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Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Scope The Atlas of Genetics and Cytogenetics in Oncology and Haematology is a peer reviewed on-line journal in open access, devoted to genes, cytogenetics, and clinical entities in cancer, and cancer-prone diseases. It presents structured review articles (“cards”) on genes, leukaemias, solid tumours, cancer-prone diseases, and also more traditional review articles (“deep insights”) on the above subjects and on surrounding topics. It also present case reports in hematology and educational items in the various related topics for students in Medicine and in Sciences. Editorial correspondance Jean-Loup Huret Genetics, Department of Medical Information, University Hospital F-86021 Poitiers, France tel +33 5 49 44 45 46 or +33 5 49 45 47 67 [email protected] or [email protected] The Atlas of Genetics and Cytogenetics in Oncology and Haematology is published 4 times a year by ARMGHM, a non profit organisation. Philippe Dessen is the Database Director, and Alain Bernheim the Chairman of the on-line version (Gustave Roussy Institute – Villejuif – France). http://AtlasGeneticsOncology.org © ATLAS - ISSN 1768-3262 The PDF version of the Atlas of Genetics and Cytogenetics in Oncology and Haematology is a reissue of the original articles published in collaboration with the Institute for Scientific and Technical Information (INstitut de l’Information Scientifique et Technique - INIST) of the French National Center for Scientific Research (CNRS) on its electronic publishing platform I-Revues. Online and PDF versions of the Atlas of Genetics and Cytogenetics in Oncology and Haematology are hosted by INIST-CNRS. Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Editor Jean-Loup Huret (Poitiers, France) Volume 3, Number 1, January - March 1999 Table of contents Gene Section KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) Lidia Larizza, Alessandro Beghini 1 LAZ3 (Lymphoma Associated Zinc finger on chromosome 3) Jean-Pierre Kerckaert 4 KITLG (KIT ligand) Lidia Larizza 6 P53 (Protein 53 kDa) Richard Hamelin, Jean-Loup Huret 8 ABCC1 (ATP-binding cassette, sub-family C (CFTR/MRP), member 1) Franck Viguié 11 NBS1 (Nijmegen breakage syndrome 1) Jean-Loup Huret 13 NUP98 (nucleoporin 98 kDa) Jean-Loup Huret 15 Leukaemia Section del(6q) in Multiple Myeloma Christophe Brigaudeau 17 Systemic mast cell disease (SMCD) Lidia Larizza, Alessandro Beghini 19 t(1;5)(p32;q31) Jean-Loup Huret 21 t(11;14)(p13;q11), t(7;11)(q35;p13) Chrystèle Bilhou-Nabera 22 B-cell prolymphocytic leukemia (B-PLL) Lucienne Michaux 24 Splenic lymphoma with villous lymphocytes Jean-Loup Huret, Hossain Mossafa 26 +8 or trisomy 8 Jean-Loup Huret 28 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) t(11;14)(q13;q32) in multiple myeloma Atlas of Genetics and Cytogenetics in Oncology and Haematology Huret JL, Laï JL OPEN ACCESS JOURNAL AT INIST-CNRS t(1;7)(q10;p10) Jean-Loup Huret 31 del(6q) abnormalities in lymphoid malignancies Christophe Brigaudeau, Chrystele Bilhou-Nabera 33 t(8;16)(p11;p13) Christine Pérot, Jean-Loup Huret 36 Solid Tumour Section Bone: Chordoma Monica Miozzo 39 Kidney: Nephroblastoma (Wilms tumor) Monica Miozzo 41 Cancer Prone Disease Section Familial gastrointestinal stromal tumors (GISTs) Lidia Larizza, Alessandro Beghini 43 Piebaldism Lidia Larizza, Alessandro Beghini 44 Nijmegen breakage syndrome Jérôme Couturier 46 Retinoblastoma Dietmar R Lohmann 48 Rothmund-Thomson syndrome (RTS) Lidia Larizza 50 Bannayan-Riley-Ruvalcaba syndrome Jean-Loup Huret 52 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) Lidia Larizza, Alessandro Beghini Department of Biology and Genetics for Medical Sciences, Medical Faculty, University of Milan, Via Viotti 3/5, 20133 Milan, Italy (LL, AB) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/KITID127.html DOI: 10.4267/2042/37473 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Transcription Identity 5,23 kb mRNA; alternative splicing of exon 9 gives rise to two isoforms, KITA and KIT, that differ by the presence or absence of four amino acids. Other names: SCFR (Stem cell factor receptor); CD117 Location: 4q12 Local order: Centromere-PDGFRA-KIT-KDRtelomere. Protein Description 976 aa; 145 kDa; type III receptor tyrosine kinase; contains an extracellular domains with 5 Ig-like loops, a highly hydrophobic transmembrane domain (23 aa), and an intracellular domain with tyrosine kinase activity split in an ATP-binding region and in the phosphotransferase domain by a kinase insert (KI). Expression Hematopoietic stem cells, mast cells, melanocytes, germ-cell lineages and ICCs (interstitial cells of Cajal). Localisation Plasma membrane. Function DNA/RNA SCF/MGF receptor with tyrosine kinase activity; binding of ligand (SCF) induces receptor dimerization, autophosphorylation and signal transduction via molecules containing SH2domains. Description Homology Spans over 70 kb; 21 exons; size of intron 1: >30 kb. With CSF-1R, PDGFRb, PDGFRa, and FLT3. KIT (4q12) - Courtesy Mariano Rocchi. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 1 KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) Systemic mast cell disease (SMCD) Mutations Disease Mast cell hyperplasia in the bone marrow, liver, spleen, lymph nodes, gastrointestinal tract and skin; gain of function mutations have been detected in a few patients. Prognosis Depending on the four clinical entities recognized: indolent form, form associated with hematologic disorder, aggressive SMCD and mast cell leukemia; leukemic transformation with mast cell involvement is characterized by rapid progression of disease with a survival time less than 1 year. Oncogenesis Clinical features of malignant hematopoietic cell growth are influenced by the time, the location of cKIT mutative events, and the number of associated lesions. Germinal In piebaldism, and in familial gastrointestinal stromal tumours (see below). Somatic In aggressive mastocytosis, mast cell leukemia, AML with mast cell involvement, myeloproliferative disorders, colon carcinoma and gastrointestinal stromal tumours. Implicated in Piebaldism Disease Autosomal dominant disorder of pigmentation; loss of function abnormalities of the c-KIT gene have been demonstrated in 59% of the typical patients. Familial gastrointestinal stromal tumours and sporadic gastrointestinal stromal tumours (GISTs) To be noted Note Loss of expression of c-KIT appears to be associated with progression of some tumors (melanoma) and autocrine/paracrine stimulation of the c-KIT/SCF system may participate in human solid tumors such as lung, breast, testicular and gynecological malignancies. Disease GISTs are the most common mesenchymal tumors in the human digestive tract; they originate from KIT-expressing cells (ICCs), and were found to have activating c-KIT mutations in the juxtamembrane domain. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Larizza L, Beghini A 2 KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog) Larizza L, Beghini A References mastocytosis: establishment of clonality in a human mast cell neoplasm. Nat Genet. 1996 Mar;12(3):312-4 Vandenbark GR, deCastro CM, Taylor H, Dew-Knight S, Kaufman RE. Cloning and structural analysis of the human c-kit gene. Oncogene. 1992 Jul;7(7):1259-66 Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y. Gain-of-function mutations of ckit in human gastrointestinal stromal tumors. Science. 1998 Jan 23;279(5350):577-80 Ezoe K, Holmes SA, Ho L, Bennett CP, Bolognia JL, Brueton L, Burn J, Falabella R, Gatto EM, Ishii N. Novel mutations and deletions of the KIT (steel factor receptor) gene in human piebaldism. Am J Hum Genet. 1995 Jan;56(1):58-66 This article should be referenced as such: Larizza L, Beghini A. KIT (v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):1-3. Longley BJ, Tyrrell L, Lu SZ, Ma YS, Langley K, Ding TG, Duffy T, Jacobs P, Tang LH, Modlin I. Somatic c-KIT activating mutation in urticaria pigmentosa and aggressive Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 3 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review LAZ3 (Lymphoma Associated Zinc finger on chromosome 3) Jean-Pierre Kerckaert Unite 124 INSERM, Institut de Recherche sur le Cancer, Place de Verdun, 59045 Lille cedex, France (JPK) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/BCL6ID20.html DOI: 10.4267/2042/37472 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology protein interaction motif and repressing domain) and C-term with 6 Krüppel-like zinc fingers (sequence specific DNA binding domain). Identity Other names: BCL6 (B-Cell Lymphoma 6) Location: 3q27 Local order: Gene orientation: telomere - 5' LAZ3 3' - centromere. Expression Normally expressed in germinal center B and T cells, in skeletal muscle cells and in keratinocytes. Localisation Nuclear dots. Function Sequence-specific DNA binding transcriptional repressor; consensus DNA-binding site: TTC(C/T)T(A/C)GAA; the LAZ3/BCL6 protein mediates transcriptional repression by recruiting (through the BTB/POZ domain) a nuclear hormone receptor co-repressor (SMRT) and histone deacetylation; it is required for the formation of germinal centers and the Th2 mediated response. BCL6 (3q27) - Courtesy Mariano Rocchi. Homology DNA/RNA BTB/POZ - Zinc Finger proteins (PLZF, HIC1, KUP, BAZF, ttk (drosophila); BrC (drosophila)...). Description Spans on a 25 kb genomic fragment. 11 exons; the two first exons 1A and 1B are alternative; translational ATG in exon 3. Implicated in 3q27 rearrangements / NHL (non Hodgkin lymphomas) Transcription 3.8 kb mRNA. Disease NHL: in 30-40% of diffuse large cell lymphoma, 514% of follicular lymphoma. Prognosis Still controversial (favourable in BCL6- vs BCL2rearranged non Hodgkin lymphomas according to some studies or not significative in other reports). Protein Description 706 amino acids; 79 kDa; BTB/POZ Zinc finger protein: N-term BTB/POZ domain (130-aa protein- Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 4 LAZ3 (Lymphoma Associated Zinc finger on chromosome 3) Kerckaert JP transcripts driven by the 5' regulatory region of LAZ3 fused to the partner gene coding region, have been characterised. Abnormal protein No fusion protein. Cytogenetics 3q27 rearrangements are diverse : translocations, micro-deletions, point mutations and hypermutation); about half of 3q27 translocations Ig genes at 14q32 (IgH), 2p12 (IgK) and 22q12 (IgL) (e.g. t(3;14)(q27;q32)); the other half includes a variety of other chromosomal regions (1q21, 2q21, 4p11, 5q31, 6p21, 7p12, 8q24, 9p13, 11q13, 11q23, 12q11, 13q14-21, 14q11, 15q21, 16p11...); frequent bi-allelic alterations (translocation and deletion or mutation on the non-translocated allele). Hybrid/Mutated gene Hybrid gene and transcripts are formed following promoter substitution between LAZ3 and its different partner: Ig-LAZ3 in t(3;14)(q27;q32); RHOH-LAZ3 in t(3;4)(q27;p13); Histone H4LAZ3 in t(3;6)(q27;p21); OBF1-LAZ3 in t(3;11)(q27;q23), L-Plastin-LAZ3 in t(3;13)(q27;q14-21); chimeric transcripts are generally detected containing the 5' part of the gene partner fused to the normal LAZ3 exon 2 splice acceptor site; in some cases reciprocal chimeric Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Breakpoints Note Clustered in a 3,3 kb EcoRI fragment (MTC) includind exon 1A and intron 1. References Kerckaert JP, Deweindt C, Tilly H, Quief S, Lecocq G, Bastard C. LAZ3, a novel zinc-finger encoding gene, is disrupted by recurring chromosome 3q27 translocations in human lymphomas. Nat Genet. 1993 Sep;5(1):66-70 This article should be referenced as such: Kerckaert JP. LAZ3 (Lymphoma Associated Zinc finger on chromosome 3). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):4-5. 5 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review KITLG (KIT ligand) Lidia Larizza Department of Biology and Genetics for Medical Sciences, Medical Faculty, University of Milan, Via Viotti 3/5, 20133 Milan, Italy (LL) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/MGFID142.html DOI: 10.4267/2042/37474 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology involves the region corresponding to exon 6 of the SCF cDNA, which contains the proteolytic cleavage site, encodes for a surface molecule. Identity Other names: SCF (Stem cell factor) Location: 12q22 Expression SCF transcripts have been found in the cells surrounding kit-positive cells, such as granulosa and Sertoli cells, bone marrow stromal cells and in fibroblasts, keratinocytes and mature granulocytes; SCF expression of peripheral lymphocytes and monocytes is still controversial. DNA/RNA Localisation Plasma membrane or interstitial space. Function SCF/MGF binding of receptor KIT, with tyrosine kinase activity, induces receptor dimerization, autophosphorylation and signal transduction via molecules containing SH2-domains; the soluble and the transmembrane protein have a different biological activity; the soluble form mainly stimulates cellular proliferation. Description Genomic sequence not known; 9 exons. Transcription 1,4 kb mRNA; alternative splicing gives rise to different transcripts, mainly represented by those for a membrane and a soluble form. Homology With PDGFRb, PDGFRa, and CSF-1. Protein Mutations Description Germinal The membrane bound form is a surface molecule of 248 aa, that includes 23 aa of the highly hydrophobic transmembrane domain; the second form corresponds to a soluble protein constituted by the first 165 aa of the extracellular domain released by a posttranslational processing, consisting in a proteolytic cleavage of the mature SCF in the extracellular juxtamembrane region; the full length transcripts encode for a transmembrane precursor of the soluble protein; an alternative splicing that Human mutations are yet unknown in human MGF/SCF gene; mouse mutations at the murine steel (Sl) locus that encodes MGF are known and give rise to deficiencies in pigment cells, germ cells, and blood cells; in particular the steel-Dickie (Sld) mouse has a 4.0-kb intragenic deletion that truncates the Sl coding sequence; Sld mice are only capable of encoding a soluble truncated growth factor that lacks both transmembrane and cytoplasmic domains. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 6 KITLG (KIT ligand) Larizza L Implicated in References Mastocytosis Martin FH, Suggs SV, Langley KE, Lu HS, Ting J, Okino KH, Morris CF, McNiece IK, Jacobsen FW, Mendiaz EA. Primary structure and functional expression of rat and human stem cell factor DNAs. Cell. 1990 Oct 5;63(1):20311 Disease In skin from patients with mastocytosis, MGF was found prevalently free in the dermis and in extracellular spaces between keratinocytes suggesting the presence of a soluble form of the protein; altered distribution of mast cell growth factor in the skin of patients with cutaneous mastocytosis is consistent with abnormal production of the soluble form of the factor, resulting by an increased cleavage of SCF with excessive release of a soluble form from the normally membrane bound form; no sequence abnormalities were detected in MGF mRNA. Zsebo KM, Williams DA, Geissler EN, Broudy VC, Martin FH, Atkins HL, Hsu RY, Birkett NC, Okino KH, Murdock DC. Stem cell factor is encoded at the Sl locus of the mouse and is the ligand for the c-kit tyrosine kinase receptor. Cell. 1990 Oct 5;63(1):213-24 Hibi K, Takahashi T, Sekido Y, Ueda R, Hida T, Ariyoshi Y, Takagi H, Takahashi T. Coexpression of the stem cell factor and the c-kit genes in small-cell lung cancer. Oncogene. 