Hypocellular acute promyelocytic leukemia with a tetraploid clone characterized by two t(15;17).
We describe a case of hypocellular acute promyelocytic leukemia with a tetraploid clone characterized by two t(15;17). The large leukemia cells had a bizarre nuclear configuration and multiple Auer rods. A bone marrow biopsy specimen revealed a markedly hypocellular marrow (<10% cellularity) in the absence of myelofibrosis. Myelodysplastic features were not detected. Chromosome analysis of marrow cells revealed a karyotype of 92,XXYY,del(2)(q?),t(15;17)(q22;q21)x2. Interphase fluorescence in situ hybridization revealed that the marrow cells were composed of a tetraploid clone carrying double t(15;17) and normal diploid cells. The leukemia responded well to all-trans retinoic acid. We think that the tetraploidy could be caused by endoreduplication or endomitosis of the diploid clone with single t(15;17). The unique karyotype largely contributed to the cell morphology and marrow hypoplasia, while it may not have affected on the prognosis of the acute promyelocytic leukemia.
Kojima
Kensuke
K
The First Department of Internal Medicine, Ehime University School of Medicine, Shingenobu, Ehime 791-0295, Japan. kkoji@m.ehime-u.ac.jp
Imaoka
Michiyoshi
M
Noguchi
Toshiyuki
T
Narumi
Hiroshi
H
Uchida
Naoyuki
N
Sakai
Ikuya
I
Yasukawa
Masaki
M
Fujita
Shigeru
S
D001854:Bone Marrow Cells / Q000166:cytology; D002884:Chromosomes, Human, Pair 15; D002886:Chromosomes, Human, Pair 17; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015473:Leukemia, Promyelocytic, Acute / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011123:Polyploidy; D017384:Sequence Deletion; D014178:Translocation, Genetic