1
|
Tzeng HE, Lee YW, Lin CT, Chuang SS, Li CC, Chuang WH, Hsu CA, Wang YH, Tien HF, Wu SJ. Multicolour and lineage-specific interphase chromosome Flow-FISH: method development and clinical validation. Pathology 2024; 56:671-680. [PMID: 38852040 DOI: 10.1016/j.pathol.2024.04.001] [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: 10/17/2023] [Revised: 03/01/2024] [Accepted: 04/14/2024] [Indexed: 06/10/2024]
Abstract
Flow cytometry can be applied in the detection of fluorescence in situ hybridisation (FISH) signals to efficiently analyse chromosomal aberrations. However, such interphase chromosome (IC) Flow-FISH protocols are currently limited to detecting a single colour. Furthermore, combining IC Flow-FISH with conventional multicolour flow cytometry is difficult because the DNA-denaturation step in FISH assay also disrupts cellular integrity and protein structures, precluding subsequent antigen-antibody binding and hindering concurrent labeling of surface antigens and FISH signals. We developed a working protocol for concurrent multicolour flow cytometry detection of nuclear IC FISH signals and cell surface markers. The protocol was validated by assaying sex chromosome content of blood cells, which was indicative of chimerism status in patients who had received sex-mismatched allogeneic haematopoietic stem cell transplants (allo-HSCT). The method was also adapted to detect trisomy 12 in chronic lymphocytic leukaemia (CLL) subjects. We first demonstrated the feasibility of this protocol in detecting multiple colours and concurrent nuclear and surface signals with high agreement. In clinical validation experiments, chimerism status was identified in clinical samples (n=56) using the optimised IC Flow-FISH method; the results tightly corresponded to those of conventional slide-based FISH (R2=0.9649 for XX cells and 0.9786 for XY cells). In samples from patients who received sex-mismatched allo-HSCT, individual chimeric statuses in different lineages could be clearly distinguished with high flexibility in gating strategies. Furthermore, in CLL samples with trisomy 12, this method could demonstrate that enriched trisomy 12 FISH signal was present in B cells rather than in T cells. Finally, by performing combined labelling of chromosome 12, X chromosome, and surface markers, we could detect rare residual recipient CLL cells with trisomy 12 after allo-HSCT. This adaptable protocol for multicolour and lineage-specific IC Flow-FISH advances the technique to allow for its potential application in various clinical contexts where conventional FISH assays are currently being utilised.
Collapse
MESH Headings
- Humans
- In Situ Hybridization, Fluorescence/methods
- Flow Cytometry/methods
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Interphase
- Female
- Male
- Hematopoietic Stem Cell Transplantation
- Trisomy/diagnosis
- Trisomy/genetics
- Middle Aged
- Chromosomes, Human, Pair 12/genetics
Collapse
Affiliation(s)
- Huey-En Tzeng
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung City, Taiwan; Ph.D. Program for Cancer Molecular Biology and Drug Discovery, and Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung-Hsing University, Taichung, Taiwan
| | - Yi-Wei Lee
- Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chien-Ting Lin
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Shih-Sung Chuang
- Department of Pathology, Chi-Mei Medical Center, Tainan, Taiwan; Center of Stem Cell and Precision Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chi-Cheng Li
- Center of Stem Cell and Precision Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wen-Hui Chuang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Cheng-An Hsu
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Hua Wang
- Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hwei-Fang Tien
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, Far-East Memorial Hospital, New Taipei City, Taiwan
| | - Shang-Ju Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan.
| |
Collapse
|
2
|
Zhang L, Deeb G, Deeb KK, Vale C, Peker Barclift D, Papadantonakis N. Measurable (Minimal) Residual Disease in Myelodysplastic Neoplasms (MDS): Current State and Perspectives. Cancers (Basel) 2024; 16:1503. [PMID: 38672585 PMCID: PMC11048433 DOI: 10.3390/cancers16081503] [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: 02/17/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Myelodysplastic Neoplasms (MDS) have been traditionally studied through the assessment of blood counts, cytogenetics, and morphology. In recent years, the introduction of molecular assays has improved our ability to diagnose MDS. The role of Measurable (minimal) Residual Disease (MRD) in MDS is evolving, and molecular and flow cytometry techniques have been used in several studies. In this review, we will highlight the evolving concept of MRD in MDS, outline the various techniques utilized, and provide an overview of the studies reporting MRD and the correlation with outcomes.
Collapse
Affiliation(s)
- Linsheng Zhang
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - George Deeb
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Kristin K. Deeb
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Colin Vale
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA
| | - Deniz Peker Barclift
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nikolaos Papadantonakis
- Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA 30322, USA
| |
Collapse
|
3
|
Schwabkey ZI, Al Ali N, Chan O, Sallman DA, Padron E, Kuykendall AT, Talati C, Sweet K, Lancet JE, Komrokji RS. Fluorescence in Situ Hybridization (FISH) Utility for Risk Score Assessment in Patients With MDS With Normal Metaphase Karyotype. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 21:e52-e56. [PMID: 33093008 DOI: 10.1016/j.clml.2020.08.012] [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: 05/29/2020] [Revised: 08/05/2020] [Accepted: 08/10/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Cytogenetic profile is an essential parameter in myelodysplastic syndromes (MDS) risk stratification by both International Prognostic Symptom Score (IPSS) and Revised (R)-IPSS. Almost one-half of patients with MDS have normal cytogenetics by metaphase karyotype. Here we report the yield of MDS fluorescence in situ hybridization (FISH) panel detecting cytogenetic abnormalities in these patients and its impact on risk stratification. PATIENTS AND METHODS Among patients with normal metaphase karyotype, we assessed those patients who had cytogenetic abnormalities detected by an MDS FISH panel, which included probes for del (5), del (7), del (20), trisomy 8, and del (17p). Risk stratification was calculated by both IPSS and R-IPSS. RESULTS Of 1600 patients with MDS with normal metaphase karyotype, 53 (3%) patients had cytogenetic abnormality detected by MDS FISH panel. Integrating the MDS FISH panel cytogenetics (IPSS + FISH restaging) resulted in upstaging the score, where 53% of low-risk IPSS were upstaged to intermediate (int)-1, 56% of int-1 were upstaged to int-2, and 78% of int-2 were upstaged to high risk. Based on the R-IPSS, 61% of very low-risk patients, all low-risk patients, 92% of intermediate-risk patients, and 50% of high-risk patients with FISH abnormalities were upstaged, respectively. CONCLUSION The yield of MDS FISH panel detecting cytogenetic abnormalities in patients with normal karyotype by G-banding is low and may not warrant ordering the panel in all patients. Among the 3% of patients with normal karyotype who had cytogenetic abnormality detected by FISH, the risk score assignment by IPSS and R-IPSS was upstaged.
Collapse
Affiliation(s)
- Zaker I Schwabkey
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Najla Al Ali
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Onyee Chan
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - David A Sallman
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Eric Padron
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | | | - Chetasi Talati
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Kendra Sweet
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Jeffrey E Lancet
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL
| | - Rami S Komrokji
- Department of Malignant Hematology, H. Lee Moffitt Cancer Center, Tampa, FL.
| |
Collapse
|
4
|
Zakhia DA, Voronel O, Zaiem F, Raval K, Yang J, Schloff D, Mohamed AN, Gabali AM. Comparative assessment of conventional chromosomal analysis and fluorescence in situ hybridization in the evaluation of suspected myelodysplastic syndromes: A single institution experience. Avicenna J Med 2019; 9:55-60. [PMID: 31143698 PMCID: PMC6530274 DOI: 10.4103/ajm.ajm_183_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background: Myelodysplastic syndromes (MDSs) are a heterogeneous group of clonal hematopoietic neoplasms, roughly half of which harbor cytogenetic abnormalities with diagnostic, prognostic, and therapeutic significance. Fluorescence in situ hybridization (FISH) for the most commonly seen abnormalities (5/5q, –7/7q, +8, and –20/20q–) is routinely performed alongside conventional cytogenetics (CC) in the evaluation of suspected MDS despite conflicting reports of its relative contribution compared to CC alone. Objectives: To assess the additional diagnostic and prognostic value of performing concurrent FISH versus CC alone in cases of suspected MDS. Materials and Methods: A total of 127 bone marrow samples submitted to our cytogenetic laboratory with a presumptive diagnosis of MDS were evaluated by concurrent CC and an MDS FISH panel. Results: CC was used as the gold standard method with 100% sensitivity in detecting suspected MDS-associated cytogenetic abnormalities. FISH alone had a sensitivity of 76%, whereas CC alone achieved a sensitivity of 97%. The addition of FISH did not change the diagnosis nor change the Revised International Prognostic Scoring System score in any patient. Moreover, in 12 cases identified as positive by both CC and FISH, CC identified multiple chromosomal aberrations of clinical significance not interrogated by the FISH probe panel. Conclusion: CC alone is sufficiently sensitive in detecting suspected MDS-associated cytogenetic abnormalities that influence clinical decision-making. Routine FISH testing does not provide a significant increase in test sensitivity when an adequate karyotype is obtained. Therefore, FISH testing is best reserved for suspected MDS cases lacking sufficient metaphases.
