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Study of cytogenetic abnormalities in 190 cases of acute promyelocytic leukemia with its morphological and cytochemical correlation at a tertiary-care cancer institute

Binal D Vaghani, Hardik R Shah, Heming Agrawal, Shilpa Singal, Dhaval Bamania, Hansa Goswami.




Abstract

Background: Acute myelogenous leukemia (AML) is a malignant disorder of the bone marrow, where a maturational arrest in blood cell progenitors results in the failure of normal hematopoiesis. Acute promyelocytic leukemia (APL) is a subtype of AML with a defined clinical course and a biology that is distinct from the other forms of AML.

Objective: To detect cytogenetic abnormalities in patients diagnosed with APL and to detect APL-like cases.

Materials and Methods: A total of 190 cases were reviewed. Bone marrow smears were studied and morphological diagnosis was made. Genotype was analyzed using G-banding.

Result: In ark of the 190 cases, it was agreed that the morphologic diagnosis was FAB M3 (either hypergranular form or variant form). Of these, 142 cases had confirmed APL, and they responded to all-trans retinoic acid (ATRA). Of these cases, 101 (53.1%) had t(15;17). Of the remaining 103 cases, six was positive fusion product PML/RARĪ±, and five cases revealed a t(11;17). The remaining 48 (25.2%) cases showed chromosomal abnormalities as del 16q, trisomy 8, t(8;21), del 8q, add 15q, +10, and ins [1q]. However, these cases presented with morphological and immunophenotype characteristics of APL; so, they were called as APL-like leukemia.

Conclusion: Our study shows that many other chromosomal abnormalities other than t(15;17) can show similar morphologic, cytochemical, and immunophenotypic characteristics of APL.

Key words: Cytogenetics, morphology, promyelocytic leukemia






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