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(Paper co-edited with the European LeukemiaNet)
A new case of t(16;21)(q24;q22) in a secondary AML-M2 following breast cancer therapy
Written2005-08Hélène Bruyère, Wilson Yeung, Peter Tsang
Department of Pathology and Laboratory Medicine, Vancouver General Hospital, UBC, Canada, and Division of Hematology, Vancouver General Hospital, UBC, Canada
Age and sex : 61 year(s) old female patient.
Previous History : no preleukemia
no inborn condition of note
Organomegaly : no hepatomegaly ; no splenomegaly ; no enlarged lymph nodes ; no central nervous system involvement
WBC : 2.4 x 109/L ; Hb : 10.7 g/dL ; platelets : 48 x 109/L; blasts : 2 % .
Bone marrow : Neutrophils 0.05 ; Band cells 0.05 ; Metamyelocytes 0.13 ; Myelocytes 0.02 ; Promyelocytes 0.02 ; Blasts 0.51 ; Late normoblasts 0.13 ; Plasma cells 0.01 ; Lymphocytes 0.05 ; Monocytes 0.01 ; Eosinophils 0.02
Cyto pathology classification
Cytology : AML-M2
Immunophenotype : Positive for HLA-DR, CD34, CD117, CD13, CD33, MPO, CD56 and CD19 ; Partial Tdt ; Negative for CD7
Precise diagnosis : Hypoplastic AML, therapy related
Date of diagnosis: 04-2005
Treatment : Three cycles of AraC and Danuribicin ; Related bone marrow transplantation planned for September 2005
Complete remission : None
Status : Alive 07-2005
Survival : 3 month(s)
Sample : Bone marrow ; culture time : 24 h ; banding : GTG
Results : 47,XX,+8,t(16;21)(q24;q22)[13]/46,XX[3]
Partial karyotype showing the t(16;21) and a +8
The t(16;21)(q24;q22) is mainly found in t-MDS/t-AML (14/16 cases (1-10)), following breast cancer therapy (five cases (7,8,10)), lymphoma (four cases), Hodgkin's disease, lung and oviductal cancers and AML-M3 (one case each). Trisomy 8, the secondary change found in the current case, is also reported in most if not all patients with previous breast cancer (7,8,10).
To note, three out of five patients had lymphoid positive antigenes (5,7, current case).
All of the nine patients whose treatments were reported (3-9), plus the current case, were treated with a combination of alkylating agents and topoisomerase II inhibitors, +/- radiotherapy.
Internal links
Atlas Cardt(16;21)(q24;q22)
Case ReportA 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)
Cytogenetics of childhood acute nonlymphocytic leukemia.
Raimondi SC, Kalwinsky DK, Hayashi Y, Behm FG, Mirro JJr, Williams DL.
Cancer Genet Cytogenet 1989; 40: 13-27.
PMID 2758395
Metaphase fluorescence in situ hybridization (FISH) in the follow-up of 60 patients with hematopoietic malignancies.
Nylund SJ, Ruutu T, Saarinen S, Knuutila S.
Br j Hematol 1994; 88: 778-783.
PMID 7819102
Clonal Kryotypic hematopoietic cell abnormalities occuring after autologous bone marrow transplantation for Hodgkin's disease and non-hodgkin's disease.
Traweek ST, Slovak ML, Nademanee AP, Brynes RK, Niland JC, Forman SJ.
Blood 1994; 84(3): 957-963.
PMID 8043877
Secondary acute myeloblastic leukemia with t(16;21) involving the AML1 gene.
Berger R, Le Coniat M, Romana SP, Jonveaux P.
Hematol Cell Ther 1996; 38: 183-186.
PMID 8932000
A recurrent translocation, t(16;21)(q24;q22), associated with acute myelogenous leukemia: identification by fluorescence in situ hybridization.
Shimada M, Ohtsuka E, Shimizu T, Matsumoto T, Matsushita K, Tanimoto F, Kajii T.
Cancer Genet Cytogenet 1997; 96: 102-105.
PMID 9216714
A case of therapy-related acute myeloblastic leukemia with t(16;21)(q24;q22) after chemotherapy with DNA_topoisomerase II inhibitors, etoposide and mitoxantrone, and the alkylating agent, cyclophosphamide.
Takeda K, Shinohara K, Kameda N, Ariyoshi K.
Int j Hematol 1998; 67: 179-186.
PMID 9631585
AML1-MTG16 fusion gene in therapy-related acute leukemia with t(16;21)(q24;q22): two new cases.
Salomon-Nguyen F, Busson-Le Coniat M, Lafage Pochitaloff M, Mozziconacci J, Berger R, Bernard OA.
Leuk 2000; 14: 1704-1710.
PMID 10995019
AML1/MTG16 fusion gene from a t(16;21)(q24;q22) translocation in treatment-induced leukemia after breast cancer.
La Starza R, Sambani C, Crescenzi B, Matteucci C, Martelli MF, Mecucci C.
Haematologica 2001; 86(2): 212-213.
PMID 11224496
A pediatric case of secondary leukamia associated with t(16;21)(q24;q22) exhibiting the chimeric AML1-MTG16 gene.
Kondoh K, Nakata Y, Furuta T, Hosoda F, Gamou T, Kurosawa Y, Kinoshita A, Ohki M, Tomita Y, Mori T.
Leuk Lymph 2002; 43(2): 415-420.
PMID 11999578
21q22 balanced chromosome aberrations in therapy-related hematopoietic disorders: report from an international workshop.
Slovak ML, Bedell V, Popplewell L, Arber DA, Schoch C, Slater R.
Genes Chrom cancer 2002; 33: 379-394
PMID 11921272


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