376
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377
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Ma SK, Wan TS, Au WY, Kwong YL, Chan LC. Atypical chronic myeloid leukemia with der(20)t(17;20)(q21;q13). CANCER GENETICS AND CYTOGENETICS 1999; 112:130-3. [PMID: 10686939 DOI: 10.1016/s0165-4608(98)00265-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We present a case of atypical chronic myeloid leukemia that developed blastic transformation four months after initial presentation, with the blast cells showing multilineage antigen expression. A novel karyotypic abnormality, der(20)t(17;20)(q21;q13), was found in bone marrow cells at diagnosis. The potential role of such an aberration in leukemogenesis is discussed.
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378
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Ma SK, Kwong YL, Shek TW, Wan TS, Chow EY, Chan JC, Chan LC. The role of trisomy 8 in the pathogenesis of chronic eosinophilic leukemia. Hum Pathol 1999; 30:864-8. [PMID: 10414507 DOI: 10.1016/s0046-8177(99)90149-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A case of chronic eosinophilic leukemia (CEL) manifesting as spinal cord compression by an extradural eosinophilic chloroma in a 32-year-old Chinese man was presented, who subsequently developed extramedullary transformation at the skin and then peritoneal cavity. Cytogenetic study of bone marrow cells at diagnosis showed a clonal karyotypic abnormality of trisomy 8 (+8), which on fluorescence in situ hybridization (FISH) was shown to be present in a clone of abnormal eosinophils, hence showing the neoplastic nature of the eosinophilic proliferation. There was another population of abnormal eosinophils that did not show +8. At blastic transformation, all blast cells in ascitic fluid were shown by FISH to harbor +8. These findings suggest that +8 in this case may have arisen from clonal evolution and is not the primary genetic event in leukemogenesis, but +8 most probably imparts a further survival advantage to the clone responsible for subsequent blastic transformation.
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379
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Wan TS, Chim CS, So CK, Chan LC, Ma SK. Complex variant 15;17 translocations in acute promyelocytic leukemia. A case report and review of three-way translocations. CANCER GENETICS AND CYTOGENETICS 1999; 111:139-43. [PMID: 10347551 DOI: 10.1016/s0165-4608(98)00230-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Complex variant 15;17 translocations are increasingly recognized in acute promyelocytic leukemia (APL). We report a novel three-way translocation in APL involving chromosomes 15, 17, and X in the form of t(X;17;15)(q13;q12;q21). Southern blot analysis showed retinoic acid receptor alpha (RARA) gene rearrangement at intron 2. Clinical and morphologic findings are typical of APL, and a complete remission was attained with a course of conventional chemotherapy. A review of three-way complex variants of 15;17 translocation in the literature reveals 21 published cases in addition to ours. PML/RARA fusion was observed in all 8 cases in which molecular genetic analysis had been performed. More cases need to be analyzed to determine if clustering to particular chromosomal bands occurs in variant translocations, and whether APL cases harboring complex 15;17 variants differ clinically from those with classical 15;17 translocation.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/pharmacology
- Blotting, Southern
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Female
- Humans
- Karyotyping
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Neoplasm Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Receptors, Retinoic Acid/genetics
- Retinoic Acid Receptor alpha
- Translocation, Genetic
- X Chromosome
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380
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Chan GC, Ma SK, Ha SY, Sriastava G, Wan TS, Kwong DL, Chan LC, Lau YL. Biphenotypic lymphoblastic non-Hodgkin lymphoma with a balanced translocation t(1;9)(p10;q10): unusual presentation with poor outcome. MEDICAL AND PEDIATRIC ONCOLOGY 1999; 32:450-2. [PMID: 10358707 DOI: 10.1002/(sici)1096-911x(199906)32:6<450::aid-mpo13>3.0.co;2-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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381
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Abstract
The curative effect of allogeneic bone marrow transplantation (BMT) for acute and chronic leukemia is attributed to the intensive conditioning chemotherapy with or without radiotherapy, as well as an immune-mediated graft versus leukemia (GVL) effect. A different pattern of relapse has been observed after allogeneic BMT for patients with leukemia. Compared with treatment using conventional chemotherapy alone, isolated extra-medullary relapse of disease appears to be seen more commonly after allogeneic BMT. While a full donor's hematopoiesis may be retained, prolonged morphological remission has been observed in the recipient's bone marrow. There appears to be a population of leukemic cells with an affinity to extra-medullary tissues. The failure of the leukemic clone to repopulate the recipient's marrow suggests the presence of a more profound GVL effect in the marrow environment. The optimal treatment for extra-medullary relapse of leukemia following allogeneic BMT remains uncertain. In the case of isolated extra-medullary relapses following BMT, the leukemia may still be responsive to further treatment with chemotherapy and/or radiotherapy. The prognosis is poor in general, but prolonged survival has been observed in some of these patients. With the preservation of donor's hematopoiesis in the recipient's marrow, the use of intensive chemotherapy followed by donor lymphocyte or stem cell re-infusion is a promising option.
