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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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Submitted December 20, 2007
Accepted November 16, 2008

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

Tadayuki Akagi*, Lee-Yung Shih, Motohiro Kato, Norihiko Kawamata, Go Yamamoto, Masashi Sanada, Ryoko Okamoto, Carl W Miller, Der-Cherng Liang, Seishi Ogawa, and H Phillip Koeffler

Division of Hematology and Oncology, Cedar-Sinai Medical Center, UCLA School of Medicine, Los Angeles, CA, United States
Division of Hematology-Oncology, Department of Internal Medicine, Chang Gung University, Taipei, Taiwan
Department of Hematology and Oncology, University of Tokyo, Tokyo, Japan
The 21st century COE program, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
Division of Pediatric Hematology-Oncology, Mackay Memorial Hospital, Taipei, Taiwan

* Corresponding author; email: tadayuki{at}staff.kanazawa-u.ac.jp.

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 (50K and 250K 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 chromosome 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) only occurred 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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