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Nadal N, Auger N, Bidet A, Nguyen-Khac F. Cytogenetics in the management of clonal chromosomal abnormalities of undetermined significance and persistent polyclonal B-cell lymphocytosis: Guidelines from the Groupe Francophone de Cytogénétique Hématologique (GFCH). Curr Res Transl Med 2023; 71:103426. [PMID: 38016423 DOI: 10.1016/j.retram.2023.103426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 11/30/2023]
Abstract
Acquired clonal chromosomal abnormalities (CAs) are usually considered to be disease-related. However, when a CA of this type is the only abnormality present (and especially in small clones), the clinical significance is unclear. Here, we review the literature on recurrent CAs whose significance is regularly subject to debate. Our objective was to help with their interpretation and develop guidelines for sex chromosome loss, trisomy 15, trisomy 8, deletion 20q and other isolated non-myelodysplastic neoplasm (MDS)-defining CAs. We suggest that non-MDS-defining CAs correspond to clonal hematopoiesis of indeterminate potential (CHIP) in the absence of cytopenia and clonal cytopenia of undetermined significance (CCUS) in the presence of cytopenia. Lastly, we review the literature on persistent polyclonal binucleated B-cell lymphocytosis; although usually benign, this condition may correspond to a premalignant state.
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Affiliation(s)
- N Nadal
- Service de génétique chromosomique et moléculaire, CHU Dijon, Dijon, France.
| | - N Auger
- Génétique des tumeurs, Gustave Roussy, Villejuif, France
| | - A Bidet
- Laboratoire d'hématologie, CHU Bordeaux, Bordeaux, France
| | - F Nguyen-Khac
- Drug Resistance in Hematological Malignancies, Centre de Recherche des Cordeliers, UMRS 1138, INSERM, Sorbonne Université, Université Paris Cité, Paris, France; Service d'Hématologie Biologique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
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2
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Goswami RS, Liang CS, Bueso-Ramos CE, Hu S, Goswami M, Yin CC, Lu G, Medeiros LJ, Tang G. Isolated +15 in bone marrow: disease-associated or a benign finding? Leuk Res 2014; 39:72-6. [PMID: 25435027 DOI: 10.1016/j.leukres.2014.11.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/25/2014] [Accepted: 11/09/2014] [Indexed: 11/18/2022]
Abstract
It has been controversial if trisomy 15 (+15) as an isolated clonal cytogenetic abnormality in bone marrow (BM) is disease-associated or a benign finding. To answer this question, we retrospectively reviewed our cytogenetic archives and identified 31 patients with isolated +15. Four patients presented with acute myeloid leukemia (AML), +15 was the major clone (56-95% of interphases) in BM and the clonal size of +15 was correlated with blast burden and disease status. For the remaining 27 patients, +15 was a minor clone (3-24% of interphases) in BM. Eighteen patients had a history of cytotoxic therapies and developed +15 after a median latency interval of 34 months. Six patients had BM involvement by lymphoma or myeloma, and +15 was exclusively detected in myeloid and erythroid cells, not in lymphoma or myeloma cells. With a median follow-up of 28 months, none of these 27 patients had clinical or morphological evidence of myelodysplastic syndromes. We conclude that +15 can be associated with AML, but more often isolated +15 presents as a minor clone in BM, and may not be disease associated. Clinical follow-up rather than an immediate therapeutic intervention seems most appropriate for non-leukemic patients with isolated +15.
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Affiliation(s)
- Rashmi Shivani Goswami
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Cynthia S Liang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Carlos E Bueso-Ramos
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Maitrayee Goswami
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Gary Lu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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3
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Hypercalcemia in pediatric acute megakaryocytic leukemia: case report and review of the literature. J Pediatr Hematol Oncol 2009; 31:373-6. [PMID: 19415024 DOI: 10.1097/mph.0b013e31819a5d29] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hypercalcemia has been described as a possible complication of many pediatric malignancies. Here, we report an 8-month-old non-Down syndrome infant with acute megakaryocytic leukemia and severe hypercalcemia at presentation. A review of the literature reveals that this is the first case of hypercalcemia complicating acute megakaryocytic leukemia reported in the pediatric literature. His initial workup, and the course of management and outcome, is described in detail. Though the etiology of this complication remains unclear, our experience suggests that early institution of chemotherapy along with supportive care is the best treatment for control of hypercalcemia.
