G. Nucifora et al., CORRELATION BETWEEN CELL MORPHOLOGY AND EXPRESSION OF THE AML1 ETO CHIMERIC TRANSCRIPT IN PATIENTS WITH ACUTE MYELOID-LEUKEMIA WITHOUT THE T(821)/, Leukemia, 8(9), 1994, pp. 1533-1538
The 8;21 chromosomal translocation involves the AML1 gene on chromosom
e 21 and the ETO gene on chromosome 8 and results in the transcription
of a chimeric message. This translocation is most often associated wi
th acute myelogenous leukemia with maturation (AML-M2). The leukemic c
ells of patients carrying t(8;21) often exhibit several characteristic
morphologic features. We identified four cases in which the morpholog
y led us to suspect a t(8;21), but in which this translocation was not
observed by cytogenetic analysis. In two of the four cases, an AML1/E
TO chimeric fragment was detected by reverse transcription and polymer
ase chain reaction (RI-PCR), and its sequence was found to be identica
l to that from patients with a cytogenetically proved t(8;21). Marrow
specimens of the four patients lacking the t(8;21) cytogenetically wer
e reviewed retrospectively with regard to seven morphologic features c
ommonly reported to be associated with this translocation, and the res
ults were compared to 13 morphologic controls with the t(8;21). Althou
gh none of the 13 controls had all of the characteristic morphologic f
eatures, all had at least six, as did the two t(8;21)-negative but RT-
PCR-positive patients. The two patients who lacked the t(8;21) and who
were RT-PCR-negative showed only three and four of these morphologic
features, respectively. Both of the RT-PCR-positive patients had delet
ions of the long arm of chromosome 9, a common change associated with
a t(8;21), supporting our assessment of these patients as having a cyt
ogenetically undetected t(8;21).