Leukemia - Acute
PreB ALL
B lymphoblastic leukemia / lymphoma with t(9;22)(q34;q11); BCR-ABL1

Author: Daniela Mihova, M.D. (see Authors page)

Revised: 11 April 2018, last major update March 2013

Copyright: (c) 2001-2018, PathologyOutlines.com, Inc.

PubMed Search: B lymphoblastic leukemia lymphoma with t(9;22)(q34;q11); BCR-ABL1

Cite this page: Mihova, D. B lymphoblastic leukemia / lymphoma with t(9;22)(q34;q11); BCR-ABL1. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/leukemiapreBt922.html. Accessed August 16th, 2018.
Definition / general
  • ALL with BCR-ABL1 fusion transcript (Philadelphia chromosome)
  • 30% of adults with ALL, 4% of children but 80% of infants
  • Excluding infants, older age and higher WBC at presentation than other B ALL
  • May have more organomegaly or CNS involvement than other B ALL
  • Poor prognosis
Treatment
Microscopic (histologic) description
  • No defining morphology, but large blasts with prominent nucleoli and cytoplasmic granules are more common than other B ALL
Microscopic (histologic) images

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Leukemic cells resemble early erythroblasts

Cytology images

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CSF - Contributed by Dr. Julia Braza, Beth Israel Deaconess Medical Center, Boston, Massachusetts (USA)

Positive stains
Flow cytometry Images

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B-ALL associated with t(9;22); lymphoblasts express B-lineage
markers CD19, CD20, CD22, immature markers CD34, TdT, CD10,
and aberrant CD25. They are aberrantly dim for CD38 and CD81.
This pattern is useful in identifying minimal residual disease

Molecular / cytogenetics description
  • Translocation involves abl on #9q34 (tyrosine kinase) and bcr on #22q11 (breakpoint cluster region)
  • Most childhood cases associated with p190 kd BCR-ABL1 fusion protein
  • In 50% of adults, has p210 kd fusion protein that is present in CML, the rest is p190 kd; no definitive clinical difference
Molecular / cytogenetics images

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Karyotype

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FISH - Contributed by Dr. Julia Braza, Beth Israel Deaconess
Medical Center, Boston, Massachusetts (USA)



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Drawing of translocation