Rare de novo acute leukemias of mature B cells may exhibit the chromosomal translocation t(14;18)(q32.3; q21.3). We report the preliminary characterization of two cases that exhibited not only t(14;18)(q32.3;q21.3) but also the novel translocation t(8;9)(q24.1;p13.3), involving the C-MYC locus with unknown sequences at 9p13.3. From these cases, two Epstein-Barr virus negative cell lines (Karpas 231 and 353) with features identical to those seen in fresh cells from the patient have been derived. Both cell lines have complex karyotypes: in addition to both t(14;18)(q32.3;q21.3) and t(8;9)(q24.1;p13.3), cell line Karpas 231 exhibited three-way translocation t(1;3;11) (q42.3;q27.1;q23.1), whereas Karpas 353 exhibited t(1;3;7)(p32.1;q21.1;q22.1). Both cases retained immunophenotypes characteristic of mature B cells with no evidence for commitment to other hematopoietic lineages. Both cases expressed abundant, normal-sized C-MYC transcript, but no rearrangement of C-MYC DNA sequences could be detected using probes that span 80 kb around the C-MYC coding sequences. Breakpoints within the BCL-2 gene were divergent. In Karpas 353 the BCL-2 breakpoint occurred within the 3′ untranslated major breakpoint region (mbr) of the gene, whereas, in Karpas 231, breaks in both the 3′ mbr and in the region 5′ of the gene were detected. The cytogenetic combination of t(14;18)(q32.3;q21.3) and t(8;9)(q24.1;p13.3) has been previously reported in diffuse B cell lymphomas. This combination may be a new recurrent abnormality, of central pathogenic importance in the transformation of B cells to high grade malignancies through simultaneous deregulation of BCL-2 and C-MYC genes, constitutive expression of C-MYC being driven by currently unknown DNA sequences on chromosome 9p13.3. The presence of other complex translocations including those affecting 11q23.1 may further accelerate the process of acute transformation.

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