Unusual deletions within the immunoglobulin heavy-chain locus in acute leukemias

We have investigated the structure of the Ig heavy (IGH) chain locus in 309 cases of acute leukemia. Seventy-one cases of B-cell precursor (BCP) acute lymphoblastic leukemia (ALL) were analyzed: in six cases deletion of joining (JH) segments in the presence of cytogenetically normal chromosome 14 was observed. Similar deletions were seen in 1 out of 8 cases of biphenotypic acute leukemia analyzed: this case exhibited t(9:22)(q34;q11) and coexpressed both myeloid and B cell differentiation antigens. Five of the 7 cases analyzed had deleted the JH segments from both chromosomes. Because these deletions may have contributed to the pathogenesis of the disease we have attempted to define their boundaries. Using probes that map both 5' and 3' of JH, the 3' (centromeric) boundary of the deletions was mapped to an approximately 30-kb central region of the 60 kb between C delta and C gamma 3 in 10 of the 12 deleted chromosomes. In the remaining two chromosomes, the 3' boundary mapped to S mu. The 5' (telomeric) boundary could not be defined. However, three cases with biallelic deletion of JH showed biallelic deletion of the most proximal variable (VH) (VH6 and VH5-B2) genes, indicating that the deletions spanned over 500 kb. VH5-B1 and VH5-B3 were retained in germline configuration and no gross deletions were observed using a VH3 subgroup-specific probe, indicating that the 5' boundary mapped within the VH locus. Unusual deletions of the portion of the IgH locus including JH segments and the C mu and C delta genes may occur in acute leukemias with immunophenotypic evidence of commitment to the B cell differentiation pathway. The possible consequences of the deletions remain to be determined. However, the clustering of the centromeric boundary of the deletions to S mu and to a region between the C delta-C gamma 3 genes, a known "hot spot" for recombination, may indicate the operation of a distinct pathogenic mechanism.     

Fibrinogen binding to human blood platelets: effect of gamma chain carboxyterminal structure and length

Recent evidence suggests that fibrinogen binding to platelets is mediated by the 12 carboxyterminal amino acid residues of the gamma chain. Because human plasma fibrinogen gamma chains differ in mol wt and carboxyterminal amino acid sequence, we examined the effect of such gamma chain heterogeneity on platelet-fibrinogen interactions, using two fibrinogens of distinct composition, separated by ion exchange chromatography. One fibrinogen possessed only gamma chains of mol wt 50,000 (F gamma 50), the predominant gamma chain species found in plasma. The other fibrinogen possessed equal amounts of gamma chains with mol wt 50,000 and 57,500 (F gamma 50,57.5), with the longer gamma chain (gamma 57.5) possessing an amino acid extension at the carboxyterminal end. The latter fibrinogen was 50% less effective than F gamma 50 in supporting ADP-induced platelet aggregation at concentrations of .01 to 2 mg/mL. Scatchard analysis revealed no difference in the binding affinities of the two fibrinogens to ADP- treated platelets, but the amount of F gamma 50,57.5 that was bound to platelets at saturation was only 50% that of F gamma 50. Fibrinogen receptors that remained unoccupied in the presence of saturating concentrations of F gamma 50,57.5, however, could be occupied by fresh F gamma 50. Excess unlabeled F gamma 50 displaced both radiolabeled fibrinogens from activated platelets, and both fibrinogens bound to the same platelet receptor, as judged by the inhibition of binding to stimulated platelets by a monoclonal antibody directed against the glycoprotein (GP) IIb/IIIa complex. Furthermore, an intact GPIIb/IIIa complex was required for these reactions, since platelets incubated with EDTA at 37 degrees C at alkaline pH failed to aggregate and bound neither fibrinogen in response to ADP following recalcification. Approximately 50% of each fibrinogen bound irreversibly to platelets after one hour and failed to dissociate in the presence of 10 mmol/L of EDTA or excess unlabeled F gamma 50. The data demonstrate that heterodimeric F gamma 50,57.5 binds less well to platelets and supports platelet aggregation only half as well as homodimeric F gamma 50. These results support prior conclusions that the carboxyterminal portion of the gamma chain is important in platelet-fibrinogen interactions, and suggest that the 20 amino acid, hydrophobic gamma chain carboxyterminal extension of F gamma 50,57.5 may sterically hinder the interaction of this fibrinogen with platelet receptors.     

Allelic loss of IRF1 in myelodysplasia and acute myeloid leukemia: retention of IRF1 on the 5q- chromosome in some patients with the 5q- syndrome

Acquired interstitial deletions of the long arm of chromosome 5 occur frequently in the myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML). Recently IRF1, a putative tumor suppressor gene localized to the long arm of chromosome 5, has been shown to be deleted from the 5q- chromosome in a group of patients with MDS and AML. It has been suggested that the loss of IRF1 may be critical to the development of the 5q- syndrome. We have investigated the allelic loss of IRF1 in a group of 12 patients with MDS and a 5q deletion and 2 patients with AML and a 5q deletion. Gene dosage experiments demonstrated that 12 of 14 patients had loss of one allele of the IRF1 gene but no evidence of homozygous loss and that 2 patients with 5q- syndrome retained both copies of the gene. The retention of IRF1 on the 5q- chromosome in these two cases has been confirmed by fluorescent in situ hybridization localization using an IRF1 cosmid. Pulsed field gel electrophoresis was used to determine whether there was any evidence for structural rearrangement in the region encompassing the IRF1 gene in these two patients. No aberrant bands were detected with a range of rare cutter enzyme digests. We conclude that IRF1 maps outside the commonly deleted segment of the 5q- chromosome and that loss of IRF1 is not solely responsible for the development of the 5q- syndrome.     

Trisomy 21 in childhood acute lymphoblastic leukemia: a Pediatric Oncology Group study (8602)

Of 1,036 children with newly diagnosed non-T, non-B acute lymphoblastic leukemia (ALL) and a demonstrated cytogenetic abnormality treated on the frontline Pediatric Oncology Group (POG) therapeutic trial 8602, there were 33 patients with trisomy 21 as the sole abnormality. Of these 33, 14 had Down syndrome (DS). Although the non-DS (NDS) trisomy 21 cases tended to be older than the DS cases, there were no other significant differences in clinicobiologic features nor in treatment outcomes between the DS and NDS groups, nor between the entire trisomy 21 group and the other chromosome abnormality group. Among NDS patients with +21 and one additional abnormality, +X, +16, -20, and structural abnormalities involving 6q or 12p were common findings. Kaplan-Meier event-free survival (EFS) curves showed a 4-year EFS of 80% (SE, 12%) in NDS trisomy 21 cases, 71% (SE, 22%) in DS cases with trisomy 21 as the sole abnormality, and 69% (SE, 2%) in cases with other chromosome abnormalities. Trisomy 21 as a sole acquired abnormality in NDS patients suggests a good prognosis.