1991 Dec;6(12):2291-6 Ferrari S, Grande A, Manfredini R, Tagliafico E, Zucchini P, Torelli G, Torelli U. Expression of interleukins 1, 3, 6, stem cell factor and their receptors in acute leukemia blast cells and in normal peripheral lymphocytes and monocytes. Eur J Haematol. 1993 Mar;50(3):141-8 Gynecological tumors Disease Findings obtained on three cervical carcinomas (ovarian serous adenocarcinoma, small cell carcinoma and ovarian immature teratoma) and two gynecological cancer cell lines (ME180 and HGCM) demonstrate coexpression of c-Kit receptor and SCF; these observations are consistent with the possibility that an autocrine activation of SCF/KIT system might be involved in gynecological malignancies. Longley BJ Jr, Morganroth GS, Tyrrell L, Ding TG, Anderson DM, Williams DE, Halaban R. Altered metabolism of mast-cell growth factor (c-kit ligand) in cutaneous mastocytosis. N Engl J Med. 1993 May 6;328(18):1302-7 Inoue M, Kyo S, Fujita M, Enomoto T, Kondoh G. Coexpression of the c-kit receptor and the stem cell factor in gynecological tumors. Cancer Res. 1994 Jun 1;54(11):3049-53 Ramenghi U, Ruggieri L, Dianzani I, Rosso C, Brizzi MF, Camaschella C, Pietsch T, Saglio G. Human peripheral blood granulocytes and myeloid leukemic cell lines express both transcripts encoding for stem cell factor. Stem Cells. 1994 Sep;12(5):521-6 Small-cell lung cancer Disease SCF is expressed in small-cell lung cancer (SCLC); abundant expression of SCF and c-Kit mRNA was seen in 32% of SCLC cell lines and 66% of SCLC tumors; an autocrine mechanism in the pathogenesis of SCLC is strongly suggested. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: Larizza L. KITLG (KIT ligand). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):6-7. 7 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review P53 (Protein 53 kDa) Richard Hamelin, Jean-Loup Huret INSERM U434, Laboratoire de Genetique des Tumeurs, CEPH, Paris, France (RH), Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/P53ID88.html DOI: 10.4267/2042/37475 This article is an update of: Hamelin R, Huret JL. P53 (protein 53 kDa). Atlas Genet Cytogenet Oncol Haematol.1998;2(4):119. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology eliminated. In both cases, the consequence is to prevent propogation of cells containing genetic alterations. Identity Other names: TP53 (Tumour Protein 53) Location: 17p13 Homology DNA/RNA The five domains are highly-conserved regions between species. Description Mutations The gene encompasses 20 kb of DNA; 11 exons (the first is non-coding). Germinal Transcription In Li-Fraumeni syndrome, a dominantly inherited disease in which affected individuals are predisposed to develop sarcomas, osteosarcomas, leukemias and breast cancers at unusually early ages. 3.0 kb mRNA; 1179 bp open reading frame. Protein Description Somatic 393 amino acids; 53 kDa phosphoprotein; contains, from N-term to C-term, a transactivation domain, a DNA-binding domain, nuclear localization signals and a tetramerization domain. P53 is mutated in about 50% of human cancers, and the non-mutated allele is generally lost; the frequency and the type of mutation may vary from one tumor type to another; in general, mutations are found in the central part (exons 4-8) of the p53 gene; these mutations are missense, non-sense, deletions, insertions or splicing mutations; there are some hot-spots for mutations at CpG dinucleotides at positions 175, 24 H8, 273 and 282; P53 mutation is an adverse prognostic feature in a number of cancer types, but not in all. Expression Widely expressed. Localisation Nucleus. Function Tumour suppressor gene; P53 is a transcriptional regulator acting as a guardian of the genome; in response to DNA damage, p53 is overexpressed and activates the transcription of genes such as p21 (implicated in cell-cycle arrest) and BAX (implicated in apoptosis); these activations allow either the cells to repair DNA damage before entering further in the cell cycle, or to be Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Implicated in Li-Fraumeni syndrome Disease Autosomal dominant condition; cancer prone disease; Li-Fraumeni syndrome is defined by the 8 P53 (Protein 53 kDa) Hamelin R, Huret JL lung tumours (squamous carcinomas, adenocarcinomas, large cell carcinomas). Oncogenesis Is multistep, through C-MYC or N-MYC activation, H-RAS1 or K-RAS2 mutation, P53, RB1, and P16 inactivation, loss of heterozygosity (LOH) at 3p, 13q, 17p; P53 mutations, in this particular case, does not seem to have prognostic implication; P53 is mutated in 30% of lung adenocarcinomas to 80% of small cell lung carcinomas; hotspots at codons 157, 179, 245, 248, and 273. existence of both a proband with a sarcoma and two other first-degree relatives with a cancer by age 45 years; a mutation of P53 is found in at least 50% of cases; a percentage of mutations may be uncovered; a gene, upstream P53, could also be implicated in other cases with germline P53; therefore, heterogeneity is likely. Prognosis Most common cancer in Li-Fraumeni children are: soft tissues sarcoma before the age of 5 years and osteosarcoma afterwards, and breast cancer in young adults; other frequent cancers: brain tumours, leukaemias, adrenocortical carcinoma; 1/3 of patients have developped more than one primary cancer, which is quite characteristic of Li-Fraumeni syndrome but may also be representative of Blooms syndrome; cancers in this disease, as in other cancer-prone diseases, often occur early in life: 50% of patients aged 30 years have had a cancer (i.e. penetrance is 50%, according to this disease definition); and penetrance is 90% at age 60 years. Oncogenesis (Known) germinal mutation are variable, but are mostly missense mutations located in exons 5 to 8 (DNA binding domain); in tumours occurring in these patients, the other (wildtype) allele is lost, in accordance with the two-hit model for neoplasia, as is found in retinoblastoma. Colorectal cancers Disease There are two types of colorectal cancers, according to the ploidy: - the diploid form, RER+ (Replication Error+), sporadic, without loss of heterozygosity (LOH), with few mutations of p53 and APC, and rightsided; - the polyploid form, RER-, with LOH (5q, 17p, 18q), mutations in p53, and more often left-sided, they have a worse prognosis. Prognosis Survival, although improving, is not much more than 50% after 5 years. Cytogenetics Diploid tumours without frequent allelic losses; aneuploid tumours with numerous allelic losses; LOH on chromosomes 17 and 18 in more than 75% of cases; other chromosome arms losses in about 50% of cases. Oncogenesis A number of genes are known to be implicated in tumour progression in colorectal cancers: APC, P53, KRAS2, mismatch repair genes (MMR genes); P53 is mutated in 60-65% of colorectal cancer cases; mutations of P53 are mostly located in exons 4 to 8 with hotspots at codons 175, 245, 248, 273 and 282. Haematological malignancies Oncogenesis P53 gene alterations have been found in: - 20-30% of blast crisis CML (mostly in the myeloid type), often associated with i(17q); in - 5% of MDS cases and 15% of ANLL often with a visible del(17p); in - 2% of ALL (but with high variations according to the ALL type, reaching 50% of L3 ALL (and Burkitt lymphomas)); in - 15% of CLL (and 40% in the aggressive CLL transformation into the Richter's syndrome) and 30% of adult T-cell leukiaemia (only found in the aggressive form); in - 5-10% of multiple myelomas; in - 60-80% of Hodgkin disease; in - 30% of high grade B-cell NHL (rare in low grade NHL), and 50% of HIV-related NHL; - P53 gene alterations in haematological malignancies are associated with a poor prognosis. Bladder cancer Prognosis Highly variable, according to the stage and the grade. Cytogenetics -9, -11 or del(11p), del(17p) and LOH at 17p, del(13q), frequent other LOH, aneuploidy, polyploidy, complex karyotypes. Oncogenesis Multi-step and largely unknown process; loss of 9q and P53 mutations would be early events; RB1, and P16 inactivation, EGFR overexpression, LOH at 3p, 8p, 11p, 13q, 17p, 18q; P53 is mutated in 40- Lung cancers Disease Lung cancers are neuroendocrine lung tumours (small cell lung carcinomas, carcinoids, large cell neuroendocrine carcinomas) or non neuroendocrine Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 9 P53 (Protein 53 kDa) Hamelin R, Huret JL Specific mutation at codon 249 related to aflatoxin B1 dietary exposure; hot spots otherwise at codons 249 and 273. 60% of bladder cancer cases; hotspot at codon 280; P53 mutations bear a prognostic implication. Breast cancer To be noted Oncogenesis P53 is mutated in 30% of breast cancers; preferentially observed in advanced and aggressive forms; probably a late event; hotspots at codons 175, 248, and 273. Note As bove quoted, heterogeneity concerning the gene(s) mutated in Li-fraumeni is probable; on the other hand, germinal mutations of P53 have also been found in families where the criteria for the LiFraumeni syndrome were not reached. Skin cancers Disease Skin cancers include basal cell carcinomas, squamous cell cercinomas, and melanomas. Prognosis Highly different prognosis according to the pathological group. Oncogenesis P53 is mutated in 40-60% of skin cancers; hotspots at codons 196, 248, 278. References P53 mutations in breast cancer: incidence and relations to tumor aggressiveness and evolution of the disease. Path Biol 1997 Dec; 45(10):882-892 P53 and lung cancer. Path Biol 1997 Dec; 45(10):852-863. (Review) The Li-Fraumeni syndrome: an inherited susceptibility to cancer. Mol Med Today 1997 Sep;3(9):390-5. (Review). Oesophagus cancers TP53 and oesophageal Dec;45(10):871-875 Disease Two main forms: squamous cell carcinoma and adenocarcinoma. Oncogenesis P53 is mutated in 50% of oesophagus cancers (80% in squamous cell carcinoma); probably an early event; hotspots at codons 175, and 248. Path Biol 1997 Cancer. p53, guardian of the genome. Nature 1992 Jul 2; 358(6381):15-16 The role of p53 in normal cells and in cancer development. Pathol Biol (Paris) 1997 Dec; 45(10):781-784 Alternative genetic pathways in colorectal carcinogenesis. Proc Natl Acad Sci USA 1997 Oct 28; 94(22):12122-12127 TP53 and hepatocellular carcinoma. Path Biol 1997 Dec; 45(10):864-870. (Review) Liver cancer Cytogenetics Losses of 1p, 4q, 5p, 5q, 8q, 13q, 16p, 16q, and 17p in 20 to 50% of cases. Oncogenesis Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Cancer. This article should be referenced as such: Hamelin R, Huret JL. P53 (Protein 53 kDa). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):8-10. 10 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review ABCC1 (ATP-binding cassette, sub-family C (CFTR/MRP), member 1) Franck Viguié Laboratoire de Cytogénétique - Service d'Hématologie Biologique, Hôpital Hôtel-Dieu, 75181 Paris Cedex 04, France (FV) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/MRPID106.html DOI: 10.4267/2042/37476 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Localisation Identity Other names: MRP associated protein) HGNC (Hugo): ABCC1 Location: 16p13.1 Note: MRP is a gene resistance, discovered in glycoprotein negative, carcinoma cell line. (multidrug In normal cells, predominant localisation in the cytoplasm; in tumor cells, predominant in plasma membrane, but also found in endoplasmic reticulum, indicating a probable different function as in normal cells. resistance- Function involved in multidrug a multidrug-resistant, Pnon small cell lung Plasma membrane drug-efflux pump; MRP induces a multidrug resistance phenotype (MDR phenotype); overexpression confers tumor cell resistance to a wide variety of hydrophobic drugs: doxorubicin, daunorubicin, vinblastine, vincristine, colchicine, VP16, Rhodamin 123; glutathione is required for the effective expulsion of the chemotherapeutic agents; the mode of action of MRP is very similar to the one of P-glycoprotein, the main protein responsible for the MDR phenotype; however, MRP does not confer resistance to Taxol or m-AMSA, but it is able to transport metallic oxyanions, glutathione and other glutathione conjugates; inhibitors of organic anion transport, such as probenecid, can block MRP activity. DNA/RNA Description Spans at least 200 kb and contains 31 exons Transcription 7 kb mRNA transcript; significant level of variant transcripts due to alternative splicing. Protein Description 1531 amino acids, 190 kDa; contains two ATP binding domains and three membrane-spanning helices; member of the ATP-binding cassette proteins (ABC proteins). Homology Structural and/or functional homology with other ABC transporter proteins (CFTR, Pgp, MOAT). Expression Implicated in Expressed at a basal level in a wide variety of normal tissues, including epithelial cells and all hematopoietic cell types, which suggests a function common to most cell types; increased expression in various tumor cell type. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Induced resistance to chemotherapeutic agents 11 ABCC1 (ATP-binding cassette, sub-family C (CFTR/MRP), member 1) multidrug resistance-associated protein (MRP) in acute and chronic leukemias. Leukemia. 1994 Jun;8(6):990-7 Disease In a wide variety of solid and hematological tumors. Oncogenesis MRP hyperexpression may confer therapeutic resistance in leukemia and solid tumor; however its relative importance, in comparison with other proteins able to induce the MDR phenotype (P-gp, LRP), is not yet clear; hyperexpression is probably linked to transcriptional activation of the gene and/or increased mRNA stability, and not to gene amplification; increased expression of MRP mRNA and protein is a factor of bad prognostic in neuroblastoma, retinoblastoma, and non small cell lung carcinoma. In haematological malignancies, overexpression is frequent in chronic lymphocytic leukemia and prolymphocytic leukemia, occasional in acute myeloid leukemia and rare in acute lymphoid leukemia, lymphoma, multiple myeloma and myeloproliferative disorders. Zaman GJ, Flens MJ, van Leusden MR, de Haas M, Mülder HS, Lankelma J, Pinedo HM, Scheper RJ, Baas F, Broxterman HJ. The human multidrug resistanceassociated protein MRP is a plasma membrane drug-efflux pump. Proc Natl Acad Sci U S A. 1994 Sep 13;91(19):8822-6 Barrand MA, Bagrij T, Neo SY. Multidrug resistanceassociated protein: a protein distinct from P-glycoprotein involved in cytotoxic drug expulsion. Gen Pharmacol. 1997 May;28(5):639-45 Deeley RG, Cole SP. Function, evolution and structure of multidrug resistance protein (MRP). Semin Cancer Biol. 1997 Jun;8(3):193-204 Kavallaris M. The role of multidrug resistance-associated protein (MRP) expression in multidrug resistance. Anticancer Drugs. 1997 Jan;8(1):17-25 Ling V. Multidrug resistance: molecular mechanisms and clinical relevance. Cancer Chemother Pharmacol. 1997;40 Suppl:S3-8 Willman CL. The prognostic significance of the expression and function of multidrug resistance transporter proteins in acute myeloid leukemia: studies of the Southwest Oncology Group Leukemia Research Program. Semin Hematol. 1997 Oct;34(4 Suppl 5):25-33 References Cole SP, Bhardwaj G, Gerlach JH, Mackie JE, Grant CE, Almquist KC, Stewart AJ, Kurz EU, Duncan AM, Deeley RG. Overexpression of a transporter gene in a multidrugresistant human lung cancer cell line. Science. 1992 Dec 4;258(5088):1650-4 This article should be referenced as such: Viguié F. ABCC1 (ATP-binding cassette, sub-family C (CFTR/MRP), member 1). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):11-12. Burger H, Nooter K, Zaman GJ, Sonneveld P, van Wingerden KE, Oostrum RG, Stoter G. Expression of the Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Viguié F 12 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review NBS1 (Nijmegen breakage syndrome 1) Jean-Loup Huret Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/NBS1ID160.html DOI: 10.4267/2042/37477 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Identity Mutations Location: 8q21.3 Germinal DNA/RNA Transcription Missense mutations in the BRCT domain or truncating mutations downstream the BRCT are found in Nijmegen breakage syndrome (see below); most mutations are a 5 bases deletion at codon 218, called 657del5, and should be due to a founder effect. 4.4 and 2.6 kb (alternative polyadenylation); open reading frame of 2265 nucleotides. Implicated in Protein Nijmegen breakage syndrome Description Spans over 51 kb; 16 exons. Disease Nijmegen breakage syndrome is a chromosome instability syndrome/cancer prone disease at risk of non Hodgkin lymphomas (NHL). Cytogenetics Chromosome rearrangements involving immunoglobulin superfamilly genes, in particular inv(7)(p13q35). Description The protein is called nibrin; 754 amino acids; 85 kDa; contains in (the telomeric) N-term a forkhead associated domain (amino acids 24-100) and a breast cancer carboterminal domain (BRCT; amino acids 105-190), both domains being found in the various DNA damage responsive cell cycle checkpoint proteins; 4 possible nuclear localization domains in the half C-term. References Expression Carney JP, Maser RS, Olivares H, Davis EM, Le Beau M, Yates JR 3rd, Hays L, Morgan WF, Petrini JH. The hMre11/hRad50 protein complex and Nijmegen breakage syndrome: linkage of double-strand break repair to the cellular DNA damage response. Cell. 1998 May 1;93(3):477-86 Wide; shorter transcript expressed at higher level in the testis (may have a role in meiotic recombination, as ATM does). Function Matsuura S, Tauchi H, Nakamura A, Kondo N, Sakamoto S, Endo S, Smeets D, Solder B, Belohradsky BH, Der Kaloustian VM, Oshimura M, Isomura M, Nakamura Y, Komatsu K. Positional cloning of the gene for Nijmegen breakage syndrome. Nat Genet. 1998 Jun;19(2):179-81 Member of the MRE/RAD50/nibrin double-strand break repair complex of 1600 kDa. Homology No known homology. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 13 NBS1 (Nijmegen breakage syndrome 1) Huret JL Varon R, Vissinga C, Platzer M, Cerosaletti KM, Chrzanowska KH, Saar K, Beckmann G, Seemanová E, Cooper PR, Nowak NJ, Stumm M, Weemaes CM, Gatti RA, Wilson RK, Digweed M, Rosenthal A, Sperling K, Concannon P, Reis A. Nibrin, a novel DNA double-strand break repair protein, is mutated in Nijmegen breakage syndrome. Cell. 1998 May 1;93(3):467-76 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: Huret JL. NBS1 (Nijmegen breakage syndrome 1). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):13-14. 14 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Gene Section Mini Review NUP98 (nucleoporin 98 kDa) Jean-Loup Huret Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Genes/NUP98.html DOI: 10.4267/2042/37478 This article is an update of: Huret JL. NUP98 (nucleoporin 98 kDa). Atlas Genet Cytogenet Oncol Haematol.1998;2(1):7. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Prognosis Mean survival: 15 months. Cytogenetics Sole anomaly most often. Hybrid/Mutated gene 5' NUP98 - 3' HOXA9. Abnormal protein Fuses the GLFG repeat domains of NUP98 to the HOXA9 homeobox. Identity Location : 11p15 DNA/RNA Transcription 3.6, 6.5, 7.0 kb mRNA. Protein inv(11)(p15q22)/MDS or ANLL --> NUP98/DDX10 Description 920 amino acids; 97 kDa; contains repeated motifs (GLFG and FG) in N-term and a RNA binding motif in C-term. Disease Therapy-related MDS and ANLL; de novo ANLL. Hybrid/Mutated gene 5' NUP98 - 3' DDX10 Abnormal protein Fuses the GLFG repeat domains of NUP98 to the acidic domain of DDX11. Expression Wide. Localisation Nuclear membrane localisation. Function t(2;11)(q31;p15)/treatment-related leukaemia --> NUP98/HOXD13 Nucleoporin: associated with the nuclear pore complex; role in nucleocytoplasmic transport processes. Disease So far, only 1 case of treatment related myelodysplasia evolving towards M6 acute non lymphocytic leukaemia. Hybrid/Mutated gene 5' NUP98 - 3' HOXD13. Abnormal protein Fuses the GLFG repeat domains of NUP98 to the HOXD13 homeodomain. Homology Member of the GLFG nucleoporins. Implicated in t(7;11)(p15;p15)/ANLL --> NUP98/HOXA9 Disease M2-M4 ANLL mostly; occasionally, CML-like cases. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 15 NUP98 (nucleoporin 98 kDa) Huret JL Powers MA, Forbes DJ, Dahlberg JE, Lund E. The vertebrate GLFG nucleoporin, Nup98, is an essential component of multiple RNA export pathways. J Cell Biol. 1997 Jan 27;136(2):241-50 References Nakamura T, Largaespada DA, Lee MP, Johnson LA, Ohyashiki K, Toyama K, Chen SJ, Willman CL, Chen IM, Feinberg AP, Jenkins NA, Copeland NG, Shaughnessy JD Jr. Fusion of the nucleoporin gene NUP98 to HOXA9 by the chromosome translocation t(7;11)(p15;p15) in human myeloid leukaemia. Nat Genet. 1996 Feb;12(2):154-8 Raza-Egilmez SZ, Jani-Sait SN, Grossi M, Higgins MJ, Shows TB, Aplan PD. NUP98-HOXD13 gene fusion in therapy-related acute myelogenous leukemia. Cancer Res. 1998 Oct 1;58(19):4269-73 Arai Y, Hosoda F, Kobayashi H, Arai K, Hayashi Y, Kamada N, Kaneko Y, Ohki M. The inv(11)(p15q22) chromosome translocation of de novo and therapy-related myeloid malignancies results in fusion of the nucleoporin gene, NUP98, with the putative RNA helicase gene, DDX10. Blood. 1997 Jun 1;89(11):3936-44 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: Huret JL. NUP98 (nucleoporin 98 kDa). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):15-16. 16 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication del(6q) in Multiple Myeloma Christophe Brigaudeau Laboratory of Hematology, University Hospital, 87000 Limoges, France Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/del6qMMID2060.html DOI: 10.4267/2042/37479 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology 2- a pattern of either pseudodiploidy, hypodiploidy or near-tetraploidy karyotypes; patients with the latter pattern appear to have a worse prognosis than patients with a hyperdiploid karyotype (med survival of 1.5 yr vs 3 yrs; p<0.04). del(6q) abnormalities were more frequent in the second hypodiploid group. Clinics and pathology Disease Multiple myeloma (MM) is a malignant plasma cell proliferation Phenotype/cell stem origin Mature differentiated B-cell, but also with CD56 expression, which is not found in normal plasma cell; CD38+, CD40+, CD138+. Cytogenetics Cytogenetics morphological Epidemiology del(6q) are mainly so-called terminal deletions, with a variable breakpoint in q12, q15, q21, or q23; overall, the break occurs predominantly in 6q21. MM's annual incidence is 30/106; del(6q) is observed in about 2 to 5% of MM cases (i.e.: 510% of cases with an abnormal karyotype). Genes involved and proteins Clinics Bone pain; susceptibility to infections; renal failure; neurologic dysfunctions. Note del(6q) in MM cases encompass the 6q21 band: loss of this band suggests that the critical gene(s) might be a recessive tumour suppressor gene sitting in 6q21, which remains to be identified Pathology MM staging: - stage I: low tumour cell mass; normal Hb; low serum calcium; no bone lesion; low monoclonal Ig rate; - stage II: fitting neither stage I nor stage II; - stage III: high tumour cell mass; low Hb and/or high serum calcium and/or advanced lytic bone lesions and/or high monoclonal Ig rate. References Laï JL, Zandecki M, Mary JY, Bernardi F, Izydorczyk V, Flactif M, Morel P, Jouet JP, Bauters F, Facon T. Improved cytogenetics in multiple myeloma: a study of 151 patients including 117 patients at diagnosis. Blood. 1995 May 1;85(9):2490-7 Evolution Prognosis Sawyer JR, Waldron JA, Jagannath S, Barlogie B. Cytogenetic findings in 200 patients with multiple myeloma. Cancer Genet Cytogenet. 1995 Jul 1;82(1):41-9 Prognosis (highly variable) is according to the staging and other parameters, of which are now the karyotypic findings: two distinct cytogenetic pattern have been reported, according to the chromosome number: 1- a hyperdiploid pattern, and Brigaudeau C, Trimoreau F, Gachard N, Rouzier E, Jaccard A, Bordessoule D, Praloran V. Cytogenetic study of 30 patients with multiple myeloma: comparison of 3 and 6 day bone marrow cultures stimulated or not with cytokines by using a miniaturized karyotypic method. Br J Haematol. 1997 Mar;96(3):594-600 MM can evolve towards plasma cell leukemia. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 17 del(6q) in Multiple Myeloma Brigaudeau C Calasanz MJ, Cigudosa JC, Odero MD, Ferreira C, Ardanaz MT, Fraile A, Carrasco JL, Solé F, Cuesta B, Gullón A. Cytogenetic analysis of 280 patients with multiple myeloma and related disorders: primary breakpoints and clinical correlations. Genes Chromosomes Cancer. 1997 Feb;18(2):84-93 Smadja NV, Fruchart C, Isnard F, Louvet C, Dutel JL, Cheron N, Grange MJ, Monconduit M, Bastard C. Chromosomal analysis in multiple myeloma: cytogenetic evidence of two different diseases. Leukemia. 1998 Jun;12(6):960-9 This article should be referenced as such: Sawyer JR, Tricot G, Mattox S, Jagannath S, Barlogie B. Jumping translocations of chromosome 1q in multiple myeloma: evidence for a mechanism involving decondensation of pericentromeric heterochromatin. Blood. 1998 Mar 1;91(5):1732-41 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Brigaudeau C. del(6q) in Multiple Myeloma. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):17-18. 18 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication Systemic mast cell disease (SMCD) Lidia Larizza, Alessandro Beghini Department of Biology and Genetics for Medical Sciences, Medical Faculty, University of Milan, Via Viotti 3/5, 20133 Milan, Italy (LL, AB) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/MastCellID2064.html DOI: 10.4267/2042/37480 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology - In mastocytosis with an associated hematological disorder the urticaria pigmentosa symptoms are accompanied by a variety of haematological findings associated with mast cell infiltrates to bone marrow, spleen, liver and lymph nodes. - Mast cell leukemia is characterized by proliferation and infiltration of immature mast cells in bone marrow, peripheral blood and various extramedullary tissues. - Aggressive mastocytosis is characterized by aggressive involvement of several haematopoietic organs. Identity Note Mastocytosis is a heterogeneous clinical entity which is classified into four categories: 1- indolent mastocytosis (the most common form), 2- mastocytosis with an associated hematologic disorder, 3- mast cell leukemia and 4- aggressive mastocytosis. Clinics and pathology Pathology Phenotype/cell stem origin Accumulation of mast cells in various organs and release of mast cell mediators which are responsible for the different clinical signs. Mast cell. Etiology Prognosis Involvement of KIT/SCF has been demonstrated in a few cases, but the diversity of the clinical pattern has not yet been elucidated; increased soluble SCF has been reported in the skin of patient with indolent mastocytosis; c-KIT mutations have been identified in mastocytosis with an associated haematological disorder and in aggressive mastocytosis. Highly dependent on the form being severe, often fatal, in all types with the exception of the indolent form. Genes involved and proteins Clinics KIT - Indolent mastocytosis involves the skin, bone marrow and gastrointestinal tract; clinical features range from a single cutaneous nodule to multiple pigmented macules resulting from increased epidermal melanin and papules (urticaria pigmentosa) or diffuse cutaneous involvement; bullae, vescicles and abnormal telangiectasia may be seen; gastrointestinal involvement leads to symptoms such as nausea, vomiting and abdominal pain. Location 4q12 DNA/RNA 21 exons. Protein Transmembrane SCF/MGF receptor with tyrosine kinase activity; binding of ligand (SCF) induces receptor dimerization, autophosphorylation and signal transduction via molecules containing SH2domains. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 19 Systemic mast cell disease (SMCD) Larizza L, Beghini A PCR in mast cell infiltrates in papulae from mastocytosis patients. Somatic mutations Gly560Val, Asp816Val, Asp816Tyr, Asp820Gly: - Asp816Val in peripheral blood lymphocytes (mastocytosis with an associated hematological disorder: AHD). - Asp816Val in skin and spleen mast cells from patients with aggressive mastocytosis. - Asp816Tyr in blasts from a patient with AML-M2 with mast cell involvement. - Asp820 Gly in blasts from a patient with aggressive SMCD. - Asp816Val and Gly560Val have been found in a human mast cell leukemia cell line (HMC1). All mutations with the exception of Gly560Val cluster to c-kit exon 17. Direct or indirect evidence has been provided that mutations affecting codon 816 promote ligand-independent autophosphorylation of the mutant receptor. References Furitsu T, Tsujimura T, Tono T, Ikeda H, Kitayama H, Koshimizu U, Sugahara H, Butterfield JH, Ashman LK, Kanayama Y. Identification of mutations in the coding sequence of the proto-oncogene c-kit in a human mast cell leukemia cell line causing ligand-independent activation of c-kit product. J Clin Invest. 1993 Oct;92(4):1736-44 Longley BJ Jr, Morganroth GS, Tyrrell L, Ding TG, Anderson DM, Williams DE, Halaban R. Altered metabolism of mast-cell growth factor (c-kit ligand) in cutaneous mastocytosis. N Engl J Med. 1993 May 6;328(18):1302-7 Nagata H, Worobec AS, Oh CK, Chowdhury BA, Tannenbaum S, Suzuki Y, Metcalfe DD. Identification of a point mutation in the catalytic domain of the protooncogene c-kit in peripheral blood mononuclear cells of patients who have mastocytosis with an associated hematologic disorder. Proc Natl Acad Sci U S A. 1995 Nov 7;92(23):10560-4 SCF/MGF Longley BJ, Tyrrell L, Lu SZ, Ma YS, Langley K, Ding TG, Duffy T, Jacobs P, Tang LH, Modlin I. Somatic c-KIT activating mutation in urticaria pigmentosa and aggressive mastocytosis: establishment of clonality in a human mast cell neoplasm. Nat Genet. 1996 Mar;12(3):312-4 Location 12q22 DNA/RNA 9 exons Protein - Soluble SCF: 248 amino acids containing a proteolytic cleavage site encoded by exon 6 sequences, which is processed, giving rise to an active form (soluble) of 165 amino acids; membrane-bound SCF: 220 amino acids, results from alternative splicing of exon 6. - Note: increased soluble SCF has been detected in the skin of patients with indolent mastocytosis; SCF-specific transcripts are detected by in situ RTAtlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Pignon JM, Giraudier S, Duquesnoy P, Jouault H, Imbert M, Vainchenker W, Vernant JP, Tulliez M. A new c-kit mutation in a case of aggressive mast cell disease. Br J Haematol. 1997 Feb;96(2):374-6 Beghini A, Cairoli R, Morra E, Larizza L. In vivo differentiation of mast cells from acute myeloid leukemia blasts carrying a novel activating ligand-independent C-kit mutation. Blood Cells Mol Dis. 1998 Jun;24(2):262-70 This article should be referenced as such: Larizza L, Beghini A. Systemic mast cell disease (SMCD). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):19-20. 