TRANSLOCATION (3-21-8)(Q21-Q22-Q22) IN A PATIENT WITH ACUTE MYELOID-LEUKEMIA - A CASE-REPORT AND REVIEW OF PROGNOSTIC INDICATORS

We report a patient with acute myeloid leukemia (AML) and t(3:21;8)(q2 1;q22;q22). This translocation has not been previously described in de novo or relapsed AML. The patient is a 25-year-old woman who presente d with WBC 6.2 x 10(9)/L, Hgb 10.2 g/dL, Hct 28.4 %, and platelets 67 x 10(9)/L, ii bone marrow biopsy revealed a 70% hematopoietic cellular ity with 65% blasts. Immunophenotyping showed aberrant expression of` lymphoid-associated marker CD19. Cytogenetic analysis on a 72-hour cul ture of bone marrow cells supplemented with conditioned media tvas eva luated by G-banding at about the 400-band level, The patient's age, cy togenetics, WBC, and immunophenotype at diagnosis would seem to sugges t a favorable prognosis, according to previous studies of prognostic i ndicators. She was treated with induction and consolidation chemothera py, followed by myeloablative conditioning and autologous peripheral b lood stem cell transplant (PBSCT). Despite multiple favourable prognos tic factors, the patient relapsed 7 months after PBSCT. Translocation of chromosomes 8 and 21 is common in AML and is generally considered a good prognostic factor. We suspect that the effect of the 3q21 transl ocation in an otherwise favorable translocation of chromosomes 8 and 2 1 may be responsible for this patient's early relapse. (C) Elsevier Sc ience Inc., 1998.