+ RAEB diagnosed in 09-2006

+ Hodgkin s lymphoma diagnosed in 2003

32 yrs

M

-

-

+ History of Hodgkin s lymphoma involving right side neck lymph node

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0.29

10.7

19

0

Megakaryocytes: none noted; Blasts: 65%; Promyelocytes: 1%; Myeloid Activity: 20%, occasional dysplastic forms; Erythroid Activity: 12%, occasional dysplastic forms; Lymphocytes: 2%

M2 arising from previous myelodysplastic syndrome (RAEB-1)

Population of immature cells is positive for CD34 +, CD45 (dim), HLA-DR +, CD117 +, CD13 +, and CD33+ and negative for CD15-, monocytic, B and T lymphoid markers.

Involvement by acute myelogenous leukemia (FAB-M2) with background dysmyelopoiesis.

Hodgkin s lymphoma: (2003); myelodysplastic syndrome: (09-2006) karyotype was not performed; therapy-related AML: (01-11-2007) karyotype showing t(16;21)

Chemotherapy and radiotherapy; chlorambucil, Vinblastine Procarbazine, Prednisone (MOPP) until June 2004; radiotherapy in 2004; ifosfamide, carboplatin and etoposide (ICE) in August 2005; autologous bone marrow transplant in August 2006, and conditioning regimen consisted of Cytoxan, BCNU and etoposide. Induction therapy in January 2007 (16-01-07) and preparation for second transplant.

+ bone marrow biopsy performed on 03-01-2007 showing no evidence of leukemia and 2% of blast. Karyotype performed on bone marrow aspirate was interpreted as 46, XY in 20 metaphases.

-

A

03-2007

Bone marrow aspirate

24

GTG

49,XY,+Y,+3,+8,t(16;21)(q24;q22)[18]/46,XY[2]

FISH evaluation for AML1 rearrangement was performed on abnormal metaphases with the LSI TEL/AML1 ES Dual Color Translocation Probe (Abbott Molecular/Vysis, Inc.).

Ish der(16)(dimAML1+), der(21)(dimAML1+)[5/5] (see Fig. 2).

Trisomy 8 is a frequent secondary abnormality associated with t(16;21), however in this current case we also report the presence of an additional chromosome Y and trisomy 3.