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382
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Chim CS, Ma SK, Lam CK. Bone marrow necrosis masquerading as interferon toxicity in chronic myeloid leukemia. Leuk Lymphoma 1999; 33:385-8. [PMID: 10221520 DOI: 10.3109/10428199909058440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Bone marrow necrosis (BMN) is a rare pathologic entity associated with a wide variety of diseases. We describe a patient with chronic myeloid leukemia on interferon treatment, who developed BMN with symptoms and signs masquerading as interferon toxicity. This is followed by a literature review of BMN in CML.
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383
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Ma SK, Lee AC, Wan TS, Lam CK, Chan LC. Trisomy 8 as a secondary genetic change in acute megakaryoblastic leukemia associated with Down's syndrome. Leukemia 1999; 13:491-2. [PMID: 10086746 DOI: 10.1038/sj.leu.2401330] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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384
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Ma SK, Wan TS, Chan LC, Au WY. Trisomy 10 in acute myeloid leukemia: revisited. CANCER GENETICS AND CYTOGENETICS 1999; 109:88-9. [PMID: 9973969 DOI: 10.1016/s0165-4608(98)00148-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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385
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Chim CS, Ma SK, Lam CK, Liang R. Two uncommon lymphomas. Case 2: signet ring lymphoma of the bone marrow. J Clin Oncol 1999; 17:728-9. [PMID: 10080620 DOI: 10.1200/jco.1999.17.2.728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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386
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Cai GQ, Fei J, Xu YP, Huang F, Ma SK, Guo LH. Nuclear proteins from liver and kidney bind a 37 bp sequence in the 5' upstream region of the mGAT1 gene. Neuroreport 1998; 9:4059-62. [PMID: 9926847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
The mouse GABA transporter (mGAT1) gene has been shown to be exclusively expressed in brain by Northern and Western blot analyses. The interactions between the 5' flanking region of the mGAT1 gene and nuclear proteins from different mouse tissues were studied by means of gel-shift assay. Our results show that nuclear protein factors from non-nervous tissues can specifically recognize a 37 bp sequence that is conserved in the 5' flanking region between the human and mouse GAT1 genes. Similar nuclear protein factors were also found to exist in rat, rabbit and pig.
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387
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Ma SK, Chan GC, Wan TS, Lam CK, Ha SY, Lau YL, Chan LC. Near-haploid common acute lymphoblastic leukaemia of childhood with a second hyperdiploid line: a DNA ploidy and fluorescence in-situ hybridization study. Br J Haematol 1998; 103:750-5. [PMID: 9858226 DOI: 10.1046/j.1365-2141.1998.01044.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Near-haploidy is a rare cytogenetic finding in childhood acute lymphoblastic leukaemia (ALL) and is associated with a poor prognosis. A second hyperdiploid line, occurring presumably by endoreduplication of the near-haploid stemline, is often observed. We present a case of common ALL in relapse characterized morphologically by a dual population of small and large lymphoblasts. Cytogenetic analysis supplemented with fluorescence in-situ hybridization (FISH) studies localized near-haploidy and hyperdiploidy to the small and large blast population respectively. DNA ploidy determination confirmed two abnormal clones with near-haploidy as the predominant one. A novel t(9;12)(q11;q13) was present in the near-haploid clone and was duplicated in the hyperdiploid clone. This finding identified cells bearing near-haploidy to be the clonogenic population following malignant transformation and confirmed endoreduplication as the mechanism for the presence of associated hyperdiploidy.
