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Shen YM, Hung GY, Yen HJ, Hsieh MY, Hsieh TK. Early development of acute myeloid leukemia following treatment of osteosarcoma: a case report and review of the literature. Pediatr Neonatol 2009; 50:239-44. [PMID: 19856869 DOI: 10.1016/s1875-9572(09)60070-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We report a case of treatment-related acute myeloid leukemia (t-AML) in a 16-year-old male following treatment for osteosarcoma (OS). He had been treated with a protocol comprising neoadjuvant chemotherapy, definitive surgery with wide excision and adjuvant chemotherapy for OS. Four months after completion of the treatment, a routine hemogram showed hyperleukocytosis with 90% blasts. Bone marrow aspirate and a chromosomal analysis disclosed acute myeloid leukemia (AML), M5b with 46, XY, t(11;19)(q23;p13.3). The t-AML was characterized by early development (just 4 months after completion of chemotherapy for OS) and generalized leukemia cutis. The patient received an alkylating agent (ifosfamide) and DNA topoisomerase II-targeted drugs (etoposide and doxorubicin). In terms of latency, cytogenetics, and presentation, DNA topoisomerase II-targeted drug-related leukemia seemed likely for this patient. Clinically, his leukemia cutis had developed during a nadir in white blood cell count after the first induction of chemotherapy for AML. The rapid progression and its refractoriness to chemotherapy were poor prognostic signs.
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Affiliation(s)
- Yu-Mei Shen
- Department of Pediatrics, Hsin Chu General Hospital, Hsinchu, Taiwan
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2
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Ramanarayanan J, Dunford LM, Baer MR, Sait SNJ, Lawrence W, McCarthy PL. Chronic myeloid leukemia after treatment of lymphoid malignancies: response to imatinib mesylate and favorable outcomes in three patients. Leuk Res 2005; 30:701-5. [PMID: 16330096 DOI: 10.1016/j.leukres.2005.10.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2005] [Revised: 10/26/2005] [Accepted: 10/29/2005] [Indexed: 11/16/2022]
Abstract
Recent improved treatments for lymphoid malignancies produce more long-term survivors, yet increase the risk for secondary malignancies. Therapy-related myelodysplasia and acute myeloid leukemia are well described, but secondary chronic myeloid leukemia (CML) has only rarely been reported. We report three patients with CML diagnosed 8, 10 and 2.5 years following Hodgkin's disease, non-Hodgkin's lymphoma and chronic lymphocytic leukemia therapy, respectively. BCR-ABL transcripts were not detected after completion of primary therapy in two cases. All three patients received imatinib therapy, with one patient subsequently undergoing allogeneic hematopoietic stem cell transplantation. All three patients have ongoing favorable responses to CML therapy.
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MESH Headings
- Adult
- Antineoplastic Agents/administration & dosage
- Benzamides
- Disease-Free Survival
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Imatinib Mesylate
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/etiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Male
- Middle Aged
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/metabolism
- Neoplasms, Second Primary/therapy
- Piperazines/administration & dosage
- Pyrimidines/administration & dosage
- Remission Induction
- Time Factors
- Transplantation, Homologous
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Affiliation(s)
- Jeyanthi Ramanarayanan
- Department of Medicine, Roswell Park Cancer Institute, State University of New York, Buffalo, NY 14263, USA
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3
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Le Deley MC, Leblanc T, Shamsaldin A, Raquin MA, Lacour B, Sommelet D, Chompret A, Cayuela JM, Bayle C, Bernheim A, de Vathaire F, Vassal G, Hill C. Risk of secondary leukemia after a solid tumor in childhood according to the dose of epipodophyllotoxins and anthracyclines: a case-control study by the Société Française d'Oncologie Pédiatrique. J Clin Oncol 2003; 21:1074-81. [PMID: 12637473 DOI: 10.1200/jco.2003.04.100] [Citation(s) in RCA: 149] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To estimate the risk of secondary leukemia as a function of the dose of epipodophyllotoxins and anthracyclines. METHODS We conducted a case-control study of the risk of secondary leukemia or myelodysplasia after a solid tumor in childhood within the Société Française d'Oncologie Pédiatrique, including 61 patients with leukemia matched with 196 controls. The characteristics of the first cancer, the patient's family history of cancer, and the treatment (type, cumulative dose of chemotherapy, schedule of etoposide administration, and radiation dose delivered to active bone marrow) were compared in the two groups. RESULTS Only two factors were found to increase the risk of leukemia in multivariate analysis, namely, the type of the first tumor, with an excess risk in patients with Hodgkin's disease (relative risk 6.4; 95% confidence interval [CI], 1.6 to 24) or osteosarcoma (relative risk 5; 95% CI, 1.3 to 19), and exposure to epipodophyllotoxins and anthracyclines. The risk of leukemia increased regularly with the cumulative dose of etoposide. In summary, patients who received between 1.2 and 6 g/m(2) of epipodophyllotoxins or more than 170 mg/m(2) of anthracyclines had a seven-fold higher risk (95% CI, 2.6 to 19) compared with patients who received lower doses or none of these drugs. The risk of leukemia in patients who received more than 6 g/m(2) of epipodophyllotoxins was multiplied by 197 (95% CI, 19 to 2,058). The risk of leukemia was not increased by exposure to alkylating agents or radiotherapy. CONCLUSION Both epipodophyllotoxins and anthracyclines increase the risk of secondary leukemia. The current challenge is to minimize the mutagenic effects of these drugs by diminishing cumulative doses without losing the therapeutic benefits.
