Difference between revisions of "Chromosomal translocations"
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[[Image:Bcrablmet.jpg|thumb|right|250px|A fusion signal (yellow - left/top of image) suggesting a BCR-ABL translocation. [[FISH]]. (WC/Pmx)]] | |||
'''Chromosomal translocations''', also '''translocations''', may be characteristic of a tumour or simply narrow down the diagnosis to a set of tumours. | '''Chromosomal translocations''', also '''translocations''', may be characteristic of a tumour or simply narrow down the diagnosis to a set of tumours. | ||
They fall into the category of [[molecular pathology]]. | |||
==Key point== | ==Key point== | ||
Line 21: | Line 24: | ||
| <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref><ref name=OMIM133450>{{OMIM|133450}}</ref> | | <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref><ref name=OMIM133450>{{OMIM|133450}}</ref> | ||
|- | |- | ||
| Myxoid liposarcoma, round-cell type liposarcoma | | [[Myxoid liposarcoma]], round-cell type liposarcoma | ||
| t(12;16) | | t(12;16) | ||
| CHOP-TLS | | CHOP-TLS | ||
Line 36: | Line 39: | ||
| <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref> | | <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref> | ||
|- | |- | ||
| Extraskeletal myxoid | | [[Extraskeletal myxoid chondrosarcoma]] | ||
| t(9;22) | | t(9;22) | ||
| CHN-EWS | | CHN-EWS | ||
Line 61: | Line 64: | ||
| <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref> | | <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref> | ||
|- | |- | ||
| Congenital fibrosarcoma | | [[Congenital fibrosarcoma]] (infantile fibrosarcoma), [[Mesoblastic nephroma|cellular mesoblastic nephroma]] | ||
| t(12;15) | | t(12;15) | ||
| ETV6-NTRK3 | | ETV6-NTRK3 | ||
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|} | |} | ||
===EWS associated=== | Notes: | ||
*''TLS'' (Translocated in LipoSarcoma), on chromosome 16, is the old name for ''FUS'' (FUsed in Sarcoma).<ref name=omim137070>{{OMIM|137070}}</ref> | |||
====EWS associated==== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
| '''Tumour''' | | '''Tumour''' | ||
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| <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref><ref name=OMIM133450>{{OMIM|133450}}</ref> | | <ref name=Ref_PBoD8_1249>{{Ref PBoD8|1249}}</ref><ref name=OMIM133450>{{OMIM|133450}}</ref> | ||
|- | |- | ||
| Extraskeletal myxoid | | [[Extraskeletal myxoid chondrosarcoma]] | ||
| t(9;22) | | t(9;22) | ||
| CHN-EWS | | CHN-EWS | ||
Line 96: | Line 101: | ||
|} | |} | ||
<center>Memory device: ''EWS EDC''.</center> | |||
===Lymphoma=== | ===Lymphoma=== | ||
Line 157: | Line 110: | ||
| '''Reference(s)''' | | '''Reference(s)''' | ||
|- | |- | ||
| Follicular lymphoma | | [[Follicular lymphoma]] | ||
| t(14,18) | | t(14,18) | ||
| | | IGH-BCL2 | ||
