International Journal of Hematology

, Volume 75, Issue 1, pp 63–66 | Cite as

Philadelphia Chromosome-Positive Acute Myeloid Leukemia With Tetraploidy

  • Hiroki Yamaguchi
  • Koiti Inokuchi
  • Ena Yokomizo
  • Junko Miyata
  • Ayako Watanabe
  • Mituharu Inami
  • Kenji Tajika
  • Kazuo Dan
Case Report

Abstract

The patient was a 62-year-old man. His hematological data in April 2000 had shown no abnormalities, but he was referred to our hospital because of a fever and leukocytosis in June 2000. The peripheral blood showed 29.8 X 109/L white blood cells, with 68.0% blasts. A bone marrow aspirate showed hypercellularity with a proliferation of large leukemic blasts. The leukemic cells were positive for CD13 (91%), CD33 (54.8%), CD34 (94.5%), and HLA-DR (97.9%). Some leukemic cells (15.6%) also expressed CD14. Cytogenetic analysis revealed 92,XXYY,t(9;22)(q34;q11)x2 in all 20 metaphase cells. Reverse transcriptase polymerase chain reaction analysis detected the minorBCR/ABL messenger RNA (mRNA) but failed to detect the majorBCR/ ABL mRNA. The patient achieved complete remission after induction chemotherapy, with no evidence of Philadelphia chromosome (Ph) or minorBCR/ABL mRNA. Ph-positive acute myeloid leukemia (Ph-AML) has rarely been reported. Herein, we report a case of Ph-AML with tetraploidy and review the previously reported Ph-AML cases.

