Concurrent juvenile myelomonocytic leukemia and T-lymphoblastic lymphoma with a shared missense mutation in NRAS

Pediatr Blood Cancer. 2014 May;61(5):946-8. doi: 10.1002/pbc.24797. Epub 2013 Oct 8.

Abstract

Single cases of B- and T-lymphoblastic leukemia/lymphoma occurring after remission of JMML, and JMML occurring after remission of B-lymphoblastic leukemia have been reported in the literature. We present a unique case of a child with concurrent JMML and T-lymphoblastic lymphoma in which an identical missense mutation in NRAS was found in both the neoplastic JMML and T-LBL cells. JMML has been considered a stem cell disorder, and our case provides additional molecular evidence for a stem cell lesion underlying the two different disease phenotypes.

Keywords: BMT for malignant conditions; JMML; lymphoblastic lymphoma.

Publication types

  • Case Reports

MeSH terms

  • Bone Marrow Transplantation
  • Child, Preschool
  • Cytogenetic Analysis
  • GTP Phosphohydrolases / genetics*
  • Humans
  • Leukemia, Myelomonocytic, Juvenile / diagnosis
  • Leukemia, Myelomonocytic, Juvenile / genetics*
  • Leukemia, Myelomonocytic, Juvenile / therapy
  • Male
  • Membrane Proteins / genetics*
  • Mutation, Missense / genetics*
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / genetics*
  • Neoplasms, Multiple Primary / therapy
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / diagnosis
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / genetics*
  • Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • Prognosis
  • Transplantation Conditioning

Substances

  • Membrane Proteins
  • GTP Phosphohydrolases
  • NRAS protein, human