Trisomy 14 in refractory anemia with excess of blasts in transformation

Trisomy 14 as a sole chromosome abnormality is associated with older age, a heterogenous group of myeloid neoplasms with dysplasia, and a wide spectrum of disease progression

Trisomy 14 is a rare recurrent cytogenetic abnormality in myeloid neoplasms; however, its clinicopathologic features have not been well described. We report the clinicopathologic, immunophenotypic, and molecular genetic features of 16 cases of myeloid neoplasms with isolated trisomy 14. Our results show that cases with isolated trisomy 14 encompass a heterogenous group of myeloid neoplasms including myelodysplastic syndrome (MDS, 44%), myelodysplastic/myeloproliferative neoplasms (31%), and acute myeloid leukemia (25%). The patients are usually elder (median age 71 years), and there is a male predominance (82%). Multilineage dysplasia is noted in all cases. Oncogenic mutations of genes involved in cell proliferation and/or survival rarely occur. Compared with cases of MDS with diploid karyotype, patients of MDS with isolated trisomy 14 demonstrate a similar overall survival and rate of leukemia transformation.

Trisomy 14 and leukemia

A total of 11 cases with trisomy 14 as the sole abnormality were found in the database of a large cytogenetic reference laboratory from 1993 to the present. Four of the 11 cases had an isochromosome 14q. In 8 cases, the trisomy 14 was a mosaic cell line. Eight cases were diagnosed with myelodysplasia, 2 cases had both myelodysplastic and myeloproliferative features similar to some atypical chronic myeloid leukemia cases, and 1 case had acute myeloid leukemia of M1 or M2 type. Nine were males and two females. The median age was 77 years. Referring physicians were contacted and clinical information was available in only 8 cases. Survival ranged from 1 month to approximately 3 years. An abnormal red cell morphology, such as elliptocytes or schistocytes or both, was observed in the majority of cases. This study along with the reported cases strengthens the hypothesis that trisomy 14 is a nonrandom cytogenetic abnormality associated with myeloid malignancy.

Trisomy 14 in hematologic diseases. Another non-random abnormality within myeloid proliferative disorders

Two cases of myelodysplastic syndrome (MDS) and a case of acute nonlymphoblastic leukemia (ANLL) with a trisomy 14 are presented. The series of results derived from our cases, and those previously reported, strongly suggest that this anomaly may be another nonrandom change, confined within myeloid disorders and associated with patients' advanced age, marked tendency to bone marrow dysplastic features, normal platelet values, and not unfavorable prognosis.

Isochromosome 14q and leukemia with dysplastic features

We report a case of chronic myelomonocytic leukemia (CMMoL) with unusual features and an isochromosome 14q as the sole abnormality. A review of the literature suggests that isochromosome 14q (or trisomy 14) is a marker of leukemia with dysplastic features.

Myelodysplastic syndrome and trisomy 14q

Trisomy 14 as a sole karyotypic abnormality in neoplasia is extremely rare. In hematologic disorders, 18 cases have been reported so far, 17 of which involved disorders of the myeloid lineage. Five were cases of myelodysplastic syndrome (MDS), and a further four involved Philadelphia-negative atypical chronic myeloid leukemia. The case presented here is the second case of trisomy 14q in MDS involving the chronic myelomonocytic leukemia subtype. There were certain features in common with some of the previously reported cases. We raise the possibility that this represents a specific entity.

Trisomy 8 and 11 in refractory anemia with excess blasts in transformation (RAEB-T)

There are no specific chromosomal abnormalities associated with refractory anemia with excess blasts in transformation [RAEB-T]. An 80-year-old white male with RAEB-T was found to have trisomies of chromosomes 8 and 11, i.e., 48,XY,+8,+11. To our knowledge, this chromosomal abnormality in RAEB-T has not been previously reported.

Four additional cases of trisomy 14 as the sole anomaly in various haematological malignancies

We report on four cases of trisomy 14 as the sole anomaly. Three cases were myelodysplastic syndromes and one was a non-Hodgkin's lymphoma. This anomaly is mainly in myeloid disorders and still remains to be well documented. On the other hand, we show this anomaly to be also a non-random anomaly in lymphoproliferative disorders.

Trisomy 13 in a case of myelodysplastic syndrome

The clinical and cytogenetic findings of a patient with refractory anemia with excess of blasts are presented. Trisomy 13 was present as the sole numerical aberration in all analyzed bone marrow metaphases; this finding has not been reported previously in myelodysblastic syndrome.