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Duek A, Trakhtenbrot L, Amariglio N, Benyamini N, Zilbershats I, Ganzel C, Shevetz O, Leiba R, Rozic G, Nagler A, Leiba M. Newly diagnosed multiple myeloma patients carrying monoallelic deletion of the whole locus of immunoglobulin heavy chain gene have a better prognosis compared to those with t(4;14) and t(14;16). Genes Chromosomes Cancer 2019; 58:516-520. [PMID: 30675954 DOI: 10.1002/gcc.22738] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 01/20/2019] [Accepted: 01/21/2019] [Indexed: 11/08/2022] Open
Abstract
The current study evaluated the prognostic significance of the monoallelic deletion of the whole locus of the immunoglobulin heavy-chain (w_del(IGH)) gene compared to translocations t(4;14) and t(14;16) among newly diagnosed multiple myeloma (MM) patients. We retrospectively analyzed clinical (age, gender, and staging) and laboratory data at diagnosis and the overall survival (OS) of 255 newly diagnosed MM patients carrying w_del(IGH) or translocations t(4;14) or t(14;16). Bone marrow samples were examined by morphological and sequential interphase fluorescense in situ hybridization analyses. Among 255 patients, 117 (45.8%) had w_del(IGH), 99 (38.8%) had t(4;14), and 39 (15.3%) had t(14;16). Mean age was 61.6 ± 11.6 years. Groups did not differ significantly in age, gender, or lactate dehydrogenase levels. Patients in the w_del(IGH) group presented more frequently at International Staging System stage I than at stage II/III. Patients in the w_del(IGH) group had significantly fewer additional chromosomal aberrations (1.58) than the other two groups (2.3 and 2.13 in the del(IGH), t(14;16) and t(4;14) groups, respectively, P < 0.0001). Furthermore, the w_del(IGH) group had significantly longer estimated median OS (9.47 years) compared to those with translocations t(14;16) (3.02 years, P = 0.002) or t(4;14) (4.18 years, P = 0.001), respectively. These findings suggest a potential prognostic significance of monoallelic deletion of IGH among these patients. Additional studies are needed to better understand the nature and mechanism of this prognostic factor.
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Affiliation(s)
- Adrian Duek
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Luba Trakhtenbrot
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel.,Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ninette Amariglio
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel.,Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Noam Benyamini
- Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
| | | | - Chezi Ganzel
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Olga Shevetz
- Department of Hematology, Kaplan Medical Center, Rehovot, Israel
| | | | - Gabriela Rozic
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel.,Department of Molecular Biology, Ariel University, Ariel, Israel
| | - Arnon Nagler
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Merav Leiba
- Division of Hematology and Bone Marrow Transplantation, The Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel-Aviv University, Israel.,Division of Hematology, Assuta Ashdod University Hospital, and Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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2
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Leiba M, Duek A, Amariglio N, Avigdor A, Benyamini N, Hardan I, Zilbershats I, Ganzel C, Shevetz O, Novikov I, Cohen Y, Ishoev G, Rozic G, Nagler A, Trakhtenbrot L. Translocation t(11;14) in newly diagnosed patients with multiple myeloma: Is it always favorable? Genes Chromosomes Cancer 2016; 55:710-8. [DOI: 10.1002/gcc.22372] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/02/2016] [Accepted: 05/03/2016] [Indexed: 12/20/2022] Open
Affiliation(s)
- Merav Leiba
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Adrian Duek
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Ninette Amariglio
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Abraham Avigdor
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Noam Benyamini
- Department of Hematology and Bone Marrow Transplantation; Rambam Health Care Campus; Haifa Israel
| | - Izhar Hardan
- Department of Hematology; Meir Medical Center; Kfar Saba Israel
| | | | - Chezi Ganzel
- Department of Hematology; Shaare Zedek Medical Center; Jerusalem Israel
| | - Olga Shevetz
- Department of Hematology; Kaplan Medical Center; Rehovot Israel
| | - Ilya Novikov
- Biostatistical Unit; Gertner Institute of Epidemiology and Health Policy Research; Ramat Gan Israel
| | - Yossi Cohen
- Department of Hematology; Laniyado Hospital; Netanya Israel
| | - Galina Ishoev
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Gabriela Rozic
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Arnon Nagler
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
| | - Luba Trakhtenbrot
- Division of Hematology and Bone Marrow Transplantation; and the Cancer Research Center, The Chaim Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University; Tel Aviv Israel
