CASE REPORTS in HAEMATOLOGY (Paper co-edited with the European LeukemiaNet)

t(16;21)(q24;q22) in therapy-related acute myelogenous leukemia arising from myelodysplastic syndrome

Paola Dal Cin, Karim Ouahchi

Clinics

Age and sex :	32 year(s) old male patient.
Previous History :	preleukemia (RAEB diagnosed in 09-2006)
	Hodgkin's lymphoma diagnosed in 2003
Organomegaly :	no hepatomegaly ; no splenomegaly ; enlarged lymph nodes (History of Hodgkin's lymphoma involving right side neck lymph node) ; no central nervous system involvement

Blood

WBC : 0.29 x 109/l; Hb : 10.7 g/dl; platelets : 19 x 109/l;

Cyto pathology classification

Cytology : M2 arising from previous myelodysplastic syndrome (RAEB-1)

Immunophenotype : Population of immature cells is positive for CD34 +, CD45 (dim), HLA-DR +, CD117 +, CD13 +, and CD33+ and negative for CD15-, monocytic, B and T lymphoid markers.

Pathology : Involvement by acute myelogenous leukemia (FAB-M2) with background dysmyelopoiesis.

Survival

Date of diagnosis: Hodgkin's lymphoma: (2003); myelodysplastic syndrome: (09-2006) karyotype was not performed; therapy-related AML: (01-11-2007) karyotype showing t(16;21)

Treatment : Chemotherapy and radiotherapy; chlorambucil, Vinblastine Procarbazine, Prednisone (MOPP) until June 2004; radiotherapy in 2004; ifosfamide, carboplatin and etoposide (ICE) in August 2005; autologous bone marrow transplant in August 2006, and conditioning regimen consisted of Cytoxan, BCNU and etoposide. Induction therapy in January 2007 (16-01-07) and preparation for second transplant.

Complete remission was obtained

Comments : bone marrow biopsy performed on 03-01-2007 showing no evidence of leukemia and 2% of blast. Karyotype performed on bone marrow aspirate was interpreted as 46, XY in 20 metaphases.

Relapse : -

Status : Alive 03-2007

Karyotype

Sample : Bone marrow aspirate ; culture time : 24 h ; banding : GTG

Results : 49,XY,+Y,+3,+8,t(16;21)(q24;q22)[18]/46,XY[2]

Other molecular cytogenetics technics : FISH evaluation for AML1 rearrangement was performed on abnormal metaphases with the LSI TEL/AML1 ES Dual Color Translocation Probe (Abbott Molecular/Vysis, Inc.).

Other molecular cytogenetics results : Ish der(16)(dimAML1+), der(21)(dimAML1+)[5/5] (see Fig. 2).

Partial GTG-banding karyotype showing t(16;21)(q24;q22)(a) and numerical anomalies. Partial FISH analysis showing the AML1 hybridization signals on the derivative chromosomes 16 and 21 and on the normal chromosome 21(b).

Comments

The t(16;21) was reported mostly in t-MDS/t-AML, and classified as M2 in a majority of cases. Two cases including this current report were observed after treatment for Hodgkin lymphoma. Trisomy 8 is a frequent secondary abnormality associated with t(16;21), however in this current case we also report the presence of an additional chromosome Y and trisomy 3.

Internal links

Atlas Card	t(16;21)(q24;q22)
Case Report	A new case of t(16;21)(q24;q22) in a secondary AML-M2 following breast cancer therapy
Case Report	A case of trisomy 8 and loss of the Y-chromosome as secondary aberrations in a ten year old boy with de novo AML FAB M2 and t(16;21)(q24;q22)

Bibliography

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A pediatric case of secondary leukemia associated with t(16;21)(q24;q22) exhibiting the chimeric AML1-MTG16 gene.

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Circle of life.

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PMID 14753098

Abnormalities of the long arm of chromosome 21 in 107 patients with hematopoietic disorders: a collaborative retrospective study of the Groupe Franˆßais de Cytogˆ©nˆ©tique Hˆ©matologique.

Jeandidier E, Dastugue N, Mugneret F, Lafage-Pochitaloff M, Mozziconacci MJ, Herens C, Michaux L, Verellen-Dumoulin C, Talmant P, Cornillet-Lefebvre P, Luquet I, Charrin C, Barin C, Collonge-Rame MA, Pˆ©rot C, Van den Akker J, Grˆ©goire MJ, Jonveaux P, Baranger L, Eclache-Saudreau V, Pagˆ®s MP, Cabrol C, Terrˆ© C, Groupe Franˆßais de Cytogˆ©nˆ©tique Hˆ©matologique (GFCH), Berger R

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PMID 16616106

Contributor(s)

Written

02-2007

Paola Dal Cin, Karim Ouahchi

Citation

This paper should be referenced as such :

Dal Cin P, Ouahchi K . t(16;21)(q24;q22) in therapy-related acute myelogenous leukemia arising from myelodysplastic syndrome. Atlas Genet Cytogenet Oncol Haematol. February 2007 . URL : http://AtlasGeneticsOncology.org/Reports/1621DalCinID100022.html

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indexed on : Mon Aug 11 21:22:57 2008

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