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Affiliation(s)
- Marie-Cécile Le Deley
- Biostatistics and Epidemiology Unit, the Radiophysics Unit, the Department of Pediatric Oncology, the Cytogenetics Laboratory, Institut Gustave-Roussy, Villejuif, France.
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4
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Aung L, Gorlick RG, Shi W, Thaler H, Shorter NA, Healey JH, Huvos AG, Meyers PA. Second malignant neoplasms in long-term survivors of osteosarcoma: Memorial Sloan-Kettering Cancer Center Experience. Cancer 2002; 95:1728-34. [PMID: 12365021 DOI: 10.1002/cncr.10861] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND The authors investigated the incidence and relative risk of secondary malignant neoplasms in long-term survivors of osteosarcoma. METHODS A comprehensive list of 509 patients with primary osteosarcoma treated at our institution between February 1973 and March 2000 was identified. All study patients received chemotherapy and/or surgery on one of six different protocols (T4, 5, 7, 10, 12, and CCG-7921/POG-9351). Chemotherapy was scheduled for up to 40 weeks with some variations in the actual treatment period and consisted of various combinations of the following agents: high-dose methotrexate, doxorubicin, bleomycin, cyclophosphamide, dactinomycin, vincristine, cisplatin, and ifosfamide. RESULTS Secondary malignant neoplasms (SMN) occurred in 14 of 509 patients. Only one had pulmonary metastasis at diagnosis and subsequent multiple recurrences that required thoracotomies and further modification of the chemotherapy regimen. The median age at diagnosis for osteosarcoma was 16.6 years (range, 3.1-74.4 years). The median follow-up was 5.2 years (range, 0.1-25.0 years). The time interval from diagnosis of the primary osteosarcoma to the development of SMN was 1.3-13.1 years (median, 5.5; 95% confidence interval [CI], 3.6-9.6). The most common SMN occurred in the central nervous system (n = 4): anaplastic glioma, meningioma, high-grade glioma, and maxillary astrocytoma. There were two cases of acute myeloid leukemia and one case each of myelodysplastic syndrome, non-Hodgkin lymphoma, high-grade pleomorphic sarcoma, leiomyosarcoma, fibrosarcoma, breast carcinoma, and mucoepidermoid carcinoma. The overall 5 and 10-year cumulative incidences of SMNs were 1.4% +/- 1.1% and 3.1% +/- 1.8%. The standardized incidence ratio was 4.6 (95% CI, 2.53-7.78, P = 0.00001) for the cohort and 3.64 (95% CI, 1.82-6.52, P = 0.0007) when patients with a history of retinoblastoma or Rothmund-Thomson syndrome were excluded. CONCLUSIONS The overall incidence of secondary malignancies in long-term survivors of osteosarcoma was significantly higher than the expected incidence of cancer in the general population. However, the standardized incidence ratios were much lower than those reported for Hodgkin disease and retinoblastoma. Although additional follow-up is warranted, the successes of current treatment regimens consisting of intensive, high-dose chemotherapy in combination with topoisomerase II inhibitors outweigh the risks.
