32 research outputs found
A collaborative study of the relationship of the morphological type of acute non-lymphocytic leukemia with patients'age and karyotype.
consecutive patients with nonlymphocytic leukemia from
six independent laboratories in the United States. Europe.
and Australia were combined. The karyotypic pattern
determined with banding was correlated with the patient’s
age and the morphological type of leukemia according to
the FAB classification. Of the 503 patients in the combined
study. 260 had acute myeloblastic leukemia (AML. Ml and
M2). 142 had acute myelomonocytic leukemia (AMMoL,
M4). 43 had acute monocytic leukemia (AMoL. M5). 30 had
erythroleukemia (EL. M6). and 28 had acute promyelocytic
leukemia (API. M3). The percentage of patients with an
abnormal karyotype was higher in EL (63%) and AMI (59%)
than in AMMoL (40%) and AMoL (42%). In AML, the
chromosome pattern showed a clear correlation with age.
The consistent translocation involving nos. 8 and 21 . which
is specifically associated with AML M2. occurred with the
greatest frequency in younger patients. particularly those
under the age of 45 yr. Other abnormalities. notably loss of
no. 5 or part of its long arm. were not seen in children and
showed a progressive increase in frequency with increasing
age. Still other abnormalities. such as - 7 or + 8. were
present in all age groups. but were more common in older
than in younger groups. In AMMoL. on the other hand. loss
of no. 5 was rare. loss of no. 7 was less frequent in older
than in younger patients. and gain of no. 8 showed some
increase with age. Young patients with AMoL had either a+ 8 or a translocation involving the long arm of no. 11
(1 1 q23); older patients also had +8 or various other
changes. with loss of no. 7 rare and loss of no. 5 not
observed in any patient. In EL. the percentage of aneuploid
patients was highest particularly in older patients. of whom
75% had an abnormal karyotype. Although loss of no. 5 or
no. 7 was not seen in any patient under age 50. loss of one
or both was seen in 47% of all EL patients over age 50. On
the other hand. a + 8 was almost twice as common in
younger than in older patients. In APL. 39% had the
t(1 5;1 7) that is specifically associated with this type of
leukemia; other abnormalities were seen in a few older
patients. In summary. loss of no. 5 and/or no. 7 occurred in
30% of all EL patients. in 1 9% of all AMI patients. and in
only 7% of AMMoL. in 5% of AMoL. and in 4% of APL
patients. These observations are significant because
patients with ANIL secondary to aggressive therapy for a
primary malignant disease tend to have AML or EL. and the
majority have - 5 and/or - 7. These same morphological
types of leukemia and the same abnormalities. - 5 and I or
- 7. are also increased in patients with ANLL de novo who
have a history of occupational exposure to potentially
mutagenic substances. In the future. the type of leukemia
and the particular karyotypic pattern may be useful in
identifying a subset of patients with ANLL de novo whose
leukemia may be mutagen-induced