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High frequency of pro-B acute lymphoblastic leukemia in adults with secondary leukemia with 11q23 abnormalities

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Abstract

To evaluate the frequency and cytogenetic and immunophenotypic features of therapy-related, precursor B-cell acute lymphoblastic leukemia (ALL), 152 cases of immature B-cell ALL were reviewed. These were compared to the frequency of therapy-related acute myeloid leukemia (t-AML) during the same time period. Eight ALL cases with a prior diagnosis of malignancy were identified, including six (4.0%) with prior therapy considered to be therapy-related ALL (t-ALL). The t-ALL cases followed treatment for breast carcinoma (two cases), lung carcinoma (two cases), lymphocyte predominance Hodgkin's disease and follicular lymphoma with a latency period of 13 months to 8 years. All t-ALL cases had a pro-B (CD10-negative) immunophenotype with significantly higher expression of CD15 and CD65, compared to the de novo CD10-positive ALL cases. All six t-ALL cases had MLL abnormalities by fluorescence in situ hybridization, and four showed t(4;11)(q21;q23). These represented half of all 11q23-positive adult ALL cases. During the same time period, 4.9% of all AML cases were considered t-AML. There was a 16.7% frequency of 11q23 abnormalities in the t-AML group. Despite the similar frequency in therapy-related disease among ALL and AML cases, there were differences in the frequency of the diseases and t-ALL represented 12% of all therapy-related leukemias. However, t-ALL represented 46% of all 11q23-positive therapy-related leukemias. The immunogenetic features of t-ALL appear distinct and may aid in identifying more cases of this disease type in the future.

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Acknowledgements

This work was supported in part by NIH CA-33572 and CA-30206.

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Author notes

  1. S Ishizawa: Visiting Scientist from Toyama Medical and Pharmacy University Hospital, Toyama, Japan

Authors and Affiliations

  1. Division of Pathology, City of Hope National Medical Center, Duarte, CA, USA

    S Ishizawa, M L Slovak, V Bedell, J E Wrede & D A Arber

  2. Hematology/Bone Marrow Transplantation, City of Hope National Medical Center, Duarte, CA, USA

    L Popplewell & D S Snyder

  3. Biostatistics, City of Hope National Medical Center, Duarte, CA, USA

    N H Carter

Authors
  1. S Ishizawa
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  2. M L Slovak
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  3. L Popplewell
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  4. V Bedell
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  5. J E Wrede
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  6. N H Carter
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  7. D S Snyder
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  8. D A Arber
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Ishizawa, S., Slovak, M., Popplewell, L. et al. High frequency of pro-B acute lymphoblastic leukemia in adults with secondary leukemia with 11q23 abnormalities. Leukemia 17, 1091–1095 (2003). https://doi.org/10.1038/sj.leu.2402918

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  • DOI: https://doi.org/10.1038/sj.leu.2402918

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