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Prenatal chromosomal diversification of leukemia in monozygotic twins

✍ Scribed by Helena Kempski; Karen A. Mensa-Bonsu; Lyndal Kearney; G. Reza Jalali; Ian Hann; Mohammed Khurshid; Mel Greaves

Publisher
John Wiley and Sons
Year
2003
Tongue
English
Weight
246 KB
Volume
37
Category
Article
ISSN
1045-2257

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✦ Synopsis

Abstract

Previous studies on concordant acute lymphoblastic leukemia (ALL) in identical twins have identified the leukemia as monoclonal with MLL or __ETV__6‐RUNX1 gene fusion as early or initiating events in utero. In the latter case, postnatal latency is associated with secondary genetic events such as ETV6 deletion. We describe here a pair of infant twins with concordant acute monoblastic leukemia (AML). They are a unique pair in that their leukemia blasts display extensive intraclonal chromosomal diversity. Comparison of the leukemic cells between the two twins by karyotype and fluorescence in situ hybridization identifies a common or shared stem line and extensive subclonal diversity for which the twins' leukemic populations are divergent. This case of leukemia illustrates in utero initiation with early imposition of chromosomal instability, the progressively divergent evolution of which can be mapped in the twins into pre‐ and postnatal periods. Β© 2003 Wiley‐Liss, Inc.

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