for the relatively favorable outcome in this group. However, Keywords: inv(16)(p13q22); t(16;16)(p13;q22); 16 p deletions; FISH; acute myeloid leukemia; prognosis in another study, no difference in prognosis was observed between deletion and non-deletion patients. 18 To assess further the incidence of the 16 p deletions and to improve the understanding of their prognostic significance, we Introduction studied 15 patients with AML and inv(16) or t(16;16) by fluorescence in situ hybridization (FISH) using the zit14 cosmid In 1983, Arthur and Bloomfield 1,2 reported five patients with as a probe. Clinical, cytogenetic and FISH data are reported acute myeloid leukemia (AML) of myelomonocytic type (M4), here. increased marrow eosinophils and a structurally abnormal chromosome 16. Soon after, a pericentric inversion of chromosome 16, inv(16)(p13q22), was described in 18 patients Patients, materials and methods who had M4 leukemia and morphologically abnormal eosinophils with irregular, basophilic-staining granules and distinct Patients cytochemical properties. 3,4 A related chromosome abnormality, t(16;16)(p13;q22), was reported in one patient with Fifteen patients with either inv(16) or t(16;16) were diagnosed similar characteristics. 5 Further studies have suggested that at the divisions of hematology of the University Hospitals of these two abnormalities were uniquely associated with M4 Zü rich (four patients), Basel (three), Bern (three), Lausanne and abnormal eosinophils and the correlation between the (two) and of the Canton Hospitals of Sankt-Gallen (two) and karyotype and morphology has led to a subcategory in the Aarau (one) between 1992 and 1995 (Table 1). Each patient FAB classification, namely M4Eo. 6 However, both rearrangewas assigned a unique patient number for this and previous ments have been reported in other types of myeloid dispublications. [19][20][21] Additionally, 10 patients with AML (nine) or orders. 7,8 In most studies, the presence of inv(16)/t(16;16) has acute lymphoblastic leukemia (ALL) (one) and normal karyobeen associated with a high cure rate with standard chemotypes or aberrations other than inv(16) or t(16;16) were investitherapy and a relatively favorable prognosis. [9][10][11][12][13] gated by FISH and served as controls. Informed consent was Inv(16) and t(16;16) have been shown to involve, on 16p13, obtained from each patient. a smooth muscle myosin heavy chain gene (MYH11) and, onThe diagnosis and classification of patients were based on morphologic and cytochemical examination of peripheral blood (PB) films, bone marrow (BM) aspirate and biopsy speci-