An adult case of biphenotypic acute leukemia with t(6;14)(q25;q32)

S Toyotaka Kawamata, Miho Ogawa, Tomomi Takei, Reina Takeda, Kiyosumi Ochi, Kazuaki Yokoyama, Tomofusa Fukuyama, Nobuhiro Ohno, Kaoru Uchimaru, Arinobu Tojo  

Department of Hematology/Oncology, Research Hospital (KT, OM, TT, TR, OK, YK, FT, ON, UK, TA); Division of Cell Therapy, Advanced Clinical Research Center (TF); Division of Molecular Therapy, Advanced Clinical Research Center, The Institute of Medical Science, the University of Tokyo (TA), 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. Toyotaka Kawamata:, Miho Ogawa:; Tomomi Takei:; Reina Takeda:; Kiyosumi Ochi:; Kazuaki Yokoyama:; Tomofusa Fukuyama:; Nobuhiro Ohno:; Kaoru Uchimaru:; Arinobu Tojo:

Previous history

Malignant disease
Inborn condition

Clinics case report

66 yrs
Lymph nodes
+ Slightly enlarged lymph nodes (submental, cervical, axial, mediastinal, inguinal) were detected by computed tomography.
Cns involv

Blood data

Bone marrow
Hypercellular marrow (NCC 497109/l) with 93.8% blast; monotonous and high nuclear-cytoplasm (N/C) ratio blast cells which had a cleaved nuclear were expanded.

Cyto path

Mixed phenotype acute leukaemia, T/myeloid, NOS
Positve for CD2,cyCD3,CD7,CD13,CD15,CD34,HLA-DR, and dimly positive for CD33,MPO,TdT. Negative for CD1a,CD5,CD11b,CD117,TCR-AB,TCR-GD
Rearranged ig tcr
Not performed.
Acute leukemia compatible.
Electron microscopy
Not performed.
Precise diagnosis
Mixed phenotype acute leukemia, T/myeloid, NOS.

Survival data

Date diagnosis
Japan adult leukemia study group T-ALL213-O induction therapy including vincristine (VCR), cyclophosphamide (CPA), daunorubicin (DNR), L-Asparaginase (L-ASP) and Predonisolone (PSL).
Complete remission
Treatment relat death
Date last follow


Bone marrow
Culture time
46,XY,t(6;14)(q25;q32) [20]
Karyotype relapse
not applicable
Mol cytogenet technics
fluorescence in situ hybridization(FISH) analysis using IgH 3 flanking region/V probes. 14q32 (IgH) break apart probe is a mixture of two probes, 3 IgH flanking probe and IgH variable region probe as shown in Figure 2a.
Mol cytogenet results
Negative for immunoglobulin heavy chain (IgH) translocation (Figure 2b).

Other molec studies

Polymerase chain reaction (PCR) and Sanger sequencing
Positive for Flt3-internal tandem duplication(ITD). Negative for c-kit mutation.


Atlas Image
Partial karyotype from bone marrow cells at the time of diagnosis showing the chromosomal translocation t(6;14)(q25;q32).
Atlas Image
FISH analysis was performed by LSI Medience (Tokyo, Japan). (a) A scheme of 3 flanking probe and V probe which is modified from the technical information of LSI Medience corporation (Tokyo, Japan) web site.(b)Negative result for IgH gene rearrangement in this case.

Comments section

We present an adult case of biphenotypic acute leukemia with t(6;14)(q25;q32). Chromosome translocations involving 14q32 are generally represented by B cell neoplasms, because the immunoglobulin heavy chain (IgH) gene is located in this region. However, BCL11B gene also located in 14q32 was shown to be involved in this translocation (Bezrookove et al.,2004). BCL11B, a member of the Kruppel family of zinc finger trascription factors, plays a critical role in T cell development and functions as a tumor suppressor (Wakabayashi et al.,2003). The partner gene of this translocation is unknown. The 28S ribosomal DNA (RN28S1) was reported as a candidate fusion partner (Kobayashi et al.,2014), but this gene is not located in 6q25. The phenotype of haematological malignancies with t(6;14)(q25;q32) is variable. These include acute lymphoblastic leukemia (ALL) (Heerema et al.,2002), mixed phenotype acute leukemia (Hayashi et al.,1990, Batanian et al.,1996, Georgy et al.,2008, Kobayashi et al.,2014), acute myeloid leukaemia (AML) (Raimondi et al.,1989, Bezrookove et al.,2004), chronic T cell neoplasm (Inwards et al.,1990) and chronic lymphocytic leukaemia (CLL) (Mayr et al.,2006). In 7 of 9 acute leukaemia cases with this translocation, both myeloid and T-cell lineage markers were detected. No immunophenotype was described in the remaining two cases. This translocation may affect expression of T-cell lineage marker, but the role of BCL11B is unclear.


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S Toyotaka Kawamata, Miho Ogawa, Tomomi Takei, Reina Takeda, Kiyosumi Ochi, Kazuaki Yokoyama, Tomofusa Fukuyama, Nobuhiro Ohno, Kaoru Uchimaru, Arinobu Tojo

An adult case of biphenotypic acute leukemia with t(6;14)(q25;q32)

Atlas Genet Cytogenet Oncol Haematol. 2015-09-01

Online version:;14)(q25;q32)