1
|
Wafa A, Jarjour RA, Alolabi D, Liehr T, Hamdan O, Melo JB, Carreira IM, Othman MAK, Al-Achkar W. A new childhood ALL case with an extremely complex karyotype and acute spontaneous tumor lysis syndrome. Mol Cytogenet 2020; 13:44. [PMID: 32944079 PMCID: PMC7488544 DOI: 10.1186/s13039-020-00512-3] [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: 07/02/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND B cell precursor acute lymphoblastic leukemia (B-ALL) is the most common malignancy of childhood, with, after corresponding treatment, an overall complete remission rate of 90%. Approximately 75% of B-ALL cases harbor recurrent abnormalities, including so-called complex karyotypes (CK). Tumor lysis syndrome (TLS) is a metabolic abnormality which may arise during cancer therapy and also, extremely rarely, as spontaneous TLS before initiation of chemotherapy in patients with ALL. CASE PRESENTATION Here we report a 9-year-old male, diagnosed with a de novo pre-B-ALL according to the WHO classification. Cytogenetic, molecular cytogenetic approaches and array comparative genomic hybridization analyses revealed a unique CK involving five chromosomes. It included four yet unreported chromosomal aberrations: a der(11)t(7;11)(p22.1;q24.2), a der(18)t(7;18)(q21.3;p11.22), del(11)(q24.2q25) and dup(18)(q11.1q23). Unfortunately, the patient died 3 months after the initial diagnosis. CONCLUSIONS To the best of our knowledge, a comparable childhood ALL case was not previously reported. Thus, the combination of the here seen chromosomal aberrations in childhood primary ALL seems to indicate for an extremely adverse prognosis.
Collapse
Affiliation(s)
- Abdulsamad Wafa
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Rami A. Jarjour
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Doaa Alolabi
- Department of Hematology, Damascus Children University Hospital, Ministry of High Education, Damascus, Syria
| | - Thomas Liehr
- Jena University Hospital, Institute of Human Genetics, Jena, Germany
| | - Othman Hamdan
- Department of Hematology, Damascus Children University Hospital, Ministry of High Education, Damascus, Syria
| | - Joana B. Melo
- Cytogenetics and Genomics Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CIMAGO-Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel M. Carreira
- Cytogenetics and Genomics Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CIMAGO-Center of Investigation on Environment Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Walid Al-Achkar
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| |
Collapse
|
2
|
Wafa A, Jarjour RA, Aljapawe A, ALmedania S, Liehr T, Melo JB, Carreira IM, Othman MAK, Al-Achkar W. An acquired stable variant of a dicentric dic(9;20) and complex karyotype in a Syrian childhood B-acute lymphoblastic leukemia case. Mol Cytogenet 2020; 13:29. [PMID: 32670411 PMCID: PMC7350665 DOI: 10.1186/s13039-020-00499-x] [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: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND About 25 years ago, the acquired chromosome abnormality dicentric dic(9;20)(p11 ~ 13;q11) was seen described as a non-random aberration in B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Yet, about 200 cases were reported. However, dicentric dic(9;20) is a subtle abnormality which easily may be mixed up with monosomy 20 and/or del(9p). The dicentric dic(9;20) can be found as a sole chromosomal abnormality or can be masked within complex rearrangements; also, a dicentric dic(9;20) is often associated with mono- or biallelic loss of CDKN2A gene. CASE PRESENTATION Here we report a case of 16-year-old male diagnosed with a de novo pre-B-ALL. Molecular approaches (array-based multicolor banding (aMCB) and array comparative genomic hybridization (aCGH)) were applied, and a unique complex karyotype involving six chromosomes was identified. It included three previously unreported chromosomal aberrations: dicentric dic(9;20;X), deletion del(7)(p22.2p15.2) and dicentric dic(7;13). The dicentric dic(9;20;X) also led to monoallelic loss of tumor suppressor gene CDKN2A. After successful chemotherapeutic treatment the patient experienced a relapse with a secondary ALL without complex karyotype but a deletion del(19)(p13). Unfortunately, the patient died after 17 months of the initial diagnosis. CONCLUSIONS To the best of our knowledge, a comparable childhood ALL associated with such complex karyotype and deletion del(19)(p13) in secondary ALL was not previously reported. Thus, the complex karyotype with dicentrc dic(9;20;X) seems to indicate for a poor prognosis.
