Chromosomal rearrangement involving 11q23 locus in chronic myelogenous leukemia: A rare phenomenon frequently associated with disease progression and poor prognosis

Wei Wang, Guilin Tang, Jorge E. Cortes, Hui Liu, Di Ai, C. Cameron Yin, Shaoying Li, Joseph D. Khoury, Carlos Bueso-Ramos, L. Jeffrey Medeiros, Shimin Hu

Research output: Contribution to journalArticle

Abstract

Background: Progression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution, commonly unbalanced chromosomal changes, such as an extra copy of Philadelphia chromosome (Ph), +8, and i(17)(q10). Balanced chromosomal translocations typically found in de novo acute myeloid leukemia occur occasionally in CML, such as inv(3)/t(3;3), t(8;21), t(15;17), and inv(16). Translocations involving the 11q23, a relatively common genetic abnormality in acute leukemia, have been seldom reported in CML. In this study, we explored the prevalence and prognostic role of 11q23 in CML. Methods: We searched our pathology archives for CML cases diagnosed in our institution from 1998 to present. Cases with 11q23 rearrangements were retrieved. The corresponding clinicopathological data were reviewed. Results: A total of 2,012 cases of CML with available karyotypes were identified. Ten (0.5%) CML cases had 11q23 rearrangement in Ph-positive cells, including 4 cases of t(9;11), 2 cases of t(11;19), and 1 case each of t(2;11), t(4;11), t(6;11), and t(4;9;11). Eight cases (80%) had other concurrent chromosomal abnormalities. There were 6 men and 4 women with a median age of 50 years (range, 21-70 years) at time of initial diagnosis of CML. 11q23 rearrangement occurred after a median period of 12.5 months (range, 0-172 months): 1 patient in chronic phase, 2 in accelerated phase, and 7 in blast phase. Eight of ten patients died after a median follow-up of 16.5 months (range, 8-186 months) following the initial diagnosis of CML, and a median of 6.7 months (range, 0.8-16.6 months) after the emergence of 11q23 rearrangement. The remaining two patients had complete remission at the last follow-up, 50.2 and 6.9 months, respectively. In addition, we also identified a case with 11q23/t(11;17) in Ph-negative cells in a patient with a history of CML. MLL involvement was tested by fluorescence in situ hybridization in 10 cases, and 7 cases (70%) were positive. Conclusions: In summary, chromosomal rearrangements involving 11q23 are rare in CML, frequently occurring in blast phase, and are often associated with other cytogenetic abnormalities. These patients had a low response rate to tyrosine kinase inhibitors and a poor prognosis.

Original languageEnglish (US)
Article number32
JournalJournal of Hematology and Oncology
Volume8
Issue number1
DOIs
StatePublished - Apr 8 2015
Externally publishedYes

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Leukemia, Myelogenous, Chronic, BCR-ABL Positive
Disease Progression
Blast Crisis
Chromosome Aberrations
Philadelphia Chromosome
Chromosomes, Human, Pair 8
Genetic Translocation
Fluorescence In Situ Hybridization
Karyotype
Acute Myeloid Leukemia
Cytogenetics
Protein-Tyrosine Kinases
Leukemia
Pathology

Keywords

  • 11q23
  • BCR-ABL1
  • Blast phase
  • Chronic myelogenous leukemia
  • Clonal evolution
  • MLL

ASJC Scopus subject areas

  • Molecular Biology
  • Hematology
  • Oncology
  • Cancer Research

Cite this

Chromosomal rearrangement involving 11q23 locus in chronic myelogenous leukemia : A rare phenomenon frequently associated with disease progression and poor prognosis. / Wang, Wei; Tang, Guilin; Cortes, Jorge E.; Liu, Hui; Ai, Di; Yin, C. Cameron; Li, Shaoying; Khoury, Joseph D.; Bueso-Ramos, Carlos; Medeiros, L. Jeffrey; Hu, Shimin.

In: Journal of Hematology and Oncology, Vol. 8, No. 1, 32, 08.04.2015.

