Translocation (14;18)(q32;q21) in acute lymphoblastic leukemia: a study of 12 cases and review of the literature

We present a series of 12 cases of de novo acute lymphoblastic leukemia (ALL) with translocation t(14;18)(q32;q21). The median age of patients at presentation was 65.5 years, and no patient presented with a past history or any clinical evidence of lymphoma. A Burkitt translocation was identified in 4 of the 12 cases by conventional cytogenetics but fluorescence in situ hybridization using a MYC probe identified a further three cases of MYC rearrangement: one with a cryptic t(8;14) involving the der(14)t(14;18), one showing MYC translocated onto a marker chromosome, and one associated with a t(8;9)(q24;p13) translocation. A review of the literature identified an extremely close association between the t(14;18) and the t(8;9), with the latter translocation found only in the presence of t(14;18). The present study confirms the previously reported dismal prognosis of t(14;18)-associated ALL.