Trisomy 4 and double minutes in acute myeloid leukemia: Further evidence that double minutes can occur as the primary cytogenetic abnormality

The specific association of trisomy 4 and double minutes (dmin) is rare and is usually reported in patients with acute myeloid leukemia (AML) primaril y M2 and M4 subtypes. Several previous reports describing this combination suggested that trisomy 4 was the primacy cytogenetic abnormality, and that the presence of the dmin was secondary. We describe a 79-year-old male who presented with myelodysplasia, transforming to AML-M2. Cytogenetic analysis of bone marrow aspirate cultures showed a 46,XY,dmin[12]/47,XY,+4,dmin[7]/ 46,XY[6] karyotype. The number of dmin ranged from Ito 150. Fluorescence in situ hybridization (FISH) analysis showed that the dmin were derived from amplification of the MYC oncogene. Dual-color interphase FISH analysis was performed with D4Z1 and MYC probes and showed no evidence of a clone contai ning trisomy 4 without dmin. These data suggest that dmin may also occur as the primary cytogenetic abnormality in patients with trisomy 4 and dmin. ( C) 2000 Elsevier Science Inc. All rights reserved.