Translocation (4;11)(p12;q23) with rearrangement of FRYL and MLL in therapy-related acute myeloid leukemia

Reciprocal chromosomal translocations involving the MLL gene at chromosome region 11q23 are recurring cytogenetic abnormalities in both de novo and therapy-related acute myeloid leukemia (AML) and in acute lymphoblastic leukemia. We report a t(4;11)(p12;q23) with rearrangement of MLL and FRYL (also known as AF4p12), a human homolog to the furry gene of Drosophila, in an adult patient with therapy-related AML after fludarabine and rituximab therapy for small lymphocytic lymphoma and radiation therapy for breast carcinoma. To our knowledge, t(4; I 1)(p I 2;q23) has been reported in two previous patients, and MLL and FRYL rearrangement was demonstrated in one of them. Both of the previous patients had therapy-related leukemias after exposure to topoisomerase 11 inhibitors, whereas our patient had received cytotoxic therapy that did not include a topoisomerase 11 inhibitor. Thus, t(4;11)(p12;q23) with MLL and FRYL involvement represents a new recurring I I q23 translocation, to date seen only in therapy-related acute leukemias. (c) 2007 Elsevier Inc. All rights reserved.