Clinical significance of acquired loss of the X chromosome in bone marrow.
Acquired loss of the X chromosome (-X) as a sole abnormality is detected rarely in bone marrow (BM) and its clinical importance remains largely unknown. We studied 38 patients with isolated -X in BM. All patients were women, with a median age of 71 years. At the time of -X detection, BM was positive for myeloid neoplasm in 14 patients, lymphoma/myeloma in 10 patients, and was normal in 14 patients. -X was detected as a major clone in 15 patients (11 of them had myeloid neoplasm) and a minor clone in 23 patients. Combined morphologic and FISH analysis was performed in 16 cases, -X was detected in myeloid/erythroid cells in all 16 patients and in lymphocytes in 15 patients. With a median of 23 months follow-up, none of the patients with a negative BM or BM with involvement by lymphoid neoplasms developed a secondary myeloid neoplasm. We conclude that isolated -X is a rare finding in BM. In majority of patients, -X presents as a minor clone and is likely to be an aging effect or a benign finding; whereas when -X presents as a major clone in BM, it is often disease associated.
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Zhenya
Z
Tang
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Yan
Y
Li
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Sa A
SA
Wang
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Shimin
S
Hu
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Shaoying
S
Li
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Xinyan
X
Lu
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Joseph D
JD
Khoury
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
L Jeffrey
LJ
Medeiros
Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. Electronic address: gtang@mdanderson.org.
Guilin
G
Tang
D000368:Aged; D000375:Aging / Q000235:genetics; D001853:Bone Marrow / Q000473:pathology*; D041321:Chromosomes, Human, X / Q000235:genetics*; D002999:Clone Cells / Q000473:pathology; D041905:Erythroid Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology; D022423:Myeloid Cells / Q000473:pathology; D009369:Neoplasms / Q000175:diagnosis
Acquired loss of X chromosome; Aging effect; Combined morphologic-FISH analysis; Disease-related; Myeloid neoplasms