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Biomedical subjects

L C Chan

Publications and source records attributed to L C Chan.

At least 145 records · Page 8Linked to original sources

Clonal expansion of p53 mutant cells in leukemia progression in vitro.

Using the polymerase chain reaction followed by single-strand conformation polymorphism (PCR-SSCP) analysis and direct nucleotide sequence determination, the p53 gene was analyzed in six fresh leukemia samples from which cell lines with p53 mutations were established. Mutations of the p53 gene which were identical to those in the cell lines were observed in three of the fresh samples. In the other three samples, p53 gene mutations were not detected by the conventional PCR-SSCP method. However, when analyzed using allele-specific gene amplification, less than 10% of the leukemic cell population of the three samples, which were below the detection threshold of PCR-SSCP, were shown to have p53 gene mutations. Two samples taken at the initial presentation of two patients, whose relapse samples were shown to contain p53 mutant clones, were also available for analysis. A small population of clonal cells, comprising less than 1% of the population, was shown to have p53 gene mutations in both of these initial samples. These observations provide a potential biologic basis for the frequent findings of p53 mutations in leukemia cell lines and also suggest a potential role for p53 mutations in the clonal overgrowth of cells responsible for relapse of the disease.

Acute Disease↗

Dual-color flow cytometric analysis of megakaryocytic DNA ploidy in the investigation of blastic phase chronic myelogenous leukemia with rearrangement of 3q26.

A patient is described with chronic myelogenous leukemia in blastic crisis, in whom numerous circulating platelet fragments and megakaryocytic nuclei were present, with 50% blasts and 50% micromegakaryocytes in the marrow. The blasts expressed myeloid-associated antigens CD34, CD33, and CD13, whereas the micromegakaryocytes were positive for CD41, CD42b, and CD61. These findings suggested a myeloblastic transformation with a possible megakaryoblastic component. Cytogenetic analysis showed rearrangement of 3q26 in the form of t(2;3) (p13;q26), in addition to t(9;22) (q34;q11). Dual-color flow cytometric analysis of DNA content of CD42b-positive cells showed that the micromegakaryocytes were predominantly 2N, indicating a maturation block before nuclear endoreplication and polyploidization. These findings confirmed a combined myeloblastic and megakaryoblastic transformation. It is concluded that dual-color flow cytometric DNA analysis is a useful method for the investigation of abnormal megakaryocytopoiesis in hematologic malignancies.

Adult↗

In utero rearrangements in the trithorax-related oncogene in infant leukaemias.

The majority (approximately 75%) of infant acute leukaemias have a reciprocal translocation between chromosome 11q23 and one of several partner chromosomes. The gene at 11q23 (named MLL, ALL-1, HRX or HTRX-1; refs 2-6) has been cloned and shares homology with the Drosophila developmental gene trithorax. Rearrangements of this gene (called HRX here) occur in introns and cluster in a region of approximately 10 kb; individual patients have different breakpoints. Here we describe three pairs of infant twins with concordant leukaemia who each share unique (clonal) but non-constitutive HRX rearrangements in their leukaemic cells, providing evidence that the leukaemogenic event originates in utero and unequivocal support for the intra-placental 'metastasis' hypothesis for leukaemia concordance in twins.

Chromosomes, Human, Pair 11↗

Near-octaploidy in essential thrombocythemia.

We report a case of essential thrombocythemia which on cytogenetic analysis showed an abnormal clone with near-octaploidy. Such hyperploidy is extremely unusual in clonal hematologic abnormalities. The possible significance of this finding is discussed.

Aged↗

Trisomy 4 may occur in a broad range of hematologic malignancies.

Trisomy 4 is an uncommon numerical chromosomal aberration in acute leukemia. We describe three cases of trisomy 4, occurring in two patients with acute myeloid leukemia (M1 and M5a) and in one patient with T-cell acute lymphoblastic leukemia. Our results suggest that trisomy 4 may occur in a broader range of hematologic and malignancies than previously described.

Adult↗

Association between t(2;9)(p12;p23) and early B-precursor acute lymphoblastic leukemia.

We report the occurrence of t(2;9)(p12;p23) in a 20-month-old girl with early B-precursor acute lymphoblastic leukemia (ALL). This translocation has only been reported once before in an adult case of early B-precursor ALL with t(4;11)(q21;q23). We suggest that t(2;9)(p12;p23) may be associated with this particular phenotype of ALL.

Chromosomes, Human, Pair 2↗

Effective salvage therapy using all-trans retinoic acid for relapsed and resistant acute promyelocytic leukemia.

All-trans retinoic acid (ATRA) has been shown to be active against acute promyelocytic leukemia (APL). Six patients with APL, either in relapse or resistant to initial chemotherapy were reinduced with ATRA 100 g/m2/day for 6 weeks. Complete remission was achieved in all six of them. Side effects were seen in two of them. ATRA appears to provide a relatively safe and reliable means to induce a complete remission in patients with refractory or relapsed APL.

Adolescent↗

Childhood acute lymphoblastic leukaemia presenting with relapsing hypoplastic anaemia: progression of the same abnormal clone.

A 13-year-old girl presented with two spontaneously reversible episodes of marrow hypoplasia. She subsequently developed acute lymphoblastic leukaemia (ALL) 8 months later. Southern analysis showed identical clonal immunoglobulin heavy chain gene rearrangement bands in the leukaemic cells as well as the marrow cells obtained at the two hypoplastic episodes. Hypoxanthine phosphoribosyl transferase polymorphism studies showed that the ALL blast cells, bone marrow and peripheral blood cells during the two hypoplastic episodes all exhibited clonal haematopoiesis with the same X-chromosome inactivated. This case provides strong evidence that aplastic anaemia and ALL may represent evolution of the same abnormal clone.

Adolescent↗

Interstitial deletion of 9q revisited.

Interstitial deletion of the long arm of chromosome 9 (9q-) is an uncommon karyotypic abnormality in acute myeloid leukemia (AML). We report a case of acute myeloid leukemia, M6 according to the FAB criteria, in which 9q- was the sole karyotypic abnormality. From our own experience and that in the literature, interstitial 9q- seems to be associated with two specific morphologic/cytogenetic categories: AML M2 and t(8;21)(q22;q22)/trisomy 21; and as the sole karyotypic aberration in AML M1/M2(M6) with dyserythropoiesis. Examination of the published karyotypes shows that 9q13 to 9q21 is the commonest deleted segment, suggesting that this region may carry genes important in leukemogenesis.

Acute Disease↗

8;21 translocation and multilineage involvement.

The translocation (8;21)(q22;q22) is commonly associated with acute myeloid leukemia (AML) M2 according to the French-American-British (FAB) classification. We describe 11 cases of t(8;21) diagnosed by strict FAB criteria. Six cases were diagnosed as AML M2, 3 cases as AML M4, 1 case as refractory anemia with excess of blasts in transformation, and 1 case as Philadelphia chromosome negative chronic myeloid leukemia in acceleration. Translocation (8;21) could thus occur in a wider variety of hematological abnormalities. Accordingly, we propose that t(8;21) may involve different hemopoietic lineages.

Acute Disease↗