title: Sequential acquisition of IgH and TCR rearrangements during the preleukemic phase of acute lymphoblastic leukemia in an adolescent patient.
abstract: Acute lymphoblastic leukemia (ALL) can be preceded by a prodromal phase of bone marrow failure. In serial trephine biopsies in a girl with acquired bone marrow hypoplasia, we have identified a monoclonal B-cell precursor population characterized by a clone-specific IgH-FR3 gene rearrangement. Progression to ALL more than 4 months later was accompanied by acquisition of an additional T-cell receptor rearrangement. Thus, hypoplastic pre- and overt leukemia share a common clonal origin. Prospective biobanking and extended molecular analysis can help to better understand the nature and sequence of genetic events during progression of a covert (pre)leukemic clone.
authors.affiliation: Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Linden
authors.forename: Ingrid
authors.initials: I
authors.lastname: Furlan
authors.forename: Stephan
authors.initials: S
authors.lastname: Schwarz
authors.forename: Robert
authors.initials: R
authors.lastname: Stoehr
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Niemeyer
authors.forename: Claudia
authors.initials: C
authors.lastname: Rossig
mesh_terms: D000293:Adolescent; D004273:DNA, Neoplasm / Q000235:genetics; D005260:Female; D015321:Gene Rearrangement; D050438:Genes, Immunoglobulin Heavy Chain / Q000235:genetics*; D019672:Genes, T-Cell Receptor / Q000235:genetics*; D006801:Humans; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D011289:Preleukemia / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology
chemical_list: D004273:DNA, Neoplasm