Korean J Lab Med.  2011 Oct;31(4):302-306. 10.3343/kjlm.2011.31.4.302.

False Homozygosity Results in HLA Genotyping due to Loss of Chromosome 6 in a Patient with Acute Lymphoblastic Leukemia

• Park H
• Hyun J
• Park SS
• Park MH
• Song EY

• KMID: 1781698
• DOI: http://doi.org/10.3343/kjlm.2011.31.4.302

Abstract

Loss of heterozygosity (LOH) in chromosome 6p has been reported in a number of tumors and some hematologic malignancies, including ALL. LOH in chromosome 6p, on which the HLA genes are located, can give rise to false homozygosity results in HLA genotyping of patients with hematologic malignancies. Here we report false homozygosity results in HLA genotyping due to the loss of whole chromosome 6 in the neoplastic cells of a patient with ALL. A 33-yr-old Korean female patient was admitted for the evaluation of leukocytosis detected during a workup for headache. Her initial white blood cell count was 336.9x109/L with 84% of blasts in the differential count. Precursor-B lymphoblastic leukemia was diagnosed from a subsequent bone marrow study. HLA high-resolution genotyping of the patient was requested at the time of diagnosis for possible hematopoietic stem cell transplantation. Homozygosity results (A*02:01, B*54:01, C*08:01, DQB1*04:01) were obtained, except for the DRB1 locus (DRB1*04:05, DRB1*11:01), in sequence-based typing. Conventional karyotyping of bone marrow metaphase cells revealed chromosomal abnormalities, with loss of multiple chromosomes including chromosome 6, and reduplication of the remaining chromosomes: 29,X,+X,+8,inv(9)(p11q13),+10,+14,+18,+21[15]/58,idemX2[3]/46,XX,inv(9)[2]. LOH at the HLA region was suspected and HLA genotyping was repeated with the peripheral blood in remission state after induction chemotherapy. All 5 HLA loci were typed as heterozygous (A*02:01, A*02:06, B*40:01, B*54:01, C*03:04, C*08:01, DRB1*04:05, DRB1*11:01, DQB1*03:01, DQB1*04:01). To avoid false HLA typing results in patients with hematologic malignancies, clinicians, as well as laboratory personnel, need to be aware of such problems and take appropriate precautions.

Keyword

Loss of heterozygosity; HLA genotyping; Precursor-B lymphoblastic leukemia

MeSH Terms

Adult
Chromosome Duplication
*Chromosomes, Human, Pair 6
Diagnostic Errors
Female
Genotype
HLA Antigens/*genetics
Hematopoietic Stem Cell Transplantation
Humans
Karyotyping
Leukocyte Count
*Loss of Heterozygosity
Nerve Tissue Proteins/genetics
Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis/*genetics/therapy
RNA-Binding Proteins/genetics