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Affiliation(s)
- Irene Roberts
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine; University of Oxford, Centre for Haematology; Oxford UK
- Oxford BRC Blood Theme, NIHR Oxford Biomedical Centre; Oxford UK
- Department of Paediatrics; University of Oxford; John Radcliffe Hospital; Oxford UK
| | - Nicholas J. Fordham
- MRC Molecular Haematology Unit, Weatherall Institute of Molecular Medicine; University of Oxford, Centre for Haematology; Oxford UK
| | - Anupama Rao
- Great Ormond Street Hospital for Children; London UK
| | - Barbara J. Bain
- St Mary's Hospital campus of Imperial College London; St Mary's Hospital; London UK
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Reynaert N, Vandenberghe P, Boeckx N, Renard M, Uyttebroeck A, Labarque V. Translocation t(1;11)(q21;q23): a new finding in congenital acute myeloid leukemia. Leuk Lymphoma 2013; 55:1435-6. [DOI: 10.3109/10428194.2013.840778] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lineage switching in acute leukemias: a consequence of stem cell plasticity? BONE MARROW RESEARCH 2012; 2012:406796. [PMID: 22852088 PMCID: PMC3407598 DOI: 10.1155/2012/406796] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2012] [Accepted: 05/08/2012] [Indexed: 01/26/2023]
Abstract
Acute leukemias are the most common cancer in childhood and characterized by the uncontrolled production of hematopoietic precursor cells of the lymphoid or myeloid series within the bone marrow. Even when a relatively high efficiency of therapeutic agents has increased the overall survival rates in the last years, factors such as cell lineage switching and the rise of mixed lineages at relapses often change the prognosis of the illness. During lineage switching, conversions from lymphoblastic leukemia to myeloid leukemia, or vice versa, are recorded. The central mechanisms involved in these phenomena remain undefined, but recent studies suggest that lineage commitment of plastic hematopoietic progenitors may be multidirectional and reversible upon specific signals provided by both intrinsic and environmental cues. In this paper, we focus on the current knowledge about cell heterogeneity and the lineage switch resulting from leukemic cells plasticity. A number of hypothetical mechanisms that may inspire changes in cell fate decisions are highlighted. Understanding the plasticity of leukemia initiating cells might be fundamental to unravel the pathogenesis of lineage switch in acute leukemias and will illuminate the importance of a flexible hematopoietic development.
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Sato Y, Izumi Y, Minegishi K, Komada M, Yamada S, Kakui K, Tatsumi K, Mikami Y, Fujiwara H, Konishi I. Prenatal Findings in Congenital Leukemia: A Case Report. Fetal Diagn Ther 2011; 29:325-30. [DOI: 10.1159/000323582] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 12/14/2010] [Indexed: 11/19/2022]
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5
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Sung TJ, Lee DH, Kim SK, Jun YH. Congenital acute myeloid leukemia with t(8;16) and t(17;19) double translocation: case presentation and literature review. J Korean Med Sci 2010; 25:945-9. [PMID: 20514319 PMCID: PMC2877231 DOI: 10.3346/jkms.2010.25.6.945] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2008] [Accepted: 02/17/2009] [Indexed: 12/03/2022] Open
Abstract
Congenital leukemia is uncommon and excluding transient myeloproliferation associated with Down syndrome, makes up approximately 1% of childhood leukemias. A newborn boy was born with multiple subcutaneous nodules and large purpuric papules. Skin biopsy revealed proliferation of atypical hematologic cells in the dermis. Bone marrow morphology was consistent with acute myeloid leukemia (M5) and cytogenetic studies revealed t(8;16) and t(17;19) double translocation. Although prognosis of congenital leukemia is known to be dismal, recent reports showed spontaneous remissions. With the fear of chemotherapy-related toxicity, to treat or not to treat may be a dilemma both to parents and pediatricians. We report our experience and review the literature.
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MESH Headings
- Chromosomes, Human, Pair 16
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 19
- Chromosomes, Human, Pair 8
- Humans
- Immunophenotyping
- Infant, Newborn
- Karyotyping
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Male
- Translocation, Genetic
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Affiliation(s)
- Tae-Jung Sung
- Department of Pediatrics, College of Medicine, Hallym University Medical Center, Seoul, Korea.
