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      Estudio molecular del gen MLL en 30 pacientes con leucemias agudas Translated title: Molecular study of MLL gen in 30 patients with acute leukemias

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          Abstract

          Los reordenamientos del gen MLL en la banda cromosómica 11q23 son frecuentes en leucemias agudas (LA) en niños y en las LA secundarias desarrolladas después de la terapia con inhibidores de la enzima topoisomerasa II. En menor medida también se aprecia en adultos con LA. La presencia de estos reordenamientos se considera un indicador de mal pronóstico asociado con resultados clínicos desfavorables, por ello es muy importante realizar su determinación en las LA. En este trabajo mostramos los resultados preliminares de la introducción del estudio del gen MLL en nuestro país mediante la técnica de Southern. Analizamos ADN de 30 pacientes con LA, incluidos niños y adultos, que en el momento del estudio se encontraban al debut o en recaída. El estudio molecular se realizó con la sonda FA4, que es un inserto genómico del gen MLL. Sólo uno de los 30 pacientes mostró bandas de reordenamiento con 2 enzimas de restricción diferentes, el resto mostró el gen MLL en configuración germinal. Es interesante destacar que el paciente con el reordenamiento era un niño con leucemia mieloblástica aguda subtipo M5b, lo cual concuerda con la literatura, donde se describe que estos reordenamientos están estrechamente correlacionados con los subtipos mielomonocítico (M4) y monocítico (M5) de leucemia mieloide aguda (LMA)

          Translated abstract

          Rearrangements of MLL gen in llq23 chromosomal band are frequents in childhood type of acute leukemia (AL) and in secondary AL, developed after therapy with II topoisomerase enzyme. To a lesser extent also is seen in adults with AL. Presence of theses rearrangements is considered to be a worse prognosis indicator, associated with unfavourable clinical results, that is why it is very important to carry our its assessment in AL. In this paper authors present preliminary results from introduction of study on MLL gen in our country through Southern technique. DNA from 30 patients was analized, including children and adults, that at the very moment when study was performed, they were in the onset or in relapse. Molecular study was carried out using FA4 probe, which is a genomic insertion of MLL gen. Only one out of 30 patients, presented rearrangement band with 2 distinct restriction enzymes, remainder showed MLL gen in germinal form. It is interesting to underline that patient with rearrangement was a child presenting subtype M5b acute myeloblastic leukemia, which agree with literature showing that these rearrangements are closely correlated to subtype myelomonocytic (M4) and monocytic (M5) of acute myeloid leukemia (AML)

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          Most cited references28

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          Growth disturbance in fetal liver hematopoiesis of Mll-mutant mice.

          The MLL (ALL-1, HRX) gene is frequently involved in chromosomal translocations in acute leukemia and has homology with Drosophila trithorax, which controls homeobox gene expression and embryogenesis. To elucidate the function of Mll, we generated mice with a mutated Mll locus. Mice with a homozygous mutation were embryonic lethal and died at embryonic day 11.5 to 14.5, showing edematous bodies and petechiae. Histological examination revealed that hematopoietic cells were decreased in the liver of homozygous embryos, although they were composed of erythroid, myeloid, monocytic, and megakaryocytic cells with normal differentiation. Colony-forming assays using cells from fetal livers and yolk sacs showed that the number of colonies was markedly reduced and many of the colonies delayed to be recognized in Mllmu/mu embryos, although some of the colonies from Mllmu/mu embryos developed similarly with that from Mll+/+ and Mll+/mu embryos, suggesting the delayed onset of the proliferation of hematopoitic precursors. These data show that the hematopoietic precursors were greatly reduced in mutant mice, and suggest that Mll functions as a regulator of the growth of hematopoietic precursors.
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            Molecular rearrangements on chromosome 11q23 predominate in infant acute lymphoblastic leukemia and are associated with specific biologic variables and poor outcome.

            Acute lymphoblastic leukemia (ALL) in infants generally shows distinctive biologic features and has a poor prognosis. Cytogenetic studies indicate that many infant leukemias have chromosome 11q23 translocations. Because of these findings and the distinct clinical features of infant leukemia, we investigated 30 cases of infant ALL for molecular defects of 11q23. Fourteen cases had cytogenetic abnormalities of 11q23, and all of them showed 11q23 rearrangements at the molecular level. An additional seven cases also had 11q23 molecular rearrangements, including one with normal cytogenetic analysis. Molecular abnormalities of 11q23 were significantly correlated with adverse prognostic factors, including age under 6 months, hyperleukocytosis, CD10- phenotype, and early treatment failure. Molecular analysis identified a group of infants with germline 11q23 that had a very good treatment outcome with a projected event-free survival of 80% at median follow-up of 46 months compared to 15% in infants with rearranged 11q23 (P < .001). These findings suggest that a high proportion (70%) of infants with ALL have 11q23 rearrangements and that these rearrangements are not always detectable by cytogenetic analysis. The presence of germline 11q23 DNA may identify a subgroup of infant ALL patients with a good outcome using current therapy and a different etiology for their ALL.
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              Incidence and characterization of MLL gene (11q23) rearrangements in acute myeloid leukemia M1 and M5.

              To determine the incidence of MLL rearrangement in acute myeloid leukemia (AML) French-American-British (FAB) type M1 and to evaluate optimal screening strategies for the characterization of such abnormalities, we analyzed specimens from 41 patients with AML by Southern blotting with two MLL genomic probes and compared the capacities of reverse transcription-polymerase chain reaction (RT-PCR) and fluorescent in situ hybridization (FISH) to identify the types of rearrangement found in AML M1 with those observed in AML M5. MLL rearrangement was found in 6 of 29 (20%) AML M1 and 6 of 10 AML M5 cases. RT-PCR characterization of 11 cases showed four MLL self-fusions, four MLL-AF6, two MLL-AF9, including a novel AF9 breakpoint, and one uncharacterized t(11:19). Only 5 of 10 MLL-rearranged cases tested demonstrated karyotypic 11q23 abnormalities. FISH analysis of nine cases with an MLL-specific yeast artificial chromosome (YAC) confirmed the cytogenetic abnormalities in two cases, clarified them in one, and did not detect six cases, including three MLL self-fusions, one case with a probable MLL-rearranged subclone not represented karyotypically, and twoMLL-AF6. A whole chromosome 11 paint detected one of these MLL-AF6, and an AF6 cosmid demonstrated that the other was probably due to insertion of a submicroscopic portion of chromosome 6, including part of AF6, into an apparently normal chromosome 11. We conclude that MLL rearrangements are common in adult AML M1, that MLL self-fusion and MLL-AF6 are the most frequent types of abnormalities, and that RT-PCR is preferable to 11q23 FISH analysis for their characterization.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                hih
                Revista Cubana de Hematología, Inmunología y Hemoterapia
                Rev Cubana Hematol Inmunol Hemoter
                Editorial Ciencias Médicas (Ciudad de la Habana )
                1561-2996
                April 2000
                : 16
                : 1
                : 38-44
                Affiliations
                [1 ] Instituto de Hematología e Inmunología Cuba
                Article
                S0864-02892000000100004
                9fa8b363-8bcf-41ae-bbb4-b31f867c75a8

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Cuba

                Self URI (journal page): http://scielo.sld.cu/scielo.php?script=sci_serial&pid=0864-0289&lng=en
                Categories
                HEMATOLOGY

                Hematology
                GENE REARRANGEMENT,HEMATOLOGIC DISEASES,LEUKEMIA, LYMPHOCYTIC,REORDENAMIENTO GENICO,ENFERMEDADES HEMATOLOGICAS,LEUCEMIA LINFOCITICA

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