20 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication t(1;5)(p32;q31) Jean-Loup Huret Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/t0105ID1141.html DOI: 10.4267/2042/37481 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Clinics and pathology Disease Result of the chromosomal anomaly T cell acute lymphocytic leukaemia (T-ALL). Hybrid gene Clinics Description Breakpoint on TAL1 was found 10 kb upstream the gene, as was found in the cases of t(1;3)(p32;p21), while it is more 3', within the gene, in the t(1;14)(p32;q11) and in TAL1 deletions. Yet poorly known: only 1 case: a young adult male patient with high WBC (common features in TALL); bone marrow transplantation; complete remission: 43 mths +. Genes involved and proteins Fusion protein TAL1 References Expression / Localisation High nuclear expression. Location 1p32 DNA/RNA Complex alternate splicing. Protein Contains a basic Helix-Loop-Helix (DNA binding) domain; forms heterodimers; transcription factor; role in haematopoietic cell differentiation. François S, Delabesse E, Baranger L, Dautel M, Foussard C, Boasson M, Blanchet O, Bernard O, Macintyre EA, Ifrah N. Deregulated expression of the TAL1 gene by t(1;5)(p32;31) in patient with T-cell acute lymphoblastic leukemia. Genes Chromosomes Cancer. 1998 Sep;23(1):36-43 This article should be referenced as such: Huret JL. t(1;5)(p32;q31). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):21. Yet unknown gene Location 5q31 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 21 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication t(11;14)(p13;q11), t(7;11)(q35;p13) Chrystèle Bilhou-Nabera Laboratoire d'Hématologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France (CBN) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/t1114ID1070.html DOI: 10.4267/2042/37482 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Identity Genes involved and proteins Note This t(11;14) must be not confused with the t(11;14)(p15;q11) associated with an immature immunophenotype (CD3-, CD4-, CD8-) and involving respectively RTBN1 gene and TRD locus. RBTN2 Location 11p13 Protein Cystein-rich protein with two tandemly arranged zinc binding LIM-domain motifs: named Lom2; Lmo2 directly interacts with the basic-loop-helix protein Tal1/Scl and the GATA DNA protein Gata1; central role in adult hematopoietic pathway regulation. t(11;14)(p13;q11) G- banding (left) and R- banding (right) Courtesy Jean-Luc Lai and Alain Vanderhaegen. TRA/D or TRB Clinics and pathology Location 14q11 and 7q35 respectively. Disease Epidemiology Result of the chromosomal anomaly 5-10% of childhood T-ALL. Hybrid gene Cytogenetics Description Chromosomal breakpoints occur 25 kb upstream RBTN2 gene, in a presumed transcriptional start site, inducing truncation of the promoter/control region and leading to inappropriate Lmo2 level especially in T-cells (abnormal T-cell differentiation). T-ALL Additional anomalies +17; to be noted that a Ph chromosome (m-BCR) has been found in one case of T-ALL. Variants t(11;14)(p13;q11) and t(7;11)(q35;p13) are variant translocations of each other. Fusion protein Oncogenesis Lmo2 is activated after chromosomal translocation by association with either the TRA/D or the TRB. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 22 t(11;14)(p13;q11), t(7;11)(q35;p13) Bilhou-Nabera C Raimondi SC, Behm FG, Roberson PK, Pui CH, Rivera GK, Murphy SB, Williams DL. Cytogenetics of childhood Tcell leukemia. Blood. 1988 Nov;72(5):1560-6 To be noted Note CELL LINE with t(11;14)(p13;q11): KOPT-K1; the breakpoints occur: - on chromosome 11 in an Alu-rich region, between two Alu sequences, 160 kb-closed from RTBN2; - on chromosome 14 within Jd1; RTBN2 is highly expressed in KOPTK1. Boehm T, Foroni L, Kaneko Y, Perutz MF, Rabbitts TH. The rhombotin family of cysteine-rich LIM-domain oncogenes: distinct members are involved in T-cell translocations to human chromosomes 11p15 and 11p13. Proc Natl Acad Sci U S A. 1991 May 15;88(10):4367-71 Dong WF, Billia F, Atkins HL, Iscove NN, Minden MD. Expression of rhombotin 2 in normal and leukaemic haemopoietic cells. Br J Haematol. 1996 May;93(2):280-6 References Wadman IA, Osada H, Grütz GG, Agulnick AD, Westphal H, Forster A, Rabbitts TH. The LIM-only protein Lmo2 is a bridging molecule assembling an erythroid, DNA-binding complex which includes the TAL1, E47, GATA-1 and Ldb1/NLI proteins. EMBO J. 1997 Jun 2;16(11):3145-57 Williams DL, Look AT, Melvin SL, Roberson PK, Dahl G, Flake T, Stass S. New chromosomal translocations correlate with specific immunophenotypes of childhood acute lymphoblastic leukemia. Cell. 1984 Jan;36(1):101-9 This article should be referenced as such: Lampert F, Harbott J, Ritterbach J, Ludwig WD, Fonatsch C, Schwamborn D, Stier B, Gnekow A, Gerein V, Stollmann B. T-cell acute childhood lymphoblastic leukemia with chromosome 14 q 11 anomaly: a morphologic, immunologic, and cytogenetic analysis of 10 patients. Blut. 1988 Mar;56(3):117-23 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Bilhou-Nabera C. t(11;14)(p13;q11), t(7;11)(q35;p13). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):22-23. 23 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication B-cell prolymphocytic leukemia (B-PLL) Lucienne Michaux Department of Hematology and Center for Human Genetics Cliniques Universitaires Saint Luc Avenue Hippocrate 10 1200 Brussels, Belgium (LM) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/BPLL.html DOI: 10.4267/2042/37483 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Clinics and pathology Cytogenetics Disease Cytogenetics morphological Chronic lymphoproliferative disorder (CLD) Few studies focused on B-PLL; the use of B-cell mitogens might increase the detection rate of cytogenetic changes; the most frequent aberrations involve chromosomes 14, 6 and 1; 14q+ changes are the most commonly observed and are often the consequence of a translocation t(11;14)(q13;q32); structural abnormalities of chromosome 6 are primary or secondary; deletion 6q, as well as translocation t(6;12)(q15;p13) are described; structural aberrations of chromosome 1 involve both p and q arms; trisomy 12 represents a secondary change in this disease; finally, i(17)(q10), as well as telomeric associations have been reported; karyotypic evolution has been documented in some cases and seems to be associated with disease progression. Phenotype/cell stem origin Disease affecting mature B-cells. Immunophenotypically, B-PLL is characterized by reactivity with pan B-cell markers CD19, CD20 and CD24. B-PLL cells are distinct from B-CLL cells in that they express bright surface immunoglobulin, unfrequently express CD5, fail to form rosettes with mouse erythrocytes and react strongly with FMC7. Expression of CD22 is often observed whereas CD23 is usually not expressed. Epidemiology Rare disease; slight male predominance with median age of 69 years. Genes involved and proteins Clinics Patients often present with advanced stage disease. B-PLL is characterized by high white blood cell counts and splenomegaly without adenopathy. Bone marrow infiltration pattern is either diffuse or mixed. Blood data: elevated white blood cell counts with prolymphocytes representing more than 55% of the circulating lymphoid cells. Anemia and thrombocytopenia may be observed. Note Little is known about underlying genetic mechanisms in B-PLL. Immunoglobulin gene rearrangements are always observed. BCL-1 gene is involved in some cases bearing t(11;14)(q13;q32), with breakpoints located centrometric to the major translocation cluster. Overall, abnormalities of P53 occur in 75% cases, representing the highest reported frequency in Bcell malignancies. Prognosis Evolution: this disease is always progressive. Prognosis: poor response to therapy is often observed; median survival is 3 years. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 24 B-cell prolymphocytic leukemia (B-PLL) Michaux L No CDKNL-2 or RB1 gene involvement has been documented so far. C-MYC rearrangement has been described in PLL. Howell RT, Kitchen C, Standen GR. Telomeric associations in a patient with B-cell prolymphocytic leukaemia. Genes Chromosomes Cancer. 1993 Jun;7(2):116-8 To be noted Brennscheidt U, Eick D, Kunzmann R, Martens U, Kiehntopf M, Mertelsmann R, Herrmann F. Burkitt-like mutations in the c-myc gene locus in prolymphocytic leukemia. Leukemia. 1994 May;8(5):897-902 Note T-cell prolymphocytic leukaemia also exists and account for 1/4 of cases of PLL. Döhner H, Pilz T, Fischer K, Cabot G, Diehl D, Fink T, Stilgenbauer S, Bentz M, Lichter P. Molecular cytogenetic analysis of RB-1 deletions in chronic B-cell leukemias. Leuk Lymphoma. 1994 Dec;16(1-2):97-103 References Galiègue-Zouitina S, Collyn-d'Hooghe M, Denis C, Mainardi A, Hildebrand MP, Tilly H, Bastard C, Kerckaert JP. Molecular cloning of a t(11;14)(q13;q32) translocation breakpoint centromeric to the BCL1-MTC. Genes Chromosomes Cancer. 1994 Dec;11(4):246-55 Pittman S, Catovsky D. Chromosome abnormalities in Bcell prolymphocytic leukemia: a study of nine cases. Cancer Genet Cytogenet. 1983 Aug;9(4):355-65 Sadamori N, Han T, Minowada J, Bloom ML, Henderson ES, Sandberg AA. Possible specific chromosome change in prolymphocytic leukemia. Blood. 1983 Oct;62(4):729-36 Schröder M, Mathieu U, Dreyling MH, Bohlander SK, Hagemeijer A, Beverloo BH, Olopade OI, Stilgenbauer S, Fischer K, Bentz M. CDKN2 gene deletion is not found in chronic lymphoid leukaemias of B- and T-cell origin but is frequent in acute lymphoblastic leukaemia. Br J Haematol. 1995 Dec;91(4):865-70 Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C. Proposals for the classification of chronic (mature) B and T lymphoid leukaemias. FrenchAmerican-British (FAB) Cooperative Group. J Clin Pathol. 1989 Jun;42(6):567-84 Lens D, De Schouwer PJ, Hamoudi RA, Abdul-Rauf M, Farahat N, Matutes E, Crook T, Dyer MJ, Catovsky D. p53 abnormalities in B-cell prolymphocytic leukemia. Blood. 1997 Mar 15;89(6):2015-23 Brito-Babapulle V, Catovsky D. Inversions and tandem translocations involving chromosome 14q11 and 14q32 in T-prolymphocytic leukemia and T-cell leukemias in patients with ataxia telangiectasia. Cancer Genet Cytogenet. 1991 Aug;55(1):1-9 This article should be referenced as such: Michaux L. B-cell prolymphocytic leukemia (B-PLL). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):24-25. Brito-Babapulle V, Ellis J, Matutes E, Oscier D, Khokhar T, MacLennan K, Catovsky D. Translocation t(11;14)(q13;q32) in chronic lymphoid disorders. Genes Chromosomes Cancer. 1992 Sep;5(2):158-65 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 25 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication Splenic lymphoma with villous lymphocytes Jean-Loup Huret, Hossain Mossafa Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH), Laboratoire Pasteur-Cerba, 95066, Cergy-Pontoise, France (HM) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/splenvillousID2063.html DOI: 10.4267/2042/37484 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Clinics and pathology Genes involved and proteins Epidemiology Occurs in the elderly (med 70 years); sex ratio 2M/1F. Note BCL1 in 11q13 and IgH in 14q32 are involved in 20% of cases, with or without a visible t(11;14); BCL1 encodes the cyclin D1; role in the cell cycle control (G1 progression and G1/S transition); 5' BCL1 translocated on chromosome 14 near JH, resulting in promoter exchange; the immunoglobulin gene enhancer stimulates the expression of BCL1, and overexpression of BCL1 which accelerates passage through the G1 phase; microdeletion in the RB1 region in half cases. Clinics Splenomegaly without hepatomegaly nor enlarged lymph nodes; peripheral blood lymphocytes with villous projections; monoclonal Ig in half cases. Cytology B-cells expressing CD19+, CD24+ and DBA44+. CD20+, CD22+, Treatment References Splenectomy. Prognosis Oscier DG, Matutes E, Gardiner A, Glide S, Mould S, BritoMulligan SP, Matutes E, Dearden C, Catovsky D. Splenic lymphoma with villous lymphocytes: natural history and response to therapy in 50 cases. Br J Haematol 1991 Jun;78(2):206-9 5-year survival: 80%; adverse prognostic factors: WBC above 30 x 109/l, low lymphocyte count; cases treated with chemotherapy have shorter survival. Wong KF, Chu YC, Hui PK. Splenic lymphoma with villous lymphocytes showing del(7) and inv(10). Cancer Genet Cytogenet 1998 Apr 15;102(2):145-7. (Review) Cytogenetics Oscier DG, Matutes E, Gardiner A, Glide S, Mould S, BritoBabapulle V, Ellis J, Catovsky D. Cytogenetic studies in splenic lymphoma with villous lymphocytes. Br J Haematol 1993 Nov;85(3):487-491 Cytogenetics morphological The karyotype is often abnormal: - del(7q) and translocations involving 7q (20% of cases), - t(11;14)(q13;q32) (15%), - other anomalies, in particular i(17q), 2p11 translocations. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Matutes E, Morilla R, Owusu-Ankomah K, Houlihan A, Catovsky D. The immunophenotype of splenic lymphoma with villous lymphocytes and its relevance to the differential diagnosis with other B-cell disorders. Blood 1994 Mar 15;83(6):1558-62 26 Splenic lymphoma with villous lymphocytes Huret JL, Mossafa H Troussard X, Valensi F, Duchayne E, Garand R, Felman P, Tulliez M, Henry-Amar M, Bryon PA, Flandrin G. Splenic lymphoma with villous lymphocytes: clinical presentation, biology and prognostic factors in a series of 100 patients. Groupe Français d'Hématologie Cellulaire (GFHC). Br J Haematol 1996 Jun;93(3):731-736 allelic imbalance of the RB1 gene but not the D13S25 locus on chromosome 13q14. Cancer Res 1998 Apr 15;58(8):1736-1740 This article should be referenced as such: Huret JL, Mossafa H. Splenic lymphoma with villous lymphocytes. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):26-27. García-Marco JA, Nouel A, Navarro B, Matutes E, Oscier D, Price CM, Catovsky D. Molecular cytogenetic analysis in splenic lymphoma with villous lymphocytes: frequent Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 27 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication +8 or trisomy 8 Jean-Loup Huret Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/tri8ID1017.html DOI: 10.4267/2042/37486 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Clinics and pathology Prognosis No prognostic significance. Disease Disease Chronic myelogenous leukaemia (CML) Epidemiology +8 is one of the major anomalies additional to the t(9;22), with i(17q), + der(22), before +19; found as a unique additional anomaly in 10%, with other in 25% of CML cases with clonal evolution; these additional anomalies may be present at the diagnosis of CML (in 10%, possibly with unfavourable significance), or may appear during course of the disease, they do not indicate the imminence of a blast crisis, although they also frequently emerge at the time of acute transformation; +8 is more often found in the myeloid than in the lymphoid blast crisis. Prognosis +8 has apparently no prognostic significance in CML. Myelodysplastic syndromes (MDS): refractory anaemia (RA), refractory anaemia with ring sideroblasts (RARS), refractory anaemia with excess of blasts ± in transformation (RAEB±T), chronic myelomonocytic leukaemia (CMML). Note The present (unpublished) review of about 250 ANLL cases with +8 is a review of literature cases and may therefore be biased, although the percentages herein given are in accordance with those of large series. Epidemiology +8 is found in 15-20% of MDS; 5-10% of MDS with +8 are treatment-related MDS; +8 is present in each FAB subgroup: up to 30% of RARS cases have +8; 15-20% of other subgroups have +8. +8 is: the sole anomaly in 55%, found with simple karyopypic changes in 20%, and part of a complex karyotype in the remaining 25% of cases. Altogether, sex ratio is 1.5M/1F (1.8/1 in cases RAEB±T and CMML, 1/1 in RA or RARS). - 15% of +8/MDS are found with -5/del(5q), often in complex karyotypes. 