Prostat kanserinden uzun süre sonra gelişen kompleks karyotipik anormali ile seyreden akut myeloblastik lösemi olgusu
Öz
Özet
Löseminin bir türü olan akut myeloblastik lösemi (AML) myeloid seriye ait olgunlaşmamış hücrelerin kemik iliğinde, kanda, bazen diğer dokularda aşırı birikimi ile karakterize hematolojik kanserdir. Lösemik hücre farklanmasında kemik iliği ve periferik kan hücrelerinde klonal kromozomal anomaliler ortaya çıkmaktadır. Bu anomaliler olgu tanısı ve prognozunu göstermesi açısından önemlidir. Yazımızda prostat kanseri nedeni ile 12 yıl önce cerrahi ve hormon tedavisi alan ilk tanı evresinde kompleks karyotip anomaliler tesbit edilen bir AML olgusu sunulmaktadır. Tanımlanan kompleks karyotipik anomalilerin prognoz üzerindeki etkisi tartışılmaktadır. Periferik kan ve kemik iliği incelemesinde AML tanısı konan 70 yaşındaki erkek olgunun kemik iliğinden yapılan sitogenetik incelemede 49, XY, -1, -2, +4, +6, +8, +8, -12, -13, der (1), +2 mar [3], 50, XY, -2, +4, +6, +8, +8, -13, +2mar [2], 50, XY, -2, +4, +6, +8, +11?, -13, +2 mar [1] saptandı. Kompleks karyotipler genelde olgularda kötü prognoz belirtecidir. AML tanısı konulan olgu her türlü destek tedavisine rağmen tanıdan iki gün sonra kaybedildi. Sonuç olarak, özellikle yaşlı AML’li hastalarda gerek tanı, gerekse prognozun belirlenebilmesi için genetik incelemelerin mutlaka yapılması gerekliliği göz önünde bulundurulmalıdır.
Anahtar sözcükler: Akut myeloid lösemi, karyotipleme, kromozom anormallikleri, sitogenetik
Abstract
Acute myeloid leukemia (AML) is a type of leukemia which is characterized by the excessive accumulation of immature myeloid bone marrow precursor cells in the marrow itself, in peripheral blood and sometimes also in other tissues. During differentiation of leukemia cells, clonal chromosomal abnormalities emerge in bone marrow and in peripheral blood cells. These anomalies are important for the disease diagnosis and prognosis. Here, an AML case who underwent surgery for prostate cancer 12 years ago and received hormonal therapy is presented. Complex karyotypic abnormalities were present in the initial diagnosis phase The correlation between complex karyotypes and the prognosis in this case was discussed. Our 70 year-old patient was diagnosed as AML after peripheral blood and bone marrow analyses. His bone marrow cytogenetic analyses revealed 49, XY, -1, -2, +4, +6, +8, +8, -12, -13, der (1), +2 mar [3], 50, XY, -2, +4, +6, +8, +8, -13, +2mar [2], 50, XY, -2, +4, +6, +8, +11?, -13, +2 mar [1]. Complex karyotypes generally represents poor prognosis in AML cases. The patient died in two days after the initial diagnosis, although AML treatment was applied. As a result genetic examination should always be performed in elderly AML patients for both diagnosis and prediction of prognosis.
Keywords: Acute myeloid leukemia, karyotyping, chromosome aberrations, cytogenetics
Anahtar Kelimeler
Kaynakça
- Sekeres MA, Peterson B, Dodge RK, Mayer RJ, Moore JO, Lee EJ, Kolitz J, Baer MR, Schiffer CA, Carroll AJ, Vardiman JW, Davey FR, Bloomfield CD, Larson RA, Stone RM; Cancer and Leukemia Group B. Differences in prognostic factors and outcomes in African Americans and whites with acute myeloid leukemia. Blood 2004; 103: 4036-42.
- Olesen LH, Aggerholm A, Andersen BL, Nyvold CG, Guldberg P, Nİrgaard JM, Hokland P. Molecular typing of adult acute myeloid leukaemia: significance of translocations, tandem duplications, methylation, and selective gene expression profiling. Br J Haematol 2005; 131: 457-67.
- Estey EH. Therapeutic options for acute myelogenous leukemia. Cancer 2001; 92: 1059-73.
- Wheatley K, Burnett AK, Goldstone AH, Gray RG, Hann IM, Harrison CJ, Rees JK, Stevens RF, Walker H. A simple, robust, validated and highly predictive index for the determination of risk-directed therapy in acute myeloid leukaemia derived from the MRC AML 10 trial. United Kingdom Medical Research Council's Adult and Childhood Leukaemia Working Parties. Br J Haematol 1999; 107: 69-79.
- Slovak ML, Kopecky KJ, Cassileth PA, Harrington DH, Theil KS, Mohamed A, Paietta E, Willman CL, Head DR, Rowe JM, Forman SJ, Appelbaum FR. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000; 96: 4075-83.
