title: Co-expression of t(15;17) and t(8;21) in a Case of Acute Promyelocytic Leukemia: Review of the Literature.
abstract: Additional chromosomal abnormalities in acute myelogenous leukemia have been identified as one of the most important prognostic factors. Favorable chromosomal changes such as t(8;21), inv(16), and t(15;17) are associated with higher rates of complete remission and event-free survival. Translocation (15;17) characterizes acute promyelocytic leukemia (APL) (French-American-British class M3) in almost all patients. Secondary chromosomal abnormalities are also present in approximately 23%-29% of patients with newly diagnosed APL. The prognostic implications of t(8;21) and other secondary cytogenetic aberrations in APL are reviewed here. We present a 47-year-old woman diagnosed with APL whose initial cytogenetic analysis included both t(8;21) and t(15;17). The initial induction chemotherapy included 3 days of idarubicin (12 mg/m2/day) and daily all-trans retinoic acid (ATRA; 45 mg/m2/day). At the sixth week of treatment, a control bone marrow biopsy was found to be normocellular, t(15;17) bcr3 and t(8;21) were negative, and t(15;17) bcr1 fusion transcripts were reduced from 5007 (1.78525699%) copies per 1 µg RNA to 40 (0.00062020%) with real-time quantitative polymerase chain reaction. Consolidation with 4 days of idarubicin (5 mg/m2/day), ATRA (45 mg/m2/day for 15 days), and cytarabine (1 g/m2/day for 4 days) was then started. However, the patient became pancytopenic and had neutropenic fever after consolidation treatment. Unfortunately, she died 3 months after the time of APL diagnosis, due to acute respiratory distress syndrome-like respiratory problems and multiorgan dysfunction requiring respiratory support and hemodialysis.
  
  
  BACKGROUND
  None declared.
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Uz
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Eylem
authors.initials: E
authors.lastname: Eliaçık
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Işık
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Salih
authors.initials: S
authors.lastname: Aksu
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Yahya
authors.initials: Y
authors.lastname: Büyükaşık
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Ibrahim C
authors.initials: IC
authors.lastname: Haznedaroğlu
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Göker
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Nilgün
authors.initials: N
authors.lastname: Sayınalp
authors.affiliation: Hacettepe University Medical School, Department of Internal Medicine, Division of Hematology, Ankara, Turkey.
authors.forename: Osman İ
authors.initials: Oİ
authors.lastname: Ozcebe
keywords: Acute promyelocytic leukemia; Additional chromosomal abnormalities