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t(2;6)(p12;p25) IRF4/IGK

t(6;14)(p25;q32) IRF4/IGH

t(6;22)(p25;q11) IRF4/IGL

Written2012-04Itziar Salaverria, Reiner Siebert
Institute of Human Genetics, University Hospital Schleswig-Holstein Campus Kiel/Christian-Albrechts University Kiel, Kiel, Germany

(Note : for Links provided by Atlas : click)

Identity

ICD-Topo C420,C421,C424 BLOOD, BONE MARROW, & HEMATOPOIETIC SYS
Atlas_Id 1175
Note The t(6;14) translocation juxtaposing the immunoglobulin heavy chain gene to the IRF4 gene have been shown to activate the transcription factor MUM1/IRF4 in multiple myeloma and in a subtype of mature B-cell lymphomas (Iida et al., 1997; Salaverria et al., 2011). The translocation leads to the overexpression of the MUM1/IRF4 gene.
In multiple myeloma, IRF4 is similarly juxtaposed by an illegitimate IG switch recombination to the IG loci (Iida et al., 1997). Moreover, in multiple myeloma, expression of IRF4 is not only driving those cases with IG/IRF4-fusion but is also essential for survival in cases lacking this translocation (Shaffer et al., 2008).
Specifically IGH/IRF4 and its variants fusions are associated with a subgroup of GC B-cell lymphomas composing follicular lymphoma grade 3 or centroblastic DLBCL characterized by coexpression of MUM1 and BCL6 in the absence of PRDM1/BLIMP1, a specific gene expression profile, and a disease onset predominantly in childhood or young adulthood (Salaverria et al., 2011).
 
  Fluorescence in situ hybridization (FISH) analyses for the detection of IRF4 breaks in, the signal constellation shows IRF4 breaks and IGH-IRF4 fusion in two cases of B-cell lymphoma respectively.

Clinics and Pathology

Disease Multiple myeloma (MM)
Phenotype / cell stem origin Plasma Cell. MUM1+/BCL6-/BLIMP1+.
Epidemiology Rare translocation, <1% (Tamura et al., 2000). Not one of the five recurrent IGH translocations in MM (Swerdlow et al., 2008).
Clinics Unknown.
Prognosis As a result, the MUM1/IRF4 gene is overexpressed, an event that contributes to tumorigenesis. The clinical significance of this alteration in MM remains unknown.

Disease B-cell lymphoma, follicular lymphoma, diffuse large B-cell lymphoma
Phenotype / cell stem origin Germinal Center derived. MUM1+/BCL6+/BLIMP1-.
Epidemiology Rare translocation. Present in 15% and 2% of the pediatric and adult GCB derived B-cell lymphomas respectively (Salaverria et al., 2011).
Clinics Clinical presentation is significantly skewed toward the involvement of the head and neck region, including Waldeyer ring and limited disease stages (Salaverria et al., 2011).
Prognosis IG/IRF4-positive cases are associated with a significantly better prognosis, although this effect is predominantly associated with the low age of the positive cases (Salaverria et al., 2011; Klapper et al., 2012).

Genetics

In MM, three cell lines have showed fusions between these two loci, which resulted in the juxtaposition of the MUM1 to the IgH 3' alpha-enhancer region by virtue of t(6;14) or insertion of the IgH sequences into the vicinity of the MUM1 gene and in the concomitant overexpression of the MUM1 mRNA (Yoshida et al., 1999).
In germinal center derived lymphomas, long-distance inverse PCR for cloning the IGH partner have been used. Sμ-long-distance inverse PCR has detected a switch μ-associated translocation t(6;14)(p25;q32) in two cases. Both translocations disrupted the coding region of EXOC2. Immediately telomeric of EXOC2 maps the IRF4 gene, which through the translocation is juxtaposed to the IGH locus on the der(14)t(6;14) in the same transcriptional direction (Salaverria et al., 2011).
The breakpoints might be located on either side of IRF4 and can affect the DUSP22 gene, immediately telomeric and the EXOC2 gene centromeric to IRF4. In this sense, a recent sequencing study has described in a young DLBCL patient carrying a fusion between 6p25 and 14q32, juxtaposing IGH with the DUSP22 gene (Morin et al., 2011).

Cytogenetics

Cytogenetics Morphological t(6;14)(p25;q32) is cytogenetically cryptic, not detectable by means of conventional cytogenetic analysis (Yoshida et al., 1999).
Cytogenetics Molecular FISH constellation have demonstrated juxtaposition of IGH and IRF4.
Additional anomalies In germinal center derived lymphomas, the IG/IRF4-positive lymphomas had fewer chromosomal imbalances suggesting that the IRF4 translocation is an early event in lymphomagenesis. In MM, the secondary copy number changes of the positive cases are unknown.
Variants Light chain variants t(2;6)(p12;p25), t(6;22)(p25;q11). IRF4 breakpoints with unknown translocation partner.

Genes involved and Proteins

Gene Name IRF4
Location 6p25
Dna / Rna 9 exons.
Protein Lymphocyte specific; The transcription factor MUM1/IRF4 is required during an immune response for lymphocyte activation and the generation of immunoglobulin-secreting plasma cell.
Gene Name IGH
Location 14q32
Dna / Rna IgH is composed of IGHV genes, IGHD segments, IGHJ segments, and IGHC genes.
Protein IgH encodes the immunoglobulin heavy chains.

Result of the chromosomal anomaly

Hybrid gene
Description IRF4 translocated on chromosome 14.
  
Fusion Protein
Description No fusion protein; the immunoglobulin gene enhancer stimulates the expression of IRF4.
  

