title: Isolated del(5q) in Patients Following Therapies for Various Malignancies May Not All Be Clinically Significant.
abstract: OBJECTIVE
  Deletion 5q is a common chromosomal abnormality in both de novo and therapy-related myeloid neoplasms (t-MNs). The detection of isolated del(5q) in patients following therapies for various malignancies raises serious concern for an emerging t-MN.
  
  
  METHODS
  We identified 25 patients who developed isolated del(5q) following cytotoxic therapy (n = 21) or tyrosine kinase inhibitor (TKI; n = 4) therapy. Twenty-four patients had an interstitial and one had a terminal 5q deletion. The 5q31/EGR1 gene was deleted in 20 patients and intact in five patients. The clone size as assessed by metaphase analysis was minor (10%-30%) in 12 patients and large (45%-100%) in 13 patients. After a median follow-up of 17 months, none of the 12 patients with a minor del(5q) clone developed t-MN; del(5q) disappeared in four patients and persisted in eight patients. By contrast, 12 of 13 patients with a large del(5q) clone developed t-MN, and del(5q) was persistent in all patients who had follow-up cytogenetic testing.
  
  
  CONCLUSIONS
  Development of del(5q) in patients following cytotoxic therapies or TKI may not always be associated with t-MN. A close follow-up seems an appropriate approach for patients who had a minor del(5q) clone.
authors.affiliation: From the Departments of Hematopathology and gtang@mdanderson.org.
authors.forename: Guilin
authors.initials: G
authors.lastname: Tang
authors.affiliation: From the Departments of Hematopathology and.
authors.forename: Rashmi Shivani
authors.initials: RS
authors.lastname: Goswami
authors.affiliation: From the Departments of Hematopathology and.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Liang
authors.affiliation: From the Departments of Hematopathology and.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Bueso-Ramos
authors.affiliation: From the Departments of Hematopathology and.
authors.forename: Shimin
authors.initials: S
authors.lastname: Hu
authors.affiliation: Leukemia, The University of Texas MD Anderson Cancer Center, Houston.
authors.forename: Courtney
authors.initials: C
authors.lastname: DiNardo
authors.affiliation: From the Departments of Hematopathology and.
authors.forename: L Jeffrey
authors.initials: LJ
authors.lastname: Medeiros
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5 / Q000235:genetics*; D005260:Female; D019337:Hematologic Neoplasms / Q000235:genetics; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000235:genetics* / Q000473:pathology
chemical_list: D000970:Antineoplastic Agents
keywords: Deletion 5q; Post–cytotoxic therapy; Therapy-related myeloid neoplasm