Collapse
Affiliation(s)
- Denyo Adjoa Zakhia
- Division of Hematopathology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, MI, USA
| | - Olga Voronel
- Division of Hematopathology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, MI, USA
| | - Feras Zaiem
- Division of Hematopathology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, MI, USA
| | - Kunil Raval
- Division of Hematopathology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, MI, USA
| | - Jay Yang
- Division of Hematology/Oncology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, MI, USA
| | - Deborah Schloff
- Division of Cytogenetics, Wayne State University, Detroit, Michigan, USA
| | - Anwar N Mohamed
- Division of Cytogenetics, Wayne State University, Detroit, Michigan, USA
| | - Ali M Gabali
- Division of Hematopathology, Barbara Ann Karmanos Center and Wayne State University School of Medicine, Detroit, MI, USA
| |
Collapse
|
5
|
Magalhães SMM, Niero-Melo L, Chauffaille MDLLF, Velloso EDRP, Lorand-Metze I, Buzzini R, Bernardo WM. Guidelines on myelodysplastic syndromes: Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Hematol Transfus Cell Ther 2018; 40:255-261. [PMID: 30128435 PMCID: PMC6098189 DOI: 10.1016/j.htct.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 05/22/2018] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Lígia Niero-Melo
- Faculdade de Medicina de Botucatu da Universidade Estadual Paulista (FMB Unesp), Botucatu, SP, Brazil
| | | | - Elvira Deolinda Rodrigues Pereira Velloso
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC FMUSP), São Paulo, SP, Brazil; Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Irene Lorand-Metze
- Instituto Nacional de Ciência e Tecnologia do Sangue da Universidade Estadual de Campinas (Hemocentro Unicamp), Campinas, SP, Brazil
| | - Renata Buzzini
- Associação Médica Brasileira (AMB), São Paulo, SP, Brazil
| | - Wanderley Marques Bernardo
- Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HC FMUSP), São Paulo, SP, Brazil; Associação Médica Brasileira (AMB), São Paulo, SP, Brazil
| |
Collapse
|
6
|
Asadi Fakhr Z, Mehrzad V, Izaditabar A, Salehi M. Evaluation of the utility of peripheral blood vs bone marrow in karyotype and fluorescence in situ hybridization for myelodysplastic syndrome diagnosis. J Clin Lab Anal 2018; 32:e22586. [PMID: 29893006 DOI: 10.1002/jcla.22586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/19/2018] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To clear the role of peripheral blood as a substitution for bone marrow in myelodysplastic syndrome and to evaluate the concordance between peripheral blood and bone marrow using karyotype and fluorescence in situ hybridization (FISH) methods. METHODS We examined 35 bone marrow (BM) and peripheral blood (PB) samples from myelodysplastic syndrome (MDS) patient using karyotype and FISH. Karyotype method for BM and PB samples performed using the standard protocol with an exception for peripheral blood in which growth factor for cultivation was not used. FISH testing was performed using a panel of MDS-associated probes to detect 20q12, 20qter, 5q31, 5q33, 5p15 and chromosome 7 and 8 centromeres. RESULTS Our results showed karyotypes of BM and PB are concordant in 74% of cases, while about 53% of these concordances were achieved from cases with normal karyotypes. However, the results of BM FISH were completely concordant with PB FISH. CONCLUSION Although peripheral blood karyotype is not trustworthy for MDS diagnosis, examining peripheral blood, using the FISH method, could be useful for clinical monitoring.
Collapse
Affiliation(s)
- Zhaleh Asadi Fakhr
- Department of Genetics and Molecular Biology, Medical School, Isfahan University of Medical Science, Isfahan, Iran
| | - Valiollah Mehrzad
- Department of Hematology and Oncology, Medical School, Omid Hospital, Isfahan University of Medical Science, Isfahan, Iran
| | | | - Mansoor Salehi
- Department of Genetics and Molecular Biology, Medical School, Isfahan University of Medical Science, Isfahan, Iran.,Medical Genetics Center of Genome, Isfahan, Iran
| |
Collapse
|
7
|
Ryu S, Park HS, Kim SM, Im K, Kim JA, Hwang SM, Yoon SS, Lee DS. Shifting of erythroleukemia to myelodysplastic syndrome according to the revised WHO classification: Biologic and cytogenetic features of shifted erythroleukemia. Leuk Res 2018; 70:13-19. [PMID: 29729583 DOI: 10.1016/j.leukres.2018.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 11/19/2022]
Abstract
The 2016 revision of the World Health Organization (WHO) classification of tumours of haematopoietic and lymphoid tissues was published. According to 2016 WHO criteria, diagnostic criteria of acute erythroid leukemia was revised. We reassessed 34 de novo acute erythroid leukemia (AEL) diagnosed by 2008 WHO criteria, according to 2016 WHO criteria. A total of 623 patients (excluding M3) with acute myeloid leukemia including 34 patients with AEL were enrolled. Among 34 patients diagnosed with AEL, diagnosis was shifted to MDS-EB in 28 patients (28/34, 82.3%) and MDS-U in 2 patients (2/34, 5.9%), while remained as AEL in 4 patients (4/34, 11.8%) according to 2016 WHO criteria. Interphase FISH for cytogenetic changes of MDS (-5/del(5q), -7/del(7q), del(20q), +8) revealed cytogenetic aberrations in 50.0% (17/34) of AEL 2008 group. AEL 2008 group showed higher frequency of complex cytogenetic abnormalities and higher MDS related cytogenetic abnormalities than AML excluding AEL group. Transformation to another AML subtype was noted in 10% in AEL shifted to MDS. Majority (88.2%) of AEL by 2008 WHO criteria was reclassified to MDS by 2016 WHO criteria. Clinical characteristics of shifted AEL were similar to those of MDS rather than de novo AML.
Collapse
Affiliation(s)
- Sohee Ryu
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hee Sue Park
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung-Min Kim
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyongok Im
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-Ah Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sang Mee Hwang
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Sung-Soo Yoon
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Hematology/Oncology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Soon Lee
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
8
|
Costa MB, Borges DDP, Melo MMDL, Magalhães SMM, Pinheiro RF. It is not just the number of metaphases that matters. Leuk Res 2018; 68:70-71. [PMID: 29567493 DOI: 10.1016/j.leukres.2018.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 02/28/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Marília Braga Costa
- Cancer Cytogenomic Laboratory, Federal University of Ceara, Fortaleza, Ceara, Brazil; Post-Graduate Program in Medical Science, Federal University of Ceara, Fortaleza, Ceara, Brazil; Center for Research and Drug Development (NPDM) , Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Daniela de Paula Borges
- Cancer Cytogenomic Laboratory, Federal University of Ceara, Fortaleza, Ceara, Brazil; Post-Graduate Program in Medical Science, Federal University of Ceara, Fortaleza, Ceara, Brazil; Center for Research and Drug Development (NPDM) , Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Mayara Magna de Lima Melo
- Cancer Cytogenomic Laboratory, Federal University of Ceara, Fortaleza, Ceara, Brazil; Post-Graduate Program in Medical Science, Federal University of Ceara, Fortaleza, Ceara, Brazil; Center for Research and Drug Development (NPDM) , Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Silvia Maria Meira Magalhães
- Cancer Cytogenomic Laboratory, Federal University of Ceara, Fortaleza, Ceara, Brazil; Post-Graduate Program in Medical Science, Federal University of Ceara, Fortaleza, Ceara, Brazil; Center for Research and Drug Development (NPDM) , Federal University of Ceara, Fortaleza, Ceara, Brazil
| | - Ronald Feitosa Pinheiro
- Cancer Cytogenomic Laboratory, Federal University of Ceara, Fortaleza, Ceara, Brazil; Post-Graduate Program in Medical Science, Federal University of Ceara, Fortaleza, Ceara, Brazil; Center for Research and Drug Development (NPDM), Federal University of Ceara, Fortaleza, Ceara, Brazil; Post-Graduate Program of Pathology, Federal University of Ceara, Fortaleza, Ceara, Brazil, Brazil.
| |
Collapse
|
9
|
Ashok V, Ranganathan R, Chander S, Damodar S, Bhat S, S NK, A SK, Jadav SS, Rajashekaraiah M, T S S. Comparison of Diagnostic Yield of a FISH Panel Against Conventional Cytogenetic Studies for Hematological Malignancies: A South Indian Referral Laboratory Analysis Of 201 Cases. Asian Pac J Cancer Prev 2017; 18:3457-3464. [PMID: 29286619 PMCID: PMC5980910 DOI: 10.22034/apjcp.2017.18.12.3457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives: Genetic markers are crucial fort diagnostic and prognostic investigation of hematological malignancies (HM). The conventional cytogenetic study (CCS) has been the gold standard for more than five decades. However, FISH (Fluorescence in Situ Hybridization) testing has become a popular modality owing to its targeted approach and the ability to detect abnormalities in non-mitotic cells. We here aimed to compare the diagnostic yields of a FISH panel against CCS in HMs. Methods: Samples of bone marrow and peripheral blood for a total of 201 HMs were tested for specific gene rearrangements using multi-target FISH and the results were compared with those from CCS. Results: Exhibited a greater diagnostic yield with a positive result in 39.8% of the cases, as compared to 17.9% of cases detected by CCS. Cases of chronic lymphocytic leukaemia (CLL) benefited the most by FISH testing, which identified chromosomal aberrations beyond the capacity of CCS. FISH was least beneficial in myelodysplastic syndrome (MDS) where the highest concordance with CCS was exhibited. Acute lymphocytic leukaemia (ALL) demonstrated greater benefit with CCS. In addition, we found the following abnormalities to be most prevalent in HMs by FISH panel testing: RUNX1 (21q22) amplification in ALL, deletion of D13S319/LAMP1 (13q14) in CLL, CKS1B (1q21) amplification in multiple myeloma and deletion of EGR1/RPS14 (5q31/5q32) in MDS, consistent with the literature. Conclusions: In conclusion, FISH was found to be advantageous in only a subset of HMs and cannot completely replace CCS. Utilization of the two modalities in conjunction or independently should depend on the indicated HM for an optimal approach to detecting chromosomal aberrations.
Collapse
Affiliation(s)
- Vishal Ashok
- Department of Cytogenetics, Anand Diagnostic Laboratory, Bangalore, India.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Bunting CT, Senior T, Susson Y, Rivera A, Saxe D, Bunting ST. Utility of Fluorescence In Situ Hybridization Panel for Myelodysplastic Syndrome in Evaluation of Cytopenia in a Pediatric Hospital: A 5-Year Retrospective Review and Utilization Management. Lab Med 2017; 48:266-270. [PMID: 28934515 DOI: 10.1093/labmed/lmx047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background MDS FISH was routinely ordered together with chromosome analysis for patients with cytopenia in our hospital. The utility of MDS FISH in the pediatric population is unknown. Objective To analyze the utility of fluorescence in situ hybridization panel for myelodysplastic syndrome (MDS FISH) in the management of patients with cytopenia. Methods We performed a retrospective review over a 5-year period, from 2009 to 2014 to determine whether chromosome analysis (CA) plus MDS FISH added useful information compared to chromosome analysis alone. Both CA and MDS FISH were performed on 253 bone marrow biopsies from 182 patients. Results CA was highly correlated with MDS FISH (P < .0001) and detected all of the abnormalities seen by MDS FISH in 93.7% of the cases. CA is less expensive and detects additional chromosomal abnormalities not tested in the myelodysplastic syndrome panel. We propose MDS FISH should be ordered when CA fails to give adequate results.
