Isochromosome 11q is Associated with Unique Characteristics and Poor Prognosis in Patients with Acute Myeloid Leukemia.

BACKGROUND: Isochromosome 11q in patients with acute myeloid leukemia is rarely reported, and little is known about its main features. METHODS: The presence of isochromosome 11q was identified in four patients (three adults and one child) from screening 441 patients with an acute myeloid leukemia diagnosis between 2009 and 2018 by using R-banding and fluorescence in situ hybridization. RESULTS: The child, patient 1 with unreported isochromosome (partial 11q isochromosome), accompanied with t(1;11) translocation, initially achieved remission after receiving chemotherapy. However, 4 months later this patient experienced a relapse. While multiple treatments were tried, it had no effect and the patient survived for 16 months. The remaining patients with isochromosome 11q exhibited numerical/structural chromosomal abnormal-ities involving myelodysplastic syndrome-related chromosomes 5, 7, 8, and 20. In patients 2 and 3, we found a derivative chromosome 21. Patient 3 was newly diagnosed with acute myeloid leukemia and was treated with many chemotherapy protocols, unfortunately with no effect. The patient then received traditional Chinese medicine and survived for 10 months, although she still has not achieved complete remission. Patients 2 and 4 received chemotherapy but experienced rapid disease progression and died within 2 months. CONCLUSIONS: In summary, patients with isochromosome 11q/partial 11q isochromosome have a poorer prognosis, especially for isochromosome 11q. Furthermore, these chromosome aberrations may be risk factors for the presence of isochromosome 11q or myelodysplastic syndrome-related genes, both of them may be associated with a failure to respond to treatment and poor outcomes. Hence, these discoveries may lay a foundation to study mechanisms and explore treatments.

A case of Pallister-Killian syndrome associated with West syndrome.

We report the case of a 19-month-old boy with Pallister-Killian syndrome associated with West syndrome. The child was born at term to a healthy mother after an uneventful pregnancy. He was born by cesarean section because of fetal macrosomia. He was observed to have nystagmus, craniofacial dysmorphism, and mental retardation. Intractable epileptic spasms developed 17 months after birth, and electroencephalography revealed a modified hypsarrhythmia. The seizures were uncontrollable with sodium valproate monotherapy. At the age of 19 months, the child was diagnosed with Pallister-Killian syndrome of mosaic tetrasomy 12p by fluorescence in situ hybridization. Combination treatment with high-dose pyridoxal phosphate and sodium valproate eliminated seizures and improved the electroencephalographic abnormalities. To our knowledge, this is the first reported case of Pallister-Killian syndrome associated with West syndrome.

Frecuencia de aberraciones cromosómicas en sujetos con gonosomopatías: experiencia en 19 años de trabajo / Frequency of chromosomal aberrations in subjects with gonosomopathies. Experience in 19 years of work

El objetivo de este trabajo fue determinar la frecuencia de aberraciones cromosómicas en un grupo de pacientes portadores de gonosomopatías y relacionar en cada caso el significado de las diferentes aberraciones cromosómicas encontradas con el diagnóstico clínico realizado. Se estudiaron desde el punto de vista citogenético 656 pacientes con diagnóstico presuntivo de gonosomopatías, recibidos en el laboratorio de genética molecular del Hospital Clinicoquirúrgico "Hermanos Ameijeiras" entre los años 1982 y 2001, procedentes de distintas instituciones hospitalarias del país. Del total de pacientes con diagnóstico presuntivo de gonosomopatías, en el 32,7(por ciento) (215/656) se confirmó el diagnóstico clínico con el estudio citogenético. El estudio cromosómico se realizó por técnicas de bandas G. Los reordenamientos cromosómicos encontrados se clasificaron en 4 grupos; el de mayor frecuencia fue el de las gonosomopatías numéricas, con 110 pacientes que representan el 51(por ciento) del total. En orden de frecuencia siguieron el grupo de las alteraciones numéricas y estructurales (mosaicos) con 59 pacientes (27,0), las inversiones de sexo con 24 (12,0) y el grupo de las gonosomopatías estructurales con 22 (10,0). Las aberraciones cromosómicas más comunes fueron las gonosomopatías numéricas (síndromes de Turner y Klinefelter). El estudio cromosómico en estos pacientes constituye un indicador de valor diagnóstico de gran importancia para la conducta terapéutica a seguir en cada caso(AU)