Gao M, Li S, Wang L, Nie S, Pang H, Lu X, Wang X, Wang M, Guo S, Ma Y, Meng F. Identification of a cryptic submicroscopic deletion using a combination of fluorescence in situ hybridization and array comparative genomic hybridization in a t(3;5)(q25;q35)-positive acute myeloid leukemia patient: A case report and review of the literature.
Medicine (Baltimore) 2020;
99:e22789. [PMID:
33120794 PMCID:
PMC7581054 DOI:
10.1097/md.0000000000022789]
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Abstract
RATIONALE
The advent of high-resolution genome arrays including array comparative genomic hybridization (aCGH) has enabled the detection of cryptic submicroscopic deletions flanking translocation breakpoints in up to 20% of the apparently "balanced" structural chromosomal rearrangements in hematological disorders. However, reports of submicroscopic deletions flanking the breakpoints of t(3;5)(q25;q35) are rare and the clinical significance of submicroscopic deletions in t(3;5) has not been explicitly identified.
PATIENT CONCERNS
We present a 47-year-old man with acute myeloid leukemia. G-banding analysis identified t(3;5)(q25;q35).
DIAGNOSIS
Array CGH-based detection initially confirmed only the deletion of chromosome 3. Further characterization using fluorescence in situ hybridization identified a cryptic submicroscopic deletion including 5' MLF1-3' NPM1 flanking the breakpoint on the derivative chromosome 3.
INTERVENTIONS
The patient started "7+3" induction chemotherapy with cytosine arabinoside and daunorubicin, and subsequently received 2 cycles of high-dose intermittent acronym of cytosine arabinoside or cytarabine.
OUTCOMES
The patient did not undergo complete remission and died from an infection due to neutropenia.
LESSONS
Haploinsufficiency of NPM1 or other deleted genes, including SSR3, may be responsible for the phenotype of t(3;5)(q25;q35)-positive myeloid neoplasms with submicroscopic deletions.
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