Cytogenetic basis of acute myeloid leukemia

Trisomy 9 in hematologic disorders: possible association with primary thrombocytosis

Ten patients with a hematologic disorder and a clone of cells with trisomy 9 in the bone marrow were studied in order to investigate the clinical significance of this chromosome anomaly. In five of the patients, trisomy 9 was the only anomaly; in four, there was also trisomy 8; and in one, a Y chromosome was also lacking. Four patients had a myelodysplastic syndrome, and six had a myeloproliferative disorder. Interestingly, four patients had primary thrombocytosis.

Trisomy 22--a new abnormality found in acute leukemia characterized by eosinophilia and monocytoid blasts expressing immature differentiation antigens

Bone marrow cells from three patients with acute myeloid leukemia, with marrow eosinophilia and monocytoid blasts, showed a new nonrandom chromosomal abnormality, trisomy 22. In two patients the classification of leukemia was M4 and in the third patient M2 (FAB classification). Pretreatment bone marrows in these patients revealed 31%, 30%, and 4% eosinophils, respectively. Blast cells isolated from peripheral blood were Ia-positive and expressed immature monocyte lineage antigens (U26, U28, U48) in 26%-92% of cells. All three patients had a population of bone marrow cells characterized by an extra chromosome #22. One patient also had inversion of chromosome #16. Trisomy 22, bone marrow eosinophilia, and monocytoid blasts displaying early monocyte differentiation antigens may represent a new subgroup of patients with acute myeloid leukemia.

Translocation (2;3) in hematologic malignancies

Cytogenetic studies have revealed nonrandom involvement of some chromosomes in specific structural abnormalities in human neoplasias. In this report we present three patients with t(2;3) associated with hematologic malignancies, and review the pertinent literature. These findings lead us to regard the region between 3q26 and 3q29 as implicated in chromosomal changes in these disorders, whereas, no vulnerable point has been observed in chromosome #2. We suggest that these translocations may activate genes on chromosome #3 related to these neoplasias.

Deletions of chromosome 13 in malignant hematologic disorders

Thirteen patients with a hematologic disorder and an interstitial deletion of part of a chromosome #13 were evaluated to determine if any specific clinical manifestations are associated with these cytogenetic anomalies. Our results suggest that these anomalies occur in approximately 1.7% of patients with a chromosomally abnormal clone and a hematologic disorder. They may occur as the sole chromosome anomaly (8 of our patients) or with other abnormalities (5 of our patients). The breakpoints are not always the same, but band 13q14 always seems to be lost. At the time of chromosome analysis, 5 patients had a history of myelofibrosis or agnogenic myeloid metaplasia, 2 had acute nonlymphocytic leukemia, 2 had a myelodysplastic syndrome, one had polycythemia vera, one had sideroblastic anemia, one had acute lymphocytic leukemia, and one had an undifferentiated myeloproliferative disorder.

Gamma heavy chain disease: report of a case associated with trisomy of chromosome 7

A case of gamma heavy chain disease is reported in a 52-year-old white male who presented with fever and generalized lymphadenopathy. A lymph node biopsy showed malignant lymphoma. A partial transient response was obtained with cyclophosphamide, vincristine, prednisone, and doxorubicin. He died 3 months after diagnosis from disease progression and infectious complications. Chromosome analysis of cells from an involved lymph node showed the presence of trisomy 7. Chromosome abnormalities have been reported in three of ten previously published cases of gamma heavy chain disease. Trisomy of chromosome #7 has not previously been reported.

Translocations involving chromosomes #3 and #12: hematologic diseases associated with abnormalities of these chromosomes

Two hematologic cases with translocations involving chromosomes #3 and #12 are described. The first case is that of a myeloproliferative disorder (preleukemia?) associated with a (3;12)(q29;q24) translocation in the bone marrow cells. No evidence of leukemic transformation has appeared to date. The second case is that of acute leukemia (AL) (M4 type) in which leukemic cells with t(3;12)(p14;q24) were seen. The roles of chromosomes #3 and #12 in hematopoiesis are considered, and the abnormalities affecting these chromosomes in various hematologic disorders have been tabulated and correlated. Abnormalities in chromosomes #3 and #12 appear to be common and nonrandom in hematologic diseases of a premalignant and a malignant type.

