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Popa CA, Andreescu NI, Arghirescu TS, Petrescu CAM, Jincă CM, Huţ EF, Drăgoi RG, Puenea G, Popa D. Classic and molecular cytogenetic findings in leukemia patients from the Western part of Romania. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2024; 65:203-208. [PMID: 39020534 PMCID: PMC11384830 DOI: 10.47162/rjme.65.2.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
Acute lymphoblastic leukemia (ALL) is the most common type of leukemia in childhood and rare in adults, while acute myeloid leukemia (AML) is less common in children and more common in older adults. The aim of the study was to present our experience for the diagnostic of leukemia by using the classic and molecular cytogenetic methods. The study was conducted between 2009 and 2019 within the Classic and Molecular Genetic Laboratory of the Oncohematology Department from the Louis Ţurcanu Emergency Hospital for Children, Timişoara, Romania. The study group included 337 children and adults, evaluated between 2009 and 2019. By using the conventional and molecular cytogenetic technique, the cytogenetic anomalies found were 35 numerical chromosomal abnormalities, 10 (9;22)(q34;q11) [four ALL, one AML, five chronic myeloid leukemia (CML)] translocations, nine (15;17)(q24;q21) translocations, three (14;14)(q11;q32) translocations, two (4;11)(q21;q23) translocations, one (1;14)(p32;q11) translocation, one (7;14)(qter;q11) translocation, one (8;21)(q22;q22) translocation, one (9;14)(p12;q32) translocation, seven rearrangements of the MLL gene and two rearrangements of the core-binding factor subunit beta∕myosin heavy chain 11 (CBFB∕MYH11) gene. The use of conventional and molecular cytogenetic analysis is one of the most important prognostic indicators in acute leukemia patients, allowing the identification of biologically distinct subtypes of disease and selection of appropriate treatment approaches.
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Affiliation(s)
- Cristina Annemari Popa
- Department of Genetics, Genomic Medicine Centre, Department of Pediatrics, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania; ;
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Srivastava VM, Nair SC, Sappani M, Manipadam MT, Kulkarni UP, Devasia AJ, Fouzia NA, Korula A, Lakshmi KM, Abraham A, Srivastava A. Cytogenetic profile of 1791 adult acute myeloid leukemia in India. Mol Cytogenet 2023; 16:24. [PMID: 37716945 PMCID: PMC10504794 DOI: 10.1186/s13039-023-00653-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/18/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Cytogenetic analysis continues to have an important role in the management of acute myeloid leukemia (AML) because it is essential for prognostication. It is also necessary to diagnose specific categories of AML and to determine the most effective form of treatment. Reports from South Asia are few because the availability of cytogenetic services is relatively limited. METHODS We performed a retrospective analysis of the cytogenetic findings in adults with AML seen consecutively in a single centre in India. The results were categorised according to the 2022 World Health Organisation (WHO), International Consensus Classification (ICC) and European LeukemiaNet (ELN) classifications. RESULTS There were 1791 patients aged 18-85 years (median age 42, 1086 males). Normal karyotypes were seen in 646 (36%) patients. The 1145 (64%) abnormal karyotypes comprised 585 (32.7%) with recurrent genetic abnormalities (RGA), 403 (22.5%) with myelodysplasia-related cytogenetic abnormalities (MRC), and 157 (8.8%) with other abnormalities. There were 567 (31.7%) patients with solitary abnormalities and 299 (16.7%) with two abnormalities. Among the 279 (15.6%) patients with ≥ 3 abnormalities, 200 (11.2%) had complex karyotypes (CK) as per the WHO/ICC and 184 (10.3%), as per the ELN definition. There were 158 (8.8%) monosomal karyotypes (MK). Patients with normal karyotypes had a higher median age (45 years) than those with abnormal karyotypes (40 years, p < 0.001), and those with ≥ 3 abnormalities (43 years), than those with fewer abnormalities (39 years, p = 0.005). Patients with CK (WHO/ICC) and monosomal karyotypes had a median age of 48 years. Those with RGA had a lower median age (35 years, p < 0.001) than MRC (46 years) or other abnormalities (44 years). The t(15;17) was the most common abnormality (16.7%),followed by trisomy 8 (11.6%), monosomy 7/del 7q (9.3%), t(8;21) (7.2%), monosomy 5/del 5q (6.7%) and monosomy 17/del 17p (5.2%). CONCLUSION Our findings confirm the lower age profile of AML in India and show similarities and differences with respect to the frequencies of individual abnormalities compared to the literature. The frequencies of the t(15;17), trisomy 8 and the high-risk abnormalities monosomy 7 and monosomy 5/del 5q were higher, and that of the inv(16), lower than in most reports.
