inv(16)(p13q22)

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inv(16)(p13q22)

t(16;16)(p13;q22)

del(16)(q22)

Identity

Note the three chromosome anomalies are variants of each other, and they share identical clinical features and genetic pathogenesis

inv(16)(p13q22) G- banding (left) - Courtesy Jean-Luc Lai and Alain Vanderhaegen; ; R- banding center below: - Courtesy Christiane Charrin, center top and FISH (right) -Courtesy Pascale Cornillet-Lefebvre and Stephanie Struski. Commercial FISH probe, split in the inv(16); t(16;16)(p13;q22) ) G-banding - Courtesy Diane H. Norback, Eric B. Johnson, and Sara Morrison-Delap, UW Cytogenetic Services

Clinics and Pathology

Disease acute non lymphoblastic leukaemia (ANLL); myelodysplastic syndromes (MDS) at times

Phenotype / cell stem origin nearly pathognomonic of M4eo-ANLL (all M4eo share the 16q22 anomaly -see also below-, but not all 16p13/16q22 are found in the M4eo subtype: i.e. this anomaly, although mainly found in M4-ANLL with marked eosinophilia, may (rarely) been found in : M2 or M5, M4 without eo, or in MDS; there are also known cases of chronic myelogenous leukaemia in blast crisis (BC-CML) with a M4 eo phenotype and inv(16); found at times in treatment related ANLL; 3 cases of infant leukaemia so far described; note: CD2 (T-cell marker) may be co-expressed

Epidemiology 5-10% of ANLL, 20% of M4

Clinics CNS involvement is frequent, according to some authors, in particular at relapse

Cytology most often: eosinophils > 5%, with large immature basophilic granules, NASCA+, in the bone marrow (but normal in blood: this M4 do not show the Œeo' characteristic in blood)

Patients with inv(16) usually correspond to the subclass of AML M4, with a specific abnormal eosinophil component and is considered as a distinct entity in correlation with these specific chromosomal abnormalities. These cases of AML M4 are referred as AML M4EO. In addition to the morphological features of AML M4 excess of monocytes), the bone marrow shows a variable number of eosinophils at all stages of maturation without significant maturation arrest. The most striking abnormalities involve the immature eosinophilic granules. Those are mainly evident at the promyelocyte and myelocyte stages. The abnormalities are not usually evident at later stages of maturation. These eosinophilic granules are often larger than those normally seen in immature eosinophils, purple-violet in color and in some cells are so dense that they obscure the cell morphology - Courtesy Georges Flandrin, CD-ROM AML/MDS G.Flandrin/ICG. TRIBVN

Prognosis high CR rate; better prognosis than most other ANLL; median survival may be 5yrs

Cytogenetics

Cytogenetics Morphological may be overlooked, especially with R-banding; best seen without banding procedure ('giemsa') for some workers

Cytogenetics Molecular with 16p13 probes : as a deletion within 16p13 often accompany the 16p13/16q22 rearrangement (in 20% of cases), the split signal may be lost

Additional anomalies none 2/3 of cases; +8, +22 in 15% each, del(7q), +2; apparently without prognostic significance

Variants are known:
1- t(16;16)(p13;q22);
- del(16)(q22): may be associated with less typical phenotype and preceding MDS, older age, complex karyotype, worse prognosis;
2- but also: translocations of 16q22 with various partners in: t(1;16)(p31-32;q22), t(3;16)(q21;q22), t(5;16)(q33;q22), associated with eosinophils anomalies

Genes involved and Proteins

Gene Name MYH11

Location 16p13

c-MYH11 (16p13) in normal cells: PAC 1032E3 (top) and PAC 1179J13 (below) - Courtesy Mariano Rocchi, Resources for Molecular Cytogenetics. Laboratories willing to validate the probes are wellcome: contact M Rocchi

Protein contains a N-term ATPase head responsible for actin binding and mechanical movement, and a C-term long repeat of coil-coil domain to facilitate filament aggregates; member of the myosin II family

