Molecular monitoring of cerebrospinal fluid can predict clinical relapse in acute lymphoblastic leukemia with eosinophilia.
Arch Pathol Lab Med
; 127(5): 601-5, 2003 May.
Article
em En
| MEDLINE
| ID: mdl-12708906
ABSTRACT
In a patient with precursor B-cell acute lymphoblastic leukemia (ALL) associated with eosinophilia that completely responded to induction chemotherapy, we assayed serial remission cerebrospinal fluid and bone marrow specimens for minimal residual disease using a quantitative polymerase chain reaction assay to assess for clone-specific immunoglobulin heavy-chain gene cluster (IGH) gene rearrangement. Cerebrospinal fluid eosinophilia and minimal residual disease were detected on day 406, preceding the morphologic diagnosis of central nervous system relapse on day 578. By day 841, the bone marrow had 35% blasts. Despite aggressive therapy, including unrelated umbilical cord blood transplantation, the patient developed testicular and bone marrow relapses and died of disease. We conclude that increasing levels of minimal residual disease in cerebrospinal fluid can predict recurrence of ALL prior to clinical and morphologic relapse. Furthermore, we demonstrate a novel translocation in this tumor, the t(5;9)(q31;p24), that possibly led to fusion of the interleukin-3 (IL3) (5q31) and JAK2 (9p24) genes and may explain the concomitant appearance of eosinophilia and ALL.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Líquido Cefalorraquidiano
/
Perfilação da Expressão Gênica
/
Eosinofilia
/
Leucemia-Linfoma Linfoblástico de Células Precursoras
/
Recidiva Local de Neoplasia
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Child
/
Humans
/
Male
Idioma:
En
Revista:
Arch Pathol Lab Med
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Estados Unidos