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Affiliation(s)
- Vivi M Srivastava
- Department of Cytogenetics, Christian Medical College, Vellore, Tamil Nadu, 632004, India.
| | - Sukesh Chandran Nair
- Department of Transfusion Medicine and Immunohaematology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Marimuthu Sappani
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, 632002, India
| | - Marie-Therese Manipadam
- Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu, 632004, India
- Department of Cellular Pathology, Maidstone Hospital, Hermitage Lane, Maidstone, ME169QQ, UK
| | - Uday P Kulkarni
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
| | - Anup J Devasia
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
- On leave at Princess Margaret Cancer Centre, Toronto, Canada
| | - N A Fouzia
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
| | - Anu Korula
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
- NCCCR, Doha, Qatar
| | - Kavitha M Lakshmi
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
| | - Aby Abraham
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
| | - Alok Srivastava
- Department of Clinical Haematology, Christian Medical College, Vellore, 632501, Tamil Nadu, India
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Elnaggar MG, Mosad E, Makboul A, Shafik EA. Cytogenetic profile of adult acute myeloid leukemia in Egypt: a single-center experience. Mol Cytogenet 2022; 15:43. [PMID: 36195917 PMCID: PMC9533520 DOI: 10.1186/s13039-022-00621-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background Acute myeloid leukemia (AML) is a diverse disease characterized by the expansion of blasts of myeloid lineage. Cytogenetic testing is the cornerstone for risk stratification of AML patients. Geographical and environmental factors may play a very important role in the development of leukemia and several differences in genetic profile may be seen among different ethnicities. In our study, we evaluated cytogenetic findings of adult AML patients in South Egypt. Methods Cytogenetic testing (karyotyping and M-FISH) was performed for 120 adult patients with AML. Twenty metaphases were analyzed for each patient. Results In our study, the median age of AML patients was 36.5 years, with an age range between 18 and 86 years. 56.7% of patients had normal karyotypes and 43.3% of patients had clonal cytogenetic abnormalities. t (15;17) was the most detected structural abnormality, and + 8 was the most detected numerical abnormality. Regarding cytogenetic risk stratification, 65% of patients were in the intermediate-risk category. Conclusion The cytogenetic profile of AML patients in our locality showed some differences and some similarities with cytogenetic profiles in different Arab, Asian and Western countries. Further studies are needed using advanced techniques such as next-generation sequencing and optical genome mapping to elucidate more ethnic and geographic genetic heterogeneity among different countries.
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Affiliation(s)
- Mohamed G Elnaggar
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71515, Egypt.
| | - Eman Mosad
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71515, Egypt
| | - Ahmed Makboul
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71515, Egypt
| | - Engy Adel Shafik
- Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, 71515, Egypt
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Jafari-Delouei N, Naimi-Tabiei M, Farajollahi M, Sedaghat SM, Khandoozi S, Ghasemi-Kebria F, Dinparastisaleh R, Pourkhani A, Roshandel G. Incidence, Time Trends and Geographical Distribution of Leukemia and Multiple Myeloma in Golestan Province, Northern Iran, 2004-2017. ARCHIVES OF IRANIAN MEDICINE 2022; 25:360-365. [PMID: 35943015 DOI: 10.34172/aim.2022.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/22/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Leukemia and multiple myeloma (MM) are the most common hematologic malignancies in Iran. This paper describes the geographic and temporal changes in their incidence in Golestan, northern Iran. METHODS Data on cases of leukemia and MM during 2004-2017 were obtained from the Golestan Population-based Cancer Registry (GPCR). The GPCR is a dynamic database of Golestan residents diagnosed with primary cancers. Age-standardized incidence rates (ASRs) (per 100000) of leukemia and MM were calculated using direct standardization method considering the world standard population. We used Joinpoint regression to assess incidence trends using the average annual percent change (AAPC). RESULTS In total, 2119 new cases of leukemia and MM were registered by the GPCR during 2004-2017. The ASRs of leukemia were 9.71 and 6.70 in males and females, respectively, while the rates were lower for MM: 2.66 and 1.97 in males and females, respectively. The incidence rates of leukemia suggested an increasing trend in urban population (AAPC=2.73; P value=0.154), while in rural area, the incidence rates were slightly decreasing (AAPC=- 0.73; P value=0.658). There were high incidence areas of leukemia in the central and western regions of Golestan. CONCLUSION Our results suggested high incidence rates of leukemia and MM in the Golestan province. We also found geographical diversities and increasing trends in the incidence of leukemia in the urban population. Exposure to occupational and environmental carcinogens including pesticides may partly explain high rates and the observed trends. Further investigations should be considered to clarify these points in our population.
