Concurrent presence of inv(14)(q11q32) and t(4;11)(q21;q23) in Pre-B Acute Lymphoblastic leukemia

✍ Scribed by David S. Chervinsky; Mauro Grossi; Surabhi Kakati; Annemarie W. Block; Peter D. Aplan

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 744 KB
• Volume: 12
• Category: Article
• ISSN: 1045-2257
• DOI: 10.1002/gcc.2870120312

✦ Synopsis

The inv( I4)(q I lq32) is a non-random chromosomal aberration which has been associated with a variety of T-cell malignancies. W e have studied a case of inv( I4)(q I I q32) that is unique in several respects. First, the inversion, which is expressed at the rnRNA level, occurred in the context of a pre-B acute lymphoblastic leukemia (ALL) as opposed to a T-cell malignancy. Second, cloning and sequencing of the inversion revealed that it resulted from a fusion between an immunoglobulin heavy chain variable (V) segment and a T-cell receptor delta diversity (D) segment. In addition, the patient had a second chromosomal abnormality at diagnosis, a t(4; I I )(q2 I ;q23) which disrupted the MLL gene. The fact that there were two distinct chromosomal abnormalities at diagnosis enabled us t o address the question of leukemic clonal evolution during the course of this patient's disease. W e present evidence wggesting that the t(4; I l)(q2 I ;q23) occurred first, with the inv( I4)(q I 1432) occurring as a second event.