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Prepublished online as a Blood First Edition Paper on April 17, 2002; DOI 10.1182/blood-2001-11-0093.

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Submitted November 29, 2001
Accepted March 21, 2002

HOX11L2 expression defines a clinical subtype of pediatric T-ALL which is associated with poor prognosis

Paola Ballerini, Annick Blaise, Maryvonne Busson-LeConiat, Xin Ying Su, Jessica Zucman-Rossi, Adam Mircea, Jacqueline van den Akker, Christine Perrot, Beatrice Pellegrino, Judith Landman-Parker, Luc Douay, Roland Berger, and Olivier A Bernard*

Hopital Armand Trousseau, Service d'Hematologie Biologique, Paris, France; 27 Rue Juliette Dodu, Unite 434 INSERM-CEPH and SD401 N-434 CNRS, Paris, France
Universite Paris 6, UPRES A1638, Paris, France
27 Rue Juliette Dodu, Unite 434 INSERM-CEPH and SD401 N-434 CNRS, Paris, France; Faculté Necker - Enfants Malades, Present address: EMI INSERM 0210, Paris, France
27 Rue Juliette Dodu, Unite 434 INSERM-CEPH and SD401 N-434 CNRS, Paris, France
Hopital Armand Trousseau, Service d'Hematologie Biologique, Paris, France
Hopital Saint Antoine, Service de cytogenetique, Paris, France
Hopital Armand Trousseau, Service d'Hematologie et d'Oncologie pediatrique, Paris, France
Hopital Armand Trousseau, Service d'Hematologie et d'Oncologie pediatrique, Paris, France; Universite Paris 6, UPRES A1638, Paris, France

* Corresponding author; email: bernard{at}cephb.fr.

The most frequent oncogenic activation events characterized in childhood T acute lymphoblastic leukemia (T-ALL), result in the transcriptional activation of genes coding for transcription factors. The main genes are TAL1/SCL a member of the basic region Helix-Loop-Helix gene family and HOX11L2, a member of homeobox containing protein family. To gain insight into the pathogenesis of this type of hematological malignancy, we analyzed 28 T-ALL samples. The SIL-TAL1/SCL fusion is detected in 6 patients; the expression of HOX11L2 is observed in 6 patients and of HOX11 in 3 patients. With one exception, these activations did not occur simultaneously in the same patients and allowed the sub-classification of 50 % of the patients. The SIL-TAL1 fusion was detected in association with weak HOX11 expression in one case and with a t(8;14)(q24;q11) in another. High expression of LYL1, LMO2 or TAL1 was mainly observed in samples negative for HOX11L2. HOX11L1 and HOX11 expression were observed in one instance each, in the absence of detectable chromosome abnormality of their respective loci, on chromosome 2 and 10, respectively. HOX11L2 expression is associated with a chromosome 5q abnormality, the location of the HOX11L2 locus in each case tested. Finally, our data show that HOX11L2 expression is a suitable marker for minimal residual disease follow up and is significantly associated with relapse (p=0.02).


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