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Caporaso NE, Whitehouse J, Bertin P, Amos C, Papadopoulos N, Muller J, Whang-peng J, Tucker MA, Fleisher TA, Marti GE. A 20 Year Clinical and Laboratory Study of Familial B-Chronic Lymphocytic Leukemia in a Single Kindred. Leuk Lymphoma 2009; 3:331-42. [DOI: 10.3109/10428199109070277] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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2
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Abstract
Chronic lymphocytic leukemia (CLL) is well characterized clinically and immunophenotypically. Demonstration of a monotypic CD19+, CD5+ B-cell population is central to the diagnosis. We report 2 cases of biclonal CLL. Two elderly men were encountered with an absolute lymphocytosis consisting of the typical CD5+, CD19+, CD23+ B-cell population seen in CLL; however, immunoglobulin light chain restriction by flow cytometry was not apparent as B cells expressed kappa or lambda light chains without a clear monotypic population. Molecular genetic analysis of flow cytometry-sorted cells (kappa and lambda populations) revealed in both cases 2 monoclonal B-cell populations. The characterization of these cases and a review of the issues surrounding biclonal CLL are presented.
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MESH Headings
- Aged
- Antigens, Differentiation, B-Lymphocyte/analysis
- B-Lymphocyte Subsets/metabolism
- B-Lymphocyte Subsets/pathology
- Blotting, Southern
- Clone Cells
- DNA, Neoplasm/analysis
- Flow Cytometry
- Gene Rearrangement, B-Lymphocyte, Heavy Chain
- Humans
- Immunoglobulin Light Chains/analysis
- Immunoglobulin kappa-Chains/metabolism
- Immunoglobulin lambda-Chains/metabolism
- Immunophenotyping
- Karyotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/metabolism
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Polymerase Chain Reaction
- Tumor Cells, Cultured
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Affiliation(s)
- E D Hsi
- Department of Clinical Pathology, Cleveland Clinic Foundation, OH 44195, USA
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3
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Crossen PE, Morrison MJ. Aberrant rearrangements of the immunoglobulin heavy chain switch region in chronic B-cell leukemia. Leuk Lymphoma 1998; 31:559-65. [PMID: 9922046 DOI: 10.3109/10428199809057615] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Analysis of the organisation of the Cmu-switch region of the immunoglobulin heavy chain locus in B-lymphocytes from 80 patients with chronic B-cell leukemia revealed 25 patients with abnormal rearrangements that could not be explained by the normal recombination events that take place in B-lymphocytes. Detailed analysis with probes spanning the Cmu -switch region and various restriction digests localised the rearrangements in two thirds of the patients to a 1300 bp region at the 5' end of the switch region while in the remaining patients the rearrangements occurred in the switch region. The consequences of these aberrant rearrangements remain to be determined, but their clustering to a defined region of the switch region suggests a "hot spot" that may be involved in the aetiology of the disease.
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MESH Headings
- B-Lymphocytes/chemistry
- B-Lymphocytes/pathology
- Blotting, Southern
- DNA, Neoplasm/genetics
- Deoxyribonuclease HindIII
- Gene Rearrangement, B-Lymphocyte, Heavy Chain
- Genes, Immunoglobulin
- Humans
- Immunoglobulin Heavy Chains/genetics
- Immunoglobulin Switch Region/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Neoplastic Stem Cells/chemistry
- Neoplastic Stem Cells/pathology
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Affiliation(s)
- P E Crossen
- Cytogenetic and Molecular Oncology Unit Christchurch Hospital, New Zealand.
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4
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Abstract
Cytogenetic analysis of patients with chronic B-cell leukemia (B-CLL) indicates that 50% have chromosome abnormalities, while fluorescence in situ hybridization (FISH) and molecular techniques reveal an even higher incidence. Trisomy 12 and deletions or translocation of chromosome 13q14 are the most common abnormalities, but in neither case has the gene or genes involved in the abnormalities been identified. Combined FISH and immunophenotyping studies suggest that both abnormalities are secondary events in B-CLL. Other recurring chromosome abnormalities include 6q-, 11q- and 12p-, but the genes involved in these abnormalities have not been identified. Involvement of the BCL1, BCL2, and BCL3 genes has been reported, but the numbers are low and the cases tend to be atypical. Trisomy 12 in association with complex karyotypic abnormalities is associated with a poor prognosis, and FISH studies show a strong correlation between trisomy 12, atypical morphology, and advanced disease. Ten to 15% of patients have mutations of p53 which is associated with advanced disease, resistance to treatment, and poor survival.