- Byrd JC, Mrózek K, Dodge RK, Carroll AJ, Edwards CG, Arthur DC, Pettenati MJ, Patil SR, Rao KW, Watson MS, Koduru PR, Moore JO, Stone RM, Mayer RJ, Feldman EJ, Davey FR, Schiffer CA, Larson RA, Bloomfield CD; Cancer and Leukemia Group B (CALGB 8461). Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood 2002; 100: 4325-36.
- Schlenk RF, Benner A, Krauter J, Büchner T, Sauerland C, Ehninger G, Schaich M, Mohr B, Niederwieser D, Krahl R, Pasold R, Döhner K, Ganser A, Döhner H, Heil G. Individual patient data-based meta-analysis of patients aged 16 to 60 years with core binding factor acute myeloid leukemia: a survey of the German Acute Myeloid Leukemia Intergroup. J Clin Oncol 2004; 22: 3741-50.
- Appelbaum FR, Kopecky KJ, Tallman MS, Slovak ML, Gundacker HM, Kim HT, Dewald GW, Kantarjian HM, Pierce SR, Estey EH. The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations. Br J Haematol 2006; 135: 165-73.
- Mrózek K. Cytogenetic, molecular genetic, and clinical characteristics of acute myeloid leukemia with a complex karyotype. Semin Oncol 2008; 35: 365-77.
- Appelbaum FR, Gundacker H, Head DR, Slovak ML, Willman CL, Godwin JE, Anderson JE, Petersdorf SH. Age and acute myeloid leukemia. Blood 2006; 107:
- Leith CP, Kopecky KJ, Godwin J, McConnell T, Slovak ML, Chen IM, Head DR, Appelbaum FR, Willman CL. Acute myeloid leukemia in the elderly: assessment of multidrug resistance (MDR1) and cytogenetics distinguishes biologic subgroups with remarkably distinct responses to standard chemotherapy. A Southwest Oncology Group study. Blood 1997; 89: 3323-9.
- Bacher U, Kern W, Schnittger S, Hiddemann W, Haferlach T, Schoch C. Population-based age-specific incidences of cytogenetic subgroups of acute myeloid leukemia. Haematologica 2005; 90: 1502-10.
- Miyamoto H, Messing EM, Chang C. Androgen deprivation therapy for prostate cancer: current status and future prospects. Prostate 2004; 61: 332-53.
- D'Amico AV, Halabi S, Vollmer R, Loffredo M, McMahon E, Sanford B, Archer L, Vogelzang NJ, Small EJ, Kantoff PW; Cancer and Leukemia Group B. p53 protein expression status and recurrence in men treated with radiation and androgen suppression therapy for higher-risk prostate cancer: a prospective phase II Cancer and Leukemia Group B Study (CALGB 9682). Urology 2008; 71: 933- 7.
- Ojha RP, Fischbach LA, Zhou Y, Felini MJ, Singh KP, Thertulien R. Acute myeloid leukemia incidence following radiation therapy for localized or locally advanced prostate adenocarcinoma. Cancer Epidemiol 2010; 34: 274-8.
Prostat kanserinden uzun süre sonra gelişen kompleks karyotipik anormali ile seyreden akut myeloblastik lösemi olgusu
Öz
Löseminin bir türü olan akut myeloblastik lösemi (AML) myeloid seriye ait olgunlaşmamış hücrelerin kemik iliğinde, kanda, bazen diğer dokularda aşırı birikimi ile karakterize hematolojik kanserdir. Lösemik hücre farklanmasında kemik iliği ve periferik kan hücrelerinde klonal kromozomal anomaliler ortaya çıkmaktadır. Bu anomaliler olgu tanısı ve prognozunu göstermesi açısından önemlidir. Yazımızda prostat kanseri nedeni ile 12 yıl önce cerrahi ve hormon tedavisi alan ilk tanı evresinde kompleks karyotip anomaliler tesbit edilen bir AML olgusu sunulmaktadır. Tanımlanan kompleks karyotipik anomalilerin prognoz üzerindeki etkisi tartışılmaktadır. Periferik kan ve kemik iliği incelemesinde AML tanısı konan 70 yaşındaki erkek olgunun kemik iliğinden yapılan sitogenetik incelemede 49, XY, -1, -2, +4, +6, +8, +8, -12, -13, der (1), +2 mar [3], 50, XY, -2, +4, +6, +8, +8, -13, +2mar [2], 50, XY, -2, +4, +6, +8, +11?, -13, +2 mar [1] saptandı. Kompleks karyotipler genelde olgularda kötü prognoz belirtecidir. AML tanısı konulan olgu her türlü destek tedavisine rağmen tanıdan iki gün sonra kaybedildi. Sonuç olarak, özellikle yaşlı AML’li hastalarda gerek tanı, gerekse prognozun belirlenebilmesi için genetik incelemelerin mutlaka yapılması gerekliliği göz önünde bulundurulmalıdır
Anahtar Kelimeler
Akut myeloid lösemi karyotipleme kromozom anormallikleri sitogenetik
Kaynakça
- Sekeres MA, Peterson B, Dodge RK, Mayer RJ, Moore JO, Lee EJ, Kolitz J, Baer MR, Schiffer CA, Carroll AJ, Vardiman JW, Davey FR, Bloomfield CD, Larson RA, Stone RM; Cancer and Leukemia Group B. Differences in prognostic factors and outcomes in African Americans and whites with acute myeloid leukemia. Blood 2004; 103: 4036-42.
