Cryptic 5' MLL gene insertion in an X-chromosome in acute myeloblastic leukemia

Nathalie Douet-Guilbert1, Bertrand Arnaud, Frédéric Morel

  • 1Service de Cytogénétique, Cytologie et Biologie de la Reproduction, CHU Morvan, Brest, France.

Insights

A rare 5' MLL insertion into the X chromosome was identified in an adult with acute myeloblastic leukemia (FAB-M5). This finding highlights a recurrent genetic abnormality in leukemia beyond infancy.

Area of Science:

  • Genetics
  • Hematology
  • Oncology

Background:

  • Band 11q23 abnormalities are common in leukemia, often leading to MLL gene rearrangements.
  • These rearrangements involve translocations and insertions with various partner chromosomes, fusing MLL with other genes.

Observation:

  • A 43-year-old male diagnosed with acute myeloblastic leukemia (FAB-M5) presented with asthenia and pancytopenia.
  • Conventional cytogenetics revealed a deletion on chromosome 11 at band q21 (del(11)(q21)).

Findings:

  • Fluorescent in situ hybridization (FISH) confirmed MLL gene disruption.
  • The 5' region of the MLL gene was found to be inserted into the X chromosome (bands q24-q25).

Implications:

  • This 5'-MLL insertion into the X chromosome is a rare but recurrent genetic abnormality in acute myeloblastic leukemia.
  • The abnormality is observed not only in infants but also in adult leukemia cases.
  • This case expands the understanding of MLL gene involvement in adult leukemia pathogenesis.

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