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3
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Oral lichen planus patients exhibit consistent chromosomal numerical aberrations: A follow-up analysis. Head Neck 2015; 38 Suppl 1:E741-6. [DOI: 10.1002/hed.24086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/12/2014] [Accepted: 04/14/2015] [Indexed: 11/07/2022] Open
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4
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Shani T, Primov-Fever A, Wolf M, Shalmon B, Amarglio N, Trakhtenbrot L, Hirshberg A. Noninvasive detection of aneuploid cells in laryngeal epithelial precursor lesions. Cancer Cytopathol 2011; 119:235-46. [DOI: 10.1002/cncy.20157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Revised: 03/11/2011] [Accepted: 03/17/2011] [Indexed: 01/22/2023]
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5
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Trakhtenbrot LY. Combined simultaneous analysis of morphology and fluorescence in situ hybridization as a novel sensitive method for detecting small populations of malignant cells in patients with a high risk of cancer, premalignant lesions, and minimal residual disease. RUSS J GENET+ 2010. [DOI: 10.1134/s1022795410100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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6
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Kreft A, Holtmann H, Schad A, Kirkpatrick CJ. Detection of residual leukemic blasts in adult patients with acute T-lymphoblastic leukemia using bone marrow trephine biopsies: comparison of fluorescent immunohistochemistry with conventional cytologic and flow-cytometric analysis. Pathol Res Pract 2010; 206:560-4. [PMID: 20413226 DOI: 10.1016/j.prp.2010.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 01/24/2010] [Accepted: 03/05/2010] [Indexed: 11/25/2022]
Abstract
Evaluation of remission in adult acute lymphoblastic leukemia (ALL) normally relies on cytologic evaluation and flow-cytometric analysis. The diagnostic impact of bone marrow trephine biopsies has not been studied so far. We investigated 26 biopsies of 16 patients with T-ALL. Double fluorescent immunostaining with TdT and CD3 was performed. Corresponding cytologic evaluation and flow-cytometric data were available. In 17 of 26 investigations, the results were concordant (either positive or negative). In one examination, residual blasts were not recognized by trephine biopsy, but by other methods. By contrast, in eight investigations, the leukemic blasts were found only in the bone marrow trephine biopsies. Regarding the evaluation of remission of T-ALL, in our retrospective study, bone marrow trephine biopsies with double immunostaining were found to be sensitive and specific for the detection of residual blasts. This method may add to the conventional cytology and flow-cytometric analysis.
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Affiliation(s)
- Andreas Kreft
- Institut für Pathologie, Klinikum der Johannes Gutenberg Universität, Langenbeckstr. 1, 55101 Mainz, Germany
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7
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Shani T, Onn A, Kabha A, Ben-Dov I, Adam I, Amariglio N, Yahalom R, Rechavi G, Trakhtenbrot L, Hirshberg A. Chromosomal numerical aberrations in apparently normal oral mucosa of heavy smokers affected by lung cancer. Oral Oncol 2009; 46:96-9. [PMID: 20004132 DOI: 10.1016/j.oraloncology.2009.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 10/25/2009] [Accepted: 10/26/2009] [Indexed: 11/25/2022]
Abstract
Cigarette smoke creates a field of injury in the epithelial lining of the entire respiratory tract causing an increased risk for the development of malignant lesions. It is conceivable, therefore, that early genetic alterations, can be detected in oral mucosa of heavy smokers mainly those affected by lung cancer. As aneuploidy was shown to be an early event in oral carcinogenesis, we aimed to investigate the prevalence of aneuploid cells (ACs) in samples obtained from apparently normal looking oral mucosa of heavy smokers affected by lung cancer (LC). Two brush samples were collected from the oral mucosa of 152 subjects; 31 heavy smokers with LC, 59 heavy smokers without LC and 62 never-smokers. The samples were simultaneously analyzed for morphology and fluorescent in situ hybridization (FISH) using chromosomes 2 and 8 centromeric probes. Over 2% ACs were found in 23% of heavy smokers with LC compared to 12% in heavy smokers without LC and 5% of the never-smokers group (P=0.015). A trend was also noticed when comparing the group of heavy smokers without LC with the never-smokers (P=0.198). We conclude that heavy smokers harbour detectable chromosomal numerical aberrations in oral epithelial cells of normal looking mucosa. These aberrations are more frequently found in heavy smokers affected by LC.
