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EAHP 2020 workshop proceedings, pediatric myeloid neoplasms. Virchows Arch 2022; 481:621-646. [PMID: 35819517 PMCID: PMC9534825 DOI: 10.1007/s00428-022-03375-8] [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] [Received: 04/04/2022] [Revised: 06/15/2022] [Accepted: 06/28/2022] [Indexed: 12/02/2022]
Abstract
The first section of the bone marrow workshop of the European Association of Haematopathology (EAHP) 2020 Virtual Meeting was dedicated to pediatric myeloid neoplasms. The section covered the whole spectrum of myeloid neoplasms, including myelodysplastic syndromes (MDS), myeloproliferative neoplasms (MPN), myelodysplastic/myeloproliferative neoplasms (MDS/MPN), and acute myeloid leukemia (AML). The workshop cases are hereby presented, preceded by an introduction on these overall rare diseases in this age group. Very rare entities such as primary myelofibrosis, pediatric MDS with fibrosis, and MDS/MPN with JMML-like features and t(4;17)(q12;q21); FIP1L1::RARA fusion, are described in more detail.
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Cytogenetic risk groups for childhood acute myeloid leukemia based on survival analysis in a cancer referral hospital from Perú. ACTA ACUST UNITED AC 2021; 41:302-313. [PMID: 34214271 PMCID: PMC8382291 DOI: 10.7705/biomedica.5747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Indexed: 12/27/2022]
Abstract
Introduction: Acute myeloid leukemia is a heterogeneous disorder characterized by immature myeloid cell proliferation. Cytogenetic analysis has revealed the presence of chromosomal aberrations important to patient prognosis.
Objective: To determine cytogenetic risk groups of pediatric patients with acute myeloid leukemia according to overall survival.
Materials and methods: In this cross-sectional observational study, the clinical records of pediatric patients diagnosed with de novo acute myeloid leukemia admitted to the Instituto Nacional de Enfermedades Neoplásicas between 2001 and 2011 with cytogenetic analysis of bone marrow were included. Cytogenetic risk groups were established according to the criteria of the Medical Research Council. Overall survival curves were generated with the Kaplan-Meier method and compared using the Mantel-Cox test and Cox regression with the software R, version 3.3.2.
Results: A total of 130 patients were included, 68 males (52.3%) and 62 females (47.7%), most of them with subtype M2 (33%). The average age was 7.7 years (range: 0-15 years). Chromosomal aberrations were observed in 60.8% of the patients, the most frequent of which was the translocation t(8;21). According to the overall survival analysis, two cytogenetic risk groups were established: favorable and unfavorable.
Conclusion: Two groups of cytogenetic risk were determined: high (or unfavorable) and standard (favorable).
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Alkhayat N, Elyamany G, Elborai Y, Sedick Q, Alshahrani M, Al Sharif O, Alenezy A, Hammdan A, Elghezal H, Alsuhaibani O, Aljabry MS, AlMoshary M, Al Mussaed E. Rare cytogenetic abnormalities and their clinical relevance in pediatric acute leukemia of Saudi Arabian population. Mol Cytogenet 2019; 12:42. [PMID: 31632455 PMCID: PMC6788108 DOI: 10.1186/s13039-019-0454-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/04/2019] [Indexed: 11/25/2022] Open
Abstract
Background Childhood Acute Leukemia (AL) is characterized by recurrent genetic aberrations in 60% of AML cases and 90% of ALL cases. Insufficient data exists of rare cytogenetic abnormalities in AL. Therefore, we tested rare cytogenetic abnormalities occurring in childhood AL and its effect on clinical prognosis in patients diagnosed at our institution from 2010 to 2017. Results Among 150 cases of AL, we detected 9 cases with rare chromosomal abnormalities. We found two hypodiploid (2n-) cases: 2n-,t (5;14)(q31;q32) and t (3;11;19)(q21;q23;q13.1) in ALL patients. AML patients showed t (7;14)(q22;q32), t (11;17)(p15;q21), t (11;20) (p15;q11), t (12;17)(q15;q23) and t (11;20)(p15;q11). Both t (1;15)(q10;q10) and t (17;19)(q21;p13.3) occurred in a case with biphenotypic AL. Complete remission (CR) status was attained in 3 patients and 6 patients never attained CR or relapsed/demised. Conclusion The study highlighted that rare cytogenetic abnormalities are associated with a poor prognosis. This finding is not well reported in the literature suggesting that ongoing cytogenetic studies for rare abnormalities associated with pediatric leukaemia are warranted.
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Affiliation(s)
- Nawaf Alkhayat
- 1Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Ghaleb Elyamany
- 2Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Yasser Elborai
- 1Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,3Department of Pediatric Oncology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Qanita Sedick
- 2Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mohammad Alshahrani
- 1Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Omar Al Sharif
- 1Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulmalik Alenezy
- 2Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Amjad Hammdan
- 2Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Hatem Elghezal
- 2Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Omar Alsuhaibani
- 2Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Mansour S Aljabry
- Department of Pathology, Hematology unit, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - May AlMoshary
- 5Basic Science Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
| | - Eman Al Mussaed
- 5Basic Science Department, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia
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Acute myeloid leukemia (AML) with t(7;12)(q36;p13) is associated with infancy and trisomy 19: Data from Nordic Society for Pediatric Hematology and Oncology (NOPHO-AML) and review of the literature. Genes Chromosomes Cancer 2018; 57:359-365. [DOI: 10.1002/gcc.22538] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 03/19/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022] Open
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Monosomal karyotype is not a predictor of dismal outcome in childhood de novo acute myeloid leukemia. Leuk Res 2016; 50:57-62. [PMID: 27683973 DOI: 10.1016/j.leukres.2016.09.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 11/21/2022]
Abstract
Monosomal karyotype (MK) is known as a far end of the unfavorable cytogenetics in adult acute myeloid leukemia (AML), while available data in childhood AML is scarce. In this study, we investigated the prevalence and prognostic value of MK with retrospectively analyzed 119 patients newly diagnosed with childhood de novo AML. Ten patients (8.4%) revealed to have MK. All MK-positive (MK(+)) AML were associated with complex cytogenetic abnormalities and belonged to the cytogenetic adverse-risk group. Nine of MK(+) patients (90%) achieved complete remission. The event-free survival (EFS) and overall survival (OS) of MK(+) adverse group were comparable to the ESF and OS of MK-negative non-adverse group (EFS 60.0±15.5% vs 59.0±5.1%, P=0.925; OS 70.0±14.5% vs 58.1±5.3%, P=0.696). In multivariate analysis, MK was not an independent adverse prognostic factor for EFS (hazard ratio 0.45, 95% C.I. 0.13-1.50, P=0.194). In addition, 7 of 9 MK(+) patients who received allogeneic hematopoietic stem cell transplantation (HSCT) survived event-free, with a median follow-up of 64 months. In conclusion, MK did not act as an adverse prognostic factor in childhood de novo AML. Allogeneic HSCT might have contributed to the excellent outcome of MK(+) childhood de novo AML.
