DETECTION OF A DORMANT 20Q- LEUKEMIA CLONE IN BONE-MARROW CULTURES WITH HEMATOPOIETIC GROWTH-FACTORS - IMPLICATIONS FOR SECONDARY LEUKEMIA POSTTRANSPLANT

A patient developed secondary acute myelogenous leukemia with a 20q- m arker chromosome abnormality six years following chemotherapy and radi ation for Hodgkins disease (HD). Routine cytogenetics on the bone marr ow which had been harvested and cryopreserved immediately following co mpletion of initial therapy for HD showed no cytogenetic abnormality. However, a 20q- clonal marker was detected after culturing bone marrow with hematopoietic growth factors (HGF). The marrow was used successf ully for an autotransplant. Post-transplant, the 20q- marker was again detected in HGF cultured samples. The patient relapsed at 165 days po st-transplant with the 20q- marker and trisomy 21, These data suggest that standard cytogenetic assays may not detect abnormal clones which can cause leukemia post-transplant.