A de novo AML with a t(1;21)(p36;q22) in an elderly patient

Paola Dal Cin, Andrew J Yee, Bimalangshu Dey  

Department of Pathology, Brigham and Women s Hospital

Previous history

Preleukaemia
-
Inborn condition
-

Clinics case report

Age
81 yrs
Sex
M
Liver
-
Spleen
-
Lymph nodes
+
Cns involv
-

Blood data

Wbc
3.3
Hb
N/A
Platelets
16
Blasts
2 (CD34+ myeloblasts)
Bone marrow
20% myeloid precursors, 16% erythroid precursor, 6% lymphocytes, 55% blasts and 2% plama cells.

Cyto path

Cytology
AML M0
Immunophenotype
CD33+, CD13+, MPO-, CD41-, CD61-, CD203c- (5% of all blast).
Rearranged ig tcr
N/A
Precise diagnosis
Immunophenotype consistent with the presence of myeloid precursors. Negative markers (CD61,CD41,CD203c) associated with megakaryocytic differentiation; AML M0.

Survival data

Date diagnosis
01-2005
Treatment
Hydroxyurea and supportive care.
Complete remission
-
Treatment relat death
-
Relapse
Patient never achieved complete remission.
Status
D
Date last follow
02-2005
Survival
1

Karyotype

Sample
Bone marrow
Culture time
24
Banding
GTG
Results
46,XY,t(1;21)(p36;q22)[15]
Mol cytogenet technics
FISH with LSI (TEL/AML1 ES Dual Color Translocation Probe (Vysis, Inc.) on metaphases (see Fig 2).
Mol cytogenet results
Ish der(1)(dimAML1+), der(21)(dimAML1+).

Images

Atlas Image
Partial FISH analysis showing the AML1 hybridization signals on derivative chromosomes 1 and 21, and on the normal chromosome 21 (b)
Atlas Image

Comments section

Comments
The t(1;21)(p36;q22) so far reported, is generally observed as the sole chromosomal abnormality (5/6), and is mostly a de novo aberration (4/6). The short survival (one month) of our case, confirms the poor prognosis in these patients carrying this chromosome abnormality.

Bibliography

Pubmed IDLast YearTitleAuthors
165983042006Identification of truncated RUNX1 and RUNX1-PRDM16 fusion transcripts in a case of t(1;21)(p36;q22)-positive therapy-related AML.Stevens-Kroef MJ et al
164905912006Contribution of multiparameter genetic analysis to the detection of genetic alterations in hematologic neoplasia. An evaluation of combining G-band analysis, spectral karyotyping, and multiplex reverse-transcription polymerase chain reaction (multiplex RT-PCR).Preiss BS et al

Citation

Paola Dal Cin, Andrew J Yee, Bimalangshu Dey

A de novo AML with a t(1;21)(p36;q22) in an elderly patient

Atlas Genet Cytogenet Oncol Haematol. 2007-03-01

Online version: http://atlasgeneticsoncology.org/case-report/208819/a-de-novo-aml-with-a-t(1;21)(p36;q22)-in-an-elderly-patient