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Prenatal chromosomal diversification of leukemia in monozygotic twins
Author(s) -
Kempski Helena,
MensaBonsu Karen A.,
Kearney Lyndal,
Jalali G. Reza,
Hann Ian,
Khurshid Mohammed,
Greaves Mel
Publication year - 2003
Publication title -
genes, chromosomes and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.754
H-Index - 119
eISSN - 1098-2264
pISSN - 1045-2257
DOI - 10.1002/gcc.10233
Subject(s) - biology , leukemia , in utero , karyotype , genetics , fluorescence in situ hybridization , etv6 , chromosomal translocation , cancer research , gene , fetus , chromosome , pregnancy
Previous studies on concordant acute lymphoblastic leukemia (ALL) in identical twins have identified the leukemia as monoclonal with MLL or ETV 6‐ RUNX1 gene fusion as early or initiating events in utero. In the latter case, postnatal latency is associated with secondary genetic events such as ETV6 deletion. We describe here a pair of infant twins with concordant acute monoblastic leukemia (AML). They are a unique pair in that their leukemia blasts display extensive intraclonal chromosomal diversity. Comparison of the leukemic cells between the two twins by karyotype and fluorescence in situ hybridization identifies a common or shared stem line and extensive subclonal diversity for which the twins' leukemic populations are divergent. This case of leukemia illustrates in utero initiation with early imposition of chromosomal instability, the progressively divergent evolution of which can be mapped in the twins into pre‐ and postnatal periods. © 2003 Wiley‐Liss, Inc.