Acute Myeloid Leukemia with 11q23 Aberrations

Although leukemias with 11q23 or MLL gene rearrangements are clinically and biologically highly heterogeneous, they are considered one category in the WHO classification.77,78 Aside from t(4;11), which is predominantly found in ALL, as discussed above, most translocations involving 11q23 occur in both AML and ALL, with predominance toward myeloid lineage.400 Multiparameter flow cytometry of de novo t(11q23) adult AML demonstrated no difference in antigen distribution when compared with cases of equal morphology but lacking t(11q23), in particular no increase in lymphoid antigen expression.401,402 In the search for a surrogate marker for MLL gene rearrangements, monoclonal antibody 7.1 specific to the NG2 antigen, a member of the chondroitin sulfate proteoglycan family, has been tested for its reactivity in t(11q23) leukemias. Although 100 percent specificity for leukemic cells with MLL rearrangements has been generally observed,403-406 sensitivity, particularly in AML, is unconvincingly low (50 to 75 percent).403,404,406

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