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Affiliation(s)
- P E Crossen
- Cytogenetic and Molecular Oncology Unit, Christchurch Hospital, New Zealand
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Garcìa-Marco J, Matutes E, Morilla R, Ellis J, Oscier D, Fantes J, Catovsky D, Price CM. Trisomy 12 in B-cell chronic lymphocytic leukaemia: assessment of lineage restriction by simultaneous analysis of immunophenotype and genotype in interphase cells by fluorescence in situ hybridization. Br J Haematol 1994; 87:44-50. [PMID: 7947255 DOI: 10.1111/j.1365-2141.1994.tb04868.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We have studied the lineage restriction of trisomy 12 in six patients with B-cell chronic lymphocytic leukaemia (CLL) by simultaneous analysis of immunophenotype and fluorescence in situ hybridization (FISH) signals in single interphase cells. Fresh uncultured cells from each patient were immunophenotyped by the alkaline phosphatase anti-alkaline phosphatase method (APAAP) using monoclonal or polyclonal antibodies and hybridized with a chromosome 12 specific alpha-satellite DNA probe. In all cases trisomy 12 was restricted to the clonal B-cells, kappa positive or lambda positive, whereas T-cells (CD3 positive) and non clonal B-cells had only two chromosome 12 signals. Within the clonal B-cell population a large proportion of cells were disomic for chromosome 12, whilst trisomic cells ranged from 21% to 37%. The absence of trisomy 12 in T-cells and the mosaicism demonstrated in the clonal B-cells suggests that this abnormality is a secondary event during the leukaemic transformation of CLL and develops in an already established neoplastic B-cell population.
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Affiliation(s)
- J Garcìa-Marco
- Academic Department of Haematology and Cytogenetics, Royal Marsden Hospital, London
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Crossen PE, Tully SM, Benjes SM, Hollings PE, Beard ME, Nimmo JC, Morrison MJ. Oligoclonal B-cell leukemia characterized by spontaneous cell division and telomere association. Genes Chromosomes Cancer 1993; 8:49-59. [PMID: 7691159 DOI: 10.1002/gcc.2870080109] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Cytogenetic analysis of unstimulated cultures from a female patient with chronic B-cell leukemia (CLL) revealed three cytogenetically distinct clones, suggesting that the patient's leukemia was oligoclonal. Immunoglobulin heavy chain gene rearrangement studies revealed 1 germline and 4 rearranged bands, indicative of an oligoclonal leukemic population. Further evidence of oligoclonality was provided by X-linked RFLP studies. This is the first report of oligoclonality in CLL demonstrated by cytogenetic, immunoglobulin gene rearrangement, and X-chromosome inactivation studies. In addition to oligoclonality, the patient's leukemic cells exhibited telomere association, a Robertsonian translocation, and clonal evolution, suggesting an underlying genomic instability.
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MESH Headings
- Cell Division
- Cells, Cultured
- Chromosomes, Human, Pair 15
- Female
- Gene Rearrangement
- Genes, Immunoglobulin
- Humans
- Karyotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/blood
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Lymphocyte Activation
- Lymphocytes/immunology
- Lymphocytes/pathology
- Middle Aged
- Polymorphism, Restriction Fragment Length
- Sex Chromosome Aberrations
- Telomere/ultrastructure
- Translocation, Genetic
- X Chromosome
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Affiliation(s)
- P E Crossen
- Cytogenetic and Molecular Oncology Unit, Christchurch Hospital, New Zealand
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7
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Hakim I, Rechavi G, Brok-Simoni F, Grossman Z, Amariglio N, Mandel M, Ramot B, Ben-Bassat I, Katzir N. Analysis of rearranged immunoglobulin genes indicating a process of clonal evolution in chronic lymphocytic leukaemia. Br J Haematol 1993; 84:436-42. [PMID: 8217794 DOI: 10.1111/j.1365-2141.1993.tb03098.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Chronic lymphocytic leukaemia (CLL) is known to be a stable monoclonal neoplasm. In contrast to early studies demonstrating no more than two hybridizing immunoglobulin heavy chain bands corresponding to the two expected alleles, we have demonstrated an unexpected multiband pattern when the HindIII-digested DNA samples from 38 CLL patients were analysed by Southern blot hybridization using JH and C mu gene probes. In order to characterize the genetic basis for the multiband pattern, we molecularly cloned the immunoglobulin heavy chain genes of one of the patients whose leukaemic DNA sample demonstrated three hybridizing JH bands and a loss of the germline band. The cloned rearranged immunoglobulin genes could be divided, based on the restriction mapping and the hybridization with the various probes, into two basic patterns representing two alleles. In one of the cloned rearranged immunoglobulin genes a secondary rearrangement occurred that resulted in the addition of 300 base-pair long sequence into the switch region, and the creation of a HindIII restriction site. The results of the study suggest that clonal evolution occurs in some CLL, and that many of these neoplasms are indeed oligoclonal due to the accumulation of secondary genetic changes.
