Pre-natal, clonal origin of acute lymphoblastic leukaemia in triplets
Language English Country United States Media print
Document type Case Reports, Journal Article, Research Support, Non-U.S. Gov't
- MeSH
- Precursor Cell Lymphoblastic Leukemia-Lymphoma genetics immunology MeSH
- Cell Lineage MeSH
- Adult MeSH
- Twins, Monozygotic MeSH
- Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor MeSH
- Gene Rearrangement, T-Lymphocyte * MeSH
- Gene Rearrangement * MeSH
- Genes, Immunoglobulin genetics MeSH
- Genes, T-Cell Receptor delta genetics MeSH
- Genes, T-Cell Receptor gamma genetics MeSH
- Immunoglobulins genetics MeSH
- Cloning, Molecular MeSH
- Bone Marrow metabolism MeSH
- Humans MeSH
- Polymerase Chain Reaction MeSH
- Child, Preschool MeSH
- Sequence Analysis, DNA MeSH
- Triplets MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- IgK MeSH Browser
- Immunoglobulins MeSH
A unique case of ALL in three monozygotic triplets diagnosed at the age of 24, 27 and 37 months is described. Archived bone marrow smears were available for molecular analysis of immunoglobulin heavy chain (IGH) and IGK genes and T-cell receptor (TCR)-delta and gamma gene rearrangements. A shared IGH rearrangement was found in triplets "A" and "B", and an identical rearrangement of TCR-delta in triplets "B" and "C". These data suggest a common, monoclonal initiation of ALL in one of these three triplets, followed by dissemination of clonal progeny to the other twins via vascular anastomoses within the single, monochorionic placenta that they shared in utero. Differences in IGH rearrangements in diagnostic samples also indicates divergent subclonal evolution of the original "pre-leukaemic" clone.
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