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t(8;14;18): A 3-way chromosome translocation in two patients with Burkitt's lymphoma/leukemia
Delong Liu*1, Josif Shimonov2, Suneeta Primanneni1, Yongrong Lai1,3, Tauseef Ahmed1 and Karen Seiter1
Address: 1Division of Oncology/Hematology, New York Medical College and Westchester Medical Center, Valhalla, NY 10595, USA,2Department of Medicine, Richmond University Medical Center, Staten Island, NY 10310, USA and 3Department of Hematology, First Affiliated University Hospital, Guangxi Medical University, Nanning, Guangxi Province, China Email: Delong Liu* - delong_liu@nymc.edu; Josif Shimonov - ishimunov@msn.com; Suneeta Primanneni - suneeta_pinna@yahoo.com; Yongrong Lai - yongronglai@hotmail.con; Tauseef Ahmed -hdtrans@gmail.com; Karen Seiter - karen_seiter@nymc.edu * Corresponding author

Published: 4 June 2007 Molecular Cancer 2007, 6:35 doi:10.1186/1476-4598-6-35

Received: 28 February 2007 Accepted: 4 June 2007

This article is available from: http://www.molecular-cancer.com/content/6/1/35 © 2007 Liu et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms ofthe Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract
Burkitt's lymphoma (BL) is a heterogeneous group of highly aggressive mature B-cell malignancies. It is characterized by a high rate of turnover of malignant cells andderegulation of the c-myc gene. It is typically associated with a t(8;14) translocation. Dual translocation of t(8;14) (c-myc) and t(14;18) (bcl-2) was reported to be associated with extremely poor prognosis. This study reports a novel t(8;14;18) triple translocation in two patients with Burkitt's lymphoma.

Background
Burkitt's lymphoma/leukemia (BL) is a heterogeneous group of highly aggressivemature B-cell malignancies. It is characterized by a high rate of turnover of malignant cells and deregulation of the c-myc gene. The BL tumor cells usually express the B-cell-specific surface markers CD19, CD20, together with surface immunoglobulin (Ig), as well as CD10. The histologic hallmark of BL is the presence of apoptotic cells within scattered macrophages, a feature responsible for the"starry sky" microscopic appearance. A characteristic chromosome translocation associated with this disease typically takes place between chromosome 8q24 (c-myc) and one of the Ig gene-containing chromosomes, 14q32 (Ig H gene), 2p12 (Ig kappa) or 22q11 (Ig lambda). The frequency of such translocation is estimated to be approximately 80% t(8;14), 15% t(2;8), and 5% t(8;22), respectively [1]. We report inthis study two cases of BL with a novel three-way chromosome translocation, t(8;14;18).

Results and discussion
Case 1 A 61 year- old Arabic female presented with abdominal pain, weakness and fever in April, 1997. Physical examination was significant for splenomegaly. Her laboratory revealed WBC 2.7 × 109/L, Hgb 107 g/L, platelets 178 × 109/L, and LDH 1250 u/L. CT scan confirmed splenomegaly.Bone marrow was hypercellular with 30% lymphoid blasts. Flowcytometric analysis revealed a B cell population expressing CD19, CD20, CD22, HLA-DR and kappa, but negative for CD5, CD10, CD23, and CD34, and tdT. The chromosome analysis of the bone marrow revealed 47, XX, +7, t(8;14;18) (q24;q32;q22) (Fig. 1). This was consistent with BL by WHO criteria. She was given chemotherapy withcyclophosphamide, doxorubicin, vincristine, and prednisone following the L-20 regimen [2,3]. The patient was in complete remission (CR) and received maintenance chemotherapy. In November, 2002 she felt abdominal pain without any other complaint. Physical

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http://www.molecular-cancer.com/content/6/1/35

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