Myeloid Neoplasms with inv(3)(q21q26.2)/t(3;3)(q21;q26.2) Are Aggressive Neoplasms Irrespective of Blast Count
Douglas W Warden, Heesun J Rogers, James Cook, Eric D Hsi. Cleveland Clinic, Cleveland, OH
Background: Acute myeloid leukemia (AML) with inv(3)/t(3;3) is a unique subset of AML with recurrent cytogenetic abnormalities (RCA) that portends a dismal prognosis. Although myelodysplastic syndrome (MDS) with inv(3)/t(3;3) are also reported to have poor prognosis, the WHO classification does not yet advocate considering such cases as AML with RCA.
Design: We reviewed all myeloid neoplasms with inv(3)(q21q26) or t(3;3)(q21;q26) by conventional cytogenetics from our institution. Clinical data and bone marrow biopsies were reviewed for outcome-data and for morphologic analysis. Kaplan-Meier survival analysis with log rank testing was used to evaluate overall survival (OS).
Results: We identified 21 patients who met our criteria, including 8 patients with MDS and 13 patients with AML (see table).
|Clinicopathologic Characteristics||MDS with inv(3)||AML with inv(3)|
|Age (median, range)||70.3 (45-85)||57.1 (17-77)|
|Survival (median, months)||7.1||4.9|
|Blast% (mean, range)||3 (range 0-9)||38.3 (9-92)|
|Progress to AML (n=)||2||N/A|