Collapse
Affiliation(s)
| | - Tal Senior
- Business Intelligence, Children's Healthcare of Atlanta, GA
| | - Yehuda Susson
- Business Intelligence, Children's Healthcare of Atlanta, GA
| | - Alethia Rivera
- Department of Pathology, Children's Healthcare of Atlanta, GA
| | - Debra Saxe
- Department of Pathology, Emory University School of Medicine, Atlanta, GA
| | - Silvia T Bunting
- Department of Pathology, Children's Healthcare of Atlanta, GA.,Department of Pathology, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
11
|
Chi K, Li Y, Xu L, Wang X. A novel recurrent copy number loss region on 6q23.3 in MDS-related myeloid malignancy patients with stable survival conditions. Leuk Lymphoma 2017; 58:2470-2479. [PMID: 28394181 DOI: 10.1080/10428194.2017.1292357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Metaphase cytogenetics (MC) karyotyping is a fundamental way to approach cytogenetic pathogenesis of MDS-related myeloid malignancies. However, in some patients, the results are normal while the patients often show discrepancies in survival conditions. To explain this question, we analyzed CytoScan™ HD array results of 20 MC-normal/failure patients who were followed up for three years. Exon sequencing was performed in genes RUNX1, TP53, ASXL1, and TET2. The array enabled the detection of additional aberrations in 16 (80%) patients. Eight patients were detected with cryptic copy number losses and six of them got aggressive disease conditions. RUNX1 mutations were sequenced in P110 and P114. Most importantly, two patients (P114 and P116) with copy number loss aberrations got stable survival conditions during follow-ups, and a novel recurrent copy number loss region harboring the proto-oncogene MYB was detected on chromosome 6q23.3 in both of them, which might benefit the survival of the patients.
Collapse
Affiliation(s)
- Kun Chi
- a Department of Laboratory Medicine , Qingdao Women & Children's Hospital , Qingdao , China.,b State Key Laboratory of Medical Genomics , Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Yang Li
- b State Key Laboratory of Medical Genomics , Shanghai Institute of Hematology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Lan Xu
- c Department of Hematology , Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| | - Xuefeng Wang
- d Department of Laboratory Medicine , Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai , China
| |
Collapse
|
12
|
Basha B, Smith J, Rogers HJ, Cook JR. What Is the Clinical Utility of Repeat SNP Array Testing in the Follow-up of Myeloid Neoplasms?: A Retrospective Analysis of 44 Patients With Serial SNP Arrays. Am J Clin Pathol 2017; 147:278-284. [PMID: 28395056 DOI: 10.1093/ajcp/aqx003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Single-nucleotide polymorphism (SNP) arrays have been shown to identify cytogenetic abnormalities in myeloid neoplasms that may be missed by metaphase cytogenetics alone at initial diagnosis. This study examines the utility of serial SNP arrays in follow-up testing of myeloid neoplasms. METHODS We retrospectively reviewed results of SNP array testing in 44 patients with myeloid neoplasms and more than one SNP array study (n = 133 SNP arrays total; median, three per patient; range, two to eight per patient). RESULTS Baseline abnormalities were identified by SNP array in 35 (79%) of 44 (79%) compared with 18 (50%) of 36 by metaphase karyotype. In follow-up studies, clonal evolution was found by both SNP array and karyotyping in seven (15.9%), by metaphase karyotyping alone in six (13.6%), and SNP arrays alone in two (4.5%). Overall survival was not significantly different between patients with or without clonal evolution detected by SNP array. CONCLUSIONS This study, the first systematic examination of serial SNP arrays in myeloid neoplasms, confirms the clinical utility of SNP arrays at initial diagnosis but shows that clonal evolution of the karyotype can be detected by metaphase cytogenetics alone in most patients. Follow-up SNP array testing is not required in routine clinical use in most cases.
Collapse
Affiliation(s)
- Basma Basha
- From the Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | - Janice Smith
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX
| | - Heesun J Rogers
- From the Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| | - James R Cook
- From the Department of Laboratory Medicine, Cleveland Clinic, Cleveland, OH
| |
Collapse
|
13
|
Chandrashekar V, Tarigopula A, Govindasami P. Cytogenetic profiling by FISH microscopy and comparison with light microscopy and complete blood count findings in myelodysplastic syndrome. J Microsc 2016; 265:94-100. [PMID: 27576943 DOI: 10.1111/jmi.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/10/2016] [Accepted: 08/02/2016] [Indexed: 11/28/2022]
Abstract
Karyotype, bone marrow blast percentage and cytopenia influence the prognosis of myelodysplastic syndrome. We studied the abnormalities detected by fluorescence in situ hybridization (FISH) in myelodysplastic syndrome and associated haematological profile with abnormalities detected by FISH. Complete blood counts, peripheral blood and bone marrow of patients were evaluated for cytopenia, dysplasia and blasts. FISH probes were used to detect del(5q), gain of chromosome 8, de (7q/-7) and del(20 q). Multiple regression analysis was used to study the association of FISH abnormalities, age and sex with haematological profile. Mc Nemar's test studied the relationship between FISH abnormalities and dysplastic features in bone marrow. Cytogenetic abnormalities were detected by FISH in 25.7% of patients. Del(20 q) was seen in 14.2% of patients. FISH was able to predict changes in peripheral blood blast count by 80% (p ˂ 0.0001). Cytogenetic abnormalities were not seen in 74.2% of patients. Groups with FISH abnormalities have a different haematological profile, and these abnormalities have a significant effect on blast percentage.
Collapse
Affiliation(s)
- V Chandrashekar
- Department of Hematology Apollo Hospitals, 21, off Greams Road, Greams Lane Chennai - 600006
| | - A Tarigopula
- Department of Centralised Molecular Diagnostics Apollo Hospitals, 21, off Greams Road, Greams Lane Chennai - 600006
| | - P Govindasami
- Perumal G M.Sc, PG DMLT, (P.hD) Department of Centralised Molecular Diagnostics Apollo Hospitals, 21, off Greams Road, India, Greams Lane Chennai - 600006
| |
Collapse
|
14
|
He R, Wiktor AE, Durnick DK, Kurtin PJ, Van Dyke DL, Tefferi A, Patnaik MS, Ketterling RP, Hanson CA. Bone Marrow Conventional Karyotyping and Fluorescence In Situ Hybridization: Defining an Effective Utilization Strategy for Evaluation of Myelodysplastic Syndromes. Am J Clin Pathol 2016; 146:86-94. [PMID: 27353768 DOI: 10.1093/ajcp/aqw077] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The current standard of practice for evaluation of myelodysplastic syndromes (MDS) includes peripheral blood and bone marrow morphology review and conventional karyotyping. Karyotype provides a global view of the chromosome complement while fluorescence in situ hybridization (FISH) targets specific abnormalities. The aim of this study was to determine if an MDS-FISH panel would add value beyond karyotype in MDS workup. METHODS We studied 505 patients who were evaluated for a possible MDS and had concurrent bone marrow examination, karyotyping, and MDS-FISH performed. RESULTS In total, 462 cases had adequate karyotyping (≥20 metaphases) and showed excellent concordance (96%, 445/462) between karyotyping and MDS-FISH. Additional FISH abnormalities had no impact on diagnosis and minimal impact on the cytogenetic prognostic scoring in the myeloid neoplasm cases (2%, 4/206). The concordance rate dropped to 82% (32/39) in the group with insufficient karyotyping (<20 metaphases), and additional FISH findings in this subgroup had no impact on the diagnosis but altered the cytogenetic prognostic scoring in 10% (2/20) of myeloid neoplasm cases. CONCLUSIONS In the evaluation of a possible MDS, FISH rarely provides additional value when karyotype is adequate. We propose a value-based, cost-effective algorithmic approach for conventional karyotyping and FISH testing in routine MDS workup.
Collapse
Affiliation(s)
- Rong He
- From the Divisions of Hematopathology
| | | | | | | | | | - Ayalew Tefferi
- Hematology, Mayo Clinic College of Medicine, Rochester, MN
| | | | | | | |
Collapse
|
15
|
Park JH, Kim M, Kong SY, Yoon SS, Lee DS. Monitoring of the Clonal Fraction by Fluorescence In Situ Hybridization in Myelodysplastic Syndrome: Comparison With International Working Group Treatment Response Criteria. Arch Pathol Lab Med 2016; 140:560-9. [PMID: 27232348 DOI: 10.5858/arpa.2015-0150-oa] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -At the initial diagnosis of myelodysplastic syndrome (MDS) and/or during follow-up, the evaluation of chromosomal abnormalities is based on standard G-banding, whereas the utility of fluorescence in situ hybridization (FISH) is still debated. OBJECTIVES -To investigate whether interphase fluorescence in situ hybridization (iFISH) clone size at initial diagnosis of MDS is correlated with survival and whether changes in clonal fraction by iFISH are concordant with the MDS International Working Group response criteria during follow-up. DESIGN -A tailored FISH panel (-5/5q-, -7/7q-, +8, -20/20q-, and +1/1q+), based on reported cytogenetic changes in Korean patients with MDS, was performed in 81 patients with MDS at initial diagnosis and in 28 patients during follow-up. RESULTS -During follow-up, absolute increases in the clone size by iFISH by 20% or more, with relative increases of 50% or more, compared with previous specimens, were associated with transformation to acute myeloid leukemia (P = .001 and P = .002, respectively). Of the 28 patients with abnormal iFISH results, 7 (25%) showed discordance between iFISH and MDS International Working Group responses. Concordance between clone size by G-banding and iFISH was higher in the refractory cytopenia with unilineage dysplasia/refractory cytopenia with multilineage dysplasia group during follow-up, whereas the group with refractory anemia with excess blasts showed higher correlation at initial diagnosis. CONCLUSIONS -We conclude that iFISH can provide additional prognostic information and can predict the response to therapy in MDS.
