A case of acute myeloid leukemia initially treated as chronic lymphocytic leukemia: what do we know about t(4;12)(q12;p13)?

摘要

Acute myeloid leukemia (AML) is the most common acute leukemia in adults, with incidence approaching 13,000 cases in the United States in 2008. It is diagnosed based on the percentage of blasts in the peripheral blood or bone marrow smear, in addition to specific cytogenetic findings. The standard therapy in the United States is anthracy-cline with cytarabine in a 7+3 protocol. Among the rare chromosomal translocations reported in AML is t(4;12) (q12;p13), which has been documented in several reports (see, for example, references [1,2]) and has poor prognosis. This entity is characterized by atypical myeloblasts, which may be reported as lymphocytes and therefore can be described also as pseudo-lymphocytes. Here we describe a case of t(4;12)(q12;p13) AML that was resistant to conventional chemotherapy. Imatinib was also tried as a possible therapy targeted to the protein transcript CHIC2-ETV6, but was not effective.