- Olesen LH, Aggerholm A, Andersen BL, Nyvold CG, Guldberg P, Nİrgaard JM, Hokland P. Molecular typing of adult acute myeloid leukaemia: significance of translocations, tandem duplications, methylation, and selective gene expression profiling. Br J Haematol 2005; 131: 457-67.
- Estey EH. Therapeutic options for acute myelogenous leukemia. Cancer 2001; 92: 1059-73.
- Wheatley K, Burnett AK, Goldstone AH, Gray RG, Hann IM, Harrison CJ, Rees JK, Stevens RF, Walker H. A simple, robust, validated and highly predictive index for the determination of risk-directed therapy in acute myeloid leukaemia derived from the MRC AML 10 trial. United Kingdom Medical Research Council's Adult and Childhood Leukaemia Working Parties. Br J Haematol 1999; 107: 69-79.
- Slovak ML, Kopecky KJ, Cassileth PA, Harrington DH, Theil KS, Mohamed A, Paietta E, Willman CL, Head DR, Rowe JM, Forman SJ, Appelbaum FR. Karyotypic analysis predicts outcome of preremission and postremission therapy in adult acute myeloid leukemia: a Southwest Oncology Group/Eastern Cooperative Oncology Group Study. Blood 2000; 96: 4075-83.
- Byrd JC, Mrózek K, Dodge RK, Carroll AJ, Edwards CG, Arthur DC, Pettenati MJ, Patil SR, Rao KW, Watson MS, Koduru PR, Moore JO, Stone RM, Mayer RJ, Feldman EJ, Davey FR, Schiffer CA, Larson RA, Bloomfield CD; Cancer and Leukemia Group B (CALGB 8461). Pretreatment cytogenetic abnormalities are predictive of induction success, cumulative incidence of relapse, and overall survival in adult patients with de novo acute myeloid leukemia: results from Cancer and Leukemia Group B (CALGB 8461). Blood 2002; 100: 4325-36.
- Schlenk RF, Benner A, Krauter J, Büchner T, Sauerland C, Ehninger G, Schaich M, Mohr B, Niederwieser D, Krahl R, Pasold R, Döhner K, Ganser A, Döhner H, Heil G. Individual patient data-based meta-analysis of patients aged 16 to 60 years with core binding factor acute myeloid leukemia: a survey of the German Acute Myeloid Leukemia Intergroup. J Clin Oncol 2004; 22: 3741-50.
- Appelbaum FR, Kopecky KJ, Tallman MS, Slovak ML, Gundacker HM, Kim HT, Dewald GW, Kantarjian HM, Pierce SR, Estey EH. The clinical spectrum of adult acute myeloid leukaemia associated with core binding factor translocations. Br J Haematol 2006; 135: 165-73.
- Mrózek K. Cytogenetic, molecular genetic, and clinical characteristics of acute myeloid leukemia with a complex karyotype. Semin Oncol 2008; 35: 365-77.
- Appelbaum FR, Gundacker H, Head DR, Slovak ML, Willman CL, Godwin JE, Anderson JE, Petersdorf SH. Age and acute myeloid leukemia. Blood 2006; 107:
- Leith CP, Kopecky KJ, Godwin J, McConnell T, Slovak ML, Chen IM, Head DR, Appelbaum FR, Willman CL. Acute myeloid leukemia in the elderly: assessment of multidrug resistance (MDR1) and cytogenetics distinguishes biologic subgroups with remarkably distinct responses to standard chemotherapy. A Southwest Oncology Group study. Blood 1997; 89: 3323-9.
- Bacher U, Kern W, Schnittger S, Hiddemann W, Haferlach T, Schoch C. Population-based age-specific incidences of cytogenetic subgroups of acute myeloid leukemia. Haematologica 2005; 90: 1502-10.
- Miyamoto H, Messing EM, Chang C. Androgen deprivation therapy for prostate cancer: current status and future prospects. Prostate 2004; 61: 332-53.
- D'Amico AV, Halabi S, Vollmer R, Loffredo M, McMahon E, Sanford B, Archer L, Vogelzang NJ, Small EJ, Kantoff PW; Cancer and Leukemia Group B. p53 protein expression status and recurrence in men treated with radiation and androgen suppression therapy for higher-risk prostate cancer: a prospective phase II Cancer and Leukemia Group B Study (CALGB 9682). Urology 2008; 71: 933- 7.
- Ojha RP, Fischbach LA, Zhou Y, Felini MJ, Singh KP, Thertulien R. Acute myeloid leukemia incidence following radiation therapy for localized or locally advanced prostate adenocarcinoma. Cancer Epidemiol 2010; 34: 274-8.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Olgu Sunumları |
| Yazarlar | |
| Yayımlanma Tarihi | 27 Mart 2012 |
| Yayımlandığı Sayı | Yıl 2012Cilt: 34 Sayı: 1 |