1. ALL-1 gene rearrangements in acute myeloid leukemia: association with M4-M5 French-American-British classification subtypes and young age.
- Author
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Cimino G, Rapanotti MC, Elia L, Biondi A, Fizzotti M, Testi AM, Tosti S, Croce CM, Canaani E, and Mandelli F
- Subjects
- Adolescent, Adult, Age Factors, Aged, Child, Child, Preschool, Female, France, Histone-Lysine N-Methyltransferase, Humans, Immunophenotyping, Infant, Infant, Newborn, Leukemia, Monocytic, Acute classification, Leukemia, Monocytic, Acute immunology, Leukemia, Myelomonocytic, Acute classification, Leukemia, Myelomonocytic, Acute immunology, Male, Middle Aged, Myeloid-Lymphoid Leukemia Protein, Restriction Mapping, United Kingdom, United States, Zinc Fingers, DNA-Binding Proteins genetics, Gene Rearrangement, Leukemia, Monocytic, Acute genetics, Leukemia, Myelomonocytic, Acute genetics, Proto-Oncogenes, Transcription Factors
- Abstract
We have analyzed by Southern blotting the ALL-1 (MLL, HRX, Hrtx 1) gene configuration in a series of 126 patients with acute myeloid leukemia (AML) representative of all ages and French-American-British Classification groups and correlated this genetic feature with clinical and biological features at diagnosis. ALL-1 gene rearrangements were detected in 17 of the 74 cases with M4-M5 (myelomonocytic and monocytic) AML and in 2 of the 52 cases with other leukemic subtypes (P < 0.01). Within the series of 74 M4-M5 patients, ALL-1 rearrangements were significantly associated with French-American-British Classification M5 (P = 0.009), high WBC (P = 0.002), and young age. In particular, all 5 infant (< 1.5 years) AML cases, 6 of the 19 (31%) patients between 1.5 and 18 years of age, and 6 of the 50 (12%) patients > 18 years old showed an altered ALL-1 genomic configuration (P < 0.001). Immunophenotypic characterization revealed coexpression of lymphoid and myeloid markers in 6 of 17 ALL-1 rearranged M4-M5 cases. The IgH gene configuration was studied in 77 of 126 AMLs. Five patients (6%) showed IgH clonal rearrangements and all were in the ALL-1 rearranged group (P < 0.0001). Our findings indicate that ALL-1 rearrangement is the commonest genetic alteration presently detectable in M4-M5 AML, particularly in childhood where it is found in up to one-third of all cases. The association of IgH rearrangements with ALL-1 alterations in AML, coupled to the frequent detection in this subset of lymphoid associated markers, further supports the origin of these tumors from a common multipotent precursor with bipotential lymphoid and monocytic differentiation capability.
- Published
- 1995