CLL With t(14;19)(q32;q13) Is Characterized by Atypical Morphologic and Immunophenotypic Features and Distinctive Genetic Features

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BlankChronic Lymphocytic Leukemia With t(14;19)(q32;q13) Is Characterized by

Atypical Morphologic and Immunophenotypic Features and Distinctive Genetic

Features

1.. Yang O. Huh, MD1,

2.. Carmen D. Schweighofer, MD1,

3.. Rhett P. Ketterling, MD3,

4.. A. Knudson3,

5.. Francisco Vega, MD, PhD1,

6.. Ji E. Kim, MD1,

7.. Rajyalakshmi Luthra, PhD1,

8.. J. Keating, MB, BS2,

9.. L. Medeiros, MD1 and

10.. Lynne V. Abruzzo, MD, PhD1

+ Author Affiliations

1.. 1From the Departments of Hematopathology and

2.. 2Leukemia, The University of Texas M. D. Cancer Center, Houston

and

3.. 3Division of Laboratory Genetics, Mayo Clinic, Rochester, MN

1.. Address reprint requests to Dr Huh: Dept of Hematopathology, The

University of Texas M. D. Cancer Center, 1515 Holcombe Blvd, Houston,

TX 77030.

Abstract

The t(14;19)(q32;q13) involving the IGH@ and BCL3 loci is an infrequent

cytogenetic abnormality detected in B-cell malignancies. We describe the

clinicopathologic, cytogenetic, and molecular genetic characteristics of 14

cases of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) with

t(14;19)(q32;q13). All patients (10 men and 4 women) had lymphocytosis; 10 had

lymphadenopathy. Blood and bone marrow lymphocytes were predominantly small, but

cytologically and immunophenotypically atypical. In all cases, t(14;19) was

found in the neoplastic stem line; it was the sole abnormality in 4. Ten cases

showed additional cytogenetic abnormalities, including trisomy 12 in 9 and

complex karyotypes in 7. Fluorescence in situ hybridization demonstrated

IGH@/BCL3 fusion gene in all cases. In all cases, the IGHV genes were unmutated,

but only 7 expressed ZAP70. Seven cases preferentially used IGHV4-39. Our

results indicate that t(14;19)(q32;q13) identifies a subset of CLL/SLL with

distinctive clinicopathologic and genetic features. Furthermore, t(14;19) may

represent an early, possibly primary, genetic event.