Leukemia - Acute
B lymphoblastic leukemia / lymphoma with t(v;11q23); MLL rearranged

Topic Completed: 1 February 2013

Revised: 22 January 2019, last major update February 2013

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PubMed Search: B lymphoblastic leukemia MLL rearranged

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Cite this page: Mihova D. B lymphoblastic leukemia / lymphoma with t(v;11q23); MLL rearranged. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/leukemiapreballMLL.html. Accessed August 24th, 2019.
Definition / general
  • Rearrangements of MLL gene
  • 20% of ALL overall (Anticancer Res 2005;25:1931) including 80% of infants (Leukemia 2007;21:633), 10% of older children and adults
  • May have bilineal lymphoblasts with monoblasts and promonocytes
  • Usually infants < 1 year with markedly increased WBC (> 100x109/L), CNS involvement; pure lymphomatous involvement not typical
  • Poor prognosis (30% event free survival)
  • Intensive chemotherapy followed by hematopoietic stem cell transplantation
Microscopic (histologic) description
  • No defining morphology
Positive stains
Negative stains
Molecular / cytogenetics description
  • Over 75 genetic arrangements; most translocations at 11q23 involve MLL (mixed lineage leukemia) gene
  • t(4;11)(q21;q23) - MLL-AF4: occurs in 60% of infants, 2% of other children and 3 - 6% of adults
  • t(11;19)(q23;p13.3) - MLL-ENL and others
  • MLL translocation is associated with FLT3 overexpression
  • 11q23 deletions are NOT included in this group because different immunophenotype, clinical and prognostic features
Molecular / cytogenetics images

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Diagram of ALL1 / MLL duplication

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