4% of +8/MDS are found with t(1;7)(q10;p10)(and 20% of t(1;7)/MDS-ANLL also associate +8). - 4% as well are found with del(20q), mainly in simple karyotypes. - +8 is strickingly found in independant subclones, with other subclones carrying other anomalies, in particular del(5q) or t(1;7) (e.g.: 46, XY, del(5q)/47, XY, +8). Disease Other chronic myeloproliferative diseases: polycytemia vera (PV), and idiopathic myelofibrosis (but not found in essential thrombocythemia). Epidemiology +8 is found in 20% of PV cases with an abnormal karyotype, mostly as the sole anomaly, may be accompanied with +9 (abnormal karyotypes in PV occur mainly with evolution, but the appearance of a clonal anomaly does not indicate progression of the disease); +8 is found in 10% of myelofibrosis cases with chromosome anomalies, sometimes with +9. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 28 +8 or trisomy 8 Huret JL Prognosis Median survival would near 2 years. - 1% of +8/ANLL are found with t(1;7)(q10;p10), but as far as 20% of t(1;7) also associate +8. - 15% of Down syndrome patients with MDS/ANLL have +8 in their leukaemic cells. Clinics From 2 studies on ANLL in adults with +8 solely: no specific FAB subgroup; median age was 60 years (vs 50 years in cases of +8 accompanying t(8;21), t(15;17) or inv(16)); no gross organomegaly; moderate WBC. Prognosis Of ANLL in adults with +8 solely: complete remission in 60-70% (vs 90% in cases accompanying t(8;21), t(15;17) or inv(16)); median survival was 13 months in one study, 20 months in another; taking all +8 cases, solely or not, median survival would be of about a year; +8 does not seem to alter the relatively good prognosis of t(8;21), t(15;17) or inv(16), while the (numerous) cases with a complex karyotype exhibit a poor outcome; age is an adverse feature. Disease Acute non lymphocytic leukaemias (ANLL) Note The present (unpublished) review of more than 500 ANLL cases with +8 is a review of literature cases and may therefore be biased, although the percentages herein given are in accordance with those of large series; we also add 39 unpublished t(11;19) to 101 published cases. Epidemiology +8 is found in 10-15% of ANLL; 10% of ANLL with +8 are treatment-related ANLL; +8 is present in each FAB subgroup (from M1 to M7) in a grossly equivalent percentage (but in M5a where the percentage is higher), in contrast to what has been previously claimed; cases may present with a preceeding myelodysplasia. +8 is: the sole anomaly in 40%, found with simple karyopypic changes in 35%, and part of a complex karyotype in the remaining 25% of cases. altogether, sex ratio is 1.2/1 (1.6/1 in cases with a complex karyotype, 1/1 otherwise). - 5-10% of +8/ANLL are found with 5/del(5q)and/or -7/del(7q), often associated, and nearly always in complex karyotypes. - 5-10% also are found in t(15;17)/M3 cases, mostly as a single additional anomaly, while 1/3 of t(15;17) are accompanied with +8. - 5-10% are found with inv(16), mainly in simple karyotypes (and 15% of inv(16) cases also carry +8). - 5% are associated with +21, often parts of a complex karyotype. - 5% also are found in 11q23 ANLL, mostly in t(9;11)(p22;q23) cases (and 20% of t(9;11) also carry +8, while 15% of t(11;19)(q23;p13.3)/ANLL or ALL (91 cases, 25 unpublished), 10% of t(6;11)(q27;q23)/ANLL, t(10;11)(p12;q23)/ANLL, and t(11;19)(q23;p13.1)/ANLL (49 cases, 14 unpublished) as well, and only 3% of t(4;11)(q21;q23)/ALL, have an additional 8 chromosome. - Less than 5% are found with t(8;21)(q21;q21) often in simple karyotypes, and 10% of t(8;21) associate +8. - Less than 5% also are associated with t(9;22)(q34;q11)/ANLL, mostly in complex karyotypes. - 2% are associated with +9, either in simple or in complex karyotypes. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Disease Acute lymphocytic leukaemia (ALL) Phenotype/cell stem origin +8 is more often found in B-cell than in T-cell cases. Epidemiology - +8 is a rare anomaly in lymphoid malignancies (90% of +8 occur in myeloid malignancies); found in about 5% of ALL. - Rarely found as a sole anomaly (5-10%), may be part of hyperploid karyotypes (>50 chromosomes mainly) without structural anomalies (20% of cases), mostly found in complex karyotypes with structural anomalies (2/3 of cases), these complex karyotypes being often hyperploid as well. - Sex ratio: 1.5/1. - Accompany (mostly in complex karyotypes): t(9;22)(q34;q11)/ALL, t(4;11) (see above) and other 11q23, del(6q), t(1;19)(q23;p13), dic(9;12) and other known primary anomalies. Disease Non-Hodgkin lymphomas Epidemiology +8 is exceptional; has been found associated with t(14;18)(q32; q21), t(8;14)(q24;q32), and other known or unknown anomalies. Disease Chronic lymphoproliferative diseases Epidemiology Very rare anomaly (to be noted that +8 is 29 +8 or trisomy 8 Huret JL Danesino C, Pasquali F. Constitutional trisomy 8 as first mutation in multistep carcinogenesis: clinical, cytogenetic, and molecular data on three cases. Genes Chromosomes Cancer. 1996 Oct;17(2):94-101 exceptional in T-prolymphocytic leukaemia, in contrast with the freqency of i(8q), which occurs by completely different mechanisms, but gives, for parts, very similar genetic imbalances). Pedersen B. MDS and AML with trisomy 8 as the sole chromosome aberration show different sex ratios and prognostic profiles: a study of 115 published cases. Am J Hematol. 1997 Dec;56(4):224-9 Genetics Note Genes (possibly) involved are unknown. Schoch C, Haase D, Fonatsch C, Haferlach T, Löffler H, Schlegelberger B, Hossfeld DK, Becher R, Sauerland MC, Heinecke A, Wörmann B, Büchner T, Hiddemann W. The significance of trisomy 8 in de novo acute myeloid leukaemia: the accompanying chromosome aberrations determine the prognosis. German AML Cooperative Study Group. Br J Haematol. 1997 Dec;99(3):605-11 To be noted Note Karyotypes with +8 may be misinterpreted with a possible overlooked constitutional trisomy 8, a syndrome associating mild to moderate mental delay and (sometimes mild as well) bone anomalies; furthermore constitutional trisomy 8 has been said to be at increased rirk of cancers, haematological malignancies in particular. Byrd JC, Lawrence D, Arthur DC, Pettenati MJ, Tantravahi R, Qumsiyeh M, Stamberg J, Davey FR, Schiffer CA, Bloomfield CD. Patients with isolated trisomy 8 in acute myeloid leukemia are not cured with cytarabine-based chemotherapy: results from Cancer and Leukemia Group B 8461. Clin Cancer Res. 1998 May;4(5):1235-41 This article should be referenced as such: References Huret JL. +8 or trisomy 8. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):28-30. Seghezzi L, Maserati E, Minelli A, Dellavecchia C, Addis P, Locatelli F, Angioni A, Balloni P, Miano C, Cavalli P, Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 30 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication t(1;7)(q10;p10) Jean-Loup Huret Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/t0107ID1003.html DOI: 10.4267/2042/37485 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Identity der(7)t(1;7)(q10;p10) G- (left) and R- (right) bandings - top: Courtesy Jean-Luc Lai; middle and bottom: - Courtesy Diane H. Norback, Eric B. Johnson, and Sara Morrison-Delap, UW Cytogenetic Services. leukaemia (ANLL); ANLL in 30%, frequently with preceeding MDS; these MDS or ANLL are therapyrelated (secondary to toxic exposure) in half cases; myeloproliferative diseases (MPD) represent the remaining 10% of cases. Clinics and pathology Disease Myelodysplasic syndromes (MDS) in 60% of cases, often evolving towards acute non lymphoblastic Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 31 t(1;7)(q10;p10) Huret JL Phenotype/cell stem origin Additional anomalies MDS cases: often RAEB±T or RA; ANLL: M4 or M1; MPD cases: myelofibrosis. Sole anomaly in half; hyperploidy in 1/3 of cases; +8 (20%); +21 (10%); +9; additional structural abnormalities in 15%. Epidemiology References Represent 3-7% of secondary leukaemias, 0.5% and 2% of de novo ANLL and MDS respectively; adults mostly (median 60 yrs; only a very few children cases); male predominance (3M/2F), but secondary leukaemias cases are more frequently female cases (presence of uncovered environmental genotoxic factors in male cases?). Geraedts JP, den Ottolander GJ, Ploem JE, Muntinghe OG. An identical translocation between chromosome 1 and 7 in three patients with myelofibrosis and myeloid metaplasia. Br J Haematol. 1980 Apr;44(4):569-75 Willem P, Pinto M, Bernstein R. Translocation t(1;7) revisited. Report of three further cases and review. Cancer Genet Cytogenet. 1988 Nov;36(1):45-54 Prognosis Horiike S, Taniwaki M, Misawa S, Nishigaki H, Okuda T, Yokota S, Kashima K, Inazawa J, Abe T. The unbalanced 1;7 translocation in de novo myelodysplastic syndrome and its clinical implication. Cancer. 1990 Mar 15;65(6):1350-4 Poor prognosis; median survival was reviewed in 1992 and was found to be of 11 mths; male sex, a low haemoglobin level may be adverse prognostic features; prognosis is better, obviously in case of a MPD. Johansson B, Mertens F, Heim S, Kristoffersson U, Mitelman F. Cytogenetics of secondary myelodysplasia (sMDS) and acute nonlymphocytic leukemia (sANLL). Eur J Haematol. 1991 Jul;47(1):17-27 Cytogenetics Cytogenetics morphological Pedersen B. Survival of patients with t(1;7)(p11;p11). Report of two cases and review of the literature. Cancer Genet Cytogenet. 1992 May;60(1):53-9 Whole-arm translocation of 7p with 1q; most often unbalanced (-7, +t(1;7)) --> trisomy for 1q/monosomy for 7q; may therefore represent an equivalent to del(7q). This article should be referenced as such: Huret JL. t(1;7)(q10;p10). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):31-32. Probes Centromeric probes. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 32 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication del(6q) abnormalities in lymphoid malignancies Christophe Brigaudeau, Chrystele Bilhou-Nabera Laboratory of Hematology, University Hospital, 87000 Limoges, France (CB); Laboratoire d'Hématologie, Hôpital du Haut-Lévêque, CHU de Bordeaux, Avenue de Magellan, 33604 Pessac, France (CBN) Published in Atlas Database: December 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/del6qID1148.html DOI: 10.4267/2042/37487 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Identity Phenotype/cell stem origin Lack of specificity for a particular immunophenotype. Epidemiology Found in 5-15% of patients after conventional cytogenetic analysis, in 30% after FISH analysis, in 5 to 25% of cases in loss of heterozygosity studies. Prognosis Not significantly different from patients lacking a 6q rearrangement. Note Deletion of the long arm of chromosome 6 (del(6q)) is more frequently described in lymphoid proliferations than in other hematological malignancies; del(6q) is observed in acute lymphoblastic leukemia (ALL), in chronic lymphocytic leukemia (CLL), in prolymphocytic leukemia and in non-Hodgkin lymphomas (NHL) (15% cases, sometimes associated with t(14;18)(q32;q21)); these deletions are mainly reported to be terminal, but also interstitial. Disease Childhood T-cell acute lymphoblastic leukemia (TALL) Epidemiology del(6q) is one of the most frequent cytogenetic aberration occurring in 10-20% of cases and often associated with 14q11 or del(9p) abnormalities. Prognosis Outcome similar to cases with normal diploid karyotypes. Disease Adult acute lymphoblastic leukemia Phenotype/cell stem origin T-cell phenotype found in 50% of cases (ALL). Epidemiology del(6q) in adult-ALL occur with a lower frequency (5%) than in children and is reported predominantly in young adult (15 to 40 years aged). Prognosis Patients with a 6q change tented to have longer event free survival (EFS) (median: 11 months; 3 del(6q) - Courtesy Diane H. Norback, Eric B. Johnson, Sara Morrison-Delap Cytogenetics at theWaisman Center; Rbanding (right) – Editor. Clinics and pathology Disease Childhood B-cell acute lymphoblastic leukemia (BALL) Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 33 del(6q) abnormalities in lymphoid malignancies Brigaudeau C, Bilhou-Nabera C years EFS: 47%) than did patients without 6q changes (median EFS: 7 month; 3 years EFS: 20%). Genes involved and proteins Disease B-cell small lymphocytic lymphoma Epidemiology del(6)(q21q23) is the most common recurrent cytogenetic abnormality in this disease. Clinics In cases with del(6q), a morphological appearance of peripheral blood large prolymphocytes, a mature B-cell phenotype and a typical clinical course of other well-differentiated lymphocytic neoplams are described. Multiple myeloma Phenotype/cell stem origin Multiple myeloma (MM) is a malignant plasma cell proliferation of mature differentiated B-cell. Epidemiology del (6q) in multiple myeloma represent 15% of cases of MM. Prognosis del(6q) are more frequent in the hypodiploid group of multiple myeloma, bearing a worse prognosis (med survival of 1.5 yr). Note 6q21 band loss suggests the presence of a recessive tumour suppressor gene whose absence might contribute to malignant transformation and development of both T and precursor B-ALLs; the lack of specificity for a particular immunophenotype may imply that the gene or genes affected by 6q abnormalities are broadly active in the multistep process of lymphoid leukemogenesis. Putative tumour suppressor gene(s) on chromosome arm 6q remains to be identified; to demonstrate this loss of heterozygosity of informative markers (LOH) was analysed using PCR amplification of polymorphic microsatellite sequences; using polymorphic markers located from the 6q14-15 to telomere, LOH was detected in 5 to 25% of childhood ALL cases. Regarding LOH results, two distinct regions were identified: - first region flanked by D6S283 and D6S302 loci at 6q21-22 - second region flanked by D6S275 and D6S283 loci at 6q21. Using LOH analysis on several cases, the authors demonstrated an identical 6q21-22 structure at diagnosis and at relapse, suggesting that 6q deletion may be an initial event in leukemogenesis and may occur less frequently during progression of the disease. Cytogenetics References Cytogenetics morphological Hayashi Y, Raimondi SC, Look AT, Behm FG, Kitchingman GR, Pui CH, Rivera GK, Williams DL. Abnormalities of the long arm of chromosome 6 in childhood acute lymphoblastic leukemia. Blood. 1990 Oct 15;76(8):1626-30 Disease Atypical chronic lymphocytic leukemia Prognosis Complex karyotypes with +12, del(13)(q14), del(11q), del(6)(q21q23) and possible 4q or 10q anomalies are associated with a poor prognosis. Disease The frequency of the deletions is difficult to estimate by conventional cytogenetic analysis because small interstitial deletions are beyond the sensitivity of the technique; furthermore, many studies have reported conflicting data on the putative region of overlap and the number of region involved; the break occurs predominantly in 6q21, but 6q15 is also often described; overall, del(6q) cases encompassed the 6q21 band. in acute lymphoblastic leukemia (ALL), del(6q) is the sole anomaly in about 30% of cases, or associated with other structural abnormalities such as del(12p) (early pre-B ALL), del(9p) (B and Tcell immunophenotype), specific aberrations, such as t(4;11), t(1;19), t(9;22), t(12;21) or with random chromosomal changes. