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Therapy-related pro-B cell acute lymphoblastic leukemia: report of two patients with MLL amplification.

Abstract
Improvements in chemotherapy and medical support of patients treated with chemotherapy and radiation have led to an ever-increasing number of cancer survivors. Unfortunately, a small fraction of these patients develop secondary hematologic malignancies as a consequence of their exposure to genotoxic anti-cancer regimens. Most of these are myeloid malignancies, therapy-related acute myeloid leukemia (t-AML) or myelodysplasia (t-MDS); however, a small but growing body of literature exists, which describes therapy-related acute lymphoblastic leukemias (t-ALL). Nearly all these cases are reportedly associated with translocations involving chromosome 11q23, the site of the MLL gene. We herein report two cases of ALL occurring after chemotherapy for other malignancies that showed complex karyotypic abnormalities and distinct MLL amplification by fluorescence in situ hybridization analysis. Immunophenotypic analysis showed that both cases expressed a pro-B cell (CD10-) phenotype with aberrant myeloid antigen expression. Although MLL amplification has been reported in therapy-related myeloid disease, to our knowledge this is the first report of MLL amplification occurring in therapy-related B cell ALL.
AuthorsFrederick Racke, Carol Cole, Alison Walker, Jeffrey Jones, Nyla A Heerema
JournalCancer genetics (Cancer Genet) Vol. 205 Issue 12 Pg. 653-6 (Dec 2012) ISSN: 2210-7762 [Print] United States
PMID23238285 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2012 Elsevier Inc. All rights reserved.
Chemical References
  • Myeloid-Lymphoid Leukemia Protein
Topics
  • Aged, 80 and over
  • Bone Marrow (pathology)
  • Drug-Related Side Effects and Adverse Reactions
  • Gene Amplification (genetics)
  • Humans
  • Karyotyping
  • Male
  • Middle Aged
  • Myeloid-Lymphoid Leukemia Protein (genetics)
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma (chemically induced, genetics)
  • Precursor Cells, B-Lymphoid (pathology)
  • Staining and Labeling

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