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Fang J, Shankar N, Bao L, Haag M, Carstens B, Pang CS. Near-tetraploidy/tetraploidy acute myeloid leukemia with clinical, pathologic and molecular characteristics. Leuk Lymphoma 2024:1-10. [PMID: 39052840 DOI: 10.1080/10428194.2024.2382923] [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: 04/17/2024] [Revised: 06/29/2024] [Accepted: 07/17/2024] [Indexed: 07/27/2024]
Abstract
Near-tetraploidy/tetraploidy (NT/T) is a cytogenetic alteration in acute myeloid leukemia (AML). In AML, specific chromosomal alterations are associated with clinical, morphological, and immunophenotypic features. The impact of cytogenetics on the prognosis of AML is well established. However, the prognostic implication of NT/T on AML remains unclear. Our aim is to further characterize the clinical, morphologic, immunophenotypic, molecular mutational, and prognostic features of NT/T AML. This retrospective chart review of NT/T AML cases showed NT/T AML was more common in older adult males, with predominately large blasts and myelodysplasia-related features. The most common lineage of dysplasia was dysgranulopoiesis in 77.8% of cases. Cases displayed multiple cytogenetic abnormalities, with only four showing NT/T as the sole abnormality. TP53 was the most common molecular mutation associated with NT/T AML (44.5%). Of the patients receiving treatment for NT/T AML, 80% achieved a CR. The median overall survival for the entire cohort was 4.5 months.
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Affiliation(s)
- Jacob Fang
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Nakul Shankar
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Liming Bao
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Mary Haag
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Billie Carstens
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Changlee S Pang
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
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2
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Hayashino K, Matsuda M, Fujishita K, Iwata J, Mizobuchi M, Uemura M, Yorita K, Maeshima A, Imai T. Acute undifferentiated leukemia limited to neck lymph nodes and a large mediastinal mass. J Clin Exp Hematop 2022; 62:222-225. [PMID: 36261335 PMCID: PMC9898720 DOI: 10.3960/jslrt.22012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
In the 2016 update of the World Health Organization (WHO) classification of myeloid neoplasms, acute undifferentiated leukemia (AUL) was defined by a lack of lineage-specific markers. AUL has very poor prognosis and no established therapies due to its rarity. We report a case of a 31-year-old man with AUL who showed complete molecular response to an acute lymphoblastic leukemia (ALL)-based regimen and received allogeneic hematopoietic stem cell transplantation. The patient's blast cells were CD7-positive and localized to lymph nodes in the neck and to a large mediastinal mass; there was also rearrangement of the T-cell receptor delta locus. Although the tumor showed characteristics of T-cell lymphoblastic lymphoma, it was categorized as AUL based on WHO classification. This case suggests that a high-intensity conditioning regimen could be effective for rare cases of AUL that present only in the extramedullary mass, and chemotherapy for AUL should be selected based on the characteristics of the blasts.
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Affiliation(s)
- Kenta Hayashino
- Department of hematology, Kochi health sciences center, Kochi, Japan
| | - Masayuki Matsuda
- Department of hematology, Kochi health sciences center, Kochi, Japan
| | - Keigo Fujishita
- Department of hematology, Kochi health sciences center, Kochi, Japan
| | - Jun Iwata
- Department of diagnostic of pathology, Kochi health sciences center, Kochi, Japan
| | - Miki Mizobuchi
- Department of hematology, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Munenori Uemura
- Department of hematology, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Kenji Yorita
- Department of diagnostic pathology, Japanese Red Cross Kochi Hospital, Kochi, Japan
| | - Akiko Maeshima
- Department of Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Toshi Imai
- Department of hematology, Kochi health sciences center, Kochi, Japan
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3
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Xie J, Nachabe A, Hathaway LJ, Farah B, Berbari B, Li Y, Brown TC, Schmid JL, Socola F, Saba NS, Safah H. The prognostic implications of tetraploidy/near-Tetraploidy in acute myeloid leukemia: a case series and systematic review of the literature. Leuk Lymphoma 2021; 62:203-210. [PMID: 32993375 DOI: 10.1080/10428194.2020.1817435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/23/2020] [Accepted: 08/22/2020] [Indexed: 10/23/2022]
Abstract
The prognostic significance and optimal management of tetraploidy/near-tetraploidy acute myeloid leukemia (T/NT AML) remains unclear given its limited data. This is especially true after factoring in additional chromosomal alterations, which carry their own prognostic weight. Here, we analyze 128 cases of T/NT in AML from the literature along with two additional cases, which is the largest review of this subject to date. Based on our retrospective analysis, we found that regardless of the risk status attributed to cytogenetics, the prognosis of tetraploid or near-tetraploid AML is dismal and should be incorporated within the unfavorable risk group. Complete remission is paramount to survival in this population. Specific induction protocols for high-risk AML appear to have higher rates of complete remission in the T/NT AML population. Moreover, longer overall survival can be achieved with chemotherapy followed by allogeneic stem cell transplantation at first complete remission.
