Acute Lymphoblastic Leukemia: Genetic Events and Molecular Signatures

Abstract

Childhood or pediatric acute precursor B cell lymphoblastic leukemia (B-ALL) is the most prevalent hematological malignancy in children. Previous studies have revealed relationships between genetic lesions and the disease. In this review, I discuss our current understanding of the genetic lesions and molecular events in childhood B-ALL and the related therapeutic implications.

Acute Precursor B-Cell Lymphoblastic Leukemia in a 1-Year-Old White Male: Diagnostic Evaluation and Flow Cytometric Analysis

“…Which diagnosis is derived from examination of the flow cytometric data? 6. How are acute B-cell leukemias subtyped genetically?…”

“…Unlike the MLL rearrangement, the ETV6-RUNX1 translocation has a favorable prognosis. 6 More rare, but still significant, is the BCR-ABL1 translocation, t(9;22)(q34;q11.2), which forms the Philadelphia chromosome normally associated with chronic myeloid leukemia(CML). Blasts typically test positive for CD10, CD19, and terminal deoxynucleotidyl transferase (TdT), with accompanying increased expression of myeloid markers CD13 and CD33 without involvement of the myeloid lineage.…”

“…Although uncommon in childhood B-ALL, the prognosis for t(9;22) patients is considered to be poor. 6 The presence or absence of these genetic abnormalities is assessed using fluorescence in situ hybridization (FISH), with probes specific for the DNA sequences of the genes that may become altered (Image 6). This patient exhibits a nonspecific genotype, which tests negative for the translocations previously discussed herein (Image 7) although still demonstrating an abnormal karyotype.…”