title: Detection of major and minor bcr/abl fusion gene transcripts in a patient with acute undifferentiated leukemia secondary to treatment with an alkylating agent.
abstract: In this paper we describe a patient with bcr/abl positive acute undifferentiated leukemia (AUL) derived from acquired sideroblastic anemia secondary to ifosphamide treatment given for the preceding non-Hodgkin lymphoma of the lung. Cytogenetically, Philadelphia chromosome was not detected through the whole course in this patient, and multiple chromosomal abnormalities including 5q- and monosomy 7 were found at the stage of sideroblastic anemia. The reverse transcriptase-polymerase chain reaction (RT-PCR) analysis showed no bcr/abl fusion transcript at the diagnosis of malignant lymphoma. The mRNA encoding the major bcr/abl fusion protein then appeared in the stage of sideroblastic anemia. Finally, the mRNA encoding both major and minor bcr/abl was detected in the stage of AUL transformation. MLL gene rearrangement was not found by RT-PCR analysis at any stage of the disorder. These results may be direct evidence for the induction of the bcr/abl fusion gene by treatment with an alkylating agent (ifosphamide).
authors.affiliation: Nagoya National Hospital, Hematological Disease Center, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hattori
authors.forename: M
authors.initials: M
authors.lastname: Tanaka
authors.forename: Y
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Y
authors.initials: Y
authors.lastname: Nakahara
authors.forename: K
authors.initials: K
authors.lastname: Tsushita
authors.forename: M
authors.initials: M
authors.lastname: Utumi
mesh_terms: D000208:Acute Disease; D000477:Alkylating Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D000756:Anemia, Sideroblastic / Q000139:chemically induced / Q000150:complications / Q000235:genetics; D001483:Base Sequence; D002471:Cell Transformation, Neoplastic / Q000235:genetics; D002869:Chromosome Aberrations; D002897:Chromosomes, Human, Pair 7; D016044:Fusion Proteins, bcr-abl / Q000032:analysis / Q000235:genetics*; D015321:Gene Rearrangement; D016313:Genes, abl; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects / Q000627:therapeutic use; D007621:Karyotyping; D007938:Leukemia / Q000139:chemically induced* / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009006:Monosomy; D016609:Neoplasms, Second Primary / Q000139:chemically induced* / Q000235:genetics*; D016133:Polymerase Chain Reaction; D012333:RNA, Messenger / Q000032:analysis / Q000235:genetics; D012680:Sensitivity and Specificity; D014158:Transcription, Genetic
chemical_list: D000477:Alkylating Agents; D012333:RNA, Messenger; D016044:Fusion Proteins, bcr-abl; D007069:Ifosfamide