TRANSLOCATION T(4-11)(Q21-Q23) AND MLL GENE REARRANGEMENT IN ACUTE LYMPHOBLASTIC-LEUKEMIA SECONDARY TO ANTI TOPOISOMERASE-II ANTICANCER AGENTS

Secondary therapy-related, acute lymphoblastic leukemia (S-ALL) is les s common than its myeloblastic counterpart. S-ALL with MLL gene rearra ngements have only been reported on six previous occasions. Only three of these had t(4;11)(q21;23) S-ALL with MLL-AF4 fusion transcript has only been reported in one earlier case. In this report a rare case of S-ALL with MLL-AF4 transcript is described in a 36 year old woman tre ated for breast carcinoma with chemotherapy which included the topoiso merase II inhibitor, VP-16. The precise incidence of MLL gene rearrang ement in S-ALL still remains to be clarified.