Additional chromosome aberrations in acute promyelocytic leukemia: characteristics and prognostic influence

Abstract

Patients with acute promyelocytic leukemia (APL) show other chromosome aberrations in addition to t(15;17) but their influence on the clinical outcome is still unclear. We have cytogeneticaly analyzed 43 APL patients with t(15;17)(q22;q21), treated with all-trans-retinoic acid (ATRA) according to the recommendations of the European APL 91 Group. Additional chromosome aberrations were observed in 14/43 patients (33%) studied at initial diagnosis. These patients were designed as 'complex' karyotype group and were compared to patients with t(15;17) asa sole cytogenetic abnormality ('simple' karyotype group). The 'complex' group had significantly lower platelet count and fibrinogen level and fewer cases without significant DIC at diagnosis than the 'simple' group. Comparison of 'simple' and 'complex' groups showed significant difference in complete remission rate (76% vs 35.7%, P = 0.0148) and early death rate (24% vs 64.3%, P = 0.0141). Survival analysis showed that the presence of additional chromosome abnormalities and significant DIC had an adverse effects on prognosis (P = 0.036 and P = 0.041, respectively), independent on other prognostic factors. These data indicate more aggressive biological nature of leukemic cells in patients with additional chromosome aberrations. Supplementary therapeutic strategies may be required for this subgroup of APL patients.

Co-expression of t(15;17) and t(8;21) in a Case of Acute Promyelocytic Leukemia: Review of the Literature

“…Her initial blood count showed pancytopenia as follows: Hb, 55 g/L (normal range: 117-155), WBC: 1.6 x 10 9 /L (normal range: 4.1-11.2) with 0.2 x 109/L absolute count (10.4%) of neutrophils, and platelets, 56 x 109/L (normal range: 159-388). Peripheral blood smear revealed 1% neutrophils, 11% lymphocytes, 88% lymphomononuclear cells, poikilocytosis, anisocytosis, and schistocytes.…”

“…t(15;17) is known to be found in almost all APL patients [1]. Chromosomal abnormalities accompanying t(15;17) are reported in 23%-39% of APL cases [2,6,7,8,9,10]. Additional chromosome rearrangements including t(8;21) and t(15;17) are rarely seen in APL patients [11,12].…”

Dicentric t(8;13)(q10;q10) as an additional chromosomal abnormality in a case of acute promyelocytic leukemia with very poor outcome

“…Several studies have shown that secondary chromosomal abnormalities do not influence therapeutic response and outcomes for newly diagnosed APL patients [2,4]. Other report has shown that the presence of additional chromosomal changes adversely affects prognosis [5] or even slightly contributes to better prognosis [6]. The younger patient described here showed the dic(8;13)(q10;q10) and she had an unusual clinical course with an aggressive disease with elevated leukocytes count and fatal hemorrhagic coagulopathy, with very short survival (3 days after diagnosis).…”

Acute Promyelocytic Leukemia with Trisomy 8 and del(9)(q22) after Treatment of Cervical Cancer with Concurrent Chemoradiotherapy: A Case Report

“…Although this needs 174 de novo AML not predictable [20] 25 68 NA 30+ 46,XY,der(7)t(7;8)(q31;q22),der(17)ins(17;?)(q21;?) [15]/46,idem,del(9)(q12q22) [3]/47,idem,+8 [2] 160 AML good prognosis [21] 26 66 CT and RT 17+ 47,XX,+8,del(9)(q22),t(15;17)(q22;q12) [20]/46,XX [6] case report good prognosis present case NA = Not available; APL = acute promyelocytic leukemia; CT = chemotherapy; RT = radiotherapy. further verification, it seems that patients who have trisomy 8 show a better prognosis despite the fact that del(9q) might pose an adverse prognostic outcome, as described in cases 14 and 25 in addition to the present case (table 1).…”