Cleavage of the ALL1 gene in acute lymphoid leukemia before treatment disappears in relapse

Background and Objective, ALL1 gene rearrangements are frequently found in secondary acute leukemias (ALs), A site-specific cleavage of the ALL1 gene in a consensus sequence for topoisomerase II recognition has been considere d to be the initial step leading to ALL1 rearrangement and subsequent thera py-related AL, The aim of the present study was to evaluate this cleavage i n our patients, to analyze whether it is a laboratory-produced artefact and to check whether it persists or causes a real ALL1 gene rearrangement at r elapse, Design and Methods, We studied ALL1 rearrangement in 74 cases of AL before treatment by Southern blot avoiding room temperature exposure or delay in p rocessing the samples which could produce ALL1 cleavage. DNA was available for two cases with ALL1 cleavage; it was analyzed by three different Southe rn blots in one and two in the other, One case with ALL1 cleavage was also studied in relapse. Results. The presence of the cleavage of the ALL1 DNA was found in 3 of 74 (4%) patients. Two of these three patients had the ALL1 cleavage in three a nd two different analyses, One case was positive for ALL1 cleavage at diagn osis, but negative for both ALL1 cleavage and ALL1 rearrangement at relapse , Interpretation and Conclusions, The fact that a constant-pattern was obtain ed from the same patients in different DNA preparations, supports the notio n that ALL1 cleavage is not a laboratory artefact, The absence of the cleav age in a sample from a relapsed patient suggests that the subclone with the ALL1 cleavage, in this case, did not play a clear role in the pathogenesis of disease recurrence. (C) 1999, Ferrata Storti Foundation.