Translocation (8; 14) (q24; q32) in ALL (L3) with Bladder Invasion

Abstract

A 39 year-old male was admitted to our hospital with a complaint of macrohematuria. Cystoscopical examination revealed a prominent lesion at bladder neck. Hemotological examination showed marked thrombocytopenia. The bone marrow aspiration on admission revealed marked infiltration of lymphoblastic cells, which had deeply basophilic cytoplasm and a few small vacuoles. At this time, diagnosis of L2 was made according to FAB classification. Pathological finding of biopsied bladder mucosa indicated an invasion of leukemic cells. Leukemic blasts obtained from bone marrow aspiration were surface immunoglobulin positive and Ia positive. Cytogenetic analyses showed specific translocation, t (8; 14) (q24, q32). According to all these findings, this patient can be classified as Burkitt's type ALL (FAB L3). He was treated with VEMP therapy and complete remission was achieved after all. But relapsed after 2 weeks of first remission Additional chemothemapy was not effective at all and he died from sepsis 4 months after the diagnosis.
In this case, we clearly demonstrated an importance of immunological and cytogenetic examinations for detailed diagnosis of ALL. They play an important role for the prediction of prognosis.