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Offit K, Louie DC, Parsa NZ, Filippa D, Gangi M, Siebert R, Chaganti RS. Clinical and morphologic features of B-cell small lymphocytic lymphoma with del(6)(q21q23). Blood. 1994 May 1;83(9):2611-8 Cytogenetic abnormalities in adult acute lymphoblastic leukemia: correlations with hematologic findings outcome. A Collaborative Study of the Group Français de Cytogénétique Hématologique. Blood. 1996 Apr 15;87(8):3135-42 Cavé H, Guidal C, Elion J, Vilmer E, Grandchamp B. A low rate of loss of heterozygosity is found at many different loci in childhood B-lineage acute lymphocytic leukemia. Leukemia. 1996 Sep;10(9):1486-91 34 del(6q) abnormalities in lymphoid malignancies Brigaudeau C, Bilhou-Nabera C Bigoni R, Cuneo A, Roberti MG, Bardi A, Rigolin GM, Piva N, Scapoli G, Spanedda R, Negrini M, Bullrich F, Veronese ML, Croce CM, Castoldi G. Chromosome aberrations in atypical chronic lymphocytic leukemia: a cytogenetic and interphase cytogenetic study. Leukemia. 1997 Nov;11(11):1933-40 from the Children's Cancer Group. J Clin Oncol. 1998 Apr;16(4):1270-8 Merup M, Moreno TC, Heyman M, Rönnberg K, Grandér D, Detlofsson R, Rasool O, Liu Y, Söderhäll S, Juliusson G, Gahrton G, Einhorn S. 6q deletions in acute lymphoblastic leukemia and non-Hodgkin's lymphomas. Blood. 1998 May 1;91(9):3397-400 Gérard B, Cavé H, Guidal C, Dastugue N, Vilmer E, Grandchamp B. Delineation of a 6 cM commonly deleted region in childhood acute lymphoblastic leukemia on the 6q chromosomal arm. Leukemia. 1997 Feb;11(2):228-32 Takeuchi S, Koike M, Seriu T, Bartram CR, Schrappe M, Reiter A, Park S, Taub HE, Kubonishi I, Miyoshi I, Koeffler HP. Frequent loss of heterozygosity on the long arm of chromosome 6: identification of two distinct regions of deletion in childhood acute lymphoblastic leukemia. Cancer Res. 1998 Jun 15;58(12):2618-23 Secker-Walker LM, Prentice HG, Durrant J, Richards S, Hall E, Harrison G. Cytogenetics adds independent prognostic information in adults with acute lymphoblastic leukaemia on MRC trial UKALL XA. MRC Adult Leukaemia Working Party. Br J Haematol. 1997 Mar;96(3):601-10 This article should be referenced as such: Heerema NA, Sather HN, Sensel MG, Kraft P, Nachman JB, Steinherz PG, Lange BJ, Hutchinson RS, Reaman GH, Trigg ME, Arthur DC, Gaynon PS, Uckun FM. Frequency and clinical significance of cytogenetic abnormalities in pediatric T-lineage acute lymphoblastic leukemia: a report Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Brigaudeau C, Bilhou-Nabera C. del(6q) abnormalities in lymphoid malignancies. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):33-35. 35 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Leukaemia Section Short Communication t(8;16)(p11;p13) Christine Pérot, Jean-Loup Huret Laboratoire de Cytogénétique, Hopital Saint-Antoine, Paris, France (CP); Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: December 1998 Online updated version : http://AtlasGeneticsOncology.org/Anomalies/t0816.html DOI: 10.4267/2042/37488 This article is an update of: Pérot C, Huret JL. t(8;16)(p11;p13). Atlas Genet Cytogenet Oncol Haematol.1997;1(2):79-80. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Identity t(8;16)(p11;p13) G- banding (left) - Courtesy Jean-Luc Lai (top left) and Charles D. Bangs (middle and bottom left), R- banding (top right) - Courtesy Jean-Luc Lai, and ideogram (bottom right) - Courtesy Charles D. Bangs. Clinics and pathology Epidemiology Disease Rare disease (<1% of ANLL); found in children (including infants) and young adults of both sexes. ANLL; t-ANLL Clinics Phenotype/cell stem origin Disseminated intra vascular coagulation may be present; extramedullary infiltration; 20% of the cases could be therapy-related. M4, M5a, M5b; possible involvement of a granulomonocytic precursor; no preceeding MDS. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 36 t(8;16)(p11;p13) Pérot C, Huret JL The t(8;16) has been cloned and shown to fuse the MOZ (monocytic leukemia zinc finger) gene at 8p11.2 to the CBP (CREB binding protein) gene at 16p13.3. The MOZ gene has also been found to be involved in variant translocations t(8;19)(p11;q13) and t(8;22)(p11;q13) and inv(8)(p11q13) translocations associated with M5/M4 AML.This translocation is associated with AML M5/M4. In the majority of cases it is associated with features of hemophagocytosis by leukemic cells, particularly erythrophagocytosis - Courtesy Georges Flandrin, CD-ROM AML/MDS G.Flandrin/ICG. TRIBVN. translocation would therefore be an equivalent (not identical), and not a simple variant with hidden 16p13 involvement. Cytology Erythrophagocytosis, esterase activities. strong peroxidase and Genes involved and proteins Prognosis Poor: remission may be obtained in half cases; infections, bleeding; survival is often less than 1 year but spontaneous remission has occurred (at least) once. MOZ Location 8p11 Cytogenetics CBP Additional anomalies Location 16p13 In half cases; +8, various; complex karyotype may be found. Result of the chromosomal anomaly Variants Complex t(8;16;Var) involving a (variable) third chromosome have been described; 8p11 breakpoint with another partner as well, of which is the recurrent t(8;22)(p11;q13), which may involve P300 on 22q13 in the place of CBP: this Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Hybrid gene Description 5' MOZ - 3' CBP 37 t(8;16)(p11;p13) Pérot C, Huret JL t(8:19)(p11:q13)--case report and review of the literature. Leuk Res. 1995 Jun;19(6):367-79 Fusion protein Description N-term MOZ fused to most of CBP; 3722 amino acids; 415 kDa; combines the MOZ finger motifs (DNA binding) and acetyl transferase with the transcriptional coactivator from CBP; the reciprocal CBP-MOZ has no role (as it is out of frame). Borrow J, Stanton VP Jr, Andresen JM, Becher R, Behm FG, Chaganti RS, Civin CI, Disteche C, Dubé I, Frischauf AM, Horsman D, Mitelman F, Volinia S, Watmore AE, Housman DE. The translocation t(8;16)(p11;p13) of acute myeloid leukaemia fuses a putative acetyltransferase to the CREB-binding protein. Nat Genet. 1996 Sep;14(1):3341 References Velloso ER, Mecucci C, Michaux L, Van Orshoven A, Stul M, Boogaerts M, Bosly A, Cassiman JJ, Van Den Berghe H. Translocation t(8;16)(p11;p13) in acute non-lymphocytic leukemia: report on two new cases and review of the literature. Leuk Lymphoma. 1996 Mar;21(1-2):137-42 Brizard A, Guilhot F, Huret JL, Benz-Lemoine E, Tanzer J. The 8p11 anomaly in "monoblastic" leukaemia. Leuk Res. 1988;12(8):693-7 Quesnel B, Kantarjian H, Bjergaard JP, Brault P, Estey E, Lai JL, Tilly H, Stoppa AM, Archimbaud E, Harousseau JL. Therapy-related acute myeloid leukemia with t(8;21), inv(16), and t(8;16): a report on 25 cases and review of the literature. J Clin Oncol. 1993 Dec;11(12):2370-9 Dinulos JG, Hawkins DS, Clark BS, Francis JS. Spontaneous remission of congenital leukemia. J Pediatr. 1997 Aug;131(2):300-3 Stark B, Resnitzky P, Jeison M, Luria D, Blau O, Avigad S, Shaft D, Kodman Y, Gobuzov R, Ash S. A distinct subtype of M4/M5 acute myeloblastic leukemia (AML) associated with t(8:16)(p11:p13), in a patient with the variant Pérot C, Huret JL. t(8;16)(p11;p13). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):36-38. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: 38 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Solid Tumour Section Mini Review Bone: Chordoma Monica Miozzo Dipartimento di Medicina Ospedale San Paolo Lab di Genetica Umana, Via di Rudini 8, 20142 Milan, Italy (MM) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Tumors/chordomaID5028.html DOI: 10.4267/2042/37490 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Pathology Identity Microscopically, it resembles normal fetal notochord in its different stages of development; it is composed of extremly large cells (know as physaliferous) and other small tumour cells; areas of cartilage and bone may be present. Note Chordoma is a malignant tumour derived from remnants of the fetal notochord; it occurs along the spinal axis, predominantly in the sphenooccipital (35%), vertebral (15%) and sacrococcygeal (50%) regions. Cytogenetics Clinics and pathology Cytogenetics Morphological Etiology In eight sporadic sacral chordomas with abnormal karyotype, a tumour-specific rearrangement has not been identified; the karyotypes, characterized by a hypo-or near-diploid chromosome number, showed complex rearrangements affecting several chromosomes, among them chromosome 1 was frequently involved in losses and translocations with different partners; no FISH experiments to clarify the complex cytogenetic picture have been performed so far. Although most chordomas are sporadics, five families with chordoma occurrence have been reported, two of them displaying an autosomal dominant transmission with incomplete penetrance (MIM. *215400); preliminary linkage data in a three generation family suggest that the disease locus might be assigned to chromosomes 1,17 or 19. Epidemiology References Chordomas accounts for 1-4% of all primary bone tumours; the sacrococcygeal lesions are more common in the fifth decade of life, whereas the sphenooccipital tumours occur predominantly in children. FOOTE RF, ABLIN G, HALL WW. Chordoma in siblings. Calif Med. 1958 May;88(5):383-6 Krengel B. Letter: Findings in pellagrin patients. S Afr Med J. 1975 Mar 15;49(11):383 Clinics Chetty R, Levin CV, Kalan MR. Chordoma: a 20-year clinicopathologic review of the experience at Groote Schuur Hospital, Cape Town. J Surg Oncol. 1991 Apr;46(4):261-4 Chordoma is a slowly-growing tumour, characterized by local destruction of bone and rarely distant metastatic spread. The differential diagnosis includes renal tumours, chondrosarcomas and myxo-papillary ependymoma. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Mertens F, Kreicbergs A, Rydholm A, Willén H, Carlén B, Mitelman F, Mandahl N. Clonal chromosome aberrations in three sacral chordomas. Cancer Genet Cytogenet. 1994 Apr;73(2):147-51 39 Bone: Chordoma Miozzo M Butler MG, Dahir GA, Hedges LK, Juliao SF, Sciadini MF, Schwartz HS. Cytogenetic, telomere, and telomerase studies in five surgically managed lumbosacral chordomas. Cancer Genet Cytogenet. 1995 Nov;85(1):51-7 Stepanek J, Cataldo SA, Ebersold MJ, Lindor NM, Jenkins RB, Unni K, Weinshenker BG, Rubenstein RL. Familial chordoma with probable autosomal dominant inheritance. Am J Med Genet. 1998 Jan 23;75(3):335-6 Korczak JF, Kelley MJ, Allikian KA, Shah AA, Goldstein AM, Parry DM. Genomic screening for linkage in a family with autosomal dominant chordoma Am J Hum Genet. 1997;61:A400. This article should be referenced as such: Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Miozzo M. Bone: Chordoma. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):39-40. 40 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Solid Tumour Section Mini Review Kidney: Nephroblastoma (Wilms tumor) Monica Miozzo Dipartimento di Medicina Ospedale San Paolo Lab di Genetica Umana, Via di Rudini 8, 20142 Milan, Italy (MM) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Tumors/WilmsID5034.html DOI: 10.4267/2042/37491 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology neoplastic, raising the possibility that undifferentiated blastema cells are precursors of the stromal and heterologous elements. Identity Alias: Wilms tumour Treatment Clinics and pathology Stage 1 and 2 are treated with nephrectomy and chemotherapy, radiation therapy is added to tumours of higher staging. Etiology - Wilms tumours are either sporadic or familial (12%); it may be associated with hemihypertrophia or genitourinary malformations (10%) and part of a recognized syndrome (2%). - The syndromes predisposing to Wilms tumours are: WAGR (Wilms tumour, aniridia, genitourinary abnormalities and mental retardation), DDS (Denys-Drash syndrome: mesangial sclerosis, male pseudohermaphrodism and Wilms tumours), BWS (Beckwith-Weideman: exomphalos, macroglossia, gigantism) and SGBS (Simpson Golabi Behmel syndrome: overgrowth, mental impairment, craniofacial anomalies). Prognosis The overall cure rate for unilateral Wilms tumours is 80%; anaplastic tumours (4%) have an unfavorable prognosis. Genetics Note This entity is heterogenous at the genetic level. Cytogenetics Cytogenetics Morphological Epidemiology The observed heterogeneity reflects the complexity of the genetic changes; structural changes at 11p13, 11p15, 1p, 1q and 7p are the most frequently reported, as well as trisomies 8, 12, and 18; 11p deletions occur in 20% of cases, trisomy 12 in 25%, del(16q) in 20%; the der(16)t(1;16), also described in a wide range of tumours, is considered a marker of tumour progression. The most common paediatric cancer of the kidney, affecting 10/105 children; 50% of cases occurs before the age of 3 years and 90% before 6 years. Clinics The localization is primarily the kidney; the incidence of bilateral involvement is 5-10%. Pathology Genes involved and proteins Wilms tumours show a mimicry of nephrogenesis as the tumour comprises undifferentiated blastemal cells, differentiated epithelial cells and stromal cells; ectopic components, particularly skeletal muscle, are observed in 5-10% of tumours; the presence of identical deletions of WT1 in all components of some sporadic Wilms tumours suggests that the stromal components are Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Note - 11p13: constitutional deletion of one copy of the WT1 gene (11p13) is responsible for predisposition to Wilms tumours and for genitourinary malformations in WAGR patients; constitutional 41 Kidney: Nephroblastoma (Wilms tumor) Miozzo M heterozygous intragenic mutations have been described in DDS; WT1 is somatically involved in 10% of the sporadic cases. - 11p15: BWS, an overgrowth syndrome, is caused by alterations of 11p15, a region subject to genomic imprinting: loss of of imprinting of IGF2 is the most common defect found; WT1 is rarely implicated solely in sporadic Wilms tumours, but maternal alleles often displays a loss of heterozygosity (LOH) at 11p15, which suggests the existence of a second locus WT2. - 7p, 17q, 19q: a third locus WT3, at least, is likely, on the grounds of the existence of familial cases of Wilms tumour without 11p13 nor 11p15 involvement; one locus has been identified in 17q in one large Wilms tumours family, and another one in 19q13 in five families; another predisposing gene to Wilms tumours maps to 7p, where constitutional translocations and somatic deletions have been described; in tumours, loss of heterozygosity for 16q has been reported for two different loci: 16q13 and 16q21. - Xq26: the gene of SGBS, an overgrowth syndrome, has been cloned at Xq26. - Mutations of P53 occur in 5% of Wilms tumours and are associated with tumour progression. IGF2 and PDGFA; the WT1-KTS isoforms associate and synergize with SF-1 (steroidogenic factor 1) to promote AMH (anti mullerian hormone or MIS, mullerian inhibiting substance). Germinal mutations Missense mutations of exons 8 and 9 in DDS; in the proximal part of the gene leading to truncated proteins in WAGR, genitourinary malformations and WT; in the donor splice site of intron 9 in Frasier syndrome (pseudohermaphroditism, glomerulopathy, not associated WT). Somatic mutations Stop and frameshift mutations in about 10% of WT. References Austruy E, Candon S, Henry I, Gyapay G, Tournade MF, Mannens M, Callen D, Junien C, Jeanpierre C. Characterization of regions of chromosomes 12 and 16 involved in nephroblastoma tumorigenesis. Genes Chromosomes Cancer. 