title: Fetal origins of the TEL-AML1 fusion gene in identical twins with leukemia.
abstract: The TEL (ETV6)-AML1 (CBFA2) gene fusion is the most common reciprocal chromosomal rearrangement in childhood cancer occurring in approximately 25% of the most predominant subtype of leukemia- common acute lymphoblastic leukemia. The TEL-AML1 genomic sequence has been characterized in a pair of monozygotic twins diagnosed at ages 3 years, 6 months and 4 years, 10 months with common acute lymphoblastic leukemia. The twin leukemic DNA shared the same unique (or clonotypic) but nonconstitutive TEL-AML1 fusion sequence. The most plausible explanation for this finding is a single cell origin of the TEL-AML fusion in one fetus in utero, probably as a leukemia-initiating mutation, followed by intraplacental metastasis of clonal progeny to the other twin. Clonal identity is further supported by the finding that the leukemic cells in the two twins shared an identical rearranged IGH allele. These data have implications for the etiology and natural history of childhood leukemia.
authors.affiliation: Leukaemia Research Fund Centre, Institute of Cancer Research, Chester Beatty Laboratories, 237 Fulham Road, London SW3 6JB, United Kingdom.
authors.forename: A M
authors.initials: AM
authors.lastname: Ford
authors.forename: C A
authors.initials: CA
authors.lastname: Bennett
authors.forename: C M
authors.initials: CM
authors.lastname: Price
authors.forename: M C
authors.initials: MC
authors.lastname: Bruin
authors.forename: E R
authors.initials: ER
authors.lastname: Van Wering
authors.forename: M
authors.initials: M
authors.lastname: Greaves
mesh_terms: D000595:Amino Acid Sequence; D019677:Artificial Gene Fusion; D001483:Base Sequence; D001752:Blast Crisis / Q000235:genetics; D002675:Child, Preschool; D002881:Chromosomes, Human, Pair 12; D002891:Chromosomes, Human, Pair 21; D050676:Core Binding Factor Alpha 2 Subunit; D004200:Diseases in Twins / Q000235:genetics*; D005260:Female; D005315:Fetal Diseases / Q000235:genetics*; D006801:Humans; D007438:Introns; D008969:Molecular Sequence Data; D009363:Neoplasm Proteins / Q000096:biosynthesis / Q000737:chemistry / Q000235:genetics*; D015514:Oncogene Proteins, Fusion; D010920:Placenta; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000473:pathology; D011247:Pregnancy; D016415:Sequence Alignment; D017384:Sequence Deletion; D012689:Sequence Homology, Nucleic Acid; D014178:Translocation, Genetic; D014430:Twins, Monozygotic; D000097764:ETS Translocation Variant 6 Protein
chemical_list: D050676:Core Binding Factor Alpha 2 Subunit; D009363:Neoplasm Proteins; D015514:Oncogene Proteins, Fusion; C102421:TEL-AML1 fusion protein; D000097764:ETS Translocation Variant 6 Protein