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CASE REPORTS in HAEMATOLOGY
Translocation t(2;19)(p11;p12-p13) in childhood with acute myeloid leukemia
 
Written2002-12Benoit Quilichini, Helene Zattara, Elodie Cas, Laure-Anne Bastide-Alliez, Annie Blachere, Catherine Curtillet, Chantal Fossat, Gérard Michel
Cytogenetic Oncology Laboratory Timone 264, rue Saint-Pierre 13385 Marseille cedex 5, France; Tel : +33-491387402 - Fax : +33-491384663 e-mail : Helene.Cannoni@mail.ap-hm.fr, Benoit.Quilichini@mail.ap-hm.fr
Clinics
Age and sex : 11 year(s) old female patient.
Organomegaly : no hepatomegaly ; no splenomegaly ; no enlarged lymph nodes ; no central nervous system involvement
Blood
WBC : 194 x 109/L ; Hb : 8.6 g/dL ; platelets : 17 x 109/L; blasts : 66 % .
Bone marrow : Granulopoiesis with myelodysplastic features.
Cyto pathology classification
Cytology : Blood: neutrophils: 17 %; eosinophils: 1%; basophils: 0%; lymphocytes: 9%; monocytes: 1% ; neutrophils myelocytes- metamyelocytes: 6%; blasts with Auer rods and myelodysplastic features.
Immunophenotype : Blasts were myeloperoxydase positive, butyrate acetate negative expressing CD 34, CD 33, CD 13, CD 64, CD 7 and HLA DR.
Precise diagnosis : Diagnosis of acute myeloid leukemia with multilineage dysplasia (WHO classification) subtype LAM- M2 (FAB classification).
Survival
Date of diagnosis: 10-2002
Treatment : Induction treatment : Aracytine : 200 mg/m2/j x 7 days, Novantrone : 12 mg/m2/j x 5 days.
Complete remission : None
Relapse : -
Status : Alive
Survival : 7 month(s)
Karyotype
Sample : Blood and bone marrow. ; culture time : Overnight unstimulated culture and 72h stimulated culture with mitogen. ; banding : R-banding
Results : 46, XX, t(2;19)(p11;p12-13) [30] / 46, XX [10]
Other molecular cytogenetics technics : Fluorescence in situ hybridization (FISH) was performed using a chromosome 2-specific labelled FITC and a chromosome 19-specific labelled Spectrum Orange painting probes (Adgenix, USA) according to the manufacturer's instructions.
Other molecular cytogenetics results : FISH confirmed the transocation t(2,19)
Other molecular studies
results : ETO / AML1: negative
No rearrangment of MLL gene.
Other findings
results : Meningeal punction without blast cells.
Blasts cells (MGG-stained) with Auer rod and degranulated neutrophil (myelodysplastic features) (x100).
Bone marrow (MGG-stained) (x50).
Karyotype (R-bands) : 46, XX, t(2;19)(p11;p12-13)
Fluorescence in situ hybridization using painting probes of chromosome 2 labelled FITC (WCP 2) and chromosome 19 labelled Spectrum Orange (WCP 19) (ADgenix, USA).
Comments
We report a translocation t(2;19)(p11;p12-13) occuring in a childhood acute myeloid leukemia, subtype M2. Cytological particularity of this case was the presence of myelodysplastic signs. Rearrangement of 19p13 is a common feature in preB-ALL showing t(1;19)(q23;p13) but not in AML. The t(1;19) involves in 19p13 E2A gene which normally encodes an immunoglobulin enhancer binding proteins. One case was reported showing t(2 ;19) in acute leukemia. The case was an AML secondary to chemotherapy for ovarian cancer. Karyotype showed complex abnormalities including a t(2 ;19)(p11 ;p13) [2]. Variability of the breakpoints at 2p and 19q in our patient, compared with the case described in literature, could be due to the fact that the authors used G banding techniques.
Internal links
Atlas Cardt(2;19)(p11;p12-p13)
Bibliography
Proposed revised criteria for the classification of acute myeloid leukemia. A report of the French-American-British Cooperative Group.
Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DA, Gralnick HR, Sultan C
Annals of internal medicine. 1985 ; 103 (4) : 620-625.
PMID 3862359
 
Short remission durations in therapy-related leukemia despite cytogenetic complete responses to high-dose cytarabine.
Larson RA, Wernli M, Le Beau MM, Daly KM, Pape LH, Rowley JD, Vardiman JW
Blood. 1988 ; 72 (4) : 1333-1339.
PMID 3167210
 
World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997.
Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J, Lister TA, Bloomfield CD
Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 1999 ; 17 (12) : 3835-3849.
PMID 10577857
 
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