[Chromosome t (4; 11) acute lymphoblastic leukemia: an analysis of 10 cases]

To characterize morphologically, immunophenotypically, cytogenetically and clinically the acute lymphoblastic leukemia (ALL) with t (4; 11) (q21; q23).

Ten cases of t (4; 11) ALL were reported. Of them, eight patients were de novo and two relapsed. The patients were treated with combination chemotherapy of DOPL or VP regimen. Immunophenotypic analysis was performed by flow cytometry in seven cases. Cytogenetic analysis was performed using bone marrow cells prepared directly and/or after 24h culture (case 7 using peripheral blood). RHG banding was used for karyotypic analysis.

Ten (3.5%) of 285 ALL patients were found to be t (4; 11) ALL. In these 10 patients, increased WBC (> 100 x 10(9)/L) was found in 6 cases. Liver, spleen and/or lymph nodes were involved in all. t (4; 11) was detected as a single abnormality in 5 karyotypes whereas the other 5 showed additional aberration besides t (4; 11). Six patients were CD(19) (+), five were CD(22) (+) and one was HLA-DR (+), CD(5) (+), supporting that most cases of t (4; 11) ALL were B cell origin. Median survival time was 5.5 months in the present series.

t (4; 11) ALL was a subtype with unique clinical and cytogenetic features, and had a poor prognosis.