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4
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Abstract
A 41-year-old patient manifested pancytopenia with macrocytosis following pesticide exposure. She was later found to have myelodysplasia with trisomy 15. Over a 15-year period of observation, and with no specific therapy, her hematological disorder remains stable, despite persistence of the chromosomal aberration. This and similar reported observations suggest that the course of this uncommon form of myelodysplasia is often indolent and not accurately predicted by application of the widely used International Prognostic Scoring System for the myelodysplastic syndromes.
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Affiliation(s)
- Ethan A Natelson
- Department of Medical Education, Christus St. Joseph Hospital, 1401 Saint Joseph Parkway, Houston, Texas 77002, USA.
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5
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Morel F, Le Bris MJ, Herry A, Morice P, De Braekeleer M. Trisomy 15 as the sole abnormality in myelodysplastic syndromes: case report and review of the literature. Leuk Lymphoma 2003; 44:549-51. [PMID: 12688332 DOI: 10.1080/1042819021000055084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Trisomy 15 as the sole autosomal anomaly is uncommon in hematological malignancies but could be preferentially associated with myelodysplasia. We report a 61-year-old man who developed pancytopenia following two courses of chemotherapy for chronic lymphoid leukemia. Cytogenetic studies at diagnosis of pancytopenia with R banding showed a 47,XY, + 15[3]/45,X[3]/46,XY[14] karyotype. A review of the 53 cases of myelodysplastic syndromes (MDS) and myeloid related disorders associated with trisomy 15 reported in the literature showed that 18 of the 31 men also lost the Y chromosome in the trisomic 15 cell line. Their mean age was significantly higher than that of males who had not lost the Y chromosome (p < 0.05). The main feature of the patient reported here is the presence of two abnormal cell lines, one having lost the Y chromosome, the other having gained a chromosome 15. Therefore, the two events occurred independently, the loss of the Y chromosome being possibly due to aging and the trisomy 15 to the hematologic disorder.
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MESH Headings
- Aging/genetics
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Chromosome Banding
- Chromosome Deletion
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Y
- Clone Cells/ultrastructure
- Cyclophosphamide/administration & dosage
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Middle Aged
- Pancytopenia/chemically induced
- Pancytopenia/genetics
- Trisomy
- Tumor Cells, Cultured/ultrastructure
- Vidarabine/administration & dosage
- Vidarabine/analogs & derivatives
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Affiliation(s)
- Frédéric Morel
- Service de Cytogénétique, Cytologie et Biologie de la Reproduction, CHU Morvan, Brest, France
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6
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Vadlamani I, Ma E, Brink DS, Batanian JR. Trisomy 15 in a case of pediatric hemangiopericytoma and review of the literature. CANCER GENETICS AND CYTOGENETICS 2002; 138:116-9. [PMID: 12505255 DOI: 10.1016/s0165-4608(02)00590-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study reports on a pediatric case of hemangiopericytoma (HPC) showing trisomy 15 as a sole anomaly. Trisomy 15 was observed in a total of 11 cells harvested at a very early passage from two different in-situ cultures. Trisomy 15, as a sole anomaly, has been described in hematologic disorders such as myelodysplastic syndromes but, to our knowledge, has never been documented in solid tumors. This is the first report of HPC with trisomy 15.
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Affiliation(s)
- Indira Vadlamani
- Department of Pathology, St. Louis University School of Medicine, St. Louis, MO, USA
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Zhang L, Mulvihill JJ, Kern WF, McMinn J, Li S. Duplication 15q as the sole anomaly in an acute promyelocytic leukemia patient without t(15;17). CANCER GENETICS AND CYTOGENETICS 2002; 138:17-21. [PMID: 12419579 DOI: 10.1016/s0165-4608(02)00538-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a unique chromosomal abnormality found in a patient with acute myeloblastic leukemia of French-American-British subtype M3. The patient was referred for an evaluation of a chromosomal anomaly exclusively associated with FAB M3 or acute promyelocytic leukemia: a translocation between chromosomes 15 and 17, t(15;17)(q22;q21.1). Neither t(15;17) nor rearrangement of RARalpha was detected by routine G-banded chromosome as well as fluorescence in situ hybridization analysis using the commercial dual-color PML/RARalpha translocation probe and the RARalpha probe, a break apart rearrangement dual-color probe. Instead of the typical rearrangement between chromosomes 15 and 17, all cells analyzed had a duplication of the segment of chromosome 15 between bands 15q15 and 15q26.
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MESH Headings
- Adult
- Bone Marrow/pathology
- Chromosomes, Human, Pair 15/genetics
- Chromosomes, Human, Pair 17
- Gene Duplication
- Humans
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Male
- Translocation, Genetic
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Affiliation(s)
- Lijun Zhang
- Department of Pediatrics, Health Sciences Center, University of Oklahoma, Oklahoma City, OK 73104, USA
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8
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Zhang L, Mulvihill JJ, Kinasewitz GT, Scott KV, Bates F, Li S. Duplication 15q in a patient with t(8;21) acute myeloblastic leukemia (M2). CANCER GENETICS AND CYTOGENETICS 2002; 133:148-51. [PMID: 11943342 DOI: 10.1016/s0165-4608(01)00596-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We present unique chromosomal abnormalities found in a patient with acute myeloblastic leukemia (AML) of French-American-British subtype M2. The patient was referred for an evaluation of chromosomal anomaly associated with AML. She was found to have an abnormal karyotype 46,XX,t(8;21)(q22;q22), and a questionable dup(15)(q15q22) in the majority of cells analyzed. Two cells had the same chromosomal anomalies plus a duplicated derivative chromosome 21 [der(21)t(8;21)(q22;q22)]. These cytogenetic findings were confirmed by fluorescence in situ hybridization utilizing the appropriate DNA probes. To our knowledge, this is the first case report of a combination of the translocation between chromosomes 8 and 21, a duplication of chromosome 15 [dup(15)(q15q22), and a duplicated derivative chromosome 21 [der(21)t(8;21)(q22;q22)].
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MESH Headings
- Adult
- Chromosomes, Human, Pair 15/genetics
- Chromosomes, Human, Pair 21/genetics
- Chromosomes, Human, Pair 8/genetics
- Female
- Gene Duplication
- Humans
- In Situ Hybridization, Fluorescence
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Translocation, Genetic/genetics
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Affiliation(s)
- Lijun Zhang
- Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
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9
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Sashida G, Tauchi T, Kimura Y, Ohyashiki K. Trisomy 15 as a single autosomal abnormality in a patient with unclassifiable myelodysplastic syndromes. CANCER GENETICS AND CYTOGENETICS 2001; 127:91-2. [PMID: 11414284 DOI: 10.1016/s0165-4608(00)00411-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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10
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Suzuki A, Ohyashiki K, Kimura Y, Matsuda S, Sano F, Yamada O, Ohno R. Frequent association between trisomy 15 and t(8;21)(q22;q22) in acute myeloid leukemia. CANCER GENETICS AND CYTOGENETICS 2001; 126:169-70. [PMID: 11394390 DOI: 10.1016/s0165-4608(00)00396-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Batanian JR, Slovak ML, Mohamed A, Dobin S, Luthardt FW, Keitges EA. Trisomy 15 is frequently observed as a minor clone in patients with Anemia/MDS/NHL and as a major clone in patients with AML. CANCER GENETICS AND CYTOGENETICS 2000; 121:186-9. [PMID: 11063805 DOI: 10.1016/s0165-4608(00)00253-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Trisomy 15 as the sole karyotypic aberration is an uncommon clonal cytogenetic aberration in hematological malignancies, making its significance unclear. Previous studies have reported relations of trisomy 15 with low-grade myelodysplasia or a benign age-related phenomenon associated with loss of the Y chromosome. To define the significance of trisomy 15, we conducted a retrospective study of all examples of trisomy 15 accessed in our laboratories. Trisomy 15 was observed as a clonal abnormality (> or =2 cells) in 17 cases and nonclonal (single cell) in 9 cases. The majority of cases (14/17 clonal cases) had a minor clone (5-35% of metaphase cells) of trisomy 15. The minority of cases (3/17) had a major clone (80-95% of metaphase cells) of trisomy 15. Two of these 3 cases were diagnosed as having acute myelocytic leukemia. Fluorescence in-situ hybridization (FISH) with the use of a chromosome 15-specific alpha-satellite probe was performed on 3 of 17 clonal cases and on 3 of 9 nonclonal cases. FISH results revealed the presence of a minor clone (from 3 to 5 of 700 interphase cells) in 5 of them, 2 of which had trisomy 15 in 20% of metaphase cells. These results may indicate that the 20% of trisomy 15 are very likely an overrepresentation of a very minor clone that could be transitory. In summary, the analysis of our cytogenetic and FISH results revealed the presence of two types of trisomy 15 clones: a minor clone that could be transitory or indolent and a major clone that could be of a neoplastic nature.
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Affiliation(s)
- J R Batanian
- Department of Pediatrics, Health Science Center, Saint Louis University and Pediatrics Research Institute, St. Louis, MO, USA
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12
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Baumgartner BJ, Shurafa M, Terebelo H, Tapazoglou E, Van Dyke DL. Trisomy 15, sex chromosome loss, and hematological malignancy. CANCER GENETICS AND CYTOGENETICS 2000; 117:132-5. [PMID: 10704683 DOI: 10.1016/s0165-4608(99)00163-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We report 6 patients with myelodysplasia who, on routine cytogenetic studies, demonstrated trisomy 15. Four of these also had sex chromosome loss. A review of the literature revealed 6 other cases of trisomy 15 with sex chromosome loss and 22 cases of trisomy 15 as the sole chromosomal abnormality. All cases had hematologic malignancy or myelodysplasia. Trisomy 15 is uncommon but tends to be associated with myelodysplasia in older subjects, and with sex chromosome loss in about one third of cases.
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Affiliation(s)
- B J Baumgartner
- Finch University of Health Sciences/Chicago Medical School, North Chicago, IL, USA
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13
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Sinclair EJ, Potter AM, Watmore AE, Fitchett M, Ross F. Trisomy 15 associated with loss of the Y chromosome in bone marrow: a possible new aging effect. CANCER GENETICS AND CYTOGENETICS 1998; 105:20-3. [PMID: 9689925 DOI: 10.1016/s0165-4608(98)00003-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Trisomy 15 as a single autosomal abnormality is a rare finding in hematological disorders and has not as yet been associated with any specific disease type. We report 20 cases of trisomy 15 observed in the bone marrow of patients referred for a suspected hematological malignancy. Most patients were elderly, and a marked male predominance was evident. Aneuploidy for the Y chromosome was observed in addition to +15 in 11 out of 15 male patients. A myelodysplastic disorder (MDS) was confirmed in six cases, and acute myeloid leukemia (AML) in one. There was no evidence of malignant hematological diseases in the remaining 13 patients. We propose that there may be an association between loss of the Y chromosome and trisomy 15 and that trisomy 15, like missing Y, may not always be a marker of malignancy, but may reflect an underlying age effect. The possibility that its presence may herald the development of a malignant condition cannot, however, be excluded.
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Affiliation(s)
- E J Sinclair
- Centre for Human Genetics, Sheffield, United Kingdom
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