Discordant clinical presentation and outcome in infant twins sharing a common clonal leukaemia.
We report the different presentation features and clinical outcome between two identical infant twins with acute lymphoblastic leukaemia with a shared clonal disease and MLL gene rearrangement. One twin relapsed and died, but the other is in complete remission > 4 years after diagnosis. These data, and similar observations on other twin infants with leukaemia, suggest that despite a common clonal in utero, post-natally these leukaemias can evolve independently, at different rates, in the twinned individuals, and that the usually fatal leukaemia associated with t(4;11) MLL gene rearrangement can be effectively treated when the leukaemic burden is small.
Campbell
M
M
Hospital Roberto del Rio, Santiago, Chile.
Cabrera
M E
ME
Legues
M E
ME
Ridge
S
S
Greaves
M
M
D001853:Bone Marrow / Q000276:immunology; D002894:Chromosomes, Human, Pair 4; D002999:Clone Cells; D004268:DNA-Binding Proteins / Q000235:genetics; D004200:Diseases in Twins / Q000235:genetics*; D005260:Female; D015321:Gene Rearrangement; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D007223:Infant; D007621:Karyotyping; D051788:Myeloid-Lymphoid Leukemia Protein; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000276:immunology; D011379:Prognosis; D011519:Proto-Oncogenes; D014157:Transcription Factors; D014430:Twins, Monozygotic; D016335:Zinc Fingers / Q000235:genetics
D004268:DNA-Binding Proteins; C497422:KMT2A protein, human; D014157:Transcription Factors; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase