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Myeloid neoplasms associated with t(3;12)(q26.2;p13) are clinically aggressive, show myelodysplasia, and frequently harbor chromosome 7 abnormalities. Mod Pathol 2021; 34:300-313. [PMID: 33110238 DOI: 10.1038/s41379-020-00663-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/12/2020] [Accepted: 08/13/2020] [Indexed: 01/13/2023]
Abstract
Sporadic reports of t(3;12)(q26.2;p13) indicate that this abnormality is associated with myeloid neoplasms, myelodysplasia, and a poor prognosis. To better characterize neoplasms with this abnormality, we assessed 20 patients utilizing clinicopathological data, cytogenetic, and targeted next-generation sequencing analysis. We also performed literature review of 58 prior reported cases. Patients included ten men and ten women with median age 55.8 years (range, 27.8-78.8). Diagnoses included 11 acute myeloid leukemia (AML, 5 de novo and 6 secondary), 5 myelodysplastic syndromes (MDS, 3 de novo excess blasts-2 and 2 therapy-related), 2 chronic myeloid leukemia BCR-ABL1-positive blast phase (1 de novo and 1 secondary), 1 primary myelofibrosis (secondary), and 1 mixed-phenotype acute leukemia T/myeloid (MPAL, secondary). Morphologic dysplasia was identified in all AML cases (5/5), MDS cases (4/4), therapy-related cases (3/3), half of myeloproliferative neoplasm cases (1/2), and one MPAL case assessed. The t(3;12) was detected de novo and in subsequent workups in 9 and 11 patients, respectively. Seven patients had t(3;12) only and eight patients had additional chromosome 7 abnormalities. Fluorescence in-situ hybridization detected MECOM (n = 11) and ETV6 (n = 7) rearrangements in all cases assessed. FLT3 internal tandem duplication was identified in five (25%) patients. We identified 13 genetic abnormalities in the de novo group (n = 9), and 25 in the secondary disease group (n = 11). All patients received chemotherapy, with seven allogeneic and two autologous stem cell transplantations. At last follow-up, 14 (70%) patients died with median survival of 6.3 months (range, 0.1-17.3) after detection of t(3;12). In summary, t(3;12)(q26.2;p13) is a rare cytogenetic abnormality in myeloid neoplasms. Myelodysplasia, chromosome 7 abnormalities, and high blast counts are common, and the prognosis is poor. Given the close relationship between the presence of this cytogenetic abnormality and the MDS-related changes, we recommend adding t(3;12)(q26.2;p13) to the list of AML with myelodysplasia-related changes defining abnormalities of the World Health Organization 2017 classification of myeloid neoplasms.
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Wang HY, Rashidi HH. The New Clinicopathologic and Molecular Findings in Myeloid Neoplasms With inv(3)(q21q26)/t(3;3)(q21;q26.2). Arch Pathol Lab Med 2016; 140:1404-1410. [DOI: 10.5858/arpa.2016-0059-ra] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Inv(3)(q21q26)/t(3;3)(q21;q26.2) is the most common form of genetic abnormality of the so-called 3q21q26 syndrome. Myeloid neoplasms with 3q21q26 aberrancies include acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), and blast crisis of myeloproliferative neoplasms. Recent advances on myeloid neoplasms with inv(3)/t(3;3) with regard to clinicopathologic features and novel molecular or genomic findings warrant a comprehensive review on this topic.
Objective.—
To review the clinicopathologic features and molecular as well as genomic alterations in myeloid neoplasms with inv(3)/t(3;3).
Data Sources.—
The data came from published articles in English-language literature.
Conclusions.—
At the clinicopathologic front, recent studies on MDS with inv(3)/t(3;3) have highlighted their overlapping clinicopathologic features with and similar overall survival to that of inv(3)/t(3;3)-harboring AML regardless of the percentage of myeloid blasts. On the molecular front, AML and MDS with inv(3)/t(3;3) exhibit gene mutations, which affect the RAS/receptor tyrosine kinase pathway. Furthermore, functional genomic studies using genomic editing and genome engineering have shown that the reallocation of the GATA2 distal hematopoietic enhancer to the proximity of the promoter of ectopic virus integration site 1 (EVI1) without the formation of a new oncogenic fusion transcript is the molecular mechanism underlying these inv(3)/t(3;3) myeloid neoplasms. Although the AML and MDS with inv(3)/t(3;3) are listed as a separate category of myeloid malignancies in the 2008 World Health Organization classification, the overlapping clinicopathologic features, similar overall survival, and identical patterns at the molecular and genomic levels between AML and MDS patients with inv(3)/t(3;3) may collectively favor a unification of AML and MDS with inv(3)/t(3;3) as AML or myeloid neoplasms with inv(3)/t(3;3) regardless of the blast count.
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Affiliation(s)
- Huan-You Wang
- From the Department of Pathology, University of California San Diego Health System, La Jolla (Dr Wang); and the Department of Pathology and Laboratory Medicine, University of California, Davis, Sacramento (Dr Rashidi)
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Shimizu R, Yamamoto M. GATA-related hematologic disorders. Exp Hematol 2016; 44:696-705. [PMID: 27235756 DOI: 10.1016/j.exphem.2016.05.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/15/2016] [Accepted: 05/17/2016] [Indexed: 01/09/2023]
Abstract
The transcription factors GATA1 and GATA2 are fundamental regulators of hematopoiesis and have overlapping expression profiles. GATA2 is expressed in hematopoietic stem cells and early erythroid-megakaryocytic progenitors and activates a certain set of early-phase genes, including the GATA2 gene itself. GATA2 also initiates GATA1 gene expression. In contrast, GATA1 is expressed in relatively mature erythroid progenitors and facilitates the expression of genes associated with differentiation, including the GATA1 gene itself; however, GATA1 represses the expression of GATA2. Switching the GATA factors from GATA2 to GATA1 appears to be one of the key regulatory mechanisms underlying erythroid differentiation. Loss-of-function analyses using mice in vivo have indicated that GATA2 and GATA1 are functionally nonredundant and that neither can compensate for the absence of the other. However, transgenic expression of GATA2 under the transcriptional regulation of the Gata1 gene rescues lethal dyserythropoiesis in GATA1-deficient mice, illustrating that the dynamic expression profiles of these GATA factors are critically important for the maintenance of hematopoietic homeostasis. Analysis of naturally occurring leukemias in GATA1-knockdown mice revealed that leukemic stem cells undergo functional alterations in response to exposure to chemotherapeutic agents. This mechanism may also underlie the aggravating features of relapsing leukemias. Recent hematologic analyses have suggested that disturbances in the balance of the GATA factors are associated with specific types of hematopoietic disorders. Here, we describe GATA1- and GATA2-related hematologic diseases, focusing on the regulation of GATA factor gene expression.
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Affiliation(s)
- Ritsuko Shimizu
- Department of Molecular Hematology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan
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Nguyen JC, Kubik MJ, Broome HE, Curtin PT, Dell'Aquila ML, Wang HY. Successful treatment of both double minute of C-MYC and BCL-2 rearrangement containing large B-cell lymphoma with subsequent unfortunate development of therapy-related acute myeloid leukemia with t(3;3)(q26.2;q21). Pathol Res Pract 2015; 211:883-91. [PMID: 26300063 DOI: 10.1016/j.prp.2015.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 06/25/2015] [Accepted: 07/13/2015] [Indexed: 11/16/2022]
Abstract
Double minute chromosomes (DMs), although relatively frequently encountered in solid tumors, are rare in hematologic neoplasms such as acute myeloid leukemia (AML), and even rarer in lymphoid neoplasms. t(3;3)(q26.2;q21) is a very rare genetic alteration observed in myeloid neoplasm. Herein we report an interesting and unique case of concomitant C-MYC DMs and t(14;18)-containing large B-cell lymphoma, which was successfully treated with R-hyper-CVAD; unfortunately, the patient has developed a therapy-related AML (t-AML) 2 years since the start of his lymphoma treatment. His t-AML contains both t(3;3)(q26.2;q21) and monosomy 7, and the patient died of AML 10 months after the initial diagnosis of t-AML despite clinical remission. To the best of our knowledge, this is the first reported case of C-MYC DM-containing de novo large B-cell lymphoma, which was successfully treated with complete remission, but unfortunately died of t-AML harboring t(3;3)(q21;q26).
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MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Chromosomes, Human, Pair 3
- Fatal Outcome
- Flow Cytometry
- Genes, bcl-2
- Genes, myc
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/chemically induced
- Leukemia, Myeloid, Acute/genetics
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/genetics
- Male
- Middle Aged
- Mutation
- Neoplasms, Second Primary/chemically induced
- Neoplasms, Second Primary/genetics
- Translocation, Genetic
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Affiliation(s)
- John C Nguyen
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Melanie J Kubik
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - H Elizabeth Broome
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Peter T Curtin
- Division of Hematology, Department of Medicine, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Marie L Dell'Aquila
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States
| | - Huan-You Wang
- Department of Pathology, University of California San Diego Health System, La Jolla, CA 92093-0960, United States.
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Zhang X, Lancet JE, Zhang L. Molecular pathology of myelodysplastic syndromes: new developments and implications for diagnosis and treatment. Leuk Lymphoma 2015; 56:3022-30. [DOI: 10.3109/10428194.2015.1037756] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Raya JM, Martín-Santos T, Luño E, Sanzo C, Perez-Sirvent ML, Such E, Navarro JT, Millá F, Alonso E, Domingo A, Rozman M, Díaz-Beva M, Batlle A, González-de-Villambrosia S, Tuset E, Vallespí T, Ortega M, Bermejo A, Martín-Ramos M, Peri V, Solé F, Florensa L. Acute myeloid leukemia with inv(3)(q21q26.2) or t(3;3)(q21;q26.2): Clinical and biological features and comparison with other acute myeloid leukemias with cytogenetic aberrations involving long arm of chromosome 3. Hematology 2015; 20:435-441. [DOI: 10.1179/1607845415y.0000000003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- Jose Maria Raya
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Taida Martín-Santos
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Elisa Luño
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Carmen Sanzo
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Maria Luz Perez-Sirvent
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Esperanza Such
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - José Tomás Navarro
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Fuensanta Millá
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Esther Alonso
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Alicia Domingo
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - María Rozman
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Marina Díaz-Beva
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Ana Batlle
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | | | - Esperanza Tuset
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
| | - Teresa Vallespí
- Department of HematologyHospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain
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Powers HR, Bachar M, Savage N, Toscano M, Dainer PM. Azacitidine as salvage therapy for acute myeloid leukemia in a severely ill patient. Hematol Rep 2014; 6:5516. [PMID: 25317318 PMCID: PMC4194383 DOI: 10.4081/hr.2014.5516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/06/2014] [Accepted: 08/19/2014] [Indexed: 11/23/2022] Open
Abstract
Acute myeloid leukemia (AML) is a hematological malignancy of myeloid progenitor cells that disrupt normal hematopoiesis. Current chemotherapy regimens result in complete remission in many cases; however, there exists no standard efficacious therapy for refractory acute myeloid leukemia. The hypomethylating agent, azacitidine, is effective in a limited number of such cases. We present a 57-year-old Filipino male with acute myeloid leukemia who was refractory to two induction chemotherapy regimens; however, he achieved complete remission after palliative therapy with azacitidine. We report this case to demonstrate the efficacy of azacitidine in refractory acute myeloid leukemia. Although the effectiveness of azacitidine in improving overall survival has been shown, this case demonstrates the effect on remission induction in high risk AML. Further studies are needed to delineate subsets of acute myeloid leukemia in which azacitidine will serve as effective therapy and to identify other targeted agents that may potentiate its effects.
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Affiliation(s)
- Harry Ross Powers
- Department of Medicine, Medical College of Georgia, Georgia Regents University , Augusta, GA, USA
| | - Moshe Bachar
- Department of Medicine, Medical College of Georgia, Georgia Regents University , Augusta, GA, USA
| | - Natasha Savage
- Department of Pathology, Medical College of Georgia, Georgia Regents University , Augusta, GA, USA ; Charlie Norwood Veteran Affairs Medical Center , Augusta, GA, USA
| | - Michael Toscano
- Department of Pathology, Medical College of Georgia, Georgia Regents University , Augusta, GA, USA
| | - Paul M Dainer
- Charlie Norwood Veteran Affairs Medical Center , Augusta, GA, USA ; Section of Hematology/Oncology, Medical College of Georgia, Georgia Regents University , Augusta, GA, USA
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Cull EH, Watts JM, Tallman MS, Kopp P, Frattini M, Rapaport F, Rampal R, Levine R, Altman JK. Acute myeloid leukemia presenting with panhypopituitarism or diabetes insipidus: a case series with molecular genetic analysis and review of the literature. Leuk Lymphoma 2014; 55:2125-9. [PMID: 24286261 DOI: 10.3109/10428194.2013.869327] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Central diabetes insipidus (DI) is a rare finding in patients with acute myeloid leukemia (AML), usually occurring in patients with chromosome 3 or 7 abnormalities. We describe four patients with AML and concurrent DI and a fifth patient with AML and panhypopituitarism. Four of five patients had monosomy 7. Three patients had chromosome 3q21q26/EVI-1 gene rearrangements. The molecular genotype of patients with AML and DI is not known. Therefore, we performed gene sequencing of 30 genes commonly mutated in AML in three patients with available leukemia cell DNA. One patient had no identifiable mutations, and two had RUNX1 F158S mutations.
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Affiliation(s)
- Elizabeth H Cull
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine and Northwestern Memorial Hospital , Chicago, IL , USA
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Xu X, Su M, Levy NB, Mohtashamian A, Monaghan S, Kaur P, Zaremba C, Garcia R, Broome HE, Dell’Aquila ML, Wang HY. Myeloid neoplasm with t(3;8)(q26;q24): report of six cases and review of the literature. Leuk Lymphoma 2014; 55:2532-7. [DOI: 10.3109/10428194.2013.878460] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Xiangdong Xu
- Department of Pathology and Immunology, Washington University in St. Louis,
St. Louis, MO, USA
| | - Mu Su
- Department of Pathology, University of Texas Southwestern Medical Center at Dallas,
Dallas, TX, USA
| | - Norman B. Levy
- Department of Pathology, Dartmonth-Hitchcook Medical Center,
Lebanon, NH, USA
| | | | - Sara Monaghan
- Department of Pathology, University of Texas Southwestern Medical Center at Dallas,
Dallas, TX, USA
| | - Prabhjot Kaur
- Department of Pathology, Dartmonth-Hitchcook Medical Center,
Lebanon, NH, USA
| | - Charles Zaremba
- Department of Pathology, University of Texas Southwestern Medical Center at Dallas,
Dallas, TX, USA
| | - Rolando Garcia
- Department of Pathology, University of Texas Southwestern Medical Center at Dallas,
Dallas, TX, USA
| | - H. Elizabeth Broome
- Department of Pathology, University of California San Diego Health System,
La Jolla, CA, USA
| | - Marie L. Dell’Aquila
- Department of Pathology, University of California San Diego Health System,
La Jolla, CA, USA
| | - Huan-You Wang
- Department of Pathology, University of California San Diego Health System,
La Jolla, CA, USA
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Polyploidy in myelofibrosis: analysis by cytogenetic and SNP array indicates association with advancing disease. Mol Cytogenet 2013; 6:59. [PMID: 24341401 PMCID: PMC3906908 DOI: 10.1186/1755-8166-6-59] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 11/25/2013] [Indexed: 11/10/2022] Open
Abstract
Background Myelofibrosis occurs as primary myelofibrosis or as a late occurrence in the evolution of essential thrombocythaemia and polycythaemia vera. It is the rarest of the three classic myeloproliferative neoplasms (MPN). Polyploidy has only rarely been reported in MPN despite the prominent involvement of abnormal megakaryocytes. The use of peripheral blood samples containing increased numbers of haematopoietic progenitors has improved the output from cytogenetic studies in myelofibrosis and together with the use of single nucleotide polymorphism arrays (SNPa) has contributed to an improved knowledge regarding the diverse genetic landscape of this rare disease. Results Cytogenetic studies performed on a consecutive cohort of 42 patients with primary or post ET/PV myelofibrosis showed an abnormal karyotype in 24 cases and of these, nine showed a polyploid clone. Six of the nine cases showed a tetraploid (4n) subclone, whereas three showed mixed polyploid subclones with both tetraploid and octoploid (4n/8n) cell lines. The abnormal clone evolved from a near diploid karyotype at the initial investigation to a tetraploid karyotype in follow-up cytogenetic analysis in four cases. In total, six of the nine polyploid cases showed gain of 1q material. The remaining three cases showed polyploid metaphases, but with no detectable structural karyotypic rearrangements. Three of the nine cases showed chromosome abnormalities of 6p, either at diagnosis or later acquired. SNPa analysis on eight polyploid cases showed additional changes not previously recognised by karyotype analysis alone, including recurring changes involving 9p, 14q, 17q and 22q. Except for gain of 1q, SNPa findings from the polyploid group compared to eight non-polyploid cases with myelofibrosis found no significant differences in the type of abnormality detected. Conclusions The study showed the use of peripheral blood samples to be suitable for standard karyotyping evaluation and DNA based studies. The overall profile of abnormalities found were comparable with that of post-MPN acute myeloid leukaemia or secondary myelodysplastic syndrome and cases in the polyploidy group were associated with features of high risk disease. The above represents the first documented series of polyploid karyotypes in myelofibrosis and shows a high representation of gain of 1q.
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Bennour A, Tabka I, Ben Youssef Y, Kmeira Z, Khelif A, Saad A, Sennana H. A novel t(3;12)(q21;p13) translocation in a patient with accelerated chronic myeloid leukemia after imatinib and nilotinib therapy. Cancer Biol Med 2013; 10:47-51. [PMID: 23691445 PMCID: PMC3643689 DOI: 10.7497/j.issn.2095-3941.2013.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 03/07/2013] [Indexed: 11/23/2022] Open
Abstract
The acquisition of secondary chromosomal aberrations in chronic myeloid leukemia (CML) patients with Philadelphia chromosome-positive (Ph+) karyotype signifies clonal evolution associated with the progression of the disease to its accelerated or blastic phase. Therefore, these aberrations have clinical and biological significance. T(3;12)(q26;p13), which is a recurrent chromosomal aberration observed in myeloid malignancies, is typically associated with dysplasia of megakaryocytes, multilineage involvement, short duration of any blastic phase, and extremely poor prognosis. We have identified a recurrent reciprocal translocation between chromosomes 3 and 12 with different breakpoint at bands 3q21 in the malignant cells from a 28-year-old man. The patient was initially diagnosed as having Ph+ CML in the chronic phase. The t(3;12)(q21;p13) translocation occurred 4 years after the patient was first diagnosed with CML while undergoing tyrosine kinase inhibitor therapy. We confirmed the t(3;12)(q21;p13) translocation via fluorescence in situ hybridization assay by using whole-chromosome paint probes for chromosomes 3 and 12. Our findings demonstrate that, similar to other recurrent translocations involving 3q26 such as t(3;3) and t(3;21), the t(3;12)(q21;p13) translocation is implicated not only in myelodysplastic syndrome and acute myeloid leukemia but also in the progression of CML. These findings extend the disease spectrum of this cytogenetic aberration.
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Affiliation(s)
- Ayda Bennour
- Department of Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Teaching Hospital, Sousse 4000, Tunisia
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Thrombocytosis and Essential Thrombocythemia. Platelets 2013. [DOI: 10.1016/b978-0-12-387837-3.00049-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Grygalewicz B, Woroniecka R, Pastwińska A, Rygier J, Krawczyk P, Borg K, Makuch-Łasica H, Patkowska E, Pieńkowska-Grela B. Acute panmyelosis with myelofibrosis with EVI1 amplification. Cancer Genet 2012; 205:255-60. [DOI: 10.1016/j.cancergen.2012.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 02/01/2012] [Accepted: 02/09/2012] [Indexed: 11/26/2022]
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De novo acute myeloid leukemia with inv(3)(q21q26.2) or t(3;3)(q21;q26.2): a clinicopathologic and cytogenetic study of an entity recently added to the WHO classification. Mod Pathol 2011; 24:384-9. [PMID: 21113141 DOI: 10.1038/modpathol.2010.210] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Acute myeloid leukemia with inv(3)(q21q26.2) or t(3;3)(q21;q26.2) is a rare type of leukemia recently added to the World Health Organization (WHO) classification scheme. In this study, we analyzed the clinicopathologic and cytogenetic features of 30 cases of de novo acute myeloid leukemia with inv(3)/t(3;3). The median patient age was 53 years (range, 27-77 years). The platelet count was variable (range, 21-597 × 10(9)/l, median: 128 × 10(9)/l), and two (6.7%) patients presented with thrombocytosis (>450 × 10(9)/l). Morphologically, these neoplasms showed a spectrum of findings. Myelomonocytic differentiation was most common in 11 (37%) cases. Morphological evidence of dysplasia was observed in at least one lineage in 23 of 25 (92%) cases in which maturing elements could be assessed. In all, 5 (17%) patients had isolated inv(3) or t(3;3) and 25 (83%) patients had additional cytogenetic abnormalities, most often monosomy 7 (40%). Eleven (37%) patients had a complex karyotype (≥ 3 additional abnormalities). FLT3 gene mutation by internal tandem duplication was identified in 2 of 23 (9%) cases assessed. No clinical, pathological, or cytogenetic features independent of inv(3) or t(3;3) correlated with a worse outcome. However, patients treated with allogeneic stem cell transplantation (n=11) had a significantly better survival than did those treated with chemotherapy alone (n=17) (13.8 vs 8.0 months, P=0.041). We conclude that de novo acute myeloid leukemia associated with inv(3)/t(3;3) is an aggressive type of leukemia regardless of morphological or karyotypic findings, supporting the inclusion of this disease as a specific entity defined by inv(3)/t(3;3) in the WHO classification. Allogeneic stem cell transplantation seems to improve outcome in patients with this disease.
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Donor-cell MDS in a 12-year-old girl 3 years after allogeneic hematopoietic SCT for MDS, both with a t(3;3)(q21;q26) cytogenetic aberration. Bone Marrow Transplant 2010; 46:908-10. [PMID: 20838388 DOI: 10.1038/bmt.2010.214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Shearer BM, Sukov WR, Flynn HC, Knudson RA, Ketterling RP. Development of a dual-color, double fusion FISH assay to detect RPN1/EVI1 gene fusion associated with inv(3), t(3;3), and ins(3;3) in patients with myelodysplasia and acute myeloid leukemia. Am J Hematol 2010; 85:569-74. [PMID: 20556821 DOI: 10.1002/ajh.21746] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Approximately 2-3% of adult patients with acute myeloid leukemia harbor a rearrangement of RPN1 (at 3q21) and EVI1 (at 3q26.2) as inv(3)(q21q26.2), t(3;3)(q21;q26.2), or ins(3;3)(q26.2;q21q26.2). The most recent World Health Organization (WHO) classification has designated AML with inv(3) or t(3;3) and associated RPN1/EVI1 fusion, as a distinct AML subgroup associated with an unfavorable prognosis. We have created a dual color, double fusion fluorescence in situ hybridization (D-FISH) assay to detect fusion of the RPN1 and EVI1 genes. A blinded investigation was performed using 30 normal bone marrow samples and 51 bone marrow samples from 17 patients with inv(3)(q21q26.2), 11 patients with t(3;3)(q21;q26.2), and one patient with ins(3;3)(q26.2;q21q26.2) previously defined by chromosome analysis. The unblinded results indicated abnormal RPN1/EVI1 fusion results in 30 (97%) of 31 samples from the inv(3)(q21q26.2) group including seven bone marrow samples for which chromosome analysis was unsuccessful or failed to detect an inv(3)(q21q26.2). Abnormal FISH results were detected in 14 (88%) of 16 samples with t(3;3)(q21;q26.2) and in the sole sample with an ins(3;3)(q26.2;q21q26.2). All 30 negative controls were normal and were used to establish a normal cutoff of 0.6% for the typical abnormal D-FISH signal pattern. Overall, this D-FISH assay was more accurate than chromosome analysis and based on the normal cutoff of 0.6%, this assay can be used for minimal residual disease detection and disease monitoring in patients with RPN1/EVI1 fusion.
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MESH Headings
- Adolescent
- Adult
- Aged
- Bone Marrow Cells/ultrastructure
- Chromosome Inversion
- Chromosomes, Artificial, Bacterial
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 3/ultrastructure
- DNA Probes
- Female
- Humans
- In Situ Hybridization, Fluorescence/methods
- Leukemia, Myeloid, Acute/genetics
- Male
- Middle Aged
- Mutagenesis, Insertional
- Myelodysplastic Syndromes/genetics
- Oncogene Proteins, Fusion/genetics
- Single-Blind Method
- Translocation, Genetic
- Young Adult
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Affiliation(s)
- Brandon M Shearer
- Department of Laboratory Medicine and Pathology, Division of Laboratory Genetics, Mayo Clinic, 200 First Street SW, Rochester, Minnesota 55905, USA
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18
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Lin P, Luthra R, Nussenzveig RH, Medeiros LJ. JAK2 V617F mutation is uncommon in patients with the 3q21q26 syndrome. Hum Pathol 2010; 41:758-62. [DOI: 10.1016/j.humpath.2009.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 11/02/2009] [Accepted: 11/04/2009] [Indexed: 10/19/2022]
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19
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Abstract
Session 5 of 2007 Workshop of the Society for Hematopathology/European Association for Haematopathology focused on therapy-related myeloid neoplasms. This report discusses the diversity and relevance of clinical, pathologic, and genetic features and provides an update on the pathogenesis of these disorders. We highlight common diagnostic issues such as the differentiation between therapy-related myelodysplastic syndrome and therapy-related acute erythroid leukemia. As similar therapeutic interventions are frequently considered for patients with either of these diagnoses, in the current World Health Organization classification, regardless of morphologic presentation, therapy-related myeloid neoplasms are considered together as a unique clinicopathologic syndrome of therapy-related myelodysplastic syndrome/acute myeloid leukemia. Nevertheless, recognition of the diverse morphologic features is crucial as bone marrow morphologic examination remains the first and important step of patient evaluation. We also present examples of therapy-related acute myeloid leukemias with recurrent cytogenetic abnormalities. In these cases, the precise classification is clinically important because it is associated with distinct clinical outcome.
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Affiliation(s)
- Magdalena Czader
- Department of Pathology and Laboratory Medicine/Clarian Pathology Laboratory, Indiana University School of Medicine, Indianapolis
| | - Attilio Orazi
- New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY
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20
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Wong KF, Wong WS, Siu LLP, Lau TC. JAK2 V617F mutation in myeloid neoplasms with 3q21 and 3q26 abnormalities in Chinese patients. Leuk Lymphoma 2009; 50:1386-8. [PMID: 19562620 DOI: 10.1080/10428190903040022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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21
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Bernimoulin M, Stern M, Tichelli A, Jotterand M, Gratwohl A, Nissen C. Leukemic cluster growth in culture is an independent risk factor for acute myeloid leukemia and short survival in patients with myelodysplastic syndrome. Acta Haematol 2008; 119:226-35. [PMID: 18566541 DOI: 10.1159/000140675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2008] [Accepted: 04/11/2008] [Indexed: 11/19/2022]
Abstract
In patients with myelodysplastic syndrome (MDS) precursor cell cultures (colony-forming unit cells, CFU-C) can provide an insight into the growth potential of malignant myeloid cells. In a retrospective single-center study of 73 untreated MDS patients we assessed whether CFU-C growth patterns were of prognostic value in addition to established criteria. Abnormalities were classified as qualitative (i.e. leukemic cluster growth) or quantitative (i.e. strongly reduced/absent growth). Thirty-nine patients (53%) showed leukemic growth, 26 patients (36%) had strongly reduced/absent colony growth, and 12 patients showed both. In a univariate analysis the presence of leukemic growth was associated with strongly reduced survival (at 10 years 4 vs. 34%, p = 0.004), and a high incidence of transformation to AML (76 vs. 32%, p = 0.01). Multivariate analysis identified leukemic growth as a strong and independent predictor of early death (relative risk 2.12, p = 0.03) and transformation to AML (relative risk 2.63, p = 0.04). Quantitative abnormalities had no significant impact on the disease course. CFU-C assays have a significant predictive value in addition to established prognostic factors in MDS. Leukemic growth identifies a subpopulation of MDS patients with poor prognosis.
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22
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Kasahara K, Nakayama Y, Yamaguchi N. v-Src and c-Src, nonpalmitoylated Src-family kinases, induce perinuclear accumulation of lysosomes through Rab7 in a kinase activity-independent manner. Cancer Lett 2008; 262:19-27. [DOI: 10.1016/j.canlet.2007.11.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2007] [Revised: 11/20/2007] [Accepted: 11/20/2007] [Indexed: 10/22/2022]
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23
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Haimi M, Elhasid R, Moustafa N, Gershoni-Baruch R. Aberration of 3q and monosomy 7 in a child with acute myelogenous leukemia. ACTA ACUST UNITED AC 2007; 174:78-81. [PMID: 17350473 DOI: 10.1016/j.cancergencyto.2006.11.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2006] [Accepted: 11/17/2006] [Indexed: 10/23/2022]
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24
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Tefferi A. Thrombocytosis and Essential Thrombocythemia. Platelets 2007. [DOI: 10.1016/b978-012369367-9/50818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Pardanani A. Dysregulated EVI1 expression in myeloid malignancies. Leuk Lymphoma 2006; 47:2443-4. [PMID: 17169788 DOI: 10.1080/10428190601040258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Lin P, Medeiros LJ, Yin CC, Abruzzo LV. Translocation (3;8)(q26;q24): a recurrent chromosomal abnormality in myelodysplastic syndrome and acute myeloid leukemia. ACTA ACUST UNITED AC 2006; 166:82-5. [PMID: 16616115 DOI: 10.1016/j.cancergencyto.2005.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2005] [Revised: 10/04/2005] [Accepted: 10/06/2005] [Indexed: 11/20/2022]
Abstract
We identified a reciprocal translocation between chromosomes 3 and 8, with breakpoints at bands 3q26 and 8q24, in five patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML). The t(3;8)(q26;q24) was the sole cytogenetic aberration in two patients, was associated with trisomy 13 in one patient, and occurred with monosomy 7 in two patients. In three patients, the AML or MDS developed 36, 52, and 57 months following chemotherapy for soft tissue sarcoma, mantle cell lymphoma, and diffuse large B-cell lymphoma, respectively; in these three patients, the neoplasms were considered to be therapy-related. All five patients displayed marked trilineage dysplasia and variable degrees of cytopenias, with marked thrombocytosis noted in one patient and a normal platelet count in another patient. All patients were treated with combination chemotherapy; at writing, four were still alive and one had died during a follow-up period ranging from 1 to 16 months. We conclude that the t(3;8)(q26;q24) is a recurrent translocation associated with therapy-related MDS/AML or de novo AML, and is frequently associated with monosomy 7.
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MESH Headings
- Acute Disease
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Chromosome Aberrations
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 8/genetics
- Female
- Humans
- Karyotyping
- Leukemia, Myeloid/chemically induced
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/pathology
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/pathology
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Lymphoma, Large B-Cell, Diffuse/pathology
- Lymphoma, Mantle-Cell/drug therapy
- Lymphoma, Mantle-Cell/pathology
- Male
- Middle Aged
- Myelodysplastic Syndromes/chemically induced
- Myelodysplastic Syndromes/genetics
- Myelodysplastic Syndromes/pathology
- Neoplasm Recurrence, Local/chemically induced
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/pathology
- Sarcoma/drug therapy
- Sarcoma/pathology
- Translocation, Genetic/genetics
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Affiliation(s)
- Pei Lin
- Department of Hematopathology, M. D. Anderson Cancer Center, Box 72, The University of Texas, Houston, TX 77030, USA.
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27
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Meyer-Monard S, Parlier V, Passweg J, Mühlematter D, Hess U, Bargetzi M, Kühne T, Cabrol C, Gratwohl A, Jotterand M, Tichelli A. Combination of broad molecular screening and cytogenetic analysis for genetic risk assignment and diagnosis in patients with acute leukemia. Leukemia 2006; 20:247-53. [PMID: 16408102 DOI: 10.1038/sj.leu.2404044] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We evaluated the impact of genetic analysis combining cytogenetics and broad molecular screening on leukemia diagnosis according to World Health Organization (WHO) and on genetic risk assignment. A two-step nested multiplex RT-PCR assay was used that allowed the detection of 29 fusion transcripts. A total of 186 patients (104 males (56%), 174 adults (94%), 12 children (6%), 155 AML (83%), 31 ALL (17%)) characterized by morphology and immunophenotyping were included. Of these 186 patients, 120 (65%) had a genetic abnormality. Molecular typing revealed a fusion transcript in 49 (26%) patients and cytogenetic analysis revealed an abnormal karyotype in 119 (64%). A total of 27 (14%) cases were genetically classified as favorable, 107 (58%) intermediate and 52 (28%) unfavorable. For 38 (20%) patients, there was a discrepancy in the genetic risk assignments obtained from broad molecular screening and cytogenetics. Cryptic fusion transcripts in nine (5%) patients changed the genetic risk assignment in four and the WHO classification in four patients. In 34 patients (18%), cytogenetics defined the risk assignment by revealing structural and numerical chromosomal abnormalities not detected by molecular screening. Broad molecular screening and cytogenetics are complementary in the diagnosis and genetic risk assignment of acute leukemia.
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Affiliation(s)
- S Meyer-Monard
- Hematology, University Hospital Basel, Basel, Switzerland.
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28
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Beyer V, Mühlematter D, Parlier V, Cabrol C, Bougeon-Mamin S, Solenthaler M, Tobler A, Pugin P, Gregor M, Hitz F, Hess U, Chapuis B, Laurencet F, Schanz U, Schmidt PM, van Melle G, Jotterand M. Polysomy 8 defines a clinico-cytogenetic entity representing a subset of myeloid hematologic malignancies associated with a poor prognosis: report on a cohort of 12 patients and review of 105 published cases. ACTA ACUST UNITED AC 2005; 160:97-119. [PMID: 15993266 DOI: 10.1016/j.cancergencyto.2004.12.003] [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: 09/07/2004] [Revised: 11/16/2004] [Accepted: 12/10/2004] [Indexed: 01/14/2023]
Abstract
Tetrasomy, pentasomy, and hexasomy 8 (polysomy 8) are relatively rare compared to trisomy 8. Here we report on a series of 12 patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative disorder (MPD) associated with polysomy 8 as detected by conventional cytogenetics and fluorescence in situ hybridization (FISH). In an attempt to better characterize the clinical and hematological profile of this cytogenetic entity, our data were combined with those of 105 published patients. Tetrasomy 8 was the most common presentation of polysomy 8. In 60.7% of patients, polysomy 8 occurred as part of complex changes (16.2% with 11q23 rearrangements). No cryptic MLL rearrangements were found in cases in which polysomy 8 was the only karyotypic change. Our study demonstrates the existence of a polysomy 8 syndrome, which represents a subtype of AML, MDS, and MPD characterized by a high incidence of secondary diseases, myelomonocytic or monocytic involvement in AML and poor overall survival (6 months). Age significantly reduced median survival, but associated cytogenetic abnormalities did not modify it. Cytogenetic results further demonstrate an in vitro preferential growth of the cells with a high level of aneuploidy suggesting a selective advantage for polysomy 8 cells.
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Affiliation(s)
- Valérie Beyer
- Service de Génétique Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne CH-1011, Switzerland
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29
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Steensma DP, List AF. Genetic testing in the myelodysplastic syndromes: molecular insights into hematologic diversity. Mayo Clin Proc 2005; 80:681-98. [PMID: 15887439 DOI: 10.4065/80.5.681] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The myelodysplastic syndromes (MDS) are associated with a diverse set of acquired somatic genetic abnormalities. Bone marrow karyotyping provides important diagnostic and prognostic information and should be attempted in all patients who are suspected of having MDS. Fluorescent in situ hybridization (FISH) studies on blood or marrow may also be valuable in selected cases, such as patients who may have 5q- syndrome or those who have undergone hematopoletic stem cell transplantation. The MDS-associated cytogenetic abnormalities that have been defined by karyotyping and FISH studies have already contributed substantially to our current understanding of the biology of malignant myeloid disorders, but the pathobiological meaning of common, recurrent chromosomal lesions such as del(5q), del(20q), and monosomy 7 is still unknown. The great diversity of the cytogenetic findings described in MDS highlights the molecular heterogeneity of this cluster of diseases. We review the common and pathophysiologically interesting genetic abnormalities associated with MDS, focusing on the clinical utility of conventional cytogenetic assays and selected FISH studies. In addition, we discuss a series of well-defined MDS-associated point mutations and outline the potential for further insights from newer techniques such as global gene expression profiling and array-based comparative genomic hybridization.
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Affiliation(s)
- David P Steensma
- Department of Internal Medicine and Division of Hematology, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA
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30
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Cabello AI, Collado R, Ruiz MA, Martínez J, Navarro I, Ferrer R, Sosa AM, Carbonell F. A retrospective analysis of myelodysplastic syndromes with thrombocytosis: reclassification of the cases by WHO proposals. Leuk Res 2005; 29:365-70. [PMID: 15725469 DOI: 10.1016/j.leukres.2004.07.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2004] [Accepted: 07/20/2004] [Indexed: 11/25/2022]
Abstract
Myelodysplastic syndromes (MDS) show occasionally thrombocytosis, common feature of myeloproliferative diseases (MPD), with the overlapping of both disorders. Classically, thrombocytosis has been associated with some MDS subtypes: refractory anaemia with ringed sideroblasts (RARS), 5q- syndrome and those MDS with 3q chromosome rearrangements. The recent WHO classification recognises an unclassifiable MDS/MPD category including some of these disorders. Our aim is to determine the frequency of presentation, subtype classification and chromosome abnormalities of MDS with thrombocytosis diagnosed in our institution. Between 1990 and 2003 we studied 317 SMD patients according to FAB and WHO revised classifications and identified 22 cases presenting thrombocytosis associated with dysplasia, that are analysed in this article.
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Affiliation(s)
- Ana I Cabello
- Service of Hematology, Consorcio Hospital General Universitario of Valencia, Spain.
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31
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Candoni A, Silvestri F, Buonamici S, Li D, Reddy P, Galili N, Nucifora G, Raza A. Targeted therapies in myelodysplastic syndromes: ASH 2003 review. Semin Hematol 2004; 41:13-20. [PMID: 15190511 DOI: 10.1053/j.seminhematol.2004.02.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The myelodysplastic syndromes (MDS) continue to pose conceptual and practical conundrums because of their heterogeneity and therapeutic challenges. They are not restricted to the presence of clonal cells that are prone to excessive proliferation and premature apoptosis. In MDS the bone marrow microenvironment also is abnormal and exhibits an excess of proinflammatory cytokines, especially tumor necrosis factor (TNF), neoangiogenesis, and poorly defined immune defects. Thalidomide, a drug with anti-TNF, antiangiogenic, and immunomodulatory activities, and other agents with anti-TNF effects, such as pentoxifylline, etanercept, and infliximab, have produced hematologic improvement in 20% to 40% of patients. These agents may provide effective therapy for a subset of lower-risk MDS patients, even if the drugs target the bone marrow microenvironment predominantly. However, in higher-risk MDS patients, especially those with more than 10% blasts, it is important to eliminate abnormal cell clones; drugs used for this purpose have included arsenic trioxide, topotecan, the farnesyl transferase inhibitor tipifarnib, and demethylating agents, such as 5-azacytidine and decitabine. To increase the therapeutic index, a combination strategy may be preferable for higher-risk MDS patients, in whom the seed (clone) and the soil (bone marrow microenvironment) must be targeted simultaneously. The challenge is to recognize the subset that is likely to respond to a given drug so that patients can be preselected for therapy.
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Affiliation(s)
- Anna Candoni
- Section of Myeloids Diseases and MDS Center, Rush University, Chicago, IL 60612, USA
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32
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Raza A, Buonamici S, Lisak L, Tahir S, Li D, Imran M, Chaudary NI, Pervaiz H, Gallegos JA, Alvi MI, Mumtaz M, Gezer S, Venugopal P, Reddy P, Galili N, Candoni A, Singer J, Nucifora G. Arsenic trioxide and thalidomide combination produces multi-lineage hematological responses in myelodysplastic syndromes patients, particularly in those with high pre-therapy EVI1 expression. Leuk Res 2004; 28:791-803. [PMID: 15203277 DOI: 10.1016/j.leukres.2003.11.018] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Twenty-eight myelodysplastic syndromes (MDS) patients were treated with arsenic trioxide (ATO) and thalidomide. Seven patients responded including one complete hematologic and cytogenetic response and one with regression in spleen size. Two trilineage responses were seen in patients with inv(3)(q21q26.2). Three of five patients who had high pre-therapy EVI1 levels showed unexpectedly good responses while two died early in the first cycle. In vitro studies using 32Dcl3 cells forced to express EVI1 confirmed increased sensitivity of these cells to ATO. Both low/high risk MDS may benefit significantly from therapy with ATO/thalidomide, and those with high pre-therapy EVI1 expression may be uniquely sensitive.
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Affiliation(s)
- Azra Raza
- Section of Myeloid Diseases and MDS Center, Rush University, Rush-Presbyterian-St. Luke's Medical Center, 2242 West Harrison Street, Suite 108, Chicago, IL 60612-3515, USA.
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33
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Beyer V, Castagné C, Mühlematter D, Parlier V, Gmür J, Hess U, Kovacsovics T, Meyer-Monard S, Tichelli A, Tobler A, Jacky E, Schanz U, Bargetzi M, Hagemeijer A, de Witte T, van Melle G, Jotterand M. Systematic screening at diagnosis of −5/del(5)(q31), −7, or chromosome 8 aneuploidy by interphase fluorescence in situ hybridization in 110 acute myelocytic leukemia and high-risk myelodysplastic syndrome patients: concordances and discrepancies with conventional cytogenetics. ACTA ACUST UNITED AC 2004; 152:29-41. [PMID: 15193439 DOI: 10.1016/j.cancergencyto.2003.10.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2003] [Accepted: 10/03/2003] [Indexed: 10/26/2022]
Abstract
To assess the contribution of interphase fluorescence in situ hybridization (I-FISH) toward the detection of recurring unbalanced chromosomal anomalies at diagnosis, a systematic screening of -5/del(5)(q31), -7, and chromosome 8 aneuploidy was performed on 110 patients with acute myelocytic leukemia or high-risk myelodysplastic syndrome. We searched for monosomy 5/del(5q) by one-color I-FISH with a probe specific for the 5q31 region and for -7/8 by dual-color I-FISH with centromeric probes for chromosomes 7 and 8. Discrepancies between conventional cytogenetics (CC) and I-FISH were observed in 8 of the 110 patients (7.3%). For -5/del(5)(q31), a discordance was observed in two patients with complex abnormalities involving chromosome 5. Whereas no discordance was observed for -7, I-FISH detected a trisomy 7 unnoticed by CC in two cases. In six patients, I-FISH revealed a chromosome 8 aneuploidy not detected by CC. Our results illustrate that, when using this specific set of probes, I-FISH is of special interest for the detection of minor clones with chromosome 8 aneuploidy, breakpoint assessment, and sequence identification (markers). Also, to avoid misinterpretations, I-FISH should not be used alone at disease presentation, particularly in cases complex changes that have clearly established prognostic significance.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aneuploidy
- Chromosome Deletion
- Chromosomes, Human, Pair 5/genetics
- Chromosomes, Human, Pair 7/genetics
- Chromosomes, Human, Pair 8/genetics
- Cytogenetic Analysis
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Interphase
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Male
- Middle Aged
- Myelodysplastic Syndromes/diagnosis
- Myelodysplastic Syndromes/genetics
- Trisomy
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Affiliation(s)
- Valérie Beyer
- Unité de cytogénétique du cancer, Service de génétique médicale, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne CH-1011, Switzerland
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34
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Kaloutsi V, Hadjileontis C, Tsatalas C, Sambani C, Kostopoulos I, Papadimitriou C. Occurrence of a variant Philadelphia translocation, t(10;22), in de novo acute megakaryoblastic leukemia. ACTA ACUST UNITED AC 2004; 152:52-5. [PMID: 15193441 DOI: 10.1016/j.cancergencyto.2003.08.022] [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] [Received: 06/25/2003] [Revised: 08/20/2003] [Accepted: 08/27/2003] [Indexed: 11/19/2022]
Abstract
Acute megakaryoblastic leukemia (AMegL) in adults is a very rare subtype of acute myeloid leukemia (AML) and is characterized by a larger diversity of chromosomal abnormalities than the other subtypes, including 3q21q26 changes, aberrations of chromosomes 5 and 7, and the t(9;22)(q34;q11). We report the case of a 24-year-old patient with de novo AMegL and thrombocythemic cell count. Diagnosis was established with a bone marrow biopsy, and cytogenetics with G-banding revealed a t(10;22), which by FISH, was found to be a variant Philadelphia translocation involving chromosome 10q in all 20 metaphases analyzed. We believe that this is the first report of de novo AMegL with this chromosomal abnormality, and its possible correlation with morphology and thrombocytosis is discussed.
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MESH Headings
- Adult
- Bone Marrow/pathology
- Chromosome Aberrations
- Chromosome Banding
- Chromosomes, Human, Pair 10/genetics
- Chromosomes, Human, Pair 12/genetics
- Female
- Humans
- Karyotyping
- Leukemia, Megakaryoblastic, Acute/diagnosis
- Leukemia, Megakaryoblastic, Acute/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Philadelphia
- Translocation, Genetic/genetics
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Affiliation(s)
- Vassiliki Kaloutsi
- Department of Pathology, Medical School, Aristotle University of Thessaloniki, 54006, Thessaloniki, Greece.
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35
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Lahortiga I, Vázquez I, Agirre X, Larrayoz MJ, Vizmanos JL, Gozzetti A, Calasanz MJ, Odero MD. Molecular heterogeneity in AML/MDS patients with 3q21q26 rearrangements. Genes Chromosomes Cancer 2004; 40:179-89. [PMID: 15138998 DOI: 10.1002/gcc.20033] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Patients with 3q21q26 rearrangements seem to share similar clinicopathologic features and a common molecular mechanism, leading to myelodysplasia or acute myeloid leukemia (AML). The ectopic expression of EVI1 (3q26) has been implicated in the dysplasia that characterizes this subset of myeloid neoplasias. However, lack of EVI1 expression has been reported in several cases, and overexpression of EVI1 was detected in 9% of AML cases without 3q26 abnormalities. We report the molecular characterization of seven patients with inv(3)(q21q26), t(3;3)(q21;q26) or related abnormalities. EVI1 expression was detected in only one case, and thus ectopic expression of this gene failed to explain all of these cases. GATA2 (3q21) was found to be overexpressed in 5 of the 7 patients. GATA2 is highly expressed in stem cells, and its expression dramatically decreases when erythroid and megakaryocytic differentiation proceeds. No mutations in GATA1 were found in any patient, excluding loss of function of GATA1 as the cause of GATA2 overexpression. We report finding molecular heterogeneity in patients with 3q21q26 rearrangements in both breakpoints and in the expression pattern of the genes near these breakpoints. Our data suggest that a unique mechanism is not likely to be involved in 3q21q26 rearrangements.
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MESH Headings
- Acute Disease
- Adult
- Aged
- Chromosome Banding/methods
- Chromosomes, Human, Pair 3
- Female
- Gene Expression Regulation, Leukemic
- Genetic Heterogeneity
- Humans
- In Situ Hybridization, Fluorescence/methods
- Karyotyping/methods
- Leukemia, Megakaryoblastic, Acute/genetics
- Leukemia, Monocytic, Acute/genetics
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myelomonocytic, Acute/genetics
- Male
- Middle Aged
- Myelodysplastic Syndromes/genetics
- Recombination, Genetic/genetics
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Affiliation(s)
- Idoya Lahortiga
- Department of Genetics, University of Navarra, Pamplona, Spain
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36
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Abstract
The classification of myeloid neoplasms now includes CMPD, mixed CMPD/ MDS, MDS, and acute myeloid leukemias. CMPD and CMPD/MDS, both clonal stem cell diseases, share myeloproliferative features, including typical hypercellular marrows, organomegaly, and cell lineage maturation. The CMPD generally differ by which myeloid cell lineage dominates hematopoiesis, and the main diseases include CML, PV, ET, and CIM. The mixed CMPD/MDS disorders also show dysplastic features and variable amounts of effective hematopoiesis; these disorders include CMML, JMML, and atypical CML. Given the overlap in morphology among these diseases, correlation with clinical, hematologic, and cytogenetic/molecular genetic findings is imperative for precise classification.
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Affiliation(s)
- Tracy I George
- Department of Pathology, Stanford University Medical Center, 300 Pasteur Drive, Room H1501B, Stanford, CA 94305-5627, USA.
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37
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Castagné C, Mühlematter D, Beyer V, Parlier V, van Melle G, Jotterand M. Determination of cutoff values to detect small aneuploid clones by interphase fluorescence in situ hybridization: the Poisson model is a more appropriate approach. Should single-cell trisomy 8 be considered a clonal defect? ACTA ACUST UNITED AC 2003; 147:99-109. [PMID: 14623458 DOI: 10.1016/s0165-4608(03)00189-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We applied a dual-color interphase in situ fluorescence hybridization (I-FISH) technique using centromeric probes specific to chromosomes 7 and 8 on 20 control samples in order to define the statistical model best suited to determine cutoff values for detection of small abnormal clones. We found that the Poisson model is a more appropriate approach than a Gaussian model. Then, based on the analysis of 91 samples from 80 patients with myelocytic malignant hemopathies and either clonal or nonclonal -7 or +8 as determined with conventional cytogenetics (CC), we compared the respective power of I-FISH and CC for detection of aneuploidy, with special emphasis on the potential contribution of I-FISH as a complement to CC in the case of small abnormal clones. The I-FISH results were positive in samples with clonal -7 or +8 according to CC analysis. Whereas I-FISH was negative in samples with nonclonal -7 according to CC, thus confirming the reliability of the criteria used to define the clonality of -7; the situation was different with nonclonal +8. I-FISH revealed the clonality of +8 in most samples with single-cell +8. In several cases, however, the unquestionable clonal nature of +8, as evidenced during follow-up, could not be established with either CC or I-FISH according to accepted criteria. Our data suggest that, in case of a single metaphase with +8, the general rule should be amended and the single-cell +8 should be considered and reported as potentially clonal.
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Affiliation(s)
- Chantal Castagné
- Unité de cytogénétique du cancer, Service de génétique médicale, Centre Hospitalier Universitaire Vaudois, 1011 Lausanne, Switzerland
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38
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Edinger AL, Cinalli RM, Thompson CB. Rab7 Prevents Growth Factor-Independent Survival by Inhibiting Cell-Autonomous Nutrient Transporter Expression. Dev Cell 2003; 5:571-82. [PMID: 14536059 DOI: 10.1016/s1534-5807(03)00291-0] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Growth factor withdrawal results in the endocytosis and degradation of transporter proteins for glucose and amino acids. Here, we show that this process is under the active control of the small GTPase Rab7. In the presence of growth factor, Rab7 inhibition had no effect on nutrient transporter expression. In growth factor-deprived cells, however, blocking Rab7 function prevented the clearance of glucose and amino acid transporter proteins from the cell surface. When Rab7 was inhibited, growth factor deprived cells maintained their mitochondrial membrane potential and displayed prolonged, growth factor-independent, nutrient-dependent cell survival. Thus, Rab7 functions as a proapoptotic protein by limiting cell-autonomous nutrient uptake. Consistent with this, dominant-negative Rab7 cooperated with E1A to promote the transformation of p53(-/-) mouse embryonic fibroblasts (MEFs). These results suggest that proteins that limit nutrient transporter expression function to prevent cell-autonomous growth and survival.
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Affiliation(s)
- Aimee L Edinger
- Abramson Family Cancer Research Institute, University of Pennsylvania, Philadelphia, PA 19104, USA
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39
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Chang VT, Aviv H, Howard LM, Padberg F. Acute myelogenous leukemia associated with extreme symptomatic thrombocytosis and chromosome 3q translocation: case report and review of literature. Am J Hematol 2003; 72:20-6. [PMID: 12508263 DOI: 10.1002/ajh.10256] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Acute leukemias with thrombocytosis have been recently linked with structural abnormalities of the short arm of chromosome 3. A 46-year-old man with a 2-month history of recurrent transient ischemic attacks and abdominal pain developed an ischemic left foot and a gangrenous toe as his initial symptoms. Platelet count was 3.5 x 10(6)/microL, and despite plateletpheresis, the patient required left-leg amputation. Pathologic examination was remarkable for arterial thrombosis in the absence of atherosclerotic lesions. A diagnosis of acute myeloid leukemia with a novel translocation between chromosomes 3q21, 16, and 7 was made. Induction therapy was unsuccessful, and the patient died of overwhelming sepsis within 5 weeks of diagnosis. The striking features of this case were extreme symptomatic thrombocytosis, peripheral gangrene without atherosclerosis, and a novel three-way chromosomal translocation involving chromosome 3q21.
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MESH Headings
- Acute Disease
- Amputation, Surgical
- Chromosome Breakage
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 3/ultrastructure
- Fatal Outcome
- Flow Cytometry
- Gangrene/etiology
- Gangrene/surgery
- Humans
- In Situ Hybridization, Fluorescence
- Ischemia/etiology
- Ischemic Attack, Transient/etiology
- Leukemia, Myeloid/complications
- Leukemia, Myeloid/genetics
- Male
- Middle Aged
- Smoking/adverse effects
- Syndrome
- Thrombocytosis/etiology
- Thrombosis/etiology
- Toes/blood supply
- Translocation, Genetic
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Affiliation(s)
- Victor T Chang
- Section of Hematology/Oncology, VA Health Care System of New Jersey, and Department of Medicine, UMDNJ/NJMS, Newark, New Jersey 07018, USA.
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40
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Müller CI, Engelhardt M, Laubenberger J, Kunzmann R, Engelhardt R, Lübbert M. Myelodysplastic syndrome in transformation to acute myeloid leukemia presenting with diabetes insipidus: due to pituitary infiltration association with abnormalities of chromosomes 3 and 7. Eur J Haematol 2002; 69:115-9. [PMID: 12366717 DOI: 10.1034/j.1600-0609.2002.02763.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
A 31-yr-old woman with myelodysplastic syndrome (MDS) in transformation to acute myeloid leukemia (AML) presented with initial symptoms of polyuria and polydipsia. Cytogenetics revealed monosomy 7 and translocation (3;3)(q21;q26). The initial symptoms, in conjunction with a low serum level of anti-diuretic hormone (ADH) and magnetic resonance imaging (MRI) findings demonstrating loss of the "bright spot" of the neurohypophysis, indicated diabetes insipidus (DI), e.g. caused by leukemic infiltration of the neurohypophysis. After induction chemotherapy the patient's bone marrow revealed blast persistence, and following a second course of chemotherapy and normalisation of MRI, an allogeneic peripheral blood stem cell transplantation (PBSCT) from the patient's HLA-identical brother was performed, resulting in ongoing complete remission. Recently, Lavabre-Bertrand et al. reported an association of AML with DI, elevated platelet counts, and monosomy 7 and chromosome 3 abnormalities in three patients (Eur. J. Haematol. 2001: 66: 66-69). Our report of an MDS with trilineage dysplasia and these karyotypic changes associated with DI indicates that this new entity may also include preleukemic cases.
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Affiliation(s)
- Claudia I Müller
- Department of Haematology/Oncology, University of Freiburg Medical Center, Hugstetter Strasse 55, D-79106 Freiburg, Germany
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41
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Abstract
Myelodysplastic syndromes (MDS) are considered to be a family of clonal disorders of hematopoietic stem cells that are characterized by ineffective hematopoiesis and susceptibility to acute myelogenous leukemias, and are shown to be strikingly refractory to current therapeutic modalities. A substantial proportion of these complex diseases arise in the setting of exposures to environmental or occupational toxins, including cytotoxic therapy for a prior malignancy or other disorder. The conversion of a normal stem cell into a preleukemic and ultimately leukemic state is a multistep process requiring the accumulation of a number of genetic lesions. On the genomic level, MDS is typified by losses and translocations involving certain key gene segments, with disruption of the normal structure and function of genes that control the balance of proliferation and differentiation of hematopoietic precursors. More than a half of the chromosomal abnormalities in MDS comprise deletions of chromosomes 5, 7, 11, 12, 13 and 20. This evidence suggests that as yet unidentified tumor suppressor genes should have important roles in the molecular mechanisms of MDS. Further molecular approaches to such genetic lesions will identify the relevant tumor suppressor genes. Over the past years, major signal transduction molecules were identified and their genetic alterations were extensively analyzed in MDS as well as leukemias. These include receptors for growth factors, RAS signaling molecules, cell cycle regulators, and transcription factors. Among them, notable is transcription factors that regulate both proliferation and differentiation of hematopoitic stem cells. The disruption of the normal flow of the signal transduction pathways involving these molecules translates into ineffective multilineage hematopoiesis and bone marrow failure. Therefore, MDS provides a fertile testing ground on which we could study the molecular dissection implicated in the multistep leukemogenesis.
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42
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Keung YK, Buss D, Powell BL, Pettenati M. Central diabetes insipidus and inv(3)(q21q26) and monosomy 7 in acute myeloid leukemia. CANCER GENETICS AND CYTOGENETICS 2002; 136:78-81. [PMID: 12165457 DOI: 10.1016/s0165-4608(02)00521-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Chromosomal anomalies involving region 3q21q26 have been reported associated with thrombocytosis in various hematological malignancies, such as chronic myeloid leukemia, myelodysplastic syndrome, and acute myeloid leukemia (AML). Recent reports described the association of central diabetes insipidus with AML and chromosomal anomalies involving region 3q21q26. We review the database in our institution and report five cases of inv(3)(q21q26) in consecutive cytogenetic studies of AML and myelodysplastic syndromes from 1992 to 2000, two cases presented as sole abnormalities and three cases were associated with monosomy 7. Only one case was associated with central diabetes insipidus. The literature of 3q21q26 syndrome and central diabetes insipidus in myeloid leukemia is reviewed.
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Affiliation(s)
- Yi-Kong Keung
- Section on Hematology and Oncology, Comprehensive Cancer Center, Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
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43
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Block AW, Carroll AJ, Hagemeijer A, Michaux L, van Lom K, Olney HJ, Baer MR. Rare recurring balanced chromosome abnormalities in therapy-related myelodysplastic syndromes and acute leukemia: report from an international workshop. Genes Chromosomes Cancer 2002; 33:401-12. [PMID: 11921274 DOI: 10.1002/gcc.10044] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Seventy-seven patients were identified with Rare recurring (excluding 11q23, 21q22, inv(16), and t(15;17)) chromosome abnormalities among 511 patients with treatment-related myelodysplastic syndromes and acute leukemia accepted from centers in the United States, Europe, and Japan. The abnormality subsets included 3q21q26 (17 patients), 11p15 (17 patients), t(9;22)(q34;q11) (10 patients), 12p13 (9 patients), t(8;16)(p11;p13) (9 patients), and an "other" subset, which included t(6;9)(p23;q34) (3 patients), t(10;11)(p13;q13 approximately q21) (3 patients), t(1;17)(p36;q21) (2 patients), t(8;14)(q24;q32) (2 patients), t(11;19)(q13;q13) (2 patients), t(1;3)(p36;q21) (2 patients), and t(3;5)(q21;q31) (1 patient). Increased karyotypic complexity with additional balanced and unbalanced rearrangements was observed in 70% of cases. Among 54 cases with secondary abnormalities, chromosome 5 and/or 7 abnormalities were observed in 59%. The most frequent primary diseases were breast cancer (24 cases), Hodgkin disease (14 cases), non-Hodgkin lymphoma (10 cases), and de novo ALL (5 cases). Thirty-seven patients received alkylating agents plus topoisomerase II inhibitors with or without radiation therapy. The presenting diagnosis was t-AML in 47 cases, t-MDS in 23 cases (10 progressed to t-AML), and t-ALL in seven cases, five of whom had a t(9;22). The median latency time from initiation of original therapy to therapy-related disease diagnosis was quite long (69 months), and the overall median survival from the date of therapy-related disease diagnosis was very short (7 months). The 1-year survival rate was 34 +/- 7%, with no significant differences among subsets. Comparison with previously reported cases showed increased karyotypic complexity and adult presentation of pediatric-associated chromosome abnormalities.
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Affiliation(s)
- AnneMarie W Block
- Clinical Cytogenetics Laboratory, Roswell Park Cancer Institute, Buffalo, New York 14263, USA.
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44
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Mhawech P, Saleem A. Myelodysplastic syndrome: review of the cytogenetic and molecular data. Crit Rev Oncol Hematol 2001; 40:229-38. [PMID: 11738946 DOI: 10.1016/s1040-8428(01)00101-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Myelodysplastic syndrome (MDS) is a monoclonal disorder of the pluripotent stem cell that frequently evolves into acute leukemia. MDS is characterized by trilineage dysplasia and by ineffective hematopoiesis. The etiology of MDS is poorly understood. However, the frequent association of chromosomal abnormalities (deletions, inversions, translocations, trisomies and monosomies) with MDS suggests that an oncogene, or a tumor suppressor gene might be involved in the pathogenesis and evolution of this disorder. This review summarizes the clinical, laboratory, chromosomal and prognostic findings of some of the cytogenetic abnormalities such as; 20q deletion, chromosome 5, 7 and 3 abnormalities, 17p-syndrome, trisomy 8, and loss of Y chromosome. In addition, this review goes into the discussion of the most recent development in the field of molecular biology to understand some of the mechanisms resulting in the development and progression of MDS.
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Affiliation(s)
- P Mhawech
- Department of Pathology, University Hospital of Geneva, Geneva, Switzerland
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45
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Lavabre-Bertrand T, Bourquard P, Chiesa J, Berthéas MF, Lefort G, Taïb J, Lavabre-Bertrand C, Navarro M, Bureau JP. Diabetes insipidus revealing acute myelogenous leukaemia with a high platelet count, monosomy 7 and abnormalities of chromosome 3: a new entity? Eur J Haematol 2001; 66:66-9. [PMID: 11168511 DOI: 10.1034/j.1600-0609.2001.00346.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We describe three cases of acute myeloid leukaemia revealed by diabetes insipidus. The patients were 42, 38 and 39 yr old and they had marked hyperleukocytosis, circulating immature granular cells and a normal or elevated platelet count. The leukaemia was type AML-M2 according to the FAB classification. Cytogenetic studies showed inversion of chromosome 3 (q21;q26) in 2 cases and a translocation (3;3)(q21;q29?) in the remaining case, both associated with monosomy 7. All the cerebral CT scans were normal. Complete remission was never achieved, and all three patients survived less than 14 months. Desmopressin therapy was active but treatment could not be reduced. The association of dysmegakaryopoiesis with a chromosome 3 abnormality and diabetes insipidus is probably not fortuitous and could represent a new entity.