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Laursen ACL, Sandahl JD, Kjeldsen E, Abrahamsson J, Asdahl P, Ha SY, Heldrup J, Jahnukainen K, Jónsson ÓG, Lausen B, Palle J, Zeller B, Forestier E, Hasle H. Trisomy 8 in pediatric acute myeloid leukemia: A NOPHO-AML study. Genes Chromosomes Cancer 2016; 55:719-26. [PMID: 27153159 DOI: 10.1002/gcc.22373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/28/2016] [Accepted: 04/28/2016] [Indexed: 01/11/2023] Open
Abstract
Trisomy 8 (+8) is a common cytogenetic aberration in acute myeloid leukemia (AML); however, the impact of +8 in pediatric AML is largely unknown. We retrospectively investigated 609 patients from the NOPHO-AML database to determine the clinical and cytogenetic characteristics of +8 in pediatric AML and to investigate its prognostic impact. Complete cytogenetic data were available in 596 patients (98%) aged 0-18 years, diagnosed from 1993 to 2012, and treated according to the NOPHO-AML 1993 and 2004 protocols in the Nordic countries and Hong Kong. We identified 86 patients (14%) with +8. Trisomy 8 was combined with other cytogenetic aberrations in 68 patients (11%) (+8 other) and in 18 patients (3%), it was the sole abnormality (+8 alone). Trisomy 8 was associated with FAB M5 (36%) but otherwise clinically comparable with non-trisomy 8 patients. Trisomy 8 was favorable in patients of young age and with t(9;11). Trisomy 8 alone was associated with older age (median age 10.1 years), FAB M2 (33%), and FLT3-ITD mutations (58%). The 5-year event-free survival for patients with +8 alone was 50% and 5-year overall survival was 75%. In conclusion, +8 is one of the most common cytogenetic aberrations in pediatric AML. Trisomy 8 positive AML is a heterogeneous group and the majority of cases have additional cytogenetic aberrations. Patients with +8 alone differed from patients with +8 other and were associated with older age, FAB M2, and FLT3-ITD aberrations. There were no differences in survival despite the more frequent occurrence of FLT3-ITD in +8 alone. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
| | | | - Eigil Kjeldsen
- Cancer Cytogenetics Laboratory, Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Jonas Abrahamsson
- Institution for Clinical Sciences, Department of Pediatrics, Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Peter Asdahl
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Shau-Yin Ha
- Department of Pediatrics, Queen Mary Hospital and Hong Kong Pediatric Hematology & Oncology Study Group (HKPHOSG), Hong Kong, China
| | - Jesper Heldrup
- Department of Pediatrics, University Hospital, Lund, Sweden
| | - Kirsi Jahnukainen
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland
| | | | - Birgitte Lausen
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Josefine Palle
- Department of Woman's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Bernward Zeller
- Department of Pediatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Erik Forestier
- Department of Medical Biosciences, Clinical Genetics, Umeå University Hospital, Umeå, Sweden
| | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
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Kayser S, Walter RB, Stock W, Schlenk RF. Minimal residual disease in acute myeloid leukemia--current status and future perspectives. Curr Hematol Malig Rep 2016; 10:132-44. [PMID: 25994952 DOI: 10.1007/s11899-015-0260-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In acute myeloid leukemia (AML), the achievement of a morphological complete remission (CR) is an important milestone on the road to cure. Still, the majority of patients who achieve a morphological CR will eventually relapse. Thus, morphological means are not sensitive enough to detect clinically relevant tumor burdens left behind after therapy. Over the last years, several methodologies, particularly multiparameter flow cytometry and polymerase chain reaction, have emerged that can detect, quantify, and monitor submicroscopic amounts of leukemia cells ("minimal residual disease", MRD). Newer techniques, such as next-generation sequencing, have not only changed our understanding of the molecular pathogenesis and clonal heterogeneity of AML but may also be used for MRD detection. Increasing evidence indicates that MRD could play an important role in dynamically refining disease risk and, perhaps, serve to fine-tune post-remission therapy in a risk-adapted manner, although the latter concept awaits validation through well-controlled trials. In this review, we discuss the current use of MRD measurements during AML treatment and highlight future perspectives.
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Affiliation(s)
- Sabine Kayser
- Department of Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany,
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A Case of Acute Myeloid Leukemia (FAB M2) with Inversion 16 Who Presented with Pelvic Myeloid Sarcoma. Case Rep Pediatr 2015; 2014:246169. [PMID: 25610688 PMCID: PMC4283287 DOI: 10.1155/2014/246169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 12/08/2014] [Indexed: 12/22/2022] Open
Abstract
Acute leukemias are the most common childhood cancer in all age groups. Acute myeloid leukemias (AML) constitute about 15–20% of acute leukemias. Fatigability, pallor, fever, and bleeding are the most common presenting symptoms of AML. Hepatosplenomegaly and lymphadenopathy are commonly encountered during physical examination. In rare instances eruptions due to skin involvement and localized tumor masses (myeloid sarcoma) may be found. Myeloid sarcoma is especially seen in AML-M2 subtype. By cytogenetic analysis, in AML-M2 subtype t(8;21) is often seen and it is more probable to find inversion 16 in AML-M4Eos subtype. Herein, we present a 15-year-old girl whose initial symptom was abdominal pain for three days and her pathological sign was a large abdominal mass which was verified by imaging studies and diagnosed as myeloid sarcoma by biopsy. On bone marrow examination, she had diagnosis of AML-M2 and by cytogenetic analysis inversion 16 was positive. She was treated with AML-BFM 2004 protocol and she is being followed up in remission on her ninth month of the maintenance therapy.
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Sandahl JD, Kjeldsen E, Abrahamsson J, Ha SY, Heldrup J, Jahnukainen K, Jónsson OG, Lausen B, Palle J, Zeller B, Forestier E, Hasle H. Ploidy and clinical characteristics of childhood acute myeloid leukemia: A NOPHO-AML study. Genes Chromosomes Cancer 2014; 53:667-75. [PMID: 24753324 DOI: 10.1002/gcc.22177] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 04/04/2014] [Indexed: 12/11/2022] Open
Abstract
We report the first large series (n = 596) of pediatric acute myeloid leukemia (AML) focusing on modal numbers (MN) from the population-based NOPHO-AML trials. Abnormal karyotypes were present in 452 cases (76%) and numerical aberrations were present in 40% (n = 237) of all pediatric AML. Among patients with an abnormal karyotype, the MN 46 was most common (n = 251; 56%) of which 36 (8%) were pseudodiploid with numerical aberrations, followed by MN 47 (n = 80; 18%) and MN 43-45 (n = 48; 8%). No cases had MN less than 43. Hyperdiploid AML with MN 48-65 comprised 11% of all cases and was associated with early onset (median age 2 years), female sex (57%), and a dominance of acute megakaryoblastic leukemia (AMKL) (29%). Hypodiploidy constituted 8% of all AML and was associated with older age (median age 9 years), male predominance (60%), FAB M2 (56%), and t(8;21)(q22;q22) (56%) with loss of sex chromosomes. Inferior outcome was observed for hypodiploid cases (5-year event-free survival 40% and 5-year overall survival 40%) but did not reach statistical significance. Chromosomes were gained in a nonrandom pattern, where chromosomes 8, 21, 19, and 6 were the most commonly gained. In conclusion, based on MNs, two cytogenetic subgroups with characteristic clinical features are described; hypodiploidy found in 8% and associated with high median age, male sex, t(8;21)(q22;q22), and FAB M2 and possibly associated with inferior outcome (P = 0.13), and hyperdiploidy with MN 48-65 in 11% associated with early onset, female sex, and AMKL.
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10
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Lum SH, Chin TF, Lau KH, Yap TY, Rajagopal R, Ariffin H. Refractory acute monoblastic leukaemia with low hypodiploidy. Int J Hematol 2014; 99:215-6. [PMID: 24470150 DOI: 10.1007/s12185-014-1515-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 01/07/2014] [Accepted: 01/15/2014] [Indexed: 11/24/2022]
Affiliation(s)
- Su Han Lum
- Department of Paediatrics, University of Malaya, Kuala Lumpur, Malaysia,
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11
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Kim HJ, Oh HJ, Lee JW, Jang PS, Chung NG, Kim M, Lim J, Cho B, Kim HK. Utility of a multiplex reverse transcriptase-polymerase chain reaction assay (HemaVision) in the evaluation of genetic abnormalities in Korean children with acute leukemia: a single institution study. KOREAN JOURNAL OF PEDIATRICS 2013; 56:247-53. [PMID: 23807891 PMCID: PMC3693043 DOI: 10.3345/kjp.2013.56.6.247] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Revised: 10/05/2012] [Accepted: 10/22/2012] [Indexed: 11/27/2022]
Abstract
Purpose In children with acute leukemia, bone marrow genetic abnormalities (GA) have prognostic significance, and may be the basis for minimal residual disease monitoring. Since April 2007, we have used a multiplex reverse transcriptase-polymerase chain reaction tool (HemaVision) to detect of GA. Methods In this study, we reviewed the results of HemaVision screening in 270 children with acute leukemia, newly diagnosed at The Catholic University of Korea from April 2007 to December 2011, and compared the results with those of fluorescence in situ hybridization (FISH), and G-band karyotyping. Results Among the 270 children (153 males, 117 females), 187 acute lymphoblastic leukemia and 74 acute myeloid leukemia patients were identified. Overall, GA was detected in 230 patients (85.2%). HemaVision, FISH, and G-band karyotyping identified GA in 125 (46.3%), 126 (46.7%), and 215 patients (79.6%), respectively. TEL-AML1 (20.9%, 39/187) and AML1-ETO (27%, 20/74) were the most common GA in ALL and AML, respectively. Overall sensitivity of HemaVision was 98.4%, with false-negative results in 2 instances: 1 each for TEL-AML1 and MLL-AF4. An aggregate of diseasesspecific FISH showed 100% sensitivity in detection of GA covered by HemaVision for actual probes utilized. G-band karyotype revealed GA other than those covered by HemaVison screening in 133 patients (49.3%). Except for hyperdiplody and hypodiploidy, recurrent GA as defined by the World Health Organizationthat were not screened by HemaVision, were absent in the karyotype. Conclusion HemaVision, supported by an aggregate of FISH tests for important translocations, may allow for accurate diagnosis of GA in Korean children with acute leukemia.
