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Clinicopathological analysis of near-tetraploidy/tetraploidy acute myeloid leukaemia
  1. Changlee S Pang1,
  2. Mark J Pettenati2,
  3. Timothy S Pardee3
  1. 1Department of Pathology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, North Carolina, USA
  2. 2Department of Genetics, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, North Carolina, USA
  3. 3Department of Hematology/Oncology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, North Carolina, USA
  1. Correspondence to Dr Changlee S Pang, Department of Pathology, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston Salem, NC 27157, USA; cpang{at}wakehealth.edu

Abstract

Aims Near-tetraploidy/tetraploidy (NT/T) is a rare cytogenetic alteration in acute myeloid leukaemia (AML). NT/T-AML is categorised as complex cytogenetics and therefore, presumed to have an unfavourable prognosis. Our aim is to further characterise the clinical, morphological, cytogenetic and prognostic features of NT/T-AML.

Methods We searched our cytogenetic laboratory database from 1991 to 2012 to reveal 13 cases of NT/T-AML. Each case was evaluated with regard to its demographics, morphology, immunophenotype and prognosis. Specific morphological features included blast size, irregularity of nuclear contours, cytoplasmic vacuoles, and presence and lineage of dysplasia.

Results Eleven men and two women had a median age of 68 years. Blasts were predominately large (11/13). Eight of 13 patients had AML with myelodysplasia-related changes. Sixty-nine per cent of patients achieved complete remission (CR). Median overall survival (OS) was 8.6 months. CR rate and median OS in cases with ≥5 cytogenetic abnormalities were 71% and 6 months, compared with 67% and 18.1 months in cases with <5 abnormalities.

Conclusions NT/T-AML occurs in older males, exhibits large blast size and is associated with myelodysplasia. Unlike previously reported data, our study reveals an overall better prognosis in this older population with NT/T-AML than was expected for a complex karyotype AML. Cytogenetic complexity independent of ploidy status did not greatly affect the high CR rates, but did appear to be a better estimation of prognostic risk in terms of median OS.

  • HEMATOPATHOLOGY
  • CYTOGENETICS
  • LEUKAEMIA

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