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Balducci E, Sanekli S, Hugues P, Soubeyrand M, Borie C, Fund X, Desterke C, Aumont C, Faivre J, Bennaceur-Griscelli A, Turhan AG. Co-occurrence of BCR-ABL1 rearrangement and CALR mutation in a single leukemic stem cell: evidence that BCR-ABL1 oncogenic addiction prevails over CALR signaling. Leuk Lymphoma 2019; 61:209-212. [PMID: 31464171 DOI: 10.1080/10428194.2019.1658101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Estelle Balducci
- INSERM, Unité Mixte de Recherche (UMR) 935, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France
| | - Safa Sanekli
- INSERM, Unité Mixte de Recherche (UMR) 935, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Patricia Hugues
- INSERM, Unité Mixte de Recherche (UMR) 935, Villejuif, France
| | | | - Claire Borie
- Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France
| | - Xavier Fund
- Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France
| | - Christophe Desterke
- INSERM, Unité Mixte de Recherche (UMR) 935, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France
| | - Cédric Aumont
- Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Jamila Faivre
- Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France.,INSERM, UMR 785, Centre Hépato-Biliaire, Villejuif, France
| | - Annelise Bennaceur-Griscelli
- INSERM, Unité Mixte de Recherche (UMR) 935, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France.,INGESTEM-ESteam Pluripotent Stem Cell Infrastructure, Villejuif, France
| | - Ali G Turhan
- INSERM, Unité Mixte de Recherche (UMR) 935, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Paul Brousse, Villejuif, France.,Assistance Publique-Hôpitaux de Paris, Service D'Hématologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France.,INGESTEM-ESteam Pluripotent Stem Cell Infrastructure, Villejuif, France
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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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3
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Kanakasetty GB, Kuntejowdahalli L, Thanky AH, Dasappa L, Jacob LA, Mallekavu SB, Kumari P. Predictive and Prognostic Implications of Variant Philadelphia Translocations in CML: Experience From a Tertiary Oncology Center in Southern India. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2016; 17:52-59. [PMID: 27743980 DOI: 10.1016/j.clml.2016.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Revised: 08/28/2016] [Accepted: 09/08/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by Philadelphia (Ph) chromosome with classical t(9;22)(q34;q11) seen in up to 90% of cases. However 5% to 10% of patients who present with variant Ph translocations (vPh) have been an area of research for their significance in predicting response to various therapies including tyrosine kinase inhibitors as well as prognosticating survival outcomes for many years involving varied patient populations, with conflicting results. MATERIALS AND METHODS We retrospectively analyzed our data from January 2002 to December 2014. Patients with vPh in chronic phase of CML (CML-CP) were analyzed with respect to their demographic parameters, response to imatinib therapy, and survival and their data were compared with data of patients with classical Ph translocation (cPh). RESULTS Of 615 patients diagnosed with CML-CP, 72 patients (11.7%) showed vPh. Most common chromosomes involved in these translocations were 14 (13.9%), 11 (12.5%), 19 (9.7%), and 7 (8.3%). Rates of complete hematological response, complete cytogenetic response, and major molecular response were not statistically different between the groups. At 5 years, event-free survival, failure-free survival, progression-free survival, and overall survival were 60% versus 67.9%, 62.7% versus 69.7%, 84.7% versus 92.1%, and 87.5% versus 92.4%, respectively, in vPh and cPh. The differences in survival were statistically not significant. CONCLUSION To our knowledge, this is the largest series of variant translocations in CML-CP, pertaining to the Indian population. Our data suggest that the presence of vPh in CML has no significant effect in predicting response to imatinib as well as in prognosticating survival.
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Affiliation(s)
| | | | - Aditi Harsh Thanky
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India.
| | - Lokanatha Dasappa
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | - Linu Abraham Jacob
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | - Suresh Babu Mallekavu
- Department of Medical Oncology, Kidwai Memorial Institute of Oncology, Bengaluru, India
| | - Prasanna Kumari
- Department of Cytogenetics, Kidwai Memorial Institute of Oncology, Bengaluru, India
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4
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Kim MB, Kim C, Chung WS, Cho JH, Nam D, Kim SH, Ahn KS. The Hydrolysed Products of Iridoid Glycosides Can Enhance Imatinib Mesylate-Induced Apoptosis in Human Myeloid Leukaemia Cells. Phytother Res 2015; 29:434-43. [DOI: 10.1002/ptr.5272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 10/31/2014] [Accepted: 11/25/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Min-Beom Kim
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
| | - Chulwon Kim
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
| | - Won-Seok Chung
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
| | - Jae-Heung Cho
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
| | - Dongwoo Nam
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
| | - Sung-Hoon Kim
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
| | - Kwang Seok Ahn
- College of Korean Medicine; Kyung Hee University; 1 Hoegidong Dongdaemungu Seoul 130-701 Korea
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5
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Mendiola C, Ortega V, Tonk VS, Coviello JM, Velagaleti G. Complex/variant translocations in chronic myelogenous leukemia (CML): genesis and prognosis with 4 new cases. Exp Mol Pathol 2014; 97:105-10. [PMID: 24927873 DOI: 10.1016/j.yexmp.2014.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 06/09/2014] [Indexed: 11/15/2022]
Abstract
In 5-10% of cases with CML, variant or complex translocations (CT) are seen that may result in atypical fluorescence in situ hybridization signal patterns. Dual color, dual fusion fluorescence in situ hybridization (D-FISH) patterns are instrumental in identifying the genesis of these CT, but their prognostic implications remain controversial. The most common mechanism is a two-step process in which a standard two-way translocation (9;22) is followed by subsequent rearrangements involving other chromosomes. The second common mechanism is the one-step process wherein breakage occurs simultaneously on different chromosomes leading to CT. The typical D-FISH pattern seen with the one-step mechanism is 1F2G2R, while the pattern for the two-step mechanism can be variable (2F1G1R, 1F1G1R, 1F1G2R, 1F2G1R, etc.). We have studied 4 cases of CT using metaphase FISH with triple color, dual fusion ASS1, ABL1 and BCR probes to understand the genesis of these CT. All the patients were treated with imatinib, but only patients 3 and 4 showed remission. Our results indicate that the CT in cases 1, 3 and 4 arose from a one-step mechanism and case 2 from a multi-step mechanism. Response to imatinib varied from full remission to no response. Long term follow-up is necessary to evaluate the prognostic implications of these CT.
