Author(s): Wafa, Abdulsamad ; Jarjour, Rami A ; Alolabi, Doaa ; Liehr, Thomas ; Hamdan, Othman ; Melo, Joana B. ; Carreira, Isabel M. ; Othman, Moneeb A. K. ; Al-Achkar, Walid
Date: 2020
Persistent ID: https://hdl.handle.net/10316/106457
Origin: Estudo Geral - Universidade de Coimbra
Subject(s): Acute lymphoblastic leukemia (ALL); Complex karyotype (CK); Molecular cytogenetics; Array comparative genomic hybridization (aCGH); Tumor lysis syndrome (TLS); Prognostic factors
Background: B cell precursor acute lymphoblastic leukemia (B-ALL) is the most common malignancy of childhood, with, after corresponding treatment, an overall complete remission rate of 90%. Approximately 75% of B-ALL cases harbor recurrent abnormalities, including so-called complex karyotypes (CK). Tumor lysis syndrome (TLS) is a metabolic abnormality which may arise during cancer therapy and also, extremely rarely, as spontaneous TLS before initiation of chemotherapy in patients with ALL. Case presentation: Here we report a 9-year-old male, diagnosed with a de novo pre-B-ALL according to the WHO classification. Cytogenetic, molecular cytogenetic approaches and array comparative genomic hybridization analyses revealed a unique CK involving five chromosomes. It included four yet unreported chromosomal aberrations: a der(11)t(7;11)(p22.1;q24.2), a der(18)t(7;18)(q21.3;p11.22), del(11)(q24.2q25) and dup(18)(q11.1q23). Unfortunately, the patient died 3 months after the initial diagnosis. Conclusions: To the best of our knowledge, a comparable childhood ALL case was not previously reported. Thus, the combination of the here seen chromosomal aberrations in childhood primary ALL seems to indicate for an extremely adverse prognosis.
