title: Intrauterine monoclonal origin of neonatal concordant acute lymphoblastic leukemia in monozygotic twins.
abstract: We report detailed immunological, cytogenetic and molecular evidence for complete identity of the leukemic cell populations in monozygotic female twins with concordant leukemia diagnosed at two months of age. Both infants had early pre-B acute lymphoblastic leukemia with the (11;19)(q23;p13) chromosomal translocation. A common clonal origin of leukemia in these infants was suggested by the finding of identical oligoclonal heavy chain immunoglobulin gene rearrangements. Leukemic cell DNA was examined for 11q23 rearrangements by Southern blotting and restriction fragments of identical size were found in the two cases, in contrast to the diversity of rearrangements observed in other unrelated and nontwinned control infants with t(11;19)(q23;p13). Similar restriction fragments were absent in blood mononuclear DNA from both parents, liver tissue from one twin and remission bone marrow of the other, indicating that the 11q23 rearrangement was acquired and not inherited as a chromosomal abnormality or polymorphism. These findings provide a definitive evidence for intrauterine single cell origin, with twin to twin transmission, of concordant leukemia in this infant twin pair.
authors.affiliation: Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101.
authors.forename: H H
authors.initials: HH
authors.lastname: Mahmoud
authors.forename: S A
authors.initials: SA
authors.lastname: Ridge
authors.forename: F G
authors.initials: FG
authors.lastname: Behm
authors.forename: C H
authors.initials: CH
authors.lastname: Pui
authors.forename: A M
authors.initials: AM
authors.lastname: Ford
authors.forename: S C
authors.initials: SC
authors.lastname: Raimondi
authors.forename: M F
authors.initials: MF
authors.lastname: Greaves
mesh_terms: D015139:Blotting, Southern; D001853:Bone Marrow / Q000473:pathology; D002051:Burkitt Lymphoma / Q000235:genetics / Q000473:pathology*; D002880:Chromosomes, Human, Pair 11; D002888:Chromosomes, Human, Pair 19; D004200:Diseases in Twins; D005260:Female; D006801:Humans; D014178:Translocation, Genetic; D014430:Twins, Monozygotic