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Blood, 19 February 2009, Vol. 113, No. 8, pp. 1741-1748.
Prepublished online as a Blood First Edition Paper on December 23, 2008; DOI 10.1182/blood-2007-12-130260.


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MYELOID NEOPLASIA

Hidden abnormalities and novel classification of t(15;17) acute promyelocytic leukemia (APL) based on genomic alterations

Tadayuki Akagi1,*, Lee-Yung Shih2,3,*, Motohiro Kato4, Norihiko Kawamata1, Go Yamamoto4,5, Masashi Sanada4,5, Ryoko Okamoto1, Carl W. Miller1, Der-Cherng Liang6, Seishi Ogawa4,{dagger}, and H. Phillip Koeffler1,{dagger}

1 Division of Hematology and Oncology, Cedars-Sinai Medical Center, University of California at Los Angeles (UCLA) School of Medicine, Los Angeles, CA; 2 Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan; 3 School of Medicine, Chang Gung University, Taoyuan, Taiwan; 4 Department of Hematology and Oncology and 5 21st century COE program, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; and 6 Division of Pediatric Hematology-Oncology, Mackay Memorial Hospital, Taipei, Taiwan

Acute promyelocytic leukemia (APL) is a hematopoietic malignant disease characterized by the chromosomal translocation t(15;17), resulting in the formation of the PML-RARA gene. Here, 47 t(15;17) APL samples were analyzed with high-density single-nucleotide polymorphism microarray (50-K and 250-K SNP-chips) using the new algorithm AsCNAR (allele-specific copy-number analysis using anonymous references). Copy-number-neutral loss of heterozygosity (CNN-LOH) was identified at chromosomes 10q (3 cases), 11p (3 cases), and 19q (1 case). Twenty-eight samples (60%) did not have an obvious alteration (normal-copy-number [NC] group). Nineteen samples (40%) showed either one or more genomic abnormalities: 8 samples (17%) had trisomy 8 either with or without an additional duplication, deletion, or CNN-LOH (+8 group); and 11 samples (23%) had genomic abnormalities without trisomy 8 (other abnormalities group). These chromosomal abnormalities were acquired somatic mutations. Interestingly, FLT3-ITD mutations (11/47 cases) occurred only in the group with no genomic alteration (NC group). Taken together, these results suggest that the pathway of development of APL differs in each group: FLT3-ITD, trisomy 8, and other genomic changes. Here, we showed for the first time hidden abnormalities and novel disease-related genomic changes in t(15;17) APL.


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