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Infant acute lymphoblastic leukemia – combined cytogenetic, immunophenotypical and molecular analysis of 77 cases

Abstract

We used karyotyping, fluorescence in situ hybridization (FISH), Southern blotting, and RT-PCR in order to analyze prospectively 77 infants (less than 1 year of age) with acute lymphoblastic leukemia for the occurrence of 11q23/MLL rearrangements and/or other cytogenetic abnormalities. Out of the 69 informative samples we found an 11q23/MLL rearrangement in 42 cases (61%). Regarding only pro-B ALL cases, the incidence of 11q23/MLL rearranged cases, however, reached more than 90% The infants were treated within the therapy studies ALL-BFM90, ALL-BFM95 and CoALL-05–92. For patients with an adequate follow-up of 4 years the event-free survival of the 11q23/MLL-positive and 11q23/MLL-negative group was 0.2 or 0.64, respectively (P = 0.024). The monoclonal antibody 7.1. (moab 7.1) does not react with normal hematopoetic precursors or mature blood cells but was shown to specifically react with leukemic cells bearing a rearrangement of chromosome 11q23 or the MLL gene, respectively. We, therefore, specifically addressed the question whether the reactivity of moab 7.1, as determined by flow cytometry, may substitute for molecular testing of an 11q23/MLL rearrangement in this cohort of infant ALLs. Reactivity of moab 7.1 indicated a 11q23/MLL rearrangement with a specificity of 100%. However, five of the 11q23/MLL-positive cases did not react with moab 7.1 indicating a sensitivity of 84% only. Three of these five moab 7.1-negative but 11q23/MLL-positive cases could be identified by their unique expression pattern of CD65s and/or CD15. Thus, 95% of all 11q23/MLL-positive ALL cases in infancy may be identified by flow cytometry based on their expression of CD15, CD65s and/or moab 7.1.

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References

  1. Dordelmann M, Reiter A, Borkhardt A, Ludwig WD, Gotz N, Viehmann S, Gadner H, Riehm H, Schrappe M . Prednisone response is the strongest predictor of treatment outcome in infant acute lymphoblastic leukemia Blood 1999 94: 1209–1217

    CAS  PubMed  Google Scholar 

  2. Silverman LB, McLean TW, Gelber RD, Donnelly MJ, Gilliland DG, Tarbell NJ, Sallan SE . Intensified therapy for infants with acute lymphoblastic leukemia: results from the Dana-Farber Cancer Institute Consortium Cancer 1997 80: 2285–2295

    Article  CAS  PubMed  Google Scholar 

  3. Huret JL, Dessen P, Bernheim A . An atlas of chromosomes in hematological malignancies. Example: 11q23 and MLL partners Leukemia 2001 15: 987–989

    Article  CAS  PubMed  Google Scholar 

  4. Pui C-H, Behm FG, Downing JR, Hancock ML, Shurtleff SA, Ribeiro RC, Head DR, Mahmoud HH, Sandlund JT, Furman WL, Roberts WM, Crist WM, Raimondi SC . 11q23/MLL rearrangement confers a poor prognosis in infants with acute lymphoblastic leukemia J Clin Oncol 1994 12: 909–915

    Article  CAS  PubMed  Google Scholar 

  5. Pui CH, Ribeiro RC, Campana D, Raimondi SC, Hancock ML, Behm FG, Sandlund JT, Rivera GK, Evans WE, Crist WM, Krance R . Prognostic factors in the acute lymphoid and myeloid leukemias of infants Leukemia 1996 10: 952–956

    CAS  PubMed  Google Scholar 

  6. Heerema NA, Sather HN, Ge J, Arthur DC, Hilden JM, Trigg ME, Reaman GH . Cytogenetic studies of infant acute lymphoblastic leukemia: poor prognosis of infants with t(4;11) – a report of the Children's Cancer Group Leukemia 1999 13: 679–686

    Article  CAS  PubMed  Google Scholar 

  7. Smith FO, Rauch C, Williams DE, March CJ, Arthur D, Hilden J, Lampkin BC, Buckley JD, Buckley CV, Woods WG, Dinndorf PA, Sorensen P, Kersey J, Hammond D, Bernstein ID . The human homologue of rat NG2, a chondroitin sulfate proteoglycan, is not expressed on the cell surface of normal hematopoietic cells but is expressed by acute myeloid leukemia blasts from poor-prognosis patients with abnormalities of chromosome band 11q23 Blood 1996 87: 1123–1133

    CAS  PubMed  Google Scholar 

  8. Behm FG, Smith FO, Raimondi SC, Pui CH, Bernstein ID . Human homologue of the rat chondroitin sulfate proteoglycan, NG2, detected by monoclonal antibody 7.1, identifies childhood acute lymphoblastic leukemias with t(4;11)(q21;q23) or t(11;19)(q23;p13) and MLL gene rearrangements Blood 1996 87: 1134–1139

    CAS  PubMed  Google Scholar 

  9. Wuchter C, Harbott J, Schoch C, Schnittger S, Borkhardt A, Karawajew L, Ratei R, Ruppert V, Haferlach T, Creutzig U, Dorken B, Ludwig WD . Detection of acute leukemia cells with mixed lineage leukemia (MLL) gene rearrangements by flow cytometry using monoclonal antibody 7.1 Leukemia 2000 14: 1232–1238

    Article  CAS  PubMed  Google Scholar 

  10. Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnick HR, Sultan C . Proposals for the classification of the acute leukemias. French–American–British (FAB) Co-operative group Br J Haematol 1976 33: 451–458

    Article  CAS  PubMed  Google Scholar 

  11. ISCN. An international system for human cytogenetic nomenclature (1985) Karger: Basel 1985

  12. Kearney L, Bower M, Gibbons B, Das S, Chaplin T, Nacheva E, Chessells JM, Reeves B, Riley JH, Lister TA, Young BD . Chromosome 11q23 translocations in both infant and adult acute leukemias are detected by in situ hybridization with a yeast artificial chromosome Blood 1992 80: 1659–1665

    CAS  PubMed  Google Scholar 

  13. von Bergh A, Emanuel B, van Zelderen-Bhola S, Smetsers T, van Soest R, Stul M, Vranckx H, Schuuring E, Hagemeijer A, Kluin P . A DNA probe combination for improved detection of MLL/11q23 breakpoints by double-color interphase-FISH in acute leukemias Genes Chromosomes Cancer 2000 28: 14–22

    Article  CAS  PubMed  Google Scholar 

  14. Repp R, Borkhardt A, Haupt E, Kreuder J, Brettreich S, Hammermann J, Nishida K, Harbott J, Lampert F . Detection of four different 11q23 chromosomal abnormalities by multiplex-PCR and fluorescence-based automatic DNA-fragment analysis Leukemia 1995 9: 210–215

    CAS  PubMed  Google Scholar 

  15. Viehmann S, Borkhardt A, Lampert F, Harbott J . Multiplex PCR – a rapid screening method for detection of gene rearrangements in childhood acute lymphoblastic leukemia Ann Hematol 1999 78: 157–162

    Article  CAS  PubMed  Google Scholar 

  16. Fuchs U, Rehkamp G, Haas OA, Slany R, Konig M, Bojesen S, Bohle RM, Damm-Welk C, Ludwig WD, Harbott J, Borkhardt A . The human formin-binding protein 17 (FBP17) interacts with sorting nexin, SNX2, and is an MLL-fusion partner in acute myelogeneous leukemia Proc Natl Acad Sci USA 2001 98: 8756–8761

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ludwig WD, Bartram CR, Ritter J, Raghavachar A, Hiddemann W, Heil A, Harbott J, Seibt-Jung H, Teichmann JV, Riehm H . Ambigous phenotypes and genotypes in 16 children with acute leukemia as characterized by multiparameter analysis Blood 1988 71: 1518–1528

    CAS  PubMed  Google Scholar 

  18. Ludwig WD, Rieder H, Bartram CR, Heinze B, Schwartz S, Gassmann W, Loffler H, Hossfeld D, Heil G, Handt S, Heyll A, Diedrich H, Fischer K, Weiss A, Volkers B, Aydemir U, Fonatsch C, Gokbuget N, Thiel E, Hoelzer D . Immunophenotypic and genotypic features, clinical characteristics, and treatment outcome of adult pro-B acute lymphoblastic leukemia: results of the German multicenter trials GMALL 03/87 and 04/89 Blood 1998 92: 1898–1909