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6
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Jiang JG, Roman E, Nandula SV, Murty VVS, Bhagat G, Alobeid B. CongenitalMLL-positive B-cell acute lymphoblastic leukemia (B-ALL) switched lineage at relapse to acute myelocytic leukemia (AML) with persistent t(4;11) and t(1;6) translocations and JH gene rearrangement. Leuk Lymphoma 2009; 46:1223-7. [PMID: 16085566 DOI: 10.1080/10428190500086055] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Congenital acute leukemia is a rare form of childhood leukemia, in which lineage conversion at relapse is very rarely reported. Here we describe a case of congenital B-cell acute lymphoblastic leukemia (B-ALL) with t(4;11) and t(1;6) translocations, which at relapse underwent a switch to monocytic lineage with persistence of the original cytogenetic translocations and clonal rearrangement of the JH gene. Similar to the other described cases of congenital acute leukemia with lineage conversion, our case had a MLL gene rearrangement and followed an aggressive clinical course.
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MESH Headings
- Burkitt Lymphoma/congenital
- Burkitt Lymphoma/diagnosis
- Burkitt Lymphoma/genetics
- Cell Lineage
- Chromosomes, Human, Pair 1/genetics
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 4/genetics
- Chromosomes, Human, Pair 6/genetics
- Cytogenetic Analysis
- Disease Progression
- Fatal Outcome
- Female
- Histone-Lysine N-Methyltransferase
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin J-Chains/genetics
- Immunophenotyping
- Infant, Newborn
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Myeloid-Lymphoid Leukemia Protein/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/congenital
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Prognosis
- Recurrence
- Translocation, Genetic
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Affiliation(s)
- Jie-Gen Jiang
- Department of Pathology, Columbia University, New York, NY 10032, USA
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7
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Ferguson EC, Talley P, Vora A. Translocation (6;17)(q23;q11.2): a novel cytogenetic abnormality in congenital acute myeloid leukemia? ACTA ACUST UNITED AC 2005; 163:71-3. [PMID: 16271959 DOI: 10.1016/j.cancergencyto.2005.03.016] [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] [Received: 02/07/2005] [Revised: 03/07/2005] [Accepted: 03/15/2005] [Indexed: 11/29/2022]
Abstract
Congenital leukemia occurring within 4 weeks of birth is extremely rare and, excluding transient neonatal myeloproliferation associated with Down syndrome, makes up approximately 1% of childhood leukemias. It is usually seen as acute myeloid leukemia (AML), most frequently French-American-British (FAB) types M4 and M5. Recurrent cytogenetic abnormalities have been reported in this group, and in approximately one third of cases the MLL gene at 11q23 is involved. These patients generally have a poor prognosis. We present a case of congenital leukemia (AML FAB type M1) with an acquired translocation between chromosomes 6 and 17.
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MESH Headings
- Chromosome Mapping
- Chromosomes, Human, Pair 17
- Chromosomes, Human, Pair 6
- Fatal Outcome
- Humans
- Infant, Newborn
- Infant, Premature
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/congenital
- Leukemia, Myeloid, Acute/genetics
- Male
- Translocation, Genetic
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Affiliation(s)
- Elspeth C Ferguson
- Department of Pediatric Haematology and North Trent Cytogenetics Service, Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, United Kingdom
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8
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Krawczuk-Rybak M, Zak J, Jaworowska B. A lineage switch from AML to ALL with persistent translocation t(4;11) in congenital leukemia. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 41:95-6. [PMID: 12764763 DOI: 10.1002/mpo.10276] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
MESH Headings
- Bone Marrow/pathology
- Cell Line, Transformed
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 4
- Fatal Outcome
- Female
- Humans
- Infant, Newborn
- Karyotyping
- Leukemia, Monocytic, Acute/congenital
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Monocytic, Acute/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Translocation, Genetic
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Abstract
The biological and clinical characteristics of perinatal leukemia differ significantly from those of leukemia in older children, and the prognosis is generally bleak. Once complete remission is achieved, neonates with acute myelocytic leukemia (AML) fare much better than those with acute lymphocytic leukemia (ALL). The results of this study suggest that age, sex, type of leukemia, and cytogenetic findings have a strong influence on outcome. Neonates, particularly females, with pre-B ALL have a much worse prognosis than neonates and older children with this disease. Transient leukemia in the Down syndrome neonate is associated with significant morbidity; close follow-up is recommended for at least the first 3 years of life because of the potential of developing acute leukemia, particularly AMKL (M7). The purpose of this review is to focus on the fetus and neonate in an attempt to determine the various ways leukemia differs clinically and morphologically from the disease occurring in older infants and children and to demonstrate that certain types of leukemia have a poor prognosis compared with those occurring in older children.