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388
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Chim CS, Ooi C, Ma SK, Lam C. Bone marrow necrosis in bone marrow transplantation: the role of MR imaging. Bone Marrow Transplant 1998; 22:1125-8. [PMID: 9877279 DOI: 10.1038/sj.bmt.1701490] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We describe an ALL patient who developed extensive bone marrow necrosis at the time of relapse 2 months after allogeneic bone marrow transplantation from an HLA-identical sibling. The excruciating and diffuse bone pain, fever and precipitous drop in peripheral blood counts were characteristic. This case illustrates the importance of repeat bone marrow biopsies for the diagnosis of disease relapse and the potential application of MR imaging in the assessment of patients with bone marrow necrosis.
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389
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Au WY, Lie AK, Ma SK, Chan LC, Lee CK, Kwong YL, Chim CS, Chan TK, Chiu E, Liang R. Allogeneic bone marrow transplantation for adult acute lymphoblastic leukemia: a single-centre experience. Hematol Oncol 1998; 16:163-8. [PMID: 10414236 DOI: 10.1002/(sici)1099-1069(199812)16:4<163::aid-hon634>3.0.co;2-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Between 1990 and 1997, we performed 29 allogeneic BMTs for acute lymphoblastic leukemia (ALL) patients with HLA-identical sibs. Their median age was 31 years (range 15 to 43); there were 15 males and 14 females. The conditioning protocol was Cy-TBI (n = 15), VP16-Cy-TBI(n = 12), CBV (n = 1) and Bu-Cy (n = 1). Cyclosporin and methotrexate were used for GVHD prophylaxis. The median disease-free survival (DFS) was 12 months (range 1 to 92) with an actuarial 4-years DFS of 42.3 per cent. Three patients died of transplant-related complications before 100 days. Relapse occurred in 11 cases at a median time of 5 months (range 3 to 14). All nine patients relapsing within one year died form resistant leukemia. Three patients died of late treatment-related complications. There were 13 survivors (median follow-up 38 months, range 12-98), with 12 in remission. Only four had limited cGVHD, and all had 100 per cent performance scores. One patient also cleared her chronic hepatitis B carrier status due to acquired immunity. The DFS rates amongst CR1 cases and R1/CR2 cases were comparable (p = 0.39). No long-term DFS is obtained from patients with resistant disease (n = 4). The survival results for BMT at CR1 were superior to those using intensive chemotherapy consolidation (p = 0.29), mainly due to poor late results in the chemotherapy arm. For young ALL patients with HLA-matched siblings, the option of BMT should be considered in light of local consolidation survival results.
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390
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Ma SK, Wan TS, Au WY, Chan LC. Trisomy 5 in two cases of acute monocytic leukemia with hyperdiploid clones. Leuk Res 1998; 22:961-4. [PMID: 9766757 DOI: 10.1016/s0145-2126(98)00095-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although numerical chromosomal aberrations are commonly seen in acute myeloid leukemia (AML), trisomy 5 (+ 5) is very rarely detected. We report two patients, both of whom suffered from acute monocytic leukemia, in which + 5 was found in hyperdiploid clones. A review of the English literature shows 17 additional cases of AML with + 5 in at least one of the abnormal clones, making a total of 19 such cases including ours. Trisomy 5 has been reported in all FAB subtypes of AML except acute promyelocytic leukemia. In the 19 cases identified in this report, + 5 was found in association with other numerical changes (four cases), structural changes (five cases) or both (eight cases). Trisomy 5 as a sole karyotypic abnormality was exceedingly rare (two cases). Its biologic and prognostic significance remains to be determined.
