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Blood, 15 June 2004, Vol. 103, No. 12, pp. 4602-4609.
Prepublished online as a Blood First Edition Paper on March 9, 2004; DOI 10.1182/blood-2003-11-3857.


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IMMUNOBIOLOGY

Utilization of Ig heavy chain variable, diversity, and joining gene segments in children with B-lineage acute lymphoblastic leukemia: implications for the mechanisms of VDJ recombination and for pathogenesis

Aihong Li, Montse Rue, Jianbiao Zhou, Hongjun Wang, Meredith A. Goldwasser, Donna Neuberg, Virginia Dalton, David Zuckerman, Cheryl Lyons, Lewis B. Silverman, Stephen E. Sallan, and John G. Gribben, for the Dana-Farber Cancer Institute ALL Consortium

From the Division of Medical Oncology, Biostatistical Science, and Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Boston, MA; and Division Hematology/Oncology, Department of Medicine, The Children's Hospital, Harvard Medical School, Boston, MA.

Sequence analysis of the immunoglobulin heavy chain genes (IgH) has demonstrated preferential usage of specific variable (V), diversity (D), and joining (J) genes at different stages of B-cell development and in B-cell malignancies, and this has provided insight into B-cell maturation and selection. Knowledge of the association between rearrangement patterns based on updated databases and clinical characteristics of pediatric acute lymphoblastic leukemia (ALL) is limited. We analyzed 381 IgH sequences identified at presentation in 317 children with B-lineage ALL and assessed the VHDHJH gene utilization profiles. The DHJH-proximal VH segments and the DH2 gene family were significantly overrepresented. Only 21% of VH-JH joinings were potentially productive, a finding associated with a trend toward an increased risk of relapse. These results suggest that physical location at the VH locus is involved in preferential usage of DHJH-proximal VH segments whereas DH and JH segment usage is governed by position-independent molecular mechanisms. Molecular pathophysiology appears relevant to clinical outcome in patients who have only productive rearrangements, and specific rearrangement patterns are associated with differences in the tumor biology of childhood ALL. (Blood. 2004;103:4602-4609)


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