Molecular cytogenetics: Solid tumors and leukemia

Acute leukemia represents one of the best-studied malignancies. Consequently, numerous dogmas have evolved over the years. One dogma to which we subscribe is that leukemia is a genetic disease and that the behavior of leukemic cells and their response to therapy is determined largely by their genetic characteristics. The relative ease of metaphase generation and culture of single leukemic cells, well-defined morphologic criteria, and availability of phenotyping reagents has contributed to a wealth of information about the karyotypic, genetic, and functional properties of these cells. Nevertheless, establishment of genotype-phenotype relationships has been particularly elusive. The genetic evolution of leukemias and the consequences of specific aberrations remains to be determined. We describe the power of new molecular cytogenetic tools, fluorescence in situ hybridization, and comparative genomic hybridization to measure the genetic evolution of leukemic cells. Lessons learned from application of these techniques to solid tumors and speculations about similar approaches to analysis of leukemia are addressed.