Chronic lymphocytic leukemia is usually a monoclonal B-cell neoplasm that occurs almost exclusively in middle-aged and elderly adults. We observed a rapidly progressive case of the disease in a 10-year-old girl. The leukemic cells bore surface IgM and IgD immunoglobulins of the kappa-light-chain type. Karyotyping of the abnormal cells revealed an unusual translocation [t(2;14) (p13;q32)], with break points at or near the kappa-light-chain and heavy-chain gene loci. Translocations involving the immunoglobulin gene loci may be important in the pathogenesis of some cases of chronic lymphocytic leukemia, as they appear to be in Burkitt's lymphoma. (N Engl J Med 1983; 309:590–4).
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