Journal of Clinical Oncology, Vol 2, 550-557, Copyright © 1984 by American Society of Clinical Oncology
Abnormalities of chromosome 16 in association with acute myelomonocytic leukemia and dysplastic bone marrow eosinophils
DE Hogge, S Misawa, NZ Parsa, A Pollak and JR Testa
Six patients with M4 acute myelomonocytic leukemia ( AMMoL ) were
identified who had abnormalities of chromosome 16 in bone marrow cells.
Five had a pericentric inversion, inv(16)( p13q22 ), and a sixth patient
had a translocation, t(16;16)(p13.1;q22). Each of these six patients had
bone marrow eosinophils that were abnormal in morphology on light and/or
electron microscopy and by cytochemical stains. The eosinophils constituted
1%-24% of nucleated marrow cells. Of 61 acute nonlymphocytic leukemia
(ANLL) patients, all those with AMMoL and abnormal bone marrow eosinophils
had an inv(16) or a t(16;16). One other patient in this group had a
rearrangement of chromosome 16 (with a break in the short arm at band p13);
however, the ANLL type was M1 and no abnormal eosinophils were present.
Four patients with ANLL types other than M4 had an increase in marrow
eosinophils; three in whom the eosinophils appeared normal and one with
ANLL-M2 and bizarre eosinophils morphologically distinct from those seen in
AMMoL . Chromosome pair 16 was normal in the latter four patients. AMMoL
with dysplastic bone marrow eosinophils appears to represent a unique
clinicopathologic entity associated with several related abnormalities
affecting 16q . The morphologic features of both blasts and eosinophils may
be more important than the absolute number of eosinophils in the marrow in
identifying this group of patients. This may have prognostic importance as
five of six patients achieved complete remission with standard antileukemic
therapy and are still alive.
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