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Affiliation(s)
- Christina Mendiola
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX, United States
| | - Veronica Ortega
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX, United States
| | - Vijay S Tonk
- Department of Pediatrics, Texas Tech University, Lubbock, TX, United States
| | - Jean M Coviello
- Department of Pathology, San Antonio Military Medical Center, San Antonio, TX, United States
| | - Gopalrao Velagaleti
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX, United States.
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6
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Al-Achkar W, Wafa A, Moassass F, Klein E, Liehr T. Multiple copies of BCR-ABL fusion gene on two isodicentric Philadelphia chromosomes in an imatinib mesylate-resistant chronic myeloid leukemia patient. Oncol Lett 2013; 5:1579-1582. [PMID: 23761821 PMCID: PMC3678658 DOI: 10.3892/ol.2013.1225] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Accepted: 06/12/2012] [Indexed: 11/06/2022] Open
Abstract
The so-called Philadelphia (Ph) chromosome is present in more than 90% of chronic myeloid leukemia (CML) cases. Amplification or duplication of the BCR-ABL gene has been found to be one of the key factors leading to drug resistance to imatinib mesylate (IM). In the present study, we identified the presence of isodicentric Ph chromosomes [idic(Ph)] in an IM-resistant patient. Fluorescence in situ hybridization (FISH) analysis on metaphase chromosomes confirmed the heterogeneity and amplification of the fused BCR-ABL gene. FISH analysis superimposed on G-banding confirmed the presence of idic(Ph) chromosomes. Reverse transcription-polymerase chain reaction (RT-PCR) products revealed the presence of the BCR-ABL fusion transcript b3a2. The idic(Ph) chromosomes in CML were shown to be fused at the satellite regions of the short arms. The patient did not respond to IM chemotherapy and did not achieve remission. In this study, the impact of the idic(Ph) chromosomes on genomic instability, heterogeneity and amplification of the BCR-ABL gene in IM-resistant patients is discussed.
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Affiliation(s)
- Walid Al-Achkar
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
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7
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Al-Achkar W, Wafa A, Moassass F, Liehr T. A unique cytogenetic abnormality, t(2;7)(p13.1;p21.3), in a Philadelphia-positive chronic myeloid leukemia. Oncol Lett 2012; 4:209-212. [PMID: 22844355 DOI: 10.3892/ol.2012.720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 02/29/2012] [Indexed: 11/05/2022] Open
Abstract
The Philadelphia (Ph) chromosome is present in more than 90% of patients suffering from chronic myeloid leukemia (CML). It is the product of a reciprocal translocation between the long arms of chromosomes 9 and 22, resulting in the transfer of the 3' portion of the proto-oncogene ABL from 9q34 to the 5' portion of the breakpoint cluster region (BCR) on 22q11. Currently, most CML cases are treated with Imatinib and variant rearrangements are thought to have no specific prognostic significance, although the events of therapy resistance have not yet been studied. In this study we report a novel case of CML exhibiting an uncommon t(2;7)(p13.1;p21.3) besides t(9;22)(q34;q11). This unusual translocation has been characterized by fluorescence in situ hybridization (FISH) and array-proven multicolor banding (aMCB), the latter being extremely significant in characterizing breakpoint regions in detail. The underlying mechanisms and prognostic implications of this cytogenetic abnormality are discussed in this study.
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Affiliation(s)
- Walid Al-Achkar
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
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8
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AL-ACHKAR WALID, WAFA ABDULSAMAD, MOASSASS FATEN, LIEHR THOMAS. A chronic myeloid leukemia case with a unique variant Philadelphia translocation: t(9;22;21)(q34;q11;p12). Oncol Lett 2012; 3:1027-1029. [PMID: 22783385 PMCID: PMC3389665 DOI: 10.3892/ol.2012.623] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2011] [Accepted: 07/25/2011] [Indexed: 11/05/2022] Open
Abstract
The so-called Philadelphia (Ph) chromosome is present in more than 90% of chronic myeloid leukemia (CML) patients. Approximately, 5-10% of these patients show complex translocations involving a third chromosome in addition to chromosomes 9 and 22. Since at present the majority of CML cases are treated with imatinib, variant rearrangements do not exhibit specific prognostic significance. However, events of therapy resistance remain to be studied. In this study, we report a unique case of CML exhibiting an uncommon t(21;22)(p12;q11). This translocation has been characterized by fluorescence in situ hybridization (FISH) and array-proven multicolor banding (aMCB). Using specific probes for the BCR and ABL genes, results of FISH showed a three-way variant Philadelphia translocation (9;22;21)(q34;q11;p12) with a BCR/ABL fusion residing on the der(22) and the 3'BCR region translocated on the short arm of the derivative chromosome 21. In addition, the aMCB technique is significant in the detection of the breakpoints of genetic changes. The underlying mechanisms and prognostic significance of these changes are discussed.
