeira MR. Multimodal genetic diagnosis of solid variant alveolar rhabdomyosarcoma. ACTA ACUST UNITED AC 2006; 163:138-43. [PMID: 16337856 DOI: 10.1016/j.cancergencyto.2005.06.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Revised: 06/27/2005] [Accepted: 06/28/2005] [Indexed: 11/26/2022]
Abstract
The most common types of rhabdomyosarcoma (RMS) are alveolar RMS (ARMS), which are characterized by the specific translocation t(2;13)(q35;q14) or its rarer variant, t(1;13)(p36;q14), producing the fusion genes PAX3-FKHR and PAX7-FKHR, respectively, and embryonal RMS (ERMS), which is characterized by multiple numeric chromosome changes. A solid variant of ARMS that is morphologically indistinguishable from ERMS has been described recently. We present two cases with an initial histopathologic diagnosis of ERMS in which the combined findings by cytogenetic, reverse-transcriptase polymerase chain reaction (RT-PCR), and comparative genomic hybridization (CGH) analyses demonstrate that both tumors were in fact the solid variant of ARMS. The cytogenetic analysis of patient 1 revealed a t(2;13)(q35;q14) and the RT-PCR study detected the corresponding PAX3-FKHR chimeric transcript. In patient 2, the cytogenetic finding of multiple trisomies was compatible with the initial histopathologic diagnosis of ERMS, but the finding of a PAX7-FKHR fusion transcript by RT-PCR pointed to the diagnosis of ARMS. Interestingly, the CGH findings of this case reconciled the molecular and cytogenetic data by detecting, in addition to the trisomies, amplification of chromosomal bands 1p36 and 13q14, where the PAX7 and FKHR genes are located, respectively. Our data indicate that this multimodal genetic analysis could be important for the differential diagnosis of these tumors. Furthermore, our findings and previous studies indicate that there are no apparent genetic differences between solid variant and typical ARMS.
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MESH Headings
- Base Sequence
- Child, Preschool
- Chromosome Banding
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 13
- Chromosomes, Human, Pair 2
- DNA Primers
- Forkhead Box Protein O1
- Forkhead Transcription Factors/genetics
- Humans
- Karyotyping
- Male
- Nucleic Acid Hybridization
- PAX3 Transcription Factor
- PAX7 Transcription Factor/genetics
- Paired Box Transcription Factors/genetics
- RNA, Messenger/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Rhabdomyosarcoma, Alveolar/diagnosis
- Rhabdomyosarcoma, Alveolar/genetics
- Translocation, Genetic
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Affiliation(s)
- Nuno Cerveira
- Department of Genetics, Portuguese Oncology Institute, Porto, Portugal
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34
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Haltrich I, Kost-Alimova M, Kovács G, Kriván G, Tamáska J, Klein G, Fekete G, Imreh S. Jumping translocation of 17q11∼qter and 3q25∼q28 duplication in a variant Philadelphia t(9;14;22)(q34;q32;q11) in a childhood chronic myelogenous leukemia. ACTA ACUST UNITED AC 2006; 164:74-80. [PMID: 16364767 DOI: 10.1016/j.cancergencyto.2005.06.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2005] [Revised: 06/01/2005] [Accepted: 06/02/2005] [Indexed: 11/24/2022]
Abstract
The virtually obligatory presence of the Philadelphia chromosome may suggest a causal homogeneity, but chronic myelogenous leukemia (CML) is a clinically heterogeneous disease. This may be a consequence of the variable BCR breakpoints on chromosome 22 and of nonrandom secondary chromosomal abnormalities. We present the case of a boy, age 12, investigated in blastic phase of CML. Karyotyping with conventional and multiplex fluorescence in situ hybridization (FISH and M-FISH) karyotyping, complemented with reverse transcriptase-polymerase chain reaction, identified a variant Philadelphia translocation t(9;14;22)(q34;q32;q11) involving a cryptic BCR/ABL fusion with formation of the p190(Bcr-Abl) oncoprotein. M-FISH revealed also an unbalanced jumping translocation of 17q11 approximately qter alternatively present on chromosomes 14 or 20, apparently hithertofore unreported in hematological malignancies. Another secondary aberration, dup(3)(q25q28), was revealed by multipoint interphase FISH (mpI-FISH). Gain of this region is known in adult hematological malignancies and solid tumors, suggesting its general involvement in tumor initiation or progression (or both), regardless of tissue origin.
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Affiliation(s)
- Irén Haltrich
- Semmelweis University, Faculty of Medicine, II. Department of Pediatrics, Budapest, Hungary
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35
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Robinson HM, Martineau M, Harris RL, Barber KE, Jalali GR, Moorman AV, Strefford JC, Broadfield ZJ, Cheung KL, Harrison CJ. Derivative chromosome 9 deletions are a significant feature of childhood Philadelphia chromosome positive acute lymphoblastic leukaemia. Leukemia 2005; 19:564-71. [PMID: 15716990 DOI: 10.1038/sj.leu.2403629] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Deletions from the derivative chromosome 9, der(9), of the translocation, t(9;22)(q34;q11), at the site of the ABL/BCR fusion gene, have been demonstrated by fluorescence in situ hybridisation (FISH), in both Philadelphia chromosome (Ph)-positive chronic myeloid leukaemia (CML) and acute lymphoblastic leukaemia (ALL). In CML they occur in 10-15% of cases and appear to indicate a worse prognosis, whereas in ALL, the situation is unclear. This study presents the findings of dual fusion FISH used to detect such deletions in a series of 27 BCR/ ABL-positive childhood ALL patients. Metaphase FISH was essential for the accurate interpretation of interphase FISH signal patterns. Three cases (11%) had a single fusion signal, resulting from deletions of the der(9). Three other patients with variant translocations and one with an insertion, also had a single fusion, but with no evidence of deletions. Gain of a fusion in approximately one-third of patients indicated a second Ph, which appears to be a diagnostic marker of Ph-positive ALL. This study shows that the incidence of deletions from the der(9) in childhood ALL is at least as high as that reported for CML.