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Affiliation(s)
- Hart Isaacs
- Department of Pathology, Children's Hospital San Diego, California 92093-0612, USA.
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10
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Abstract
Our report concerns a neonate who was noted to have palpable kidneys soon after birth. Her clinical and radiologic findings were compatible with the diagnosis of autosomal recessive polycystic kidney disease. The patient eventually died of sepsis-related multiorgan failure, and on autopsy, surprisingly, was found to have leukemic infiltrates in the kidney. Healthcare providers need to be aware that congenital acute myelogenous leukemia, although rare, can present in the newborn period with nephromegaly.
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Affiliation(s)
- Lavjay Butani
- Section of Pediatric Nephrology, University of California, Davis Medical Center, Sacramento, California 95817, USA.
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11
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Morerio C, Rosanda C, Rapella A, Micalizzi C, Panarello C. Is t(10;11)(p11.2;q23) involving MLL and ABI-1 genes associated with congenital acute monocytic leukemia? CANCER GENETICS AND CYTOGENETICS 2002; 139:57-9. [PMID: 12547160 DOI: 10.1016/s0165-4608(02)00616-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Congenital, or perinatal, leukemias are rarely observed, but retrospective molecular studies seem to suggest a more frequent onset in prenatal life. Myelocytic types are common, and chromosome band 11q23 rearrangements at the MLL locus are characteristic genetic markers. The fusion of the MLL gene with one of its partners, ABI-1, has recently been described in two infant leukemia patients with monocytic involvement and good clinical outcome. We report a case of congenital monocytic leukemia with the same gene involvement and good response to chemotherapy. The blast metaphases were probed by fluorescence in situ hybridization, and t(10;11)(p11.2;q23) involving MLL and ABI-1 genes was demonstrated with the same breakpoint in ABI-1. The congenital presentation of this case suggests a possible relationship of this genetic event with in utero leukemogenesis.
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MESH Headings
- Adaptor Proteins, Signal Transducing
- Apgar Score
- Chromosome Mapping
- Chromosomes, Human, Pair 10
- Chromosomes, Human, Pair 11
- Cytoskeletal Proteins
- DNA-Binding Proteins/genetics
- Female
- Histone-Lysine N-Methyltransferase
- Homeodomain Proteins/genetics
- Humans
- Infant, Newborn
- Karyotyping
- Leukemia, Monocytic, Acute/congenital
- Leukemia, Monocytic, Acute/genetics
- Myeloid-Lymphoid Leukemia Protein
- Proto-Oncogenes
- Transcription Factors
- Translocation, Genetic
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Affiliation(s)
- Cristina Morerio
- Divisione di Ematologia ed Oncologia Pediatrica, Istituto Giannina Gaslini, Largo G. Gaslini 5, 16148, Genova, Italy
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Bresters D, Reus ACW, Veerman AJP, van Wering ER, van der Does-van den Berg A, Kaspers GJL. Congenital leukaemia: the Dutch experience and review of the literature. Br J Haematol 2002; 117:513-24. [PMID: 12028017 DOI: 10.1046/j.1365-2141.2002.03459.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We reviewed Dutch patients and those described in the literature with congenital leukaemia in the past 25 years, with the intention to obtain an overview of the characteristics of this rare disease. Among the 117 patients reviewed, acute myeloid leukaemia (AML) was more frequent (64%) than acute lymphoblastic leukaemia (ALL, 21%). Most patients had a high leukaemic cell load with hepatosplenomegaly, leukaemia cutis and hyperleucocytosis. Cytogenetic abnormalities were found in the majority of the patients tested (72%); 11q23 abnormalities were found in less than half of them (42%). The probability of overall survival at 24 months was only 23%. When congenital AML and ALL were compared, clinical characteristics and overall survival were not significantly different. However, in patients at risk, the probability of event-free survival (EFS) and disease-free survival (DFS) were significantly higher in AML than in ALL, 43% versus 13% and 68% versus 0% respectively. Among the congenital AML cases, six spontaneous remissions have been described. In conclusion, the clinical characteristics of congenital leukaemia differ from those of leukaemia in older children and prognosis is generally poor. Once complete remission is achieved, patients with AML fare better than those with ALL. Chemotherapy for congenital leukaemia needs improvement to increase the sustained remission rate.