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Affiliation(s)
- WALID AL-ACHKAR
- Molecular Biology and Biotechnology Department, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - ABDULSAMAD WAFA
- Molecular Biology and Biotechnology Department, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - FATEN MOASSASS
- Molecular Biology and Biotechnology Department, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - THOMAS LIEHR
- Jena University Hospital, Institute of Human Genetics, Jena, Germany
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9
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Variant Philadelphia translocations: molecular-cytogenetic characterization and prognostic influence on frontline imatinib therapy, a GIMEMA Working Party on CML analysis. Blood 2011; 117:6793-800. [PMID: 21447834 DOI: 10.1182/blood-2011-01-328294] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Variant Philadelphia (Ph) chromosome translocations have been reported in 5%-10% of patients with newly diagnosed chronic myeloid leukemia (CML). Variant translocations may involve one or more chromosomes in addition to 9 and 22, and can be generated by 2 different mechanisms, 1-step and 2-step rearrangements, as revealed by fluorescence in situ hybridization. The prognostic significance of the occurrence of variant translocations has been discussed in previous studies. The European LeukemiaNet recommendations do not provide a “warning” for patients with variant translocations, but there is limited information about their outcome after therapy with tyrosine kinase inhibitors. To identify the role of variant translocations in early chronic phase (CP) CML patients treated with imatinib mesylate, we performed an analysis in a large series of 559 patients enrolled in 3 prospective imatinib trials of the Gruppo Italiano Malattie EMatologiche dell'Adulto (GIMEMA) Working Party on CML. Variant translocations occurred in 30 patients (5%). Our data show that the presence of variant translocations has no impact on the cytogenetic and molecular response or on outcome, regardless of the involvement of different mechanisms, the number of involved chromosomes, or the presence of deletions. Therefore, we suggest that patients with variant translocations do not constitute a “warning” category in the imatinib era. This study is registered at www.clinicaltrials.gov as NCT00514488 and NCT00510926.
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10
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Kim MK, Mun YC, Seong CM, Chung WS, Huh J. [Variant Philadelphia chromosome identified by interphase fluorescence in situ hybridization (FISH) without evidence on G-banded karyotyping and metaphase FISH]. Korean J Lab Med 2011; 30:711-7. [PMID: 21157160 DOI: 10.3343/kjlm.2010.30.6.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
A variant Philadelphia chromosome (Ph) is generated from translocation of one or more partner chromosomes in addition to chromosomes 9 and 22. We have described the cases of 2 patients bearing variant Ph detected by interphase FISH but not detected by G-banded karyotyping and metaphase FISH. FISH was performed using BCR/ABL dual color dual fusion translocation probes (Abbott Molecular, USA). A 52-year-old man was diagnosed with acute leukemia of mixed phenotype. G-banded karyotyping showed 46,XY,t(9;22)(q34;q11.2)[12]/47,idem,+der(22)t(9;22)[5]/46,XY[3]. Interphase FISH revealed nuc ish(ABL1,BCR) × 3(ABL1 con BCR × 2)[329/450]/(ABL1,BCR) × 4(ABL1 con BCR × 3)[5/450]/(AL1,BCR) × 3(ABL1 con BCR × 1)[44/450]. Metaphase FISH showed ish (9;22)(ABL1+,BCR1+;BCR+,ABL+)[22]/der(22)(BCR+,ABL1+)[3]. The other case was that of a 31-yr-old male patient diagnosed with CML in the blastic phase. G-banded karyotyping of all 20 metaphase cells showed 47,XYYc,dup(1)(q21q32),del(7)(p11.2),t(9;22)(q34;q11.2). Interphase FISH revealed nuc ish(ABL1,BCR) × 3(ABL1 con BCR × 2)[254/600]/(ABL1,BCR) × 3(ABL1 con BCR × 1)[191/600]. Metaphase FISH showed ish t(9;22)(ABL1+,BCR+;BCR+,ABL1+)[16]. These results suggest that typical t(9;22) and variant Ph may coexist in the same patient, and interphase FISH may facilitate the detection of the variant Ph that cannot be detected by G-banded karyotyping alone.