| <ref name=pmid18684042>{{Cite journal | last1 = Gu | first1 = K. | last2 = Chan | first2 = WC. | last3 = Hawley | first3 = RC. | title = Practical detection of t(14;18)(IgH/BCL2) in follicular lymphoma. | journal = Arch Pathol Lab Med | volume = 132 | issue = 8 | pages = 1355-61 | month = Aug | year = 2008 | doi = 10.1043/1543-2165(2008)132[1355:PDOBIF]2.0.CO;2 | PMID = 18684042 }}</ref> | |||
|- | |- | ||
| Mantle cell lymphoma | | [[Mantle cell lymphoma]] | ||
| t(11;14) | | t(11;14) | ||
| | | IGH-CCND1 | ||
| <ref>{{Cite journal | last1 = Li | first1 = JY. | last2 = Gaillard | first2 = F. | last3 = Moreau | first3 = A. | last4 = Harousseau | first4 = JL. | last5 = Laboisse | first5 = C. | last6 = Milpied | first6 = N. | last7 = Bataille | first7 = R. | last8 = Avet-Loiseau | first8 = H. | title = Detection of translocation t(11;14)(q13;q32) in mantle cell lymphoma by fluorescence in situ hybridization. | journal = Am J Pathol | volume = 154 | issue = 5 | pages = 1449-52 | month = May | year = 1999 | doi = 10.1016/S0002-9440(10)65399-0 | PMID = 10329598 }}</ref> | |||
|- | |- | ||
| Burkitt lymphoma | | [[Burkitt lymphoma]] | ||
| t(8;14) | | t(8;14) | ||
| | | MYC-IGH (IGH-MYC) | ||
| <ref name=pmid19074108>{{Cite journal | last1 = Perkins | first1 = AS. | last2 = Friedberg | first2 = JW. | title = Burkitt lymphoma in adults. | journal = Hematology Am Soc Hematol Educ Program | volume = | issue = | pages = 341-8 | month = | year = 2008 | doi = 10.1182/asheducation-2008.1.341 | PMID = 19074108 }} | |||
</ref> | |||
|- | |- | ||
<!-- | Tumour | <!-- | Tumour | ||
Line 185: | Line 139: | ||
| '''Reference(s)''' | | '''Reference(s)''' | ||
|- | |- | ||
| Chronic myelogenous leukemia | | [[Chronic myelogenous leukemia]] | ||
| t(9;22) | | t(9;22) | ||
| | | BCR-ABL | ||
| <ref>{{Cite journal | last1 = Cilloni | first1 = D. | last2 = Saglio | first2 = G. | title = CML: a model for targeted therapy. | journal = Best Pract Res Clin Haematol | volume = 22 | issue = 3 | pages = 285-94 | month = Sep | year = 2009 | doi = 10.1016/j.beha.2009.04.004 | PMID = 19959080 }}</ref> | |||
|- | |- | ||
| Acute promyelocytic leukemia (APL | | [[Acute promyelocytic leukemia]] (APL) | ||
| t(15;17) | | t(15;17) | ||
| reference (???) | | PML-RARA | ||
| <ref name=pmid20306254>{{Cite journal | last1 = Grimwade | first1 = D. | last2 = Mistry | first2 = AR. | last3 = Solomon | first3 = E. | last4 = Guidez | first4 = F. | title = Acute promyelocytic leukemia: a paradigm for differentiation therapy. | journal = Cancer Treat Res | volume = 145 | issue = | pages = 219-35 | month = | year = 2010 | doi = 10.1007/978-0-387-69259-3_13 | PMID = 20306254 }}</ref><ref name=omim102578>{{OMIM|102578}}</ref><ref name=omim180240>{{OMIM|180240}}</ref> | |||
|- | |||
<!-- | tumour | |||
| genes (???) | |||
| translocation | |||
| reference (???) --> | |||
|} | |||
===Renal tumours=== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | |||
| '''Tumour''' | |||
| '''Translocation(s)''' | |||
| '''Genes''' | |||
| '''Reference(s)''' | |||
|- | |||
