BACKGROUND MLL gene rearrangement is a common genetic abnormality of acute myeloid leukemia(AML),which predicts poor prognosis and is important in clinical diagnosis.MLL rearrangement involves many chromosomes,among w...BACKGROUND MLL gene rearrangement is a common genetic abnormality of acute myeloid leukemia(AML),which predicts poor prognosis and is important in clinical diagnosis.MLL rearrangement involves many chromosomes,among which,t(4;11)translocation is rare in AML.The present case was t(4;11)AML,accompanied by a hyperdiploid karyotype.Such cases have not been reported previously.CASE SUMMARY An adult male with self-reported symptoms of fatigue,febrility and hyperleukocytosis was diagnosed with AML by morphology and confirmed by immunophenotype analysis.Uncommonly,chromosomal and fluorescence in situ hybridization(FISH)analysis showed a hyperdiploid karyotype with t(4;11)translocation and MLL rearrangement,and a negative MLL–AF4 fusion gene result.The patient died of respiratory and circulatory failure 5 days after diagnosis.CONCLUSION t(4;11)AML with hyperdiploid karyotype has not been reported.In this case,t(4;11)was only detected by karyotype analysis and FISH,suggesting their importance in MLL rearrangement detection.展开更多
目的探讨快速、敏感、有效揭示11q23/MLL 基因重排的方法,确定11q23/MLL 异常在成人急性白血病(AL)中的发生情况及其临床特征,指导 AL 风险治疗。方法 112例成人 AL 患者骨髓细胞经24h 短期培养按常规方法制备染色体标本,R 显带行核型分...目的探讨快速、敏感、有效揭示11q23/MLL 基因重排的方法,确定11q23/MLL 异常在成人急性白血病(AL)中的发生情况及其临床特征,指导 AL 风险治疗。方法 112例成人 AL 患者骨髓细胞经24h 短期培养按常规方法制备染色体标本,R 显带行核型分析;LSI MLL 双色分离信号 DNA探针行间期荧光原位杂交(FISH)筛选异常信号,有异常信号者行中期 FISH 确定 11q23/MLL 基因重排。结果 112例 AL 患者 FISH 揭示9例11q23/MLL 易位(检出率8.0%),其中常规细胞遗传学分析(CCA)只检出4例(检出率3.6%)。3例 CCA 示 del(11)(q23)者 FISH 揭示2例为11q23/MLL 易位,1例为11号染色体长臂末端缺失。在1例正常核型、1例11q+和1例无11q23明显异常者,FISH 揭示为11q23/MLL 易位。除9例易位外,FISH 揭示8例存在 MLL 基因扩增,包括多倍体、均匀染色区(hsr)和双微染色体(dmin)。AL 伴11q23/MLL 异常者多诊断为 B 系祖细胞急性淋巴细胞白血病(pro-B ALL)、急性单核细胞白血病(AMoL)或急性双表型白血病(BAL)。结论使用 MLL 双色分离信号 DNA 探针行 FISH 确定11q23/MLL 异常是快速敏感的方法,其检出率高于 CCA,有效揭示11q23/MLL 易位和扩增。临床诊断 pro-B ALL、AMoL 或 BAL,尤其正常核型者应行 FISH 以确定11q23/MLL异常。展开更多
文摘BACKGROUND MLL gene rearrangement is a common genetic abnormality of acute myeloid leukemia(AML),which predicts poor prognosis and is important in clinical diagnosis.MLL rearrangement involves many chromosomes,among which,t(4;11)translocation is rare in AML.The present case was t(4;11)AML,accompanied by a hyperdiploid karyotype.Such cases have not been reported previously.CASE SUMMARY An adult male with self-reported symptoms of fatigue,febrility and hyperleukocytosis was diagnosed with AML by morphology and confirmed by immunophenotype analysis.Uncommonly,chromosomal and fluorescence in situ hybridization(FISH)analysis showed a hyperdiploid karyotype with t(4;11)translocation and MLL rearrangement,and a negative MLL–AF4 fusion gene result.The patient died of respiratory and circulatory failure 5 days after diagnosis.CONCLUSION t(4;11)AML with hyperdiploid karyotype has not been reported.In this case,t(4;11)was only detected by karyotype analysis and FISH,suggesting their importance in MLL rearrangement detection.
文摘目的探讨快速、敏感、有效揭示11q23/MLL 基因重排的方法,确定11q23/MLL 异常在成人急性白血病(AL)中的发生情况及其临床特征,指导 AL 风险治疗。方法 112例成人 AL 患者骨髓细胞经24h 短期培养按常规方法制备染色体标本,R 显带行核型分析;LSI MLL 双色分离信号 DNA探针行间期荧光原位杂交(FISH)筛选异常信号,有异常信号者行中期 FISH 确定 11q23/MLL 基因重排。结果 112例 AL 患者 FISH 揭示9例11q23/MLL 易位(检出率8.0%),其中常规细胞遗传学分析(CCA)只检出4例(检出率3.6%)。3例 CCA 示 del(11)(q23)者 FISH 揭示2例为11q23/MLL 易位,1例为11号染色体长臂末端缺失。在1例正常核型、1例11q+和1例无11q23明显异常者,FISH 揭示为11q23/MLL 易位。除9例易位外,FISH 揭示8例存在 MLL 基因扩增,包括多倍体、均匀染色区(hsr)和双微染色体(dmin)。AL 伴11q23/MLL 异常者多诊断为 B 系祖细胞急性淋巴细胞白血病(pro-B ALL)、急性单核细胞白血病(AMoL)或急性双表型白血病(BAL)。结论使用 MLL 双色分离信号 DNA 探针行 FISH 确定11q23/MLL 异常是快速敏感的方法,其检出率高于 CCA,有效揭示11q23/MLL 易位和扩增。临床诊断 pro-B ALL、AMoL 或 BAL,尤其正常核型者应行 FISH 以确定11q23/MLL异常。