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Affiliation(s)
- Mi Kyung Kim
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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11
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Gorusu M, Benn P, Li Z, Fang M. On the genesis and prognosis of variant translocations in chronic myeloid leukemia. ACTA ACUST UNITED AC 2007; 173:97-106. [PMID: 17321324 DOI: 10.1016/j.cancergencyto.2006.10.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2006] [Revised: 10/06/2006] [Accepted: 10/13/2006] [Indexed: 10/23/2022]
Abstract
Variant translocations involving 9q, 22q, and at least one additional genomic locus occur in 5-10% of patients with chronic myeloid leukemia (CML). The mechanisms for the formation of these variant translocations are not fully characterized. Studies on the prognosis of these variant translocations revealed conflicting results. In addition, deletions in the derivative chromosome 9 are reportedly more frequent among variant translocation cases. We analyzed cytogenetic and FISH data from 22 CML patients with variant translocations tested at our laboratory. Deletions were observed in 6 of the 14 cases with FISH data available (43%), consistent with the literature and higher than in typical translocation cases (12-15%). Sequential changes of 9q deletions are possible and could be acquired as the disease progresses in addition to simultaneous formation of the Philadelphia chromosome with the deletion. Variant translocation CML patients with a deletion showed a worse cytogenetic response 1 year after therapy than those without a deletion (P < 0.05). Variant translocations may be formed by either a one-step or a two-step mechanism. Proper assessment of the prognostic significance of variant translocations requires better categorization of these translocations based on their mechanisms of genesis and the deletion status.
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MESH Headings
- Chromosome Banding
- Chromosome Deletion
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Fusion Proteins, bcr-abl/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Models, Genetic
- Prognosis
- Translocation, Genetic
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Affiliation(s)
- Madhavi Gorusu
- Neag Comprehensive Cancer Center, University of Connecticut Health Center, MC1614, Farmington, CT 06030, USA
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12
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Fisher AM, Strike P, Scott C, Moorman AV. Breakpoints of variant 9;22 translocations in chronic myeloid leukemia locate preferentially in the CG-richest regions of the genome. Genes Chromosomes Cancer 2005; 43:383-9. [PMID: 15884100 DOI: 10.1002/gcc.20196] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
From 5% to 10% of 9;22 translocations in chronic myeloid leukemia (CML) are reported to occur in variant form, that is, with the involvement of other regions of the genome in 3-way or more rearrangements. The literature indicates that the alternative breakpoints are not distributed randomly in the genome but show hotspots. We present data on 289 unpublished cases of CML with variant 9;22 translocations having a total of 342 variant breakpoints, the largest independent series to date. We found that the distribution of breaks was in loose agreement with the literature but that some new hotspots were identified; furthermore, some published hotspots were not fully supported by our data. Moreover, when our 342 variant breakpoints were plotted against profiles of CG heterogeneity in the genome, a significant positive correlation between breakpoint locations and CG composition was observed. In an ancillary study, we compared the frequency of variant t(9;22) with that of variants of t(15;17) associated with acute promyelocytic leukemia (AML M3). We found that the frequency of the former, 9.3%, was significantly higher than that of the latter, 2.6%.
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MESH Headings
- Base Composition
- Chromosome Breakage
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Databases, Factual
- Genome, Human
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Acute/genetics
- Translocation, Genetic
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Affiliation(s)
- Andrew M Fisher
- Wessex Regional Genetics Laboratory, Salisbury District Hospital, UK.
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13
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El-Zimaity MMT, Kantarjian H, Talpaz M, O'Brien S, Giles F, Garcia-Manero G, Verstovsek S, Thomas D, Ferrajoli A, Hayes K, Nebiyou Bekele B, Zhou X, Rios MB, Glassman AB, Cortes JE. Results of imatinib mesylate therapy in chronic myelogenous leukaemia with variant Philadelphia chromosome. Br J Haematol 2004; 125:187-95. [PMID: 15059141 DOI: 10.1111/j.1365-2141.2004.04899.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Five to 10 per cent of patients with Philadelphia chromosome (Ph)-positive chronic myelogenous leukaemia (CML) have variant translocations involving chromosomes other than 9 and 22. We investigated the characteristics and outcome of patients with variant translocations treated with imatinib. Among 721 patients, 44 (6%) had variant translocations, involving one (n = 39) or two (n = 4) additional chromosomes. Nineteen patients (44%) were in chronic (12 previously untreated), 24 (55%) in accelerated and one (2%) in blastic phase. A major cytogenetic response was achieved in 14 (74%) patients treated in chronic phase and in 14 (58%) treated in accelerated phase. Six of 13 (46%) evaluable patients had deletion of derivative chromosome 9, and there was a trend for a lower response rate in these patients. We compared the 43 patients in chronic or accelerated phase to 678 patients with classic Ph treated with imatinib. The only significant difference in clinical characteristics was a higher frequency of accelerated phase among those with variant translocations (56%) compared with those with classic translocations (38%). No differences in outcome were evident. In a multivariate analysis, variant Ph translocations had no impact in response rate, overall survival or duration of response. We conclude that patients with variant Ph translocations have a similar prognosis to those with classic Ph translocations when treated with imatinib.
