iAMP21 in acute myeloid leukemia is associated with complex karyotype, TP53 mutation and dismal outcome

Wei Xie, Jie Xu, Shimin Hu, Shaoying Li, Wei Wang, C. Cameron Yin, Gokce Toruner, Zhenya Tang, L. Jeffrey Medeiros, Guilin Tang

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Acute myeloid leukemia (AML) with intrachromosomal amplification of chromosome 21 (iAMP21) is rare and has not been well characterized. We report 13 patients, 7 men and 6 women, with a median age of 65 years. Eleven patients presented with AML with myelodysplasia-related changes, and two patients had therapy-related AML. Cytopenias were detected in all patients (11 pancytopenia and two bi-lineage cytopenia). Myelodysplastic changes were observed in all 11 patients with adequate cells to evaluate. Myelofibrosis was present in ten patients. All patients had a complex karyotype, including abnormalities of chromosomes 5, 7, 17, and hsr(21)(q22), and ten patients showed TP53 deletion and/or mutation. Eleven patients received AML-based chemotherapy, one of whom also received hematopoietic stem cell transplant. By the end of the last follow-up, eight patients died with median survival of 3.2 months, four patients were alive with persistent AML, and one was in complete remission. The median overall survival was 6 months for all patients. We conclude that AML with iAMP21 is often associated with cytopenias, myelodysplasia, a complex karyotype, TP53 mutation/deletion, and a poor prognosis despite current therapies.

Original languageEnglish (US)
Pages (from-to)1389-1397
Number of pages9
JournalModern Pathology
Volume33
Issue number7
DOIs
StatePublished - Jul 1 2020
Externally publishedYes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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