title: Aggressive transformation of anaplastic large cell lymphoma with increased number of ALK-translocated chromosomes.
abstract: Pediatric anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) usually has a benign clinical course. A small fraction of patients with ALCL develops an aggressive clinical course; however, its etiology remains unclear. Here we report on an ALK-positive ALCL patient, who had complex translocations with TPM3-ALK revealed by RNA sequencing, with a very aggressive clinical course. On admission, the patient had extraordinarily high white blood cell count with double ALK-translocated chromosomes, and subsequently developed a more aggressive transformation with invasion into multiple organs with triple ALK-translocated chromosomes. The aggressive clinical course may have been related to these additional chromosomal aberrations. Our report provides new insights into the clonal evolution in ALCL and suggests the importance of monitoring examinations including fluorescence in situ hybridization analysis.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan, nrb52665@yahoo.co.jp.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hoshino
authors.forename: Keiko
authors.initials: K
authors.lastname: Nomura
authors.forename: Takeru
authors.initials: T
authors.lastname: Hamashima
authors.forename: Tomoya
authors.initials: T
authors.lastname: Isobe
authors.forename: Masafumi
authors.initials: M
authors.lastname: Seki
authors.forename: Mitsuteru
authors.initials: M
authors.lastname: Hiwatari
authors.forename: Kenichi
authors.initials: K
authors.lastname: Yoshida
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shiraishi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Chiba
authors.forename: Hiroko
authors.initials: H
authors.lastname: Tanaka
authors.forename: Satoru
authors.initials: S
authors.lastname: Miyano
authors.forename: Seishi
authors.initials: S
authors.lastname: Ogawa
authors.forename: Junko
authors.initials: J
authors.lastname: Takita
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kanegane
mesh_terms: D000077548:Anaplastic Lymphoma Kinase; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D002471:Cell Transformation, Neoplastic / Q000235:genetics*; D002675:Child, Preschool; D056905:Chromosome Breakpoints; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D059785:Karyotype; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology*; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D014178:Translocation, Genetic
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases