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Lymphoma

De novo acute B cell leukemia/lymphoma with t(14;18)

Leukemia volume 14, pages 1960–1966 (2000)Cite this article

Abstract

The t(14;18)(q32;q21) translocation is the most common translocation in B cell malignancies being found in 80% of follicular lymphomas and about 20% of diffuse large B cell lymphomas. Only rare cases of de novo acute B cell lymphoblastic leukemia with t(14;18) have been described. We describe five cases of this entity which appears to have very homogeneous clinical, phenotypic and genotypic features. None of these patients had prior history of follicular lymphoma. The disease was characterized by acute clinical features with nodal and/or extranodal disease, massive bone marrow infiltration and rapid increase of circulating blast cells of mature B cell phenotype. All patients disclosed complex chromosomal and molecular abnormalities involving at least the BCL-2 and c-MYC genes. Furthermore, three patients had evidence of BCL-6 involvement and one patient had a p53 mutation. Despite intensive chemotherapy, including for two patients allogeneic bone marrow transplantation in first complete remission, all patients died within a few months. Neuro-meningeal relapse occurred in three of the five patients in spite of neuro-meningeal prophylaxis. De novo leukemia/lymphoma with t(14;18) is a rare entity with a very poor prognosis. Whether early bone marrow transplant could modify the natural history of the disease remains to be determined. An intensive neuro-meningeal prophylaxis appears to be mandatory in these patients.

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Acknowledgements

This work was supported by the Comité Départemental de Seine-Maritime de la Ligue contre le Cancer.

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Authors and Affiliations

  1. Département d'Hematologie, Centre Henri Becquerel, Rouen, France

    A Stamatoullas, S Lepretre, P Lenain & H Tilly

  2. Laboratoire d'Hématologie, Hôpital Charles Nicolle, Rouen, France

    G Buchonnet, B Lenormand & M-P Callat

  3. Service d'Anatomie Pathologique, Centre Henri Becquerel, Rouen, France

    C Duval

  4. Département de Pathologie, Hôpital Henri Mondor, Créteil, France

    P Gaulard

  5. Génétique et Hématologie Moléculaire, INSERM EPI 9906, IFRMP 23, Centre Henri Becquerel, Rouen, France

    C Bastard & H Tilly

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  1. A Stamatoullas
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Stamatoullas, A., Buchonnet, G., Lepretre, S. et al. De novo acute B cell leukemia/lymphoma with t(14;18). Leukemia 14, 1960–1966 (2000). https://doi.org/10.1038/sj.leu.2401910

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  • DOI: https://doi.org/10.1038/sj.leu.2401910

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