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Affiliation(s)
- Nastaran Jafari-Delouei
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mehran Farajollahi
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | | | | | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
| | - Roshan Dinparastisaleh
- Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran
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Monosomal karyotype as an adverse risk factor for inferior survivals in children with acute myeloid leukemia. PEDIATRIC HEMATOLOGY ONCOLOGY JOURNAL 2021. [DOI: 10.1016/j.phoj.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chen X, Wang X, Dou H, Yang Z, Bi J, Huang Y, Lu L, Yu J, Bao L. Cytogenetic and mutational analysis and outcome assessment of a cohort of 284 children with de novo acute myeloid leukemia reveal complex karyotype as an adverse risk factor for inferior survival. Mol Cytogenet 2021; 14:27. [PMID: 34011412 PMCID: PMC8136172 DOI: 10.1186/s13039-021-00547-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/08/2021] [Indexed: 12/12/2022] Open
Abstract
Background Acute myeloid leukemia (AML) is rare in children. Although complex karyotype (CK) defined as ≥ 3 cytogenetic abnormalities is an adverse risk factor in adult AML, its prognostic impact on childhood AML remains to be determined. Results We studied the prevalence, cytogenetic and mutational features, and outcome impact of CK in a cohort of 284 Chinese children with de novo AML. Thirty-four (12.0%) children met the criteria for CK-AML with atypical CK being more frequent than typical CK featured with -5/5q-, -7/7q-, and/or 17p aberration. Mutational prevalence was low and co-occurrence mutants were uncommon. Children with CK-AML showed shorter overall survival (OS) (5-year OS: 26.7 ± 10.6% vs. 37.5 ± 8.6%, p = 0.053) and event-free survival (EFS) (5-year EFS: 26.7 ± 10.6% vs. 38.8 ± 8.6%, p = 0.039) compared with those with intermediate-risk genetics. Typical CK tended to correlate with a decreased OS than atypical CK (5-year OS: 0 vs. 33 ± 12.7%.; p = 0.084), and CK with ≥ 5 cytogenetic aberrations was associated with an inferior survival compared with CK with ≤ 4 aberrations (5-year OS: 13.6 ± 11.7% vs. 50.0 ± 18.6%; p = 0.040; 5-year EFS: 13.6 ± 11.7% vs. 50.0 ± 18.6%; p = 0.048). Conclusion Our results demonstrate CK as an adverse risk factor for reduced survival in childhood AML. Our findings shed light on the cytogenetic and mutational profile of childhood CK-AML and would inform refinement of risk stratification in childhood AML to improve outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s13039-021-00547-0.
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Affiliation(s)
- Xi Chen
- Center for Clinical Molecular Medicine, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xingjuan Wang
- Center for Reproductive Medicine, Baoji Maternal and Child Health Hospital, Shanxi, China
| | - Hu Dou
- Department of Clinical Laboratory, Key Laboratory of Pediatrics in Chongqing, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenzhen Yang
- Department of Clinical Laboratory, Nanchong Central Hospital, Nanchong, Sichuan, China
| | - Junqin Bi
- Department of Laboratory Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yi Huang
- Chongqing Key Laboratory of Child Infection and Immunity, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Ling Lu
- Department of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Yu
- Department of Hematology and Oncology, Children's Hospital of Chongqing Medical University, No. 136 Zhongshang 2nd Road, Chongqing, 400014, China.
| | - Liming Bao
- Department of Pathology, School of Medicine, University of Colorado Anschutz Medical Campus, 12705 E. Montview Boulevard, Suite 400, Aurora, CO, 80045, USA.