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Affiliation(s)
- Tali Shani
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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8
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Stanchescu R, Betts DR, Rechavi G, Amariglio N, Trakhtenbrot L. Involvement of der(12)t(12;21)(p13;q22) and as well as additional rearrangements of chromosome 12 homolog in ETV6/RUNX1-positive acute lymphoblastic leukemia. ACTA ACUST UNITED AC 2009; 190:26-32. [PMID: 19264230 DOI: 10.1016/j.cancergencyto.2008.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 11/20/2008] [Indexed: 12/18/2022]
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9
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Yamazaki J, Baba K, Goto-Koshino Y, Setoguchi-Mukai A, Fujino Y, Ohno K, Tsujimoto H. Quantitative assessment of minimal residual disease (MRD) in canine lymphoma by using real-time polymerase chain reaction. Vet Immunol Immunopathol 2008; 126:321-31. [PMID: 18977540 DOI: 10.1016/j.vetimm.2008.09.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 08/25/2008] [Accepted: 09/12/2008] [Indexed: 11/25/2022]
Abstract
Lymphoma is the most common hematopoietic malignancy in dogs. Although a large proportion of dogs with lymphoma can achieve clinical remission by initial chemotherapy, most dogs die as a consequence of tumor relapse. We established a quantitative detection system for minimal residual disease (MRD) in canine lymphoma by using real-time polymerase chain reaction (PCR). A canine T-cell lymphoma-derived cell line, namely, UL-1, was used to examine the specificity and sensitivity of the MRD detecting system. Allele-specific oligonucleotide primers and probes were designed based on the sequence of T-cell receptor gamma chain (TCRgamma) gene fragment of UL-1 cells in conjunction with its downstream sequence, which were obtained from the dog genome database. The real-time PCR system for plasmid DNA containing the TCRgamma gene derived from UL-1 cells and the genomic DNA of UL-1 cells revealed that the system was accurate for 10-100,000 copies per reaction and its sensitivity was 1 cell per 10,000 cells. In order to monitor the kinetics of tumor cell number in canine lymphoma, we quantified the level of MRD in the peripheral blood of 7 dogs with lymphoma under chemotherapy. Since the lymphoma cells from the 7 patients were shown to be B-cell origin from the finding of clonal rearrangement of immunoglobulin heavy chain (IgH) gene, allele-specific oligonucleotide primers and probes were prepared based on the sequence of rearranged IgH gene in each case. The number of peripheral blood tumor cells measured by the real-time PCR was comparable to that estimated by conventional hematological examination in 2 cases of stage V lymphoma. MRD in the peripheral blood was detectable in all 7 cases, even in the complete remission (CR) phase. In the 7 lymphoma dogs, changes in the MRD levels of peripheral blood generally paralleled with the changes in the volumes of lymph nodes. Molecular CR, in which the MRD level was below the detection limit, was not observed in any of these 7 patients under chemotherapy. The MRD level detected by the real-time PCR method described here would be useful for investigating the kinetics of tumor cell growth and its regression in canine lymphoma patients.
