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Cytogenetic abnormalities in acute myeloid leukemia

Cytogenetic abnormalities in acute myeloid leukemia
Cytogenetic finding Affected genes Clinical features Prognosis Approximate incidence in de novo AML
t(8;21) RUNX1/RUNX1T1

Younger adults (average age 30 years)

AML with maturation (FAB M2)

Auer rods usually present

Favorable 5 to 7%
t(15;17) PML/RARA

Younger adults (average age 40 years)

Atypical promyelocytes with bilobed nucleus and granules (APL, FAB M3)

Disseminated intravascular coagulation common
Favorable; high cure rate with all-trans retinoic acid-based therapy 5 to 8%
t(11;17) ZBTB16/RARA Similar to APL but with sparser granules and absence of the typical bilobed nucleus Poor response to all-trans retinoic acid-based treatment <1%
abn(16q22) CBFB/MYH11

Younger adults (average age 35 to 40 years)

Acute myelomonocytic leukemia (FAB M4) with eosinophilia
Favorable; high reinduction rate post relapse 5%
abn(11q23) MLL and many partners

Older adults (average age >50 years)

Acute monoblastic and monocytic leukemia (FAB M5)

Hyperleukocytosis and extramedullary disease common
Poor, except t(9;11) 3%
+8  

Older adults (average age >60 years)

Varied morphology

Often associated with other chromosomal additions and deletions
Poor 3 to 10%
del 5, del 7, 5q-, 7q-, or combinations  

Older adults (average age >60 years)

Varied morphology, common in acute erythroid leukemia (FAB M6)

Common in patients with secondary AML and prior MDS
Poor 15 to 20%
Inv 3 RPN1/MECOM

Morphologically abnormal megakaryocytes; increased platelet count

Other abnormalities common (del 5,7)
Poor <1%
abn(p17) TP53

Younger adults (average age <60 years)

Varied morphology

Other abnormalities common (del 5,7, complex karyotype)
Poor 5%
+13  

Older adults (average age >60 years)

Varied morphology, sometimes undifferentiated, high frequency of hybrid features
Poor Approximately 1 to 2%
t(6;9)(p2;q34) DEK/NUP214 AML with maturation (FAB M2)/Acute myelomonocytic leukemia (FAB M4) with prominent basophilia Poor <1 to 2%
t(9;22) BCR/ABL1

Older adults (average age >50 years)

Usually AML with minimal differentiation (FAB M1), prominent splenomegaly, possible transformation of unrecognized CML
Poor Approximately 1%
t(1;22) RBM15/MKL1

Infants (aged 0 to 3 years)

Often acute megakaryoblastic leukemia (FAB M7), prominent organomegaly
Poor <1%
t(8;16) KAT6A/CREBBP Acute myelomonocytic leukemia (FAB M4) and acute monoblastic and monocytic leukemia (FAB M5), erythrophagocytosis Poor <1%
AML: acute myeloid leukemia; APL: acute promyelocytic leukemia; FAB: French American British classification system; MDS: myelodysplastic syndrome; CML: chronic myeloid leukemia.
References:
  1. WHO classification of tumours of haematopoietic and lymphoid tissues, 4th ed, Swerdlow SH, Campo E, Harris NL, et al (Eds), IARC: Lyon, 2008.
  2. Mehta AB, Bain BJ, Fitchett M, et al. Trisomy 13 and myeloid malignancy--characteristic blast cell morphology: a United Kingdom Cancer Cytogenetics Group survey. Br J Haematol 1998; 101:749.
  3. Grimwade D, Hills RK, Moorman AV, et al. Refinement of cytogenetic classification in acute myeloid leukemia: determination of prognostic significance of rare recurring chromosomal abnormalities among 5876 younger adult patients treated in the United Kingdom Medical Research Council trials. Blood 2010; 116:354.
  4. PĂ©rot C, Huret JL. t(8;16)(p11;p13). Atlas Genet Cytogenet Oncol Haematol 1999; 3:36.
  5. Schiffer C, Stone RM. Acute myeloid leukemia in adults: mast cell leukemia and other mast cell neoplasms. In Hong WK, Bast RC, Hait WN, et al (Eds), Holland-Frei Cancer Medicine, 8th Ed, Shelton: PMPH USA, 2010.
  6. Ferrara F, Schiffer CA. Acute myeloid leukaemia in adults. Lancet 2013; 381:484.
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