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Molecular monitoring in NUP214-ABL-positive T-acute lymphoblastic leukemia reveals clonal diversity and helps to guide targeted therapy

Leukemia volume 28, pages 419–422 (2014)Cite this article

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A 20-year-old male patient presented to our department because of cervical lymphadenopathy, which progressed over a month. No acute EBV or CMV titers were detected. B symptoms (fever, night sweats and weight loss of 4 kg in 8 weeks) were accompanied by axillary and inguinal lymphadenopathy. LDH was found to be increased to 900 U/l (reference <240 U/l). In addition, CT scanning revealed both hilar and mediastinal lymphadenopathy. The spleen was enlarged to 7.6 × 13.3 × 16.8 cm. Immunophenotyping of the bone marrow (BM) revealed dense infiltration by T-lymphoblasts expressing cyCD3, CD5, CD7 and CD34, but lacking CD1a, CD2, sCD3, CD4 and CD8, although coexpressing CD79a and CD33. CD52 was not expressed on the blasts.

Polychemotherapy according to the German ALL study group protocol 07/2003 (www.clinicaltrials.gov: NCT00198991) was initiated after a written informed consent was obtained from the patient. BM aspiration on day 11 and day 26 showed persistence of 50–60 and 70% blasts, respectively, with FISH analysis revealing deletion of 9q34 in 6% (13 of 209) and extrachromosomal ABL amplification in 63% (132 of 209) of interphases on day 26. In addition, MRD analysis demonstrated persistent disease using NUP214-ABL-transcript- and TCR-DNA-based qRT-PCR (Figure 2).

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Figure 1
Figure 2

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Acknowledgements

(TB was supported by DFG grant BU 2453/1-1).

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Author notes

  1. S Koschmieder

    Present address: 6Current address: Department of Medicine (Oncology, Hematology, and Stem Cell Transplantation), University Medical Center of Aachen, RWTH Uniklinik Aachen, Pauwelsstr. 30, D-52074 Aachen, Germany.,

Authors and Affiliations

  1. Department of Medicine A (Hematology and Oncology), University of Münster, Münster, Germany

    S Koschmieder, A Berkemeier, G Silling, C Müller-Tidow, W E Berdel & M Stelljes

  2. Charité, CBF, Med. Klinik für Hämatologie, Onkologie und Tumorimmunologie, Hindenburgdamm 30, Berlin, Germany,

    T Burmeister

  3. Second Medical Department, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany

    M Brüggemann

  4. Institute of Human Genetics, University of Münster, Münster, Germany

    S Volpert & P Wieacker

  5. Department of Hematology/Oncology, University Hospital Frankfurt, Frankfurt, Germany

    N Gökbuget

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Koschmieder, S., Burmeister, T., Brüggemann, M. et al. Molecular monitoring in NUP214-ABL-positive T-acute lymphoblastic leukemia reveals clonal diversity and helps to guide targeted therapy. Leukemia 28, 419–422 (2014). https://doi.org/10.1038/leu.2013.272

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