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Affiliation(s)
- Jumpei Yamazaki
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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10
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Koren-Michowitz M, Hardan I, Berghoff J, Yshoev G, Amariglio N, Rechavi G, Nagler A, Trakhtenbrot L. Chromosome 13q deletion and IgH abnormalities may be both masked by near-tetraploidy in a high proportion of multiple myeloma patients: A combined morphology and I-FISH analysis. Cancer Lett 2007; 255:307-14. [PMID: 17590504 DOI: 10.1016/j.canlet.2007.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2007] [Revised: 05/04/2007] [Accepted: 05/08/2007] [Indexed: 11/21/2022]
Abstract
Ploidy status and chromosomal aberrations involving chromosome 13q and the immunoglobulin heavy chain locus (IgH) are important prognostic features in multiple myeloma (MM). However, conventional cytogenetic studies are often not reveling and determination of plasma cells (PC) ploidy status in MM is technically difficult. We have used a combined cell morphology and interphase FISH (I-FISH) analysis in 184 consecutive BM samples from 136 MM patients for the diagnosis of chromosome 13q deletion [del (13q)] and IgH abnormalities. We have found a high prevalence (37%) of near-tetraploid (NT) PC in the BM samples studied. NT status of PC was verified with DNA index (DI) measurements. del (13q) was found in 69% and a total absence of one IgH copy (loss of IgH) in 20% of NT samples. We have shown that the presence of del (13q) and loss of IgH can be masked in NT cases: in 12 NT samples originally identified as normal for del (13q) the abnormality was obscured in the majority of plasma cells due to the presence of NT. Similarly, loss of IgH was masked in four samples with a large population of NT cells. Moreover, in one case the appearance of a 100% tetraploidy during disease progression masked the presence of del (13q), originally present, and could therefore falsely appear as disappearance of this prognostic marker. In conclusion, we have shown that a combination of three abnormalities, i.e., del (13q), loss of IgH and NT, all of potential prognostic significance, can be overlooked unless NT is specifically searched for and ruled out. Therefore, we suggest that a search for NT should be added to the routine BM assessment in MM patients.
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Affiliation(s)
- Maya Koren-Michowitz
- Division of Hematology, The Sheba Cancer Research Center, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.
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11
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Hirshberg A, Yarom N, Amariglio N, Yahalom R, Adam I, Stanchescu R, Ben-Dov I, Taicher S, Rechavi G, Trakhtenbrot L. Detection of non-diploid cells in premalignant and malignant oral lesions using combined morphological and FISH analysis - a new method for early detection of suspicious oral lesions. Cancer Lett 2007; 253:282-90. [PMID: 17386971 DOI: 10.1016/j.canlet.2007.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2006] [Revised: 02/02/2007] [Accepted: 02/05/2007] [Indexed: 11/15/2022]
Abstract
Alteration in DNA content is an early event in oral carcinogenesis. We have examined oral brush samples to detect non-diploid cells (NDC) using simultaneous morphological and cytogenetic analysis. The study included 8 oral squamous cell carcinomas (OSCC), 22 premalignant lesions (OPLs), and 25 control individuals. Slides stained with Giemsa followed by FISH using chromosome 2 centromeric DNA probe, were scanned and fluorescent signals were simultaneously analyzed in parallel with the morphology. The proportion of NDC increased with the severity of the diagnosis. In two control subjects, 1-1.5% of the examined cells were NDC. Over 2% NDC were present in all OSCC cases and in 11 of the OPLs, of which, in 8 the histologic diagnosis was either epithelial hyperplasia or mild dysplasia. A significant number of NDC had normal morphology when cytomorphology and FISH were compared. Two patients with OPLs developed OSCC these patients had a significant proportion of NDC. We suggest that the combined morphological and cytogenetic analysis of cells collected by a non-invasive brush sampling can enhance early detection of potentially malignant cells.
