title: A complex, four-way variant t(15;17) in acute promyelocytic leukemia.
abstract: Complex variant 15;17 translocations are increasingly recognized in acute promyelocytic leukemia (APL). We report the case of a 47-year-old woman with APL harboring a novel four-way translocation. She presented with persistent bleeding after a tooth extraction. Blood cell counts at admission were hemoglobin at 9.0 g/dL, platelets at 15 x 10(9)/L, and white blood cells at 0.460 x 10(9)/L with abnormal promyelocytes. Most nucleated cells of bone marrow aspirates were abnormal promyelocytes with Auer rods. Chromosome analysis of unstimulated bone marrow cell cultures revealed a variant t(15;17) in the form of t(10;17;15;22)(q22;q21;q22;q11.2). Fluorescence in situ hybridization with a PML/RARA dual-color DNA probe showed the fusion signals on der(15) and the residual PML signals on der(22). RT-PCR showed long-form PML/RARA fusion transcripts. A complete remission was attained with a course of conventional chemotherapy including ATRA. A literature review revealed that our case is one of the very rare four-way translocations and the first report of the involvement of chromosomes 10 and 22 in a variant t(15;17).
authors.affiliation: Department of Laboratory Medicine, Sanggye Paik Hospital, Sanggye 7 dong 761-7, Seoul, Republic of Korea.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Yoo
authors.forename: Eul-Ju
authors.initials: EJ
authors.lastname: Seo
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Yiel-Hea
authors.initials: YH
authors.lastname: Seo
authors.forename: Pil-Whan
authors.initials: PW
authors.lastname: Park
authors.forename: Jeong-Yeal
authors.initials: JY
authors.lastname: Ahn
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001854:Bone Marrow Cells / Q000648:ultrastructure; D002478:Cells, Cultured; D002884:Chromosomes, Human, Pair 15 / Q000648:ultrastructure; D002886:Chromosomes, Human, Pair 17 / Q000648:ultrastructure; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015473:Leukemia, Promyelocytic, Acute / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D008875:Middle Aged; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014178:Translocation, Genetic; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D014212:Tretinoin