Concurrent t(4;11) and t(1:19) in a Pediatric Patient with B-Lymphoblastic Leukemia/Lymphoma (B-ALL): A Case Report and Review of the Literature.

We herein present the case of a pediatric patient with B-lymphoblastic leukemia (B-ALL) with MLL gene rearrangement associated with the t(4;11)(q21;q23). Complete remission was achieved with standard B-ALL-directed chemotherapy and whole brain radiation. The patient subsequently relapsed and cytogenetic assessment revealed an additional acquired t(1;19)(q23;p13) associated with the TCF3-PBX1 fusion. After reinduction chemotherapy with a relapse B-ALL protocol the patient achieved disease remission; however, he developed respiratory complications and died. This represents a unique case as these two translocations have never been described concurrently in pediatric acute leukemia patients.