Gene Name CBFb

Location 16q22

Protein subunit of the transcription factor complex CBF; CBFb by itself does not contain any DNA binding motif or transcriptional activation domain, but forms a dimer with CBFa: --> transcription factor

Result of the chromosomal anomaly

Hybrid gene
Description 5' CBFb - 3' MYH11; breakpoint in CBFB intron n° 5 and in MYH11 intron A (i.e. : 5)

Transcript at least 8 different CBFb-MYH11 fusion transcripts have been described, transcript type A (with positions at nucleotides 495 and 1921 respectively) being found in about 90% of the patients;most braekpoints in MYH11 are also clustered; no reciprocal MYH11-CBFB transcript

Fusion Protein
Description N-term - the first 165 (or 133 in a few cases) amino acids of CBFb, removing only 17 or 22 amino acids fused to the tail of MYH11 C-term with its multimerization domain; also variable breakpoint in MYH11; identical fusion protein in the cases of RAEBT and BC-CML

Expression Localisation nuclear localisation

Oncogenesis the fusion protein seems both to diminuish the quantity of active CBF and to compete with it, there is accumulation of CBFb-MYH11/CBFa multimeres in the nucleus

External links

Other database inv(16)(p13q22) Mitelman database (CGAP - NCBI)

Other database t(16;16)(p13;q22) Mitelman database (CGAP - NCBI)

Other database t(16;16)(p13;q22) CancerChromosomes (NCBI)

Other database del(16)(q22) Mitelman database (CGAP - NCBI)

Other database inv(16) involving CBFB and MYH11 genes (Bari)

Probe CBFB (16q22) in normal cells

Probe MYH11 (16p13) in normal cells (Bari)

Other database	inv(16)(p13q22)	Mitelman database (CGAP - NCBI)
Other database	t(16;16)(p13;q22)	Mitelman database (CGAP - NCBI)
Other database	t(16;16)(p13;q22)	CancerChromosomes (NCBI)
Other database	del(16)(q22)	Mitelman database (CGAP - NCBI)
Other database	inv(16) involving CBFB and MYH11 genes (Bari)
Probe	CBFB (16q22) in normal cells
Probe	MYH11 (16p13) in normal cells (Bari)

Bibliography

Acute nonlymphocytic leukemia with marrow eosinophilia and chromosome 16 abnormality: a report of 18 cases.

Bernard P, Dachary D, Reiffers J, Marit G, Wen Z, Jonveaux P, David B, Lacombe F, Broustet A

Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 1989 ; 3 (10) : 740-745.

PMID 2779289

Chromosome 16 abnormalities associated with myeloid malignancies.

Campbell LJ, Challis J, Fok T, Garson OM

Genes, chromosomes & cancer. 1991 ; 3 (1) : 55-61.

PMID 2069909

Abnormalities of chromosome 16q in myeloid malignancy: 14 new cases and a review of the literature.

Betts DR, Rohatiner AZ, Evans ML, Rassam SM, Lister TA, Gibbons B

Leukemia : official journal of the Leukemia Society of America, Leukemia Research Fund, U.K. 1992 ; 6 (12) : 1250-1256.

PMID 1453770

Cloning the breakpoint cluster region of the inv(16) in acute nonlymphocytic leukemia M4 Eo.

Dauwerse JG, Wessels JW, Giles RH, Wiegant J, van der Reijden BA, Fugazza G, Jumelet EA, Smit E, Baas F, Raap AK

Human molecular genetics. 1993 ; 2 (10) : 1527-1534.

PMID 8268905

Identification of yeast artificial chromosomes containing the inversion 16 p-arm breakpoint associated with acute myelomonocytic leukemia.

Liu P, Claxton DF, Marlton P, Hajra A, Siciliano J, Freedman M, Chandrasekharappa SC, Yanagisawa K, Stallings RL, Collins FS

Blood. 1993 ; 82 (3) : 716-721.

PMID 8338941

Molecular pathogenesis of the chromosome 16 inversion in the M4Eo subtype of acute myeloid leukemia.

