der(21)t(1;21)(q11-12;p11-13) and der(21)t(1;21)(q21-32;p11-13)

2017-10-01   Adriana Zamecnikova 

1.Kuwait Cancer Control Center, Kuwait annaadria@yahoo.com

Abstract

Unbalanced chromosome translocations involving all or part of the whole long arm of chromosome 1 and the short arms of acrocentric chromosomes are widely reported in human neoplasia. Among them, chromosome translocations between the long arm of chromosome 1 and chromosome 21 have been reported in patients with various conditions, including myeloid malignancies, acute lymphoblastic leukemia, multiple myeloma and lymphomas.

Clinics and Pathology

Disease

Chronic and acute myeloid malignancies, acute lymphoblastic leukemia (ALL), multiple myeloma (MM) and various lymphoid neoplasms.

Embryonic origin


Epidemiology

There were 13 males and 10 females (1 unknown) aged 8 to 90 years old (median 65 years) in a group of patients with 1q11-12 translocations (Table 1). Patients with 1q25-32 translocations tended to be younger and included 6 males and 5 females aged 0 to 72 years (median age 17 years), 2 of them were infants (Felix et al., 1998; Chessells et al., 2002) (Table 2).
 SEX/AGEDISEASEKARYOTYPE
MYELOPROLIFERATIVE DISORDERS 
1M/68CMML46,XY,der(21)t(1;21)(q11;p11)
2F/76PV46,XX,der(4)t(1;4)(q12;p16)/46,XX,der(21)t(1;21)(q12;p12)
3FET46,XX,der(21)t(1;21)(q11;p13)
MYELODYSPLASTIC SYNDROME
4M/56MDS
APL-like
47,XY,+11
47,XY,t(4;11)(q10;p15),+11/48,idem,+8/48,idem,+11/48,idem,+13/48,idem,+17/48,idem,+19/47,idem,der(22)t(1;22)(q12;p13)
47,XY,t(4;11),+11,der(21)t(1;21)(q12;p13) 
5F/75RARS46,XX,del(20)(q11)/46,idem,der(21)t(1;21)(q12;p11)
6F/80RAEB46,XX,der(21)t(1;21)(q10;p10)
ACUTE MYELOID LEUKEMIA
7M/36AML58,XY,-X,-1,-3,-4,-5,+6,-7,-9,-10,-12,der(15)t(1;15)(q12;p11),-16,-17,-18,-21/58,idem,-der(15),der(21)t(1;21)(q12;p11)/47,XY,+8
ACUTE LYMHOBLASTIC LEUKEMIA
8MB-ALL46,XY,der(19)t(1;19)(q23;p13)/46,idem,der(21)t(1;21)(q12;p13)
9FALL46,XX,der(19)t(1;19)(q23;p13)/46,idem,der(21)t(1;21)(q11;p11)
10MALL46,XY,del(13)(q1?2),der(21)t(1;21)(q12;p12)
11 B-ALL46,X?,der(1)t(1;19)(q23;p13),i(7)(q10),der(21)t(1;21)(q12;p13)
12MB-ALL46,XY,del(6)(q13q23),der(19)t(1;19)(q23;p13)/46,idem,der(21)t(1;21)(q12;p11)