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Affiliation(s)
- Hye-Jin Kim
- Department of Pediatrics, The Catholic University of Korea College of Medicine, Seoul, Korea
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12
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Cytogenetic abnormalities and monosomal karyotypes in children and adolescents with acute myeloid leukemia: correlations with clinical characteristics and outcome. Cancer Genet 2013; 206:63-72. [PMID: 23411131 DOI: 10.1016/j.cancergen.2013.01.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 01/04/2013] [Accepted: 01/04/2013] [Indexed: 01/24/2023]
Abstract
The whole spectrum of chromosomal abnormalities and their prognostic significance in children and adolescents with acute myeloid leukemia (AML) has not been fully elucidated yet, although a considerable amount of knowledge has been gained recently. Moreover, the incidence and prognostic impact of monosomal karyotypes (MKs), which are new cytogenetic categories reported recently in adults with AML, are currently unknown for childhood and adolescent AML. In this study, we investigated the cytogenetic and clinical characteristics of 140 children and adolescents (≤21 y) with AML, and correlated their cytogenetic features with both the clinical characteristics and outcomes of our patient cohort. The most frequent cytogenetic abnormality found in our study was the t(15;17), followed by the t(8;21). Striking differences in the genetic abnormalities and French-American-British subtypes were found among infants, children, and adolescents. Of 124 cases, 15 (12.1%) met the criteria of the MK definition, and 12 of the 15 MKs (80%) were complex karyotypes. Of 124 cases, 27 (21.8%) had cytogenetic abnormalities sufficient to be diagnosed as AML with myelodyspastic sydrome-related features. As expected, patients with the t(15;17) had the most favorable outcomes, whereas patients with 11q23 rearrangements and monosomy 7 had the worst outcomes. These data expand our knowledge by providing novel insights into the cytogenetic features and their correlations with clinical characteristics and outcomes in childhood and adolescent AML.
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Al-Tahou K, Jamil S, Mody R, Knaus A, Micale M, Huang J. Secondary acute myelogenous leukemia (AML) with trisomy 10 and del(9q) following precursor B-cell acute lymphoblastic leukemia (ALL) with a hyperdiploid karyotype. Cancer Genet 2012; 205:533-6. [PMID: 22944559 DOI: 10.1016/j.cancergen.2012.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Revised: 06/08/2012] [Accepted: 06/11/2012] [Indexed: 11/16/2022]
Abstract
Acute myelogenous leukemia (AML) secondary to acute lymphoblastic leukemia (ALL) in children is uncommon and usually occurs within 10 years of completing therapy for ALL. A variety of recurrent cytogenetic abnormalities have been described, suggesting significant biological heterogeneity. We report a case of highly refractory secondary AML with trisomy 10 and del(9q) occurring in an adolescent female 12 years after she was treated successfully for precursor B-cell ALL with chemotherapy only.
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Affiliation(s)
- Karima Al-Tahou
- Department of Pediatric Hematology/Oncology, NBK Children's Hospital, Shuwaikh, Alkuwait, Kuwait
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Chromosomal aberrations associated with clonal evolution and leukemic transformation in fanconi anemia: clinical and biological implications. Anemia 2012; 2012:349837. [PMID: 22675616 PMCID: PMC3366199 DOI: 10.1155/2012/349837] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 03/13/2012] [Indexed: 12/30/2022] Open
Abstract
Fanconi anaemia (FA) is an inherited disease with congenital and developmental abnormalities, bone marrow failure, and extreme risk of leukemic transformation. Bone marrow surveillance is an important part of the clinical management of FA and often reveals cytogenetic aberrations. Here, we review bone marrow findings in FA and discuss the clinical and biological implications of chromosomal aberrations associated with leukemic transformation.
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So CC, Wan TS, Chow JL, Hui KC, Choi WW, Lam CC, Chan LC. A single-center cytogenetic study of 629 Chinese patients with de novo acute myeloid leukemia--evidence of major ethnic differences and a high prevalence of acute promyelocytic leukemia in Chinese patients. Cancer Genet 2011; 204:430-8. [PMID: 21962893 DOI: 10.1016/j.cancergen.2011.06.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 06/01/2011] [Accepted: 06/06/2011] [Indexed: 11/20/2022]
Abstract
Cytogenetic information is important in the diagnosis, classification, and prognostication of acute myeloid leukemia (AML). Data obtained from multicenter treatment trials are well published. In this study, we contribute cytogenetic data from a large series of 629 Chinese patients with de novo AML that were karyotyped in a single laboratory. A higher prevalence of acute promyelocytic leukemia was observed when compared with non-Chinese series. The difference was most prominent in the younger age group. Abnormalities at chromosomal region 11q23 and inv(16) seemed uncommon. These ethnic differences may indicate underlying genetic susceptibility to AML development and/or environmental differences. More comprehensive data on AML in the elder population are needed to assess the role of cytogenetics in predicting prognosis and guiding treatment in this large subgroup of patients.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Asian People/genetics
- Child
- Child, Preschool
- China/epidemiology
- Ethnicity/genetics
- Female
- Humans
- Infant
- Karyotyping
- Leukemia, Myeloid, Acute/epidemiology
- Leukemia, Myeloid, Acute/ethnology
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Promyelocytic, Acute/epidemiology
- Leukemia, Promyelocytic, Acute/ethnology
- Leukemia, Promyelocytic, Acute/genetics
- Male
- Middle Aged
- Neoplasms, Second Primary/epidemiology
- Neoplasms, Second Primary/ethnology
- Neoplasms, Second Primary/genetics
- Prevalence
- Prognosis
- Young Adult
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Affiliation(s)
- Chi-Chiu So
- Department of Pathology, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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16
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Verdeguer A. Genetic alterations in children and adolescents with acute myeloid leukaemia. Clin Transl Oncol 2010; 12:590-6. [DOI: 10.1007/s12094-010-0563-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Keefe JG, Sukov WR, Knudson RA, Nguyen LP, Williamson C, Sinnwell JP, Ketterling RP. Development of five dual-color, double-fusion fluorescence in situ hybridization assays for the detection of common MLL translocation partners. J Mol Diagn 2010; 12:441-52. [PMID: 20539022 PMCID: PMC2893628 DOI: 10.2353/jmoldx.2010.090214] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2010] [Indexed: 11/20/2022] Open
Abstract
Chromosomal rearrangements involving the mixed lineage leukemia (MLL) gene at 11q23 are frequent in adult and childhood acute leukemia and have been associated with an unfavorable prognosis. Recent evidence suggests that MLL gene partners may influence prognosis. Five translocations account for approximately 80% of MLL rearrangements: t(4;11)(q21;q23), AFF1/MLL; t(6;11)(q27;q23), MLLT4/MLL; t(9;11)(p22;q23), MLLT3/MLL; t(11;19)(q23;p13.1), MLL/ELL; and t(11;19)(q23;p13.3), MLL/MLLT1. We have designed dual-color, double-fusion fluorescence in situ hybridization (D-FISH) probe sets to identify these translocations. A blinded study was performed for each probe set using 25 normal bone marrow samples, 25 t(4;11), 20 t(6;11), 20 t(9;11), 18 t(11;19p13.1), and 20 t(11;19p13.3) leukemia specimens as defined by chromosome analysis. The findings demonstrated abnormal D-FISH results for 24 of 25 AFF1/MLL, 19 of 20 MLLT4/MLL, all 20 MLLT3/MLL, all 18 MLL/ELL, and all 20 MLL/MLLT1 samples, confirming the efficacy of these D-FISH assays in detecting these common MLL/partner translocations. Our D-FISH assays were more accurate than chromosome analysis at distinguishing disruption of 19p13.1/ELL from that of 19p13.3/MLLT1. We also demonstrated a statistically significant increase in complex/unbalanced MLL/partner translocations occurring in pediatric patients versus adult patients (P = 0.02). A normal cutoff of 0.6% was established, suggesting an application for these assays in minimal residual disease detection and disease monitoring.
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Affiliation(s)
- Jeannette G. Keefe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - William R. Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Ryan A. Knudson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Lai P. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Cynthia Williamson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Jason P. Sinnwell
- Divisions of Laboratory Genetics, and Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | - Rhett P. Ketterling
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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von Neuhoff C, Reinhardt D, Sander A, Zimmermann M, Bradtke J, Betts DR, Zemanova Z, Stary J, Bourquin JP, Haas OA, Dworzak MN, Creutzig U. Prognostic Impact of Specific Chromosomal Aberrations in a Large Group of Pediatric Patients With Acute Myeloid Leukemia Treated Uniformly According to Trial AML-BFM 98. J Clin Oncol 2010; 28:2682-9. [DOI: 10.1200/jco.2009.25.6321] [Citation(s) in RCA: 164] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose Because cytogenetic data are essential for risk stratification of childhood acute myeloid leukemia (AML), the impact of chromosomal aberrations is crucial. Patients and Methods Data of a large group of patients younger than 18 years treated according to study AML–Berlin-Frankfurt-Münster (BFM) 98 (n = 454), including their cytogenetics, were analyzed. Results The favorable outcome in the subgroups of patients with t(8;21), inv(16), and t(15;17), with an overall survival of 91% (SE, 4%), 92% (SE, 6%), and 87% (SE, 5%), respectively, was confirmed. Within this group, the 5-year probability of event-free survival (pEFS) of all 17 children with t(8;21) and additional aberrations apart from del(9q) or −X/−Y was 100%. As expected, the cytogenetic finding of a complex karyotype (n = 35; pEFS, 33%; SE, 8%) or a monosomy 7 (n = 12; pEFS, 17%; SE, 11%) was associated with a poor outcome. Compared with remaining patients with cytogenetic data (pEFS, 48%; SE, 2%), prognosis in patients with an MLL rearrangement (n = 91) was inferior (pEFS, 34%; SE, 5%; P = .0005). Particularly, children with t(9;11) and additional aberrations (n = 13; pEFS, 31%; SE, 14%) and MLL rearrangements other than t(9;11) and t(11;19) (n = 41; pEFS, 24%; SE, 7%) had an unfavorable outcome. Nine patients with aberrations in 12p showed an adverse prognosis (pEFS, 11%; SE, 10%). The outcome of patients with aberrations of chromosome 5 (n = 13) was better than expected (pEFS, 50%; SE, 13%). Conclusion Because the prognostic value of rare recurrent chromosomal aberrations still has to be elucidated, these data will contribute to future risk stratification for the treatment of pediatric AML.
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Affiliation(s)
- Christine von Neuhoff
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Dirk Reinhardt
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Annette Sander
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Martin Zimmermann
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Jutta Bradtke
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - David R. Betts
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Zuzana Zemanova
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Jan Stary
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Jean-Pierre Bourquin
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Oskar A. Haas
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Michael N. Dworzak
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
| | - Ursula Creutzig
- From Pediatric Hematology/Oncology, Medical School Hannover, Hannover; Pediatric Haematology/Oncology, Oncogenetic Laboratory, Justus-Liebig-Universität Giessen, Giessen; Children's Hospital, Pediatric Hematology/Oncology, University of Münster, Münster Germany; Our Lady's Children's Hospital, National Centre for Medical Genetics, Crumlin, Dublin, Ireland; Center of Oncocytogenetics, Institute of Clinical Biochemistry and Laboratory Diagnostics, General University Hospital and First Faculty of Medicine,
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Harrison CJ, Hills RK, Moorman AV, Grimwade DJ, Hann I, Webb DK, Wheatley K, de Graaf SS, van den Berg E, Burnett AK, Gibson BE. Cytogenetics of Childhood Acute Myeloid Leukemia: United Kingdom Medical Research Council Treatment Trials AML 10 and 12. J Clin Oncol 2010; 28:2674-81. [DOI: 10.1200/jco.2009.24.8997] [Citation(s) in RCA: 224] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Karyotype is an independent indicator of prognosis in acute myeloid leukemia (AML) that is widely applied to risk-adapted therapy. Because AML is rare in children, the true prognostic significance of individual chromosomal abnormalities in this age group remains unclear. Patients and Methods This cytogenetic study of 729 childhood patients classified them into 22 subgroups and evaluated their incidence and risk. Results Rearrangements of 11q23 were the most frequent abnormality found in approximately 16% of patients, with 50% of these in infants. The outcome for all patients with 11q23 abnormalities was intermediate; no difference was observed for those with t(9;11)(p21-22;q23). The core binding factor leukemias with the translocations t(8;21)(q22;q22) and inv(16)(p13q22) occurred at incidences of 14% and 7%, respectively, predominantly in older children, and their prognosis was favorable. An adverse outcome was observed in patients with monosomy 7, abnormalities of 5q, and t(6;9)(p23;q34). Abnormalities of 3q and complex karyotypes, in the absence of favorable-risk features, have been associated with an adverse outcome in adults, but the results were not significant in this childhood series. However, the presence of 12p abnormalities predicted a poor outcome. Conclusion Because the spectrum of chromosomal changes and their risk association seem to differ between children and adults with AML, biologic differences are emerging, which will contribute to the redefinition of risk stratification for different age groups in the future.
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Affiliation(s)
- Christine J. Harrison
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Robert K. Hills
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Anthony V. Moorman
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - David J. Grimwade
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Ian Hann
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - David K.H. Webb
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Keith Wheatley
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Siebold S.N. de Graaf
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Eva van den Berg
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Alan K. Burnett
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
| | - Brenda E.S. Gibson
- From the Leukaemia Research Cytogenetics Group, Northern Institute for Cancer Research, Newcastle University, Newcastle-upon-Tyne; Department of Haematology, Cardiff University, Cardiff; Department of Medical and Molecular Genetics, King's College London School of Medicine; Department of Haematology, Hospital for Sick Children, London; University of Birmingham Clinical Trials Unit, Birmingham; Department of Haematology, Royal Hospital for Sick Children, Glasgow, United Kingdom; Dutch Childhood Oncology
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Cytogenetic features of acute lymphoblastic and myeloid leukemias in pediatric patients with Down syndrome: an iBFM-SG study. Blood 2008; 111:1575-83. [DOI: 10.1182/blood-2007-09-114231] [Citation(s) in RCA: 127] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Children with Down syndrome (DS) have a markedly increased risk of acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). To identify chromosomal changes cooperating with +21 that may provide information on the pathogenesis of these leukemias, we analyzed 215 DS-ALLs and 189 DS-AMLs. Unlike previous smaller series, a significant proportion of DS-ALLs had the typical B-cell precursor ALL abnormalities high hyperdiploidy (HeH; 11%) and t(12;21)(p13;q22) (10%). The HeH DS-ALLs were characterized by gains of the same chromosomes as non–DS-HeH, suggesting the same etiology/pathogenesis. In addition, specific genetic subtypes of DS-ALL were suggested by the significant overrepresentation of cases with +X, t(8;14)(q11;q32), and del(9p). Unlike DS-ALL, the common translocations associated with non–DS-AML were rare in DS-AML, which instead were characterized by the frequent presence of dup(1q), del(6q), del(7p), dup(7q), +8, +11, del(16q), and +21. This series of DS leukemias—the largest to date—reveals that DS-ALL is a heterogeneous disorder that comprises both t(12;21) and HeH as well as DS-related abnormalities. Furthermore, this analysis confirms that DS-AML is a distinct entity, originating through other genetic pathways than do non–DS-AMLs, and suggests that unbalanced changes such as dup(1q), +8, and +21 are involved in the leukemogenic process.
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22
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Specific chromosomal aberrations in de novo acute myeloid leukemia: A comparative analysis of results with a report of three novel chromosomal rearrangements t(7;14)(q35;q13), t(8;18)(p11.2;q12), t(13;15) in Indian population. ACTA ACUST UNITED AC 2008; 32:168-77. [DOI: 10.1016/j.cdp.2008.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2008] [Indexed: 11/20/2022]
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23
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Shimada A, Ichikawa H, Taki T, Kubota C, Hongo T, Sako M, Morimoto A, Tawa A, Tsukimoto I, Hayashi Y. Low frequency of KIT gene mutation in pediatric acute myeloid leukemia with inv(16)(p13q22): a study of the Japanese Childhood AML Cooperative Study Group. Int J Hematol 2007; 86:289-90. [PMID: 17989000 DOI: 10.1532/ijh97.07098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Yeh TC, Liu HC, Wang LY, Chen SH, Lin WY, Liang DC. The development of a novel protocol for the treatment of de novo childhood acute myeloid leukemia in a single institution in Taiwan. J Pediatr Hematol Oncol 2007; 29:826-31. [PMID: 18090930 DOI: 10.1097/mph.0b013e31815a05aa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
From November 1, 1995 to July 31, 2004, 49 children with de novo acute myeloid leukemia (AML) were treated at our institution. One patient who was treated by a different protocol was excluded. In total, 48 patients with de novo AML were enrolled in this study. Forty-two patients with AML other than acute promyelocytic leukemia (non-APL) were treated consecutively with 2 novel protocols: Mackay Memorial Hospital (MMH)-AML-96, designed as a pilot phase, and Taiwan Pediatric Oncology Group (TPOG)-AML-97A, on the basis of MMH-AML-96 with minor modifications. Six patients with APL were treated consecutively with 2 protocols, TPOG-APL-97 and APL-2001. As of July 31, 2006, the remission rates were 79%, 92%, and 98% after 1, 2, and 3 courses of induction therapy, respectively. The 5-year overall survival was 64%+/-6.9% (SE), and the 5-year event-free survival was 60%+/-7.1%; for non-APL AML, the rates were 62%+/-7.5% and 59%+/-7.6%; for APL, 83+/-15.2 and 67+/-19.3%. Among the factors analyzed, a complete remission achieved after 1 course of induction therapy, lactate dehydrogenase <500 IU/L at diagnosis, patients without invasive fungal infection during chemotherapy, and male sex were associated with a favorable outcome.
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Affiliation(s)
- Ting-Chi Yeh
- Department of Pediatrics, Mackay Memorial Hospital,Taipei, Taiwan
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25
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Betts DR, Ammann RA, Hirt A, Hengartner H, Beck-Popovic M, Kuhne T, Nobile L, Caflisch U, Wacker P, Niggli FK. The prognostic significance of cytogenetic aberrations in childhood acute myeloid leukaemia. A study of the Swiss Paediatric Oncology Group (SPOG). Eur J Haematol 2007; 78:468-76. [PMID: 17419750 DOI: 10.1111/j.1600-0609.2007.00854.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
In childhood-onset acute myeloid leukaemia (AML) the clinical value of karyotypic aberrations is now acknowledged, although there is still debate concerning the prognostic significance of some events. To add to this knowledge, cytogenetic analysis was performed on a consecutive series of 84 childhood AML patients diagnosed in Switzerland. A result was obtained for all patients, with 69 (82%) showing a clonal karyotypic aberration. In the remaining 15 (18%), no karyotypic aberration was seen by either conventional or fluorescence in situ hybridisation analyses. The most frequent aberrations observed were t(11q23) (19% of all patients), t(8;21) (12%) and +8 (11%). Except for cytogenetics, no clinical parameter was shown to be significantly associated with outcome. The analysis of individual cytogenetic subgroups demonstrated that aberrations involving chromosome 16q were the strongest predictor of a good prognosis, while +8 and complex karyotypes represented the strongest predictors of a poor prognosis. It was also noteworthy that patients with the rare aberrations of del(11q) (n = 4) and t(16;21)(p11;q22) (n = 3) had a poor outcome. The results support the importance of cytogenetic analysis in childhood AML, but show that further work is required in the classification of the poor prognosis aberrations.
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Affiliation(s)
- David R Betts
- Department of Oncology, University Children's Hospital, Zurich, Switzerland.
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26
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Shimada A, Ichikawa H, Taki T, Kubota C, Hongo T, Sako M, Morimoto A, Tawa A, Tsukimoto I, Hayashi Y. Low frequency of KIT gene mutation in pediatric acute myeloid leukemia with inv(16)(p13q22): A study of the Japanese childhood AML cooperative study group. Int J Hematol 2007. [DOI: 10.1007/bf03006937] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Seppa L, Hengartner H, Leibundgut K, Kuhne T, Niggli FK, Betts DR. Loss of i(8)(q10) at relapse in two cases of childhood acute myeloid leukaemia. Leuk Lymphoma 2007; 48:1045-7. [PMID: 17487754 DOI: 10.1080/10428190701245120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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28
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Meyer S, Fergusson WD, Whetton AD, Moreira-Leite F, Pepper SD, Miller C, Saunders EK, White DJ, Will AM, Eden T, Ikeda H, Ullmann R, Tuerkmen S, Gerlach A, Klopocki E, Tönnies H. Amplification and translocation of 3q26 with overexpression of EVI1 in Fanconi anemia-derived childhood acute myeloid leukemia with biallelic FANCD1/BRCA2 disruption. Genes Chromosomes Cancer 2007; 46:359-72. [PMID: 17243162 DOI: 10.1002/gcc.20417] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Fanconi anemia (FA) is an inherited disease with congenital abnormalities and an extreme risk of acute myeloid leukemia (AML). Genetic events occurring during malignant transformation in FA and the biology of FA-associated AML are poorly understood, but are often preceded by the development of chromosomal aberrations involving 3q26-29 in bone marrow of FA patients. We report here the molecular cytogenetic characterization of FA-derived AML cell lines SB1685CB and SB1690CB by conventional and array comparative genomic hybridization, fluorescence in situ hybridization, and SKY. We identified gains of a 3.7 MB chromosomal region on 3q26.2-26.31, which preceded transformation to overt leukemia. This region harbors the oncogenic transcription factor EVI1. A third FA-derived cell line, FA-AML1, carried a translocation with ectopic localization of 3q26 including EVI1. Rearrangements of 3q, which are rare in childhood AML, commonly result in overexpression of EVI1, which determines specific gene expression patterns and confers poor prognosis. We detected overexpression of EVI1 in all three FA-derived AML. Our results suggest a link between the FA defect, chromosomal aberrations involving 3q and overexpression of EVI1. We hypothesize that constitutional or acquired FA defects might be a common factor for the development of 3q abnormalities in AML. In addition, cryptic imbalances as detected here might account for overexpression of EVI1 in AML without overt 3q26 rearrangements.
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Affiliation(s)
- Stefan Meyer
- Academic Unit of Paediatric Oncology, Christie Hospital Trust, University of anchester, Manchester, UK.
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Andersson A, Ritz C, Lindgren D, Edén P, Lassen C, Heldrup J, Olofsson T, Råde J, Fontes M, Porwit-Macdonald A, Behrendtz M, Höglund M, Johansson B, Fioretos T. Microarray-based classification of a consecutive series of 121 childhood acute leukemias: prediction of leukemic and genetic subtype as well as of minimal residual disease status. Leukemia 2007; 21:1198-203. [PMID: 17410184 DOI: 10.1038/sj.leu.2404688] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Gene expression analyses were performed on 121 consecutive childhood leukemias (87 B-lineage acute lymphoblastic leukemias (ALLs), 11 T-cell ALLs and 23 acute myeloid leukemias (AMLs)), investigated during an 8-year period at a single center. The supervised learning algorithm k-nearest neighbor was utilized to build gene expression predictors that could classify the ALLs/AMLs according to clinically important subtypes with high accuracy. Validation experiments in an independent data set verified the high prediction accuracies of our classifiers. B-lineage ALLs with uncharacteristic cytogenetic aberrations or with a normal karyotype displayed heterogeneous gene expression profiles, resulting in low prediction accuracies. Minimal residual disease status (MRD) in T-cell ALLs with a high (>0.1%) MRD at day 29 could be classified with 100% accuracy already at the time of diagnosis. In pediatric leukemias with uncharacteristic cytogenetic aberrations or with a normal karyotype, unsupervised analysis identified two novel subgroups: one consisting mainly of cases remaining in complete remission (CR) and one containing a few patients in CR and all but one of the patients who relapsed. This study of a consecutive series of childhood leukemias confirms and extends further previous reports demonstrating that global gene expression profiling provides a valuable tool for genetic and clinical classification of childhood leukemias.
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Affiliation(s)
- A Andersson
- Department of Clinical Genetics, Lund University Hospital, Lund, Sweden.
