Acute Myeloid Leukemia Presenting as Subcutaneous and Epidural Granulocytic Sarcoma Inside and Outside of the Frontal Bone

An 18 year-old male was admitted to our hospital suffering from a large tumor which was located at the right frontal bone. He was diagnosed to have acute myeloid leukemia (AML) with granulocytic sarcoma (GS). A chromosomal analysis showed t(8; 21), and a flow cytometric analysis demonstrated the leukemic cells to be positive for CD56. Systemic chemotherapy and radiation therapy to the GS, but the patient experienced a relapse in the lumbar vertebrae. He underwent an umbilical-cord blood stem cell transplantation, however, he died 7 months thereafter. GS is a localized tumor consisting of leukemic myelolasts, which is generally observed as a complication of either AML, myelodysplastic syndrome, or myelobproliferative disorders. We herein report this case due to its rarity, even though various sites of GS have been reported

Genetic differences between Asian and Caucasian chronic lymphocytic leukemia.

Chronic lymphocytic leukemia (CLL) is a common hematological malignancy in Western countries. However, this disease is very rare in Asian countries. It is not clear whether the mechanisms of development of CLL in Caucasians and Asians are the same. We compared genetic abnormalities in Asian and Caucasian CLL using 250k GeneChip arrays. Both Asian and Caucasian CLL had four common genetic abnormalities: deletion of 13q14.3, trisomy 12, abnormalities of ATM (11q) and abnormalities of 17p. Interestingly, trisomy 12 and deletion of 13q14.3 were mutually exclusive in both groups. We also found that deletions of miR 34b/34c (11q), caspase 1/4/5 (11q), Rb1 (13q) and DLC1 (8p) are common in both ethnic groups. Asian CLL more frequently had gain of 3q and 18q. These suggest that classic genomic changes in the Asian and Caucasina CLL are same. Further, we found amplification of IRF4 and deletion of the SP140/SP100 genes; these genes have been reported as CLL-associated genes by previous genome-wide-association study. We have found classic genomic abnormalities in Asian CLL as well as novel genomic alteration in CLL

Der(2)t(2;11)(p21;q23), a Variant form of t(2;11), in Biphenotypic Acute Leukemia with T Lymphoid Lineage and M yeloid Lineage Differentiation

We describe a patient with biphenotypic acute leukemia (BAL) with T-lymphoid lineage and myeloid lineage differentiation［BAL (T/M)］. Cytogenetic analysis revealed complex chromosomal abnormalities, including der(2)t(2;11)(p21;q23). Neither leukemia cells nor T-cell receptor gene rearrangements were detected in the bone marrow samples after four courses of high dose cytosine arabinoside regimen. However, der(2)t(2;11)(p21;q23) anomaly persisted in most of metaphases. Fluorescence in situ hybridization (FISH)analysis with a probe for MLL did not detect the split signal. Forty-five cases of hematological disorder with t(2;11)(p21;q23) abnormality have been previously reported. The majority of such cases have been classified as myelodysplastic syndrome(MDS) or acute myeloid leukemia (AML). This is the first case BAL (T/M) associated with a t(2;11)(p21;q23) anomaly