Two independent clones in myelodysplastic syndrome following treatment of acute myeloid leukemia.
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)(pl5;ql3). 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 toAML, cytogenetic evaluation revealed 46,XX,t(1;2)(p36;p21),del(7)(q22),add(19)(p13).
Masuya
Masahiro
M
Second Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
Katayama
Naoyuki
N
Inagaki
Koichi
K
Miwa
Hiroshi
H
Hoshino
Natsuki
N
Miyashita
Hiroyuki
H
Suzuki
Hirohito
H
Araki
Hiroto
H
Mitani
Hidetsugu
H
Nishii
Kazuhiro
K
Kageyama
Shin-ichi
S
Minami
Nobuyuki
N
Shiku
Hiroshi
H
D000208:Acute Disease; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000633:toxicity; D002878:Chromosomes, Human, Pair 1; D002880:Chromosomes, Human, Pair 11; D002881:Chromosomes, Human, Pair 12; D002889:Chromosomes, Human, Pair 2; D002999:Clone Cells / Q000473:pathology; D020732:Cytogenetic Analysis; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000139:chemically induced* / Q000235:genetics / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000139:chemically induced / Q000235:genetics / Q000473:pathology; D014178:Translocation, Genetic
D000970:Antineoplastic Agents