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Hematopoietic stem cell transplantation for pediatric mature B-cell acute lymphoblastic leukemia with non-L3 morphology and MLL-AF9 gene fusion: three case reports and review of the literature.
- Source :
-
International journal of hematology [Int J Hematol] 2016 Jul; Vol. 104 (1), pp. 139-43. Date of Electronic Publication: 2016 Mar 18. - Publication Year :
- 2016
-
Abstract
- Mature B-cell acute lymphoblastic leukemia (B-ALL) is typically associated with French-American-British (FAB)-L3 morphology and MYC gene rearrangement. However, rare cases of mature B-ALL with non-L3 morphology and MLL-AF9 fusion have been reported, and such cases are characterized by a rapid and aggressive clinical course. We here report three such cases of pediatric mature B-ALL in female patients respectively aged 15 months, 4 years, and 4 months. Bone marrow smears at diagnosis showed FAB-L1 morphology in all patients. Immunophenotypically, they were positive for cluster of differentiation (CD)10, CD19, CD20 (or CD22), Human Leukocyte Antigen-DR, and surface immunoglobulin λ. No evidence of MYC rearrangement was detected in any of the cases by fluorescent in situ hybridization (FISH) analysis. However, MLL rearrangement was detected by FISH, and MLL-AF9 fusion was confirmed by reverse transcriptase-polymerase chain reaction. All patients achieved complete remission after conventional chemotherapy and subsequently underwent hematopoietic stem cell transplantation as high-risk ALL; patient 3 for infantile ALL with MLL rearrangement and the others for ALL with MLL rearrangement and hyperleukocytosis (white blood cell count at diagnosis >50 × 10(9)/L). At the latest follow-up for each case (12-98 months post-transplantation), complete remission was maintained. Moreover, we discuss the clinical, genetic, and immunophenotypic features of this rare disease.
- Subjects :
- Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Leukemia, B-Cell genetics
Leukemia, B-Cell pathology
Myeloid-Lymphoid Leukemia Protein genetics
Oncogene Proteins, Fusion genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma pathology
Remission Induction methods
Translocation, Genetic
Hematopoietic Stem Cell Transplantation methods
Leukemia, B-Cell therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1865-3774
- Volume :
- 104
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 27084248
- Full Text :
- https://doi.org/10.1007/s12185-016-1971-9