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Hasle H, Alonzo TA, Auvrignon A, Behar C, Chang M, Creutzig U, Fischer A, Forestier E, Fynn A, Haas OA, Harbott J, Harrison CJ, Heerema NA, van den Heuvel-Eibrink MM, Kaspers GJL, Locatelli F, Noellke P, Polychronopoulou S, Ravindranath Y, Razzouk B, Reinhardt D, Savva NN, Stark B, Suciu S, Tsukimoto I, Webb DK, Wojcik D, Woods WG, Zimmermann M, Niemeyer CM, Raimondi SC. Monosomy 7 and deletion 7q in children and adolescents with acute myeloid leukemia: an international retrospective study. Blood 2007; 109:4641-7. [PMID: 17299091 DOI: 10.1182/blood-2006-10-051342] [Citation(s) in RCA: 92] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Monosomy 7 (-7) and deletion 7q \del(7q)] are rare in childhood acute myeloid leukemia (AML). We retrospectively collected data on 258 children with AML or refractory anemia with excess blasts in transformation (RAEB-T) and -7 or del(7q) with or without other cytogenetic aberrations \+/- other]. Karyotypes included -7 (n = 90), -7 other (n = 82), del(7q) (n = 21), and del(7q) other (n = 65). Complete remission (CR) was achieved in fewer patients with -7 +/- other compared with del(7q) +/- other (61% versus 89%, P < .001). Overall, the 5-year survival rate was 39% (SE, 3%). Survival was superior in del(7q) +/- other compared with -7 +/- other (51% versus 30%, P < .01). Cytogenetic aberrations considered favorable in AML \t(8;21)(q22;q22), inv(16)(p13q22), t(15;17)(q22;q21), t(9;11)(p22;q23)] (n = 24) were strongly associated with del(7q) and a higher 5-year survival rate compared with del(7q) without favorable cytogenetics (75% versus 46%, P = .03). Patients with -7 and inv(3),-5/del(5q), or + 21 had a 5-year survival rate of 5%. Stem cell transplantation analyzed as a time-dependent variable had no impact on overall survival. However, patients not achieving CR had a 31% survival rate after stem cell transplantation. Childhood AML with chromosome 7 aberrations represents a heterogeneous group of disorders with additional cytogenetic aberrations having a major prognostic impact which should be reflected in future risk-group stratification.
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Affiliation(s)
- Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital Skejby, Aarhus, Denmark.
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Anwar Iqbal M, Al-Omar HM, Owaidah T, Al-Humaidan H, Bhuiyan ZA, Sahovic E. del(6)(p23) in two cases of de novo AML--a new recurrent primary chromosome abnormality. Eur J Haematol 2006; 77:245-50. [PMID: 16856925 DOI: 10.1111/j.1600-0609.2006.00698.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Previously, deletion 6p23 was generally reported in therapy-related secondary acute myeloid leukemia (AML) as part of complex karyotypes. In this report, we present two young adult patients with de novo AML-M2 and a terminal deletion 6p23 as a sole primary abnormality, confirmed by chromosome 6 specific subtelomeric probes. METHODS Two female patients 35 and 20 yr of age presented with anemia, but no bleeding, infections, lymphadenopathy or organomegaly. Morphological, immunophenotyping, chromosome and fluorescent in situ hybridization (FISH) analysis was performed on bone marrow aspirate cells. RESULTS A diagnosis of AML-M2 was confirmed in both patients by morphological and immunophenotyping studies. Chromosome analysis in case no. 1 showed deletion 6p23 in 20% of metaphases whereas in case no. 2 the deletion 6p23 was present in 100% metaphases. FISH analysis confirmed the deletion as terminal in both cases. The DEK oncogene at 6p23 in both cases was found not to be deleted. CONCLUSION To our knowledge, deletion 6p23 as a sole primary abnormality was reported in only one case. The common morphological, immunophenotypic, and cytogenetic features in our two patients strongly support a separate new entity of de novo AML with deletion 6p23.
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MESH Headings
- Adult
- Chromosomal Proteins, Non-Histone/genetics
- Chromosome Deletion
- Chromosomes, Human, Pair 6/genetics
- Cytogenetics
- Female
- Humans
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Karyotyping
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/immunology
- Leukemia, Myeloid, Acute/therapy
- Oncogene Proteins/genetics
- Oncogenes
- Poly-ADP-Ribose Binding Proteins
- Recurrence
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Affiliation(s)
- M Anwar Iqbal
- Section of Cytogenetics/Molecular Genetics, Department of Pathology and Laboratory Medicine, King Faisal Cancer Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
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32
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Forestier E, Schmiegelow K. The incidence peaks of the childhood acute leukemias reflect specific cytogenetic aberrations. J Pediatr Hematol Oncol 2006; 28:486-95. [PMID: 16912588 DOI: 10.1097/01.mph.0000212972.90877.28] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The correlation between age and karyotype was studied in 1425, 0 to 14.9 years old children who were diagnosed with acute lymphoblastic leukemia (ALL) or acute myeloblastic leukemia. Almost 80% of the non-Down B-cell precursor ALL cases in the 2 to 7 years frequency peak group who had aberrant cytogenetic results had either a high-hyperdiploid clone (51 to 61 chromosomes) or a translocation t(12;21)(p13;q22). Among B-cell precursor ALL cases, high white blood cell counts correlated with earlier age at diagnosis (rS=-0.23; P<0.001) being most evident for 11q23/MLL-aberrations, translocation t(12;21)(p13;q22), and high-hyperdiploidy. Among acute myeloblastic leukemia patients, frequency peaks were found for those with MLL/11q23 rearrangements (peak: first year), Down syndrome (peak: second to third year), or cytogenetic abnormalities other than translocations t(8;21), t(15;17), and inv(16)/t(16;16) (peak: first to third year). The epidemiology of the cytogenetic subsets of acute leukemias questions whether age as a disease-related prognostic parameter has any relevance in childhood leukemia clinical research beyond being a surrogate marker for more important, truly biologic features such as cytogenetic aberrations and white cell count at diagnosis. Further research is needed to explore whether the 2 to 7 years age incidence peak in childhood ALL harbor yet unidentified cytogenetic subsets with the same natural history as the high-hyperdiploid and t(12;21)-positive leukemias.
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Affiliation(s)
- Erik Forestier
- Department of Clinical Sciences, Pediatrics, University of Umeå, Sweden, and Pediatric Clinic II, The University Hospital Rigshospitalet, Copenhagen, Denmark
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Lapillonne H, Renneville A, Auvrignon A, Flamant C, Blaise A, Perot C, Lai JL, Ballerini P, Mazingue F, Fasola S, Dehée A, Bellman F, Adam M, Labopin M, Douay L, Leverger G, Preudhomme C, Landman-Parker J. High WT1 expression after induction therapy predicts high risk of relapse and death in pediatric acute myeloid leukemia. J Clin Oncol 2006; 24:1507-15. [PMID: 16575000 DOI: 10.1200/jco.2005.03.5303] [Citation(s) in RCA: 132] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine whether minimal residual disease (MRD) measured by Wilms' tumor gene 1 (WT1) expression is a prognostic marker in pediatric acute myeloid leukemia (AML), we quantified WT1 transcript by real-time quantitative-polymerase chain reaction in 92 AML at diagnosis and during follow-up. PATIENTS AND METHODS Patients (median age, 6 years; cytogenetics, favorable 27%, intermediate 59%, poor 13%) were treated between 1995 and 2002 and enrolled in Leucémie aiguë Myéloblastique Enfant (LAME) 89/91, LAME 99 pilot study and Acute Promyelocytic Leukemia French collaborative protocols. With a median follow-up of 26 months, event-free survival was 56% with a standard deviation (SD) of 5% and overall survival of 62.5% with an SD of 6%. WT1 copy number was normalized by TATA box binding protein gene transcripts and expressed as WT1/TBP x 1,000 ratio. Median WT1 ratio in normal patient controls was 12 (range, 0 to 57). A level over two SD than normal bone marrow controls (ie, WT1 ratio > 50), was considered as significant overexpression. RESULTS At diagnosis, WT1 overexpression was detected in 78% of patients (72 of 92 patients; median copy ratio, 2231). The WT1 values were significantly higher (P = .01) in favorable cytogenetics and lower (P < .0001) in M5-FAB subtype, 11q23 rearrangements (P < .001), and infants (P = .003) and demonstrate a strong correlation with fusion transcript AML1-ETO, PML-RARalpha expression. After induction treatment, WT1 ratio was analyzed in 46 of 72 patients and found above 50 in nine of 36 patients and five of 25 patients at D35-50 and 3 to 5 months, respectively. WT1 ratio > 50 after induction is an independent prognostic risk factor of relapse (P = .002) and death (P = .02). CONCLUSION WT1 quantification is an informative molecular marker for MRD in pediatric AML and is now performed as prospective analysis in ELAM02 protocol.
