PMID- 8656674
OWN - NLM
STAT- MEDLINE
DCOM- 19960726
LR  - 20151119
IS  - 0887-6924 (Print)
IS  - 0887-6924 (Linking)
VI  - 10
IP  - 5
DP  - 1996 May
TI  - Lineage involvement by BCR/ABL in Ph+ lymphoblastic leukemias: chronic 
      myelogenous leukemia presenting in lymphoid blast vs Ph+ acute lymphoblastic 
      leukemia.
PG  - 795-802
AB  - Chronic myelogenous leukemia (CML) can sometimes present in lymphoid blast phase 
      (L-BP), and can be difficult to distinguish from Philadelphia chromosome-positive 
      (Ph+) acute lymphoblastic leukemia (ALL). Some have suggested that the 
      determination of cell lineages involved by the Ph chromosome may be used for 
      distinguishing CML presenting in L-BP (presumably multilineage disease) from Ph+ 
      ALL (presumably lymphoid-restricted), although others have suggested the term 
      'stem cell ALL' for the multilineage process. Because it has been difficult to 
      perform lineage studies of the Ph chromosome, we investigated the use of 
      fluorescence in situ hybridization (FISH) with probes for BCR (on chromosome 22) 
      and ABL (on chromosome 9) to study lineage involvement in Ph+ lymphoblastic 
      malignancies. We analyzed routine blood and marrow specimens from eight patients 
      who presented with Ph+ lymphoblastic leukemia and found that FISH recognized the 
      9;22 translocation, distinguished between the two common molecular variants, and 
      readily identified multilineage vs lymphoblast-restricted disease. In our series, 
      four patients had multilineage and four had lymphoblast-restricted disease. 
      Multilineage disease was associated with morphologic features of CML at diagnosis 
      and/or reversion to chronic phase CML after treatment leading us to consider it 
      as CML presenting in L-BP. Patients with lymphoid-restricted disease lacked such 
      findings. The survival of three of our four patients with multilineage disease 
      was prolonged, at 25, 28+, and 126+ months, and when data from our entire series 
      are added to those of 18 previously reported cases that were studied for lineage 
      involvement (reviewed in Leukemia 1993; 7: 147), the difference in overall 
      survival between patients with multilineage and lymphoblast-restricted disease is 
      significant (median overall survival of 47 months vs 8 months, respectively; 
      P=0.013, log rank). Our findings illustrate that FISH analysis can be used to 
      recognize lineage involvement in patients presenting with Ph+ lymphoblastic 
      malignancies, and they provide further support to the notion that multilineage 
      and lymphoblast-restricted disease are distinct clinically as well as 
      biologically.
FAU - Anastasi, J
AU  - Anastasi J
AD  - Department of Pathology, University of Chicago, IL, USA.
FAU - Feng, J
AU  - Feng J
FAU - Dickstein, J I
AU  - Dickstein JI
FAU - Le Beau, M M
AU  - Le Beau MM
FAU - Rubin, C M
AU  - Rubin CM
FAU - Larson, R A
AU  - Larson RA
FAU - Rowley, J D
AU  - Rowley JD
FAU - Vardiman, J W
AU  - Vardiman JW
LA  - eng
GR  - CA42557/CA/NCI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - Leukemia
JT  - Leukemia
JID - 8704895
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Neoplasm Proteins)
RN  - EC 2.7.10.2 (Fusion Proteins, bcr-abl)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Biomarkers, Tumor/*analysis
MH  - Blast Crisis/genetics/*pathology
MH  - Cell Lineage
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Fusion Proteins, bcr-abl/*analysis
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics/*pathology
MH  - Male
MH  - Neoplasm Proteins/*analysis
MH  - Neoplastic Stem Cells/metabolism/*pathology
MH  - *Philadelphia Chromosome
MH  - Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics/*pathology
EDAT- 1996/05/01 00:00
MHDA- 1996/05/01 00:01
CRDT- 1996/05/01 00:00
PHST- 1996/05/01 00:00 [pubmed]
PHST- 1996/05/01 00:01 [medline]
PHST- 1996/05/01 00:00 [entrez]
PST - ppublish
SO  - Leukemia. 1996 May;10(5):795-802.