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Affiliation(s)
- Maha M T El-Zimaity
- Department of Leukaemia, M D Anderson Cancer Center, The University of Texas, 1515 Holcombe Boulevard, Houston, TX 77030, USA
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14
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Morel F, Herry A, Le Bris MJ, Morice P, Bouquard P, Abgrall JF, Berthou C, De Braekeleer M. Contribution of fluorescence in situ hybridization analyses to the characterization of masked and complex Philadelphia chromosome translocations in chronic myelocytic leukemia. ACTA ACUST UNITED AC 2003; 147:115-20. [PMID: 14623460 DOI: 10.1016/s0165-4608(03)00204-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Bone marrow samples from 112 patients with chronic myelocytic leukemia were investigated using cytogenetic methods. Fluorescent in situ hybridization (FISH) with whole-chromosome paints and BCR-ABL probes was used to confirm and/or complete the banding findings when a variant or a masked Philadelphia chromosome (Ph) translocation was found. Eight variant Ph translocations were identified. Three-way Ph translocations were found in seven patients. Chromosome 4 was involved in two of these cases and chromosomes 3, 11, 14, 17, and 16 in one case each; in the patient with chromosome 16 involvement, a ring of the translocated chromosome 9 was identified, that is r(9)t(9;16;22). The eighth patient had a five-way Ph translocation: t(2;9;16;22;22). The BCR-ABL fusion gene was detected on the Ph chromosome in all eight cases; two cases presented also a deletion of the 5' ABL region on the derivative chromosome 9. In the five-way translocation, the 3' DNA sequence of the ABL oncogene was fused with the 5' DNA sequence of the BCR gene on the Ph chromosome and the 5' end of ABL was inserted into the other chromosome 22. A masked Ph chromosome was identified in one of the 112 patients; it involved the insertion of the 3' ABL into BCR on an apparently normal chromosome 22, resulting in the BCR-ABL fusion gene. In conclusion, FISH analyses allowed not only a more accurate characterization of complex Ph translocations with subtle abnormalities and the identification of cryptic rearrangements, but also the recognition of deletion of the 5' ABL region, which could carry with it a poor prognosis.
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Affiliation(s)
- F Morel
- Service de Cytogénétique, Cytologie et Biologie de la Reproduction, CHU Morvan, Brest, France
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15
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Naumann S, Decker HJ. Genesis of variant philadelphia chromosome translocations in chronic myelocytic leukemia. ACTA ACUST UNITED AC 2003; 147:18-22. [PMID: 14580766 DOI: 10.1016/s0165-4608(03)00128-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The Philadelphia (Ph) chromosome is found in more than 90% of chronic myelocytic leukemia (CML) patients. In most cases, it results from the reciprocal t(9;22)(q34;q11), with the ABL proto-oncogene from 9q34 fused to the breakpoint cluster region (BCR) locus on 22q11. In 5%-10% of patients with CML, the Ph chromosome originates from variant translocations, involving various breakpoints in addition to 9q34 and 22q11. In our investigation, three CML cases with complex Ph translocations have been analyzed by G-banding and fluorescence in situ hybridization (FISH). FISH with breakpoint-spanning probes for the BCR and ABL genes revealed information about the genesis of complex Ph translocations. The occurrence of one fusion signal indicates a one-step mechanism (case 1). Two fusion signals indicate a two-step mechanism (case 2). Lack of signals indicates deletions of parts of the BCR and ABL genes or of adjacent regions (case 3).
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MESH Headings
- Adult
- Chromosome Banding
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Female
- Genetic Markers
- Genetic Variation
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Philadelphia Chromosome
- Proto-Oncogene Mas
- Translocation, Genetic
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Affiliation(s)
- Sabine Naumann
- Third Medical Clinic, Department of Hematology, Johannes Gutenberg University of Mainz, Germany
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16
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Reid AG, Swanton S, Grace C, Campbell LJ, Green AR, Nacheva EP. Double Philadelphia masquerading as chromosome 20q deletion - a new recurrent abnormality in chronic myeloid leukaemia blast crisis. Br J Haematol 2003; 123:442-8. [PMID: 14617003 DOI: 10.1046/j.1365-2141.2003.04606.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The most common abnormality of chromosome 20 in haematological malignancy is deletion of the long arm [del(20q)]. These interstitial deletions are variable in size and are seen in both premalignant haematological conditions and acute myeloid neoplasia. A commonly deleted region (CDR), mapped within the 20q11.2/q13.1 segment with an estimated size of 1.7 Mbp, is considered to present a primary genetic lesion marking a gene(s), the loss of which is responsible for the pathogenesis of these haematological disorders. While a small number of recurrent translocations involving chromosome 20 have also been reported, no recurrent aberration of this chromosome has been associated with myeloid disease progression. We present nine cases of Philadelphia (Ph)-positive chronic myeloid leukaemia (CML) in which deletions of chromosome 20 were also detected by conventional karyotyping. In six cases, fluorescent in situ hybridization (FISH) mapping confirmed a del(20q) which corresponded to the myeloid CDR. In the remaining three cases however, the presumed del(20q) marker was shown to be the result of an unbalanced translocation between band 20p11 and a second copy of the Ph chromosome. This new abnormality, termed dic(20;Ph) for short, was identical to a del(20)q by G-banding, and combined duplication of the breakpoint cluster region and Abelson murine leukaemia viral oncogene homologue (BCR-ABL) fusion with loss of the 20p11-pter segment. In all three cases, the dic(20;Ph) was associated with disease progression and therefore represents a new recurrent abnormality in CML blast crisis.