| [[Renal tumour with Xp11.2 translocation]] | |||
| ASPL-TFE (???) | |||
| t(X;1) | |||
| <ref name=Ref_WMSP281>{{Ref WMSP|281}}</ref><ref name=Ref_WMSP285>{{Ref WMSP|285}}</ref> | |||
|- | |||
| [[Renal tumour with t(6;11) translocation]] | |||
| Alpha-TFEB | |||
| t(6;11) | |||
| <ref name=Ref_WMSP281>{{Ref WMSP|281}}</ref> | |||
|- | |||
<!-- | tumour | |||
| genes (???) | |||
| translocation | |||
| reference (???) --> | |||
|} | |||
===Prostate cancer=== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | |||
| '''Tumour''' | |||
| '''Translocation(s)''' | |||
| '''Genes''' | |||
| '''Reference(s)''' | |||
|- | |||
| Prostate cancer | |||
| TMPRSS2-ERG | |||
| t(21;21) | |||
| <ref name=pmid20478527>{{cite journal | author = Yu J, Yu J, Mani RS, Cao Q, Brenner CJ, Cao X, Wang X, Wu L, Li J, Hu M, Gong Y, Cheng H, Laxman B, Vellaichamy A, Shankar S, Li Y, Dhanasekaran SM, Morey R, Barrette T, Lonigro RJ, Tomlins SA, Varambally S, Qin ZS, Chinnaiyan AM | title = An Integrated Network of Androgen Receptor, Polycomb, and TMPRSS2-ERG Gene Fusions in Prostate Cancer Progression | journal = Cancer Cell | volume = 17 | issue = 5 | pages = 443–54 | year = 2010 | month = May | pmid = 20478527 | pmc = 2874722 | doi = 10.1016/j.ccr.2010.03.018 | url = }}</ref><ref name=omim602060>{{OMIM|602060}}</ref> | |||
|- | |- | ||
<!-- | tumour | <!-- | tumour | ||
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| reference (???) --> | | reference (???) --> | ||
|} | |} | ||
===Uterine tumours=== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | |||
| '''Tumour''' | |||
| '''Translocation(s)''' | |||
| '''Genes''' | |||
| '''Reference(s)''' | |||
|- | |||
| [[Endometrial stromal sarcoma]] | |||
| JAZF1-SUZ12 | |||
| t(7;17) | |||
| <ref name=omim606246>{{OMIM|606246}}</ref><ref name=omim606245>{{OMIM|606245}}</ref> | |||
|} | |||
===Paediatric table=== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | |||
| '''Tumour(s)''' | |||
| '''Translocation''' | |||
| '''Genes''' | |||
| '''Reference''' | |||
|- | |||
| [[Angiomatoid fibrous histiocytoma]] | |||
| t(12;16) | |||
| FUS-ATF1 | |||
| <ref name=PST14feb11>PST. 14 February 2011.</ref><ref>URL: [https://iris.ucl.ac.uk/research/browse/show-publication?pub_id=238366&source_id=2 https://iris.ucl.ac.uk/research/browse/show-publication?pub_id=238366&source_id=2]. Accessed on: 13 December 2011.</ref><ref name=pmid18251589>{{Cite journal | last1 = Thway | first1 = K. | title = Angiomatoid fibrous histiocytoma: a review with recent genetic findings. | journal = Arch Pathol Lab Med | volume = 132 | issue = 2 | pages = 273-7 | month = Feb | year = 2008 | doi = 10.1043/1543-2165(2008)132[273:AFHARW]2.0.CO;2 | PMID = 18251589 }}</ref> | |||
|- | |||
| [[Angiomatoid fibrous histiocytoma]] | |||
| t(12;22) | |||
| EWS-ATF1 | |||
| <ref name=PST14feb11>PST. 14 February 2011.</ref><ref name=pmid18251589/> | |||
|- | |||
| [[Myxoid liposarcoma]] | |||
| t(12;16) | |||
| CHOP-TLS | |||