Liu PP, Hajra A, Wijmenga C, Collins FS

Blood. 1995 ; 85 (9) : 2289-2302.

PMID 7727763

RT-PCR diagnosis of patients with acute nonlymphocytic leukemia and inv(16)(p13q22) and identification of new alternative splicing in CBFB-MYH11 transcripts.

van der Reijden BA, Lombardo M, Dauwerse HG, Giles RH, Mˆºhlematter D, Bellomo MJ, Wessels HW, Beverstock GC, van Ommen GJ, Hagemeijer A

Blood. 1995 ; 86 (1) : 277-282.

PMID 7795233

Heterogeneity in CBF beta/MYH11 fusion messages encoded by the inv(16)(p13q22) and the t(16;16)(p13;q22) in acute myelogenous leukemia.

Shurtleff SA, Meyers S, Hiebert SW, Raimondi SC, Head DR, Willman CL, Wolman S, Slovak ML, Carroll AJ, Behm F

Blood. 1995 ; 85 (12) : 3695-3703.

PMID 7780153

Genomic acute myeloid leukemia-associated inv(16)(p13q22) breakpoints are tightly clustered.

van der Reijden BA, Dauwerse HG, Giles RH, Jagmohan-Changur S, Wijmenga C, Liu PP, Smit B, Wessels HW, Beverstock GC, Jotterand-Bellomo M, Martinet D, Mˆºhlematter D, Lafage-Pochitaloff M, Gabert J, Reiffers J, Bilhou-Nabera C, van Ommen GJ, Hagemeijer A, Breuning MH

Oncogene. 1999 ; 18 (2) : 543-550.

PMID 9927211

Contributor(s)

Written 11-1997 Jean-Loup Huret

Updated 06-1999 Jean-Loup Huret

Citation

This paper should be referenced as such :
- . inv(16)(p13q22); t(16;16)(p13;q22); del(16)(q22). Atlas Genet Cytogenet Oncol Haematol. November 1997 .
URL : http://AtlasGeneticsOncology.org/Genes/inv16.html

Huret JL . inv(16)(p13q22); t(16;16)(p13;q22); del(16)(q22). Atlas Genet Cytogenet Oncol Haematol. June 1999 .
URL : http://AtlasGeneticsOncology.org/Genes/inv16.html

Huret JL . inv(16)(p13q22); t(16;16)(p13;q22); del(16)(q22). Atlas Genet Cytogenet Oncol Haematol. .
URL : http://AtlasGeneticsOncology.org/Genes/inv16.html

© Atlas of Genetics and Cytogenetics in Oncology and Haematology
indexed on : Wed Sep 24 21:06:02 2008

Home Genes Leukemias Solid Tumours Cancer-Prone Deep Insight Case Reports Journals Portal Teaching

For comments and suggestions or contributions, please contact us

j.l.huret@chu-poitiers.fr.

Note	the three chromosome anomalies are variants of each other, and they share identical clinical features and genetic pathogenesis


	inv(16)(p13q22) G- banding (left) - Courtesy Jean-Luc Lai and Alain Vanderhaegen; ; R- banding center below: - Courtesy Christiane Charrin, center top and FISH (right) -Courtesy Pascale Cornillet-Lefebvre and Stephanie Struski. Commercial FISH probe, split in the inv(16); t(16;16)(p13;q22) ) G-banding - Courtesy Diane H. Norback, Eric B. Johnson, and Sara Morrison-Delap, UW Cytogenetic Services

