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Clinical and laboratory characteristics of acute leukemia with the 4;11
translocation
J Mirro, G Kitchingman, D Williams, GJ Lauzon, CC Lin, T Callihan and TF Zipf
This report describes the clinical and laboratory features of seven cases
of acute leukemia associated with the 4;11 chromosomal translocation. All
seven children had acute lymphoblastic leukemia by standard morphologic and
cytochemical criteria. Leukemic blasts from six of seven patients were
terminal deoxynucleotidyl transferase- positive. Immunologic phenotyping
suggested the leukemias were of B cell origin; blasts from five patients
expressed HLA-DR and p24 (CD-9 antibody), blasts from three patients
expressed B4 (CD-19), and blasts from two patients expressed the common
acute lymphoblastic leukemia antigen (CD-10). One patient's leukemic blasts
contained cytoplasmic immunoglobulin. Analysis of DNA from four of five
patients demonstrated additional evidence of B cell differentiation with
heavy-chain immunoglobulin gene rearrangement. When DNA from the four
patients with heavy-chain immunoglobulin gene rearrangement was analyzed,
one patient's DNA demonstrated light-chain immunoglobulin gene
rearrangement. However, flow cytometric analysis of blasts from three
patients showed the simultaneous expression of the lymphoid-associated
antigen B4 (CD-19) and the myeloid-associated antigen My-1 (X-Hapten).
Electron microscopic examination of blasts from one patient that expressed
both lymphoid- and myeloid-associated antigens demonstrated ultrastructural
characteristics of both lineages. These findings suggest that acute
leukemia with the t(4;11) abnormality has mixed lineage characteristics as
a result of leukemogenesis in a multipotential progenitor cell or aberrant
gene expression later in differentiation. Furthermore, serial analysis of
karyotype, immunophenotype, and heavy-chain immunoglobulin genes revealed
changes in these biologic markers over time, suggesting continued
chromosome rearrangement and gene modulation after the leukemogenic event
in cells with the t(4;11).
Volume 67,
Issue 3,
pp. 689-697,
03/01/1986
Copyright © 1986 by The American Society of Hematology
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