title: [Extramedullary onset of mixed phenotype acute leukemia with MLL gene rearrangement].
abstract: Rearrangements of the mixed lineage leukemia MLL gene at chromosome 11q23 are common chromosomal abnormalities in human leukemia. MLL fused with numerous partner genes causes different leukemia phenotypes that depend on the function of partner genes. MLLT3-MLL is generated by translocation t(9;11), which primarily induces acute myeloid leukemia in humans, whereas MLLT3-MLL induces ALL or biphenotypic leukemia in mice. The microenvironment that surrounds leukemia cells plays a central role in this process. We report a patient with mixed phenotype acute leukemia with MLLT3-MLL. This patient, a 44-year-old woman, initially exhibited extramedullary leukemia with multiple tumors and subsequently developed bone marrow disease. The leukemia cells exhibited myeloid (CD13 and MPO) and B cell (CD19 and CD79a) phenotypes. Chromosomal analysis and RT-PCR assay revealed tumor cells with the MLLT3-MLL fusion gene. We treated this patient with a drug regimen for AML (Ara-C plus anthracycline), and complete remission was obtained. This report describes the fourth case of mixed phenotypic leukemia with extramedullary disease. The extramedullary circumstance may underlie the biphenotypic features of these patients.
authors.affiliation: Department of Hematology/Oncology, University of Yamanashi, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawashima
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shobu
authors.forename: Takeo
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamanaka
authors.forename: Yumi
authors.initials: Y
authors.lastname: Nozaki
authors.forename: Kei
authors.initials: K
authors.lastname: Nakajima
authors.forename: Toru
authors.initials: T
authors.lastname: Mitsumori
authors.forename: Keita
authors.initials: K
authors.lastname: Kirito
mesh_terms: D000328:Adult; D005260:Female; D015321:Gene Rearrangement / Q000235:genetics*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000235:genetics*; D051788:Myeloid-Lymphoid Leukemia Protein / Q000235:genetics*; D010641:Phenotype; D014157:Transcription Factors / Q000378:metabolism*; D014178:Translocation, Genetic / Q000235:genetics*
chemical_list: D014157:Transcription Factors; D051788:Myeloid-Lymphoid Leukemia Protein