MULTIPLE MYELOMA
13MMM43,X,-Y,+1,der(1;15)(q10;q10),der(4)t(1;4)(q11;q35),-13,-14,der(21)t(1;21)(q11;p11),-22  /td>
14FMM44,X,-X,der(6)add(6)(p25)t(1;6)(q12;q12),?inv(7)(p14p22),del(8)(p11),-13,del(20)(q12),der(21)t(1;21)(q10;p11)
15FMM44-45,XX,del(1)(p13p32),t(2;14)(p23;q32),t(4;14)(p16;q32),add(5)(q33),der(5)t(1;5)(q10;p15),der(7;7) t(7;7)(p22;?q33)add(7)(p22),-13,del(14)(q24),der(21)t(19;21)(?p13;p11),add(21)(p11)/45,XX,der(1) del(1)add(1)(q32),t(2;14),t(4;14)(p16;q32),add(5),der(5)t(1;5)(q11-12;p15),-13,del(14),der(19)t(1;19)  (q11-12;q13),der(21)t(19;21),add(21)/45,XX,der(1)del(1)add(1),t(2;14),t(4;14)(p16;q32),add(5),der(5)t(1;5),-13,del(14),der(14)del(14)t(1;14)(q11-12;q24),der(21)t(19;21),add(21)/45,XX,der(1)del(1)add(1), t(2;14),t(4;14)(p16;q32),add(5),der(5)t(1;5),-13,del(14),der(21)t(1;21)(q11-12;p11),der(21)t(19;21), add(21)
16FMM46,X,-X,add(1)(q21),ider(1)(q10)del(1)(q42),?del(5)(p15),+hsr(7)(p15),der(8)t(1;8)(p13;q24),+add(9) (p12),der(10)t(1;10)(q21;p13)add(10)(q26),del(11)(q21q23),del(13)(q12q22),i(13)(q10),-14,add(15)(q26),der(18)t(1;18)(q12;q23),add(20)(q13),der(21)t(1;21)(q12;p13)ins(21;?)(p13;?),add(22)(p11)
NON HODGKIN LYMHOMA
17M/8MBN46,XY,der(8)t(7;8)(q21;q24)dup(7)(q21q36),der(14)t(8;14)(q24;q32),der(21)t(1;21)(q11;p13)
18MMBN42-47,XY,add(3)(q11),add(8)(q24),der(14)t(8;14)(q24;q32),t(14;18)(q32;q21),del(16)(q13),+20/42-47, idem,der(21)t(1;21)(q11;p11)/47-48,idem,+X/47-48, idem,+7/49,idem,+X,+7 LN
19FFL49-50,X,del(X)(p21),dic(1;12)(?p21;q24),t(3;4)(q27;p13),+i(6)(p10),t(14;18)(q32;q21),i(17)(q10), +add(19)(q13),der(21)t(1;21)(q11;p11),+2mar LN
20FFL 42-54,XX,t(6;7)(p21;q22),+7,+der(7)t(6;7),t(8;14)(q24;q32),+11,+11,+12,+der(14)t(8;14),+21,der(21)t(1;21)(q12;p13)x2 LN
21MDLBCL46,X,-Y,add(1)(p32),dup(1)(q21q31),t(3;14)(q27;q32),add(8)(p11),del(9)(p11),der(21)t(1;21)(q12;p13), +mar LN LN
22M/90BL46,XY,t(8;14)(q24;32),der(21)t(1;21)(q14;p12) LN
OTHERS
23M/65PCL82-87,XXY,-Y,-1,-2,-3,-4,-5,del(6)(q21)x2,-8,del(8)(p21),-10,-10,add(11)(p15)x2,-13,-13,-14,-15,-15,-18, +19,der(20)t(1;20)(q11;q13)ins(20;?)(q13;?)x2,der(21)t(1;21)(q11;p13)ins(21;?)(p13;?),-22,inc
24M/30HD46,X,-Y,del(4)(q28),+8,add(9)(p24),der(14)t(1;14)(q11;p11),der(21)t(1;21)(q11;p11) LN