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Lenzi L, Lee-Jones L, Mostofa MA, de Andrade DP, Ribeiro RC, Figueiredo BC. Second Primary Malignancy after Acute Promyelocytic Leukemia: A Population-Based Study. Cancers (Basel) 2020; 12:E3610. [PMID: 33287098 PMCID: PMC7761603 DOI: 10.3390/cancers12123610] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/16/2020] [Accepted: 11/18/2020] [Indexed: 11/17/2022] Open
Abstract
Acute promyelocytic leukemia (APL), is now highly curable with treatment approaches that include all-trans retinoic acid (ATRA). The high incidence of APL in the Hispanics suggests an association with genetic variants in this population. Information on second primary malignancies (SPMs) in patients with APL is limited. The Surveillance, Epidemiology, and End Results (SEER) database was used to interrogate whether the rate of SPMs in patients with APL was associated with ethnicity and/or ATRA treatment. Between 2000 and 2016, 116 cases of SPM were diagnosed among 4019 patients with APL. The mean age at diagnosis of primary APL was 53.9 years (±15.7 years), and the mean age at diagnosis of SPMs was 59.0 years (±14.5 years). Comparisons with 3774 APL survivors who did not develop SPMs revealed that age ≥40 years at diagnosis of APL (p < 0.001) and non-Hispanic white ethnicity (p = 0.025) were associated with SPMs in APL survivors. Salivary gland, liver, and soft tissue malignancies were significantly more common in patients with primary APL than in individuals with non-APL malignancies. A risk analysis comparing patients who had APL with patients who had non-APL AML suggests that SPMs after APL is associated with ATRA treatment. Therefore, patient follow-up after APL should focus on early diagnosis of SPMs.
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Affiliation(s)
- Luana Lenzi
- Departamento de Análises Clínicas, Universidade Federal do Paraná, Curitiba, Paraná 80210-170, Brazil;
- Life Sciences Department, Manchester Metropolitan University, Manchester M1 5GD, UK; (L.L.-J.); (M.A.M.)
- Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná 80250-060, Brazil;
| | - Lisa Lee-Jones
- Life Sciences Department, Manchester Metropolitan University, Manchester M1 5GD, UK; (L.L.-J.); (M.A.M.)
| | - Maruf A. Mostofa
- Life Sciences Department, Manchester Metropolitan University, Manchester M1 5GD, UK; (L.L.-J.); (M.A.M.)
| | - Diancarlos P. de Andrade
- Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná 80250-060, Brazil;
- Pele Pequeno Principe Research Institute, Faculdades Pequeno Príncipe, Curitiba, Paraná 80230-020, Brazil
| | - Raul C. Ribeiro
- Leukemia and Lymphoma Division, Department of Oncology, St. Jude Children’s Research Hospital, Memphis, TN 38105, USA
| | - Bonald C. Figueiredo
- Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná 80250-060, Brazil;
- Pele Pequeno Principe Research Institute, Faculdades Pequeno Príncipe, Curitiba, Paraná 80230-020, Brazil
- Centro de Genética Molecular e Pesquisa do Câncer em Crianças (CEGEMPAC), Curitiba, Paraná 80030-110, Brazil
- Departamento de Saúde Coletiva, Universidade Federal do Paraná, Curitiba, Paraná 80060-240, Brazil
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Khoubila N, Bendari M, Hda N, Lamchahab M, Qachouh M, Rachid M, Quessar A. Cytogenetic profile of a representative cohort of young adults with de novo acute myéloblastic leukaemia in Morocco. Cancer Genet 2019; 238:1-9. [PMID: 31425919 DOI: 10.1016/j.cancergen.2019.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 02/02/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND We analyzed the cytogenetic characteristics of a representative population of young adults with de novo acute myéloblastic leukemia (AML) treated in a single center institution. METHODS Patients with de novo AML included were aged between 20 and 60 years. Cytogenetic analysis was done at diagnosis. Twenty cells were analyzed, although examination of lower numbers of metaphases was also acceptable if an abnormal clone was detected. FINDINGS From 1/1/04 to 31/12/2014, among 1315 adult patients, 1055 (80%) patients were aged between 20 and 60 years. Karyotype was done in 927 (88%) patients and cytogenetic analysis failed in 32 cases (3·4%). Clonal abnormalities were observed in 520 (58%) patients. 