To be noted

Additional cases are needed to delineate the epidemiology of this rare entity:
you are welcome to submit a paper to our new Case Report section.

Bibliography

Recurrent immunoglobulin gene translocations identify distinct molecular subtypes of myeloma.
Chesi M, Kuehl WM, Bergsagel PL.
Ann Oncol. 2000;11 Suppl 1:131-5. (REVIEW)
PMID 10707795
 
Deregulation of MUM1/IRF4 by chromosomal translocation in multiple myeloma.
Iida S, Rao PH, Butler M, Corradini P, Boccadoro M, Klein B, Chaganti RS, Dalla-Favera R.
Nat Genet. 1997 Oct;17(2):226-30.
PMID 9326949
 
Patient age at diagnosis is associated with the molecular characteristics of diffuse large B-cell lymphoma.
Klapper W, Kreuz M, Kohler CW, Burkhardt B, Szczepanowski M, Salaverria I, Hummel M, Loeffler M, Pellissery S, Woessmann W, Schwanen C, Trumper L, Wessendorf S, Spang R, Hasenclever D, Siebert R; Molecular Mechanisms in Malignant Lymphomas Network Project of the Deutsche Krebshilfe.
Blood. 2012 Feb 23;119(8):1882-7. Epub 2012 Jan 11.
PMID 22238326
 
Frequent mutation of histone-modifying genes in non-Hodgkin lymphoma.
Morin RD, Mendez-Lago M, Mungall AJ, Goya R, Mungall KL, Corbett RD, Johnson NA, Severson TM, Chiu R, Field M, Jackman S, Krzywinski M, Scott DW, Trinh DL, Tamura-Wells J, Li S, Firme MR, Rogic S, Griffith M, Chan S, Yakovenko O, Meyer IM, Zhao EY, Smailus D, Moksa M, Chittaranjan S, Rimsza L, Brooks-Wilson A, Spinelli JJ, Ben-Neriah S, Meissner B, Woolcock B, Boyle M, McDonald H, Tam A, Zhao Y, Delaney A, Zeng T, Tse K, Butterfield Y, Birol I, Holt R, Schein J, Horsman DE, Moore R, Jones SJ, Connors JM, Hirst M, Gascoyne RD, Marra MA.
Nature. 2011 Jul 27;476(7360):298-303. doi: 10.1038/nature10351.
PMID 21796119
 
Translocations activating IRF4 identify a subtype of germinal center-derived B-cell lymphoma affecting predominantly children and young adults.
Salaverria I, Philipp C, Oschlies I, Kohler CW, Kreuz M, Szczepanowski M, Burkhardt B, Trautmann H, Gesk S, Andrusiewicz M, Berger H, Fey M, Harder L, Hasenclever D, Hummel M, Loeffler M, Mahn F, Martin-Guerrero I, Pellissery S, Pott C, Pfreundschuh M, Reiter A, Richter J, Rosolowski M, Schwaenen C, Stein H, Trumper L, Wessendorf S, Spang R, Kuppers R, Klapper W, Siebert R; Molecular Mechanisms in Malignant Lymphomas Network Project of the Deutsche Krebshilfe; German High-Grade Lymphoma Study Group; Berlin-Frankfurt-Munster-NHL trial group.
Blood. 2011 Jul 7;118(1):139-47. Epub 2011 Apr 12.
PMID 21487109
 
IRF4 addiction in multiple myeloma.
Shaffer AL, Emre NC, Lamy L, Ngo VN, Wright G, Xiao W, Powell J, Dave S, Yu X, Zhao H, Zeng Y, Chen B, Epstein J, Staudt LM.
Nature. 2008 Jul 10;454(7201):226-31. Epub 2008 Jun 22.
PMID 18568025
 
WHO classification of tumors of hematopoietic and lymphoid tissues.
Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Vardiman JW.
IARC, Lyon, 2008.
 
Detection of MUM1/IRF4-IgH fusion in multiple myeloma.
Yoshida S, Nakazawa N, Iida S, Hayami Y, Sato S, Wakita A, Shimizu S, Taniwaki M, Ueda R.
Leukemia. 1999 Nov;13(11):1812-6.
PMID 10557056
 

Citation

This paper should be referenced as such :
Salaverria I, Siebert R
t(2;6)(p12;p25) IRF4/IGK; t(6;14)(p25;q32) IRF4/IGH; t(6;22)(p25;q11) IRF4/IGL;
Atlas Genet Cytogenet Oncol Haematol. in press
On line version : http://AtlasGeneticsOncology.org/Anomalies/t614p25q32IRF4IGHID1175.html


Other genes implicated (Data extracted from papers in the Atlas) [ 2 ]

Genes BCL6 IRF4

Translocations implicated (Data extracted from papers in the Atlas)

 t(2;6)(p12;p25) IRF4/IGK
 t(6;14)(p25;q32) IRF4/IGH
 t(6;22)(p25;q11) IRF4/IGL

External links

arrayMap (UZH-SIB Zurich)
Mitelman databaset(2;6)(p12;p25) [Case List]    t(2;6)(p12;p25) [Association List] Mitelman database (CGAP - NCBI)
Mitelman databaset(6;14)(p25;q32) [Case List]    t(6;14)(p25;q32) [Association List] Mitelman database (CGAP - NCBI)
Mitelman databaset(6;22)(p25;q11) [Case List]    t(6;22)(p25;q11) [Association List] Mitelman database (CGAP - NCBI)
arrayMap[select an item]
 
 
Disease databaset(2;6)(p12;p25) IRF4/IGK
REVIEW articlesautomatic search in PubMed
Last year articlesautomatic search in PubMed
All articlesautomatic search in PubMed


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