Abbreviations: M, male; F, female; CMML, Chronic myelomonocytic leukemia; PV, Polycythemia vera; ET,  Essential thrombocythemia; MDS, Myelodysplastic syndrome; APL, Acute promyelocytic leukemia; RARS, Refractory anemia with ringed sideroblasts;  RAEB, Refractory anemia with excess of blasts; AML, Acute myeloid leukemia; ALL, Acute lymphoblastic leukemia/lymphoblastic lymphoma;  MM, Multiple myeloma; MBN, Mature B-cell neoplasm; LN, lymph node; FL, Follicular lymphoma; DLBCL, Diffuse large B-cell lymphoma; BL, Burkitt lymphoma/leukemia; PCL, Plasma cell leukemia; HD, Hodgkin disease.
1. Amenomori et al., 1986; 2. Juneau et al., 1998; 3. Gangat et al., 2009; 4. Najfeld et al., 1994; 5. Huh et al., 2010; 6. Makishima et al., 2013; 7. Liu et al., 2007; 8. Raimondi et al., 1990; 9. Uckun et al., 1998; 10. Heerema et al., 2000; 11. Lu et al., 2002; 12. Bousquet et al., 2007; 13. Sawyer et al., 1998; 14. Sawyer et al., 1998; 15. Gabrea et al., 2008; 16. Sawyer et al., 2014; 17. Dayton et al., 1994; 18. Schmitz et al., 1997; 19. Roumier et al., 2000; 20. Katzenberger et al., 2004; 21. Ruminy et al., 2006; 22. Trcic et al., 2010; 23. Andreasson et al., 1998; 24. Stamatoullas et al., 2007
 SEX/AGEDISEASEKARYOTYPE
ACUTE MYELOID LEUKEMIA
1M/0AML-M546,XY,der(1)t(1;1)(p36;q21)/45,idem,-Y/47,idem,+8/46,XY,der(21)t(1;21)(q21;p11)
B-CELL ACUTE LYMHOBLASTIC LEUKEMIA
2MALL46,XY,der(21)t(1;21)(q21;p13)dup(1)(q21q32)
3F/0ALL47,XX,+X,t(11;19)(q23;p13),der(21)t(1;21)(q25;p11)
4M/11ALL46,XY,del(6)(q13q21),der(19)t(1;19)(q23;p13),der(21)t(1;21)(q21;p11)
5M/50ALL46,XY,der(8)t(8;9)(p22;p24)t(8;22)(q24;q11),der(9)t(8;9)(p21;p24),der(21)t(1;21)(q21;p11),der(22)t(8;22) (q24;q11)
46,XY,t(8;9)(q22;q24)
46,XY,der(8),der(9)x2,der(21),der(22)/46,idem,der(16)t(16;22)(q24;q11) 
T-CELL ACUTE LYMPHOBLASTIC LEUKEMIA
6M/72ALL46,XY,der(21)t(1;21)(q25;p11) 
MULTIPLE MYELOMA
7FMM39-41,-X,der(X)t(X;18)(q28;q11)ins(X;?)(q28;?),t(1;8)(p11-13;q24),add(2)(p25),dup(3)(q21q29),
add(4)(q?31),t(4;14)(p16;q32),add(7)(p22),-8,der(9;17)(p10;q10),der(10)t(8;10)(q11;p13),-13,-14,
add(15)(p11),der(15)t(9;15)(q12;p11),der(18)t(X;18),add(19)(q13),+20, der(21)t(1;21)(q23;p11)
ins(21;?)(p11;?),+mar
8FMM39-45,XX,der(1;21)(p10;q10),+r(?1)(p13q?31),der(2)t(1;2)(q12;q37),add(3)(q29),der(4;18)(p10;q10),
add(5)(q34),+7,add(10)(q26),add(12)(p12),-13,add(15)(p11),der(15)t(?14;15)(q31;q24),add(17)(q25),
der(19)t(?7;19)(p13;q13),add(20)(p12),der(21)t(1;21)(q?31;p13)
NON HODGKIN LYMHOMA
9F/17BL46,XX,del(7)(q22q32),t(8;14)(q24;q32)/46,idem,t(1;18)(q11;p11)/46,idem,t(1;21)(q11;p11)
48,X,der(X)t(X;8)(q11;q11),+del(3)(q21q29),t(3;16)(p12;q24),+del(7),t(8;14),?del(14)(q11q21), der(21)t(1;21)(q21;p13)
10F/67DLBCL51-56,XX,+X,+del(1)(q21),+2,+5,+6,+7,+del(8)(q24),+9,+10,+11,+13,+14,+17,+20,-21,der(21 t(1;21)(q21;p11),-22,-22,+2mar exudate
OTHERS
11M/65MF/SS 45,XY,der(1)t(1;17)(p13;q21),t(2;5)(p14;q14),t(3;7)(p21;q35),t(4;9)(p?15;p?22),-5,-6,-9,-11,del(12)(q22),-17,-19,add(19)(q13),der(21)t(1;21)(q32;p13),+5mar

