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Trisomy 13: a new recurring chromosome abnormality in acute leukemia
H Dohner, DC Arthur, ED Ball, RE Sobol, FR Davey, D Lawrence, L Gordon, SR Patil, RB Surana and JR Testa
Cancer and Leukemia Group B, Boston, MA.
A new recurring chromosome abnormality was identified in 8 of 621
consecutive successfully karyotyped adults with de novo acute leukemia.
These eight patients had trisomy 13 as the sole cytogenetic abnormality. On
central morphologic review, five cases were classified as subtypes of acute
myeloid leukemia, one as acute mixed lymphoid and myeloid leukemia, one as
acute lymphoid leukemia, and one as acute undifferentiated leukemia. Blasts
of all eight cases expressed one or more myeloid differentiation antigens.
Three also expressed T-lineage- associated antigens; however, none of these
had rearrangement of the T- cell receptor beta, gamma, or delta genes. Four
of six cases tested were TdT positive. All eight patients with trisomy 13
were treated with intensive induction chemotherapy; only three entered a
short-lived complete remission. Survival of patients with trisomy 13 ranged
from 0.5 to 14.7 months, and was significantly shorter than that of the
remaining patients (median 9.5 v 16.2 months, P = .007). We conclude that
trisomy 13 is a rare, recurring clonal chromosome abnormality in acute
leukemia associated with a poor prognosis. Malignant transformation of an
immature hematopoietic precursor cell is suggested by the expression of
antigens characteristic of both the myeloid and lymphoid lineage, the high
incidence of TdT positivity, and the morphologic heterogeneity in these
leukemias.
Volume 76,
Issue 8,
pp. 1614-1621,
10/15/1990
Copyright © 1990 by The American Society of Hematology

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