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Affiliation(s)
- H M Robinson
- Leukaemia Research Fund Cytogenetics Group, Cancer Sciences Division, University of Southampton, Southampton, UK
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36
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Tefferi A, Dewald GW, Litzow ML, Cortes J, Mauro MJ, Talpaz M, Kantarjian HM. Chronic myeloid leukemia: current application of cytogenetics and molecular testing for diagnosis and treatment. Mayo Clin Proc 2005; 80:390-402. [PMID: 15757021 DOI: 10.4065/80.3.390] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Chronic myeloid leukemia provides an illustrative disease model for both molecular pathogenesis of cancer and rational drug therapy. Chronic myeloid leukemia is a clonal stem cell disease caused by an acquired somatic mutation that fuses, through chromosomal translocation, the abl and bcr genes on chromosomes 9 and 22, respectively. The bcr/abl gene product is an oncogenic protein that localizes to the cytoskeleton and displays an up-regulated tyrosine kinase activity that leads to the recruitment of downstream effectors of cell proliferation and cell survival and consequently cell transformation. Such molecular information on pathogenesis has facilitated accurate diagnosis, the development of pathogenesis-targeted drug therapy, and most recently the application of molecular techniques for monitoring minimal residual disease after successful therapy. These issues are discussed within the context of clinical practice.
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MESH Headings
- Antimetabolites, Antineoplastic/therapeutic use
- Antineoplastic Agents/therapeutic use
- Benzamides
- Cytarabine/therapeutic use
- Genes, abl/genetics
- Humans
- Imatinib Mesylate
- In Situ Hybridization, Fluorescence
- Interferon-alpha/therapeutic use
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Neoplasm, Residual/diagnosis
- Philadelphia Chromosome
- Piperazines/therapeutic use
- Prognosis
- Pyrimidines/therapeutic use
- Reverse Transcriptase Polymerase Chain Reaction
- Stem Cell Transplantation
- Treatment Outcome
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Affiliation(s)
- Ayalew Tefferi
- Department of Internal Medicine and Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA
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37
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Tosi S, Ballabio E, Teigler-Schlegel A, Boultwood J, Bruch J, Harbott J. Characterization of 6q abnormalities in childhood acute myeloid leukemia and identification of a novel t(6;11)(q24.1;p15.5) resulting in aNUP98-C6orf80 fusion in a case of acute megakaryoblastic leukemia. Genes Chromosomes Cancer 2005; 44:225-32. [PMID: 16028218 DOI: 10.1002/gcc.20233] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Chromosome abnormalities of 6q are not frequently observed in myeloid disorders. In this article, we report the incidence of these chromosome changes in childhood myeloid leukemia as 2%-4% based on the cytogenetic database of a single institution. We applied fluorescence in situ hybridization (FISH) to characterize precisely the types of 6q abnormalities in seven patients (six with acute myeloid leukemia and one with myelodysplastic syndrome). They carried various translocations involving different breakpoints in 6q, as confirmed by FISH using a whole-chromosome-6 paint. Four cases were reported as t(6;11), although the breakpoints varied. Among these, we identified a novel translocation, t(6;11)(q24.1;p15.5), in a patient with acute megakaryoblastic leukemia. Molecular cytogenetic studies using the PAC clone RP5-1173K1 localized the genomic breakpoint on chromosome 11 to within the NUP98 gene. The breakpoint on chromosome 6 was narrowed down to a 500-kb region between BAC clones RP11-721P14 and RP11-39H10. Reverse-transcription PCR was performed using a forward primer specific for NUP98 and a reverse primer for the candidate gene in the 500-kb interval in 6q. This experiment resulted in the identification of a new fusion between NUP98 and C6orf80. Further studies will aim to fully characterize C6orf80 and will elucidate the role of this new NUP98 fusion in myeloid leukemia.
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MESH Headings
- Acute Disease
- Adolescent
- Amino Acid Sequence
- Base Sequence
- Child
- Child, Preschool
- Chromosome Breakage
- Chromosomes, Artificial, Bacterial
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 6/genetics
- Cytogenetic Analysis
- DNA, Neoplasm/analysis
- Humans
- In Situ Hybridization, Fluorescence
- Infant
- Leukemia, Myeloid/genetics
- Molecular Sequence Data
- Nuclear Pore Complex Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- RNA, Neoplasm/analysis
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic
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Affiliation(s)
- Sabrina Tosi
- Leukaemia Research Fund Molecular Haematology Unit, Nuffield Department of Clinical Laboratory Science, John Radcliffe Hospital, Oxford, United Kingdom.
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