Multiple active X chromosomes in myelofibrosis with myeloid metaplasia

A woman with myelofibrosis and myeloid metaplasia had a karyotype of 47,X,del(X)(q22),+del(X)(q22) in unstimulated peripheral blood and bone marrow aspirate cultures. The normal X chromosome was late replicating, and the two deleted X chromosomes always replicated early and synchronously. The karyotype from phytohemagglutin-stimulated peripheral blood cultures was uniformly 46,XX. Structurally abnormal X chromosomes are exceedingly rare in myeloproliferative disease. The abnormal karyotype very likely reflects monoclonal proliferation of an abnormal myeloid cell line. The X chromosome inactivation process, which acts upon embryonic somatic cells of all mammals, apparently does not react to postembryonic nondisjunction of the active X chromosome.

Inactive normal X in a female leukaemic patient with an acquired X/autosome translocation

An X;9;22 translocation was detected in bone marrow cells of a female patient with blastic crisis of CML. A dynamic study following 5-BrdU treatment showed that the inactive late-replicating X chromosome was the normal one. This pattern of X-chromosome replication appears to be superimposable on the most usual model found in congenital X/autosome translocations. It is suggested that preferential autosome translocation onto the active X chromosome could be the general rule in acquired X/autosome translocations associated with long survival.

Chromosome 8 abnormalities as components of neoplastic and hematologic disorders

Publications involving patients with any abnormality of chromosome 8 have been reviewed in detail. For the time period involved, a total of 277 cases were found, including 74 instances of congenital aneuploidy, 130 instances of acquired aneuploidy, 38 instances of congenital rearrangements, and 35 instances of acquired rearrangements. A total of 170 cases of neoplastic and hematologic disorders were included; three were associated with congenital aneuploidy, two with congenital rearrangements, and the remaining 165 with acquired aberrations. The specific disorders ranged from sideroblastic anemia through chronic and acute leukemia to solid tumors. There appears to be a definite, though non-specific correlation between congenital or acquired chromosome 8 abnormalities and the development of certain types of neoplastic growth.

Correlation of clinical findings with quinacrine-banded chromosomes in 90 adults with acute nonlymphocytic leukemia: an eight-year study (1970-1977)

We observed chromosome-banding abnormalities in leukemic cells of 46 of 90 (51 per cent) adults with acute nonlymphocytic leukemia at initial hospital admission. The difference in survival between 37 treated patients with an initially normal karyotype (10 months) and 43 with an initially abnormal karyotype (four months) was significant (P less than 0.01). When patients were classified as having acute myelogenous leukemia or acute myelomonocytic leukemia, this difference in survival was even more pronounced. Of 16 treated patients with acute myelogenous leukemia and a normal karyotype, 11 (69 per cent) had a complete remission and a median survival of 13 months. Of eight patients with acute myelogenous leukemia in whom only abnormal metaphases were observed, none had a complete remission, and the median survival was only two months (P approximately 0.50). Remission rate and median survival were not significantly different in patients with acute myelomonocytic leukemia grouped according to initial karyotypes.

Myelofibrosis with complex chromosome abnormality in a patient with erythrocytosis due to hemoglobin Rainier and treated with 32P

A patient with familial erythrocytosis associated with Hemoglobin Rainier, and previously treated with 32P, developed myelofibrosis with a hyperdiploid chromosome clone in the myeloid cells (51,XX,+1,2q-(q33),+6,+9,+11,-19,+20q+,+mar 1.) This transformation from a benign disorder of differentiated erythrocytes to a malignant disorder may have been secondary to radiophosphorus therapy.

Non-random chromosome changes in acute myeloid leukemia. Chromosome banding examination of 30 cases at diagnosis

Bone-marrow chromosomes were examined with the G-banding technique in 30 patients with acute myeloid leukemia at the time of diagnosis. In 13 of the 30 patients (43%) only normal diploid bone-marrow cells were found, and no deviations from the normal banding pattern could be detected in these cells. In bone-marrow cells of 17 patients (57%), distinct chromosome abnormalities were found; in 10 of the patients only abnormal cells were observed, whereas in 7 of the patients the abnormal cells coexisted with normal diploid cells without any visible chromosome banding abnormality. The results of the detailed analysis of the karyotypic aberrations demonstrated that when chromosome aberrations occurred they were clearly non-random. All patients except two displayed trisomy 8,9 or 21 or monosomy 7. Analysis of cases of acute leukemia from other laboratories indicated that the same consistent pattern of chromosome involvement prevailed in them.