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Affiliation(s)
- Alistair G Reid
- Department of Haematology, University of Cambridge, Cambridge, UK
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17
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Normann AP, Egeland T, Madshus IH, Heim S, Tjønnfjord GE. CD7 expression by CD34+ cells in CML patients, of prognostic significance? Eur J Haematol 2003; 71:266-75. [PMID: 12950236 DOI: 10.1034/j.1600-0609.2003.00133.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of the study was to identify a unique immunophenotype of normal or Philadelphia chromosome positive (Ph+) CD34+ cells that might be used to purify normal CD34+ cells from chronic myelogenous leukemia (CML) patients. An immunophenotypical study of CD34+ bone marrow cells of 20 patients with CML at diagnosis and during hydroxyurea treatment, and 39 controls were performed. All patients were Ph+, two patients had variant translocations and three patients displayed cytogenetic signs of clonal evolution. The immature progenitor cell compartment (CD34+ HLA-DR- and CD34+ CD38- cells) was comparable. The CD34+ AC133+ progenitor cell compartment was decreased in CML patients. We found no difference for any of the adhesion molecules examined except for CD62L, where the percentage of CD34+ CD62L+ cells was decreased in CML patients. The number of myeloid progenitors (CD34+ CD33+) was increased at the expense of B-lymphoid progenitors (CD34+ CD10+ and CD34+ CD19+) in CML patients indicating that B-lymphopoiesis is inhibited in CML. The megakaryocytic (CD34+ CD61+) and erythroid (CD34+ CD71+) progenitors were increased in CML patients. The number of CD34+ CD7+ cells was also significantly increased (mean 25.3% vs. 4.9%). However, the level of CD7 expression was quite heterogeneous, and the patients could be separated into two populations according to CD7 expression (more or less than 20% CD7+ CD34+ cells). The Sokal and Hasford risk scores did not differ between CD34+ CD7- CML and CD34+ CD7+ CML, but all patients with signs of disease progression clustered in the CD34+ CD7+ population indicating that the level of CD7 expression on CD34+ cells may be of prognostic importance in CML.
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MESH Headings
- Adult
- Aged
- Antigens, CD34/biosynthesis
- Antigens, CD7/biosynthesis
- Cell Adhesion
- Female
- Flow Cytometry
- Humans
- Hydroxyurea/pharmacology
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- L-Selectin/biosynthesis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology
- Male
- Middle Aged
- Prognosis
- Stem Cells/cytology
- Time Factors
- Tumor Cells, Cultured
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Affiliation(s)
- Are P Normann
- Institute of Immunology, Rikshospitalet University Hospital, Oslo, Norway.
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18
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Reid AG, Huntly BJP, Grace C, Green AR, Nacheva EP. Survival implications of molecular heterogeneity in variant Philadelphia-positive chronic myeloid leukaemia. Br J Haematol 2003; 121:419-27. [PMID: 12716364 DOI: 10.1046/j.1365-2141.2003.04291.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The BCR-ABL fusion in chronic myeloid leukaemia (CML) is generated by the Philadelphia (Ph) translocation t(9;22) or, in 10% of patients, variants thereof (vPh). Deletion encompassing the reciprocal product (ABL-BCR) from the derivative chromosome 9 [der(9)] occurs in 15% of all patients, but with greater frequency in vPh patients. Reports of physical separation of ABL-BCR in non-deleted patients, as well as evolution from classical to variant Ph, introduce further heterogeneity to the vPh subgroup and raise the possibility that such translocations may herald disease progression. Survival analyses, however, have thus far yielded contradictory results. We assessed the frequency of der(9) deletions, ABL-BCR abrogation, cytogenetic evolution and cryptic rearrangement in a large cohort of 54 patients with vPh CML. Deletions encompassing ABL-BCR were detected in 37% of patients, consistent with a model in which a greater number of chromosome breaks increases the risk of genomic loss. The components of ABL-BCR were physically separated in a further 52% of patients while fused in the remaining 11%. Evolution from classical to vPh was demonstrated in three patients. The difference in survival, as indicated by Kaplan-Meier analysis, was marked between classical and vPh patients (105 vs 60 months respectively; P = 0.0002). Importantly, this difference disappeared when patients with deletions were removed from the analysis. Our study showed that, despite the existence of several levels of genomic heterogeneity in variant Ph-positive CML, der(9) deletion status is the key prognostic factor.
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MESH Headings
- Chromosomes, Human, Pair 9
- Cohort Studies
- Evolution, Molecular
- Fusion Proteins, bcr-abl/genetics
- Gene Deletion
- Gene Frequency
- Gene Rearrangement
- Genes, abl
- Humans
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Prognosis
- Survival Analysis
- Translocation, Genetic
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Affiliation(s)
- Alistair G Reid
- University College London, Department of Academic Haematology, London, UK
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19
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Willis MS, Wilson KS. Chronic Myelogenous Leukemia. Lab Med 2002. [DOI: 10.1309/v4kd-9c4a-3hrb-hajj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Monte S. Willis
- University of Texas Southwestern Medical Center, Department of Pathology, Dallas, TX
| | - Kathleen S. Wilson
- University of Texas Southwestern Medical Center, Department of Pathology, Dallas, TX
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20
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Bertorelle R, Bonaldi L, Bianchini E, Ramazzina E, Del Mistro A, Zamboni S, Chieco-Bianchi L, Paolini R. The e19a2 BCR/ABL fusion transcript with additional chromosomal aberrations on a new case of chronic myeloid leukemia (CML) of mild type. Leukemia 2001; 15:2003-4. [PMID: 11753631 DOI: 10.1038/sj.leu.2402292] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2001] [Accepted: 07/20/2001] [Indexed: 11/09/2022]
MESH Headings
- Chromosome Aberrations
- Cytogenetic Analysis
- Fusion Proteins, bcr-abl/genetics
- Gene Rearrangement/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- RNA, Messenger/genetics
- Thrombocytosis
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21
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Abstract
The standard Philadelphia (Ph) translocation t(9;22), its variants and a proportion of Ph-negative cases are positive for the BCR-ABL fusion gene, as determined by molecular analysis. Extensive deletions of chromosome 9 and 22 derived sequences around the translocation breakpoints on the derivative 9 are seen in 10-30% of patients at diagnosis and may confer a worse prognosis. Additional cytogenetic changes can occur in the few months before or during disease progression and are often specific for blast morphology; however, the molecular basis of the most common additional cytogenetic abnormalities is largely unknown. Cytogenetics is important for monitoring patient response to treatment but is increasingly being replaced by the more sensitive and less invasive techniques of RT-PCR and FISH.
