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Prenatal Chromosomal Diversification Of Leukemia In Monozygotic Twins, Helena Kempski, Karen A. Mensa- Bonsu, Lyndal Kearney, G. Reza Jalali, Ian Hann, Mohammad Khurshid, Mel Greaves

Section of Haematology/Oncology

Previous studies on concordant acute lymphoblastic leukemia (ALL) in identical twins have identified the leukemia as monoclonal with MLL or ETV6-RUNX1 gene fusion as early or initiating events in utero. In the latter case, postnatal latency is associated with secondary genetic events such as ETV6 deletion. We describe here a pair of infant twins with concordant acute monoblastic leukemia (AML). They are a unique pair in that their leukemia blasts display extensive intraclonal chromosomal diversity. Comparison of the leukemic cells between the two twins by karyotype and fluorescence in situ hybridization identifies a common or shared stem line …