Research output: Contribution to journalArticle

Wang, Wei ; Tang, Guilin ; Cortes, Jorge E. ; Liu, Hui ; Ai, Di ; Yin, C. Cameron ; Li, Shaoying ; Khoury, Joseph D. ; Bueso-Ramos, Carlos ; Medeiros, L. Jeffrey ; Hu, Shimin. / Chromosomal rearrangement involving 11q23 locus in chronic myelogenous leukemia : A rare phenomenon frequently associated with disease progression and poor prognosis. In: Journal of Hematology and Oncology. 2015 ; Vol. 8, No. 1.
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title = "Chromosomal rearrangement involving 11q23 locus in chronic myelogenous leukemia: A rare phenomenon frequently associated with disease progression and poor prognosis",
abstract = "Background: Progression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution, commonly unbalanced chromosomal changes, such as an extra copy of Philadelphia chromosome (Ph), +8, and i(17)(q10). Balanced chromosomal translocations typically found in de novo acute myeloid leukemia occur occasionally in CML, such as inv(3)/t(3;3), t(8;21), t(15;17), and inv(16). Translocations involving the 11q23, a relatively common genetic abnormality in acute leukemia, have been seldom reported in CML. In this study, we explored the prevalence and prognostic role of 11q23 in CML. Methods: We searched our pathology archives for CML cases diagnosed in our institution from 1998 to present. Cases with 11q23 rearrangements were retrieved. The corresponding clinicopathological data were reviewed. Results: A total of 2,012 cases of CML with available karyotypes were identified. Ten (0.5{\%}) CML cases had 11q23 rearrangement in Ph-positive cells, including 4 cases of t(9;11), 2 cases of t(11;19), and 1 case each of t(2;11), t(4;11), t(6;11), and t(4;9;11). Eight cases (80{\%}) had other concurrent chromosomal abnormalities. There were 6 men and 4 women with a median age of 50 years (range, 21-70 years) at time of initial diagnosis of CML. 11q23 rearrangement occurred after a median period of 12.5 months (range, 0-172 months): 1 patient in chronic phase, 2 in accelerated phase, and 7 in blast phase. Eight of ten patients died after a median follow-up of 16.5 months (range, 8-186 months) following the initial diagnosis of CML, and a median of 6.7 months (range, 0.8-16.6 months) after the emergence of 11q23 rearrangement. The remaining two patients had complete remission at the last follow-up, 50.2 and 6.9 months, respectively. In addition, we also identified a case with 11q23/t(11;17) in Ph-negative cells in a patient with a history of CML. MLL involvement was tested by fluorescence in situ hybridization in 10 cases, and 7 cases (70{\%}) were positive. Conclusions: In summary, chromosomal rearrangements involving 11q23 are rare in CML, frequently occurring in blast phase, and are often associated with other cytogenetic abnormalities. These patients had a low response rate to tyrosine kinase inhibitors and a poor prognosis.",
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author = "Wei Wang and Guilin Tang and Cortes, {Jorge E.} and Hui Liu and Di Ai and Yin, {C. Cameron} and Shaoying Li and Khoury, {Joseph D.} and Carlos Bueso-Ramos and Medeiros, {L. Jeffrey} and Shimin Hu",
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T1 - Chromosomal rearrangement involving 11q23 locus in chronic myelogenous leukemia

T2 - A rare phenomenon frequently associated with disease progression and poor prognosis

AU - Wang, Wei

AU - Tang, Guilin

AU - Cortes, Jorge E.

AU - Liu, Hui

AU - Ai, Di

AU - Yin, C. Cameron

AU - Li, Shaoying

AU - Khoury, Joseph D.