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MESH Headings
- Antineoplastic Agents
- Bone Marrow Transplantation
- Chromosome Aberrations
- Cytogenetic Analysis
- Disease Progression
- Fusion Proteins, bcr-abl/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Philadelphia Chromosome
- Prognosis
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Affiliation(s)
- A Chase
- Wessex Regional Genetics Laboratory, Salisbury District Hospital, Salisbury, Wilts SP2 8BJ, UK
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22
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Emberger W, Behmel A, Tschernigg M, Seewann HL, Petek E, Kroisel PM, Wagner K. Chronic myeloid leukemia with a rare variant Philadelphia translocation: t(9;10;22)(q34;q22;q11). CANCER GENETICS AND CYTOGENETICS 2001; 129:76-9. [PMID: 11520571 DOI: 10.1016/s0165-4608(01)00417-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We report a 59-year-old, male, chronic myeloid leukemia patient with a rare variant Philadelphia (Ph) translocation t(9;10;22)(q34;q22;q11). Fluorescence in situ hybridization with whole chromosome paints was used to confirm the cytogenetic findings. With a BCR/ABL-specific probe, the known rearrangement on the derivative chromosome 22 was found. The prognostic implications as well as the relevance of the additional breakpoint region 10q22 are discussed.
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MESH Headings
- Chromosomes, Human, Pair 10
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Male
- Middle Aged
- Philadelphia Chromosome
- Translocation, Genetic
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Affiliation(s)
- W Emberger
- Institute of Medical Biology and Human Genetics, University of Graz, Harrochgasse 21/8, A-8010 Graz, Austria.
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23
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Reid A, Gribble SM, Huntly BJ, Andrews KM, Campbell L, Grace CD, Wood ME, Green AR, Nacheva EP. Variant Philadelphia translocations in chronic myeloid leukaemia can mimic typical blast crisis chromosome abnormalities or classic t(9;22): a report of two cases. Br J Haematol 2001; 113:439-42. [PMID: 11380413 DOI: 10.1046/j.1365-2141.2001.02778.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A range of fluorescent in situ hybridization techniques have been used to reveal hidden variant Philadelphia translocations in two cases of Ph-positive chronic-phase chronic myeloid leukaemia. In one patient, a highly complex variant Ph translocation affecting four chromosomes had resulted in the formation of structures with the appearance of i(17q) and +8. Misinterpretation of these karyotypes has direct clinical relevance. Our findings illustrate that even established cytogenetic abnormalities may contain cryptic abnormalities beyond the resolution of conventional cytogenetic methods.
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MESH Headings
- Aged
- Chromosome Banding
- Chromosomes, Human, Pair 1
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 9
- Diagnosis, Differential
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Metaphase
- Philadelphia Chromosome
- Translocation, Genetic
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Affiliation(s)
- A Reid
- Department of Haematology, University of Cambridge, Addenbrookes Hospital, Cambridge, UK
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24
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Verma RS, Chandra P. Clinical significance of reverse BCR/ABL gene rearrangement in Ph-negative chronic myelogenous leukemia. Leuk Res 2000; 24:631-5. [PMID: 10867140 DOI: 10.1016/s0145-2126(00)00034-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
MESH Headings
- Chromosomes, Human, Pair 9
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/metabolism
- Gene Rearrangement
- Humans
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Translocation, Genetic
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Affiliation(s)
- R S Verma
- Division of Molecular Medicine and Genetics, Department of Medicine, Wyckoff Heights Medical Center-New York Hospital, Weill Medical College of Cornell University, 375 Stockholm Street, Brooklyn, New York, NY 11237, USA
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25
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Guillaume B, Ameye G, Libouton JM, Dierlamm J, Vaerman JL, Straetmans N, Ferrant A, Verellen-Dumoulin C, Michaux L. Chronic myeloid leukemia with a rare variant Philadelphia translocation: t(9;22;21)(q34;q11;q22). CANCER GENETICS AND CYTOGENETICS 2000; 116:166-9. [PMID: 10640151 DOI: 10.1016/s0165-4608(99)00115-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A case of chronic myeloid leukemia displaying an uncommon t(21;22)(q22;q11) is reported. For the first time, this translocation has been characterized by fluorescence in situ hybridization (FISH) and the reverse transcriptase polymerase chain reaction (RT-PCR). FISH, with the use of whole-chromosome painting probes and probes specific for the BCR and ABL genes, showed a three-way variant Philadelphia translocation (9;22;21)(q34;q11;q22) with a BCR/ABL fusion residing on the der(22). In addition, RT-PCR demonstrated a b2a3 BCR/ABL fusion transcript. Underlying mechanisms and prognostic implications are discussed.