| <ref name=omim613488>{{OMIM|613488}}</ref> | |||
|- | |||
| [[Myxoid liposarcoma]] | |||
| t(12;22) | |||
| EWS-ATF1 | |||
| <ref name=PST14feb11>PST. 14 February 2011.</ref><ref name=pmid21115923>{{Cite journal | last1 = Suzuki | first1 = K. | last2 = Matsui | first2 = Y. | last3 = Endo | first3 = K. | last4 = Kubo | first4 = T. | last5 = Hasegawa | first5 = T. | last6 = Kimura | first6 = T. | last7 = Ohtani | first7 = O. | last8 = Yasui | first8 = N. | title = Myxoid liposarcoma with EWS-CHOP type 1 fusion gene. | journal = Anticancer Res | volume = 30 | issue = 11 | pages = 4679-83 | month = Nov | year = 2010 | doi = | PMID = 21115923 }}</ref> | |||
|- | |||
| [[Clear cell sarcoma]] | |||
| t(12;22) | |||
| EWS-ATF1 | |||
| <ref name=PST14feb11>PST. 14 February 2011.</ref> | |||
|- | |||
| [[Ewing sarcoma]] | |||
| t(21;22) | |||
| EWS-ERG | |||
| <ref name=omim165080>{{OMIM|165080}}</ref> | |||
|- | |||
| [[Ewing sarcoma]] | |||
| t(16;21) | |||
| FUS-ERG | |||
| <ref name=pmid8187069>{{Cite journal | last1 = Ichikawa | first1 = H. | last2 = Shimizu | first2 = K. | last3 = Hayashi | first3 = Y. | last4 = Ohki | first4 = M. | title = An RNA-binding protein gene, TLS/FUS, is fused to ERG in human myeloid leukemia with t(16;21) chromosomal translocation. | journal = Cancer Res | volume = 54 | issue = 11 | pages = 2865-8 | month = Jun | year = 1994 | doi = | PMID = 8187069 }}</ref> | |||
|- | |||
| [[Acute myeloid leukemia]] | |||
| t(16;21) | |||
| FUS-ERG | |||
| <ref name=pmid8187069>{{Cite journal | last1 = Ichikawa | first1 = H. | last2 = Shimizu | first2 = K. | last3 = Hayashi | first3 = Y. | last4 = Ohki | first4 = M. | title = An RNA-binding protein gene, TLS/FUS, is fused to ERG in human myeloid leukemia with t(16;21) chromosomal translocation. | journal = Cancer Res | volume = 54 | issue = 11 | pages = 2865-8 | month = Jun | year = 1994 | doi = | PMID = 8187069 }}</ref> | |||
|- | |||
<!-- | Translocation | |||
| Genes | |||
| Tumour | |||
| Reference --> | |||
|} | |||
Notes: | |||
*''TLS'' (Translocated in LipoSarcoma), on chromosome 16, is the old name for ''FUS'' (FUsed in Sarcoma).<ref name=omim137070>{{OMIM|137070}}</ref> | |||
==See also== | ==See also== | ||
*[[Lymphoma]]. | *[[Lymphoma]]. | ||
*[[Molecular pathology]]. | *[[Molecular pathology]]. | ||
*[[Chromosomal anomalies]]. | |||
==References== | ==References== |
Latest revision as of 18:12, 30 November 2014
Chromosomal translocations, also translocations, may be characteristic of a tumour or simply narrow down the diagnosis to a set of tumours.
They fall into the category of molecular pathology.
Key point
The key point is:
- One should be aware of the existence of specific (i.e. diagnostic/near diagnostic) translocations and translocations which significantly narrow down the diagnosis -- which are available to (clinical) pathologists.
Unfortunate reality of residency
Translocations are often a subject of pimping and show-up on examinations.
