A t(4;12)(q11;p13) in a patient with coincident CLL at the same time of AML diagnosis
2007-05-01 Paola Dal Cin, Daniel J DeAngelo, Richard M Stone Affiliation(PDC) Department of Pathology, Brigham and Womens Hospital ; (DJD, RMS) Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA
Previous history
Preleukaemia
-
Malignant disease
-, but coincident CLL at the same time of AML diagnosis. No prior therapy for CLL
Inborn condition
-
Clinics case report
Age
56 yrs
Sex
M
Liver
-
Spleen
-
Lymph nodes
-
Cns involv
no symptoms (no LP done)
Blood data
Wbc
52.2
Hb
10.2
Platelets
158.0
Blasts
86 (peripheral blood)
Bone marrow
Bone Marrow Differential : Cellularity : o.k.- Megakaryocytes : present - Blasts : 66% "blast like" immature forms - Promyelocytes : 1% - Myeloid Activity : 13% - Erythroid Activity : 6% - Lymphocytes : 13% - Other : -
Cyto path
Cytology
M0
Immunophenotype
A population of immature cells positive for CD45(dim), HLA-DR, CD7, CD34 (majority) and myeloid markers CD33 and CD13, with absence of staining for B cell, monocytic, and other T cell markers, consistent with myeloblast. A minor clonal kappa positive (moderate intensity) population of CD5 positive B cells which were negative for CD23 was also detected, suggesting a co-existing CD5 positive B cell lymphoproliferative disorder. A minor population of CD19 positive B cells co-expresses CD5 and exhibits monotypic surface immunoglobulin kappa light chain staining, consistent with involvement by the patient s known B cell lymphoproliferative disorder.
Rearranged ig tcr
n/a
Pathology
Cellular aspirate with prominent population of "blast-like" large cells with dispersed chromatin, distinct nucleoli and modest amounts of blue, agranular cytoplasm.
Electron microscopy
n/a
Precise diagnosis
Acute Myelogenous Leukemia and Chronic Lymphocytic Leukemia
Survival data
Date diagnosis
01-2002
Treatment
Induction: ADE consisting of daunorubicin, cytarabine and etoposide plus PSC-833 (he was randomized to the treatment arm) on CALGB 19808. Consolidation with high-dose cytarabine and etoposide with stem cell harvest as per CALGB 19808.Auto stem cell transplant: on April 24, 2002. Conditioning regimen consisted of busulfan and etoposide as per CALGB 19808.
Complete remission
+ on BM on Feb 8, 2002
Treatment relat death
-
Relapse
+ June 17, 2003
Phenotype relapse
AML M0
Status
D
Date last follow
06-2003
Survival
21
Karyotype
Sample
Bone Marrow
Culture time
24
Banding
GTG
Results
46,XY,t(4;12)(q11-12;p13)[18]/46,XY[2]
Karyotype relapse
46,XY,t(4;12)(q11-q2;p13),+16,-17[1]/46,XY[19]
Other molec studies
Technics
FISH with LSI (TEL/AML1 ES Dual Color Translocation Probe (Vysis, Inc.)) on metaphases
Results
ish der(4)(dimTEL+), der(12)(dimTEL+)
Images
Partial GTG-banding karyotype showing t(4;12)(q11;p13) (a ). Partial FISH analysis showing the ETV6 hybridization signals on derivative chromosomes 4 and 12, and on the normal chromosome 12 (b)é
Comments section
Comments
The findings are consistent with AML. Although histologic features of chronic lymphocytic leukemia (CLL) are not seen, flow cytometric analysis shows a small subset of monoclonal B cells, consistent with persistent involvement by the patient s known CLL.
Bibliography
No bibliography items were found for this article.
Citation
Paola Dal Cin, Daniel J DeAngelo, Richard M Stone
A t(4;12)(q11;p13) in a patient with coincident CLL at the same time of AML diagnosis
Atlas Genet Cytogenet Oncol Haematol. 2007-05-01
Online version: http://atlasgeneticsoncology.org/case-report/208821/a-t(4
