Abstract
Three cases of de novo acute B-cell lymphoblastic leukemia are presented, all with an unusual phenotype, involvement of translocation t(14;18) and additional chromosomal abnormalities, including translocation t(8;14) and deletion of chromosome 9. In contrast to normal FAB-L2 or FAB-L3 acute lymphoblastic leukemia (ALL), these leukemias did not express cytoplasmatic and membranous immunoglobulin. The combination of translocation t(14;18) and additional chromosomal events on the other chromosome 14 account for the lack of immunoglobulin expression. In one case a low grade follicular lymphoma was found next to a high grade Burkitt type ALL. The translocation t(14;18) takes place as a mistake in the VDJH joining in pre-B cells in the bone marrow. It is proposed that some cases of de novo ALL may arise as a blast crisis induced by genetic events, secondary to the primary t(14;18) translocation. This type of ALL seems to have a poor prognosis.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Adult
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Antigens, CD / metabolism
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Antigens, CD19
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Antigens, Differentiation / metabolism
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Antigens, Differentiation, B-Lymphocyte / metabolism
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Antigens, Neoplasm / metabolism
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Burkitt Lymphoma / genetics*
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Burkitt Lymphoma / immunology
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Burkitt Lymphoma / pathology
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Cell Membrane / immunology
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Chromosome Deletion
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Chromosomes, Human, Pair 14*
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Chromosomes, Human, Pair 18*
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Chromosomes, Human, Pair 8
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Chromosomes, Human, Pair 9
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Cytoplasm / immunology
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DNA Nucleotidylexotransferase / deficiency
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Humans
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Immunoglobulins / metabolism
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Immunophenotyping
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Lymphoma, Follicular / genetics
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Lymphoma, Follicular / immunology
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Lymphoma, Follicular / pathology
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Male
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Middle Aged
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Neprilysin
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Prognosis
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Translocation, Genetic*
Substances
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Antigens, CD
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Antigens, CD19
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Antigens, Differentiation
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Antigens, Differentiation, B-Lymphocyte
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Antigens, Neoplasm
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Immunoglobulins
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DNA Nucleotidylexotransferase
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Neprilysin