Advertisement

International Journal of Hematology

, Volume 75, Issue 2, pp 182–186 | Cite as

Two Independent Clones in Myelodysplastic Syndrome Following Treatment of Acute Myeloid Leukemia

  • Masahiro Masuya
  • Naoyuki Katayama
  • Koichi Inagaki
  • Hiroshi Miwa
  • Natsuki Hoshino
  • Hiroyuki Miyashita
  • Hirohito Suzuki
  • Hiroto Araki
  • Hidetsugu Mitani
  • Kazuhiro Nishii
  • Shin-ichi Kageyama
  • Nobuyuki Minami
  • Hiroshi Shiku
Case Report

Abstract

We describe a 55-year-old Japanese woman with therapy-related myelodysplastic syndrome (t-MDS) with 2 independent clones, t(1;2)(p36;p21) and t(11;12)(p15;q13). She was diagnosed with acute myeloid leukemia (AML) with cytological features of the bone marrow and peripheral blood. Cytogenetic evaluation revealed a 46,XX karyotype. She received chemotherapy and achieved complete remission (CR). Despite maintenance chemotherapy, she suffered a relapse. Chromosomal analysis showed t(1;2)(p36;p21) in 2 of 20 metaphases. At second CR, this clone transiently disappeared. Nine months later, t(1;2) (p36;p21) was detected again in 3 of 20 metaphases while the patient remained in CR. Six months later, bone marrow examination disclosed trilineage dysplasia without an excess of blasts, suggesting MDS. t(1;2)(p36;p21) was observed in 16 of 20 metaphases. The clinical course and serial cytogenetic findings were diagnostic of t-MDS. The duration of t-MDS was 6 years. During this period, persistent t(1;2)(p36;p21) and transient t(11;12)(p15;q13) were found.When t-MDS evolved to AML, cytogenetic evaluation revealed 46,XX,t(1;2)(p36;p21),del(7)(q22),add(19)(p13).

Key words

Therapy-related MDS Therapy-related AML t(1,2) t(11,12) del(7)(q22) 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Referencess

