engleski

Emergence of karyotypically unrelated clone during complete remission of acute monocytic leukemia

AML is a heterogeneous group of disease. Besides morphological and cytogenetic heterogeneity, of interest are different types of remissions. One form of remission is characterized by repopulation of the marrow by normal cells, and the other by clonal cell proliferation. The data on clonal remission are limited, and some 40 cases have been reported so far. The frequency of clonal remission is variable and range from 1% to 12% of acute leukemia. Nature, mechanisms of origin and clinical significance of clonal cell proliferation at remission are not elucidated yet. We present the results of clinical and cytogenetic investigation in a girl with AML and unrelated clonal chromosome aberration during remission and literature review of published data on clonal remission in patient with acute leukemia. Our patient is 3½-old-girl referred to the hospital with hepatospenomegaly, hematomas and polymicroadenia. Cytomorphologic analysis revealed AML-M5A. Chromosome study at diagnosis showed abnormal clone with 48, XX, +21, +mar and at remission following induction therapy a normal karyotype was observed. Eleven months after diagnosis, while the patient was in first complete remission an unrelated abnormal clone with t(1 ; 18) was observed. This report highlights the importance of cytogenetic study in patients follow up and detection of unrelated clonal rearrangement during remission of acute leukemia.

Clonal aberrations; children; AML

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