Detection of the chimeric ABL/BCR gene located on chromosome 9 by the FISH technique in a Ph negative CML

Chronic myelogeous leukemia (CML) is characterized by the presence of the Philadelphia (Ph) chromosome, which arises from a reciprical translocation between chromosomes 9 and 22 and is found in over 90% of all reported cases. This translocation results in the fusion of the chromosome 9 ABL gene with the chromosome 22 BCR gene forming a chimeric gene that encodes a unique protein. The chimeric gene has been demonstrated in variant translocations. In cases without Ph chromosomes, the ABL/BCR rearrangement was located on chromosome 22 at band q11. We report a case that presented with typical symptoms of classical CML. Cytogenetic analysis revealed a normal 46,XX karyotype in all his mitotic bone marrow cells. Fluorescence in situ hybridization using a two color ABL/BCR probe (Oncor, Gaithersburg, MD) showed the presence of two ABL genes located on both chromosome 9s, one BCR located on chromosome 22 and one located in tandem with one ABL gene on chromosome 9q34. Southern blotting using the transprobe (Oncogene Science, Uniondale, NY) confirmed that a break was located within the 5.8 Kb major BCR. This is one of the first cases where the chimeric ABL/BCR gene was demonstrated to be on chromosome 9q34. This variant stresses themore » importance of the ABL/BCR gene in the etiology of this disease as this patient was clinically indistinguishable from those CML patients with the standard Ph translocation.« less