175 (19·5%) were classified in the favorable group, 609 were in the intermediate group and 111 (12·5%) were in the adverse group. The most frequent chromosomal abnormality observed was t(8;21) in 112 (12·5%). Thirty three (3·7%) patients had t(15;17) and 30 (3·3%) had inv16, trisomy 8 was found in 47 (5·2%), 11q23 rearrangements in 32 (3·6%), 67 (7·4%) had a complex karyotype, -5/del(5q) and -7/del(7q) were seen in, respectively, 11(1%) and 27 (3%). Monosomy occurred in 115 (13%) patients, 70 (8%) responded to the definition of monosomal karyotypes. INTERPRETATION This is the largest study done in Morocco, Africa and Middle East. Epidemiological studies involving different ethnic populations and geographic regions of the world should help unfold the true nature of environmental and genetic interplay in the development of AML. Our cytogenetic profile reveals some particularities when compared to other populations; it does not seem to be similar neither to eastern or western countries.
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Affiliation(s)
- Nisrine Khoubila
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco.
| | - Mounia Bendari
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco
| | - Nezha Hda
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco
| | - Mouna Lamchahab
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco
| | - Meryem Qachouh
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco
| | - Mohamed Rachid
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco
| | - Asmaa Quessar
- Hematology and Pediatric Oncology Unit, University Hospital Ibn Rochd, 20 August 1953 Hospital, 6, Rue Lahcen EL Arjoune, Casablanca 20000, Morocco; Faculty of Medicine and Pharmacy of Casablanca. Casablanca Hassan II university, Morocco
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Lins MM, Mello MJG, Ribeiro RC, De Camargo B, de Fátima Pessoa Militão de Albuquerque M, Thuler LCS. Survival and risk factors for mortality in pediatric patients with acute myeloid leukemia in a single reference center in low-middle-income country. Ann Hematol 2019; 98:1403-1411. [PMID: 30915498 DOI: 10.1007/s00277-019-03661-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/06/2019] [Indexed: 01/13/2023]
Abstract
Despite advances in therapy and care for children with acute myeloid leukemia (AML), survival rates for children in low- and middle-income countries (LMICs) remain poor. We studied risk factors for mortality and survival in children with AML in a LMIC to develop strategies to improve survival for AML children in these countries. This retrospective cohort (2000-2014) analyzed newly diagnosed AML patients (age < 19 years) at a reference center in Brazil. Demographic and clinical variables were reviewed by AML subtype: acute promyelocytic leukemia (APL), AML with Down syndrome (AML-DS), and other AML subtypes. Cumulative hazard risk for early death (ED) until 6 weeks of treatment and risk factors for mortality were determined by the multivariate Cox hazard models. Survival was assessed for each AML subtypes. A total of 220 patients were diagnosed: APL 50 (22.7%), AML-DS 16 (7.3%), and other AML subtypes 154 (70.0%). The cumulative hazard function values for ED for all patients with AML were 12.5% (95% CI 8.5-18.4%); for each AML patients subtypes: APL, 21.7% (95% CI 11.7-40.5%); AML-DS, 6.2% (95% CI 0.9-44.4%); and other AML subtypes, 10.2% (95% CI 6.2-17.0%). White blood cell count (cutoff 10 × 109/L for APL and 100 × 109/L for other AML subtypes) and Afro-descendance were significant risk factors for mortality in APL and other AML subtypes, respectively. Overall survival for patients with APL, AML-DS, and other AML subtypes was 66.8%, 62.5%, and 38.0%, respectively. APL patients had the highest incidence of ED and those with other subtypes had increased relapse risk. We also observed high rates of death in complete remission mainly due to infection. Better risk classification and identification of risk factors for infection may improve the survival of these patients.