1995 Dec;14(4):285-94 Little M, Wells C. A clinical overview of WT1 gene mutations. Hum Mutat. 1997;9(3):209-25 Soukup S, Gotwals B, Blough R, Lampkin B. Wilms tumor: summary of 54 cytogenetic analyses. Cancer Genet Cytogenet. 1997 Sep;97(2):169-71 Zhuang Z, Merino MJ, Vortmeyer AO, Bryant B, Lash AE, Wang C, Deavers MT, Shelton WF, Kapur S, Chandra RS. Identical genetic changes in different histologic components of Wilms' tumors. J Natl Cancer Inst. 1997 Aug 6;89(15):1148-52 WT1 Location 11p13 DNA / RNA 50 kb, 10 exons. Protein Protein tumour zing finger transcription factor expressed during renal and gonadal development; exons 1-6 encode a proline/glutamine rich transcriptional regulation region; exons 7-10 encode the four zinc fingers; two alternative splicing regions allow synthesis of four isoforms showing different binding specificity; WT1 regulates transcription of several genes, including Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Jeanpierre C, Béroud C, Niaudet P, Junien C. Software and database for the analysis of mutations in the human WT1 gene. Nucleic Acids Res. 1998 Jan 1;26(1):271-4 McDonald JM, Douglass EC, Fisher R, Geiser CF, Krill CE, Strong LC, Virshup D, Huff V. Linkage of familial Wilms' tumor predisposition to chromosome 19 and a two-locus model for the etiology of familial tumors. Cancer Res. 1998 Apr 1;58(7):1387-90 This article should be referenced as such: Miozzo M. Kidney: Nephroblastoma (Wilms tumor). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):41-42. 42 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Cancer Prone Disease Section Mini Review Familial gastrointestinal stromal tumors (GISTs) Lidia Larizza, Alessandro Beghini Department of Biology and Genetics for Medical Sciences, Medical Faculty, University of Milan, Via Viotti 3/5, 20133 Milan, Italy (LL, AB) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Kprones/GastroISTID10029.html DOI: 10.4267/2042/37492 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology DNA/RNA Description: 21 exons Protein Description: Transmembrane SCF/MGF receptor with tyrosine kinase activity; binding of ligand (SCF) induces receptor dimerization, autophosphorylation and signal transduction via molecules containing SH2- domains. Mutations Germinal: Small deletion of one of two consecutive valine residues (codon 559 or 560, GTTGTT). Somatic: In frame deletions (550del27, 551del15, 559del6) and missense mutations (Lys 550Ile and Val559Asp); all mutations, clustered in exon 11, lead to constitutive phosphorylation and kinase activation. Identity Note A recently described familial cancer syndrome characterized by development of multiple GISTs in different family members. Inheritance Autosomal dominant. Clinics Phenotype and clinics Symptoms are attributable to development of benign and malignant GISTs. Hyperpigmentation and mast-cell disease may be associated. - Etiology: GISTs originate from the CD34+/KIT+ interstitial cells of Cajal (ICCs) which development depends on the SCF/KIT interaction; germline/somatic KIT mutations in familial/solitary GISTs. - Pathology: mesenchymal tumours developped in the gastrointestinal wall mainly characterized by positivity for both KIT and CD34; precursor tumour cells are likely ICCs that are located in and near the circular muscle layer of the stomach, small intestine and large intestine. References Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y. Gain-of-function mutations of ckit in human gastrointestinal stromal tumors. Science. 1998 Jan 23;279(5350):577-80 Nishida T, Hirota S, Taniguchi M, Hashimoto K, Isozaki K, Nakamura H, Kanakura Y, Tanaka T, Takabayashi A, Matsuda H, Kitamura Y. Familial gastrointestinal stromal tumours with germline mutation of the KIT gene. Nat Genet. 1998 Aug;19(4):323-4 Genes involved and proteins This article should be referenced as such: Larizza L, Beghini A. Familial gastrointestinal stromal tumors (GISTs). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):43. KIT Location 4q12 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 43 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Cancer Prone Disease Section Mini Review Piebaldism Lidia Larizza, Alessandro Beghini Department of Biology and Genetics for Medical Sciences, Medical Faculty, University of Milan, Via Viotti 3/5, 20133 Milan, Italy (LL, AB) Published in Atlas Database: September 1998 Online updated version : http://AtlasGeneticsOncology.org/Kprones/piebaldID10030.html DOI: 10.4267/2042/37494 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Prognosis Identity In contrast to vitiligo, piebaldism is both congenital and non-progressive. Note Defect in melanocyte development; one of the first genetic disorders for which a pedigree was presented in 1786. Inheritance Autosomal dominant; frequency is about 2.5/105 newborns. Cytogenetics Inborn conditions A few patients with interstitial deletions of chromosome 4q12-q21.1 have been identified; they are charaterized by multiple congenital anomalies, short stature and mental retardation. Clinics Genes involved and proteins Phenotype and clinics Congenital patches of white skin and white hair, principally located on the scalp, forehead, chest and abdomen and on the limbs; several patients report lifelong severe constipation; a hierarchical correlation has been elaborated between severe or mild phenotypic traits and the associated KIT mutations; in a few patients with interstitial deletions, mental retardation and congenital anomalies have been also described. Etiology: defective melanoblasts proliferation, survival and migration from the neural crest during development and defective migration of entericplexus ganglion cells from the neural crest to the gut. Pathology: white spotting in human piebaldism results from the absence of melanocytes from the nonpigmented patches of skin and from hairbulbs in the white patches of hair; occasionally, individuals lack ganglion cells of the intestinal enteric neural plexus, which, like melanoblasts, are derived from the neural crest. KIT Location 4q12 DNA/RNA Description: 21 exons Protein Description: Transmembrane SCF/MGF receptor with tyrosine kinase activity; binding of ligand (SCF) induces receptor dimerization, autophosphorylation and signal transduction via molecules containing SH2- domains. Mutations Germinal: Loss of function mutations resulting in haploinsufficiency of the receptor; different kinds of point mutations have been identified (diagram). - Missense substitutions (Glu583Lys; Phe584Leu; Ala621Thr; His650Pro; Gly664Arg; Gly791Arg; Val812Gly; Glu861Ala) and small deletions (641del2; 892del12) in the intracellular tyrosine kinase domain; correlate with severe piebald Neoplastic risk An increased risk of epithelioma has been reported. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 44 Piebaldism Larizza L, Beghini A phenotypes, because of dominant-negative inhibition of the KIT receptor via formation of impaired receptor heterodimers between a normal and a mutant KIT monomer, and a 75% decrease of KIT- dependent signal transduction. - Proximal frameshifts (84del1; 249del4); Trp557Term; and missense mutations (Cys136Arg; Ala178Thr; Met318Gly) associated with a mild piebald phenotype, the result of pure haploinsufficiency due to a 50% decrease of KITdependent signal transduction. - Distal frameshifts: 630insA; and splice junction mutations (IVS1+4G-A; IVS12+1G-A), located near the intracellular TK domain associated with variable phenotypes, as the truncated polypeptides via incorporation into nonfunctional receptor heterodimers would decrease KIT-dependent signal transduction by 50-75%, depending on their stability. - Complete deletions of the entire KIT gene (null mutations) result in a mild-intermediate phenotype. SCF/MGF Location 12q22 Note No alteration of this gene has been so far identified in typical patients; at difference with the mouse system, where steel mice bearing SCF mutations show the white spotting phenotype likewise W mice bearing kit mutations; however, as mutations of KIT could not be detected in a consistent fraction of these patients, involvement of SCF is still an open question. References Ezoe K, Holmes SA, Ho L, Bennett CP, Bolognia JL, Brueton L, Burn J, Falabella R, Gatto EM, Ishii N. Novel mutations and deletions of the KIT (steel factor receptor) gene in human piebaldism. Am J Hum Genet. 1995 Jan;56(1):58-66 Riva P, Milani N, Gandolfi P, Larizza L. A 12-bp deletion (7818del12) in the c-kit protooncogene in a large Italian kindred with piebaldism. Hum Mutat. 1995;6(4):343-5 PDGFRA Fleischman RA, Gallardo T, Mi X. Mutations in the ligandbinding domain of the kit receptor: an uncommon site in human piebaldism. J Invest Dermatol. 1996 Nov;107(5):703-6 Location 4q12 Note PDGFRA is also deleted in patients with interstitial cytogenetic deletions (contiguous gene syndrome). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: Larizza L, Beghini A. Piebaldism. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):44-45. 45 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Cancer Prone Disease Section Mini Review Nijmegen breakage syndrome Jérôme Couturier Department of Pathology, Institut Curie, Paris, France (JC) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Kprones/NijmegenID10020.html DOI: 10.4267/2042/37495 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology is absent; alphafoetoprotein levels are normal, in contrast to AT patients. - Craniofacial dysmorphy: progressive and severe microcephaly, "bird-like" face with prominent midface, long nose and receding mandible. - Immunodeficiency: severe combined deficiency with agammaglobulinemia, IgA, IgG2 and IgG4 deficiencies, decreased CD3+ and CD4+ lymphocytes, and decreased CD4+/CD8+ ratio; these disturbances are responsible of frequent respiratory, gastrointestinal and urinary infections. Identity Alias Ataxia-telangiectasia, variant VI; Seemanova syndrome II; Microcephaly with normal intelligence, immunodeficiency, lymphoreticular malignancies; Immunodeficiency, microcephaly, chromosomal instability Note Belongs to the group of inherited chromosomal instability syndromes including Bloom's syndrome, Fanconi's disease, and ataxia telangiectasia (AT). Inheritance Autosomal recessive disease; since the recognition of the Nijmegen breakage syndrome (NBS) in 1981, about 50 patients are included in the NBS Registry in Nijmegen; the disease appears to have originated in central Europe, in the Slavic population, and to have spread through a founder effect. Neoplastic risk High frequency and early development of lymphomas, more often involving B-cells, in contrast with those found in AT. Other forms of cancer may also be at higher risk. Cytogenetics Inborn conditions - Lymphocyte cultures often show low mitotic index. - Structural chromosome aberrations are observed in 10-30% of metaphases; most of the rearrangements occur in or between chromosomes 7 and 14, at bands 7p13, 7q35, 14q11, and 14q32, as in AT; these bands contain immunoglobulin and Tcell receptor genes; the most frequent rearrangement is the inv(7)(p13q35). Clinics Note The condition is characterised by growth and mental retardation, craniofacial dysmorphy, ovarian failure, immunodeficiency, chromosome instability, predisposition to lymphoid malignancies, and radiosensitivity. Phenotype and clinics Other findings - Growth and mental development: 30% of children have low birth weight and short stature, and 75% a head circumference at birth below the 3rd percentile; all patients develop a severe microcephaly during the first months of life; mental development is normal in 35% of the patients, moderately retarded in the others; cerebellar ataxia Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Note Radiosensitivity: increased sensitivity of both lymphocytes and fibroblasts to ionising radiations and radiomimetics, radio-resistant DNA synthesis. 46 Nijmegen breakage syndrome Couturier J Genes involved and proteins References van der Burgt I, Chrzanowska KH, Smeets D, Weemaes C. Nijmegen breakage syndrome. J Med Genet. 1996 Feb;33(2):153-6 NBS1 Shiloh Y. Ataxia-telangiectasia and the Nijmegen breakage syndrome: related disorders but genes apart. Annu Rev Genet. 1997;31:635-62 Location 8q21 DNA/RNA Description: 16 exons Protein Function: The product of NBS1, the nibrin, should have a role in the control of double-strand DNA breaks involved, for example, in VDJ joining in immunoglobulin and T-cell receptor genes recombination process, in meiotic recombination, and in radio-induced DNA lesions; this suggests that nibrin and the product of ATM could act in a common pathway of detection or repair of doublestrand breaks. Mutations Germinal: All Nijmegen patients show truncating mutations. Matsuura S, Tauchi H, Nakamura A, Kondo N, Sakamoto S, Endo S, Smeets D, Solder B, Belohradsky BH, Der Kaloustian VM, Oshimura M, Isomura M, Nakamura Y, Komatsu K. Positional cloning of the gene for Nijmegen breakage syndrome. Nat Genet. 1998 Jun;19(2):179-81 Varon R, Vissinga C, Platzer M, Cerosaletti KM, Chrzanowska KH, Saar K, Beckmann G, Seemanová E, Cooper PR, Nowak NJ, Stumm M, Weemaes CM, Gatti RA, Wilson RK, Digweed M, Rosenthal A, Sperling K, Concannon P, Reis A. Nibrin, a novel DNA double-strand break repair protein, is mutated in Nijmegen breakage syndrome. Cell. 1998 May 1;93(3):467-76 Yamazaki V, Wegner RD, Kirchgessner CU. Characterization of cell cycle checkpoint responses after ionizing radiation in Nijmegen breakage syndrome cells. Cancer Res. 1998 Jun 1;58(11):2316-22 This article should be referenced as such: Couturier J. Nijmegen breakage syndrome. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):46-47. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 47 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Cancer Prone Disease Section Mini Review Retinoblastoma Dietmar R Lohmann Institut fuer Humangenetik, Hufelandstr. 