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Affiliation(s)
- John Xie
- Deming Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | | | | | - Bachir Farah
- Southern Illinois Healthcare, Carterville, IL, USA
| | | | - Yuwen Li
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA, USA
| | - Theresa C Brown
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA, USA
| | - Janet L Schmid
- Department of Pathology, Tulane University, New Orleans, LA, USA
| | - Francisco Socola
- Section of Hematology and Medical Oncology, Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Nakhle S Saba
- Section of Hematology and Medical Oncology, Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Hana Safah
- Section of Hematology and Medical Oncology, Department of Internal Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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4
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Vilches AS, Díaz de Bustamante A, Sanchez-Calero J, Darnaude MT. Tetraploidy acute myeloid leukaemia after chromosome 16 inversion. BMJ Case Rep 2017; 2017:bcr-2017-219274. [PMID: 28331025 DOI: 10.1136/bcr-2017-219274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Our patient is a 36-year-old man referred by his general physician to the Department of Hematology because of mild neutropenia in a routine analysis at work. There was no history of previous diseases, and examination was normal. Blood investigations confirmed the neutropenia and showed elongation of prothrombin time. A bone marrow examination was performed revealing about 10% of myeloblasts on the aspirate smears. A cytogenetic study showed chromosome 16 inversion in all of these cells and tetraploidy only in some of them, which were extremely large in size. According to the revised WHO classification of tumours (2008), the patient was diagnosed as a case of acute myeloid leukaemia with chromosome 16 inversion.
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Affiliation(s)
- Alba Sara Vilches
- Department of Hematology, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain
| | | | - Jorge Sanchez-Calero
- Department of Hematology, Hospital Universitario de Mostoles, Mostoles, Madrid, Spain
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5
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Huang L, Wang SA, DiNardo C, Li S, Hu S, Xu J, Zhou W, Goswami M, Medeiros LJ, Tang G. Tetraploidy/near-tetraploidy acute myeloid leukemia. Leuk Res 2016; 53:20-27. [PMID: 27951415 DOI: 10.1016/j.leukres.2016.11.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/27/2016] [Accepted: 11/30/2016] [Indexed: 10/20/2022]
Abstract
A tetraploid/near tetraploid (T/NT) karyotype is a rare finding in acute myeloid leukemia (AML). Here we report 38 AML patients with a T/NT karyotype, including 26 men and 12 women with a median age of 65 years. T/NT karyotype was detected at initial diagnosis of AML in 16 patients, and acquired during the course of disease in 22 patients. All patients showed large blasts with frequent prominent nucleoli, cytoplasmic vacuoles and/or inclusions, nuclear irregularity and/or budding. Eleven patients had a non-complex and 27 had a complex T/NT karyotype; 21 patients also had pseudodiploid and/or triploid clones. After T/NT karyotype detection, 32 patients received chemotherapy and 10 also received stem cell transplant. After a median of 6.2 months follow-up, 32 patients died of disease or complications, 5 were alive with complete remission, and 1 alive with persistent AML. Median overall survival (OS) was 5 months. Patients with a non-complex T/NT karyotype had a significantly superior OS compared to those with a complex T/NT karyotype (10.7 vs. 3.4 months, p=0.0280). We conclude that T/NT karyotype in AML is often associated with distinctive morphologic features and conveys generally poor outcomes. Distinction of complex versus non-complex T/NT karyotype provides further prognostic information.
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Affiliation(s)
- Lanshan Huang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Sa A Wang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Courtney DiNardo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shaoying Li
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Shimin Hu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jie Xu
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Wenli Zhou
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Maitrayee Goswami
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Guilin Tang
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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Lazarevic V, Rosso A, Juliusson G, Antunovic P, Rangert-Derolf Å, Lehmann S, Möllgård L, Uggla B, Wennström L, Wahlin A, Höglund M, Johansson B. Prognostic significance of high hyperdiploid and triploid/tetraploid adult acute myeloid leukemia. Am J Hematol 2015; 90:800-5. [PMID: 26088289 DOI: 10.1002/ajh.24091] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 06/16/2015] [Accepted: 06/17/2015] [Indexed: 11/07/2022]
Abstract
To ascertain the clinical implications of high hyperdiploid (HH; 49-65 chromosomes) and triploid/tetraploid (TT; >65 chromosomes) adult acute myeloid leukemia (AML), all such cases were retrieved from the Swedish AML Registry. Of the 3,654 cytogenetically informative cases diagnosed between January 1997 and May 2014, 68 (1.9%) were HH (n = 50)/TT (n = 18). Patients with HH/TT were older than those with intermediate risk (IR) AML (median 71 years vs. 67 years; P = 0.042) and less often had de novo AML (63% vs. 79%; P = 0.004); no such differences were observed between HH/TT and complex karyotype (CK) AML. The overall survival (OS) was similar between patients with HH/TT and CK AML (median 0.9 years vs. 0.6 years; P = 0.082), whereas OS was significantly longer (median 1.6 years; P = 0.028) for IR AML. The OS was shorter for cases with HH than with TT (median 0.6 years vs. 1.4 years; P = 0.032) and for HH/TT AMLs with adverse abnormalities (median 0.8 years vs. 1.1 years; P = 0.044). In conclusion, HH/TT AML is associated with a poor outcome, but chromosome numbers >65 and absence of adverse aberrations seem to translate into a more favorable prognosis. Thus, HH/TT AMLs are clinically heterogeneous and should not automatically be grouped as high risk.
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Affiliation(s)
- Vladimir Lazarevic
- Department of Hematology and Vascular Disease; Skåne University Hospital; Lund Sweden
- Stem Cell Center; Lund University; Lund Sweden
| | - Aldana Rosso
- Epidemiology and Registry Center in South Sweden; Skåne University Hospital; Lund Sweden
| | - Gunnar Juliusson
- Department of Hematology and Vascular Disease; Skåne University Hospital; Lund Sweden
- Stem Cell Center; Lund University; Lund Sweden
| | - Petar Antunovic
- Department of Hematology; Linköping University Hospital; Linköping Sweden
| | - Åsa Rangert-Derolf
- Department of Medicine; Division of Hematology Stockholm and Huddinge; Karolinska University Hospital, Karolinska; Sweden
| | - Sören Lehmann
- Department of Medicine; Division of Hematology Stockholm and Huddinge; Karolinska University Hospital, Karolinska; Sweden
| | - Lars Möllgård
- Department of Medicine; Sahlgrenska University Hospital; Göteborg Sweden
| | - Bertil Uggla
- Department of Medicine; School of Health and Medical Sciences; Örebro University Hospital; Örebro Sweden
| | - Lovisa Wennström
- Department of Medicine; Sahlgrenska University Hospital; Göteborg Sweden
| | - Anders Wahlin
- Department of Radiation Sciences; Umeå University; Umeå Sweden
| | - Martin Höglund
- Department of Hematology; Academic Hospital; Uppsala Sweden
| | - Bertil Johansson
- Department of Clinical Genetics; University and Regional Laboratories Region Skåne; Lund Sweden
- Department of Laboratory Medicine; Division of Clinical Genetics; Lund University; Lund Sweden
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7
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Abstract
OBJECTIVES This session of the Society for Hematopathology/European Association for Haematopathology Workshop focused on acute leukemias of ambiguous origin. METHODS We provide an overview of mixed-phenotype acute leukemia (MPAL) as recognized in the current World Health Organization classification and summarize diagnostic criteria for major categories of MPAL: B/myeloid, T/myeloid, B/T, and B/T/myeloid. RESULTS Most MPAL cases submitted were B/myeloid and T/myeloid MPAL, the most frequent types, but three cases of B/T MPAL were also submitted, and examples of all categories are illustrated. We emphasize that a comprehensive approach to immunophenotyping is required to accurately establish the diagnosis of MPAL. Flow cytometry immunophenotyping using a large panel of antibodies is needed as well as confirmatory immunohistochemical analysis and cytochemistry studies for myeloperoxidase and nonspecific esterase. We discuss technical issues in determining blast lineage and possible pitfalls in MPAL diagnosis. In particular, rare cases of B-acute lymphoblastic leukemia (B-ALL) can express myeloperoxidase but are otherwise consistent with B-ALL and should be treated as such. Last, we review the differential diagnosis between acute undifferentiated leukemia and acute myeloid leukemia with minimal differentiation. CONCLUSIONS There was an agreement that diagnosis of MPAL can be challenging, especially if applied flow cytometry panels are not comprehensive enough.
