Characterization of a complex translocation [t(4;9;22)(p16;q34;q11)] in chronic myelogenous leukemia by fluorescence in situ hybridization technique.
A patient was referred with a high leukocyte count and diagnosed with chronic myelogenous leukemia (CML). Although practically asymptomatic since the time of diagnosis, he had a variable and inconsistent response to treatment. All of his bone marrow cells had a complex, three-way translocation, involving chromosomes 4, 9 and 22. Translocation of chromosome 4 to chromosome 9 was undetectable by routine cytogenetic techniques; however, by the fluorescence in situ hybridization technique, a three-way translocation was identified, 46,XY,t(4;9;22)(p16;q34;q11). Although, other chromosomes are frequently involved in complex or variant translocations with chromosome 9 and 22, participation of chromosome 4 is a very rare event. So far, two previous cases have been described in the literature with translocations involving chromosome 4p16. We present a third case of CML having similar break points whose clinical presentation is unusual.
Gudi
R
R
Division of Hematology and Oncology, New York Methodist Hospital-Cornell Medical Center, USA.
Elizalde
A
A
Gogineni
S K
SK
Macera
M J
MJ
Badillo
A
A
Verma
R S
RS
D000493:Allopurinol / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002066:Busulfan / Q000627:therapeutic use; D002871:Chromosome Banding; D002874:Chromosome Mapping; D002892:Chromosomes, Human, Pair 22; D002894:Chromosomes, Human, Pair 4; D002899:Chromosomes, Human, Pair 9; D006801:Humans; D006918:Hydroxyurea / Q000627:therapeutic use; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014178:Translocation, Genetic
D000970:Antineoplastic Agents; D000493:Allopurinol; D002066:Busulfan; D006918:Hydroxyurea