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Affiliation(s)
- Mecneide Mendes Lins
- Pediatric Oncology Unit, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
| | - Maria Julia Gonçalves Mello
- Pediatric Research Center, Instituto de Medicina Integral Prof. Fernando Figueira, Rua dos Coelhos, 300 Boa Vista, Recife, PE, 50070-550, Brazil.
| | - Raul C Ribeiro
- Department of Oncology and Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
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Cytogenetic abnormalities and monosomal karyotypes in children and adolescents with acute myeloid leukemia: correlations with clinical characteristics and outcome. Cancer Genet 2013; 206:63-72. [PMID: 23411131 DOI: 10.1016/j.cancergen.2013.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 01/04/2013] [Accepted: 01/04/2013] [Indexed: 01/24/2023]
Abstract
The whole spectrum of chromosomal abnormalities and their prognostic significance in children and adolescents with acute myeloid leukemia (AML) has not been fully elucidated yet, although a considerable amount of knowledge has been gained recently. Moreover, the incidence and prognostic impact of monosomal karyotypes (MKs), which are new cytogenetic categories reported recently in adults with AML, are currently unknown for childhood and adolescent AML. In this study, we investigated the cytogenetic and clinical characteristics of 140 children and adolescents (≤21 y) with AML, and correlated their cytogenetic features with both the clinical characteristics and outcomes of our patient cohort. The most frequent cytogenetic abnormality found in our study was the t(15;17), followed by the t(8;21). Striking differences in the genetic abnormalities and French-American-British subtypes were found among infants, children, and adolescents. Of 124 cases, 15 (12.1%) met the criteria of the MK definition, and 12 of the 15 MKs (80%) were complex karyotypes. Of 124 cases, 27 (21.8%) had cytogenetic abnormalities sufficient to be diagnosed as AML with myelodyspastic sydrome-related features. As expected, patients with the t(15;17) had the most favorable outcomes, whereas patients with 11q23 rearrangements and monosomy 7 had the worst outcomes. These data expand our knowledge by providing novel insights into the cytogenetic features and their correlations with clinical characteristics and outcomes in childhood and adolescent AML.
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Ali N, Adil SN, Shaikh MU, Masood N. Allogeneic stem cell transplantation in acute myeloid leukemia. Hematol Rep 2012; 4:e25. [PMID: 23355943 PMCID: PMC3555213 DOI: 10.4081/hr.2012.e25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 09/11/2012] [Accepted: 11/08/2012] [Indexed: 11/25/2022] Open
Abstract
We report a case series of 12 patients with acute myeloid leukemia who underwent allogeneic stem cell transplant with a matched related donor. Male to female ratio was 1:1. The main complication post-transplant was graft-versus-host disease (n=7 patients). Transplant-related mortality involved one patient; cause of death was multi-organ failure. After a median follow up of 36.0±11.3 months, overall survival was 16%.
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Gmidène A, Sennana H, Wahchi I, Youssef YB, Jeddi R, Elloumi M, Saad A. Cytogenetic profile of a large cohort of Tunisian de novo acute myeloid leukemia. ACTA ACUST UNITED AC 2012; 17:9-14. [PMID: 22549442 DOI: 10.1179/102453312x13221316477417] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Cytogenetic data are essential not only for the diagnosis of acute myeloid leukemia but also for the evaluation of prognosis. Large systematic studies of cytogenetic aberrations in patients with acute myeloid leukaemia (AML) from Arab countries are not available. METHODS We analysed 631 consecutive newly diagnosed AML patients by conventional cytogenetics and compared our results with reports from other regions of the world. There were 97 (15·4%) children and 534 (84·6%) adults. RESULTS Abnormal karyotypes were found in 397 (62·9%) of all cases. T(15;17) and t(8;21) were the most frequent chromosomal abnormalities observed in 83 (13·2%) and in 78 (12·4%) patients, respectively. -5/del(5q) and -7/del(7q) were less frequent, seen in only 14 (2·2%) and 19 (3%) cases, respectively. Trisomy 8 was found in 44 (7%) of our patients followed by 11q23 rearrangements seen in 24 (3·8%) and then by inv(16) observed in only 22 (3·5%) of all cases. Unusual or novel cytogenetic abnormalities were found in 107 (17%) of our patients. DISCUSSION Although we confirmed, as usually described, that some recurrent cytogenetic abnormalities are correlated with the FAB subtypes, we noted however that some of them vary in frequency among different geographical areas and ethnic groups. This finding suggests a geographic heterogeneity in the pathogenesis of AML but more extensive epidemiological studies are required to confirm this.