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Affiliation(s)
- Hélène Lapillonne
- Laboratoire d'hématologie, Service d'hématologie et d'oncologie pédiatrique, hôpital Trousseau, Paris, France
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Haltrich I, Kost-Alimova M, Kovács G, Klein G, Fekete G, Imreh S. Multipoint interphase FISH analysis of chromosome 3 abnormalities in 28 childhood AML patients. Eur J Haematol 2006; 76:124-33. [PMID: 16405433 DOI: 10.1111/j.1600-0609.2005.00576.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We detected non-random 3p losses and 3q gains on well-determined regions in both murine and human tumors using a microcell hybrid-based model system called 'elimination test'. We suggest that these are general malignancy-associated aberrations not necessarily linked to a particular tissue of origin. To examine chromosome 3 abnormalities, in 28 childhood acute myeloid leukemia bone marrow samples, we performed interphase multipoint-fluorescence in situ hybridization using 84 chromosome 3-specific probes and detected clonal chromosome 3 aberrations in nine cases, which is of a higher frequency than the previously reported one. In 3/28 children, a chromosome 3 abnormality was detected which was not visible using conventional cytogenetic analysis. We did not detect any 3p deletion. Increased copy number of 3q was found in four cases with trisomy of whole chromosome 3 and one case with 3q tetrasomy (isodisomy). We identified rare structural rearrangements in childhood acute myeloblastic leukemia, involving 3q21 and 3q26 loci around RPN1 and MDS1/EVI1 respectively. The poor outcome in pediatric patients with 3q rearrangements appears to be quite uniform.
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Affiliation(s)
- Irén Haltrich
- Department of Pediatrics, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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35
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Abstract
Abnormal number of chromosomes, aneuploidy, is the most common abnormality in leukemia and cancer. However, the casual relationship between aneuploidy and cancer is unclear. Additional copies of chromosome 21 are frequently found in leukemic cells. Constitutional trisomy 21 that characterizes Down Syndrome is associated with markedly increased risk for childhood leukemia. In this perspective I review recent studies that suggest that constitutional trisomy 21 promotes leukemic transformation during fetal hematopoiesis. As most of childhood leukemias arise in-utero, these studies are of general relevance to sporadic childhood leukemias.
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Affiliation(s)
- Shai Izraeli
- Department of Pediatric Hemato-Oncology, Cancer Research Center, Safra's Children's Hospital, Sheba Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel.
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Andersson A, Olofsson T, Lindgren D, Nilsson B, Ritz C, Edén P, Lassen C, Råde J, Fontes M, Mörse H, Heldrup J, Behrendtz M, Mitelman F, Höglund M, Johansson B, Fioretos T. Molecular signatures in childhood acute leukemia and their correlations to expression patterns in normal hematopoietic subpopulations. Proc Natl Acad Sci U S A 2005; 102:19069-74. [PMID: 16354839 PMCID: PMC1323166 DOI: 10.1073/pnas.0506637102] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Accepted: 10/31/2005] [Indexed: 12/24/2022] Open
Abstract
Global expression profiles of a consecutive series of 121 childhood acute leukemias (87 B lineage acute lymphoblastic leukemias, 11 T cell acute lymphoblastic leukemias, and 23 acute myeloid leukemias), six normal bone marrows, and 10 normal hematopoietic subpopulations of different lineages and maturations were ascertained by using 27K cDNA microarrays. Unsupervised analyses revealed segregation according to lineages and primary genetic changes, i.e., TCF3(E2A)/PBX1, IGH@/MYC, ETV6(TEL)/RUNX1(AML1), 11q23/MLL, and hyperdiploidy (>50 chromosomes). Supervised discriminatory analyses were used to identify differentially expressed genes correlating with lineage and primary genetic change. The gene-expression profiles of normal hematopoietic cells were also studied. By using principal component analyses (PCA), a differentiation axis was exposed, reflecting lineages and maturation stages of normal hematopoietic cells. By applying the three principal components obtained from PCA of the normal cells on the leukemic samples, similarities between malignant and normal cell lineages and maturations were investigated. Apart from showing that leukemias segregate according to lineage and genetic subtype, we provide an extensive study of the genes correlating with primary genetic changes. We also investigated the expression pattern of these genes in normal hematopoietic cells of different lineages and maturations, identifying genes preferentially expressed by the leukemic cells, suggesting an ectopic activation of a large number of genes, likely to reflect regulatory networks of pathogenetic importance that also may provide attractive targets for future directed therapies.
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Affiliation(s)
- Anna Andersson
- Department of Clinical Genetics, Lund University Hospital, SE-221 85 Lund, Sweden.
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Barnard DR, Woods WG. Treatment-related myelodysplastic syndrome/acute myeloid leukemia in survivors of childhood cancer--an update. Leuk Lymphoma 2005; 46:651-63. [PMID: 16019502 DOI: 10.1080/10428190500051042] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Treatment-related myelodysplastic syndrome/acute myeloid leukemia (t-MDS/t-AML) is a devastating complication of treatment for childhood cancer. However, the major cause of premature death of children treated for cancer remains their primary cancer. The understanding of the presentation, incidence, predisposing risk factors and pathobiology of t-MDS/t-AML is increasing. This increased understanding has not yet been translated into improved outcomes of therapy for t-MDS/t-AML. However, newer approaches are under study.
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Affiliation(s)
- D R Barnard
- Division of Pediatric Hematology/Oncology, IWK Health Center, 5850 University Ave, Halifax, Nova Scotia, Canada.
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38
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Beyer V, Mühlematter D, Parlier V, Cabrol C, Bougeon-Mamin S, Solenthaler M, Tobler A, Pugin P, Gregor M, Hitz F, Hess U, Chapuis B, Laurencet F, Schanz U, Schmidt PM, van Melle G, Jotterand M. Polysomy 8 defines a clinico-cytogenetic entity representing a subset of myeloid hematologic malignancies associated with a poor prognosis: report on a cohort of 12 patients and review of 105 published cases. ACTA ACUST UNITED AC 2005; 160:97-119. [PMID: 15993266 DOI: 10.1016/j.cancergencyto.2004.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Revised: 11/16/2004] [Accepted: 12/10/2004] [Indexed: 01/14/2023]
Abstract
Tetrasomy, pentasomy, and hexasomy 8 (polysomy 8) are relatively rare compared to trisomy 8. Here we report on a series of 12 patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative disorder (MPD) associated with polysomy 8 as detected by conventional cytogenetics and fluorescence in situ hybridization (FISH). In an attempt to better characterize the clinical and hematological profile of this cytogenetic entity, our data were combined with those of 105 published patients. Tetrasomy 8 was the most common presentation of polysomy 8. In 60.7% of patients, polysomy 8 occurred as part of complex changes (16.2% with 11q23 rearrangements). No cryptic MLL rearrangements were found in cases in which polysomy 8 was the only karyotypic change. Our study demonstrates the existence of a polysomy 8 syndrome, which represents a subtype of AML, MDS, and MPD characterized by a high incidence of secondary diseases, myelomonocytic or monocytic involvement in AML and poor overall survival (6 months). Age significantly reduced median survival, but associated cytogenetic abnormalities did not modify it. Cytogenetic results further demonstrate an in vitro preferential growth of the cells with a high level of aneuploidy suggesting a selective advantage for polysomy 8 cells.
