De novo acute B-cell leukemia with translocation t(14;18): an entity with a poor prognosis

• Published in: Leukemia Vol. 5; no. 6; p. 473
• Main Authors: Kramer, M H, Raghoebier, S, Beverstock, G C, de Jong, D, Kluin, P M, Kluin-Nelemans, J C
• Format: Journal Article
• Language: English
• Published: England 01-06-1991
• Subjects: Adult; Antigens, CD - metabolism; Antigens, CD19; Antigens, Differentiation - metabolism; Antigens, Differentiation, B-Lymphocyte - metabolism; Antigens, Neoplasm - metabolism; Burkitt Lymphoma - genetics; Burkitt Lymphoma - immunology; Burkitt Lymphoma - pathology; Cell Membrane - immunology; Chromosome Deletion; Chromosomes, Human, Pair 14; Chromosomes, Human, Pair 18; Chromosomes, Human, Pair 8; Chromosomes, Human, Pair 9; Cytoplasm - immunology; DNA Nucleotidylexotransferase - deficiency; Humans; Immunoglobulins - metabolism; Immunophenotyping; Lymphoma, Follicular - genetics; Lymphoma, Follicular - immunology; Lymphoma, Follicular - pathology; Male; Middle Aged; Neprilysin; Prognosis; Translocation, Genetic
• ISSN: 0887-6924

Three cases of de novo acute B-cell lymphoblastic leukemia are presented, all with an unusual phenotype, involvement of translocation t(14;18) and additional chromosomal abnormalities, including translocation t(8;14) and deletion of chromosome 9. In contrast to normal FAB-L2 or FAB-L3 acute lymphoblastic leukemia (ALL), these leukemias did not express cytoplasmatic and membranous immunoglobulin. The combination of translocation t(14;18) and additional chromosomal events on the other chromosome 14 account for the lack of immunoglobulin expression. In one case a low grade follicular lymphoma was found next to a high grade Burkitt type ALL. The translocation t(14;18) takes place as a mistake in the VDJH joining in pre-B cells in the bone marrow. It is proposed that some cases of de novo ALL may arise as a blast crisis induced by genetic events, secondary to the primary t(14;18) translocation. This type of ALL seems to have a poor prognosis.