Disease	acute non lymphoblastic leukaemia (ANLL); myelodysplastic syndromes (MDS) at times
Phenotype / cell stem origin	nearly pathognomonic of M4eo-ANLL (all M4eo share the 16q22 anomaly -see also below-, but not all 16p13/16q22 are found in the M4eo subtype: i.e. this anomaly, although mainly found in M4-ANLL with marked eosinophilia, may (rarely) been found in : M2 or M5, M4 without eo, or in MDS; there are also known cases of chronic myelogenous leukaemia in blast crisis (BC-CML) with a M4 eo phenotype and inv(16); found at times in treatment related ANLL; 3 cases of infant leukaemia so far described; note: CD2 (T-cell marker) may be co-expressed
Epidemiology	5-10% of ANLL, 20% of M4
Clinics	CNS involvement is frequent, according to some authors, in particular at relapse
Cytology	most often: eosinophils > 5%, with large immature basophilic granules, NASCA+, in the bone marrow (but normal in blood: this M4 do not show the Œeo' characteristic in blood)


	Patients with inv(16) usually correspond to the subclass of AML M4, with a specific abnormal eosinophil component and is considered as a distinct entity in correlation with these specific chromosomal abnormalities. These cases of AML M4 are referred as AML M4EO. In addition to the morphological features of AML M4 excess of monocytes), the bone marrow shows a variable number of eosinophils at all stages of maturation without significant maturation arrest. The most striking abnormalities involve the immature eosinophilic granules. Those are mainly evident at the promyelocyte and myelocyte stages. The abnormalities are not usually evident at later stages of maturation. These eosinophilic granules are often larger than those normally seen in immature eosinophils, purple-violet in color and in some cells are so dense that they obscure the cell morphology - Courtesy Georges Flandrin, CD-ROM AML/MDS G.Flandrin/ICG. TRIBVN

Prognosis	high CR rate; better prognosis than most other ANLL; median survival may be 5yrs

Cytogenetics Morphological	may be overlooked, especially with R-banding; best seen without banding procedure ('giemsa') for some workers
Cytogenetics Molecular	with 16p13 probes : as a deletion within 16p13 often accompany the 16p13/16q22 rearrangement (in 20% of cases), the split signal may be lost
Additional anomalies	none 2/3 of cases; +8, +22 in 15% each, del(7q), +2; apparently without prognostic significance
Variants	are known: 1- t(16;16)(p13;q22); - del(16)(q22): may be associated with less typical phenotype and preceding MDS, older age, complex karyotype, worse prognosis; 2- but also: translocations of 16q22 with various partners in: t(1;16)(p31-32;q22), t(3;16)(q21;q22), t(5;16)(q33;q22), associated with eosinophils anomalies

Gene Name	MYH11
Location	16p13


	c-MYH11 (16p13) in normal cells: PAC 1032E3 (top) and PAC 1179J13 (below) - Courtesy Mariano Rocchi, Resources for Molecular Cytogenetics. Laboratories willing to validate the probes are wellcome: contact M Rocchi

Protein	contains a N-term ATPase head responsible for actin binding and mechanical movement, and a C-term long repeat of coil-coil domain to facilitate filament aggregates; member of the myosin II family

Gene Name	CBFb
Location	16q22
Protein	subunit of the transcription factor complex CBF; CBFb by itself does not contain any DNA binding motif or transcriptional activation domain, but forms a dimer with CBFa: --> transcription factor

Description	5' CBFb - 3' MYH11; breakpoint in CBFB intron n° 5 and in MYH11 intron A (i.e. : 5)
Transcript	at least 8 different CBFb-MYH11 fusion transcripts have been described, transcript type A (with positions at nucleotides 495 and 1921 respectively) being found in about 90% of the patients;most braekpoints in MYH11 are also clustered; no reciprocal MYH11-CBFB transcript

Description	N-term - the first 165 (or 133 in a few cases) amino acids of CBFb, removing only 17 or 22 amino acids fused to the tail of MYH11 C-term with its multimerization domain; also variable breakpoint in MYH11; identical fusion protein in the cases of RAEBT and BC-CML
Expression Localisation	nuclear localisation
Oncogenesis	the fusion protein seems both to diminuish the quantity of active CBF and to compete with it, there is accumulation of CBFb-MYH11/CBFa multimeres in the nucleus

Written	11-1997	Jean-Loup Huret

Updated	06-1999	Jean-Loup Huret