55, D-45122 Essen, Germany (DRL) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Kprones/RbKprID10031.html DOI: 10.4267/2042/37496 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology - brain tumours (pinealoma in particular some patients also show multiple benign tumours of adipose tissue (lipoma). Identity Inheritance Predisposition to retinoblastoma is transmitted as an autosomal dominant trait; it is caused by mutations in the RB1 gene; penetrance and expressivity depend on the nature of the predisposing mutational change; there is also a non-hereditary form of retinoblastoma (mostly in children with isolated unilateral retinoblastoma) that is caused by RB1mutations confined to somatic cells. Treatment Clinics Retinoblastomas can be cured by (depending on size and location): local therapy (photocoagulation, cryotherapy, radiation), combined systemic and local therapy, or enucleation of the eye; surveillance: following the diagnosis of retinoblastoma, repeated examinations under general anesthesia are required for early diagnosis of new tumour foci; up to now, no screening for second primary neoplasms. Phenotype and clinics Prognosis Retinoblastoma in early childhood: white reflexes in one or both eyes or strabismus usually are the first signs indicating this malignant eye tumour; in most children with the hereditary retinoblastoma, both eyes are affected by multiple tumour foci (bilateral multifocal retinoblastoma). Adults (most often relatives of patients with retinoblastoma) may show retinal scars indicating regressed retinoblastomas or retinomas (nonprogressive tumours). In addition to retinoblastoma, children with cytogenetic deletions involving 13q14 may show developmental delay and dysmorphic signs. Most often, treatment of retinoblastoma is very effective and, therefore, death from retinoblastoma is rare; however, life span in patients that develop second primary neoplasms is reduced (cumulative mortality at age 40: 6.4% in bilateral patients without radiotherapy, 1.5% in patients with unilateral retinoblastoma). Neoplastic risk Location: 13q14 DNA/RNA Genes involved and proteins RB1 (retinoblastoma susceptibility gene) Early childhood: formation of retinoblastomas (see genotype-phenotype correlation). Adolescence and adulthood: tumours outside the eye (second primary neoplasms): - osteosarcoma, - melanoma, c-RB1 at 13q14 in normal cells: PAC 825K21 - Courtesy Mariano Rocchi. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) 48 Retinoblastoma Lohmann DR Musarella MA, Gallie BL. A simplified scheme for genetic counseling in retinoblastoma. J Pediatr Ophthalmol Strabismus. 1987 May-Jun;24(3):124-5 Description: 180 kb genomic DNA containing 27 exons. Transcription: 4.7 kb mRNA with 2.7 kb open reading frame. Protein Description: 928 aa nuclear phosphoprotein. Localisation: Nucleus. Function: Involved in cell cycle regulation. Mutations Note: Mutations predisposing to retinoblastoma are one allele mutations; in retinoblastoma, both copies of the RB1 gene are mutated (two-step inactivation mechanism typical of tumor suppressor genes). Nature and localization of individual mutations are heterogeneous regarding their nature: 20% deletions larger 1kb; 30% small deletions or insertions; 45% point mutations. And location: mutations have been found in 25 of the 27 coding exons and in promoter elements. Genotype-phenotype correlation: most mutant RB1alleles show premature termination codons; typically, these mutant alleles are associated with almost complete penetrance (>95%) and high expressivity (more than 6 individual retinoblastoma foci per individual and, therefore, most often involvement of both eyes); some rare mutant alleles that code for proteins with retention of parts of the functions of the wild-type prote in or that result in diminished amounts of wild-type transcript are associated with incomplete penetrance (<75%) and low expressivity (mean of less than 2 tumor foci). Sakai T, Ohtani N, McGee TL, Robbins PD, Dryja TP. Oncogenic germ-line mutations in Sp1 and ATF sites in the human retinoblastoma gene. Nature. 1991 Sep 5;353(6339):83-6 Dryja TP, Rapaport J, McGee TL, Nork TM, Schwartz TL. Molecular etiology of low-penetrance retinoblastoma in two pedigrees. Am J Hum Genet. 1993 Jun;52(6):1122-8 Eng C, Li FP, Abramson DH, Ellsworth RM, Wong FL, Goldman MB, Seddon J, Tarbell N, Boice JD Jr. Mortality from second tumors among long-term survivors of retinoblastoma. J Natl Cancer Inst. 1993 Jul 21;85(14):1121-8 Toguchida J, McGee TL, Paterson JC, Eagle JR, Tucker S, Yandell DW, Dryja TP. Complete genomic sequence of the human retinoblastoma susceptibility gene. Genomics. 1993 Sep;17(3):535-43 Fleischman RA, Gallardo T, Mi X. Mutations in the ligandbinding domain of the kit receptor: an uncommon site in human piebaldism. J Invest Dermatol. 1996 Nov;107(5):703-6 Fleischman RA, Gallardo T, Mi X. Mutations in the ligandbinding domain of the kit receptor: an uncommon site in human piebaldism. J Invest Dermatol. 1996 Nov;107(5):703-6 Gallie BL, Budning A, DeBoer G, Thiessen JJ, Koren G, Verjee Z, Ling V, Chan HS. Chemotherapy with focal therapy can cure intraocular retinoblastoma without radiotherapy. Arch Ophthalmol. 1996 Nov;114(11):1321-8 Abramson DH, Frank CM. Second nonocular tumors in survivors of bilateral retinoblastoma: a possible age effect on radiation-related risk. Ophthalmology. 1998 Apr;105(4):573-9; discussion 579-80 References Abramson DH, Frank CM, Susman M, Whalen MP, Dunkel IJ, Boyd NW 3rd. Presenting signs of retinoblastoma. J Pediatr. 1998 Mar;132(3 Pt 1):505-8 Gallie BL, Ellsworth RM, Abramson DH, Phillips RA. Retinoma: spontaneous regression of retinoblastoma or benign manifestation of the mutation? Br J Cancer. 1982 Apr;45(4):513-21 Sippel KC, Fraioli RE, Smith GD, Schalkoff ME, Sutherland J, Gallie BL, Dryja TP. Frequency of somatic and germ-line mosaicism in retinoblastoma: implications for genetic counseling. Am J Hum Genet. 1998 Mar;62(3):610-9 Friend SH, Bernards R, Rogelj S, Weinberg RA, Rapaport JM, Albert DM, Dryja TP. A human DNA segment with properties of the gene that predisposes to retinoblastoma and osteosarcoma. Nature. 1986 Oct 1622;323(6089):643-6 This article should be referenced as such: Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Lohmann DR. Retinoblastoma. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):48-49. 49 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Cancer Prone Disease Section Mini Review Rothmund-Thomson syndrome (RTS) Lidia Larizza Department of Biology and Genetics for Medical Sciences, Medical Faculty, University of Milan, Via Viotti 3/5, 20133 Milan, Italy (LL) Published in Atlas Database: October 1998 Online updated version : http://AtlasGeneticsOncology.org/Kprones/RothmundID10021.html DOI: 10.4267/2042/37497 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology - premature aging. Diagnosis: the diagnosis is difficult before the development of the erythema. Identity Alias: Poikiloderma atrophicans and cataract Note RTS is a chromosomal instability syndrome with an increased risk of cancers. Inheritance Autosomal recessive; rare geno-dermatosis with increased frequency in females; more than 200 cases reviewed in the medical literature. Differential Diagnosis Differential diagnosis with: Werner syndrome, dyskeratosis congenita, Cockayne syndrome, Anhidrotic ectodermal dysplasia, Bloom syndrome, Fanconi anaemia. Neoplastic risk There are more than 30 documented cases of malignancies in RTS patients, predominantly affecting skin (squamous cell carcinoma, basal cell carcinoma) and bone (osteosarcoma). Etiology is unknown; a DNA repair deficiency has been postulated to account for cancer proneness, but no conclusive results have so far been achieved. Clinics Phenotype and clinics Clinical expression highly variable. Main features include: - growth retardation, - skin defects appearing within the first year of life (90%): atrophic dermatosis, poikiloderma, hyperpigmentation, teleangiectasia, - sparse hair which may progress to partial or total alopecia; dystrophic nails, - photosensitivity, - congenital skeletal defects: hypoplasia or absence of the radii and thumbs, osteopenia, cystic or sclerotic changes of the long bones (in more than 50%); bone age lower than chronological age, - juvenile cataract, corneal dystrophy (50%), - hypodontia, - hypogonadism (25%), - proportionate short stature, Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) Treatment Only protection against sunlight is possible; dermatologic therapies; surgical correction of skeletal malformations and cataracts; regular and careful work-up of signs and symptoms of both cutaneous and internal malignancy; caution is warranted in administering chemotherapy to affected individuals due to their sensitivity to chemotherapeutic agents. Evolution The disease tends to progress during the first years of life, but becomes static so that patients may have a normal lifespan; the mortality from neoplastic disease during the second or third decade is very significantly increased. 50 Rothmund-Thomson syndrome (RTS) Larizza L Cytogenetics homozygosity mapping have been performed due to the few reported families. Inborn conditions References Spontaneous/induced chromatid breaks were found increased in only a very few studies; In contrast with (mainly negative) chromatid results, consistent clonal/non clonal structural chromosomal abnormalities were evidenced in most studies, often involving chromosome 8, in cultured lymphocytes and in fibroblasts; low frequency trisomy 8 mosaicism has been reported in both lymphocyte and primary fibroblast cultures as well as in uncultured blood and buccal smears, indicating this characteristic chromosomal abnormality is present in vivo; a propensity to centromere misdivision with development of clones carrying isochromosomes, such as i(8q), is peculiar of RTS. Smith PJ, Paterson MC. Enhanced radiosensitivity and defective DNA repair in cultured fibroblasts derived from Rothmund Thomson syndrome patients. Mutat Res. 1982 May;94(1):213-28 Der Kaloustian VM, McGill JJ, Vekemans M, Kopelman HR. Clonal lines of aneuploid cells in Rothmund-Thomson syndrome. Am J Med Genet. 1990 Nov;37(3):336-9 Ying KL, Oizumi J, Curry CJ. Rothmund-Thomson syndrome associated with trisomy 8 mosaicism. J Med Genet. 1990 Apr;27(4):258-60 Vennos EM, Collins M, James WD. Rothmund-Thomson syndrome: review of the world literature. J Am Acad Dermatol. 1992 Nov;27(5 Pt 1):750-62 Shinya A, Nishigori C, Moriwaki S, Takebe H, Kubota M, Ogino A, Imamura S. A case of Rothmund-Thomson syndrome with reduced DNA repair capacity. Arch Dermatol. 1993 Mar;129(3):332-6 Cytogenetics of cancer Marked chromosomal instability has been detected in mesenchymal tumours developed by RTS sibs. Orstavik KH, McFadden N, Hagelsteen J, Ormerod E, van der Hagen CB. Instability of lymphocyte chromosomes in a girl with Rothmund-Thomson syndrome. J Med Genet. 1994 Jul;31(7):570-2 Other findings Note Reduced unscheduled DNA synthesis, 37% of normal after exposure to ultraviolet C or gamma irradiation. Lindor NM, Devries EM, Michels VV, Schad CR, Jalal SM, Donovan KM, Smithson WA, Kvols LK, Thibodeau SN, Dewald GW. Rothmund-Thomson syndrome in siblings: evidence for acquired in vivo mosaicism. Clin Genet. 1996 Mar;49(3):124-9 Genes involved and proteins Miozzo M, Castorina P, Riva P, Dalprà L, Fuhrman Conti AM, Volpi L, Hoe TS, Khoo A, Wiegant J, Rosenberg C, Larizza L. Chromosomal instability in fibroblasts and mesenchymal tumors from 2 sibs with Rothmund-Thomson syndrome. Int J Cancer. 1998 Aug 12;77(4):504-10 Note The gene has not been mapped; it has been provisionally assigned to chromosome 8 on the basis of trisomy 8 mosaicism in affected individuals; no linkage studies exploiting Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: Larizza L. Rothmund-Thomson syndrome (RTS). Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):50-51. 51 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Cancer Prone Disease Section Mini Review Bannayan-Riley-Ruvalcaba syndrome Jean-Loup Huret Genetics, Dept Medical Information, University of Poitiers, CHU Poitiers Hospital, F-86021 Poitiers, France (JLH) Published in Atlas Database: November 1998 Online updated version : http://AtlasGeneticsOncology.org/Kprones/BannayanID10044.html DOI: 10.4267/2042/37498 This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 2.0 France Licence. © 1999 Atlas of Genetics and Cytogenetics in Oncology and Haematology Neoplastic risk Identity - Multiple lipomas (75% of cases). - Hemangiomas (40%). - Hamartomatous polyps (ileus and colon; 45%). - Lymphangiomas (10%). Alias Bannayan-Zonana syndrome; Riley-Smith syndrome; Ruvalcaba-Myhre-Smith syndrome; Macrocephaly, pseudopapilledema, multiple hemangiomata; Macrocephaly, multiple lipomas, hemangiomata Inheritance autosomal dominant; existence of sporadic cases. Genes involved and proteins PTEN Clinics Location 10q23 Protein Description: 403 amino acids. Function: Protein tyrosine phosphatase; tumour suppressor gene. Mutations Germinal: May be not all Bannayan-RileyRuvalcaba syndrome cases are due to PTEN mutations; germ-line mutations have also been described in Cowden disease and in some cases with juvenile polyposis syndrome. Somatic: PTEN is mutated in a large number of cancer types. Note Bannayan-Riley-Ruvalcaba syndrome is an overgrowth syndrome/hamartomatous polyposis condition with an increased risk of benign and malignant tumours; other overgrowth syndromes at (known) risk of tumourigenesis are: - Beckwith-Weideman syndrome, - Sotos syndrome (cerebral gigantism), - Hemihyperplasia (hemihypertrophy), and - Simpson Golabi Behemel syndrome. Phenotype and clinics Onset in chilhood (in contrast with Cowden disease, although an allelic disorder, see below); more often found in male patients (lower penetrance in female patients). - Overgrowth at birth (postnatal growth decelerates). - Macrocephaly. - Hypotonia and mental deficiency. - Subcutaneous and visceral lipomas and hemangiomas, and intestinal juvenile polyposis. - Myopathy of the proximal type in 2/3 of cases. - Pigmentation spots of the male genitalia. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) References Riley HD Jr and Smith WR. Macrocephaly, pseudopapilledema and multiple hemangiomata: a previously undescribed heredofamilial syndrome. Pediatrics. 1960;26:293-300. Bannayan GA. Lipomatosis, angiomatosis, and macrencephalia. A previously undescribed congenital syndrome. Arch Pathol. 1971 Jul;92(1):1-5 Ruvalcaba RH, Myhre S, Smith DW. Sotos syndrome with intestinal polyposis and pigmentary changes of the genitalia. Clin Genet. 1980 Dec;18(6):413-6 52 Bannayan-Riley-Ruvalcaba syndrome Huret JL Arch EM, Goodman BK, Van Wesep RA, Liaw D, Clarke K, Parsons R, McKusick VA, Geraghty MT. Deletion of PTEN in a patient with Bannayan-Riley-Ruvalcaba syndrome suggests allelism with Cowden disease. Am J Med Genet. 1997 Sep 5;71(4):489-93 DiLiberti JH. Inherited macrocephaly-hamartoma syndromes. Am J Med Genet. 1998 Oct 2;79(4):284-90 Marsh DJ, Coulon V, Lunetta KL, Rocca-Serra P, Dahia PL, Zheng Z, Liaw D, Caron S, Duboué B, Lin AY, Richardson AL, Bonnetblanc JM, Bressieux JM, CabarrotMoreau A, Chompret A, Demange L, Eeles RA, Yahanda AM, Fearon ER, Fricker JP, Gorlin RJ, Hodgson SV, Huson S, Lacombe D, Eng C. Mutation spectrum and genotype-phenotype analyses in Cowden disease and Bannayan-Zonana syndrome, two hamartoma syndromes with germline PTEN mutation. Hum Mol Genet. 1998 Mar;7(3):507-15 Marsh DJ, Dahia PL, Zheng Z, Liaw D, Parsons R, Gorlin RJ, Eng C. Germline mutations in PTEN are present in Bannayan-Zonana syndrome. Nat Genet. 1997 Aug;16(4):333-4 Carethers JM, Furnari FB, Zigman AF, Lavine JE, Jones MC, Graham GE, Teebi AS, Huang HJ, Ha HT, Chauhan DP, Chang CL, Cavenee WK, Boland CR. Absence of PTEN/MMAC1 germ-line mutations in sporadic BannayanRiley-Ruvalcaba syndrome. Cancer Res. 1998 Jul 1;58(13):2724-6 Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1) This article should be referenced as such: Huret JL. Bannayan-Riley-Ruvalcaba syndrome. Atlas Genet Cytogenet Oncol Haematol. 1999; 3(1):52-53. 53 Atlas of Genetics and Cytogenetics in Oncology and Haematology OPEN ACCESS JOURNAL AT INIST-CNRS Instructions to Authors Manuscripts submitted to the Atlas must be submitted solely to the Atlas. Iconography is most welcome: there is no space restriction. The Atlas publishes "cards", "deep insights", "case reports", and "educational items". Cards are structured review articles. 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