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Affiliation(s)
- Dorine Bresters
- Department Pediatric Hematology/Oncology, VU University Medical Center, Amsterdam, The Netherlands.
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Somjee S, Sapre R, Shinde S, Kumar A, Dhond S, Badrinath Y, Mahadik S, Chougale A, Ansari R, Nair CN, Advani SH. Leukemia in infants. Indian J Pediatr 2002; 69:225-7. [PMID: 12003297 DOI: 10.1007/bf02734226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Acute Leukemia is rare in infants. It is characterized by non-specific symptomatology requiring a high index of suspicion on the part of a pediatrician for referral and diagnosis. It has peculiar biological features, unresponsiveness to treatment and poor prognosis. METHODS Eighteen infants with acute leukemia were seen during 1994 to 2001 and were analyzed on the basis of clinical and laboratory data. There were 13 cases of Acute Lymphoblastic Leukemia (ALL), 4 cases of Acute Myeloid Leukemia (AML) and one case remained unclassifiable, as the surface markers could not be done. Morphologically 9/13 cases of ALL were of FAB L1 type and remaining of L2 subtype, and 2/4 cases of AML were of FAB M1 type and remaining of M2 subtype. RESULT Clinical data was available completely only in 11 cases. Hyperleucocytosis was present in 4 cases, organomegaly in 8 cases and lympadenopathy in 5 cases. One patient presented with a chloroma in the retrorbital region although there was no parenchymal involvement of the brain. Immunophenotyping could be done in 13 cases, where 7 cases were diagnosed as CALLA positive-ALL (HLADR+, CD19+, CD10+), 2 cases as Early Pre-B ALL (HLADR+, CD19+, CD10 negative), one as T ALL (cCD3+, CD2+, CD7+) and 3 cases as AML (CD13+, CD33+, HLADR+). None of our patients received treatment.
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Affiliation(s)
- Saika Somjee
- Department of Medical Oncology, Tata Memorial Hospital, Parel, Mumbai, India.
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Mora J, Dobrenis AM, Bussel JB, Aledo A. Spontaneous remission of congenital acute nonlymphoblastic leukemia with normal karyotype in twins. MEDICAL AND PEDIATRIC ONCOLOGY 2000; 35:110-3. [PMID: 10918232 DOI: 10.1002/1096-911x(200008)35:2<110::aid-mpo4>3.0.co;2-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Congenital acute nonlymphoblastic leukemia (cANLL) is an extremely rare event and represents only 0.5-1% of the leukemias in the first year of life. It is usually more common among patients with chromosomal abnormalities. Transient myeloproliferative disease (TMD) is an hyperleukocytosis entity that occurs almost exclusively in Down syndrome patients and remits spontaneously. Spontaneous remission of congenital leukemia has been reported and related to the presence of an extra chromosome 21. PROCEDURE A pair of non-Down syndrome newborn twins presented with a clinical picture of skin rash and hyperleukocytosis. Twin B had full-blown cANLL with bone marrow, peripheral blood, skin, CSF, and placental invasion. Twin A presented transient peripheral blood and skin involvement by the same type of blast cells. No cytotoxic therapy was given. With 2 years follow-up, they continue to do well. RESULTS Histologic and immunophenotypical analysis of placentas, cord blood, skin, CSF, bone marrows, and peripheral blood revealed a consistent picture of intrautero cANLL in twin B, with transplacental invasion of twin A. Normal and blast cells were found to be karyotypically normal. Spontaneous remission occurred. CONCLUSIONS cANLL with karyotypically normal blasts can develop a self-limited clinical course, which has resemblances to TMD.
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Affiliation(s)
- J Mora
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
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