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

Paola Dal Cin, Andrew J Yee, Bimalangshu Dey Affiliation

Department of Pathology, Brigham and Women s Hospital

Previous history

Preleukaemia

Inborn condition

Clinics case report

Age

81 yrs

Sex

Liver

Spleen

Lymph nodes

Cns involv

Blood data

Wbc

3.3

N/A

Platelets

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

Date last follow

02-2005

Survival

Karyotype

Sample

Bone marrow

Culture time

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

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

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.

Article Bibliography

Pubmed ID	Last Year	Title	Authors
16598304	2006	Identification 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
16490591	2006	Contribution 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/haematological-explorer/tumors-explorer/teaching-explorer/