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Affiliation(s)
- LeLe Aung
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA
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5
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Kawai A, Sugihara S, Naito N, Ozaki T, Isu K, Hatae Y, Inoue H. Development of acute myeloid leukemia after chemotherapy for osteosarcoma. Clin Orthop Relat Res 2001:239-46. [PMID: 11603675 DOI: 10.1097/00003086-200110000-00027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The current study describes two patients with osteosarcoma who had acute myeloid leukemia develop after treatment with multiagent chemotherapy. The incidence density for the chemotherapy protocol was 129.8 per 10,000 person-year of followup. Karyotype analysis of 16 reported patients (including the current two patients) indicated that most leukemias after treatment of osteosarcoma correlated with the use of topoisomerase II inhibitors, such as doxorubicin. The deoxyribonucleic acid-damaging activity of doxorubicin reinforced by the use of alkylating agents is highly suspected as a causative event in the development of leukemia after treatment of osteosarcoma. As the next step in the development of treatment for patients with osteosarcoma, the type and intensity of treatment must be evaluated to minimize possible leukemogenic effects without compromising the potential for cure.
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Affiliation(s)
- A Kawai
- Department of Orthopaedic Surgery, Faculty of Medicine, Okayama University Medical School, Japan
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6
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Panizo C, Patiño A, Calasanz MJ, Rifón J, Sierrasesumaga L, Rocha E. Emergence of secondary acute leukemia in a patient treated for osteosarcoma: implications of germline TP53 mutations. MEDICAL AND PEDIATRIC ONCOLOGY 1998; 30:165-9. [PMID: 9434825 DOI: 10.1002/(sici)1096-911x(199803)30:3<165::aid-mpo7>3.0.co;2-f] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Secondary leukemia and myelodysplastic syndromes have been reported in patients following treatment for a wide range of neoplastic disorders. However second malignancies after chemotherapy and/or irradiation for osteosarcoma are unusual. PROCEDURE We report the case of a 15-year-old girl who developed a myelodysplastic syndrome with evolution to acute nonlymphocytic leukemia after treatment for osteosarcoma. Therapy-related acute leukemia karyotype findings such as abnormalities of chromosomes 5, 7, and 17 were found in the cytogenetic analysis. Moreover, using denaturing gradient gel electrophoresis and DNA sequencing, we detected the presence of a double germline mutation in exon 7 of the TP53 gene. CONCLUSION This observation supports the possibility of a causal relationship between germline TP53 mutations and the development of secondary leukemia and myelodysplasia.
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Affiliation(s)
- C Panizo
- Department of Hematology, University Clinic of Navarra, School of Medicine, University of Navarra, Pamplona, Spain
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7
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Pratt CB, Meyer WH, Luo X, Cain AM, Kaste SC, Pappo AS, Rao BN, Fleming ID, Jenkins JJ. Second malignant neoplasms occuring in survivors of osteosarcoma. Cancer 1997; 80:960-5. [PMID: 9307198 DOI: 10.1002/(sici)1097-0142(19970901)80:5<960::aid-cncr19>3.0.co;2-u] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Second malignant neoplasms have been noted infrequently in survivors of osteosarcoma treated before 1970. METHODS For the above reason, the authors surveyed their patients to determine the actuarial incidence and relative risk of second malignancies among patients treated with adjuvant chemotherapy for osteosarcoma. RESULTS Between March 1962 and March 1996, 334 patients received chemotherapy for newly diagnosed primary or metastatic osteosarcoma. Of these patients, 47 presented with metastases, 14 had multifocal osteosarcoma, and 273 had localized disease. Nine patients developed second malignant neoplasms 0.45-17.8 years (median, 6.3 years) after receiving definitive surgery and adjuvant chemotherapy for primary osteosarcoma; 2 of these patients had pulmonary metastasectomies before receiving adjuvant chemotherapy. The second neoplasms comprised two cases of malignant fibrous histiocytoma and one case each of melanoma, glioblastoma multiforme, chondrosarcoma, and carcinoma of the breast: stomach, colon, rectum. The overall 10-year cumulative incidence of second malignancies was 2% +/- 1%; by comparison, this rate was 2% +/- 1% for patients with localized osteosarcoma but was 8% +/- 5% (P = 0.15) for those who presented with metastatic disease. CONCLUSIONS Since the advent of successful adjuvant chemotherapy, more patients are surviving primary osteosarcoma; therefore, the number of osteosarcoma patients who develop second malignancies can be expected to increase. Recognition of osteosarcoma patients who are members of families with Li-Fraumeni syndrome may lead to earlier intervention for these individuals.