Key words

Philadelphia chromosome Tetraploidy Acute myeloid leukemia 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Sattler M, Griffin JD. Mechanisms of transformation by the BCR/ ABL oncogene.Int J Hematol. 2001;73:278–291.CrossRefGoogle Scholar
  2. 2.
    Melo JV. The diversity of BCR-ABL fusion proteins and their relationship to leukemia phenotype.Blood. 1996;88:2375–2384.PubMedGoogle Scholar
  3. 3.
    Erikson J, Griffin CA, AR-Rushdi A, et al. Heterogeneity of chromosome 22 breakpoint in Philadelphia-positive (Ph+) acute lym- phocytic leukemia.Proc Natl Acad Sci U S A. 1986;83:1807–1811.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kurzrock R, Shtalrid M, Talpaz M, Kloetzer WS, Gutterman JU. Expression of c-abl in Philadelphia-positive acute myelogenous leukemia.Blood. 1987;70:1584–1588.PubMedGoogle Scholar
  5. 5.
    Hirsch-Ginsberg C, Childs C, Chang KS, et al. Phenotypic and molecular heterogeneity in Philadelphia chromosome-positive acute leukemia.Blood. 1988;71:186–195.PubMedGoogle Scholar
  6. 6.
    Chen SJ, Flandrin G, Daniel MT, et al. Philadelphia-positive acute leukemia: lineage promiscuity and inconsistently rearranged breakpoint cluster region.Leukemia. 1988;2:261–273.PubMedGoogle Scholar
  7. 7.
    Saglio G, Gueerrasio A, Tassinari C, et al. Variability of the molecular defects corresponding to the presence of a Philadelphia chromosome in human hematologic malignancies.Blood. 1988;72:1203–1208.PubMedGoogle Scholar
  8. 8.
    Najfeld V, Cuttner J, Figur A, Kawasaki ES, Witte ON, Clark SS. P185BCR-ABL in two patients with late appearing Philadelphia chro- mosome-positive acute nonlymphocytic leukemia.Leukemia. 1989;3:841–846PubMedGoogle Scholar
  9. 9.
    Kantarjian HM, Talpaz M, Dhingra K, et al. Significance of the P210 versus P190 molecular abnormalities in adults with Philadelphia chromosome-positive acute leukemia.Blood. 1991;78:2411–2418.PubMedGoogle Scholar
  10. 10.
    Preudhomme C, Lai JL, Plantier I, Demory JL, Zandecki M, Fenaux P. Cytogenetic and molecular remission in a case of acute myeloid leukemia (AML) with inversion of chromosome 16 (Inv[16]) and Philadelphia chromosome (Ph).Br J Haematol. 1992;82:623–626.CrossRefPubMedGoogle Scholar
  11. 11.
    Secker-Walker LM, Morgan GJ, Min T, et al. inversion of chromosome 16 with Philadelphia chromosome in acute myelomonocytic leukemia with eosinophilia.Cancer Genet Cytogenet. 1992;58:29–34.CrossRefPubMedGoogle Scholar
  12. 12.
    Cuneo A, Ferrant A, Michaux JL, et al. Philadelphia chromosome- positive acute myeloid leukemia: cytoimmunologic and cytogenetic features.Haematologica. 1996;81:423–427.PubMedGoogle Scholar
  13. 13.
    Alimena G, Cedrone M, Nanni M, et al. Acute leukemia presenting a variant ph chromosome with p190 expression, dup 3q and -7, developed after malignant lymphoma treated with alkylating agents and topoisomerase II inhibitors.Leukemia. 1995;9:1483–1486.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Chen Z, Morgan R, Notohamiprodjo M, et al. The Philadelphia chromosome as a secondary change in leukemia: three case reports and an overview of the literature.Cancer Genet Cytogenet. 1998;101:148–151.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Yamamoto K, Nakamura Y, Arai H, Saito K, Furusawa S. Triple Philadelphia chromosomes with major-bcr rearrangement in hypotriploid erythroleukaemia.Eur J Haematol. 2000;65:182–187.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Abe R, Raza A, Preisler HD, Tebbi CK, Sandberg AA. Chromosomes and causation of human cancer and leukemia. Near- tetraploidy in acute leukemia.Cancer Genet Cytogenet. 1985;14:45–59.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Pui CH, Carroll AJ, Head D, et al. Near-triploid and near-tetraploid acute lymphoblastic leukemia of childhood.Blood. 1990;76:590–596.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Clarke MR, Lynch EF, Contis LC, Sherer ME, Levin SS. Near- tetraploidy in adult acute myelogenous leukemia.Cancer Genet Cytogenet. 1996;86:107–115.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Inokuchi K, Futaki M, Dan K, Nomura T. Possible correlation of b3- a2 type bcr-abl messenger RNA defined by semiquantitative RT- PCR to platelet and megakaryocyte counts in Philadelphia-positive chronic myelogenous leukemia.Intern Med. 1994;33:189–192.CrossRefGoogle Scholar
  20. 20.
    Yamaguchi H, Inokuchi K, Shinohara T, Dan K. Extramedullary presentation of chronic myelogenous leukemia with P190 BCR/ ABL transcripts.Cancer Genet Cytogenet. 1998;102:74–77.CrossRefPubMedGoogle Scholar
  21. 21.
    Nakamura H, Inokuchi K, Hanawa H, et al. A case of chronic myeloid leukemia with minor bcr-abl transcript following fluorouracil therapy for esophageal carcinoma.Ann Hematol. 2000;79:396–401.CrossRefPubMedGoogle Scholar
  22. 22.
    Kelliher M, Knott A, McLaughlin J, Witte ON, Rosenberg N. Significance of the P210 versus P190 molecular abnormalities in adults with Philadelphia chromosome-positive acute leukemia.Mol Cell Biol. 1991;11:4710–4716.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Au WY, Ma SK, Chan AC, Liang R, Lam CC, Kwong YL. Near tetraploidy in three cases of acute myeloid leukemia associated with mediastinal granulocytic sarcoma.Cancer Genet Cytogenet. 1998;102:50–53.CrossRefPubMedGoogle Scholar
  24. 24.
    Yamaguchi H, Inokuchi K, Hanawa H, et al. Establishment of a near-triploid human B-cell lymphoma cell line with t(14;18) and a p53 gene point mutation.Br J Haematol. 1999;105:764–767.CrossRefPubMedGoogle Scholar
  25. 25.
    Inokuchi K, Miyake K, Takahashi H, Dan K, Nomura T. DCC protein expression in hematopoietic cell populations and its relation to leukemogenesis.J Clin Invest. 1996;97:852–857.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Hiroki Yamaguchi
    • 1
  • Koiti Inokuchi
    • 1
  • Ena Yokomizo
    • 1
  • Junko Miyata
    • 1
  • Ayako Watanabe
    • 1
  • Mituharu Inami
    • 1
  • Kenji Tajika
    • 1
  • Kazuo Dan
    • 1
  1. 1.Division of Hematology, Department of Internal MedicineNippon Medical SchoolTokyoJapan

Personalised recommendations