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Affiliation(s)
- Valérie Beyer
- Service de Génétique Médicale, Centre Hospitalier Universitaire Vaudois, Lausanne CH-1011, Switzerland
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39
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Palle J, Frost BM, Forestier E, Gustafsson G, Nygren P, Hellebostad M, Jonsson OG, Kanerva J, Schmiegelow K, Larsson R, Lönnerholm G. Cellular drug sensitivity in MLL-rearranged childhood acute leukaemia is correlated to partner genes and cell lineage. Br J Haematol 2005; 129:189-98. [PMID: 15813846 DOI: 10.1111/j.1365-2141.2005.05433.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rearrangements in the 11q23 region, the site of the mixed lineage leukaemia (MLL) gene, are found in both childhood acute myeloid (AML) and lymphoblastic (ALL) leukaemia. We studied the in vitro drug resistance by the fluorometric microculture cytotoxicity assay (FMCA) in 132 children with AML and 178 children with ALL (aged 0-17 years). In AML, children with t(9;11) (n = 10) were significantly more sensitive to cytarabine (P < 0.001) and doxorubicin (P = 0.005) than non-11q23 rearranged patients (n = 108). Children with other 11q23 rearrangements (n = 14) differed less from non-rearranged children. The 'AML-profile' common to all three groups included relative resistance to glucocorticoids and vincristine. In ALL, children with 11q23 rearrangement (n = 22) were significantly more sensitive to cytarabine (P = 0.026) than children without 11q23 rearrangement (n = 156), also after stratification for white blood cell count. In conclusion, the findings indicate that the cellular drug resistance is correlated to both the cell lineage and the type of 11q23 rearrangement. High cellular sensitivity to cytarabine and doxorubicin might explain the excellent treatment results in children with AML and t(9;11). The present study supports the strategy of contemporary protocols to include high-dose cytarabine in the treatment of 11q23-positive patients both in AML and ALL.
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MESH Headings
- Acute Disease
- Adolescent
- Antineoplastic Agents/pharmacology
- Cell Lineage
- Child
- Child, Preschool
- Chromosomes, Human, Pair 11
- Chromosomes, Human, Pair 9
- Cytarabine/pharmacology
- Cytotoxicity Tests, Immunologic
- DNA-Binding Proteins/genetics
- Doxorubicin/pharmacology
- Drug Resistance, Neoplasm/genetics
- Female
- Fluorometry
- Gene Rearrangement
- Glucocorticoids/pharmacology
- Histone-Lysine N-Methyltransferase
- Humans
- Infant
- Infant, Newborn
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/immunology
- Male
- Myeloid-Lymphoid Leukemia Protein
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/immunology
- Prospective Studies
- Proto-Oncogenes/genetics
- Statistics, Nonparametric
- Transcription Factors/genetics
- Translocation, Genetic
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Affiliation(s)
- J Palle
- Department of Women's and Children's Health, University Children's Hospital, Uppsala, Sweden.
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40
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Zeller B, Gustafsson G, Forestier E, Abrahamsson J, Clausen N, Heldrup J, Hovi L, Jonmundsson G, Lie SO, Glomstein A, Hasle H. Acute leukaemia in children with Down syndrome: a population-based Nordic study. Br J Haematol 2005; 128:797-804. [PMID: 15755283 DOI: 10.1111/j.1365-2141.2005.05398.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To determine the epidemiology and outcome of children with Down syndrome (DS) diagnosed with acute leukaemia in the Nordic countries, data registered in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) population-based leukaemia registry were analysed. Of 3494 children with acute leukaemia diagnosed between July 1984 and December 2001, 136 patients (3.9%) with DS were identified. 2.1% of the children with acute lymphoid leukaemia (ALL) and 14.0% of the children with acute myeloid leukaemia (AML) had DS. In ALL, DS patients had similar age and sex distribution and no major differences in blood counts compared with non-DS children. None of the DS patients had T cell leukaemia. Outcome was inferior to that of non-DS children and treatment results did not improve over time. In AML, DS patients showed a significant female predominance and all but one were <5 years old. DS patients with AML had significantly lower platelet and white blood cell counts and two-thirds were type M7 as according to the French-American-British classification. None of the patients <5 years of age had typical AML cytogenetic aberrations. Outcome was far better in the DS group. DS patients treated for AML after 1992 had an excellent outcome (probability of event-free survival, 83 +/- 6%). The high proportion of female DS patients with AML is unexplained. The differing treatment results in AML versus ALL need further evaluation and represent a challenge for the coming years.
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Affiliation(s)
- Bernward Zeller
- Department of Paediatrics, National Hospital of Norway, N-0027 Oslo, Norway.
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41
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Stark B, Jeison M, Gabay LG, Mardoukh J, Luria D, Bar-Am I, Avrahami G, Kapeliushnik Y, Sthoeger D, Herzel G, Steinberg DM, Cohen IJ, Goshen Y, Stein J, Zaizov R, Yaniv I. Classical and molecular cytogenetic abnormalities and outcome of childhood acute myeloid leukaemia: report from a referral centre in Israel. Br J Haematol 2004; 126:320-37. [PMID: 15257704 DOI: 10.1111/j.1365-2141.2004.05038.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The incidence of cytogenetic abnormalities in childhood de novo acute myeloid leukaemia (AML) and its prognostic significance was assessed in an Israeli paediatric referral centre. Cytogenetic analysis was successful in 86 of 97 children (< 20 years of age) diagnosed between 1988 and 2002 with de novo AML. Fluorescence in situ hybridization analysis detected new information in 11 of them, leading to reassignment in cytogenetic group classification. The incidence of the various cytogenetic subgroups was as follows: normal - 9%; t(11q23) - 22%; t(8;21) - 13%; t(15;17) - 8%; inv(16) - 3.4%; abn(3q) - 4.6%; 7/7q-(sole or main) - 5.8%; del(9q)(sole) and +21(sole) - 4.6% each; t(8;16) - 2.3%; t(6;9), t(1;22), +8(sole) - 1.1% each; and miscellaneous - 18%. The overall survival (OS) and event-free survival (EFS) (4 years) for 94 patients treated with the modified Berlin-Frankfürt-Münster (BFM) AML protocols (non-irradiated) were 59.9% (SE = 5%) and 55.7% (SE = 5%), respectively, and for the favourable t(8;21), t(15;17) and inv(16), OS was 60% (SE = 15%), 83% (SE = 15%) and 100% respectively. For the normal group it was 62% (SE = 17%), miscellaneous 64% (SE = 12%), t(11q23) 44.6% (SE = 11%) and of the -7/7q-, del(9q)(sole) or t(6;9), none had survived at 4 years. The incidence of cytogenetic subgroups in the Israeli childhood AML population and their outcome were similar to other recently reported paediatric series. Cytogenetic abnormalities still carry clinical relevance for treatment stratification in the context of modern chemotherapy.
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Affiliation(s)
- Batia Stark
- Centre of Pediatric Hematology/Oncology, Schneider Children's Medical Centre of Israel, Petah Tiqva, Israel.
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42
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Frascella E, Rondelli R, Pigazzi M, Zampieron C, Fagioli F, Favre C, Lippi AA, Locatelli F, Luciani M, Menna G, Micalizzi C, Rizzari C, Testi AM, Pession A, Basso G. Clinical features of childhood acute myeloid leukaemia with specific gene rearrangements. Leukemia 2004; 18:1427-9. [PMID: 15201852 DOI: 10.1038/sj.leu.2403410] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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43
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Tsang KS, Li CK, Lau TT, Wong APY, Leung Y, Ng MHL. Translocation (11;13)(q23;q14) as the sole abnormality in a childhood de novo acute myelocytic leukemia. ACTA ACUST UNITED AC 2004; 150:78-80. [PMID: 15041229 DOI: 10.1016/j.cancergencyto.2003.08.016] [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: 07/07/2003] [Revised: 08/14/2003] [Accepted: 08/20/2003] [Indexed: 10/26/2022]
Abstract
We report a case of childhood de novo acute myelocytic leukemia (AML) with hyperleukocytosis with monoblastic features and deranged hemostasic function. G-band karyotyping demonstrated a previously unreported t(11;13)(q23;q14) in metaphase preparations from a fluorodeoxyuridine synchronized 1-day culture of leukophoresed cells. Multicolor fluorescence in situ hybridization revealed no cryptic rearrangements except for the translocation. Reverse transcriptase polymerase chain reaction showed no concomitant positivity of AML1/ETO, BCR/ABL, PML/RARA, and CBFbeta/MYH11 resulting from t(8;21)(q22;q22), t(9;22)(q34;q11), t(15;17)(q22;q11), and inv(16) (p13q22), respectively. This report of childhood de novo AML harboring t(11;13)(q23;q14) as the sole cytogenetic abnormality provides more data on the leukemogenesis of de novo AML with a 11q23 rearrangement.
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Affiliation(s)
- Kam Sze Tsang
- Department of Anatomical and Cellular Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Ngan Shing Street, Hong Kong, China.
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