Collapse
Affiliation(s)
- Jae Hyeon Park
- From the Departments of Laboratory Medicine (Drs Park and Lee), Internal Medicine (Dr Yoon), and the Cancer Research Institute (Drs Yoon and Lee), Seoul National University College of Medicine, Seoul, Korea; Department of Laboratory Medicine, National Cancer Center, Goyang-si, Korea (Dr Kong); and the Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, Korea (Dr Kim)
| | | | | | | | | |
Collapse
|
16
|
Lai YY, Huang XJ, Li J, Zou P, Xu ZF, Sun H, Shao ZH, Zhou DB, Chen FP, Liu ZG, Zhu HL, Wu DP, Wang C, Zhang Y, Li Y, Hou M, Du X, Wang X, Li W, Lai YR, Zhou J, Zhou YH, Fang MY, Qiu L, Wang XM, Zhang GS, Jiang M, Liang YM, Zhang LS, Chen XQ, Bai H, Lin JY. Standardized fluorescence in situ hybridization testing based on an appropriate panel of probes more effectively identifies common cytogenetic abnormalities in myelodysplastic syndromes than conventional cytogenetic analysis: a multicenter prospective study of 2302 patients in China. Leuk Res 2015; 39:530-5. [PMID: 25823643 DOI: 10.1016/j.leukres.2015.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/22/2015] [Accepted: 02/10/2015] [Indexed: 02/05/2023]
Abstract
In an attempt to establish the advantages of fluorescence in situ hybridization (FISH) studies over conventional cytogenetic (CC) analysis, a total of 2302 de novo MDS patients from 31 Chinese institutions were prospectively selected in the present study for both CC and standardized FISH analysis for +8, -7/7q-, -5/5q-, 20q- and-Y chromosomal abnormalities. CC analysis was successful in 94.0% of the patients; of these patients, 35.9% of the cases were abnormal. FISH analysis was successful in all 2302 patients and detected at least one type of common cytogenetic abnormality in 42.7% of the cases. The incidences of +8, -7/7q-, -5/5q-, 20q- and-Y chromosomal abnormalities by FISH were 4.1% to 8.7% higher than those by CC. FISH identified abnormalities in 23.6% of the patients exhibiting normal CC results and revealed that 20.7% of the patients with adequate normal metaphases (≥20) had abnormal clones. FISH identified cytogenetic abnormalities in 50.4% of the patients with failed CC analysis. In summary, our multicenter studies emphasised and confirmed the importance of applying standardized FISH testing based on an appropriate panel of probes to detect common cytogenetic abnormalities in Chinese de novo MDS patients, particularly those with normal or failed CC results.
Collapse
Affiliation(s)
- Yue-Yun Lai
- Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China
| | - Xiao-Jun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Beijing, China.
| | - Juan Li
- Department of Hematology, First Affiliated Hospital of Zhongshan University, Guangzhou, China
| | - Ping Zou
- Department of Hematology, Wuhan Union Hospital, Wuhan, China
| | - Ze-Feng Xu
- Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Hui Sun
- Department of Hematology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zong-Hong Shao
- Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China
| | - Dao-Bin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Beijing, China
| | - Fang-Ping Chen
- Department of Hematology, Xiangya Hospital of Central-South University, Changsha, China
| | - Zhuo-Gang Liu
- Department of Hematology, Shengjing Hospital, China Medical University, Shenyang, China
| | - Huan-Ling Zhu
- Department of Hematology, West China Hospital of Sichuan University, Chengdu, China
| | - De-Pei Wu
- Department of Hematology, First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun Wang
- Department of Hematology, Shanghai First People's Hospital, Shanghai, China
| | - Yin Zhang
- Department of Hematology, Henan Province People's Hospital, Zhengzhou, China
| | - Yan Li
- Department of Hematology, First Affiliated Hospital, China Medical University, Shenyang, China
| | - Ming Hou
- Department of Hematology, Qilu Hospital of Shandong University, Jinan, China
| | - Xin Du
- Department of Hematology, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital of Shandong University, Jinan, China
| | - Wei Li
- Department of Hematology, First Affiliated Hospital of Jilin University, Changchun, China
| | - Yong-Rong Lai
- Department of Hematology, First Affiliated Hospital, Guangxi Medical University, Nanning, China
| | - Jin Zhou
- Department of Hematology, First Clinical College of Harbin Medical University, Harbin, China
| | - Yu-Hong Zhou
- Department of Hematology, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou, China
| | - Mei-Yun Fang
- Department of Hematology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lin Qiu
- Harbin Institute of Hematology and Oncology, Harbin, China
| | - Xiao-Min Wang
- Department of Hematology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
| | - Guang-Sen Zhang
- Department of Hematology, Second Xiangya Hospital of Central-South University, Changsha, China
| | - Ming Jiang
- Department of Hematology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Ying-Min Liang
- Department of Hematology, Tangdu Hospital, Fourth Military Medical University, Xian, China
| | - Lian-Sheng Zhang
- Department of Hematology, Second Hospital of Lanzhou University, Lanzhou, China
| | - Xie-Qun Chen
- Department of Hematology, Xijing Hospital Affiliated to the Fourth Military Medical University, Xian, China
| | - Hai Bai
- Department of Hematology, Lanzhou General Hospital of Lanzhou Command, Lanzhou, China
| | - Jin-Ying Lin
- Department of Hematology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| |
Collapse
|
17
|
Nybakken GE, Bagg A. The genetic basis and expanding role of molecular analysis in the diagnosis, prognosis, and therapeutic design for myelodysplastic syndromes. J Mol Diagn 2014; 16:145-58. [PMID: 24457119 DOI: 10.1016/j.jmoldx.2013.11.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 11/09/2013] [Accepted: 11/21/2013] [Indexed: 12/31/2022] Open
Abstract
The myelodysplastic syndromes (MDS) are clonal hematopoietic stem cell disorders of ineffective hematopoiesis that characteristically demonstrate peripheral blood cytopenia, bone marrow hypercellularity, and morphologically defined dysplasia of one or more hematopoietic lineages. Classical metaphase cytogenetics and judicious use of fluorescence in situ hybridization play central roles in the contemporary diagnosis and classification of MDS. An abundance of recent molecular studies are beginning to delineate additional genetic and epigenetic aberrations associated with these disorders. These alterations affect diagnosis, prognosis, and therapy, and with this understanding classification systems are evolving from a primarily hematological and morphological basis toward a multifactorial appreciation that includes histomorphology, metaphase cytogenetics, and directed molecular studies. In the present health-care environment, it is critical to develop a cost-effective, efficient testing strategy that maximizes the diagnostic potential of even limited specimens. Here, we briefly review the classical genetic approach to MDS, outline exciting new advances in the molecular understanding of this heterogeneous group of hematological neoplasms, and discuss how these advances are driving the evolution of classification and prognostic systems. Rapidly growing understanding of the genetic basis of MDS holds much promise for testing, and here we provide a frame of reference for discussion of current testing protocols and for addressing testing modalities likely to enter clinical practice in the near future.
Collapse
Affiliation(s)
- Grant E Nybakken
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Adam Bagg
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|
18
|
Cherian S, Bagg A. The genetics of the myelodysplastic syndromes: Classical cytogenetics and recent molecular insights. Hematology 2013; 11:1-13. [PMID: 16522543 DOI: 10.1080/10245330500276691] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Myelodysplastic syndromes (MDS) are a complex group of clonal hematopoietic disorders with an attendant diverse array of associated genetic changes. Conventional cytogenetics plays a prominent and well-established role in determining the contemporary diagnosis and prognosis of these disorders. More recently, molecular approaches have been useful in further characterizing this group of diseases, albeit in a largely experimental context, with the detection of changes at the single gene level including mutations, amplification and epigenetic phenomena. Nevertheless, we remain largely ignorant of the genetic underpinnings of MDS. Here we briefly review the established role of cytogenetics in MDS, and emphasize recent advances in unraveling the genetics of MDS, with a view towards how such findings might facilitate our ability to understand, diagnose and treat these disorders in a more rational manner.
Collapse
Affiliation(s)
- Sindhu Cherian
- University of Washington Medical Center, Department of Laboratory Medicine, Seattle, 98195, USA.
| | | |
Collapse
|
19
|
Gratzinger D, Greenberg PL. Update on Myelodysplastic Syndromes Classification and Prognosis. Surg Pathol Clin 2013; 6:693-728. [PMID: 26839194 DOI: 10.1016/j.path.2013.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Myelodysplastic syndromes (MDS) are a collection of cytogenetically heterogeneous clonal bone marrow (BM) failure disorders derived from aberrant hematopoietic stem cells in the setting of an aberrant hematopoietic stem cell niche. Patients suffer from variably progressive and symptomatic bone marrow failure with a risk of leukemic transformation. Diagnosis of MDS has long been based on morphologic assessment and blast percentage as in the original French-American-British classification. The recently developed Revised International Prognostic Scoring System provides improved prognostication using more refined cytogenetic, marrow blast, and cytopenia parameters. With the advent of deep sequencing technologies, dozens of molecular abnormalities have been identified in MDS.
Collapse
Affiliation(s)
- Dita Gratzinger
- Department of Pathology, Stanford University Medical Center, 300 Pasteur Drive, L235, Stanford, CA 94305, USA.