List of translocations
Soft tissue table
Tumour | Translocation(s) | Genes | Reference(s) |
Ewing sarcoma/PNET | t(11;22) | FLI1-EWS | [1][2] |
Myxoid liposarcoma, round-cell type liposarcoma | t(12;16) | CHOP-TLS | [1][3][4] |
Synovial sarcoma | t(X;18) | SYT-SSX | [1] |
Alveolar rhabdomyosarcoma | t(1;13) t(2,13) |
PAX7-FKHR PAX3-FKHR |
[1] |
Extraskeletal myxoid chondrosarcoma | t(9;22) | CHN-EWS | [1] |
Desmoplastic small round cell tumour | t(11;22) | EWS-WT1 | [1] |
Clear cell sarcoma | t(12;22) | EWS-ATF1 | [1] |
Dermatofibrosarcoma protuberans | t(17;22) | COLA1-PDGFB | [1] |
Alveolar soft part sarcoma | t(X;17) | TFE3-ASPL | [1] |
Congenital fibrosarcoma (infantile fibrosarcoma), cellular mesoblastic nephroma | t(12;15) | ETV6-NTRK3 | [1] |
Notes:
- TLS (Translocated in LipoSarcoma), on chromosome 16, is the old name for FUS (FUsed in Sarcoma).[5]
EWS associated
Tumour | Translocation(s) | Genes | Reference(s) |
Ewing sarcoma/PNET | t(11;22) | FLI1-EWS | [1][2] |
Extraskeletal myxoid chondrosarcoma | t(9;22) | CHN-EWS | [1] |
Desmoplastic small round cell tumour | t(11;22) | EWS-WT1 | [1] |
Clear cell sarcoma | t(12;22) | EWS-ATF1 | [1] |
Lymphoma
Tumour | Translocation(s) | Genes | Reference(s) |
Follicular lymphoma | t(14,18) | IGH-BCL2 | [6] |
Mantle cell lymphoma | t(11;14) | IGH-CCND1 | [7] |
Burkitt lymphoma | t(8;14) | MYC-IGH (IGH-MYC) | [8] |
Leukemia
Tumour | Translocation(s) | Genes | Reference(s) |
Chronic myelogenous leukemia | t(9;22) | BCR-ABL | [9] |
Acute promyelocytic leukemia (APL) | t(15;17) | PML-RARA | [10][11][12] |
Renal tumours
Tumour | Translocation(s) | Genes | Reference(s) |
Renal tumour with Xp11.2 translocation | ASPL-TFE (???) | t(X;1) | [13][14] |
Renal tumour with t(6;11) translocation | Alpha-TFEB | t(6;11) | [13] |
Prostate cancer
Tumour | Translocation(s) | Genes | Reference(s) |
Prostate cancer | TMPRSS2-ERG | t(21;21) | [15][16] |
Uterine tumours
Tumour | Translocation(s) | Genes | Reference(s) |
Endometrial stromal sarcoma | JAZF1-SUZ12 | t(7;17) | [17][18] |
Paediatric table
Tumour(s) | Translocation | Genes | Reference |
Angiomatoid fibrous histiocytoma | t(12;16) | FUS-ATF1 | [19][20][21] |
Angiomatoid fibrous histiocytoma | t(12;22) | EWS-ATF1 | [19][21] |
Myxoid liposarcoma | t(12;16) | CHOP-TLS | [22] |
Myxoid liposarcoma | t(12;22) | EWS-ATF1 | [19][23] |
Clear cell sarcoma | t(12;22) | EWS-ATF1 | [19] |
Ewing sarcoma | t(21;22) | EWS-ERG | [24] |
Ewing sarcoma | t(16;21) | FUS-ERG | [25] |
Acute myeloid leukemia | t(16;21) | FUS-ERG | [25] |
Notes:
- TLS (Translocated in LipoSarcoma), on chromosome 16, is the old name for FUS (FUsed in Sarcoma).[5]
See also
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1249. ISBN 978-1416031215.
- ↑ 2.0 2.1 Online 'Mendelian Inheritance in Man' (OMIM) 133450
- ↑ Antonescu CR, Tschernyavsky SJ, Decuseara R, et al. (December 2001). "Prognostic impact of P53 status, TLS-CHOP fusion transcript structure, and histological grade in myxoid liposarcoma: a molecular and clinicopathologic study of 82 cases". Clin. Cancer Res. 7 (12): 3977–87. PMID 11751490.
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 613488
- ↑ 5.0 5.1 Online 'Mendelian Inheritance in Man' (OMIM) 137070
- ↑ Gu, K.; Chan, WC.; Hawley, RC. (Aug 2008). "Practical detection of t(14;18)(IgH/BCL2) in follicular lymphoma.". Arch Pathol Lab Med 132 (8): 1355-61. doi:10.1043/1543-2165(2008)132[1355:PDOBIF]2.0.CO;2. PMID 18684042.