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391
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Ma SK, Chan JC, Wan TS, Chan AY, Chan LC. Myelodysplastic syndrome with myelofibrosis and basophilia: detection of trisomy 8 in basophils by fluorescence in-situ hybridization. Leuk Lymphoma 1998; 31:429-32. [PMID: 9869209 DOI: 10.3109/10428199809059238] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We report a case of myelodysplastic syndrome (MDS) with myelofibrosis and pulmonary tuberculosis who had marked basophilia in the peripheral blood. A clonal karyotypic abnormality characterized by trisomy 8 was demonstrated by cytogenetic analysis. By correlation of cell morphology with results of fluorescence in situ hybridization using a chromosome 8 probe, we demonstrated that the basophils were not reactive but belonged to the neoplastic MDS clone.
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MESH Headings
- Adult
- Anemia, Refractory/complications
- Anemia, Refractory/genetics
- Anemia, Refractory/pathology
- Anemia, Refractory/physiopathology
- Basophils/pathology
- Chromosomes, Human, Pair 8
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Primary Myelofibrosis/complications
- Primary Myelofibrosis/genetics
- Primary Myelofibrosis/pathology
- Primary Myelofibrosis/physiopathology
- Trisomy
- Tuberculosis, Pulmonary/complications
- Tuberculosis, Pulmonary/genetics
- Tuberculosis, Pulmonary/physiopathology
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392
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Lee AC, Ma SK, Wan TS, Ching LM, Chan LC. A novel t(7;17)(q11;q11) as the sole karyotypic abnormality in childhood pre-B-cell acute lymphoblastic leukemia. CANCER GENETICS AND CYTOGENETICS 1998; 104:70-1. [PMID: 9648563 DOI: 10.1016/s0165-4608(97)00393-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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393
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Huang F, Fei J, Ma SK, Zhu LH, Liu ZP, Cai GQ, Ye ZC, Guo LH. Analysis of the 5' flanking sequence of the human norepinephrine transporter gene. Cell Res 1998; 8:143-9. [PMID: 9669029 DOI: 10.1038/cr.1998.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
The human norepinephrine transporter (NET) gene was cloned and structurally analyzed. The far 5' fragment containing exon 1 (a non-coding exon) and exon 2 was sequenced. The transcription start site of the gene in human brain stem tissue was determined by primer extension analysis. It was found that the gene could be transcribed from multiple starting points. The 5' flanking sequence contains a proximal G-C rich region, one possible GSG element and several SP1 sites. However it does not contain TATA box and CAAT box motifs. Gel shift analysis with nuclear extracts from different tissues of mouse shows that the G-C rich region may be involved in tissue specific expression of the gene.
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394
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Au WY, Ma SK, Chan AC, Liang R, Lam CC, Kwong YL. Near tetraploidy in three cases of acute myeloid leukemia associated with mediastinal granulocytic sarcoma. CANCER GENETICS AND CYTOGENETICS 1998; 102:50-3. [PMID: 9530340 DOI: 10.1016/s0165-4608(97)00294-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Granulocytic sarcoma (GS) is a rare manifestation of acute myeloid leukemia (AML), blastic transformation of chronic myeloid leukemia, and the myelodysplastic syndromes. The mediastinum is an unusual site of presentation. We report a series of three female patients with mediastinal GS. They were characterized by the presence of large and bizarre blast cells and near tetraploidy on cytogenetic analysis. All three patients responded poorly to chemotherapy. Near tetraploid AML is a rare entity, usually present in male patients, and has not been associated with GS. The clinical and pathological similarities in these three cases suggest a distinct category of poor-risk AML for which more intensive treatment is needed.