| | - Peter L Greenberg
- Hematology Division, Stanford University Medical Center, 875 Blake Wilbur Drive, Stanford, CA 94305, USA
| |
Collapse
|
20
|
Arenillas L, Mallo M, Ramos F, Guinta K, Barragán E, Lumbreras E, Larráyoz MJ, De Paz R, Tormo M, Abáigar M, Pedro C, Cervera J, Such E, José Calasanz M, Díez-Campelo M, Sanz GF, Hernández JM, Luño E, Saumell S, Maciejewski J, Florensa L, Solé F. Single nucleotide polymorphism array karyotyping: A diagnostic and prognostic tool in myelodysplastic syndromes with unsuccessful conventional cytogenetic testing. Genes Chromosomes Cancer 2013; 52:1167-77. [DOI: 10.1002/gcc.22112] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 12/15/2022] Open
Affiliation(s)
- Leonor Arenillas
- Laboratori de CitologiaHematològica. Laboratori de Citogenètica Molecular, Pathology Department, Hospital del Mar, GRETNHE, IMIM (Hospital del Mar ResearchInstitute); Barcelona Spain
| | - Mar Mallo
- Institut de Recerca contra la Leucèmia Josep Carreras (IJC); Badalona Spain
| | - Fernando Ramos
- Hematology Department, Hospital Universitario de León, Instituto de Biomedicina (IBIOMED); Universidad de León; León Spain
| | - Kathryn Guinta
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic; Cleveland OH
| | - Eva Barragán
- Hematology Department; Hospital Universitario La Fe; Valencia Spain
| | - Eva Lumbreras
- IBSAL, IBMCC (Centro de Investigación del Cáncer; Universidad de Salamanca-CSIC) and Hematology Department, Hospital Universitario de Salamanca; Spain
| | | | - Raquel De Paz
- Hematology Department; Hospital Universitario La Paz; Madrid Spain
| | - Mar Tormo
- Hematology and Oncology Department; Hospital Clínico Universitario de Valencia; Spain
| | - María Abáigar
- IBSAL, IBMCC (Centro de Investigación del Cáncer; Universidad de Salamanca-CSIC) and Hematology Department, Hospital Universitario de Salamanca; Spain
| | - Carme Pedro
- Clinic Hematology Department, Hospital del Mar, GRETNHE. IMIM (Hospital del Mar ResearchInstitute); Barcelona Spain
| | - José Cervera
- Hematology Department; Hospital Universitario La Fe; Valencia Spain
| | - Esperanza Such
- Hematology Department; Hospital Universitario La Fe; Valencia Spain
| | | | - María Díez-Campelo
- IBSAL, IBMCC (Centro de Investigación del Cáncer; Universidad de Salamanca-CSIC) and Hematology Department, Hospital Universitario de Salamanca; Spain
| | | | - Jesús María Hernández
- IBSAL, IBMCC (Centro de Investigación del Cáncer; Universidad de Salamanca-CSIC) and Hematology Department, Hospital Universitario de Salamanca; Spain
| | - Elisa Luño
- Hematology Department; Hospital Universitario Central de Asturias; Oviedo Spain
| | - Sílvia Saumell
- Laboratori de CitologiaHematològica. Laboratori de Citogenètica Molecular, Pathology Department, Hospital del Mar, GRETNHE, IMIM (Hospital del Mar ResearchInstitute); Barcelona Spain
| | - Jaroslaw Maciejewski
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic; Cleveland OH
| | - Lourdes Florensa
- Laboratori de CitologiaHematològica. Laboratori de Citogenètica Molecular, Pathology Department, Hospital del Mar, GRETNHE, IMIM (Hospital del Mar ResearchInstitute); Barcelona Spain
| | - Francesc Solé
- Institut de Recerca contra la Leucèmia Josep Carreras (IJC); Badalona Spain
| |
Collapse
|
21
|
Abstract
Myelodysplastic syndromes are heterogeneous bone marrow diseases with a variable pathogenetic background. Cytomorphological alterations in peripheral blood films as well as bone marrow aspirates and histological findings in trephine biopsies result from cytogenetic and molecular abnormalities, epigenetic dysregulation and immune dysfunction and are key elements for setting the diagnosis of MDS. Whereas diagnosis can be made quite easily in advanced MDS this is much more difficult in early MDS, especially in cases with cytopenias or dysplasias of uncertain significance (ICUS and IDUS). Recommendations, illustrated by case reports for a stepwise annealing to the final diagnosis and exclusion of differential diagnoses are given. Furthermore, the problem of correct counting and identification of blasts is covered and features defining dysplasia in all three cell lineages are recapitulated thoroughly. Histopathology is not mandatory but has a distinct diagnostic and prognostic value especially in cases with hypoplasia or fibrosis and when the TP53 mutational status is of relevance. In up to 70% of patients with MDS clonal chromosome abnormalities can be identified which have a high impact on setting the correct diagnosis and estimation of prognosis. Incidence, type, molecular background and clinical relevance of distinct anomalies as well as cytogenetic subgroups are presented in detail and the development of the new cytogenetic prognostic scoring system as part of the IPSS-R is explained. The value of FISH-Analysis as a complementary tool for chromosome analysis in MDS is demonstrated with special emphasis on the possibility to perform frequent cytogenetic monitoring by CD34-FISH examination of peripheral blood. Finally the evolution of MDS-classification systems from FAB to WHO with a critical discussion of their shortcomings like degree of dysplasia, blast thresholds, inclusion/exclusion of CMML, and the lack of dynamic information is presented.
Collapse
Affiliation(s)
- Aristoteles Giagounidis
- Clinic for Oncology, Hematology and Palliative Medicine, Marien Hospital Düsseldorf, Rochusstr. 2, 40479 Düsseldorf, Germany.
| | - Detlef Haase
- University of Göttingen, Department of Hematology and Oncology, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
| |
Collapse
|
22
|
Seegmiller AC, Wasserman A, Kim AS, Kressin MK, Marx ER, Zutter MM, Mosse CA. Limited utility of fluorescencein situhybridization for common abnormalities of myelodysplastic syndrome at first presentation and follow-up of myeloid neoplasms. Leuk Lymphoma 2013; 55:601-5. [DOI: 10.3109/10428194.2013.801470] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
23
|
Diagnosis and treatment of primary myelodysplastic syndromes in adults: recommendations from the European LeukemiaNet. Blood 2013; 122:2943-64. [PMID: 23980065 DOI: 10.1182/blood-2013-03-492884] [Citation(s) in RCA: 478] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Within the myelodysplastic syndrome (MDS) work package of the European LeukemiaNet, an Expert Panel was selected according to the framework elements of the National Institutes of Health Consensus Development Program. A systematic review of the literature was performed that included indexed original papers, indexed reviews and educational papers, and abstracts of conference proceedings. Guidelines were developed on the basis of a list of patient- and therapy-oriented questions, and recommendations were formulated and ranked according to the supporting level of evidence. MDSs should be classified according to the 2008 World Health Organization criteria. An accurate risk assessment requires the evaluation of not only disease-related factors but also of those related to extrahematologic comorbidity. The assessment of individual risk enables the identification of fit patients with a poor prognosis who are candidates for up-front intensive treatments, primarily allogeneic stem cell transplantation. A high proportion of MDS patients are not eligible for potentially curative treatment because of advanced age and/or clinically relevant comorbidities and poor performance status. In these patients, the therapeutic intervention is aimed at preventing cytopenia-related morbidity and preserving quality of life. A number of new agents are being developed for which the available evidence is not sufficient to recommend routine use. The inclusion of patients into prospective clinical trials is strongly recommended.
Collapse
|
24
|
Ademà V, Hernández JM, Abáigar M, Lumbreras E, Such E, Calull A, Dominguez E, Arenillas L, Mallo M, Cervera J, Marugán I, Tormo M, García F, González T, Luño E, Sanzo C, Martín ML, Fernández M, Costa D, Blázquez B, Barreña B, Marco F, Batlle A, Buño I, Martínez-Laperche C, Noriega V, Collado R, Ivars D, Carbonell F, Vallcorba I, Melero J, Delgado E, Vargas MT, Grau J, Salido M, Espinet B, Melero C, Florensa L, Pedro C, Solé F. Application of FISH 7q in MDS patients without monosomy 7 or 7q deletion by conventional G-banding cytogenetics: does -7/7q- detection by FISH have prognostic value? Leuk Res 2013; 37:416-21. [PMID: 23337401 DOI: 10.1016/j.leukres.2012.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 12/07/2012] [Accepted: 12/13/2012] [Indexed: 10/27/2022]
Abstract
Chromosomal abnormalities are detected in 40-60% of patients with de novo myelodysplastic syndromes (MDS). This study used the FISH technique in 773 patients with de novo MDS without evidence of monosomy 7 (-7) or 7q deletion (7q-) by conventional G-banding cytogenetics (CC) to analyze their prognostic impact by FISH alone. FISH detected -7/7q- in 5.2% of patients. Presence of -7/7q- was associated with shorter overall survival than absence of such aberrations. Our results suggest that FISH 7q could be beneficial in patients with intermediate WHO morphologic risk stratification and no evidence of -7/7q- by CC.
Collapse
Affiliation(s)
- Vera Ademà
- Institut de Recerca Contra la Leucèmia Josep Carreras, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Monaghan SA, Dai L, Mapara MY, Normolle DP, Gollin SM, Lentzsch S. Longitudinal bone marrow evaluations for myelodysplasia in patients with myeloma before and after treatment with lenalidomide. Leuk Lymphoma 2012; 54:1965-74. [PMID: 23216269 DOI: 10.3109/10428194.2012.755177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Lenalidomide (LEN) treatment in multiple myeloma (MM) results in a superior outcome. However, there is concern for increased myelodysplastic syndrome/acute myeloid leukemia (MDS/AML) associated with LEN. Thus, bone marrow morphology and cytogenetics studies from 40 patients were evaluated for early signs of MDS prior to therapy, during therapy and at follow-up. Newly diagnosed patients with MM treated with LEN and dexamethasone (LD) alone or followed by autologous stem cell transplant (LD/ASCT), or patients with relapsed/refractory MM treated with LEN, bendamustine and dexamethasone (BLD) were included. One patient developed MDS. Baseline prevalence of mild morphologic myelodysplasia was highest in pretreated patients with MM (BLD, 71%), but was also seen in newly diagnosed patients (LD and LD/ASCT, 17%). The prevalence of myelodysplasia did not increase over time. Thus, this study did not reveal rapidly emerging MDS in 39 of 40 patients with MM treated with LEN. The development of MDS in one patient suggests that longer follow-up is needed for all.
Collapse
Affiliation(s)
- Sara A Monaghan
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | | | | | | | | | | |
Collapse
|
26
|
Abstract
A 2-day method using flow cytometry and FISH for interphase cells was developed to detect monosomy 7 cells in myelodysplastic syndrome patients. The method, Interphase Chromosome Flow-FISH (IC Flow-FISH), involves fixation of leukocytes from blood, membrane permeabilization, hybridization of cellular DNA with peptide nucleic acid probes with cells intact, and analysis by flow cytometry. Hundreds to thousands of monosomy 7 cells were consistently detected from 10-20 mL of blood in patients with monosomy 7. Proportions of monosomy 7 cells detected in IC Flow-FISH were compared with results from conventional cytogenetics; identification of monosomy 7 populations was verified with FACS; and patient and donor cells were mixed to test for sensitivity. IC Flow-FISH allows for detecting monosomy 7 without requiring bone marrow procurement or the necessity of metaphase spreads, and wider applications to other chromosomal abnormalities are in development.
Collapse
|
27
|
Will a peripheral blood (PB) sample yield the same diagnostic and prognostic cytogenetic data as the concomitant bone marrow (BM) in myelodysplasia? Leuk Res 2012; 36:832-40. [PMID: 22537394 DOI: 10.1016/j.leukres.2012.03.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 03/13/2012] [Accepted: 03/14/2012] [Indexed: 02/04/2023]
Abstract
In patients with myelodysplastic syndromes (MDS), chromosome anomalies are detected by conventional cytogenetic studies (CCS) and/or interphase fluorescence in situ hybridization (FISH) of bone marrow (BM) samples and provide prognostic and diagnostic information, which can direct therapy. Whether peripheral blood (PB) can be substituted for bone marrow in these cases and can provide the same information remains unknown. Concurrent BM and PB specimens collected from 100 patients with recently diagnosed MDS were studied using both CCS and FISH. While 68% of BM samples showed an abnormal karyotype by CCS, only 31% of PB samples were abnormal by CCS. In 12% of patients, FISH and CCS were discordant due to the inability of the FISH panel to detect all possible abnormalities. However, only one case (1%) had a cryptic abnormality detected by FISH. BM and PB FISH were discordant in 3% of cases, most likely due to the smaller clone size in PB vs. BM. While PB should not be substituted for BM at diagnosis, it is a viable alternative for monitoring patients using the appropriate FISH probe(s).