  1. 1.
    Gale RE. Evaluation of clonality in myeloid stem-cell disorders.Semin Hematol. 1999;36:361–372.PubMedGoogle Scholar
  2. 2.
    Furuya T, Morgan R, Sandberg AA. Cytogenetic biclonality in malignant hematologic disorders.Cancer Genet Cytogenet. 1992;62:25–28.CrossRefPubMedGoogle Scholar
  3. 3.
    Pedersen-Bjergaard J, Timshel S, Andersen MK, Andersen AST, Philip P. Cytogenetically unrelated clones in therapy-related myelodysplasia and acute myeloid leukemia: experience from the Copenhagen series updated to 180 consecutive cases.Genes Chromosomes Cancer. 1998;23:337–349.CrossRefPubMedGoogle Scholar
  4. 4.
    Park DJ, Koeffler HP. Therapy-related myelodysplastic syndromes.Semin Hematol. 1996;33:256–273.PubMedGoogle Scholar
  5. 5.
    Jubashi T, Nagai K, Miyazaki Y, et al. A unique case of t(15;17) acute promyelocytic leukaemia (M3) developing into acute myeloblastic leukaemia (M1) with t(7;21) at relapse.Br J Haematol. 1993;83:665–668.CrossRefPubMedGoogle Scholar
  6. 6.
    Todisco E, Testi AM, Avvisati G, et al. Therapy-related acute myelomonocytic leukemia following successful treatment for acute promyelocytic leukemia.Leukemia. 1995;9:1583–1585.PubMedGoogle Scholar
  7. 7.
    Aquino VM, Schneider NR, Sandler ES. Secondary myelodysplasia with monosomy 7 arising after treatment for acute lymphoblastic leukemia in childhood.J Pediatr Hematol Oncol. 2001;23:48–50.CrossRefPubMedGoogle Scholar
  8. 8.
    Au WY, Lam CCK, Ma ESK, Man C, Wan T, Kwong YL. Therapyrelated myelodysplastic syndrome after eradication of acute promyelocytic leukemia: cytogenetic and molecular features.Hum Pathol. 2001;32:126–129.CrossRefPubMedGoogle Scholar
  9. 9.
    Bennett JM, Catovsky D, Daniel MT, et al. Proposed revised criteria for the classification of acute myeloid leukemia: a report of the French-American-British cooperative group.Ann Intern Med. 1985;103:626–629.CrossRefGoogle Scholar
  10. 10.
    Bennett JM, Catovsky D, Daniel MT, et al. Proposals for the classification of the myelodysplastic syndromes.Br J Haematol. 1982;51:189–199.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Bennett JM, Catovsky D, Daniel MT, et al. Proposal for the recognition of minimally differentiated acute myeloid leukaemia (AML-M0).Br J Haematol. 1991;78:325–329.CrossRefPubMedGoogle Scholar
  12. 12.
    Horiike S, Taniwaki M, Misawa S, Abe T. Chromosome abnormalities and karyotypic evolution in 83 patients with myelodysplastic syndrome and predictive value for prognosis.Cancer. 1988;62:1129–1138.CrossRefPubMedGoogle Scholar
  13. 13.
    Whang-Peng J, Knutsen T, Jaffe ES, et al. Sequential analysis of 43 patients with non-Hodgkin’s lymphoma: clinical correlation with cytogenetic, histologic, immunophenotyping, and molecular studies.Blood. 1995;85:203–216.PubMedGoogle Scholar
  14. 14.
    Mochizuki N, Shimizu S, Nagasawa T, et al. A novel gene,MELI,mapped to 1p36.3 is highly homologous to theMDS1/EVI1 gene and is transcriptionally activated in t(1;3)(p36;q21)-positive leukemia cells.Blood. 2000;96:3209–3214.PubMedGoogle Scholar
  15. 15.
    Hanash SM, Beretta L, Barcroft CL, et al. Mapping of the gene for interferon-inducible dsRNA-dependent protein kinase to chromosome region 2p21-22: a site of rearrangements in myeloproliferative disorders.Genes Chromosomes Cancer. 1993;8:34–37.CrossRefPubMedGoogle Scholar
  16. 16.
    Love EM, Liu Yin JA, Harrison CJ, Narayanan MN, Bhavnani M. Acute monocytic leukaemia and t(2;6)(p21;q26) translocation.Clin Lab Haematol. 1989;11:277–280.CrossRefPubMedGoogle Scholar
  17. 17.
    Lossos IS, Bogomolski-Yahalome V, Yehuda O, et al. A novel translocation (1;2)(p34;p21-22) in acute myelomonoblastic leukemia.Cancer Genet Cytogenet. 1998;106:78–79.CrossRefPubMedGoogle Scholar
  18. 18.
    Wong KF, Kwong YL, So CC.De novo AML with trilineage myelodysplasia and a novel t(11;12)(p15;q13).Cancer Genet Cytogenet. 1998;100:49–51.CrossRefPubMedGoogle Scholar
  19. 19.
    Nishiyama M, Arai Y, Tsunematsu Y, et al. 11p15 translocations involving the NUP98 gene in childhood therapy-related acute myeloid leukemia/myelodysplastic syndrome.Genes Chromosomes Cancer. 1999;26:215–220.CrossRefPubMedGoogle Scholar
  20. 20.
    Hayashi Y, Raimondi SC, Behm FG, et al. Two karyotypically independent leukemic clones with the t(8;21) and 11q23 translocation in acute myeloblastic leukemia at relapse.Blood. 1989;73:1650–1655.PubMedGoogle Scholar
  21. 21.
    Pui C-H, Raskind WH, Kitchingman GR, et al. Clonal analysis of childhood acute lymphoblastic leukemia with “cytogenetically independent” cell populations.J Clin Invest. 1989;83:1971–1977.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Ghaddar HM, Stass SA, Pierce S, Estey EH. Cytogenetic evolution following the transformation of myelodysplastic syndrome to acute myelogeneous leukemia: implication on the overlap between the two diseases.Leukemia. 1994;8:1649–1653.PubMedGoogle Scholar
  23. 23.
    Tricot G, Boogaerts MA, De Wolf-Peeters C, Van den Berghe H, Verwilghen RL. The myelodysplastic syndromes: different evolu tion patterns based on sequential morphological and cytogenetic investigations.Br J Haematol. 1985;59:659–670.CrossRefPubMedGoogle Scholar
  24. 24.
    Le Beau MM, Albain KS, Larson RA, et al. Clinical and cytogenetic correlations in 63 patients with therapy-related myelodysplastic syndromes and acute nonlymphocytic leukemia: further evidence for characteristic abnormalities of chromosomes no. 5 and 7.J Clin Oncol. 1986;4:325–345.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Mitelman F, Brandt L, Nilsson PG. Relation among occupational exposure to potential mutagenic/carcinogenic agents, clinical findings, and bone marrow chromosomes in acute nonlymphocytic leukemia.Blood. 1978;52:1229–1237.PubMedGoogle Scholar
  26. 26.
    Golomb HM, Alimena G, Rowley JD, Vardiman JW, Testa JR, Sovik C. Correlation of occupation and karyotype in adults with acute nonlymphocytic leukemia.Blood. 1982;60:404–411PubMedGoogle Scholar
  27. 27.
    Cuneo A, Ferrant A, Michaux JL, et al. Cytogenetic profile of minimally differentiated (FAB M0) acute myeloid leukemia: correlation with clinicobiologic findings.Blood. 1995;85:3688–3694.PubMedGoogle Scholar

Copyright information

© The Japanese Society of Hematology 2002

Authors and Affiliations

  • Masahiro Masuya
    • 1
  • Naoyuki Katayama
    • 1
  • Koichi Inagaki
    • 2
  • Hiroshi Miwa
    • 3
  • Natsuki Hoshino
    • 1
  • Hiroyuki Miyashita
    • 1
  • Hirohito Suzuki
    • 1
  • Hiroto Araki
    • 1
  • Hidetsugu Mitani
    • 1
  • Kazuhiro Nishii
    • 1
  • Shin-ichi Kageyama
    • 1
  • Nobuyuki Minami
    • 4
  • Hiroshi Shiku
    • 1
  1. 1.Second Department of Internal MedicineMie University School of MedicineTsu
  2. 2.Cell Morphology DivisionBiocellology Section, BML IncKawagoe
  3. 3.Second Department of Internal MedicineAichi Medical UniversityNagakute
  4. 4.Blood Transfusion ServiceMie University HospitalTsuJapan

Personalised recommendations