AU - Bueso-Ramos, Carlos

AU - Medeiros, L. Jeffrey

AU - Hu, Shimin

PY - 2015/4/8

Y1 - 2015/4/8

N2 - Background: Progression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution, commonly unbalanced chromosomal changes, such as an extra copy of Philadelphia chromosome (Ph), +8, and i(17)(q10). Balanced chromosomal translocations typically found in de novo acute myeloid leukemia occur occasionally in CML, such as inv(3)/t(3;3), t(8;21), t(15;17), and inv(16). Translocations involving the 11q23, a relatively common genetic abnormality in acute leukemia, have been seldom reported in CML. In this study, we explored the prevalence and prognostic role of 11q23 in CML. Methods: We searched our pathology archives for CML cases diagnosed in our institution from 1998 to present. Cases with 11q23 rearrangements were retrieved. The corresponding clinicopathological data were reviewed. Results: A total of 2,012 cases of CML with available karyotypes were identified. Ten (0.5%) CML cases had 11q23 rearrangement in Ph-positive cells, including 4 cases of t(9;11), 2 cases of t(11;19), and 1 case each of t(2;11), t(4;11), t(6;11), and t(4;9;11). Eight cases (80%) had other concurrent chromosomal abnormalities. There were 6 men and 4 women with a median age of 50 years (range, 21-70 years) at time of initial diagnosis of CML. 11q23 rearrangement occurred after a median period of 12.5 months (range, 0-172 months): 1 patient in chronic phase, 2 in accelerated phase, and 7 in blast phase. Eight of ten patients died after a median follow-up of 16.5 months (range, 8-186 months) following the initial diagnosis of CML, and a median of 6.7 months (range, 0.8-16.6 months) after the emergence of 11q23 rearrangement. The remaining two patients had complete remission at the last follow-up, 50.2 and 6.9 months, respectively. In addition, we also identified a case with 11q23/t(11;17) in Ph-negative cells in a patient with a history of CML. MLL involvement was tested by fluorescence in situ hybridization in 10 cases, and 7 cases (70%) were positive. Conclusions: In summary, chromosomal rearrangements involving 11q23 are rare in CML, frequently occurring in blast phase, and are often associated with other cytogenetic abnormalities. These patients had a low response rate to tyrosine kinase inhibitors and a poor prognosis.

AB - Background: Progression of chronic myelogenous leukemia (CML) is frequently accompanied by cytogenetic evolution, commonly unbalanced chromosomal changes, such as an extra copy of Philadelphia chromosome (Ph), +8, and i(17)(q10). Balanced chromosomal translocations typically found in de novo acute myeloid leukemia occur occasionally in CML, such as inv(3)/t(3;3), t(8;21), t(15;17), and inv(16). Translocations involving the 11q23, a relatively common genetic abnormality in acute leukemia, have been seldom reported in CML. In this study, we explored the prevalence and prognostic role of 11q23 in CML. Methods: We searched our pathology archives for CML cases diagnosed in our institution from 1998 to present. Cases with 11q23 rearrangements were retrieved. The corresponding clinicopathological data were reviewed. Results: A total of 2,012 cases of CML with available karyotypes were identified. Ten (0.5%) CML cases had 11q23 rearrangement in Ph-positive cells, including 4 cases of t(9;11), 2 cases of t(11;19), and 1 case each of t(2;11), t(4;11), t(6;11), and t(4;9;11). Eight cases (80%) had other concurrent chromosomal abnormalities. There were 6 men and 4 women with a median age of 50 years (range, 21-70 years) at time of initial diagnosis of CML. 11q23 rearrangement occurred after a median period of 12.5 months (range, 0-172 months): 1 patient in chronic phase, 2 in accelerated phase, and 7 in blast phase. Eight of ten patients died after a median follow-up of 16.5 months (range, 8-186 months) following the initial diagnosis of CML, and a median of 6.7 months (range, 0.8-16.6 months) after the emergence of 11q23 rearrangement. The remaining two patients had complete remission at the last follow-up, 50.2 and 6.9 months, respectively. In addition, we also identified a case with 11q23/t(11;17) in Ph-negative cells in a patient with a history of CML. MLL involvement was tested by fluorescence in situ hybridization in 10 cases, and 7 cases (70%) were positive. Conclusions: In summary, chromosomal rearrangements involving 11q23 are rare in CML, frequently occurring in blast phase, and are often associated with other cytogenetic abnormalities. These patients had a low response rate to tyrosine kinase inhibitors and a poor prognosis.

KW - 11q23

KW - BCR-ABL1

KW - Blast phase

KW - Chronic myelogenous leukemia

KW - Clonal evolution

KW - MLL

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U2 - 10.1186/s13045-015-0128-2

DO - 10.1186/s13045-015-0128-2

M3 - Article

C2 - 25888368

AN - SCOPUS:84927557272

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JO - Journal of Hematology and Oncology

JF - Journal of Hematology and Oncology

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