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Translocations, amplifications and epigenetic changes in cancer !

  • Topic

Besides point mutations, cancers swap chromosome pieces, copy genes many times and silence genes without changing their sequence.

Updated 2026-11-01

What it is

Many tumours are driven by large-scale changes: balanced translocations that create fusion proteins or move an oncogene under a strong promoter, gene amplifications that multiply an oncogene, and epigenetic changes such as promoter hypermethylation that silence tumour suppressors. Translocations are especially typical of leukaemias, lymphomas and sarcomas, and they are diagnostic tools detected by karyotype, FISH or PCR.

Key facts

  • Translocations involving immunoglobulin or T-cell receptor genes arise from errors of the normal recombination machinery of lymphocytes.
  • Amplified genes appear as double minutes or homogeneously staining regions on a karyotype.
  • Cancer genomes show global DNA hypomethylation together with focal hypermethylation of tumour suppressor promoters.
  • Mutations in chromatin regulators (for example EZH2, ARID1A) are common in many cancers.
  • Epigenetic marks are reversible, which makes them drug targets (hypomethylating agents in myelodysplastic syndromes).

Translocations to know

TranslocationGenes involvedEffectTumour
t(9;22)BCR-ABL1Constitutive tyrosine kinaseChronic myeloid leukaemia (also some ALL)
t(8;14)MYC-IGHMYC overexpressionBurkitt lymphoma
t(14;18)IGH-BCL2Blocks apoptosisFollicular lymphoma
t(11;14)CCND1-IGHCyclin D1 overexpressionMantle cell lymphoma
t(15;17)PML-RARABlocks myeloid maturationAcute promyelocytic leukaemia
t(11;22)EWSR1-FLI1Aberrant transcription factorEwing sarcoma
inv(2)EML4-ALKConstitutive kinaseLung adenocarcinoma

Clinical notes

  • Endemic Burkitt lymphoma is linked to EBV and malaria in equatorial Africa; sporadic and immunodeficiency-related forms occur worldwide.
  • Acute promyelocytic leukaemia is a haematological emergency because of disseminated intravascular coagulation; its translocation predicts an excellent response to retinoic acid.

In the lab

  • Karyotype shows large translocations; FISH detects fusions and amplifications (HER2, N-MYC, BCR-ABL) on interphase nuclei.
  • RT-PCR quantifies BCR-ABL transcripts to monitor response in chronic myeloid leukaemia.
  • Next-generation sequencing panels detect fusions (ALK, ROS1, NTRK) that guide targeted therapy.

Test yourself

Think of the answer, then tap the question to see it.

Which translocation is typical of Burkitt lymphoma?

t(8;14), which places MYC under control of the immunoglobulin heavy chain locus.

What fusion gene drives Ewing sarcoma?

EWSR1-FLI1, from t(11;22).

How does promoter hypermethylation cause cancer?

It silences tumour suppressor genes (such as MLH1 or CDKN2A) without changing their DNA sequence.

Which technique detects HER2 amplification on tissue sections?

FISH (or immunohistochemistry for HER2 protein overexpression, with FISH for equivocal cases).

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Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.

Sources: ABL1 gene: MedlinePlus Genetics (MedlinePlus, US National Library of Medicine, 2026); What is epigenetics?: MedlinePlus Genetics (MedlinePlus, US National Library of Medicine, 2026); The Genetics of Cancer (National Cancer Institute (NCI), 2026); Targeted Therapy to Treat Cancer (National Cancer Institute (NCI), 2026).

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