Collapse
|
28
|
Abstract
The myelodysplastic syndromes are a diverse group of clonal stem cell disorders characterized by ineffective hematopoiesis, peripheral cytopenias, and an increased propensity to evolve to acute myeloid leukemia. The molecular pathogenesis of these disorders is poorly understood, but recurring chromosomal abnormalities occur in approximately 50% of cases and are the focus of much investigation. The availability of newer molecular techniques has allowed the identification of additional genetic aberrations, including mutations and epigenetic changes of prognostic and potential therapeutic importance. This review focuses on the key role of cytogenetic analysis in myelodysplastic syndromes in the context of the diagnosis, prognosis, and pathogenesis of these disorders.
Collapse
Affiliation(s)
- Olatoyosi Odenike
- Assistant Professor of Medicine, Section of Hematology/Oncology, and the Comprehensive Cancer Center, University of Chicago
| | - John Anastasi
- Associate Professor of Pathology, Hematopathology and Clinical Hematology Laboratory, and the Comprehensive Cancer Center, University of Chicago
| | - Michelle M. Le Beau
- Professor of Medicine, Section of Hematology/Oncology, and the Comprehensive Cancer Center, University of Chicago
| |
Collapse
|
29
|
Jiang H, Xue Y, Wang Q, Pan J, Wu Y, Zhang J, Bai S, Wang Q, He G, Sun A, Wu D, Chen S. The utility of fluorescence in situ hybridization analysis in diagnosing myelodysplastic syndromes is limited to cases with karyotype failure. Leuk Res 2011; 36:448-52. [PMID: 22047706 DOI: 10.1016/j.leukres.2011.10.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 10/13/2011] [Accepted: 10/15/2011] [Indexed: 11/19/2022]
Abstract
Fluorescence in situ hybridization (FISH) is being used increasingly in cytogenetic diagnosis of myelodysplastic syndromes (MDS). However, the utility of FISH in this role has not been well-defined. A total of 249 de novo MDS patients were submitted to karyotyping and FISH analysis for -5/del(5)(q31), -7/del(7)(q31), +8, -17/i(17)(q10), del(20)(q12), and -Y. Of the 234 patients with available karyotypic data, 143 cases (60.9%) demonstrated normal karyotype and 91 cases (39.1%) showed abnormal karyotype. FISH confirmed R-banding findings in 96.6% (226/234) of samples with successful karyotyping and detected cytogenetic abnormalities in 46.7% (7/15) of cases with karyotype failure. Of the 3.4% (8/234) patients showing discrepancies between FISH and R-banding, FISH revealed cytogenetic abnormalities in four patients with normal karyotypes and four patients with complex karyotypes. These results highlight FISH analysis has limited value in MDS cases with successful karyotyping and is only informative in MDS cases with karyotype failure.
Collapse
Affiliation(s)
- Hui Jiang
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, Jiangsu, PR China
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Kim M, Chung S, See CJ, Yoon SS, Kim BK, Kim HK, Lee DS. Quantity of clonal cells detected by conventional cytogenetic analysis correlates with bone marrow blasts and survival in myelodysplastic syndromes. Leuk Res 2011; 36:163-8. [PMID: 21920602 DOI: 10.1016/j.leukres.2011.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 08/22/2011] [Accepted: 08/23/2011] [Indexed: 11/19/2022]
Abstract
We performed quantitative and qualitative analyses of conventional cytogenetic analysis and interphase FISH results in 87 MDS patients. The quantity of clonal cells for each chromosome of CCA did not correlate with the result of iFISH (r, range 0.0761-1.0577). The clonal cell percentage in CCA was higher in patients with >5% bone marrow blasts than those with <5% (44.7% vs. 23.1%, p=0.017). Multivariate analysis showed that a high quantity of clonal cells in CCA analysis is an independent prognostic factor for overall survival in MDS (p=0.012).
Collapse
Affiliation(s)
- Miyoung Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Jongno-gu, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|
31
|
Coleman JF, Theil KS, Tubbs RR, Cook JR. Diagnostic yield of bone marrow and peripheral blood FISH panel testing in clinically suspected myelodysplastic syndromes and/or acute myeloid leukemia: a prospective analysis of 433 cases. Am J Clin Pathol 2011; 135:915-20. [PMID: 21571964 DOI: 10.1309/ajcpw10ybrmwswye] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
It is unclear how often and in what setting fluorescence in situ hybridization (FISH) panels for myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) provide additional information over metaphase cytogenetics alone. Furthermore, the usefulness of peripheral blood vs bone marrow FISH has also not been directly compared. We prospectively compared metaphase cytogenetics and FISH for -5/5q-, -7/7q-, +8, and 20q- in 433 cases of suspected MDS/AML. FISH testing was abnormal in 6 (14%) of 43 and 10 (19%) of 54 cases with fewer than 20 normal metaphases or no growth, respectively. FISH was only rarely abnormal in cases with 20 normal metaphases obtained (6/222 [2.7%]). Comparison of peripheral blood and bone marrow results in 48 cases showed abnormal peripheral blood FISH results in 18 (69%) of 26 cases with abnormal bone marrow FISH results and in 5 (23%) of 22 cases with normal bone marrow FISH results. These findings, the largest published comparison of FISH vs metaphase cytogenetics in MDS/AML, provide a rational strategy for FISH testing in peripheral blood and bone marrow.
Collapse
|
32
|
Göhring G, Giagounidis A, Büsche G, Hofmann W, Kreipe HH, Fenaux P, Hellström-Lindberg E, Schlegelberger B. Cytogenetic follow-up by karyotyping and fluorescence in situ hybridization: implications for monitoring patients with myelodysplastic syndrome and deletion 5q treated with lenalidomide. Haematologica 2010; 96:319-22. [PMID: 21109690 DOI: 10.3324/haematol.2010.026658] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In patients with low and intermediate risk myelodysplastic syndrome and deletion 5q (del(5q)) treated with lenalidomide, monitoring of cytogenetic response is mandatory, since patients without cytogenetic response have a significantly increased risk of progression. Therefore, we have reviewed cytogenetic data of 302 patients. Patients were analyzed by karyotyping and fluorescence in situ hybridization. In 85 patients, del(5q) was only detected by karyotyping. In 8 patients undergoing karyotypic evolution, the del(5q) and additional chromosomal aberrations were only detected by karyotyping. In 3 patients, del(5q) was only detected by fluorescence in situ hybridization, but not by karyotyping due to a low number of metaphases. Karyotyping was significantly more sensitive than fluorescence in situ hybridization in detecting the del(5q) clone. In conclusion, to optimize therapy control of myelodysplastic syndrome patients with del(5q) treated with lenalidomide and to identify cytogenetic non-response or progression as early as possible, fluorescence in situ hybridization alone is inadequate for evaluation. Karyotyping must be performed to optimally evaluate response.
Collapse
Affiliation(s)
- Gudrun Göhring
- Institute of Cell and Molecular Pathology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Costa D, Valera S, Carrió A, Arias A, Muñoz C, Rozman M, Belkaid M, Coutinho R, Nomdedeu B, Campo E. Do we need to do fluorescence in situ hybridization analysis in myelodysplastic syndromes as often as we do? Leuk Res 2010; 34:1437-41. [PMID: 20226525 DOI: 10.1016/j.leukres.2010.02.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 02/13/2010] [Accepted: 02/15/2010] [Indexed: 11/25/2022]
|
34
|
Kwon WK, Lee JY, Mun YC, Seong CM, Chung WS, Huh J. Clinical utility of FISH analysis in addition to G-banded karyotype in hematologic malignancies and proposal of a practical approach. THE KOREAN JOURNAL OF HEMATOLOGY 2010; 45:171-6. [PMID: 21120205 PMCID: PMC2983032 DOI: 10.5045/kjh.2010.45.3.171] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Revised: 08/24/2010] [Accepted: 09/10/2010] [Indexed: 11/24/2022]
Abstract
Background Fluorescence in situ hybridization (FISH) analysis can provide important information in the management of patients with hematologic malignancies. However, FISH performed in addition to G-banded karyotype can be labor-intensive and expensive. The aim of this study was to evaluate whether FISH gives additional information in the setting of adequate conventional cytogenetics in cases of hematologic malignancies. Methods Bone marrow aspirates were obtained from 135 patients at diagnosis (56 AML, 32 MDS, 20 ALL, and 27 MM) between 2005 and 2010. Interphase FISH was performed using the following probes: BCR/ABL1, AML1/ETO, PML/RARA, CBFB, MLL, EGR1, CEP8, and D7S486 for AML; CEP8, D20S108, EGR1, and D7S486 for MDS; BCR/ABL1, MLL, CDKN2A (p16), ETV6, and 6q21/c-myc for ALL; IgH, TP53, D13S25, IgH/CCND1, IgH/MAF, IgH/FGFR3, and 1q21/8p21 for MM. We compared the results of FISH with the corresponding aberrations identified by G-banded karyotype. Results Additional genetic aberrations detected by FISH (which were not identified by G-banded karyotype) were 4%, 9%, 50%, and 67% in AML, MDS, ALL, and MM, respectively. In ALL, CDKN2A and ETV6 FISH revealed additional genetic aberrations in 33% and 28% of cases, respectively. In MM, FISH was of benefit in detecting IgH, D13S25, TP53, and 1q21 rearrangements, not detected by G-banded karyotype (31%, 36%, 20%, and 40%, respectively). Conclusion These results suggest that performing FISH in addition to G-banded karyotype may contribute little additional genetic information in AML and MDS, whereas routine FISH analysis appears to be an efficient screening method in ALL and MM.
Collapse
Affiliation(s)
- Won Kyung Kwon
- Department of Laboratory Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
35
|
Pinheiro RF, Chauffaille MLLF. Comparison of I-FISH and G-banding for the detection of chromosomal abnormalities during the evolution of myelodysplastic syndrome. Braz J Med Biol Res 2010; 42:1110-2. [PMID: 19855907 DOI: 10.1590/s0100-879x2009001100018] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2009] [Accepted: 09/25/2009] [Indexed: 11/21/2022] Open
Abstract
Myelodysplastic syndrome (MDS) patients with a normal karyotype constitute a heterogeneous group from a biological standpoint and their outcome is often unpredictable. Interphase fluorescence in situ hybridization (I-FISH) studies could increase the rate of detection of abnormalities, but previous reports in the literature have been contradictory. We performed I-FISH and conventional karyotyping (G-banding) on 50 MDS patients at diagnosis, after 6 and 12 months or at any time if a transformation to acute myeloid leukemia (AML) was detected. Applying a probe-panel targeting the centromere of chromosomes 7 and 8, 5q31, 5p15.2 and 7q31, we observed one case with 5q deletion not identified by G-banding. I-FISH at 6 and 12 months confirmed the karyotype results. Eight cases transformed to AML during follow-up, but no hidden clone was detected by I-FISH in any of them. The inclusion of I-FISH during follow-up of MDS resulted in a small improvement in abnormality detection when compared with conventional G-banding.