Abbreviations: M, male, f, female, BL, AML-M5, Acute monoblastic leukemia; ALL, Acute lymphoblastic leukemia; MM, Multiple myeloma; Burkitt lymphoma/leukemia; DLBCL, Diffuse large cell lymphoma; MF/SS, Mycosis fungoides/Sezary syndrome.
1. Chessells et al., 2002; 2. Raimondi et al., 1990; 3. Felix et al., 1998; 4. Andersen et al., 2011; 5. Patterer et al., 2013; 6. Safavi et al., 2015; 7. Gabrea et al., 2008; 8. Sawyer et al., 2014; 9. Fitzgerald et al., 1984; 10. Gladstone et al., 1994; 11. Schlegelberger et al., 1994.
Patients with centromeric 1q11-12 translocations were diagnosed mainly with myeloid malignancies and lymphomas
  • Myeloid malignancies in 7: 1 chronic myelomonocytic leukemia (CMML) (Amenomori et al., 1986), 1 myelodysplastic syndrome (MDS)/ acute promyelocytic leukemia (APL)-like leukemia (Najfeld et al 1994), 1 polycythemia vera (PV) (Juneau et al., 1998), 1 essential thrombocythemia (ET) (Gangat et al., 2009), 1 refractory anemia with ringed sideroblasts (RARS) (Huh et al., 2010), 1 refractory anemia with excess of blasts (RAEB) (Makishima et al., 2013) and 1 acute myeloid leukemia (AML) (Liu et al., 2007).
  • Acute lymphoblastic leukemia in 5 (Raimondi et al., 1990; Uckun et al., 1998; Heerema et al., 2000; Lu et al., 2002; Bousquet et al., 2007).
  • Multiple myeloma in 4 (Sawyer et al., 1998; Gabrea et al., 2008; Sawyer et al., 2014).
  • Various lymphoid malignancies in 7: 2 mature B-cell neoplasm (MBN) (Schmitz et al., 1997; Dayton et al., 1994), 1 Burkitt lymphoma/leukemia (BL) (Trcic et al., 2010), 1 Plasma cell leukemia (PCL) (Andreasson et al., 1998), 2 follicular lymphoma (FL) (Roumier et al., 2000; Katzenberger et al., 2004), 1 diffuse large B-cell lymphoma (DLBCL) (Ruminy et al., 2006) and 1 HD (Hodgkin disease) (Stam atoullas et al., 2007).
    der(21)t(1;21) with 1q21-32 breakpoints was less frequent and has been detected mainly in patients with ALL: 4 of them were diagnosed with B-cell ALL (Raimondi et al 1990; Felix et al., 1998; Andersen et al., 2011; Patterer et al., 2013) and 1 patient with T-ALL (Safavi et al., 2015). In addition, there were sporadic cases with other malignancies: 1 acute monoblastic leukemia (AML-M5) (Chessells et al., 2002), 1 diffuse large B-cell lymphoma (DLBCL), 1 Burkitt lymphoma/leukemia (BL) (Fitzgerald et al., 1984), 1 mycosis fungoides/Sezary syndrome (MF/SS) (Schlegelberger et al., 1994) and 2 multiple myeloma patients (Gabrea et al., 2008; Sawyer et al., 2014).
  • Prognosis

    Associated with poor-risk genetic features and/or complex karyotypes in the majority of described patients, indicative of chromosomal instability related to disease progression and therapy resistance.

    Cytogenetics

    Atlas Image
    Figure 1. Partial karyotypes with der(21)t(1;21)(q11-12;p11-13) (A). Fluoresce in situ hybridization with LSI RUNX1/ RUNX1T1 probe (Vysis/Abott Molecular, US) revealing hybridization of RUNX1 probe to der(21) chromosome (green signal). (B). Hybridization with LSI 1p36/1q25 probe on metaphases and interphase cells showing the presence of extra green signal of 1q25 on der(21) chromosome and in interphase cells (green signal) (C).

    Cytogenetics morphological

    der(21)t(1;21)(q11-12;p11-13) has been detected as sole anomaly in 3 myeloproliferative disorders (Amenomori et al., 1986; Gangat et al., 2009; Makishima et al., 2013), found in association with trisomy 11 in MDS transforming to APL-like leukemia (Najfeld et al., 1994), del(20)(q11) in RARS (Huh et al., 2010) and additional 1q abnormalities in PV (Juneau et al., 1998) and AML patients (Liu et al., 2007). In patients diagnosed with ALL, there was a notable association with der(19)t(1;19)(q23;p13) as except 1 case with del(13q), in the remaining 4 ALL patients der(19)t(1;19)(q23;p13) was detected. Associated with t(8;14)(q24;q32) in 4 mature B-cell/Burkitt lymphoma/leukemia (Dayton et al., 1994; Schmitz et al., 1997; Katzenberger et al 2004; Trcic et al 2010) and with highly complex karyotypes in the remaining patients.In the group of patients with 1q21-32 breakpoints , sole anomaly was detected only in 1 T-ALL (Safavi et al., 2015); found in association with t(11;19)(q23;p13) in an infant with B-ALL (Felix et al., 1998), der(19)t(1;19)(q23;p13) in the pediatric B-ALL (Andersen et al., 2011), t(8;22)(q24;q11) in 1 B-ALL (Patterer et al., 2013) and (8;14)(q24;q32) in the BL patient (Fitzgerald et al., 1984). Found in the sideline with der(1)t(1;1)(p36;q21) and -Y/ +8 in infant with AML-M5 (Chessells et al., 2002) and as a part of complex karyotypes in the remaining patients.
    Atlas Image
    Figure 2. Partial karyotypes with der(21)t(1;21)(q21;p11-13) (A). Fluorescence in situ hybridization with LSI 1p36/1q25 probe (Vysis/Abott Molecular, US) on metaphase showing the extra 1q25 signal on der(21) chromosome and in interphase cells (B).

    Result of the Chromosomal Anomaly

    Oncogenesis

    Unbalanced 1q translocations to the short arms of acrocentric chromosomes are recurrent chromosome anomalies detectable in both hematologic neoplasms and lymphomas. Their main consequence is an extra copy of part of the long arm of chromosome 1 resulting in gene dosage abnormalities. Unbalanced translocations involving 1q and an acrocentric chromosome typically do not involve key genes, but they have as main consequence gain of the long arm of chromosome 1. 1q gains typically involve large chromosome regions, therefore simultaneous overexpression of multiple genes that might cooperate in an additive or synergistic way is likely implicated in neoplastic processes. der(21)t(1;21) was apparently a late event in the majority of reported patients- occurring together with the well-known primary abnormalities or as part of complex karyotypes, therefore representing clonal evolution change preceding or accompanying disease evolution.