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Affiliation(s)
- I Hakim
- Institute of Haematology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
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8
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Kerim S, Geuna M, Francia di Celle P, Carbone A, Ponti R, Novero D, Foa R, Palestro G. Heterogeneous immunoglobulin gene rearrangement in a B-chronic lymphocytic leukemia progressing into non-Hodgkin lymphoma (Richter syndrome). Cancer 1993; 71:359-63. [PMID: 8422629 DOI: 10.1002/1097-0142(19930115)71:2<359::aid-cncr2820710215>3.0.co;2-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The relationship between chronic lymphocytic leukemia (CLL) and supervening non-Hodgkin lymphoma is debated, as is whether a particular genomic pattern is related to the emergence of the terminal lymphoma. To investigate these features, the molecular organization of the immunoglobulin (Ig) gene region in a case during both the B-CLL and Richter transformation phase was studied. METHODS B-CLL and non-Hodgkin lymphoma cells were processed for Southern blot analysis of Ig heavy- and light-chain gene configuration. RESULTS Molecular studies of B-CLL cells revealed the presence of a single Ig heavy-chain rearrangement with both kappa and lambda light-chain rearranged genes, which was consistent with the occurrence of multiple mutational events during the development of the B-CLL clone. Molecular analysis of the lymphoma DNA showed new Ig heavy- and kappa light-chain rearrangements in addition to the original ones related to the CLL phase, indicating that the lymphoma tissue consisted of two genotypically distinct populations of cells. CONCLUSIONS On the basis of the overall molecular configuration, this heterogeneous pattern of Ig gene rearrangement was interpreted as an inherent genetic instability of the CLL clone, in which multiple mutational events allowed a selective pressure toward more aggressive subclones, resulting in the emergence of the terminal lymphoma.
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MESH Headings
- Antigens, CD/analysis
- Gene Rearrangement
- Genes, Immunoglobulin
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Lymphoma, Non-Hodgkin/genetics
- Lymphoma, Non-Hodgkin/immunology
- Male
- Middle Aged
- Syndrome
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Affiliation(s)
- S Kerim
- Department of Biomedical Sciences and Human Oncology, University of Torino, Italy
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9
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Cuneo A, Wlodarska I, Sayed Aly M, Piva N, Carli MG, Fagioli F, Tallarico A, Pazzi I, Ferrari L, Cassiman JJ. Non-radioactive in situ hybridization for the detection and monitoring of trisomy 12 in B-cell chronic lymphocytic leukaemia. Br J Haematol 1992; 81:192-6. [PMID: 1643016 DOI: 10.1111/j.1365-2141.1992.tb08206.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Non-radioactive in situ hybridization (NISH) with a chromosome 12-specific alpha satellite probe was performed on 20 patients with chronic lymphocytic leukaemia (CLL) with normal karyotype (15 cases) or with inadequate mitotic yield (5 cases) from mitogen-stimulated cultures. All patients had over 70% lymphocytes coexpressing the CD5/CD23 antigens. While less than 1% interphase nuclei showed three fluorescent spots in 16/20 patients, evidence of trisomy 12 in 15-25% interphase cells was detected in four patients. According to the FAB classification the diagnosis in these patients was typical B-CLL, stage III (Rai's staging system) in one case, CLL/PLL, stage II and III in two cases, PLL, stage III in one case. In order to confirm these results, NISH was repeated after 1 month in one patient and after 2 years in three patients. All patients had been treated with chemotherapy in the period between the two NISH experiments. In all cases a 1.8-3-fold increase of percentage of trisomic interphase cells was detected. These findings suggest that in B-CLL clones with trisomy 12 may have proliferative advantage over clonal B-lymphocyte without +12 and, possibly, that they may be more resistant to chemotherapy. We conclude that NISH is a sensitive technique allowing for the detection and monitoring of trisomy 12 in a fraction of B-CLL patients with normal karyotype or with no analysable mitoses despite employment of polyclonal B-cell mitogens.
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MESH Headings
- Aged
- Chromosomes, Human, Pair 12
- Clone Cells
- DNA Probes
- Evaluation Studies as Topic
- Female
- Humans
- Interphase
- Karyotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Mitosis
- Nucleic Acid Hybridization
- Time Factors
- Trisomy
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Affiliation(s)
- A Cuneo
- Institute of Haematology, University of Ferrara, Italy
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Oscier D, Fitchett M, Herbert T, Lambert R. Karyotypic evolution in B-cell chronic lymphocytic leukaemia. Genes Chromosomes Cancer 1991; 3:16-20. [PMID: 2069906 DOI: 10.1002/gcc.2870030104] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Sequential cytogenetic studies were performed on a minimum of two and a maximum of nine occasions (mean 3.6) on the peripheral blood leucocytes of 112 patients with B-CLL. On initial cytogenetic analysis, 58 had a normal karyotype and 64 had a clonal abnormality. Karyotypic evolution occurred in 18 patients (16%). There was no significant difference in the incidence of disease progression between patients with a stable karyotype and those who underwent karyotypic evolution. In only one patient was there a clear association between disease progression, a change in cell morphology and karyotypic evolution.
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Affiliation(s)
- D Oscier
- Department of Haematology, Royal Victoria Hospital, Bournemouth, England
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