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MESH Headings
- Adult
- Chromosome Aberrations
- Chromosome Inversion
- Chromosomes, Human, Pair 3/ultrastructure
- Chromosomes, Human, Pair 7
- Deamino Arginine Vasopressin/therapeutic use
- Diabetes Insipidus/drug therapy
- Diabetes Insipidus/etiology
- Fatal Outcome
- Female
- Humans
- Leukemia, Myeloid, Acute/blood
- Leukemia, Myeloid, Acute/complications
- Leukemia, Myeloid, Acute/diagnosis
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/physiopathology
- Leukocytosis/etiology
- Male
- Monosomy
- Platelet Count
- Thrombocytosis/etiology
- Translocation, Genetic
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Affiliation(s)
- T Lavabre-Bertrand
- Laboratoire de Biologie cellulaire et de Cytogénétique Moléculaire, Faculté de Médecine de Montpellier-Nîmes, France.
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46
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Castagné C, Mühlematter D, Martinet D, Jotterand M. Effect of conditioned medium, nutritive elements and mitotic synchronization on the accuracy of the cytogenetic analysis in patients with chronic myeloid leukemia at diagnosis and during alpha-interferon therapy. CANCER GENETICS AND CYTOGENETICS 1999; 109:166-71. [PMID: 10087954 DOI: 10.1016/s0165-4608(98)00171-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To improve the yield of the cytogenetic analysis in patients with CML at presentation and during alpha-interferon therapy, three culture conditions for bone marrow or peripheral blood cells were tested in parallel. The effects of 5637 conditioned medium (CM), nutritive elements (NE), and methotrexate (MTX) cell synchronization were investigated in 10 Ph-positive (Ph+) CML patients at diagnosis (group 1), and in 13 Ph+ CML patients receiving treatment with alpha-interferon (group 2). In the presence of 5637 CM and NE with or without MTX, the mitotic index values were significantly improved in both groups. In group 2, the morphological index was significantly increased when using 5637 NE, and percentages of abnormal cells did not differ in 5637 NE and 5637 NE MTX compared to the control condition. Although cessation of interferon administration before sampling may improve the yield of the technique, it does not seem necessary when using 5637 CM and NE. The variability of the response of leukemic cells to different culture conditions further supports the recommendation that, in addition to the control condition, supplementations with 5637 CM and NE with or without cell synchronization be used in parallel in all CML patients. Results suggest that, when the number of cells available is not sufficient for several cultures, 5637 NE with or without MTX should replace the control condition.
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MESH Headings
- Antimetabolites, Antineoplastic/pharmacology
- Antineoplastic Agents/therapeutic use
- Bone Marrow/drug effects
- Cell Division/drug effects
- Culture Media
- Culture Media, Conditioned/pharmacology
- Cytogenetics/methods
- Humans
- Interferon-alpha/therapeutic use
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Methotrexate/pharmacology
- Mitotic Index
- Tumor Cells, Cultured/drug effects
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Affiliation(s)
- C Castagné
- Unité de cytogénétique du cancer, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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47
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Heimpel H, Seifried E. Thrombozytenbildungs- und Verteilungsstörungen: Thrombozytosen und Thrombozytopenien. Hamostaseologie 1999. [DOI: 10.1007/978-3-662-07673-6_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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48
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Igarashi T, Shimizu S, Morishita K, Ohtsu T, Itoh K, Minami H, Fujii H, Sasaki Y, Mukai K. Acute myelogenous leukemia with monosomy 7, inv(3) (q21q26), involving activated EVI 1 gene occurring after a complete remission of lymphoblastic lymphoma: a case report. Jpn J Clin Oncol 1998; 28:688-95. [PMID: 9861236 DOI: 10.1093/jjco/28.11.688] [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: 11/14/2022] Open
Abstract
A 42-year-old female with a mediastinal tumor and massive pleural effusion ws admitted to our hospital in June 1993. Biopsy revealed lymphoblastic lymphoma. She had no evidence of distant metastasis except pleural effusion. Bone marrow examination revealed a normal karyotype (46, XY). The patient had been progression-free for more than 1 year after achieving complete remission by induction, consolidation and maintenance therapy according to the standard chemotherapy and involved-field radiation for lymphoblastic lymphoma. From May 1996 progressive leukopenia and thrombocytopenia developed. The diagnosis of refractory anemia with excess of blasts (RAEB) was made. Subsequently, in November 1996, she developed acute myelogenous leukemia (AML), M4 type by FAB classification. The karyotype of MDS and AML clones involved inversion (3) (q21q26) and monosomy 7. The EVI 1 gene was examined and was proved to be rearranged and activated. This may be the first case among the therapy-related cases of MDS/AML reported whose karyotypes were followed and in which the mRNA expression of EVI 1 gene involved was directly proved in the leukemogenesis process of chemotherapy-induced secondary MDS and AML.
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MESH Headings
- Chromosome Inversion
- Chromosomes, Human, Pair 3
- Chromosomes, Human, Pair 7
- Combined Modality Therapy
- DNA-Binding Proteins/genetics
- Female
- Humans
- Karyotyping
- Leukemia, Myeloid, Acute/etiology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- MDS1 and EVI1 Complex Locus Protein
- Middle Aged
- Monosomy
- Neoplasms, Second Primary/etiology
- Neoplasms, Second Primary/genetics
- Neoplasms, Second Primary/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy
- Proto-Oncogenes
- Remission Induction
- Transcription Factors
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Affiliation(s)
- T Igarashi
- Department of Medicine, National Cancer Center Hospital East, Chiba, Japan.
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49
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Giles FJ, Kanemaki TJ, Schreck RR, Qasabian L, Fuerst MP, Lim SW. Translocation (3;21;8)(q21;q22;q22) in a patient with acute myeloid leukemia. A case report and review of prognostic indicators. CANCER GENETICS AND CYTOGENETICS 1998; 104:66-9. [PMID: 9648562 DOI: 10.1016/s0165-4608(97)00438-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
We report a patient with acute myeloid leukemia (AML) and t(3;21;8)(q21;q22;q22). This translocation has not been previously described in de novo or relapsed AML. The patient is a 25-year-old woman who presented with WBC 6.2 x 10(9)/L, Hgb 10.2 g/dL, Hct 28.4%, and platelets 67 x 10(9)/L. A bone marrow biopsy revealed a 70% hematopoietic cellularity with 65% blasts. Immunophenotyping showed aberrant expression of lymphoid-associated marker CD19. Cytogenetic analysis on a 72-hour culture of bone marrow cells supplemented with conditioned media was evaluated by G-banding at about the 400-band level. The patient's age, cytogenetics, WBC, and immunophenotype at diagnosis would seem to suggest a favorable prognosis, according to previous studies of prognostic indicators. She was treated with induction and consolidation chemotherapy, followed by myeloablative conditioning and autologous peripheral blood stem cell transplant (PBSCT). Despite multiple favorable prognostic factors, the patient relapsed 7 months after PBSCT. Translocation of chromosomes 8 and 21 is common in AML and is generally considered a good prognostic factor. We suspect that the effect of the 3q21 translocation in an otherwise favorable translocation of chromosomes 8 and 21 may be responsible for this patient's early relapse.
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MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bone Marrow Cells/pathology
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 3/genetics
- Chromosomes, Human, Pair 8/genetics
- Combined Modality Therapy
- Female
- Hematopoietic Stem Cell Transplantation
- Humans
- Karyotyping
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Prognosis
- Remission Induction
- Translocation, Genetic/genetics
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Affiliation(s)
- F J Giles
- Department of Medicine, Cedars-Sinai Medical Center, University of California, Los Angeles School of Medicine, USA
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50
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Abstract
Cytogenetic changes in primary myelodysplastic syndromes (MDS) have been extremely useful to identify clonality and to define specific clinico-pathological entities. More recently, with the development of DNA technology, a bulk of new information has been added to classical cytogenetics. Genes corresponding to chromosomal breakpoints implicated in reciprocal translocations have been cloned. Search for the minimal lost region has been the aim of the so-called deletion mapping approach to pick up the hypothetical suppressor gene(s) critical for typical deletions of MDS. Correlation has been found between gene mutations, deletions, expression, and clinical-hematological or cytogenetic features of MDS. Integration of fluorescence in situ hybridization at DNA level and of immunophenotyping at cellular level is an elegant tool to investigate clonal affiliation in MDS with distinct genetic changes.
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Affiliation(s)
- C Mecucci
- Hematology and Bone Marrow Transplantation Unit, University of Perugia, Policlinico Monteluce, Italy.
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