- ↑ Li, JY.; Gaillard, F.; Moreau, A.; Harousseau, JL.; Laboisse, C.; Milpied, N.; Bataille, R.; Avet-Loiseau, H. (May 1999). "Detection of translocation t(11;14)(q13;q32) in mantle cell lymphoma by fluorescence in situ hybridization.". Am J Pathol 154 (5): 1449-52. doi:10.1016/S0002-9440(10)65399-0. PMID 10329598.
- ↑ Perkins, AS.; Friedberg, JW. (2008). "Burkitt lymphoma in adults.". Hematology Am Soc Hematol Educ Program: 341-8. doi:10.1182/asheducation-2008.1.341. PMID 19074108.
- ↑ Cilloni, D.; Saglio, G. (Sep 2009). "CML: a model for targeted therapy.". Best Pract Res Clin Haematol 22 (3): 285-94. doi:10.1016/j.beha.2009.04.004. PMID 19959080.
- ↑ Grimwade, D.; Mistry, AR.; Solomon, E.; Guidez, F. (2010). "Acute promyelocytic leukemia: a paradigm for differentiation therapy.". Cancer Treat Res 145: 219-35. doi:10.1007/978-0-387-69259-3_13. PMID 20306254.
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 102578
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 180240
- ↑ 13.0 13.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 281. ISBN 978-0781765275.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 285. ISBN 978-0781765275.
- ↑ Yu J, Yu J, Mani RS, Cao Q, Brenner CJ, Cao X, Wang X, Wu L, Li J, Hu M, Gong Y, Cheng H, Laxman B, Vellaichamy A, Shankar S, Li Y, Dhanasekaran SM, Morey R, Barrette T, Lonigro RJ, Tomlins SA, Varambally S, Qin ZS, Chinnaiyan AM (May 2010). "An Integrated Network of Androgen Receptor, Polycomb, and TMPRSS2-ERG Gene Fusions in Prostate Cancer Progression". Cancer Cell 17 (5): 443–54. doi:10.1016/j.ccr.2010.03.018. PMC 2874722. PMID 20478527. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874722/.
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 602060
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 606246
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 606245
- ↑ 19.0 19.1 19.2 19.3 PST. 14 February 2011.
- ↑ URL: https://iris.ucl.ac.uk/research/browse/show-publication?pub_id=238366&source_id=2. Accessed on: 13 December 2011.
- ↑ 21.0 21.1 Thway, K. (Feb 2008). "Angiomatoid fibrous histiocytoma: a review with recent genetic findings.". Arch Pathol Lab Med 132 (2): 273-7. doi:10.1043/1543-2165(2008)132[273:AFHARW]2.0.CO;2. PMID 18251589.
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 613488
- ↑ Suzuki, K.; Matsui, Y.; Endo, K.; Kubo, T.; Hasegawa, T.; Kimura, T.; Ohtani, O.; Yasui, N. (Nov 2010). "Myxoid liposarcoma with EWS-CHOP type 1 fusion gene.". Anticancer Res 30 (11): 4679-83. PMID 21115923.
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 165080
- ↑ 25.0 25.1 Ichikawa, H.; Shimizu, K.; Hayashi, Y.; Ohki, M. (Jun 1994). "An RNA-binding protein gene, TLS/FUS, is fused to ERG in human myeloid leukemia with t(16;21) chromosomal translocation.". Cancer Res 54 (11): 2865-8. PMID 8187069.
Further reading
Rowley JD (September 2008). "Chromosomal translocations: revisited yet again". Blood 112 (6): 2183–9. doi:10.1182/blood-2008-04-097931. PMID 18779403. http://bloodjournal.hematologylibrary.org/content/112/6/2183.full.