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Published on: September 1, 2019
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.
Abstract:
Band 11q23 is known to be involved in translocations and insertions with a variety of partner chromosomes. They lead to MLL rearrangement, resulting in fusion with numerous genes. We report here on a 43-year-old man presenting with asthenia and pancytopenia who was diagnosed with acute myeloblastic leukemia FAB-M5. Conventional cytogenetic techniques showed a del(11)(q21). Using a specific probe for fluorescent in situ hybridization, the MLL gene was found to be disrupted, with the 5' region being inserted into the X-chromosome (around bands q24 approximately q25), as confirmed by whole X-chromosome painting. The accumulating data on acute myeloblastic leukemia demonstrate that the 5'-MLL insertion in an X-chromosome is a rare but recurrent abnormality associated with leukemia, not only in infants, but also in adults.
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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