Preiss Birgitte S, Bergmann Olav J, Friis Lone S, Sørensen Anne G, Frederiksen Michael, Gadeberg Ole V, Mourits-Andersen Torben, Oestergaard Birthe, Kerndrup Gitte B
Department of Pathology, Odense University Hospital, Odense C, Denmark.
Cancer Genet Cytogenet. 2010 Oct 15;202(2):108-22. doi: 10.1016/j.cancergencyto.2010.06.013.
During a 15-year period, 161 adult patients were diagnosed with secondary acute myeloid leukemia (s-AML) in the region of Southern Denmark. In 73 patients, the AML diagnosis was preceded by myelodysplastic syndrome (MDS-AML), in 31 patients by an antecedent hematologic disease, and in 57 patients by treatment with chemotherapy and/or irradiation (t-AML). Cytogenetic analysis was carried out in 93%, of which 61% had clonal chromosome aberrations. MDS-AML correlated to a normal karyotype (P < 0.001). t-AML correlated to abnormal clones with numerical and structural aberrations (P = 0.03), five or more unrelated aberrations (P = 0.03), marker chromosomes (P = 0.006), abnormal mitoses only (P = 0.01), female sex (P < 0.001), and -7 (P = 0.006). Centromeric breakage correlated to a complex karyotype (P = 0.01). The frequencies of aberrations in s-AML patients were compared with an age-matched group of de novo AML patients diagnosed in the same area and period. In this comparison, s-AML only correlated to -7 (P = 0.02). In 42 patients, we found that MDS patients with an abnormal karyotype were more likely to show cytogenetic evolution during progression to AML than MDS patients with a normal karyotype (P = 0.01). We conclude that population-based cytogenetic studies of adult s-AML and age- and sex-matched de novo AML show comparable distributions of chromosome abnormalities.
在15年期间,丹麦南部地区有161例成年患者被诊断为继发性急性髓系白血病(s-AML)。其中73例患者在AML诊断之前患有骨髓增生异常综合征(MDS-AML),31例患者有前驱血液系统疾病,57例患者因化疗和/或放疗而发病(t-AML)。93%的患者进行了细胞遗传学分析,其中61%有克隆性染色体异常。MDS-AML与正常核型相关(P<0.001)。t-AML与具有数量和结构异常的异常克隆相关(P=0.03)、与五个或更多不相关的异常相关(P=0.03)、与标记染色体相关(P=0.006)、仅与异常有丝分裂相关(P=0.01)、与女性性别相关(P<0.001)以及与-7相关(P=0.006)。着丝粒断裂与复杂核型相关(P=0.01)。将s-AML患者的异常频率与在同一地区和时期诊断的年龄匹配的初发AML患者组进行比较。在该比较中,s-AML仅与-7相关(P=0.02)。在42例患者中,我们发现核型异常的MDS患者在进展为AML的过程中比核型正常的MDS患者更有可能出现细胞遗传学演变(P=0.01)。我们得出结论,基于人群的成年s-AML以及年龄和性别匹配的初发AML的细胞遗传学研究显示染色体异常的分布具有可比性。