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Affiliation(s)
- C B Pratt
- Department of Hematology/Oncology, St. Jude Children's Research Hospital, and College of Medicine, University of Tennessee-Memphis, 38105, USA
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8
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Izumi T, Ohtsuki T, Ohya K, Ogawa Y, Yoshida M, Muroi K, Imagawa S, Hatake K, Kuriki K, Saito K, Miura Y. Therapy-related leukemia with a novel 21q22 rearrangement. CANCER GENETICS AND CYTOGENETICS 1996; 90:45-8. [PMID: 8780746 DOI: 10.1016/0165-4608(96)00044-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We present a case of a 59-year-old Japanese man with therapy-related acute myeloblastic leukemia (AML) after the chemotherapy for non-Hodgkin's lymphoma (NHL). Accumulated doses of cyclophosphamide, procarbazine, doxorubicin, mitoxantrone, and etoposide were 18,300 mg, 3000 mg, 580 mg, 100 mg, and 4150 mg, respectively, which had been administered for the treatment of NHL. Myeloblasts in the peripheral blood increased 43 months after the onset of NHL. He was diagnosed as having AML (M2; FAB classification). The karyotype of the bone marrow cells in the present case contained the following abnormalities: t(2;21)(q21;q22), t(8;21)(q22;q22), and add(13)(q34). In the present case, 645 base pairs of chimeric mRNA were detected by reverse transcription-polymerase chain reaction, indicating the presence of AML1/MTG8 rearrangement. Translocation (2;21)(q21;q22) has not been described previously to our knowledge. It is interesting that the breakpoint of 21q22 existed both in t(2;21) and t(8;21). The disrupted AML1 gene resulting from two 21q22 rearrangements may be involved in the pathogenesis of AML in the present case. The clinical importance of therapy-related AML having the 21q22 rearrangement remains to be examined.
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MESH Headings
- Aclarubicin/administration & dosage
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Bleomycin/administration & dosage
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 21/ultrastructure
- Core Binding Factor Alpha 2 Subunit
- Cyclophosphamide/administration & dosage
- Cyclophosphamide/adverse effects
- DNA-Binding Proteins
- Doxorubicin/administration & dosage
- Doxorubicin/adverse effects
- Fatal Outcome
- Humans
- Leukemia, Myeloid, Acute/chemically induced
- Leukemia, Myeloid, Acute/genetics
- Lymphoma, Non-Hodgkin/drug therapy
- Male
- Middle Aged
- Mitoxantrone/administration & dosage
- Mitoxantrone/adverse effects
- Neoplasm Proteins/genetics
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/genetics
- Polymerase Chain Reaction
- Prednisolone/administration & dosage
- Prednisolone/adverse effects
- Prednisone/administration & dosage
- Prednisone/adverse effects
- Procarbazine/administration & dosage
- Proto-Oncogene Proteins
- Transcription Factors/genetics
- Vincristine/administration & dosage
- Vincristine/adverse effects
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Affiliation(s)
- T Izumi
- Department of Medicine, Jichi Medical School, Tochigi-Ken, Japan
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9
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Berger R, Hillion J, Janvier D, Chen Z, Bussel A. t(8;21) prior to acute leukemia. CANCER GENETICS AND CYTOGENETICS 1993; 70:125-6. [PMID: 8242592 DOI: 10.1016/0165-4608(93)90181-k] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
A t(8;21)(q22;q22) without blood and bone marrow invasion by immature myeloid precursor cells occurred in a patient previously treated for polycythemia vera. The presence of a molecular rearrangement confirmed that the chromosomal abnormality was identical to that observed in acute leukemia with t(8;21). This case shows that the translocation, t(8;21), may occur in myelodysplasia and suggests that it can precede the appearance of overt leukemia.