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Affiliation(s)
- Anna Porwit
- Department of Laboratory Medicine and Pathobiology, University Health Network, University of Toronto, Toronto, Canada, and
| | - Marie C. Béné
- Immunology Laboratory, University Hospital of Nancy-Brabois, Nancy, France
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8
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Pang CS, Pettenati MJ, Pardee TS. Clinicopathological analysis of near-tetraploidy/tetraploidy acute myeloid leukaemia. J Clin Pathol 2015; 68:236-40. [PMID: 25563333 DOI: 10.1136/jclinpath-2014-202697] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS Near-tetraploidy/tetraploidy (NT/T) is a rare cytogenetic alteration in acute myeloid leukaemia (AML). NT/T-AML is categorised as complex cytogenetics and therefore, presumed to have an unfavourable prognosis. Our aim is to further characterise the clinical, morphological, cytogenetic and prognostic features of NT/T-AML. METHODS We searched our cytogenetic laboratory database from 1991 to 2012 to reveal 13 cases of NT/T-AML. Each case was evaluated with regard to its demographics, morphology, immunophenotype and prognosis. Specific morphological features included blast size, irregularity of nuclear contours, cytoplasmic vacuoles, and presence and lineage of dysplasia. RESULTS Eleven men and two women had a median age of 68 years. Blasts were predominately large (11/13). Eight of 13 patients had AML with myelodysplasia-related changes. Sixty-nine per cent of patients achieved complete remission (CR). Median overall survival (OS) was 8.6 months. CR rate and median OS in cases with ≥ 5 cytogenetic abnormalities were 71% and 6 months, compared with 67% and 18.1 months in cases with <5 abnormalities. CONCLUSIONS NT/T-AML occurs in older males, exhibits large blast size and is associated with myelodysplasia. Unlike previously reported data, our study reveals an overall better prognosis in this older population with NT/T-AML than was expected for a complex karyotype AML. Cytogenetic complexity independent of ploidy status did not greatly affect the high CR rates, but did appear to be a better estimation of prognostic risk in terms of median OS.
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Affiliation(s)
- Changlee S Pang
- Department of Pathology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, North Carolina, USA
| | - Mark J Pettenati
- Department of Genetics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, North Carolina, USA
| | - Timothy S Pardee
- Department of Hematology/Oncology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, North Carolina, USA
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9
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Kim BH, Kim HR, Lee MK, Chi H. Two cases of near-tetraploidy in acute leukemias of ambiguous lineage. Ann Lab Med 2013; 33:371-4. [PMID: 24003431 PMCID: PMC3756245 DOI: 10.3343/alm.2013.33.5.371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/02/2013] [Accepted: 07/01/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Bo Hyun Kim
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
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10
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11
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A tetraploid minimally differentiated acute myeloblastic leukemia with extensive erythrophagocytosis: a case report and literature review. Int J Hematol 2012; 96:801-5. [DOI: 10.1007/s12185-012-1179-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Revised: 09/09/2012] [Accepted: 09/11/2012] [Indexed: 10/27/2022]
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12
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Lemež P, Klamová H, Zemanová Z, Marinov I, Fuchs O, Schwarz J, Březinová J, Provazníková D, Kostečka A, Marková J, Michalová K, Jelínek J. Unusually long survival of a 67-year-old patient with near-tetraploid acute myeloid leukemia m0 without erythroblastic and megakaryocytic dysplasia. Acta Haematol 2011; 126:129-34. [PMID: 21701158 DOI: 10.1159/000328199] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 04/07/2011] [Indexed: 11/19/2022]
Abstract
Patients with near-tetraploid acute myeloid leukemia (NT-AML) typically have poor survival. We present the case of a 67-year-old Caucasian male with NT-AML M0 who had an unusually long first complete remission of 51 months and an overall survival of 80 months. The only characteristic distinguishing him from other previously described patients with NT-AML was the absence of erythroblastic and/or megakaryocytic dysplasia (EMD) at diagnosis. Molecular-genetic testing for AML fusion transcripts associated with a favorable prognosis (PML/RARα,AML1/ETO, and CBFβ/MYH11) were negative, as were other prognostic markers like MLL-PTD,FLT3-ITD, or mutations of FLT3-D835,NPM1, or CEBPA. Expression studies of ERG,MN1, and EVI1 revealed overexpression of ERG only. The absence of EMD may be a useful prognostic/diagnostic feature of this new rare subtype of NT-AML.