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Affiliation(s)
- Abir Gmidène
- Department of Cytogenetics and Reproductive Biology, Farhat Hached University Hospital, Sousse, Tunisia.
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Epidemiology and treatment of acute promyelocytic leukemia in latin america. Mediterr J Hematol Infect Dis 2011; 3:e2011049. [PMID: 22110899 PMCID: PMC3219651 DOI: 10.4084/mjhid.2011.049] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 09/23/2011] [Indexed: 11/08/2022] Open
Abstract
Distinct epidemiological characteristics have been described in Acute Promielocytic Leukemia (APL). Populations from Latin America have a higher incidence of APL and in some geographic areas a distinct distribution of the PML-RARA isoforms is present. Here, we review the main differences in APL epidemilogy in Latin America as well as treatment outcomes.
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Hernández JM, Granada I, Solé F. [From conventional cytogenetics to microarrays. Fifty years of Philadelphia chromosome]. Med Clin (Barc) 2011; 137:221-9. [PMID: 20591449 DOI: 10.1016/j.medcli.2010.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Accepted: 04/27/2010] [Indexed: 11/16/2022]
Abstract
In 1960 Ph-chromosome was found associated with the presence of chronic myelogenous leukemia. In these 50 years an increasing number of cytogenetic abnormalities have been found associated with hematological malignancies. The presence of these abnormalities is not only important for the diagnosis of the patient, but it also contributes to the prognosis of patients with leukemia or lymphoma. For this reason the WHO classification of hematological disease has included these studies for the correct characterization of leukemias and lymphomas. In addition, the use of FISH and micromatrix methodologies have refined the genetic lesions present in these malignancies. The cytogenetic changes observed also provide further information in relation to the therapy.
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Affiliation(s)
- Jesús M Hernández
- Servicio de Hematología, Hospital Universitario de Salamanca y Unidad de Diagnóstico Molecular y Celular del Cáncer, Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Centro de Investigación del Cáncer, Universidad de Salamanca, Salamanca, España.
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Ribeiro RC, Rego E. Management of APL in Developing Countries: Epidemiology, Challenges and Opportunities for International Collaboration. Hematology 2006:162-8. [PMID: 17124056 DOI: 10.1182/asheducation-2006.1.162] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Acute promyelocytic leukemia (APL), a relatively rare hematologic malignancy, is highly curable with current treatment strategies. However, these strategies may be unavailable in countries with limited resources. A review of records in several Latin American countries revealed that approximately 30% of deaths among children and adults with APL were caused by early complications associated with the disease or its treatment. Further, APL accounts for 20% to 25% of cases of AML in these countries, consistent with the previous observation of increased incidence of APL in Latin Americans. The lack of population-based registries in developing countries has made it difficult to determine the real incidence of APL. Moreover, APL appears to have other unique epidemiologic characteristics, including association of primary APL with an increased body mass index at diagnosis and association of secondary APL with breast cancer. To facilitate the development of local capacity and implement effective treatment of APL in developing countries, the International Committee of the American Society of Hematology has assembled a working group to formulate treatment guidelines based on evidence from clinical trials results in the developed world but adapted to local resources. It is hoped that uniform treatment, careful documentation of specific outcome data, and ongoing monitoring of treatment efficacy and toxicity will improve the cure rate and provide biologic and epidemiologic information about APL in developing countries. This initial demonstration project may be joined by other countries, providing a framework for additional clinical investigation in this highly curable form of leukemia.
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Affiliation(s)
- Raul C Ribeiro
- St. Jude Children's Research Hospital, 332 North Lauderdale Street, Memphis, TN 38105-2794, USA.
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