title: Complex variant Philadelphia translocations involving the short arm of chromosome 6 in chronic myeloid leukemia.
abstract: OBJECTIVE
  Around 5% of chronic myeloid leukemias (CML) are characterized by complex variant Philadelphia (Ph) translocations involving one or more chromosomal regions in addition to 9 and 22. The BCR/ABL1 fusion gene is usually found on der(22). The additional gene(s) involved in complex variant Ph rearrangements have not been characterized.
  
  
  METHODS
  We performed fluorescent in situ hybridization (FISH) in three complex variant Ph translocations involving the short arm of chromosome 6 in addition to 9 and 22. The BCR/ABL1 D-FISH probe was applied to localize the BCR/ABL1 fusion gene as well as the 5'ABL1 and the 3'BCR. Locus-specific probes were used to narrow the 6p breakpoint.
  
  
  RESULTS
  In all cases the BCR/ABL1 fusion gene was located on the Ph chromosome whereas the reciprocal ABL1/BCR gene was detected only in patient #2. On 6p, breakpoints were narrowed to three different regions: centromeric to the human major histocompatibility complex (MHC), between PAC 524E15 and PAC162J16, in the first patient, and telomeric to the MHC, between PAC 329A5 and PAC 145H9, and between PAC 136B1 and PAC 206F19, in the second and third patients, respectively. In patients #2 and 3 a chromosomal rearrangement different from a true complex variant was discovered. In both cases, a classical t(9;22) was associated with an additional translocation involving the der(9)t(9;22).
  
  
  CONCLUSIONS
  Rearrangements at 6p in complex Ph aberrations involve more than one gene/locus. Classical t(9;22), masked by additional chromosomal rearrangements, can resemble complex variant Ph translocations, and can be detected only using appropriate FISH probes.
authors.affiliation: Hematology and Bone Marrow Transplantation Unit, University of Perugia, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: La Starza
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Testoni
authors.forename: Marina
authors.initials: M
authors.lastname: Lafage-Pochitaloff
authors.forename: Deborah
authors.initials: D
authors.lastname: Ruggeri
authors.forename: Emanuela
authors.initials: E
authors.lastname: Ottaviani
authors.forename: Gianni
authors.initials: G
authors.lastname: Perla
authors.forename: Massimo Fabrizio
authors.initials: MF
authors.lastname: Martelli
authors.forename: Peter
authors.initials: P
authors.lastname: Marynen
authors.forename: Cristina
authors.initials: C
authors.lastname: Mecucci
mesh_terms: D000368:Aged; D019457:Chromosome Breakage; D002874:Chromosome Mapping; D020223:Chromosome Painting; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics / Q000648:ultrastructure*; D002896:Chromosomes, Human, Pair 6 / Q000235:genetics / Q000648:ultrastructure*; D002999:Clone Cells / Q000648:ultrastructure; D005260:Female; D016313:Genes, abl; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014411:Neoplastic Stem Cells / Q000648:ultrastructure; D010677:Philadelphia Chromosome; D020133:Reverse Transcriptase Polymerase Chain Reaction