TY - JOUR
T1 - Isolated del(5q) in patients following therapies for various malignancies may not all be clinically significant
AU - Tang, Guilin
AU - Goswami, Rashmi Shivani
AU - Liang, Cynthia S.
AU - Bueso-Ramos, Carlos E.
AU - Hu, Shimin
AU - DiNardo, Courtney
AU - Medeiros, L. Jeffrey
N1 - Publisher Copyright:
© American Society for Clinical Pathology.
PY - 2015/7
Y1 - 2015/7
N2 - Objectives: Deletion 5q is a common chromosomal abnormality in both de novo and therapy-related myeloid neoplasms (t-MNs). The detection of isolated del(5q) in patients following therapies for various malignancies raises serious concern for an emerging t-MN. Methods: We identified 25 patients who developed isolated del(5q) following cytotoxic therapy (n = 21) or tyrosine kinase inhibitor (TKI; n = 4) therapy. Twenty-four patients had an interstitial and one had a terminal 5q deletion. The 5q31/EGR1 gene was deleted in 20 patients and intact in five patients. The clone size as assessed by metaphase analysis was minor (10%-30%) in 12 patients and large (45%-100%) in 13 patients. After a median follow-up of 17 months, none of the 12 patients with a minor del(5q) clone developed t-MN; del(5q) disappeared in four patients and persisted in eight patients. By contrast, 12 of 13 patients with a large del(5q) clone developed t-MN, and del(5q) was persistent in all patients who had follow-up cytogenetic testing. Conclusions: Development of del(5q) in patients following cytotoxic therapies or TKI may not always be associated with t-MN. A close follow-up seems an appropriate approach for patients who had a minor del(5q) clone.
AB - Objectives: Deletion 5q is a common chromosomal abnormality in both de novo and therapy-related myeloid neoplasms (t-MNs). The detection of isolated del(5q) in patients following therapies for various malignancies raises serious concern for an emerging t-MN. Methods: We identified 25 patients who developed isolated del(5q) following cytotoxic therapy (n = 21) or tyrosine kinase inhibitor (TKI; n = 4) therapy. Twenty-four patients had an interstitial and one had a terminal 5q deletion. The 5q31/EGR1 gene was deleted in 20 patients and intact in five patients. The clone size as assessed by metaphase analysis was minor (10%-30%) in 12 patients and large (45%-100%) in 13 patients. After a median follow-up of 17 months, none of the 12 patients with a minor del(5q) clone developed t-MN; del(5q) disappeared in four patients and persisted in eight patients. By contrast, 12 of 13 patients with a large del(5q) clone developed t-MN, and del(5q) was persistent in all patients who had follow-up cytogenetic testing. Conclusions: Development of del(5q) in patients following cytotoxic therapies or TKI may not always be associated with t-MN. A close follow-up seems an appropriate approach for patients who had a minor del(5q) clone.
KW - Deletion 5q
KW - Post-cytotoxic therapy
KW - Therapy-related myeloid neoplasm
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U2 - 10.1309/AJCPBADO22WXOFHJ
DO - 10.1309/AJCPBADO22WXOFHJ
M3 - Article
C2 - 26071464
AN - SCOPUS:84939456406
SN - 0002-9173
VL - 144
SP - 78
EP - 86
JO - American journal of clinical pathology
JF - American journal of clinical pathology
IS - 1
ER -