B acute lymphoblastic leukemia with t(14;19)(q32;p13.1) involving IGH/EPOR: A clinically aggressive subset of disease

Jesse M. Jaso, C. Cameron Yin, Victoria W. Lu, Ming Zhao, Lynne V. Abruzzo, M. James You, Yaling Yang, Raja Luthra, L. Jeffrey Medeiros, Gary Lu

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7 Scopus citations

Abstract

B acute lymphoblastic leukemia (B-ALL) with t(14;19)(q32;p13.1), in which IGH and EPOR are juxtaposed, has been reported rarely. We describe the clinicopathological features of six patients, three men and three women, with a median age of 39 years. Initial and follow-up bone marrow samples were examined from each patient. The clinical, morphologic, and immunophenotypic results were compared with data obtained from conventional cytogenetic analysis and by using home-brew fluorescence in situ hybridization (FISH) probes for IGH at 14q32 and EPOR at 19p13.1. The bone marrow specimens were hypercellular (median 90%; range 80-100%), with a median blast count of 90% (range 60-93%). Immunophenotypic analysis performed by flow cytometry demonstrated a stable, precursor B-cell immunophenotype. The t(14;19)(q32;p13.1) was present in all cases with morphologic evidence of disease. The translocation was stable and appeared morphologically subtle on conventional karyotypic analysis. Detection was facilitated using FISH, which confirmed IGH/EPOR rearrangement in all cases. All patients received aggressive multiagent chemotherapy as part of a variety of regimens. Four of six patients achieved an initial complete remission, but all relapsed. At last follow-up, five of six patients had died of disease (median survival, 12 months after diagnosis). We conclude that B-ALL associated with t(14;19)(q32;p13.1) is a distinctive form of disease that is associated with younger patient age and an aggressive clinical course.

Original languageEnglish (US)
Pages (from-to)382-389
Number of pages8
JournalModern Pathology
Volume27
Issue number3
DOIs
Publication statusPublished - Mar 1 2014

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Keywords

  • B lymphoblastic leukemia
  • EPOR
  • FISH
  • Hematopathology
  • IGH
  • T(14 19)

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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