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395
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Ma SK, Lam CK, Ha SY, Chan GC, Chan LC. Megakaryoblastic transformation of juvenile myelomonocytic leukaemia. Br J Haematol 1998; 100:797-8. [PMID: 9531352 DOI: 10.1046/j.1365-2141.1998.0678a.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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396
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Chim CS, Fong CY, Ma SK, Wong SS, Yuen KY. Reactive hemophagocytic syndrome associated with Penicillium marneffei infection. Am J Med 1998; 104:196-7. [PMID: 9528739 DOI: 10.1016/s0002-9343(97)00253-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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397
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Abstract
A case of non-Hodgkin's lymphoma with features mimicking that of multiple myeloma is reported. A 67-year-old man presented with lymphadenopathy and the classic constellation of symptoms and signs of multiple myeloma, including generalised bone pain, hypercalcemia and multiple osteolytic lesions on the skeletal survey. However, cervical lymph node biopsy showed diffuse large cell lymphoma and marrow aspirate showed infiltration with lymphoma cells different in both morphology and surface markers to myeloma cells.
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398
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Ma SK, Lie AK, Au WY, Wan TS, Chan LC. CD7+ acute myeloid leukaemia with 'mature lymphoid' blast morphology, marrow basophilia and t(4;12)(q12;p13). Br J Haematol 1997; 99:978-80. [PMID: 9432054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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399
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Ma SK, Chan GC, Ha SY, Chiu DC, Lau YL, Chan LC. Clinical presentation, hematologic features and treatment outcome of childhood acute lymphoblastic leukemia: a review of 73 cases in Hong Kong. Hematol Oncol 1997; 15:141-9. [PMID: 9600113 DOI: 10.1002/(sici)1099-1069(199708)15:3<141::aid-hon608>3.0.co;2-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Seventy-three consecutive cases of childhood acute lymphoblastic leukemia (ALL) diagnosed and managed in Queen Mary Hospital over a 10-year period from 1985 to 1994 were retrospectively analysed for their presenting features and treatment outcome. The 48 boys and 25 girls ranged in age from 0.4 to 14.2 years (median: 4.3 years). Bone and joint pain was a relatively common presenting feature besides fever, hepatosplenomegaly and lymphadenopathy. Immunophenotyping of blast cells showed: 51 B-cell precursor ALL, one B-ALL, 10 T-ALL and three myeloid-antigen positive ALL. Eight cases were unclassified since immunophenotyping had not been performed. Out of the 73 patients, treatment outcome was analysed in 20 cases treated with UKALL-VIII regimen and 28 cases treated with either the UKALL-XI regimen or the Hong Kong Children Cancer Study Group (HKCCSG) protocol which was modelled upon UKALL-XI. Although complete remission rates were similar between the two groups, patients treated with the former regimen that was less intensified suffered more relapses than the latter (56 per cent versus 21 per cent, P = 0.04). There were, however, no significant differences both in event-free survival (38.2 +/- 11.2 per cent versus 71.3 +/- 9.3 per cent, P = 0.12) and overall survival (70.0 +/- 10.2 per cent versus 79.6 +/- 8.3 per cent, P = 0.41) between the two groups at 3 years by long-rank test. With the use of risk-directed therapy and improved supportive care, two-thirds of our patients are able to enjoy long-term event-free survival.
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400
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Ma SK, Ha SY, Wan TS, Chan LC. t(5;7)(q34;q21) in acute megakaryoblastic leukemia associated with Down syndrome. CANCER GENETICS AND CYTOGENETICS 1997; 96:177. [PMID: 9216727 DOI: 10.1016/s0165-4608(96)00294-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
MESH Headings
- Acute Disease
- Child, Preschool
- Chromosome Aberrations/genetics
- Chromosome Banding
- Chromosome Disorders
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 7
- Down Syndrome/complications
- Down Syndrome/genetics
- Humans
- Leukemia, Megakaryoblastic, Acute/complications
- Leukemia, Megakaryoblastic, Acute/genetics
- Male
- Translocation, Genetic
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