Sequential acquisition of IgH and TCR rearrangements during the preleukemic phase of acute lymphoblastic leukemia in an adolescent patient.
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.
Linden
Tobias
T
Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany.
Furlan
Ingrid
I
Schwarz
Stephan
S
Stoehr
Robert
R
Niemeyer
Charlotte M
CM
Rossig
Claudia
C
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
D004273:DNA, Neoplasm