    CAS  PubMed  Google Scholar 

  19. Bene MC, Castoldi G, Knapp W, Ludwig WD, Matutes E, Orfao A, Van't Veer MB . Classification of acute leukemias – reply Leukemia 1996 10: 1363–1364

    CAS  PubMed  Google Scholar 

  20. Hilden JM, Smith FO, Frestedt JL, McGlennen R, Howells WB, Sorensen PH, Arthur DC, Woods WG, Buckley J, Bernstein ID, Kersey JH . MLL gene rearrangement, cytogenetic 11q23 abnormalities, and expression of the NG2 molecule in infant acute myeloid leukemia Blood 1997 89: 3801–3805

    CAS  PubMed  Google Scholar 

  21. Mauvieux L, Delabesse E, Bourquelot P, Radford-Weiss I, Bennaceur A, Flandrin G, Valensi F, MacIntyre EA . NG2 expression in MLL rearranged acute myeloid leukaemia is restricted to monoblastic cases Br J Haematol 1999 107: 674–676

    Article  CAS  PubMed  Google Scholar 

  22. Kaplan EL, Meier P . Nonparametric estimation from incomplete observations J Am Stat Assoc 1958 53: 457–481

    Article  Google Scholar 

  23. Gu Y, Alder H, Nakamura T, Schichman SA, Prasad R, Canaani O, Saito H, Croce CM, Canaani E . Sequence analysis of the breakpoint cluster region in the ALL-1 gene involved in acute leukemia Cancer Res 1994 54: 2327–2330

    CAS  PubMed  Google Scholar 

  24. Biondi A, Cimino G, Pieters R, Pui CH . Biological and therapeutic aspects of infant leukemia Blood 2000 96: 24–33

    CAS  PubMed  Google Scholar 

  25. Cimino G, Rapanotti MC, Rivolta A, Lo Coco F, D'Arcangelo E, Rondelli R, Basso G, Barisone E, Rosanda C, Santostasi T, Canaani E, Masera G, Mandelli F, Biondi A . Prognostic relevance of ALL-1 gene rearrangement in infant acute leukemias Leukemia 1995 9: 391–395

    CAS  PubMed  Google Scholar 

  26. Huret JL, Dessen P, Le Minor S, Bernheim A . The ‘Atlas of Genetics and Cytogenetics in Oncology and Haematology’ on the Internet and a review on infant leukemias Cancer Genet Cytogenet 2000 120: 155–159

    Article  CAS  PubMed  Google Scholar 

  27. Raimondi SC, Frestedt JL, Pui CH, Downing JR, Head DR, Kersey JH, Behm FG . Acute lymphoblastic leukemias with deletion of 11q23 or a novel inversion (11)(p13q23) lack MLL gene rearrangements and have favorable clinical features Blood 1995 86: 1881–1886

    CAS  PubMed  Google Scholar 

  28. Harbott J, Mancini M, Verellen-Dumoulin C, Moorman AV, Secker-Walker LM European 11q23 Workshop Participants. Hematological malignancies with a deletion of 11q23: cytogenetic and clinical aspects Leukemia 1998 12: 823–827

    Article  CAS  PubMed  Google Scholar 

  29. Pallisgaard N, Hokland P, Riishoj DC, Pedersen B, Jorgensen P . Multiplex reverse transcription-polymerase chain reaction for simultaneous screening of 29 trnaslocations and chromosomal aberrations in acute leukemia Blood 1998 92: 574–588

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by grants from the ‘Mildred-Scheel-Stiftung for Cancer Research’ (10–1658-Bo 2), the ‘Monika Kutzner-Foundation’, and the ‘Forschungshilfe Station Peiper’.

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Borkhardt, A., Wuchter, C., Viehmann, S. et al. Infant acute lymphoblastic leukemia – combined cytogenetic, immunophenotypical and molecular analysis of 77 cases. Leukemia 16, 1685–1690 (2002). https://doi.org/10.1038/sj.leu.2402595

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