Acute myelogenous leukemia with translocation t(8;21): a cytogenetic study of seven cases

Trisomy 5 in two cases of acute monocytic leukemia with hyperdiploid clones

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.

Cytogenetic studies in acute nonlymphocytic leukemia

Cytogenetic studies were performed in 74 untreated patients with acute nonlymphocytic leukemia (ANLL) between 1985 and 1988. Among 56 patients who were examined successfully at the time of diagnosis, 36 had abnormal karyotypes (64.2%). The distribution of chromosome abnormalities was uneven, according to the categories of the French-American-British (FAB) nomenclature. The highest frequency of chromosome abnormalities was observed in ANLL M4 with bone marrow (BM) eosinophilia (M4Eo). Numerical changes were observed in 11 cases; chromosome 8 was most frequently gained (11 patients), whereas chromosome 7 was most frequently lost (4 patients). Structural rearrangements were detected in 18 patients. Involvement of 16q22 was noted in 7 patients, 5q- was noted in 5, t(8;21) in 3, t(1;7) in 2, del(20) in 2, and involvement of 11q23 was noted in 2. The inversion of chromosome 16 was restricted to the M4Eo subtype. This study identified a novel abnormality [inv(2) (p11.2q11.2)] that had not been reported previously by other investigators.

del(2)(p23): a consistent recurrent abnormality in acute myelogenous leukemia

A case of acute myelogenous leukemia (AML-M2) with an unusual chromosomal finding is presented. In addition to the most frequently observed translocation in this neoplasia, involving the long arms of chromosomes 8 and 21, there was a partial deletion of the short arm of chromosome 2 band (p23), i.e., 46,XX,del(2)(p23),t(8;21)(q22;q22). Deletion of the short arm of chromosome 2 has been described in association with other chromosome abnormalities in two other cases of AML and as the sole abnormality in three cases of AML, indicating that this abnormality is nonrandom and may be associated with leukemic transformation of hematopoietic cells. Therefore, we propose that the del(2)(p23),t(8;21)(q22;q22) abnormality be accorded status III and possibly considered a subset of AML (M2).

Secondary acute promyelocytic leukemia with t(8;21) and t(9;22) at onset and loss of the Philadelphia chromosome at relapse

The translocation (8;21) is a typical marker of the M2 subtype of acute nonlymphocytic leukemia, whereas the Philadelphia (Ph) chromosome is predominantly associated with chronic myelogenous leukemia, and seldom with immature acute leukemias, either lymphoblastic or nonlymphoblastic. Furthermore, the association between t(8;21) and a Ph in the same cell is extremely rare. We present a case of secondary acute promyelocytic leukemia with a karyotype 46,XY,t(8;21), t(9;22) at onset. At relapse the patient lost the Ph, while maintaining the t(8;21). This apparently paradoxical pattern of cytogenetic features and evolution is discussed.

Involvement of bands 9q21-q22 in five cases of acute nonlymphocytic leukemia

Five patients with acute nonlymphocytic leukemia (ANLL) with chromosomal aberrations involving bands 9q21-q22 are described. The abnormalities were an interstitial deletion in two cases of ANLL FAB type M4 and M4 with eosinophilia, a terminal deletion in two cases of M4 and M5 type ANLL, and a translocation in an M2 ANLL. A review of reported cases of ANLL with abnormalities of chromosome 9 revealed a clustering of breaks at the region 9q21-q22, suggesting a possible role for these bands in leukemogenesis.

Translocation (8;21) and its variants in acute nonlymphocytic leukemia. The relative importance of chromosomes 8 and 21 to the genesis of the disease

Chromosome analysis was performed in 25 patients with acute nonlymphocytic leukemia (ANLL), mostly of the M2 type. Eighteen had the standard translocation, t(8;21)(q22;q22), four had complex translocations involving 1p36, 11p13, 17p11, and 17p23, respectively, with chromosomes 8 and 21, and the remaining three patients had simple translocations, one with t(3;21)(p14;q22) and two with t(16;21)(p11;q22), without involving chromosome 8. Chromosome abnormalities additional to t(8;21) and its variants that were most frequently observed were -X, -Y, and del(9). Complex translocations are thought to be derived from the standard translocation and to be essentially similar in nature. The finding that chromosome 21 was involved in all of the standard, simple, and complex translocations, and that chromosome 8 was not involved in simple variants suggest a greater weight of chromosome 21 in the relative importance of the two chromosomes to the genesis of ANLL.