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CASE REPORTS in HAEMATOLOGY
(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 Bruy&eagrave;re, Wilson Yeung, Peter Tsang
Department of Pathology and Laboratory Medicine, Vancouver General Hospital, UBC, Canada, Helene.Bruyere@vch.ca and Division of Hematology, Vancouver General Hospital, UBC, Canada
Clinics
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
Blood
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
Survival
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)
Karyotype
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
Comments
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)
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