Collapse
Affiliation(s)
- R F Pinheiro
- Disciplina de Hematologia e Hemoterapia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | | |
Collapse
|
36
|
Sokol L, Caceres G, Rocha K, Stockero K, Dewald D, List A. JAK2V617F mutation in myelodysplastic syndrome (MDS) with del(5q) arises in genetically discordant clones. Leuk Res 2010; 34:821-3. [DOI: 10.1016/j.leukres.2009.09.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Revised: 09/12/2009] [Accepted: 09/12/2009] [Indexed: 10/20/2022]
|
37
|
Adding FISH to karyotype in Myelodysplastic syndrome investigation diagnosis: Are all questions answered? Leuk Res 2010; 34:413-5. [DOI: 10.1016/j.leukres.2009.10.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Revised: 10/09/2009] [Accepted: 10/11/2009] [Indexed: 11/23/2022]
|
38
|
Yang W, Stotler B, Sevilla DW, Emmons FN, Murty VV, Alobeid B, Bhagat G. FISH analysis in addition to G-band karyotyping: Utility in evaluation of myelodysplastic syndromes? Leuk Res 2010; 34:420-5. [PMID: 19800120 DOI: 10.1016/j.leukres.2009.09.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 09/02/2009] [Accepted: 09/10/2009] [Indexed: 11/17/2022]
Affiliation(s)
- Wendy Yang
- Department of Pathology, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | | | | | | | | | | | | |
Collapse
|
39
|
|
40
|
Heng JL, Chen YC, Quah TC, Liu TC, Yeoh AEJ. Dedicated Cytogenetics Factor is Critical for Improving Karyotyping Results for Childhood Leukaemias – Experience in the National University Hospital, Singapore 1989-2006. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v39n2p102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Introduction: Childhood leukaemia accounts for more than 40% of new childhood cancer cases. Karyotyping of cytogenetic abnormalities in such cases continues to provide critical prognostic information which allows the delivery of an appropriate intensity of treatment. Unfortunately, karyotyping of childhood leukaemia is difficult, laborious and often unsuccessful. Banding resolution tends to be poor unlike routine antenatal cytogenetics. The aim of the study is to highlight the benefit of dedicated cytogenetics in improving karyotyping results. Materials and Methods: We analysed the impact of setting up a team of cytogeneticists in the National University Hospital (NUH) on the success of karyotyping, evaluating cytogenetic data collected from 1989 to 2006. From 1989 to 2006, 4789 cases have been processed. Among them, 369 newly diagnosed and relapsed childhood acute leukaemia cases [281 acute lymphoblastic leukaemia (ALL) and 88 acute myeloid leukaemia (AML)] have been diagnosed at NUH. A dedicated cytogenetics laboratory with clearly defi ned standard operating procedures and quality control was set up in 2002. It used the established recommendation of a complete analysis of at least 20 metaphases per analysis. Results: Overall, the frequency of successful karyotyping was significantly higher (P = 0.002) at 90.7% (185/204) from 2002-2006 compared to 79.4% (131/165) from 1989-2001. For ALL cases, the success rate improved from 77.6% (97/125) in 1989 to 2001 to 89.1% (139/156) in the 2002 to 2006 cohort. For AML, the success rate also was significantly improved (P = 0.04) from 85% (34/40) to 95.8% (46/48). Significantly, this high rate of success is still maintained despite a yearly increase in volume. Conclusion: The establishment of a dedicated cytogenetics service leads to an improvement in results.
Key words: Childhood leukaemia, Dedicated cytogenetics service, Successful karyotyping
Collapse
Affiliation(s)
- JL Heng
- Viva-University Children’s Cancer Centre, University Children’s Medical Institute, National University Hospital, National University Health System, Singapore
| | - YC Chen
- National University Cancer Institute, National University Hospital, National University Health System, Singapore
| | - TC Quah
- Viva-University Children’s Cancer Centre, University Children’s Medical Institute, National University Hospital, National University Health System, Singapore
| | - TC Liu
- National University Cancer Institute, National University Hospital, National University Health System, Singapore
| | - AEJ Yeoh
- Viva-University Children’s Cancer Centre, University Children’s Medical Institute, National University Hospital, National University Health System, Singapore
| |
Collapse
|
41
|
Pitchford CW, Hettinga AC, Reichard KK. Fluorescence in situ hybridization testing for -5/5q, -7/7q, +8, and del(20q) in primary myelodysplastic syndrome correlates with conventional cytogenetics in the setting of an adequate study. Am J Clin Pathol 2010; 133:260-4. [PMID: 20093235 DOI: 10.1309/ajcpz4jl5zmrpftd] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Multiple studies, with differing results, have compared the added sensitivity of fluorescence in situ hybridization (FISH) with conventional cytogenetics (CC) to detect genetic abnormalities in myelodysplastic syndrome (MDS). We hypothesized that in the setting of an adequate CC study, FISH would correlate with microscopic genetic abnormalities involving chromosomes 5, 7, 8, and 20. We performed FISH for -5/5q, -7/7q, +8, and del(20q) on 102 MDS cases with normal CC (> or =20 consecutive metaphases) and on 35 MDS cases with abnormal CC. Of the 102 MDS cases with normal CC, only 1 was discrepant between FISH (showing +8) and CC (<1% of total cases). Of the 35 MDS cases with abnormal CC, 1 showed a minor discrepancy (-5 by CC vs del(5q) by FISH). FISH for MDS abnormalities (-5/5q, -7/7q, +8, and del(20q)) correlates with an adequate karyotypic result without increased sensitivity. Consequently, we recommend that FISH not be performed in MDS cases with an adequate karyotype.
Collapse
|
42
|
Codispoti KET, Depalma L. Myelodysplastic syndrome in elderly patients: correlation of CBC with cytogenetic and FISH analysis. Int J Lab Hematol 2009; 32:443-8. [PMID: 20041967 DOI: 10.1111/j.1751-553x.2009.01210.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Unexplained anemia in the elderly could represent myelodysplastic syndrome (MDS). We assessed the utility of using a fluorescence in situ hybridization (FISH) panel for common chromosomal abnormalities seen in MDS. A total of 101 elderly outpatients with anemia of unknown etiology were evaluated. Complete blood count, bone marrow biopsy, conventional cytogenetic analysis (CC), and FISH panel were reviewed. A total of 21 (21%) of the 101 patients had MDS. A combination of CC and FISH identified chromosomal abnormalities in 17 (81%) of the patients with MDS. The remaining 4 (19%) were diagnosed with MDS based solely on morphologic criteria. Except in two cases, FISH did not reveal abnormalities not already detected by CC. Furthermore, MDS patients infrequently had isolated anemia (14%) as opposed to those without MDS (75%). A MDS FISH panel is not more sensitive than CC in elderly outpatients with unexplained anemia. MDS is more likely if in addition to anemia, leukopenia and/or thrombocytopenia are also present.
Collapse
Affiliation(s)
- K-E T Codispoti
- Department of Pathology, The George Washington University Medical Center, NW, Washington, DC, USA.
| | | |
Collapse
|
43
|
Bacher U, Haferlach C, Kröger N, Schnittger S, Kern W, Wiedemann B, Zander AR, Haferlach T. Diagnostic tools in the indications for allogeneic stem cell transplantation in myelodysplastic syndromes. Biol Blood Marrow Transplant 2009; 16:1-11. [PMID: 20053328 DOI: 10.1016/j.bbmt.2009.08.007] [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: 07/01/2009] [Accepted: 08/10/2009] [Indexed: 11/18/2022]
Abstract
The rates of allogeneic stem cell transplantation (SCT) to treat the myelodysplastic syndromes (MDS) is continually increasing. However, given the growing arsenal of therapeutic options in parallel to deeper insight into the heterogeneity of this disorder, determining the indications for SCT in MDS remains a difficult task. The International Prognostic Scoring System (IPSS) serves as a guideline for therapeutic decisions, but many aspects (eg, interpretation of rare cytogenetic abnormalities, combinations of chromosomal alterations and/or molecular markers, variant clinical courses within distinct biological subgroups) remain the subject of continuous investigation. In an effort to achieve a more well-differentiated risk categorization, attempts have been made to perform a more detailed cytogenetic categorization, and the use of various fluorescein in situ hybridization (FISH) techniques has improved the description of aberrations. Multicenter initiatives have standardized multiparameter flow cytometry techniques for diagnosis of MDS. In advanced MDS, screening for molecular mutations can identify cases with a high transformation risk. Finally, the new World Health Organization classification system provides a more homogenous morphological categorization of MDS compared with the former French-American-British system. Consequently, in the near future, risk stratification in MDS might incorporate additional diagnostic tools and categorization systems aimed at improving the timing and indication for SCT in this complex disorder.
Collapse
Affiliation(s)
- Ulrike Bacher
- Interdisciplinary Clinic for Stem Cell Transplantation, University Cancer Center Hamburg, Hamburg, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Ou JJ, Bagg A. Diagnostic challenges in the myelodysplastic syndromes: the current and future role of genetic and immunophenotypic studies. EXPERT OPINION ON MEDICAL DIAGNOSTICS 2009; 3:275-91. [PMID: 23488463 DOI: 10.1517/17530050902813947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Myelodysplastic syndromes (MDS) comprise a clinically and pathologically diverse collection of hematopoietic neoplasms, most commonly presenting with peripheral cytopenias typically in the context of bone marrow hypercellularity. Mechanistically, at least in the early phases of the disease, this apparently paradoxical picture is primarily due to ineffective hematopoiesis, which is accompanied by a variety of morphologic abnormalities in hematopoietic cells. The identification of recurrent, clinically relevant cytogenetic defects in MDS has spurred the research of molecular mechanisms that contribute to its inception as well as to the development of heterogeneous subtypes. Although conventional cytogenetic analyses remain a diagnostic mainstay in MDS, the application of contemporary techniques including molecular cytogenetics, microarray technologies and multiparametric flow cytometry may ultimately reveal new diagnostic parameters that are theoretically more objective and sensitive than current morphologic approaches. This review aims to outline the role of genetic and immunophenotypic studies in the evaluation of MDS, including findings that may potentially influence future diagnostic classifications, which could refine prognostication and ultimately facilitate the growth of targeted therapies.
Collapse
Affiliation(s)
- Joyce J Ou
- University of Pennsylvania, Department of Pathology and Laboratory Medicine, 3400 Spruce Street, 6 Founders Pavilion, PA 19406-4283, USA
| | | |
Collapse
|
45
|
Sreekantaiah C. FISH panels for hematologic malignancies. Cytogenet Genome Res 2007; 118:284-96. [DOI: 10.1159/000108312] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Accepted: 06/18/2007] [Indexed: 11/19/2022] Open
|
46
|
Wimazal F, Fonatsch C, Thalhammer R, Schwarzinger I, Müllauer L, Sperr WR, Bennett JM, Valent P. Idiopathic cytopenia of undetermined significance (ICUS) versus low risk MDS: The diagnostic interface. Leuk Res 2007; 31:1461-8. [PMID: 17507091 DOI: 10.1016/j.leukres.2007.03.015] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2007] [Revised: 01/17/2007] [Accepted: 03/02/2007] [Indexed: 11/28/2022]
Abstract
It may sometimes be difficult to diagnose low risk MDS in patients with mild cytopenia. We report on 10 patients with mild to marked, unexplained cytopenia without definitive signs of a myeloid neoplasm. In two patients, a karyotype-abnormality (trisomy 14; monosomy 7) was detected in a small subset of bone marrow cells. Progression to overt MDS was seen in two patients including the one with monosomy 7. In the remaining cases, no MDS developed in a follow-up of at least 6 months. The phrase "idiopathic cytopenia of undetermined significance (ICUS)", as also suggested by Mufti and co-workers, is proposed and long term follow-up is recommended to assess the evolution.
Collapse
Affiliation(s)
- Friedrich Wimazal
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Vienna, Austria
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Gerr H, Gadzicki D, Kreipe H, Schlegelberger B, Wilkens L. Fluorescence in situ hybridization reveals closely correlated results in cytological and histological specimens of hematological neoplasias compared to conventional cytogenetics. Pathobiology 2007; 73:271-9. [PMID: 17374964 DOI: 10.1159/000099121] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2006] [Accepted: 11/10/2006] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Fluorescence in situ hybridization (FISH) has become a useful tool to identify chromosomal aberrations in non-dividing cells. Numerous studies have compared chromosomal banding analysis (CBA) and FISH on fixed cultured bone marrow cells. However, up to now, there has been no study comparing two main sources of diagnostic material, i.e. bone marrow aspirates and trephine biopsies. We therefore analyzed these materials by FISH in comparison with CBA. METHODS CBA revealed chromosomal aberrations in 18 patients suffering from myelodysplastic syndrome (n = 13), acute myeloid leukemia (n = 3), or chronic myeloproliferative syndrome (n = 2). FISH was performed on fixed cultured bone marrow cells, aspirates and trephine biopsies from each patient. RESULTS Percentages of aberrant cells in the different materials correlated highly with Pearson values of 0.909 for biopsy/fixed cultured cells (p < 0.001), 0.830 for biopsy/aspirate (p < 0.001) and 0.768 for aspirate/fixed cultured cells (p < 0.001). Moreover, in bone marrow biopsies peritrabecular and central intertrabecular areas yielded very similar FISH results with a high correlation (r = 0.968, p < 0.001). FISH revealed a lower proportion of aberrant cells than CBA in 90% of the specimens. CONCLUSIONS In summary, the different materials available for the FISH examination are comparable in sensitivity and show similar quantitative results. Therefore, the use of biopsy sections for the routine FISH examination of chromosomal abnormalities is a valid method.
Collapse
Affiliation(s)
- Heidrun Gerr
- Institute of Cell and Molecular Pathology, Hannover Medical School, Hannover, Germany
| | | | | | | | | |
Collapse
|
48
|
Valent P, Horny HP, Bennett JM, Fonatsch C, Germing U, Greenberg P, Haferlach T, Haase D, Kolb HJ, Krieger O, Loken M, van de Loosdrecht A, Ogata K, Orfao A, Pfeilstöcker M, Rüter B, Sperr WR, Stauder R, Wells DA. Definitions and standards in the diagnosis and treatment of the myelodysplastic syndromes: Consensus statements and report from a working conference. Leuk Res 2007; 31:727-36. [PMID: 17257673 DOI: 10.1016/j.leukres.2006.11.009] [Citation(s) in RCA: 376] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2006] [Revised: 11/14/2006] [Accepted: 11/14/2006] [Indexed: 11/29/2022]
Abstract
The classification, scoring systems, and response criteria for myelodysplastic syndromes (MDS) have recently been updated and have become widely accepted. In addition, several new effective targeted drugs for patients with MDS have been developed. The current article provides a summary of updated and newly proposed markers, criteria, and standards in MDS, with special reference to the diagnostic interface and refinements in evaluations and scoring. Concerning the diagnostic interface, minimal diagnostic criteria for MDS are proposed, and for patients with unexplained cytopenia who do not fulfill these criteria, the term 'idiopathic cytopenia of uncertain significance' (ICUS) is suggested. In addition, new diagnostic and prognostic parameters, histopathologic and immunologic determinants, proposed refinements in scoring systems, and new therapeutic approaches are discussed. Respective algorithms and recommendations should facilitate diagnostic and prognostic evaluations in MDS, selection of patients for therapies, and the conduct of clinical trials.
Collapse
Affiliation(s)
- Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
McDevitt MA, Condon M, Stamberg J, Karp JE, McDiarmid M. Fluorescent in situ hybridization (FISH) in bone marrow and peripheral blood of leukemia patients: implications for occupational surveillance. Mutat Res 2007; 629:24-31. [PMID: 17276720 DOI: 10.1016/j.mrgentox.2007.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2006] [Revised: 12/21/2006] [Accepted: 01/02/2007] [Indexed: 11/17/2022]
Abstract
Although there has been a rapid rise in the application of fluorescent in situ hybridization (FISH) analysis of bone marrow tissue for the staging and prognosis determination of hematopoietic malignacies such as the chronic and acute leukemias, it's application as a surveillance tool for leukemogen exposed high risk occupational cohorts is understandably limited by the invasiveness of sample collection. While some small occupational studies have been performed using FISH in peripheral blood with promising results, some of the basic assumptions made in utilizing the FISH technique have not been fully explored. These include selection of the correct hematopoietic cell to assay (myeloid or lymphoid); selection of appropriate chromosomal markers and the sensitivity of peripheral blood FISH in detecting unbalanced genomic abnormalities. In this study, we performed a pilot 'validation' exercise utilizing the FISH technique and standard metaphase cytogenetics, comparing results in tandem pairs of peripheral blood with bone marrow cells, where clonal abnormalities arise. Samples were taken from patients with known chromosomal lesions associated with active leukemia. We carefully chose markers most frequently associated with leukemogen-inducing DNA damage and probes that have been utilized successfully in clinical practice. Ten de novo or therapy-related acute myeloid leukemia (t-AML) patients underwent bone marrow cell karyotyping and fluorescent in situ hybridization (FISH) analysis. Parallel peripheral blood samples were concommitently drawn and evaluated with FISH using the same probes. In six of eight paired samples treated with a 3-day phytohemagglutinin (PHA) stimulation, typically used to assay lymphocytes and their progenitors, we detected abnormal clones. In one of the two remaining cases, we identified an abnormal clone in both bone marrow and PHA-stimulated peripheral blood, although at a level in the peripheral blood sample that would typically be reported as "non-diagnostic" for clinical purposes. These results suggest that use of FISH in PHA stimulated peripheral blood samples with probes commonly employed in t-AML evaluations (chromosomes 5q, 7q, 8, 11q) to detect cytogenetic abnormalities in peripheral blood represents a potentially promising though as yet, under-utilized approach for the occupational surveillance of workers exposed to leukemogens, especially if it could be linked to automated high-throughput assays for increased sensitivity.
Collapse
MESH Headings
- Bone Marrow Cells/pathology
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 5
- Chromosomes, Human, Pair 7
- Chromosomes, Human, Pair 8
- Cohort Studies
- Cytogenetic Analysis/methods
- Humans
- In Situ Hybridization, Fluorescence/methods
- Karyotyping
- Leukemia, Myeloid, Acute/pathology
- Leukocytes, Mononuclear/metabolism
- Occupational Exposure/adverse effects
- Pilot Projects
- Population Surveillance
- Reproducibility of Results
Collapse
Affiliation(s)
- M A McDevitt
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore MD 21205, USA
| | | | | | | | | |
Collapse
|
50
|
Vance GH, Kim H, Hicks GA, Cherry AM, Higgins R, Hulshizer RL, Tallman MS, Fernandez HF, Dewald GW. Utility of interphase FISH to stratify patients into cytogenetic risk categories at diagnosis of AML in an Eastern Cooperative Oncology Group (ECOG) clinical trial (E1900). Leuk Res 2006; 31:605-9. [PMID: 16996130 DOI: 10.1016/j.leukres.2006.07.026] [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: 05/10/2006] [Revised: 07/26/2006] [Accepted: 07/27/2006] [Indexed: 11/25/2022]
Abstract
We evaluated the efficacy of FISH to detect chromosome anomalies in the evaluation of young (<60 years) patients with AML. Patients were enrolled in E1900, an ECOG clinical trial for AML. The protocol was designed to collect bone marrow or blood for both cytogenetic and FISH studies at study entry (diagnosis). FISH for each patient was performed and utilized eight probe sets to detect t(8;21), t(9;22), t(11;var), t(15;17), inv(16), +8, -5/5q, and -7/7q. We analyzed 237 specimens with complete cytogenetic and FISH results. Results for each specimen were classified by probe set into one of six categories. The concordance rate between cytogenetic and FISH results ranged from 98 to 100% for all probe sets and kappa analysis for concordance had a p-value of <0.0001. The high level of agreement between cytogenetic and FISH results demonstrate the accuracy of a panel of eight FISH probe sets for the detection of significant abnormalities in AML. Data from this investigation support the use of FISH as an adjunct method to increase the yield of useful cytogenetic results in large cooperative trials and demonstrate the potential of FISH as a follow-up study of minimal residual disease in ECOG trials.
Collapse
Affiliation(s)
- Gail H Vance
- Medical and Molecular Genetics, Indiana University School of Medicine, 975 W. Walnut Street IB 264, Indianapolis, IN 46202, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|