CD7(+) near-tetraploid acute myeloblastic leukemia M2 with double t(8;21)(q22;q22) translocations and AML1/ETO rearrangements detected by fluorescence in situ hybridization analysis
K. Yamamoto et al., CD7(+) near-tetraploid acute myeloblastic leukemia M2 with double t(8;21)(q22;q22) translocations and AML1/ETO rearrangements detected by fluorescence in situ hybridization analysis, INT J HEMAT, 74(3), 2001, pp. 316-321
Near-tetraploidy is a rare cytogenetic abnormality observed in acute myelob
lastic leukemia (AML). It was recently suggested that near-tetraploid AML m
ay be associated specifically with t(8;21)(q22;q22). We report here a new c
ase of near-tetraploid AML with double t(8;21)(q22;q22) translocations. A 6
1-year-old woman was admitted to our hospital because of high fever and pan
cytopenia. Her bone marrow was markedly hypercellular, with 72% giant and b
izarre myeloblasts. These myeloblasts were positive for CD7. CD13, CD19, CD
33, CD34, and HLA-DR but negative for CD2 and CD56. The patient's disease w
as diagnosed as the M2 subtype of AML (by French-American-British classific
ation). Chromosome analysis revealed a karyotype of 45,X -X, t(8;21) (q22;q
22)[1]/90,XXX,-X,t(8;21)(q22;q22)x2,-9[7]/46,XX[12]. Fluorescence in situ h
ybridization (FISH) analysis with an AML1/ETO probe detected 4 fusion signa
ls on 2 der(8)t(8:21) and 2 der(21)t(8;21) in near-tetraploid cells. Revers
e transcription-polymerase chain reaction analysis revealed the presence of
the AML1/ETO fusion transcript. These findings suggested that near-tetrapl
oidy may be a secondary genetic change originating from a diploid clone wit
h t(8;21) and that 2 AML1/ETO fusion genes are generated on the der(8)t(8;2
1) in near-tetraploid clones. Consideration of the other reported cases sug
gests that the immunophenotypes of near-tetraploid AML with double t(8,21)
are heterogenous. but it is possible that t(8;21)-AML with expression of CD
2 or CD7 may be associated with a secondary clonal evolution to near-tetrap
loidy. (C) 2001 The Japanese Society of Hematology.