Therapy‐related B‐lymphoblastic leukemia associated with Philadelphia chromosome and MLL rearrangement: Single institution experience and the review of the literature

Therapy related acute lymphoblastic leukemia (t‐ALL) of B cell origin is rare and constitutes approximately 2% of all ALL. Previously compiled data on the complete cytogenetic analysis of 48 t‐B‐ALL cases suggested that MLL rearrangement at 11q23 gene locus is the most common abnormality. Philadelphia chromosome (Ph) and a normal karyotype were reported as the second and third most common karyotypes, respectively. We investigated cytogenetic karyotypes of six t‐B‐ALL cases with a pre‐B cell immunophenotype. Ph + t‐B‐ALL was noted in four of six patients previously treated with radiation and/or chemotherapy. In addition, one case demonstrated MLL rearrangement at 11q23 locus while one case demonstrated normal cytogenetic karyotype. Five of the six t‐B‐ALL patients had persistent leukemia following initiation of chemotherapy for secondary leukemia with survival ranging from 10 to 21 months. To our knowledge, only fourteen patients with Ph + t‐B‐ALL have been described in the literature. In the current study, three of four cases with Ph + t‐B‐ALL were associated with treated breast carcinoma while one patient was treated for Hodgkin lymphoma. All four patients had undergone radiation therapy. The results may indicate a plausible association between Ph+t‐B‐ALL and prior radiation exposure.     

“I feel your disgust and relief”: can the action understanding system (mirror neuron system) be recruited to induce disgust and relief from contamination vicariously,in individuals with obsessive–compulsive disorder symptoms?

Research has shown that brain regions mediating disgust (e.g., the insula) become activated when viewing others’ disgust, a response mediated, perhaps by the mirror neuron system or the Theory of Mind module. In a novel behavioral experiment, we explore vicarious disgust and relief, in individuals with obsessive–compulsive disorder (OCD) symptoms. Participants (N = 10) provided disgust ratings to self-contamination or watching the contamination of an experimenter; and to the experimenter washing his own hands after the subjects had been contaminated. To our surprise, we found that subjects experienced disgust from merely watching the experimenter contaminating himself. More intriguingly, after subjects had contaminated themselves, they obtained relief from merely watching the experimenter washing his own hands; even while recognizing the logical absurdity of this. The result is counterintuitive since neither the subjects nor anyone else would have predicted this. These preliminary findings – if confirmed in placebo-controlled studies – might pave the way toward novel therapeutic approaches for OCD.