International Journal of Hematology

DOI: 10.1007/s12185-017-2289-y Pages: 847-851

Reemergence of translocation t(11;19)(q23;p13.1) in the absence of clinically overt leukemia

1. Children’s Cancer Center, Kobe Children’s Hospital, Department of Hematology and Oncology

2. Kobe University Graduate School of Medicine, Department of Pediatrics

3. Ehime University Graduate School of Medicine, Department of Pediatrics

Correspondence to:
Suguru Uemura
Tel: +81-78-945-7300
Email: sgr3u31@yahoo.co.jp

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Abstract

We report the case of a 10-year-old female with acute myeloid leukemia (AML) FAB M0 carrying a novel t(11;19)(q23;p13.1) MLLELL variant, in which intron 8 of MLL is fused to exon 6 of ELL. Complete remission, judged by morphology and cytogenetic analysis, was achieved after the conventional chemotherapy. Eight months after completion of therapy, the level of WT-1 in peripheral blood and the number of cells with the MLLELL fusion transcript resurged. However, the patient remained overtly healthy and the morphology in the bone-marrow smear was innocuous, with no sign of relapse or secondary leukemia. Without any evidence of relapse, the patient has been closely observed without any therapeutic intervention. For approximately 2 years after the completion of therapy, despite clonal proliferation of pre-leukemic cells with an MLLELL fusion gene, she has maintained complete remission. In this case, the rare variant form of MLLELL fusion that has been identified may be related to diminished leukemogenic capacity, resulting in the persistence of pre-leukemic status; an additional genetic abnormality may thus be necessary for full transformation of pre-leukemic cells.

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