Abstract
Reciprocal chromosomal translocations involving the MLL gene at chromosome region 11q23 are recurring cytogenetic abnormalities in both de novo and therapy-related acute myeloid leukemia (AML) and in acute lymphoblastic leukemia. We report a t(4;11)(p12;q23) with rearrangement of MLL and FRYL (also known as AF4p12), a human homolog to the furry gene of Drosophila, in an adult patient with therapy-related AML after fludarabine and rituximab therapy for small lymphocytic lymphoma and radiation therapy for breast carcinoma. To our knowledge, t(4;11)(p12;q23) has been reported in two previous patients, and MLL and FRYL rearrangement was demonstrated in one of them. Both of the previous patients had therapy-related leukemias after exposure to topoisomerase II inhibitors, whereas our patient had received cytotoxic therapy that did not include a topoisomerase II inhibitor. Thus, t(4;11)(p12;q23) with MLL and FRYL involvement represents a new recurring 11q23 translocation, to date seen only in therapy-related acute leukemias.
Publication types
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Case Reports
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Research Support, N.I.H., Extramural
MeSH terms
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Acute Disease
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Chromosomes, Human, Pair 11 / genetics*
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Chromosomes, Human, Pair 4 / genetics*
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DNA-Binding Proteins / genetics*
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Female
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Gene Rearrangement*
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Histone-Lysine N-Methyltransferase
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Humans
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In Situ Hybridization, Fluorescence
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Karyotyping
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Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy
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Leukemia, Myeloid / chemically induced
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Leukemia, Myeloid / genetics*
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Middle Aged
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Myeloid-Lymphoid Leukemia Protein / genetics*
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Nuclear Proteins / genetics*
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Rituximab
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Transcriptional Elongation Factors
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Translocation, Genetic*
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Vidarabine / administration & dosage
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Vidarabine / analogs & derivatives
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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DNA-Binding Proteins
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KMT2A protein, human
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Nuclear Proteins
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Transcriptional Elongation Factors
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Myeloid-Lymphoid Leukemia Protein
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AFF1 protein, human
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Rituximab
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Histone-Lysine N-Methyltransferase
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Vidarabine
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fludarabine