Loss of the Y chromosome: an age-related or clonal phenomenon in acute myelogenous leukemia/myelodysplastic syndrome?
BACKGROUND
The clinical association between loss of the Y chromosome and acute myelogenous leukemia and myelodysplastic syndrome (AML/MDS) has been debated because both phenomena are related to aging. A prior publication suggests that loss of the Y chromosome in more than 75% of cells may indicate a clonal phenomenon that could be a marker for hematologic disease.


OBJECTIVE
To evaluate the relationship between loss of the Y chromosome and AML/MDS.


METHODS
A retrospective review of cytogenetic reports of 2896 male patients ascertained from 1996 to 2007 was performed. Results were stratified based on the percentage of cells missing the Y chromosome and were correlated with patients' ages and bone marrow biopsy reports through logistic regression analysis with adjustment for age.


RESULTS
Loss of the Y chromosome was found in 142 patients. Of these, 16 patients demonstrated myeloid disease, with 2 cases of AML and 14 cases of MDS. An increased incidence (P < .05) of AML/MDS was seen only in the group composed of 8 patients with complete loss of the Y chromosome in all karyotyped cells (1 case of AML and 7 cases of MDS).


CONCLUSIONS
Loss of the Y chromosome appears to be primarily an age-related phenomenon. However, in individuals in which all cells on cytogenetic analysis showed loss of the Y chromosome, there was a statistically significant increase in AML/MDS, suggesting that the absence of any normal-dividing cells in a bone marrow analysis may be indicative of AML/MDS.
Wong
Anna K
AK
Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. anna.wong@cshs.org
Fang
Belle
B
Zhang
Ling
L
Guo
Xiuqing
X
Lee
Stephen
S
Schreck
Rhona
R
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002872:Chromosome Deletion; D041322:Chromosomes, Human, Y; D020732:Cytogenetic Analysis; D006801:Humans; D015994:Incidence; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology / Q000235:genetics*; D008297:Male; D009190:Myelodysplastic Syndromes / Q000453:epidemiology / Q000235:genetics*; D012189:Retrospective Studies