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10
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Haas OA, Köller U, Grois N, Nowotny H. Immunophenotype of hematologic neoplasms with a translocation t(8;21). Recent Results Cancer Res 1993; 131:361-8. [PMID: 8210654 DOI: 10.1007/978-3-642-84895-7_32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- O A Haas
- Children's Cancer Research Institute, St. Anna Children's Hospital, Vienna, Austria
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11
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Abstract
A 12-year-old girl with nonmetastatic osteogenic sarcoma received treatment with doxorubicin, methotrexate, cisplatin, cyclophosphamide, bleomycin, and dactinomycin. She developed unexplained persistent pancytopenia after completion of chemotherapy. Twenty-three months after the initial diagnosis of osteosarcoma an evaluation revealed a bone marrow pattern consistent with the diagnosis of refractory anemia with excess blasts, and karyotype analysis showed characteristic findings of therapy-related myelodysplasia (loss of chromosomes 5 and 7, as well as 12p and 17p deletions). Bone marrow transplantation from an human leukocyte antigen (HLA)-compatible sibling donor was performed 26 months after the diagnosis of the primary malignancy. Although it is unproven that the alkylating agents administered to this patient were responsible for the myelodysplastic syndrome, careful follow-up of osteosarcoma patients who receive alkylating agents is warranted.
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Affiliation(s)
- A Pappo
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas 75235-9063
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12
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Auger MJ, Ross FM, Mackie MJ. 8;21 translocation with duplication of the der(21) in a patient with myelomonocytic leukemia. CANCER GENETICS AND CYTOGENETICS 1991; 51:139-41. [PMID: 1984844 DOI: 10.1016/0165-4608(91)90021-l] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
An 8;21 translocation with duplication of the der(21) is described in a 72-year-old man who presented with features of chronic myelomonocytic leukemia. Progression to acute myelomonocytic leukemia occurred within one month of diagnosis. The possible prognostic significance of the t(8;21) with duplicated der(21) in myelodysplasia is discussed.
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Affiliation(s)
- M J Auger
- Department of Haematology, Western General Hospital, Edinburgh
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13
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Pui CH, Hancock ML, Raimondi SC, Head DR, Thompson E, Wilimas J, Kun LE, Bowman LC, Crist WM, Pratt CB. Myeloid neoplasia in children treated for solid tumours. Lancet 1990; 336:417-21. [PMID: 1974952 DOI: 10.1016/0140-6736(90)91956-b] [Citation(s) in RCA: 88] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Therapy-related myeloid neoplasia developed 14 to 189 months after diagnosis of the primary malignancy in 12 out of 3365 children treated for malignant solid tumours; 6 of the 12 were in their first complete remission. The 10-year cumulative incidence of myeloid neoplasia was 1.3% (95% Cl 0.5-3.6) for the 447 patients with Hodgkin's disease, 1.3% (0.4-4.3) for the 420 with non-Hodgkin lymphoma, and 1.2% (0.3-5.2) for the 440 with neuroblastoma. This complication appeared in 1 of 180 children with brain tumours and in none of the 1878 with other malignancies. Risk of therapy-related myeloid neoplasia in patients with Hodgkin's disease was associated with recurrence of the primary malignancy, a combination of radiotherapy and chemotherapy with alkylating agents, and age greater than or equal to 12 years at diagnosis of Hodgkin's disease. Of the 8 patients who underwent chromosomal analysis of neoplastic myeloid cells, 2 showed complete loss of chromosome 7 and 4 showed t(9;11) or t(8;21) with or without del(16)(q22). The 2 patients who had received an epipodophyllotoxin had an 11q23 abnormality. The risk of therapy-related myeloid neoplasia is low in children with malignant solid tumours.
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Affiliation(s)
- C H Pui
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38101
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14
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Dallorso S, Sessarego M, Garré ML, Haupt R, Pasino M, Sansone R. Secondary acute promyelocytic leukemia with t(8;21) and t(9;22) at onset and loss of the Philadelphia chromosome at relapse. CANCER GENETICS AND CYTOGENETICS 1990; 47:41-6. [PMID: 2357686 DOI: 10.1016/0165-4608(90)90260-h] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
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.
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MESH Headings
- Bone Marrow/pathology
- Bone Marrow/ultrastructure
- Bone Marrow Transplantation
- Child
- Chromosome Banding
- Chromosome Deletion
- Chromosomes, Human, Pair 21
- Chromosomes, Human, Pair 22
- Chromosomes, Human, Pair 8
- Chromosomes, Human, Pair 9
- Genetic Markers
- Humans
- Karyotyping
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- Leukemia, Promyelocytic, Acute/surgery
- Male
- Philadelphia Chromosome
- Recurrence
- Translocation, Genetic
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Affiliation(s)
- S Dallorso
- Division of Pediatric Hematology/Oncology, G. Gaslini Children's Hospital, Genova, Italy
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