title: Cryptic ins(4;11)(q21;q23q23) detected by fluorescence in situ hybridization: a variant of t(4;11)(q21;q23) in an infant with a precursor B-cell acute lymphoblastic leukemia report of a second case.
abstract: We report the chromosomal findings in a 4-year-old female with precursor B-cell acute lymphoblastic leukemia (ALL). The diagnostic karyotype showed an isochromosome 7q, i(7)(q10), as well as questionable rearrangements on 9p and 11q. Fluorescence in situ hybridization (FISH) studies on both interphase and metaphase cells using the MLL "break-apart" and the centromeric chromosome 4 probes were instrumental in the characterization of an MLL gene rearrangement, which was cryptic by conventional cytogenetic analysis. Specifically, the FISH pattern was consistent with an insertion of the 5' region of the MLL gene into chromosome 4 at band q21, most likely a variant t(4;11)(q21;q23). This is the second case of FISH detection of an ins(4;11) in ALL. Our case exemplifies the importance of FISH in the further characterization of precursor B-cell ALL cases without any apparent prognostically significant chromosomal abnormalities.
authors: Laboratory of Cytogenetics, Quest Diagnostics Nichols Institute, 14225 Newbrook Drive, Chantilly, VA 20151, USA. CTIRADO@gw.mp.sc.edu <CTIRADO@gw.mp.sc.edu>
authors: C A
authors: CA
authors: Tirado
authors: A M
authors: AM
authors: Meloni-Ehrig
authors: T
authors: T
authors: Edwards
authors: J
authors: J
authors: Scheerle
authors: K
authors: K
authors: Burks
authors: C
authors: C
authors: Repetti
authors: N C
authors: NC
authors: Christacos
authors: J C
authors: JC
authors: Kelly
authors: J
authors: J
authors: Greenberg
authors: C
authors: C
authors: Murphy
authors: C D
authors: CD
authors: Croft
authors: D
authors: D
authors: Heritage
authors: P N
authors: PN
authors: Mowrey
mesh_terms: D002051:Burkitt Lymphoma / Q000235:genetics* / Q000473:pathology; D002675:Child, Preschool; D002871:Chromosome Banding; D002880:Chromosomes, Human, Pair 11; D002894:Chromosomes, Human, Pair 4; D005260:Female; D011495:Histone-Lysine N-Methyltransferase; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D016254:Mutagenesis, Insertional; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000473:pathology; D014178:Translocation, Genetic
chemical_list: C497422:KMT2A protein, human; D051788:Myeloid-Lymphoid Leukemia Protein; D011495:Histone-Lysine N-Methyltransferase