title: Cytogenetically Unrelated Clones in Acute Myeloid Leukemia Showing Different Responses to Chemotherapy.
abstract: We report a case of acute myeloid leukemia (AML) with two cytogenetically unrelated clones. The patient was a 45-year-old male who was diagnosed with acute monoblastic leukemia (AMoL). Initial G-band analysis showed 51,XY,+6,+8,inv(9)(p12q13)c,+11,+13,+19[12]/52,idem,+Y[8], but G-band analysis after induction therapy showed 45,XY,-7,inv(9)(p12q13)c[19]/46,XY,inv(9)(p12q13)c[1]. Retrospective FISH analysis revealed a cryptic monosomy 7 clone in the initial AML sample. The clone with multiple trisomies was eliminated after induction therapy and never recurred, but a clone with monosomy 7 was still detected in myelodysplastic marrow with a normal blast percentage. Both clones were successfully eliminated after related peripheral blood stem cell transplantation, but the patient died of relapsed AML with monosomy 7. We concluded that one clone was de novo AMoL with chromosome 6, 8, 11, 13, and 19 trisomy and that the other was acute myeloid leukemia with myelodysplasia-related changes(AML-MRC) with chromosome 7 monosomy showing different responses to chemotherapy. Simultaneous onset of cytogenetically unrelated hematological malignancies that each have a different disease status is a rare phenomenon but is important to diagnose for a correct understanding of the disease status and for establishing an appropriate treatment strategy.
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Kohei
authors.identifier: 0000-0002-8423-3826
authors.initials: K
authors.lastname: Kasahara
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Onozawa
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Miyashita
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Yokohata
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kanaya
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Mizuha
authors.initials: M
authors.lastname: Kosugi-Kanaya
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Takemura
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Shojiro
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Sugita
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Shigematsu
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Takahata
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Fujisawa
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Daigo
authors.initials: D
authors.lastname: Hashimoto
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Fujimoto
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Endo
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Department of Hematology, Hokkaido University Hospital, Sapporo 060-8638, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima