Low curative potential of bone marrow transplantation for highly aggressive acute myelogenous leukemia with inversion inv (3)(q-21q26) or homologous translocation t(3;3) (q21;q26)

Structural rearrangements of the long arm of chromosome 3 involving bands 3 q21 and 3q26 and leading either to a paracentric inversion inv (3)(q21q26) or a translocation between both homologous chromosomes - t (3;3)(q21q26) -h ave been reported in patients with acute myelogenous leukemia (AML), myelod ysplastic syndromes, myeloproliferative disorders, and chronic myelogenous leukemia in blast crisis. We describe three patients with de novo AML with these structural abnormalities who received multiple courses of conventiona l chemotherapy followed by unrelated donor (n=2) and autologous (n =1) bone marrow transplantation (BMT). All three patients had early relapse: patien ts 1 and 2 had relapse 69 days and 306 days after BMT, respectively, and pa tient 3 immediately after autologous BMT. Despite further chemotherapy, the y died without achieving another remission. These findings, together with o ther recorded similar cases, show that AML with structural abnormalities of the long arm of chromosome 3 as described has an extremely poor prognosis even with the most potent anti-leukemic treatment modalities.