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Affiliation(s)
- Petr Lemež
- Department of Hematology-Blood Transfusion, Hospital Jihlava, Jihlava, Czech Republic.
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13
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Lemez P, Attarbaschi A, Béné MC, Bertrand Y, Castoldi G, Forestier E, Garand R, Haas OA, Kagialis-Girard S, Ludwig WD, Matutes E, Mejstríková E, Pages MP, Pickl W, Porwit A, Orfao A, Schabath R, Starý J, Strobl H, Talmant P, van't Veer MB, Zemanová Z. Childhood near-tetraploid acute lymphoblastic leukemia: an EGIL study on 36 cases. Eur J Haematol 2010; 85:300-8. [PMID: 20561032 DOI: 10.1111/j.1600-0609.2010.01493.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Petr Lemez
- Department of Hematology and Blood Transfusion, Hospital Jihlava, Jihlava, Czech Republic.
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14
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Enlarged and prominent nucleus may be indicative of tetraploidy: a laboratory study of a rare near-tetraploidy in a child patient with acute myelogenous leukemia AML-M4. J Pediatr Hematol Oncol 2010; 32:19-21. [PMID: 19816206 DOI: 10.1097/mph.0b013e3181b794b2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Near-tetraploidy is a rare cytogenetic abnormality in myelocytic malignancies in children and its significance is unknown. To investigate the pathologic characteristics of a near-tetraploidy in a child with acute myelogenous leukemia (AML-M4), bone marrow smears were prepared for morphologic analysis. Bone marrow samples were collected at presentation for flow cytometry, prepared by short-term (24 h) unstimulated culture and R-banding for conventional cytogenetic assay. We have performed a multifactorial analysis of the laboratory test results. In this case, the chromosomal analysis (R-banding) demonstrated a near-tetraploidy. Combined with morphologic and immunophenotypic results, the diagnosis was established as acute myelogenous leukemia (AML-M4). Near-tetraploidy is an uncommon cytogenetic finding, and the experience of this case further emphasizes the importance of the laboratory diagnostic methods.
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Pan J, Xue Y, Qiu H, Wu Y, Wang Y, Zhang J, Shen J. Tetraploid clone characterized by two t(15;17) in five cases of acute promyelocytic leukemia. ACTA ACUST UNITED AC 2009; 188:57-9. [PMID: 19061783 DOI: 10.1016/j.cancergencyto.2008.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2008] [Accepted: 08/22/2008] [Indexed: 10/21/2022]
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Derolf AR, Björklund E, Mazur J, Björkholm M, Porwit A. Expression patterns of CD33 and CD15 predict outcome in patients with acute myeloid leukemia. Leuk Lymphoma 2008; 49:1279-91. [PMID: 18604716 DOI: 10.1080/10428190802123994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Expression patterns of CD33 and CD15 in normal/reactive bone marrow (n = 13) and in leukemic blasts from patients with acute myeloid leukemia (n = 129) were determined using multiparameter flow cytometry and a standard panel of triple antibody combinations. Five patterns, corresponding to the consecutive stages of myeloid differentiation, were identified [I: CD33-/CD15- (n = 18), II: CD33+/CD15- (n = 43), III: CD33+/CD15 heterogeneous (n = 10), IV: CD33+/CD15+ (n = 50), V: CD33-/CD15+ (n = 8)]. Patients with pattern II had the highest relapse rate and shortest median overall survival (OS, 8 months), but they were also the oldest (median age 72 years) and had the highest frequency of unfavorable cytogenetic aberrations. Pattern V patients had a short OS (median 14 months) even though they were the youngest (median age 50 years), had high remission rate and did not have unfavorable cytogenetics. In multivariate analysis, age, cytogenetics, CD15 expression and the presented immunophenotypic classification were significant for OS (age p = 0.004, cytogenetics p = 0.011, immunophenotype pattern p = 0.024, CD15 p = 0.031). Age (p = 0.001) and immunophenotypic classifications (p = 0.015) were significant for disease-free survival in patients who achieved complete remission.
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Affiliation(s)
- Asa Rangert Derolf
- Department of Medicine, Division of Hematology, Karolinska Institutet and Karolinska University Hospital, Solna, Stockholm, Sweden.
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