    Bibliography

    Pubmed IDLast YearTitleAuthors
    219026802011Paediatric B-cell precursor acute lymphoblastic leukaemia with t(1;19)(q23;p13): clinical and cytogenetic characteristics of 47 cases from the Nordic countries treated according to NOPHO protocols.Andersen MK et al
    95291341998Fluorescence in situ hybridization analyses of hematologic malignancies reveal frequent cytogenetically unrecognized 12p rearrangements.Andreasson P et al
    171792302007A novel PAX5-ELN fusion protein identified in B-cell acute lymphoblastic leukemia acts as a dominant negative on wild-type PAX5.Bousquet M et al
    119869372002Clinical features, cytogenetics and outcome in acute lymphoblastic and myeloid leukaemia of infancy: report from the MRC Childhood Leukaemia working party.Chessells JM et al
    81165661994L3 acute lymphoblastic leukemia. Comparison with small noncleaved cell lymphoma involving the bone marrow.Dayton VD et al
    97030011998MLL genomic breakpoint distribution within the breakpoint cluster region in de novo leukemia in children.Felix CA et al
    63333801984Telomeric association of chromosomes in B-cell lymphoid leukemia.Fitzgerald PH et al
    183816412008Secondary genomic rearrangements involving immunoglobulin or MYC loci show similar prevalences in hyperdiploid and nonhyperdiploid myeloma tumors.Gabrea A et al
    192364462009Cytogenetic abnormalities in essential thrombocythemia: prevalence and prognostic significance.Gangat N et al
    110784972000Abnormalities of chromosome bands 13q12 to 13q14 in childhood acute lymphoblastic leukemia.Heerema NA et al
    200950392010Characterization of chromosome arm 20q abnormalities in myeloid malignancies using genome-wide single nucleotide polymorphism array analysis.Huh J et al
    96149091998Detection of RB1 deletions by fluorescence in situ hybridization in malignant hematologic disorders.Juneau AL et al
    152772222004Cytogenetic alterations affecting BCL6 are predominantly found in follicular lymphomas grade 3B with a diffuse large B-cell component.Katzenberger T et al
    171599882007Chromosome 5q deletion and epigenetic suppression of the gene encoding alpha-catenin (CTNNA1) in myeloid cell transformation.Liu TX et al
    123999652002The utility of spectral karyotyping in the cytogenetic analysis of newly diagnosed pediatric acute lymphoblastic leukemia.Lu XY et al
    75198691994Myelodysplastic syndrome transforming to acute promyelocytic-like leukemia with trisomy and rearrangement of chromosome 11.Najfeld V et al
    234006752013Hematologic malignancies with PCM1-JAK2 gene fusion share characteristics with myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB, and FGFR1.Patterer V et al
    23807591990Cytogenetics of pre-B-cell acute lymphoblastic leukemia with emphasis on prognostic implications of the t(1;19).Raimondi SC et al
    119201792000FISH analysis with a YAC probe improves detection of LAZ3/BCL6 rearrangement in non-Hodgkin's lymphoma.Roumier C et al
    166190462006Two patterns of chromosomal breakpoint locations on the immunoglobulin heavy-chain locus in B-cell lymphomas with t(3;14)(q27;q32): relevance to histology.Ruminy P et al
    92476091997Effect of CPT-11 on lipid peroxide level in mouse tissues.Sadzuka Y et al
    252610972015Novel gene targets detected by genomic profiling in a consecutive series of 126 adults with acute lymphoblastic leukemia.Safavi S et al
    244975332014Jumping translocations of 1q12 in multiple myeloma: a novel mechanism for deletion of 17p in cytogenetically defined high-risk disease.Sawyer JR et al
    79878001994Recurrent chromosome abnormalities in peripheral T-cell lymphomas.Schlegelberger B et al
    91676981997Diagnosis of small non-cleaved cell lymphoma by fine needle aspiration utilizing cytomorphologic features combined with cytogenetic analysis.Schmitz L et al
    174959682007Conventional cytogenetics of nodular lymphocyte-predominant Hodgkin's lymphoma.Stamatoullas A et al
    206981072010Recurrent chromosomal abnormalities in lymphomas in fine needle aspirates of lymph node.Trcić RL et al
    94693371998Clinical significance of translocation t(1;19) in childhood acute lymphoblastic leukemia in the context of contemporary therapies: a report from the Children's Cancer Group.Uckun FM et al

    Citation

    Adriana Zamecnikova

    der(21)t(1;21)(q11-12;p11-13) and der(21)t(1;21)(q21-32;p11-13)

    Atlas Genet Cytogenet Oncol Haematol. 2017-10-01

    Online version: http://atlasgeneticsoncology.org/haematological/1478/der(21)t(1;21)(q21-32;p11-13)

    External Links