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Affiliation(s)
- Abraham Hirshberg
- Department of Oral Pathology and Oral Medicine, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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12
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Rothman R, Trakhtenbrot L, Bielorai B, Izraeli S, Ishoev G, Amariglio N, Rechavi G, Toren A. Co-existence of multiple subclones in TEL-AML1 at diagnosis of acute lymphoblastic leukaemia in association with submicroscopic deletion of AML1. Br J Haematol 2005; 129:491-8. [PMID: 15877731 DOI: 10.1111/j.1365-2141.2005.05479.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The TEL/AML1 (ETV6/RUNX1) fusion gene is the most common genetic rearrangement in paediatric acute lymphoblastic leukaemia (ALL). Although considered to be a low-risk leukaemia, it is associated with a relapse rate of 10-20%. The coexistence of different subclones at diagnosis, based on polymerase chain reaction (PCR) studies of IG/TCR gene rearrangement, with differential response to chemotherapy, was recently reported in this subtype of ALL. We wished to demonstrate such subclones at diagnosis by a recently developed technique of quantitative multiparametric fluorescence in situ hybridization (FISH). Bone marrow cells from 80 paediatric patients with ALL at diagnosis were analysed for the presence of the TEL/AML1 fusion gene by interphase FISH. Fourteen patients were positive for the translocation. Four of them had several subclones associated with various combinations of additional chromosomal abnormalities. The most striking was an atypical and unexpected hybridization pattern consistent with a submicroscopic deletion of the 5' region of the AML1 breakpoint. Other abnormalities included TEL deletion, trisomy and tetrasomy 21 as well as double TEL-AML1 fusion. The presence of numerous subclones in about 25% of patients with TEL/AML1+ ALL suggests extensive clonal evolution by the time of diagnosis.
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Affiliation(s)
- Rachel Rothman
- Department of Paediatric Haemato-Oncology and Institute of Haematology, The Edmond and Lily Safra Children Hospital, The Chaim Sheba Medical Centre, Tel-Hashomer, Israel
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13
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Raanani P, Trakhtenbrot L, Rechavi G, Rosenthal E, Avigdor A, Brok-Simoni F, Leiba M, Amariglio N, Nagler A, Ben-Bassat I. Philadelphia-chromosome-positive T-lymphoblastic leukemia: acute leukemia or chronic myelogenous leukemia blastic crisis. Acta Haematol 2005; 113:181-9. [PMID: 15870488 DOI: 10.1159/000084448] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2004] [Accepted: 12/13/2004] [Indexed: 11/19/2022]
Abstract
The Ph1 chromosome has rarely been reported in T-lineage acute lymphoblastic leukemia (T-ALL), and the clinical relevance of this translocation in T-ALL is currently unknown. In chronic myelogenous leukemia (CML) some data indicate derivation of T-cells from the leukemic clone and only a few cases of T-derived blastic crisis have been reported and quite often disputed. Particularly in cases identified initially in blastic crisis it may be difficult to distinguish those from Ph1-positive T-ALL. We herein report 2 patients who presented with a clinical picture of Ph1-positive T-ALL and who raised a differential diagnosis from T-cell blastic crisis of CML. We review the literature and suggest clinical and laboratory features that can help in the diagnosis. According to our literature review, 23 cases of Ph1-positive T-ALL and 44 cases of T-cell blastic crisis of CML, including ours, were reported. Some major differences between the two entities could help in establishing a diagnosis of Ph1-positive T-cell blastic crisis of CML vs. Ph1-positive T-ALL: Male sex and younger age was more predominant in T-ALL. While in most cases of CML blastic crisis there was a history of CML there was no such history in the T-ALL cases. Medullary involvement with lymphoblastic leukemia was present in all cases of T-ALL but only in about half of the cases of CML blastic crisis. None of the CML-blastic crisis cases tested by RT-PCR showed the minor breakpoint transcript, while 2 cases with T-ALL had the minor breakpoint transcript and 1 had both transcripts. Combined morphologic and FISH analysis can help to distinguish between the two entities and was applied in one of our cases. Although both entities carry a severe prognosis, differentiating between them might have clinical relevance, especially in the imatinib era.
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MESH Headings
- Blast Crisis/genetics
- Blast Crisis/pathology
- Cell Lineage/genetics
- Diagnosis, Differential
- Female
- 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-Lymphoma, Adult T-Cell/genetics
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Male
- Middle Aged
- Philadelphia Chromosome
- Reverse Transcriptase Polymerase Chain Reaction
- Translocation, Genetic/genetics
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Affiliation(s)
- Pia Raanani
- Institute of Hematology, Sheba Medical Center and Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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