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MESH Headings
- Chromosome Banding
- Chromosomes, Human, Pair 21
- Female
- Fusion Proteins, bcr-abl/genetics
- Humans
- Hydroxyurea/therapeutic use
- In Situ Hybridization, Fluorescence
- Interferon-alpha/therapeutic use
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Middle Aged
- Philadelphia Chromosome
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- B Guillaume
- Centre de Génétique Médicale UCL, Brussels, Belgium
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26
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Konstantinidou P, Szydlo RM, Chase A, Goldman JM. Cytogenetic status pre-transplant as a predictor of outcome post bone marrow transplantation for chronic myelogenous leukaemia. Bone Marrow Transplant 2000; 25:143-6. [PMID: 10673671 DOI: 10.1038/sj.bmt.1702133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We have analysed pre-transplant cytogenetic findings in 418 patients with CML in pre-blastic phase who underwent allogeneic BMT between February 1981 and January 1998. Five different patient groups were identified: A = Philadelphia (Ph)+; B = Ph-, BCR-ABL+; C = variant Ph (VPh); D = Ph chromosome plus at least one of: trisomy 8, +Ph, chromosome 17 abnormalities and E = other abnormalities in addition to the Ph chromosome. There were two principal conclusions. Firstly, Ph- patients showed a better outcome, and VPh patients a worse outcome, than those with a standard Ph, both in terms of leukaemia-free survival (LFS) (76.9%, 22.1% and 31.9%) and the risk of treatment failure relative to those with a standard Ph (relative risks of 0.49 and 1.92, respectively). One contributing factor may be relapse: no Ph- patients relapsed, whereas all other groups showed similar probabilities of relapse at 5 years (range 33.0-44. 0%). Secondly, those with the additional changes of +8, +Ph and i(17q) did not show a worse outcome than those with no additional changes (5 year survival of 44.7% vs 51.8%; 5 year LFS of 40.6% vs 31.9%), whereas those with other additional changes may fare worst of all (40.4% and 16.0%, respectively). Bone Marrow Transplantation (2000) 25, 143-146.
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MESH Headings
- Adolescent
- Adult
- Bone Marrow Transplantation
- Child
- Child, Preschool
- Chromosome Aberrations
- Cytogenetic Analysis
- Disease-Free Survival
- Female
- Genetic Variation/genetics
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/blood
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/therapy
- Male
- Middle Aged
- Proportional Hazards Models
- Recurrence
- Retrospective Studies
- Risk Factors
- Treatment Failure
- Trisomy/genetics
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Affiliation(s)
- P Konstantinidou
- Department of Haematology, Imperial College School of Medicine, Hammersmith Hospital, London, UK
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27
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Yehuda O, Abeliovich D, Ben-Neriah S, Sverdlin I, Cohen R, Varadi G, Orr R, Ashkenazi YJ, Heyd J, Lugassy G, Ben Yehuda D. Clinical implications of fluorescence in situ hybridization analysis in 13 chronic myeloid leukemia cases: Ph-negative and variant Ph-positive. CANCER GENETICS AND CYTOGENETICS 1999; 114:100-7. [PMID: 10549264 DOI: 10.1016/s0165-4608(99)00067-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Thirteen chronic myeloid leukemia (CML) patients, 10 with variant Philadelphia (Ph) translocations and 3 Ph negative cases, were analyzed by fluorescence in situ hybridization (FISH) with the use of BCR and ABL cosmid probes and a chromosome 22 painting probe. In the variant Ph translocations, the BCR-ABL fusion gene was located on the Ph chromosome; in 1 CML Ph-negative patient, the BCR-ABL fusion gene was located on the Ph chromosome; and, in 2 patients, it was located on chromosome 9. The chromosome 22 painting probe was detected on the third-party chromosome of the variant translocation, and in none of the variant translocations was there any detectable signal on chromosome 9. In CML patients with clonal evolution of a simple Ph, a signal of the chromosome 22 painting probe was detected on the der(9) of the Ph translocation. It was concluded that the variant Ph translocations evolved simultaneously in a three-way rearrangement. The clinical parameters of the 13 patients were similar to those of a large group of CML patients with a simple Ph translocation. It is suggested that, to determine the prognosis of CML patients with a complex karyotype, FISH analysis with a chromosome 22 painting probe be performed.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Chromosome Painting
- Chromosomes, Human, Pair 22/genetics
- Chromosomes, Human, Pair 9/genetics
- Female
- Fusion Proteins, bcr-abl/genetics
- Genetic Variation/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/genetics
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/mortality
- Leukemia, Myeloid, Chronic, Atypical, BCR-ABL Negative/pathology
- Male
- Middle Aged
- Philadelphia Chromosome
- Prognosis
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Affiliation(s)
- O Yehuda
- Department of Human Genetics, Hadassah Hebrew University Hospital, Hadassah Hebrew University Medical School, Jerusalem, Israel
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