title: Clonal analysis of childhood acute lymphoblastic leukemia with "cytogenetically independent" cell populations.
abstract: Acute lymphoblastic leukemia (ALL) is generally regarded as a clonal disease in which a single abnormal progenitor cell gives rise to neoplastic progeny. Five of 463 cases of childhood ALL with adequately banded leukemic cells were found to have two cytogenetically independent cell populations. In addition, two of the four cases tested had more than two rearranged immunoglobulin genes and (or) T cell receptor genes. To investigate the clonality of these unusual leukemias, we examined the neoplastic cells for X-linked markers extrinsic to the disease. Leukemic cells from each of the three patients heterozygous for an X-linked, restriction fragment length polymorphism showed a single active parental allele, suggesting that both apparently independent cell populations developed from a common progenitor. These cases provide evidence that leukemogenesis involves a multistep process of mutation and suggest that karyotypic abnormalities may be a late event of malignant transformation.
authors.affiliation: Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101.
authors.forename: C H
authors.initials: CH
authors.lastname: Pui
authors.forename: W H
authors.initials: WH
authors.lastname: Raskind
authors.forename: G R
authors.initials: GR
authors.lastname: Kitchingman
authors.forename: S C
authors.initials: SC
authors.lastname: Raimondi
authors.forename: F G
authors.initials: FG
authors.lastname: Behm
authors.forename: S B
authors.initials: SB
authors.lastname: Murphy
authors.forename: W M
authors.initials: WM
authors.lastname: Crist
authors.forename: P J
authors.initials: PJ
authors.lastname: Fialkow
authors.forename: D L
authors.initials: DL
authors.lastname: Williams
mesh_terms: D000483:Alleles; D014408:Biomarkers, Tumor / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D002999:Clone Cells / Q000145:classification* / Q000201:enzymology; D004247:DNA / Q000032:analysis; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007041:Hypoxanthine Phosphoribosyltransferase / Q000235:genetics; D007621:Karyotyping; D010641:Phenotype; D012150:Polymorphism, Restriction Fragment Length; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification / Q000201:enzymology / Q000235:genetics*; D012074:Remission Induction
chemical_list: D014408:Biomarkers, Tumor; D004247:DNA; D007041:Hypoxanthine Phosphoribosyltransferase