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Acute leukemias with the t(4;11)(q21;q23)
1Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101-0318.
Leukemia & Lymphoma
|June 1, 1992
Summary
The t(4;11) chromosomal translocation is common in acute lymphoblastic leukemia (ALL), particularly in children. This genetic marker influences ALL subtypes, prognosis, and treatment outcomes across different age groups.
Area of Science:
- Hematology
- Cytogenetics
- Pediatric Oncology
Background:
- The t(4;11)(q21;q23) chromosomal translocation is a significant genetic abnormality observed in various leukemias.
- This translocation is frequently identified in acute lymphoblastic leukemia (ALL), affecting both pediatric and adult populations.
- Previous studies indicate lineage heterogeneity and distinct clinical features associated with the t(4;11) translocation.
Purpose of the Study:
- To investigate the clinical and biological characteristics of acute leukemia associated with the t(4;11) translocation.
- To analyze the impact of t(4;11) on immunophenotype, patient demographics, and treatment outcomes.
- To explore the association between t(4;11) and secondary acute myeloid leukemia (AML) following specific chemotherapies.
Main Methods:
- Review and analysis of reported cases of acute leukemia with the t(4;11) translocation.
- Correlation of cytogenetic findings with immunophenotypic data (e.g., CD10, CD19, CD15).
- Evaluation of age-related differences in clinical presentation and treatment prognosis.
Main Results:
- The t(4;11) translocation is a common finding in ALL, occurring in 2% of childhood and 5% of adult cases.
- In childhood ALL, t(4;11) is linked to younger age (<1 year), female sex, hyperleukocytosis, a B-precursor immunophenotype (CD10-/CD19+), and CD15 expression.
- Prognosis varies by age, with adults having the worst outcomes and children aged 1-9 years showing better results than infants or adolescents.
- Secondary leukemias with t(4;11) often follow treatment with topoisomerase II-targeting agents like epipodophyllotoxins or doxorubicin.
Conclusions:
- The t(4;11) translocation is a key indicator of specific acute leukemia subtypes with distinct clinical and biological profiles.
- Age is a critical factor influencing prognosis in patients with t(4;11)-associated leukemia.
- Further molecular studies are needed to identify the genes involved in t(4;11) for improved diagnostic classification.