Collapse
Affiliation(s)
- Abdulsamad Wafa
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Rami A. Jarjour
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Abdulmunim Aljapawe
- Department of Molecular Biology and Biotechnology, Mammalians Biology Division, Atomic Energy Commission, Damascus, Syria
| | - Suher ALmedania
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Thomas Liehr
- Jena University Hospital, Institute of Human Genetics, Jena, Germany
| | - Joana B. Melo
- Cytogenetics and Genomics Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CIMAGO-Center of Investigation On Environment Genetics and Oncobiology-Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Isabel M. Carreira
- Cytogenetics and Genomics Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- CIMAGO-Center of Investigation On Environment Genetics and Oncobiology-Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | | | - Walid Al-Achkar
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| |
Collapse
|
3
|
Zhong J, Yu X, Zhang X. Comparison of Overall Survival Between De Novo and Secondary Acute Lymphoblastic Leukemia Patients of Different Ages. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 20:e622-e627. [PMID: 32565127 DOI: 10.1016/j.clml.2020.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare the overall survival (OS) between de novo and secondary acute lymphoblastic leukemia (ALL) patients in different age groups after chemotherapy. PATIENTS AND METHODS Data from 8305 ALL patients undergoing chemotherapy from the Surveillance, Epidemiology, and End Results (SEER) database during 1975 to 2015 were included in this study, of which 7454 (80.11%) were in the de novo ALL group, and 851 (19.89%) were in the secondary ALL (sALL) group. Propensity matching was used before comparison of OS between the two groups. RESULTS Female ALL patients had a lower risk of death than male (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.88-0.98; P < .01). The mortality of black patients was higher than in white patients (HR, 1.29; 95% CI, 1.18-1.42; P < .001). Patients aged 45-75 years (HR, 1.82; 95% CI, 1.72-1.94; P < .001) and ≥ 75 years (HR, 3.85; 95% CI, 3.52-4.23; P < .001) had a higher risk of death. Separated/divorced (HR, 1.21; 95% CI, 1.10-1.34; P < .001) and widowed (HR, 1.35; 95% CI, 1.21-1.51; P < .001) patients had a higher risk of death than single patients. sALL patients had a higher risk of death than de novo ALL patients (HR, 1.21; 95% CI, 1.12-1.30; P < .001). The mean age of the de novo ALL group was lower than in the sALL group (51.05 vs. 60.25; P < .001) after the propensity score was matched, and the 1-, 2-, 3-, 4-, and 5-year OS of the de novo ALL group were higher than that of the sALL group aged 18-75 years (P < .001). CONCLUSION The survival rate of ALL decreased with increased age. Patients with sALL had poorer OS than de novo patients aged 18-75 years.
Collapse
Affiliation(s)
- Jiansheng Zhong
- Department of Hematology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, PR China.
| | - Xiaoyang Yu
- Department of Clinical Laboratory, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, PR China
| | - Xing Zhang
- Department of Hematology, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, PR China
| |
Collapse
|
4
|
Kolesnikova M, Sen'kova A, Tairova S, Ovchinnikov V, Pospelova T, Zenkova M. Clinical and Prognostic Significance of Cell Sensitivity to Chemotherapy Detected in vitro on Treatment Response and Survival of Leukemia Patients. J Pers Med 2019; 9:jpm9020024. [PMID: 31067780 PMCID: PMC6617197 DOI: 10.3390/jpm9020024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/23/2019] [Accepted: 05/06/2019] [Indexed: 02/07/2023] Open
Abstract
Multidrug resistance (MDR) is a major challenge in leukemia treatment. The objective of this study was to identity predictors of MDR to allow for rapid and economical assessment of the efficacy of planned antitumor therapy for leukemia patients. The study included 113 patients with acute and chronic leukemias. Prior to antitumor therapy, we measured the sensitivity of tumor cells of patients to the panel of chemotherapeutic drugs, together with MDR1 mRNA and P-glycoprotein (P-gp) expression as one of the mechanisms of MDR, and compared these data with the response to therapy. The scales for leukemia patients according to therapy response, drug sensitivity of tumor cells, MDR1 mRNA and P-gp levels, and the presence of unfavorable immunological and cytogenetic markers were introduced for subsequent correlation analysis. We show that the drug resistance of tumor cells of leukemia patients estimated in vitro at diagnosis correlates with a poor response to chemotherapy and is usually combined with aberrant and immature immunological markers, cytogenetic abnormalities, and a high expression of MDR1 mRNA and P-gp. All together, these factors indicate unfavorable prognosis and low survival of leukemia patients. Thus, the sensitivity of tumor cells to chemotherapeutic drugs measured in vitro at diagnosis may have prognostic value for individual types of leukemia.
Collapse
Affiliation(s)
- Maria Kolesnikova
- Department of therapy, hematology and transfusiology, Novosibirsk State Medical University, Krasny Prospect 52, 630091 Novosibirsk, Russia.
| | - Aleksandra Sen'kova
- Laboratory of nucleic acids biochemistry, Institute of Chemical Biology and Fundamental Medicine SB RAS, Lavrentieva ave. 8, 630090 Novosibirsk, Russia.
| | - Sofia Tairova
- Clinical and diagnostic laboratory, City Hematology Center, Polzunova Street 21, 630051 Novosibirsk, Russia.
| | - Viktor Ovchinnikov
- Clinical and diagnostic laboratory, City Hematology Center, Polzunova Street 21, 630051 Novosibirsk, Russia.
