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Research Article Free access | 10.1172/JCI114106

Clonal analysis of childhood acute lymphoblastic leukemia with "cytogenetically independent" cell populations.

C H Pui, W H Raskind, G R Kitchingman, S C Raimondi, F G Behm, S B Murphy, W M Crist, P J Fialkow, and D L Williams

Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38101.

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Published June 1, 1989 - More info

Published in Volume 83, Issue 6 on June 1, 1989
J Clin Invest. 1989;83(6):1971–1977. https://doi.org/10.1172/JCI114106.
© 1989 The American Society for Clinical Investigation
Published June 1, 1989 - Version history
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Abstract

Acute lymphoblastic leukemia (ALL) is generally regarded as a clonal disease in which a single abnormal progenitor cell gives rise to neoplastic progeny. Five of 463 cases of childhood ALL with adequately banded leukemic cells were found to have two cytogenetically independent cell populations. In addition, two of the four cases tested had more than two rearranged immunoglobulin genes and (or) T cell receptor genes. To investigate the clonality of these unusual leukemias, we examined the neoplastic cells for X-linked markers extrinsic to the disease. Leukemic cells from each of the three patients heterozygous for an X-linked, restriction fragment length polymorphism showed a single active parental allele, suggesting that both apparently independent cell populations developed from a common progenitor. These cases provide evidence that leukemogenesis involves a multistep process of mutation and suggest that karyotypic abnormalities may be a late event of malignant transformation.

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