| | - Tatiana Pospelova
- Department of therapy, hematology and transfusiology, Novosibirsk State Medical University, Krasny Prospect 52, 630091 Novosibirsk, Russia.
| | - Marina Zenkova
- Laboratory of nucleic acids biochemistry, Institute of Chemical Biology and Fundamental Medicine SB RAS, Lavrentieva ave. 8, 630090 Novosibirsk, Russia.
| |
Collapse
|
5
|
Wafa A, ALmedania S, Aljapawe A, Liehr T, Soulaiman SE, Mouna R, Othman MAK, ALachkar W. A new adult AML case with an extremely complex karyotype, remission and relapse combined with high hyperdiploidy of a normal chromosome set in secondary AML. BMC HEMATOLOGY 2018; 18:21. [PMID: 30186609 PMCID: PMC6119272 DOI: 10.1186/s12878-018-0114-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/09/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chromosomal abnormalities are diagnostic and prognostic key factors in acute myeloid leukemia (AML) patients, as they play a central role for risk stratification algorithms. High hyperdiploidy (HH), a rare cytogenetic abnormality seen commonly in elder male AML patients, is normally categorized under AML with complex karyotype (CK). Accordingly, patients with HH generally are associated with low remission rates and a short overall survival. CASE PRESENTATION Here we report a case of 21-year-old female, diagnosed with a de novo AML-M1 according to WHO classification and a CK at diagnosis. Cytogenetic, molecular cytogenetic approaches (standard fluorescence in situ hybridization (FISH), array-proven multicolor banding (aMCB)) and high resolution array comparative genomic hybridization (aCGH) analyses revealed a unique complex but still near diploid karyotype involving eleven chromosomes was identified. It included pentasomy 4, three yet unreported chromosomal aberrations t(1;2)(p35;p22), t(1;3)(p36.2;p26.2), and t(10;12)(p15.2;q24.11), and a combination of two cytogenetic events, yet unreported to appear in together, i.e. a reciprocal translocation t(1;3)(p36.2;p26.2) leading to EVI1/PRDM16 gene fusion, and monoallelic loss of tumor suppressor gene TP53. After successful chemotherapeutic treatment the patient experienced a relapse to AML-M1, and she developed secondary AML-M6 with tetraploidy and HH. Unfortunately, the young woman died 8.5 months after initial diagnosis. CONCLUSIONS To the best of our knowledge, a comparable adult AML associated with such a CK, coexistence of 3q rearrangements with loss of TP53 at diagnosis, and HH in secondary AML were not previously reported. Thus, the combination of the here seen chromosomal aberrations in adult primary AML seems to indicate for an adverse prognosis.
Collapse
Affiliation(s)
- Abdulsamad Wafa
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Suher ALmedania
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| | - Abdulmunim Aljapawe
- Department of Molecular Biology and Biotechnology, Mammalians Biology Division, Atomic Energy Commission, Damascus, Syria
| | - Thomas Liehr
- Institute of Human Genetics, Jena University Hospital, Jena, Germany
| | | | - Raja Mouna
- Department of Haematology-transplantation, Tishreen Hospital, Damascus, Syria
| | | | - Walid ALachkar
- Department of Molecular Biology and Biotechnology, Human Genetics Division, Atomic Energy Commission, Damascus, Syria
| |
Collapse
|
6
|
Wheeler FC, Kim AS, Mosse CA, Shaver AC, Yenamandra A, Seegmiller AC. Limited Utility of Fluorescence In Situ Hybridization for Recurrent Abnormalities in Acute Myeloid Leukemia at Diagnosis and Follow-up. Am J Clin Pathol 2018. [PMID: 29538617 DOI: 10.1093/ajcp/aqy002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Acute myeloid leukemia (AML) is classified in part by recurrent cytogenetic abnormalities, often detected by both fluorescent in situ hybridization (FISH) and karyotype. The goal of this study was to assess the utility of FISH and karyotyping at diagnosis and follow-up. METHODS Adult AML samples at diagnosis or follow-up with karyotype and FISH were identified. Concordance was determined, and clinical characteristics and outcomes for discordant results were evaluated. RESULTS Karyotype and FISH results were concordant in 193 (95.0%) of 203 diagnostic samples. In 10 cases, FISH detected an abnormality, but karyotype was normal. Of these, one had a FISH result with clinical significance. In follow-up cases, 17 (8.1%) of 211 showed FISH-positive discordant results; most were consistent with low-level residual disease. CONCLUSIONS Clinically significant discordance between karyotype and AML FISH is uncommon. Consequently, FISH testing can safely be omitted from most of these samples. Focused FISH testing is more useful at follow-up, for minimal residual disease detection.
Collapse
Affiliation(s)
- Ferrin C Wheeler
- Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Annette S Kim
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | - Claudio A Mosse
- Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Aaron C Shaver
- Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Ashwini Yenamandra
- Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Adam C Seegmiller
- Department of Pathology and Laboratory Medicine, Vanderbilt University Medical Center, Nashville, TN
| |
Collapse
|